Programme budget 2012-2013 : budget performance (interim Report)

WORLD HEALTH ORGANIZATION

ORGANISATION MONDIALE DE LA SANTÉ

REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU RÉGIONAL DU PACIFIQUE OCCIDENTAL

REGIONAL COMMITTEE Sixty-fourth session Manila, Philippines 21–25 October 2013 Provisional agenda item 9

WPR/RC64/3 4 September 2013 ORIGINAL: ENGLISH

PROGRAMME BUDGET 2012–2013: BUDGET PERFORMANCE (INTERIM REPORT)

This document presents the interim report on implementation of the Programme Budget for the 2012–2013 biennium by source of funding, strategic objective, budget centre and category of expenditure as of 30 June 2013. Implementation of assessed contributions amounted to US$ 54.4 million or 71.3% of the current working allocation (US$ 76.3 million) for the period 1 January 2012 to 30 June 2013 (see Table 3a). In addition, the activities implemented with voluntary

contributions amounted to US$ 137.2 million (see Tables 3a and 3b), representing 66.7% of the available awards. Total implementation was US$ 191.6 million or 67.9% of the total available resources. Implementation of funds by strategic objective and by budget centre is shown in Tables 4a and 4b, respectively. The implementation by category of expenditure is reflected in Table 5. Information on outputs and results by strategic objective and regional expected results is provided in Annex 1. The information is based on a midterm assessment and covers the period 1 January 2012 to 31 December 2012. The Regional Committee may wish to review the implementation and take note of the report.

WPR/RC64/3 page 2

IMPLEMENTATION OF PROGRAMME BUDGET 2012–2013

This document presents the interim report on implementation of the Programme Budget for the 2012–2013 biennium by source of funding, strategic objective, budget centre and category of expenditure. Level of programme budget The Global Programme Budget 2012–2013 was approved at the Sixty-fourth World Health Assembly in May 2011. The Proposed Programme Budget 2012–2013 was presented to the WHO Regional Committee for the Western Pacific at its sixty-second session in October 2011. The assessed contributions approved by the Health Assembly for the Region amounted to US$ 78.7 million, which represented no change from the US$ 78.7 million approved for 2010–2011. Table 1. Financing sources summary: 2012–2013 (US$ millions) Programme Budget 2012–2013 as at 30 June 2013 Source of financing Approved budget Current working allocation 76.3 219.6 295.9 % Programme Budget 2010–2011 as at 30 June 2011 Approved Working % budget allocation

Assessed contributions Voluntary contributions Total

78.7 167.0 245.7

97.0 131.5 120.4

78.7 227.8 306.5

77.9 236.2 314.1

99.0 103.7 102.5

As a result of uncertainties regarding contributions from Member States, the Director-General decided to establish the initial working allocation at 97%, thereby reducing the Western Pacific Region's assessed contributions to US$ 76.3 million. As in previous years, there is a high dependence on voluntary contributions. The voluntary contributions approved by the Health Assembly for the Region amounted to US$ 167 million in 2012–2013, which represented a 26.7% decrease from the US$ 227.8 million approved for 2010–2011. However, even with this large decrease, the total of voluntary contributions mobilized as of 30 June 2013 was US$ 205.7 million (see Table 2), a decrease of only 1.3% compared to US$ 208.4 million mobilized during the same period in the past biennium (see Table 3a).

WPR/RC64/3 page 3 Table 2 reveals the gaps in financing for the biennium 2012–2013 as of 30 June 2013. Table 2: Gaps in financing for 2012–2013 by strategic objective — all funds (US$ millions) Strategic objective Current working allocation 1 2 3 4 5 6 7 8 9 Communicable diseases HIV/AIDS, tuberculosis and malaria Chronic noncommunicable conditions Child, adolescent, maternal, sexual and reproductive health and ageing Emergencies and disasters Risk factors for health Social and economic determinants of health Healthier environment Nutrition and food safety 76.8 39.9 19.2 14.1 8.5 14.7 1.4 9.7 6.9 44.6 11.9 23.1 25.1 295.9 2012–2013 total as at 30 June 2013 Income AC 5.9 4.3 5.1 4.4 1.1 3.6 0.2 2.4 1.9 16.4 2.6 14.8 13.6 76.3 VC 62.2 37.4 15.2 12.2 3.4 10.7 0.9 6.9 4.5 29.7 7.2 6.5 8.9 205.7 Total 68.1 41.7 20.3 16.6 4.5 14.3 1.1 9.3 6.4 46.1 9.8 21.3 22.5 282.0 (8.7 ) 1.8 1.1 2.5 (4.0 ) (0.4 ) (0.3 ) (0.4 ) (0.5 ) 1.5 (2.1 ) (1.8 ) (2.6 ) (13.9 ) (12.8 ) 4.3 5.4 15.1 (88.9 ) (2.8 ) (27.3 ) (4.3 ) (7.8 ) 3.3 (21.4 ) (8.5 ) (11.6 ) (4.9 ) 8.1 (2.1 ) (2.6 ) (8.5 ) (4.6 ) (7.0 ) (0.1 ) (2.2 ) (3.7 ) (1.8 ) (1.2 ) (1.1 ) (1.0 ) (27.8 ) Gap % to Income 2010–2011 Gap as at 30 June 2011

10 Health systems and services 11 Medical products and technologies 12 WHO leadership, governance and partnerships 13 Enabling and support functions Total AC=assessed contributions; VC=voluntary contributions.

Implementation The implementation of assessed contributions amounted to US$ 54.4 million or 71.3% of the current working allocation for the period 1 January 2012 to 30 June 2013. In addition, the activities implemented utilizing voluntary contributions during the same period amounted to US$ 137.2 million or 66.7% of the available resources (US$ 205.7 million).

WPR/RC64/3 page 4 The implementation by source and by level of funding is shown in Tables 3a and 3b. These figures have been compared with those of the previous biennium.

Table 3a. Implementation of all funds (US$ millions) Implementation 2012–2013 as at 30 June 2013 Fund Assessed contributions Voluntary contributions Total Income 76.3 205.7 282.0 Expenditure 50.1 124.8 174.9 Encumbrances 4.3 12.4 16.7 Total 54.4 137.2 191.6 % 71.3 66.7 67.9 Implementation 2010–2011 as at 30 June 2011 Income 77.9 208.4 286.3 Implementation 55.6 132.6 188.2 % 71.4 63.6 65.7

Table 3b. Implementation by country office and Regional Office (US$ millions) Implementation 2012–2013 as at 30 June 2013 Level Country Regional Total Assessed contributions 33.1 21.3 54.4 Voluntary contributions 86.2 51.0 137.2 Total 119.3 72.3 191.6 % 62.3 37.7 100.0 Implementation 2010–2011 as at 30 June 2011 Assessed contributions 34.0 21.6 55.6 Voluntary contributions 86.4 46.2 132.6 Total 120.4 67.8 188.2 % 64.0 36.0 100.0

WPR/RC64/3 page 5 Table 4a and Table 4b show the implementation of all funds (expenditures plus encumbrances) by strategic objective and by budget centre, respectively.

Table 4a: Implementation by strategic objective as at 30 June 2013 (US$ millions) Strategic objective Expenditure Encumbrances Total Impl Current working allocation Income % Impl to Current Working Allocation % Impl to Income 2010-11 Impl as at 30 Jun 11 % Impl to Income

AC 1 Communicable diseases 2 HIV/AIDS, tuberculosis and malaria 3 Chronic noncommunicable conditions 4 Child, adolescent, maternal, sexual and reproductive health and ageing 5 Emergencies and disasters 6 Risk factors for health 7 Social and economic determinants of health 8 Healthier environment 9 Nutrition and food safety 10 Health systems and services 11 Medical products and technologies 12 WHO leadership, governance and partnerships 13 Enabling and support functions Total 3.7

VC 37.7

AC 0.4

VC 3.1

AC 4.1

VC 40.8 44.9 76.8 68.1 58.5 65.9 43.9 64.5

3.0 3.1

22.6 9.1

0.2 0.3

2.2 1.0

3.2 3.4

24.8 10.1

28.0 13.5

39.9 19.2

41.7 20.3

70.2 70.3

67.1 66.5

31.7 9.8

65.4 57.6

2.4

6.4

0.2

0.9

2.6

7.3

9.9

14.1

16.6

70.2

59.6

9.5

66.9

0.6 2.1 0.1 1.4 1.2 9.3 1.9 11.0

2.8 7.8 0.7 3.8 3.0 17.0 3.8 4.0

0.1 0.4 0.0 0.1 0.1 1.6 0.1 0.2

0.2 0.7 0.1 0.6 0.6 1.9 0.3 0.2

0.7 2.5 0.1 1.5 1.3 10.9 2.0 11.2

3.0 8.5 0.8 4.4 3.6 18.9 4.1 4.2

3.7 11.0 0.9 5.9 4.9 29.8 6.1 15.4

8.5 14.7 1.4 9.7 6.9 44.6 11.9 23.1

4.5 14.3 1.1 9.3 6.4 46.1 9.8 21.3

43.5 74.8 64.3 60.8 71.0 66.8 51.3 66.7

82.2 76.9 81.8 63.4 76.6 64.6 62.2 72.3

6.3 9.0 1.2 7.3 4.5 24.2 7.8 13.4

79.7 69.8 63.2 64.6 53.6 67.2 58.6 68.7

10.3 50.1

6.1 124.8

0.6 4.3

0.6 12.4

10.9 54.4

6.7 137.2

17.6 191.6

25.1 295.9

22.5 282.0

70.1 64.7

78.2 67.9

19.6 188.2

71.8 65.7

AC=assessed contributions; VC=voluntary contributions; Impl=implementation

WPR/RC64/3 page 6

Table 4b: Implementation by budget centre as at 30 June 2013 (US$ millions) Income Budget Centre AC American Samoa Cambodia China Cook Islands Fiji Kiribati Lao People's Democratic Republic Malaysia Marshall Islands Micronesia, Federated States of Mongolia Nauru Niue Palau Papua New Guinea Philippines Republic of Korea Samoa Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam Pacific island countries and areas Office of the Regional Director Division, Administration and Finance Division, Combating Communicable Diseases Division, Building Healthy Communities & Populations Division, Health Sector Development Division, Programme Management Division, Health Security and Emergencies Total 0.1 3.3 8.0 0.4 2.6 1.1 2.7 1.6 0.3 0.8 2.5 0.1 0.1 0.1 3.5 2.2 0.1 2.3 2.0 0.1 1.3 0.1 1.7 5.7 2.6 3.6 5.1 3.1 6.3 6.8 4.4 1.7 76.3 1.6 18.1 16.4 3.3 3.3 29.7 14.6 13.0 3.0 13.5 205.7 0.3 19.6 11.6 0.2 0.5 3.9 0.1 3.7 1.9 0.3 14.9 0.3 15.8 16.1 VC Total 0.1 19.1 24.1 0.4 4.5 1.4 17.6 1.9 0.3 0.9 6.2 0.1 0.1 0.1 23.1 13.8 0.3 2.8 5.9 0.1 1.6 0.1 3.3 23.8 19.0 6.9 8.4 32.8 20.9 19.8 7.4 15.2 282.0 AC 0.1 2.1 5.6 0.3 1.9 0.9 2.3 1.2 0.1 0.5 1.9 0.1 3.0 1.6 0.1 1.7 1.6 0.1 1.1 1.5 4.1 1.3 2.3 4.2 2.2 4.0 4.5 3.1 1.0 54.4 0.8 12.4 12.6 2.0 2.3 18.4 9.6 8.3 2.2 8.2 137.2 0.1 13.0 8.4 0.2 0.4 2.3 0.1 3.0 1.5 0.2 10.1 0.1 10.8 10.2 VC Total 0.1 12.9 15.8 0.3 3.4 1.1 12.4 1.3 0.1 0.6 4.9 0.1 16.0 10.0 0.3 2.1 3.9 0.1 1.2 2.3 16.5 13.9 4.3 6.5 20.6 13.6 12.8 5.3 9.2 191.6 AC 100.0 63.6 70.0 75.0 73.1 81.8 85.2 75.0 33.3 62.5 76.0 100.0 85.7 72.7 100.0 73.9 80.0 100.0 84.6 88.2 71.9 50.0 63.9 82.4 71.0 63.5 66.2 70.5 58.8 71.3 VC 68.4 63.4 78.9 66.7 67.8 33.3 100.0 81.1 66.3 72.4 100.0 80.0 59.0 33.3 50.0 68.5 76.8 60.6 69.7 62.0 65.8 63.8 73.3 60.7 66.7 Total 100.0 67.5 65.6 75.0 75.6 78.6 70.5 68.4 33.3 66.7 79.0 100.0 69.3 72.5 100.0 75.0 66.1 100.0 75.0 69.7 69.3 73.2 62.3 77.4 62.8 65.1 64.6 71.6 60.5 67.9 Implementation % Implementation/ available resources 2010–2011 Impl as at 30 Jun 2011 0.1 17.0 21.7 0.3 2.7 0.9 10.6 1.5 0.1 0.4 4.5 0.1 0.1 0.1 9.5 11.3 0.2 2.4 2.6 0.1 1.3 0.1 2.2 19.0 11.6 2.3 9.5 18.1 11.4 12.0 5.7 8.8 188.2 % 2010–2011 Impl to 2010–2011 Income 100.0 71.7 71.1 60.0 64.3 69.2 66.3 71.4 33.3 66.7 70.3 100.0 100.0 100.0 54.9 64.6 66.7 80.0 68.4 100.0 72.2 50.0 73.3 64.4 71.6 65.7 75.4 60.7 62.6 63.8 64.0 55.7 65.7

AC=assessed contributions; VC=voluntary contributions; Impl=implementation

WPR/RC64/3 page 7 The implementation of assessed and voluntary contributions, combined and broken down by category of expenditure, is shown below in Table 5. Table 5: Implementation by category of expenditure (US$ millions) 2012–2013 Amount spent as at 30 June 2013 89.7 29.9 25.7 16.3 6.0 9.6 14.4 191.6 2010–2011 Amount spent as at 30 June 2011 84.4 29.3 21.9 18.0 8.0 7.8 18.8 188.2

Category Staff cost Contractual services Direct financial cooperation Travel Medical supplies and literature General operating costs Others* Total

% 46.8 15.6 13.4 8.5 3.1 5.0 7.6 100.0

% 44.8 15.6 11.6 9.6 4.3 4.1 10.0 100.0

*Others include equipment, furniture and vehicles, training, consulting, research services, Special Services Agreement expenses and fellowships

The largest percentage of expenditure was attributed to staff costs (46.8%), followed by contractual services (15.6%), direct financial cooperation (13.4%) and travel (8.5%). The increase in staff costs of US$ 5.3 million (from US$ 84.4 million in June 2011 to US$ 89.7 million in June 2013) was as a result of the increase in salary rates of General Service staff (GS) and National Professional Officers (NPO) in various duty stations within the Region, as well as the devaluation of the US dollar in relation to the Philippine peso (Php), which gained more than 9% in value compared to the US dollar from January 2010 to January 2013. Travel costs include those associated with attending training activities and meetings convened and/or supported by WHO. expenditures. The final report on budget performance for biennium 2012–2013 will be presented to the Sixty-fifth session of the Regional Committee for the Western Pacific. Outputs and results Annex 1 contains the midterm assessment of implementation of the Programme Budget 2012–2013 conducted as of 31 December 2012. The midterm assessment examines the progress towards achievement of the Organization-wide expected results (OWERs) and regional expected results (RERs), and provides an overview of programmatic achievements, identifies issues affecting performance and actions required to foster overall progress. The midterm assessment notes the specific countries contributing to each of the RERs, identifies the specific issues and challenges The Secretariat continues to implement measures to reduce travel

WPR/RC64/3 page 8 affecting the achievement of each RER and presents a summary of required actions to ensure full achievement. The work of the Western Pacific Region contributes to meeting the targets for 155 (84%) of the 185 OWER indicators for the biennium 2012–2013. Of the targets to which the Region contributes, the Region’s contribution is at risk in only four instances; at risk means that progress towards achieving the Region’s contribution is being affected by impediments and risks for which corrective action is required. Out of a total of 171 RERs for the biennium 2012–2013, 92 (54%) were fully achieved by the end of 2012. Achievement of regional expected results by strategic objective Strategic objective SO 1 SO 2 SO 3 To reduce the health, social and economic burden of communicable diseases To combat HIV/AIDS, tuberculosis and malaria To prevent and reduce disease, disability and premature death from chronic noncommunicable diseases, mental disorders, violence and injuries and visual impairment To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development Regional expected results Fully Remain to be Total achieved achieved 14 7 12 12 6 10 26 13 22

SO 4

5

5

10

SO 5

1

3

4

SO 6

7

4

11

SO 7

3

5

8

SO 8

5

5

10

SO 9

12

1

13

WPR/RC64/3 page 9

SO 10

To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research To ensure improved access, quality and use of medical products and technologies To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively

13

12

25

SO 11 SO 12

4 4

8 5

12 9

SO 13

5

3

8

Total

92

79

171

The technical and managerial follow-up actions required to ensure all RERs are fully achieved include continued cost-cutting measures, prioritization of work to match funding available for programme needs and formulation of concrete plans for the implementation of priority activities, the aim being to realign resources to focus on key activities. The detailed information is found in the RER summary of required actions (see Annex 1).

WPR/RC64/3 page 10

WPR/RC64/3 page 11 ANNEX 1

PROGRAMME BUDGET 2012–2013 OUTPUTS AND RESULTS

SUMMARY OF PROGRESS MADE TOWARDS STRATEGIC OBJECTIVES AND REGIONAL EXPECTED RESULTS 1 January 2012–31 December 2012

July 2013

WPR/RC64/3 page 12 Annex 1

WPR/RC64/3 page 13 Annex 1 COUNTRIES AND AREAS* OF THE WESTERN PACIFIC REGION COUNTRY American Samoa Australia Brunei Darussalam Cambodia China Cook Islands Fiji French Polynesia Guam Hong Kong (China) Japan Kiribati Lao People's Democratic Republic Macao (China) Malaysia Marshall Islands Micronesia, Federated States of Mongolia Nauru ∗ ACRONYM ASM AUS BRN KHM CHN COK FJI PYF GUM HOK JPN KIR LAO MAC MYS MHL FSM MNG NRU Areas are indicated by italics. COUNTRY New Caledonia New Zealand Niue Northern Mariana Islands, Commonwealth of the Palau Papua New Guinea Philippines Pitcairn Islands Republic of Korea Samoa Singapore Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam Wallis and Futuna ACRONYM NEC NEZ NIU MNP PLW PNG PHL PCN KOR WSM SGP SLB TKL TON TUV VUT VNM WAF

WPR/RC64/3 page 14 Annex 1 List of abbreviations AC ADB AeHIN AFHS AMR APSED AusAID CAM CBR Assessed Contributions Asian Development Bank Asia e-Health and Health Information Network adolescent-friendly health services antimicrobial resistance Asia Pacific Strategy for Emerging Diseases Australian Agency for International Development Complementary Medicine Community-based Rehabilitation ESHUT CCs CCS CO CSF d4T DCC DHP Collaborating Centres ESR Country Cooperation Strategy EST Country office Country Strategic Framework Stavudine FETP Division of Combating Communicable Diseases FSER Division of Building Healthy Communities and Populations Division of Health Sector Development GATS GAVI Field Epidemiology Training Programme National Food Safety Emergency Response Global Adult Tobacco Survey Global Alliance for Vaccines and Immunization FAO DPM DPS DSE EHA EMS EOC EPI ESCAP Division of Programme Management Division of Pacific Technical Support Division of Health Security and Emergencies Emergency and Humanitarian Action event-management system Emergency Operation Centre Expanded Programme on Immunization United Nations Economic & Social Commission for Asia and the Pacific Environmentally Sustainable and Healthy Urban Transport Emerging Disease Surveillance and Response Environmentally Sustainable Transport Food and Agriculture Organization of the United Nations

DHS

WPR/RC64/3 page 15 Annex 1 GEF GEMS GFN GMP GOARN GSHS GSM GYTS HCF HCWM HEART Global Environment Facilityfunded Global Environment Monitoring System Global Foodborne Infections Network good manufacturing practice Global Outbreak Alert and Response Network Global School-based Student Health Survey Global Management System Global Youth Tobacco Survey Health Care Financing health care waste management Urban Health Equity Assessment and Response Tool Health Impact Assessment health information systems Health in All Policies Health in Transitions human immunodeficiency virus Health Promoting Schools Health Services Development Human Resources Human Resources for Health MVP MOH MOSS HR HRH IMCI INFOSAN IPPH IPV IVM JE LF LLIN M&E MCH MCN MDA MMR MNCH HPS HSD HSS HWTS ICS IHR Health Systems Strengthening household water treatment and safe storage Incident Command System International Health Regulations Integrated Management of Childhood Illness International Food Safety Authorities Network Idiopathic Palmoplantar Eccrine Hidradenitis inactivated polio vaccines integrated vector management Japanese encephalitis lymphatic filariasis long lasting insecticidal nets monitoring and evaluation Mother and Child Health Maternal Child Health and Nutrition mass drug administration measles, mumps rubella maternal newborn and child health Ministry of Health Minimum Operating Security Standards Malaria, other Vectorborne and Parasitic Diseases

HIA HIS HiAP HiTs HIV

WPR/RC64/3 page 16 Annex 1 NCD NEHAP NFP NRA NTD OIE OPV PB PCR PEN PHC PHIN PICs PIHOA PMDS PMO RAS Noncommunicable Diseases National Environmental Health Action Plan National IHR Focal Points SMS National Regulatory Authority neglected tropical diseases World Organization for Animal Health oral polio vaccine TA Programme Budget TAG Polymerase Chain Reaction TB TEAM package of essential NCD intervention TDR primary health care TRIPS Pacific Health Information Network TSF Pacific island countries and areas USAID Pacific Island Health Offices Association VC Performance Management and Development System Programme Management Officer Rapid Alert System for Combating Counterfeit Medicines WIFS RCM RER RNAS+ Regional Committee Meeting Regional Expected Result WPSAR Regional Network for Asian Schistosomiasis and other HelminthZoonoses WPR Western Pacific Surveillance and Response Western Pacific Region VDPV VPD WHO FCTC Trade-Related Aspects of Intellectual Property Rights Technical Strategic Framework United States Agency for International Development Voluntary contributions vaccine-derived poliovirus vaccine-preventable disease WHO Framework Convention on Tobacco Control weekly iron and folic acid supplementation TB Technical Assistance Mechanism Tropical Disease Research Technical Advisory Group Technical Assistance SO SRH STEPS short text messaging service Strategic Objective sexual and reproductive health STEPwise approach to surveillance SDH SIA Social Determinants of Health supplementary immunization activity

WPR/RC64/3 page 17 Annex 1 WPRO WRA WRs/CLOs WSP Western Pacific Regional Office Women of reproductive age WHO Representatives and Country Liaison Officers water safety plan

WPR/RC64/3 page 18 Annex 1

WPR/RC64/3 page 19 Annex 1 TABLE OF CONTENTS STRATEGIC OBJECTIVE 1 ..............................................................................................21 STRATEGIC OBJECTIVE 2 ..............................................................................................59 STRATEGIC OBJECTIVE 3 ..............................................................................................82 STRATEGIC OBJECTIVE 4 ............................................................................................108 STRATEGIC OBJECTIVE 5 ............................................................................................129 STRATEGIC OBJECTIVE 6 ............................................................................................138 STRATEGIC OBJECTIVE 7 ............................................................................................157 STRATEGIC OBJECTIVE 8 ............................................................................................170 STRATEGIC OBJECTIVE 9 ............................................................................................192 STRATEGIC OBJECTIVE 10 ..........................................................................................215 STRATEGIC OBJECTIVE 11 ..........................................................................................255 STRATEGIC OBJECTIVE 12 ..........................................................................................276 STRATEGIC OBJECTIVE 13 ..........................................................................................290

WPR/RC64/3 page 20 Annex 1

WPR/RC64/3 page 21 Annex 1 STRATEGIC OBJ ECT IV E 1 TO REDUCE THE HEALTH, SOCIAL AND ECONOM IC BURDEN OF COMMUNICABLE DISEASES EXPECTED RESULT 01.001 COUNTRIESAND OFFICES CONTRIBUTING TO RESULTS CHN,FJI, FSM, KHM,KIR, LAO, MNG, NIU, PHL, PIC, PNG, SLB, TKL, TON, VNM and VUT DCC and RDO CHN, KHM, LAO, MNG, PHL, PIC and PNG DCC CHN, FJI, FSM, KHM, KIR, LAO, MHL, MNG, MYS, PHL, PIC, PNG, SLB, TON, VNM and VUT DCC CHN, LAO, MNG, VNM and WSM DCC and DSE PNG DCC BRN, KHM, LAO, MNG, PHL, SLB, VNM and VUT DSE BRN, FJI, FSM, KHM, KIR, LAO, MHL, MNG, MNP, MYS, PHL, PIC, PNG, PYF, SGP, TON, TUV and VNM DSE DSE LAO and PHL DCC and DSE TOTAL 18

01.002 01.003

8 17

01.004 01.005 01.006 01.007

7 2 9 19

01.008 01.009

1 4

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE EXPANDED PROGRAMME ON IMMUNIZATION (EPI): Good progress towards measles elimination continued in 2012, measles incidence was at an historic low in the Region and 33 of 37 countries and areas may have interrupted endemic measles transmission. The Regional Verification Commission (RVC) for Measles Elimination in the Western Pacific Region was established in January 2012, with its 14 members appointed by the Regional Director. The RVC, with support from WHO and in consultation with Member States, has been working on formulating regional mechanisms on verification of

Strategic Objective 1

WPR/RC64/3 page 22 Annex 1 measles elimination. The Western Pacific Region (WPR) was the first Region to commit to controlling hepatitis B (HB) virus, the second most common known carcinogen in the world. Available data indicate that the Region as a whole, and at least 30 countries, have achieved the Region’s 2012 milestone of reducing HB seroprevalence to <2% amongst children 5 years of age. This makes WPR as the only Region to have met a hepatitis B control milestone. Country commitments to HB control represent a remarkable public health achievement by preventing 3.6 million future chronic infections and 635 000 future HBV-related deaths amongst children born in 2011 when compared to those born in 1990. This phenomenal progress must be sustained into the future. However, timely birth dose provision remains challenging in many countries, especially those with a high proportion of unattended home births. In 2012, no country in the WPR reported any case of wild poliovirus. The 2011 CHN outbreak after detecting 21 wild polio cases was closed within three months after onset of the first case. The 18th Regional Certification Commission (RCC) has concluded that CHN had adequately responded to the polio outbreak and its certified polio-free status was retained as well as for the WPR. Despite important population movements between countries and others experiencing poliovirus circulation no reimportation was detected in these countries. This major achievement should be sustained as the programme is entering now the last chapter of the Global Polio Eradication Initiative. The Polio eradication and end-game strategic plan 2013–2018 under finalization and clearance by governing and policy bodies has a main goal to complete the polio eradication and containment of all wild, vaccine-related and Sabin polioviruses. For countries and areas in the WPR, the second (out of four) specific objective related to strengthening routine immunization and oral polio vaccine (OPV) withdrawal will be key focus for the Region. Currently, 18 countries are still using OPV and its withdrawal and switch to inactivated polio vaccines (IPV) should be planned in advance to consider the global requirements of IPV vaccines in the coming months. Response to polio outbreak in CHN resulted in this country being taken off the list of countries with active polio outbreaks six months after the last case, achieving an important global milestone. The 18th meeting of RCC confirmed that CHN stops transmission and is polio-free now and all countries and areas in the WPR remain polio-free. The Vaccine-preventable diseases (VPD) laboratory network composed of about 500 network laboratories in the Region maintained the required quality standards, and 50 measles/rubella and 10 Japanese encephalitis (JE) laboratories participated in WHO accreditation programme.

Strategic Objective 1

WPR/RC64/3 page 23 Annex 1 About 48 out of 50 measles rubella and eight out of ten JE network laboratories were accredited as of January 2013. After the WPR’s 4th hands-on training workshop on molecular diagnosis of measles and rubella in October 2012, molecular capacity of measles rubella network laboratories has been further strengthened in the Region to support measles elimination verification process. The Region is well advanced in formulating regional alliance for National Regulatory Authority (NRA) for vaccines to assist countries in addressing many of the challenges faced by the NRAs and to build the independent, competent and effective regulatory systems for immunizing assured quality vaccines. CHN made tremendous progress in strengthening NRA capacity and for the prequalification process of vaccines in order to improve regional and global vaccine security. NEGLECTED TROPICAL DISEASES (NTD): The Regional Action Plan for Neglected Tropical Diseases in the Western Pacific (2012–2016) was endorsed by the 63rd session of the Regional Committee for the Western Pacific held from 24 to 28 September 2012 in Hanoi, Viet Nam. It is a tool for advocacy, planning monitoring and evaluation and serves as the Regional NTD roadmap for milestones and targets and feeds into the Global Roadmap 2020. The regional plan also serves as a guide for updating and developing national action plans. Lymphatic filariasis (LF) has been eliminated in CHN, KOR and SLB. NIU is on track to prepare the dossier on elimination and PLW and WAF are on track to confirming elimination. Mass drug administration (MDA) against LF was carried out in eight countries: FJI, KIR, LAO, MYS, PHL, PNG, TUV and VUT. Schistosomiasis elimination activities were conducted in all four endemic countries and programme reviews in three countries: KHM, LAO and PHL. Mass treatment against foodborne trematodiases (FBT) was carried out in three countries (KHM, LAO and VNM). MDA against LF was carried out in eight countries: FJI, KIR, LAO, MYS, PHL, PNG, TUV and VUT. Soil-transmitted helminth programmes are functioning in 12 countries, but overall they need to be scaled up. Global target of 75% coverage of deworming school-aged children was achieved in KHM, LAO and TUV. Leprosy elimination as a public health problem was achieved and maintained in all but three countries in the Region. These three countries—FSM, KIR and MHL—are now the focus of intensified elimination efforts, after the Regional Director for the WPR declared leprosy and LF elimination a regional priority. Under the Regional Action Plan for Neglected Tropical Diseases in the Western Pacific (2012–2016), elimination target to achieve in these three countries is set for 2016.

Strategic Objective 1

WPR/RC64/3 page 24 Annex 1 EMERGING DISEASES SURVEILLANCE AND RESPONSE (ESR): The Asia Pacific Region has been identified as a high-risk area for emerging and re-emerging diseases and other public health security threats, such as severe acute respiratory syndrome (SARS), the first newly emergent disease in the 21st century, avian influenza (H5N1) and dengue, which has doubled in the past two decades. Year 2012 was a critical year for International Health Regulations (2005) or IHR (2005). IHR (2005) aims to ensure that the national core capacity requirements specified in the Regulations are developed, strengthened and maintained. The core capacities required of Member States by the Regulations were to be in place by 15 June 2012. In the WPR, the Asia Pacific Strategy for Emerging Diseases or APSED (2010) serves as a regional tool to help meet the IHR core capacity requirements. The results of the global IHR core capacity monitoring questionnaire in 2011 showed good overall progress in the Region. Despite the achievements, nearly half of the Member States in the Region, based on justified need and an implementation plan, requested two-year extension of the June 2012 deadline. DENGUE: A community-based dengue vector control pilot project, using guppy fish, is ongoing in FJI while the experience in KHM and LAO on the same activity was published jointly with Asian Development Bank (ADB). The climate change and vectorborne diseases project, which mainly focused on dengue surveillance and response in KHM and PNG, was concluded in June 2012. Regional capacity-building activities on dengue surveillance and integrated vector management were conducted with support from National Environment Agency, Singapore and the Ministry of Health, Malaysia, respectively. Malaria, other vectorborne and parasitic diseases (MVP) unit maintains close collaboration with ESR on dengue situation updates and outbreak response, for example, during the recent outbreak in FSM and KOR in November 2012, where WHO provided technical support including for vector control. In the PHL, a dengue vector control programme review was conducted in preparation for the new national dengue strategy and plan. In LAO, five priority provinces were trained on dengue case classification and management, and on dengue outbreak standard operating procedures (SOP). In VNM, a workshop on susceptibility of dengue vector to insecticide was conducted and dengue control network was established nationwide, while in VUT a routine dengue case notification system was put in place.

Strategic Objective 1

WPR/RC64/3 page 25 Annex 1 RESEARCH: The Western Pacific Regional Office (WPRO) was the only regional office to present progress report (update) of research programme at Scientific and Technical Advisory Committee (STAC) and Joint Coordinating Board (JCB) of the Special Programme for Research and Training in Tropical Diseases. The Regional Research Framework to Strengthen Communicable Disease Control and Elimination in the Western Pacific (RRFDCC) was further refined in collaboration with Stop TB (STB), HIV/AIDS and Sexually Transmitted Infections (HSI) and Expanded Programme on Immunization (EPI) units. Research, including capacity-building of local researchers, examining impacts of climate on vectorborne disease transmission was conducted as part of the project in KHM, MNG and PNG funded by the Korean International Cooperation Agency (KOICA). A total of four new research studies were started in this period on antimalarial drug efficacy monitoring trials in CHN, KHM, LAO and VNM. A research protocol to assess safety of primaquine in vivax malaria patient in KHM was finalized and funding was acquired from WHO Headquarters (HQ).

CHALLENGES/ISSUES EXPANDED PROGRAMME ON IMMUNIZATION (EPI): Strengthening routine immunization, assisting Member States in elimination of measles and maternal and neonatal tetanus, maintaining polio-free status, conducting supplementary immunization activities (SIAs), and introducing new vaccines and supply of assured quality vaccine was a challenge. The progress in reducing HB seroprevalence needs to be continued into the future to reach < 1% seroprevalene of HBAgs in children 5 years of age. Reaching newborns with timely birth dose provision remains a challenge in many countries, especially those with a high proportion of unattended home births. NEGLECTED TROPICAL DISEASES (NTD): NTDs include over 30 diseases caused by different pathogens, with different strategies for elimination or control. Due to the challenges in dealing effectively with all NTDs, there is a need to focus on the priority diseases in the Region. There is a need to scale up the implementation of the Regional Action Plan for NTDs in the WPR focusing on NTDs, such as LF, soil-transmitted helminthiases (STH), schistosomiasis, FBT, leprosy, trachoma and yaws. Strategic Objective 1

WPR/RC64/3 page 26 Annex 1 Soil-transmitted helminth programmes are functioning well only in 12 countries, but overall they need to be scaled up. Less attention is paid on deworming of women of child-bearing age (WCBA) by most endemic countries. More efforts are needed to achieve leprosy elimination as a public health problem in the remaining three countries in the Region. More efforts are required to correctly assess the population requiring preventive chemotherapy (PC) and improve on PC coverage and reporting. EMERGING DISEASES SURVEILLANCE AND RESPONSE (ESR): Despite the overall progress made, urgent actions are needed to fully comply with IHR. Nearly half of Member States in the Region were unable to meet the 15 June 2012 deadline for IHR core capacity development due to a number of factors, including the relatively low baseline capacities in resource-limited countries, the demanding requirements of IHR monitoring indicators, and inadequate financial and technical resource allocation for national core capacity development. As a result, a significant number of Member States in the Region requested (and have now obtained) a two-year extension, indicating that additional time and technical and financial resources are required to meet IHR core capacity requirements. Those countries that need the additional two years—until 15 June 2014—to meet the IHR core capacities requirements should allocate resources and maximize efforts to achieve the core capacities. Meanwhile, continuing long-term efforts are vital to enhance and sustain the IHR core capacities in all Member States. DENGUE: Dengue is the most important mosquito-borne viral disease. It is transmitted by two or more Aedes mosquito species and widely distributed in the tropics. Of the 37 countries and areas in the WPR, over 23 have reported dengue outbreaks. Chikungunya is a threat as well and spreading across the Region, making it the next big challenge.

Strategic Objective 1

WPR/RC64/3 page 27 Annex 1 RESEARCH: There exist significant programmatic gaps in tackling research issues in the Region. The continuous research capacity-building and operational research is needed to fill these gaps.

SUMMARY OF ACTIONS REQUIRED Effective implementation of national plans is vital if IHR requirements are to be met, but they require sustainable national investment, as well as technical and financial support from external sources. More predictable financial resources are needed not only during emergency situations but also in the gaps between emergencies. In addition, Pacific island countries and areas (PIC) face unique challenges and need tailored approaches to implement IHR (2005). Many national capacities can be enhanced at the subregional level in the Pacific through collective effort and resource-sharing. A regionwide corporate approach for resource mobilization and advocacy should be further developed and strengthened. Close collaboration with Member States and WHO Country Offices for bottom-up planning should continue. Intensified levels of activity, support and political commitment are needed to maintain disease control and elimination goals. In less developed countries, low technical capacity and human resources of national programmes are challenges to programme implementation in certain areas. WHO should tap on middle-income Member States and WHO collaborating centres (WHO CCs) for support. In the current environment of resource constraints, the Division of Combating Communicable Diseases (DCC) will need to prioritize activities in its portfolio.

Strategic Objective 1

WPR/RC64/3 page 28 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.1 Policy and technical support provided to Member States in order to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential child-health interventions with immunization. Performance Indicators Number of Member States with at least 90% national vaccination coverage (DTP3). Number of Member States that have introduced Haemophilus influenza type b vaccine in their national immunization schedule. Baseline 2012 130 Target by 2013 Status by end 2012

1.1.1

135 on track

1.1.2

169

180 on track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.001.WP01Member States supported to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential interventions with immunization and to control or eliminate targeted VPDs. Indicator Number of countries and areas supported to integrate immunization services by integrating with other health services (e.g. prevention and treatment of vitamin A deficiency, bednet distribution, deworming). Number of priority Baseline 2012 8 Target by 2013 11 Achievement to date On Track/Fully Achieved

Remarks

1

10 COK, KHM, KIR, LAO, MNG, PHL, PLW, PNG,SLB and VNM

2

2

4

3 National EPI

Strategic Objective 1

WPR/RC64/3 page 29 Annex 1 countries and areas that received support to monitor and evaluate disparities in access to immunization programme at subnational level. reviews were carried out in LAO and SLB with WHO support to address the disparities. PHL has started active consultation with WHO to more actively monitor the disparity. 18 24 26 ASM, BRN, CHN, COK, FJI, FSM, JPN, KHM, KIR, LAO, MHL, MNG, MYS, NIU, NRU, PHL, PLW, PNG, SGP, SLB, TKL, TON, TUV, VNM, VUT and WSM. 23 CHN, COK, FJI, FSM, KHM, KIR, LAO, MAC, MHL, MNG, MYS, NIU, NRU, PHL, PNG, , SLB, TOK, TON, TUV,VNM, VUT and WSM.

3

Number of countries and areas supported in regional vaccine quality, safety, security and management initiatives.

4

Number of countries and areas assisted with activities to facilitate decisions about appropriate changes and additions to the immunization schedule, including introduction of new vaccines and/or technologies. Number of countries and areas supported to control or eliminate targeted VPDs.

22

25

5

36

36

36 ASM, AUS, BRN, CHN, COK, FJI, FSM, GUM, HOK, JPN, KIR, KHM, KOR, LAO, MAC, MHL, MNG, MYS, , NEC, NEZ, NIU, NRU, MNP, PHL, PLW, PNG, PYF, SGP,, SLB, TOK, TON, TUV, VNM, Strategic Objective 1

WPR/RC64/3 page 30 Annex 1 VUT,WAF and WSM.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Progress in implementation of planned activities for all regional expected results (RERs) is on track. Evidence-based policy guidance has been provided to countries to support decision-making on introduction of new and underutilized vaccines and to strengthen implementation of these vaccines. Progress towards measles elimination continued in 2012. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Financial constraints for RERs1 and 2have limited the implementation of activities. Some laboratory accreditations in priority countries are still pending. There are not enough human resources/experts to support the maintenance of laboratory quality performance. SUMMARY OF ACTIONS REQUIRED Mobilization of more financial resources for activities for RERs 1 and 2 is required. To maintain the quality of laboratory performance and to achieve full accreditation of laboratories with pending accreditation status (two measles and two JE labs), close follow-up of those laboratories by WPRO and WHO country offices and on-site visits to the laboratories in priority countries would be needed. Regular on-site visits (quarterly) in WHO country offices and technical support from laboratory focal points (ESR or DHS) would be helpful to resolve any remaining challenges. Consistent communication with ministry of health officials is important to identifying evidence and policy needs in order that timely technical support can be provided. Additional consultants with expertise in these areas need to be identified. Provide technical orientation on regional verification guideline and the new Measles Elimination Field Guide to ensure good implementation and push for rapid and adequate outbreak response.

Strategic Objective 1

WPR/RC64/3 page 31 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.2 Effective coordination and support provided in order to achieve certification of poliomyelitis eradication, and destruction, or appropriate containment, of polioviruses, leading to a simultaneous cessation of oral poliomyelitis vaccination globally. Performance Indicators Percentage of final country reports demonstrating interruption of wild poliovirus transmission and containment of wild poliovirus stocks accepted by the relevant regional commission for the certification of poliomyelitis eradication. Percentage of Member States using trivalent oral poliovirus vaccine that have a timeline and strategy for eventually stopping its use in routine immunization programmes. Baseline 2012 80% Target by 2013 Status by end 2012

1.2.1

100% On track

1.2.2

0%

75% On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.002.WP01 Effective coordination and provision of support to Member States to retain certification of poliomyelitis elimination; including destruction and/or appropriate containment of polioviruses and other post eradication activities as required. Indicator Number of countries and areas supported to maintain polio-free status certification. Baseline 2012 36 Target by 2013 36 Achievement to date On Track/Fully Achieved

Remarks

1

36 ASM, AUS, BRN, CHN, COK, FJI, , FSM, GUM, HOK, JPN, KHM, KIR, KOR, LAO, MAC, MHL, MNG, MNP, MYS, NEC, NEZ, NIU, NRU,

Strategic Objective 1

WPR/RC64/3 page 32 Annex 1 PHL, PLW, PNG, PYF, , SGP, SLB, TOK, TON, TUV, VNM, VUT, WAF and WSM.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE During its 18th meeting in November 2012, the Regional Certification Commission (RCC) concluded that after successful control of a polio outbreak in CHN following wild poliovirus (WPV) importation in 2011, and with surveillance (including laboratory) and immunization efforts in all 37 countries and areas, the Region continued to remain polio-free and retains it certification status. Laboratory containment remains up-to-date and post eradication activities are being considered, as appropriate. Global end-game strategy under development in countries of the WPR that aims to complete the eradication and containment of all wild, vaccine-related and Sabin polioviruses is yet to be finalized and fully implemented. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Strong collaboration with Member States are required to keep WPR polio-free, and meet the goals and progress towards measles elimination and hepatitis B control, among others. Disadvantages and hard-to-reach populations need to be fully covered by vaccines of assured quality to further decrease morbidity and mortality. To ensure the long-term sustainability of immunization programmes, WHO will continue to assist countries in increasing commitment for funding immunization programmes and providing guidance in making evidence-based decisions on introduction of new vaccines. In order to meet immunization goals, regional surveillance systems, including laboratory quality and diagnostics, need to be strengthened. SUMMARY OF ACTIONS REQUIRED The polio outbreak in CHN highlighted how future control of polio outbreaks following importation will get increasingly complex due to the epidemiology changing over time; adolescents and adults will also be affected due to increased disease severity in adults; fatality rates will be higher; and outbreaks affecting larger age groups will be more difficult to control and have higher resource requirements. To implement the global end-game strategy currently

Strategic Objective 1

WPR/RC64/3 page 33 Annex 1 being finalized in WPR countries and areas, a series of actions needs to be initiated; especially in terms of orientations/briefings to Member States, reviewing current progress towards required standards, providing specific technical support to priority countries (like CHN, PHL and VNM) and conducting a technical and funding evaluation of the feasibility of this strategy within the WPR countries and areas. The Regional Strategy needs to be compiled and presented once all requirements have been summarized for its endorsement and implementation to adequate policy committees. Close follow-up actions taken to implement the new virus isolation algorithm and real time polymerase chain reaction (PCR) for internal tandem duplication (ITD) and vaccine-derived poliovirus (VDPV) screening are needed for six national and 23 subnational laboratories in CHN. WPRO provided continuous inputs for four implementation steps to successfully introduce real time PCR in the laboratories which were trained in 2012. PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.3 Effective coordination and support provided to Member States in order to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases Performance Indicators Number of Member States certified for eradication of dracunculiasis. Number of Member States that have eliminated leprosy at subnational levels. Number of reported cases of human African trypanosomiasis for all endemic countries. Number of Member States having achieved the recommended target coverage of population at risk of lymphatic filariasis, schistosomiasis and soiltransmitted Helminthiasis through regular anthelminthic preventive Baseline 2012 180 Target by 2013 Status by end 2012

1.3.1

193 On track

1.3.2

Not available

On track

1.3.3

8000

7500

NA

1.3.4

23

25 On track

Strategic Objective 1

WPR/RC64/3 page 34 Annex 1 chemotherapy.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.003.WP01 Effective coordination and support provided to Member States in order to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases. Indicator Number of countries and areas that have achieved elimination of leprosy at national and subnational levels. Baseline 2012 34 Target by Achievement 2013 to date 34 On Track/Fully Achieved

Remarks

1

34 34 of 37 countries and areas have achieved and maintained elimination at national levels as in previous years; only FSM, KIR and MHL have not yet achieved the elimination target for leprosy. 7 FJI, KHM, NIU, PYF, TON, VUT, and VNM

2

Number of countries and areas that have achieved 80% coverage over five consecutive rounds of mass drug administration. Number of countries and areas receiving technical support for the development and implementation of national dengue prevention and control plans and assistance as needed in resource mobilization. Number of countries and areas supported to complete the mapping of food-borne trematodes infections

3

3

3

9

10

10 CHN, FJI, FSM, KHM, LAO, MHL, MYS, PHL, VNM and VUT received support for the development and implementation of national dengue plans. 5 CHN, KHM, KOR, LAO and VNM have information on endemicity. KHM is continuing with

4

5

6

Strategic Objective 1

WPR/RC64/3 page 35 Annex 1 in high-risk areas. further mapping. Partially completed in the PHL.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The Regional Action Plan for NTD for Western Pacific (2012–2016) was endorsed at the 63rd session of the Regional Committee. Lymphatic filariasis, schistosomiasis, leprosy and yaws programmes are progressing well and on target for elimination by 2020 except for three countries (FSM, KIR and MHL). Deworming is scaled up in most endemic countries with global target achieved in the three countries. Five countries (CHN, KHM, KOR, LAO and VNM) have information on endemicity of foodborne trematodiasis and KHM is continuing with further mapping. Mapping has been partially completed in the PHL. Dengue control activities continued, shared between ESR and MVP: outbreak response under APSED, while vector control activities were limited due to lack of funds. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Dengue outbreaks have been widely reported in 23 of the 37 countries and areas of the WPR; however, currently, MVP has no dedicated dengue staff working in countries and funding for activities is limited although ESR and MVP have collaborated to provide technical assistance for dengue prevention and control activities. National action plans are not yet updated or harmonized with the Regional NTD action plan. Two out of the six WHO CCs on NTDs are currently actively working with the Regional Office. The four CCs (two each in CHN and MYS) are yet to be activated for collaborative activities.

Strategic Objective 1

WPR/RC64/3 page 36 Annex 1 SUMMARY OF ACTIONS REQUIRED LEPROSY Case finding activities and surveillance need to be strengthened, and leprosy services must be improved, particularly at points of care. Different areas may require a tailored approach. General advocacy efforts on leprosy are also required to strengthen the integration of leprosy control into general health services, build capacity among health workers and prevent disabilities and reduction of stigma. In order to maximize the community-based rehabilitation (CBR), the synergies and integration with other programmes must be explored. Contribution from leprosy programme to disability alleviation needs, arising from other diseases, such as lymphatic filariasis and noncommunicable diseases and viceversa must be explored. DENGUE Strong leadership, commitment and advocacy are needed at each level of government to combat the disease. Resource mobilization to conduct outbreak and inter-outbreak dengue activities is needed. In the absence of an effective dengue vaccine, vector control and effective case management need to be strengthened. Dengue outbreak response stockpiles for the PIC should be continuously monitored and replenished. WHO needs technical staff to guide implementation of national dengue plans, monitor progress and provide technical assistance on best practices in dengue control. Draft regional integrated vector management (IVM) framework needs to be finalized and implemented. Collaboration between ESR and MVP, and working closely with governments and partners on the implementation of dengue prevention and control activities should be continued and strengthened. NTDS The Regional NTD Action Plan that was endorsed by the 63rd session of the Regional Committee must be progressively implemented. National action plans must be developed or updated harmonizing with the regional plan.

Strategic Objective 1

WPR/RC64/3 page 37 Annex 1 There are seven WHO CCs on NTDs (two in AUS, four in CHN and one in MYS) but only two of them (James Cook University in Australia and the National Institute of Parasitic Diseases in Shanghai) are actively collaborating with WPRO. More efforts are required to activate the collaboration activities with the remaining four WHO CCs. NIU, PLW, TON and VUT need technical assistance to complete verification dossiers for LF. LF/NTD activities in PNG are lagging far behind, and a full-time staff member on the ground is needed to plan, coordinate and fund-raise. The United States Agency for International Development (USAID) has now come on board to bilaterally support PNG. Collaboration between WHO and USAID will be critical to monitor the progress of activities in the country. The successes in deworming of school-aged children in KHM, LAO and TUV need to be maintained and replicated in other countries. Schistosomiasis control must be intensified, especially in the PHL. Experience gained and lessons learned from implementation of yaws elimination activities in VUT in 2012 for the first time will be useful when rolling out these activities in PNG and SLB. Case management for all NTDs should be integrated into the routine local health services in order to provide those affected with sustainable access to treatment. Focus should be on reaching the targets set in the regional action plan and the NTD Global Roadmap 2020. It is important to have clear guidelines on how to verify/certify eliminate/eradicate, such as for schistosomiasis and yaws when the countries are close to the target. Intersectoral collaboration with health and nonhealth sectors is a key factor for achieving better health outcomes from NTD control efforts as well as sustaining the achievements. Efforts must be made to ensure this at all levels, including at the level of implementing unit.

Strategic Objective 1

WPR/RC64/3 page 38 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.4 Policy and technical support provided to Member States in order to enhance their capacity to carry out surveillance and monitoring of all communicable diseases of public health importance. Performance Indicators Number of Member States with surveillance systems and training for all communicable diseases of public health importance for the country. Baseline 2012 150 Target by 2013 Status by end 2012

1.4.1

193 On track (In WPR, there are 11 countries with field epidemiology training (FETP) programmes, either FETP or FET: AUS, CHN, JPN, KHM, KOR, LAO, MNG, MYS, PHL, SGP and VNM)

1.4.2

Number of Member States for which WHO/UNICEF joint reporting forms on immunization surveillance and monitoring are received on time at global level in accordance with established time-lines.

151

165

NA

Strategic Objective 1

WPR/RC64/3 page 39 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.004.WP01 Policy, strategy developed and technical advice provided to Member States and partners for ensuring collective regional health security. Indicator Number of Member States supported for development or update of national strategy, policy or workplan for managing emerging diseases. Baseline 2012 5 Target by 2013 9 Achievement to date On Track/Fully Achieved Remarks

1

7 KHM, LAO, MNG, PHL, PIC, PNG and VNM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Through the common regional strategy–Asia Pacific Strategy for Emerging Diseases (APSED), the countries and areas in the Region worked with WHO and partners to improve their capacities to detect and respond to disease outbreaks. The updated APSED (2010), endorsed by the Technical Advisory Group (TAG) meeting and the Regional Committee Meeting (RCM) in 2010, was based on the momentum gained by the APSED (2005), extensive country consultations, lessons learned from response to pandemic influenza 2009 and the core capacity requirements under the IHR (2005). A robust monitoring and evaluation framework to ensure APSED implementation has been in place and will be further improved to ensure accountability and learning for programme improvements at both national and regional levels. This includes the regular country-level planning meetings involving stakeholders within each country, and annual meeting of the Asia Pacific TAG to bring countries, donors and partners together to review progress, identify key issues and recommend solutions to the issues and priority actions. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Regular planning and review meetings at country level are critical, as they provide opportunity to facilitate prioritization and harmonization of various activities, and help avoid duplication. However, many partners have failed to fully utilize this country-level APSED

Strategic Objective 1

WPR/RC64/3 page 40 Annex 1 monitoring and evaluation mechanism as a platform for joint coordination, as well as financial support. SUMMARY OF ACTIONS REQUIRED The ability to demonstrate results and document achievements, challenges and solutions is becoming increasingly critical for securing comprehensive support to ensure the Strategy implementation. It is seen as one of the key obstacles for ensuring broader “buy in” of all partners at country level. Future efforts should focus on addressing this critical area of work.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.004.WP02 Policy and technical support provided to Member States to enhance their capacity to carry out vaccine-preventable diseases surveillance and monitoring and strengthen laboratory networks. Indicator Number of countries and areas receiving technical assistance from WHO in strengthening vaccinepreventable diseases surveillance and monitoring. Baseline 2012 36 Target by 2013 36 Achievement to date On Track/Fully Achieved

Remarks

1

36 ASM, AUS, BRN, CHN, COK, FJI, FSM, GUM, HOK, JPN, KHM, KIR, KOR, LAO, MAC, MHL, MNG, MNP, MYS, NEC, NEZ, NIU, NRU, PHL, PLW, PNG, PYF, SGP, SLB, TOK, TON, TUV, VNM, VUT,WAF and WSM. Polio: AUS, CHN, HOK, JPN, KOR, MNG, MYS, NEZ, PHL, SGP and VNM. Measles/Rubella: AUS, CHN, FIJ, GUM, HOK, JPN, KHM, KOR, LAO, MAC, MNG,

2

Number of countries and areas receiving technical and financial assistance for vaccinepreventable diseases laboratories.

16

16 11 for polio, 18 for measles rubella; 9 for JE; 10 (NV)

Strategic Objective 1

WPR/RC64/3 page 41 Annex 1 MYS, NEZ, PHL, PNG, PYF, SGP and VNM JE: JPN, KHM, KOR, LAO, MYS, PHL, PNG, VNM (2) NV: AUS, CHN, FJI, KHM, KOR, LAO, MNG, PHL, PNG and VNM. 3 Number of countries and areas that have established a surveillance and information system for diseases targeted by new vaccines. 13 15 13 CHN, FJI, KHM, LAO, MNG, PHL, PNG and VNM for rotavirus/IBVPD; COK, KIR, MYS for HPV; SLB for cholera; and VUT for HPV and typhoid.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Support was provided to strengthen molecular capacity for genotyping in polio and measles laboratories in CHN (including provincial laboratories), HOK, JPN, KOR, MNG, PHL and VNM, and on-site review conducted for laboratory accreditation in priority countries (CHN, FJI, LAO, KHM, PHL, PNG and VNM).Two regional hands-on training workshops for polio and measles network laboratories and CHN laboratory network meetings and hands-on training workshops were organized in 2012. Quality assurance measures for polio, measles and JE including WHO proficiency test and/or confirmatory testing were arranged for all laboratory network members (AUS, CHN, FJI, GUM, HOK, JPN, KHM, KOR, LAO, , MAC, MNG, MYS, PHL, PNG, PYF,SGP and VNM. Fully functional network laboratories were developed for rotavirus and invasive bacterial vaccine-preventable diseases (IB-VPD) surveillance generating quality assured data. Tools and technical support provided to strengthen surveillance and monitoring systems for rotavirus, IB-VPD, JE, HPV and typhoid.

Strategic Objective 1

WPR/RC64/3 page 42 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Laboratory accreditation of measles laboratories in LAO and Xinjiang, China is still pending and urgent follow-up action to achieve full accreditation is needed. This would be a critical issue to verify measles elimination. Increasing workload for Regional EPI laboratory coordinator of coordinating the growing EPI laboratory network (about 500 national public health laboratories in the Region) activities needs to be addressed to ensure the high quality performance of the network. SUMMARY OF ACTIONS REQUIRED Polio laboratory network: Close follow-up of implementation of new virus isolation algorithm and real time PCR for ITD and VDPV screening is needed for six national and 23 subnational laboratories in CHN. WPRO needs to provide continuous inputs for four implementation steps to successfully introduce real time PCR in the laboratories that received training in 2012. Measles and JE laboratory networks: To maintain the quality of laboratory performance and to achieve full accreditation of laboratories with pending accreditation status (two measles and two JE laboratories), close follow-up of those laboratories by WPRO and WHO Country Office and on-site visits to the laboratories in priority countries would be needed. Regular onsite visit (quarterly) and technical support from laboratory focal points (ESR or DHS) in WHO country offices would be helpful to resolve any remaining challenges. Increased political and financial commitment is necessary to sustain high quality surveillance. Regular communication with network laboratories and annual in-country visits are important to monitor and identify gaps in performance, provide technical support and corrective actions early. Explore alternative mechanisms for the efficient delivery of supplies to countries in need.

Strategic Objective 1

WPR/RC64/3 page 43 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.5 New knowledge, intervention tools and strategies that meet priority needs for the prevention and control of communicable diseases developed and validated, with scientists from developing countries increasingly taking the lead in this research. Performance Indicators Number of new and improved tools or implementation strategies, developed with significant contribution from WHO, introduced by the public sector in at least one developing country. Proportion of peer-reviewed publications based on WHO-supported research where the main author’s institution is in a developing country. Baseline 2012 17 Target by 2013 Status by end 2012 12 On track

1.5.1

1.5.2

71%

60%

On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.005.WP01 Technical coordination in developing research proposal protocols for the prevention and control of communicable diseases with scientists from developing countries and areas increasingly taking the lead. Indicator Number of studies/surveys being conducted that focus on intervention tools and strategies for the control of Baseline 2012 9 Target by 2013 11 Achievement to date On Track/Fully Achieved

Remarks

1

31 + 10 (three studies/ surveys in CHN, one in KHM, five in PIC, one in VNM);EPI: + 12 (two studies in

Strategic Objective 1

WPR/RC64/3 page 44 Annex 1 communicable diseases in developing countries and areas. Percentage of total research funds in the Region used by developing-country research institutes or with developing-country researchers. Number of research projects supported, directly addressing programmatic gaps. Regional research strategic plan in tropical neglected diseases developed. 30% 30% PHL, three in PNG, three in VNM and one study each in CHN, COK, LAO and WAF) 100% All studies/surveys were used by developing country research institutes/ researchers. 39 NTD: three (one study each in CHN, KHM, VNM) EPI: +12 (see above) 1 1 (draft)

2

3

24

32

4

1

1

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Despite the severe financial constraints to support research programmes, progress was made in strengthening research capacity on NTDs and in implementing immunization-related research. RRF-DCC is nearly complete. Collaboration with WHOCCs, regional research networks and other institutions were strengthened via joint initiatives to identify research priorities and exchange of human resources. Ten studies/surveys in NTDs and 12 EPI studies were initiated. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Financial constraints DCC-wide have affected the support for research programmes.

Strategic Objective 1

WPR/RC64/3 page 45 Annex 1 SUMMARY OF ACTIONS REQUIRED Due to the financial constraints, DCC-wide research programmes need to be integrated into existing disease-specific programmes for sustainable continuation of research capacity strengthening activities. Close collaboration with country-driven initiatives such as Regional Network for Asian Schistosomiasis and other Helminth Zoonoses (RNAS+) continues to play an important role in strengthening research and resource mobilization. The RRF-DCC needs to be finalized and published for wider circulation. Grant seeking and resource mobilization from funding institutions and agencies is necessary to implement the RRF-DCC. Continuing effort is necessary to mobilize resources on research via brokering research grants and fellowships/scholarships for researchers in the Region. In addition, collaboration with other sectors and ministries such as the Ministry of Science and Technology, Agriculture, and Education is also an important aspect in strengthening research activities in the Region. Fund-seeking to continue small grants programme is vital, because of the discontinuation of financial support from Tropical Disease Research (TDR) due to their financial crisis. Monitoring and follow-up of TDR-funded projects is necessary to measure progress, provide technical advice and to assess outcomes. Continuing activities such as scientific writing workshop targeting TDR-grant recipients is vital to help them publish the results of their TDR-supported studies. In order to resume the TDR small grants programme, financial support and a fellow from TDR is necessary for managing the programme.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.6 Support provided to Member States in order to achieve the minimum core capacities required by the International Health Regulations (2005) for the establishment and strengthening of alert and response systems for use in epidemics and other public health emergencies of international concern. Performance Indicators Number of Member States that have completed the assessment and developed a Baseline 2012 129 Target by 2013 Status by end 2012

1.6.1

160 According to IHR core capacity monitoring

Strategic Objective 1

WPR/RC64/3 page 46 Annex 1 national action plan to achieve core capacities for surveillance and response in line with their obligations under the International Health Regulations (2005). questionnaire 2012, question #5.1.1.2, 23 countries in WPR has a national plan (out of 25 countries that responded) 121 160 According to IHR core capacity monitoring questionnaire 2012, question #8.1.1.6, 20countries in WPR has national laboratory participating in EQA (out of 25 countries that responded).

1.6.2

Number of Member States whose national laboratory system is engaged in at least one external quality-control programme for epidemicprone communicable diseases.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.006.WP01 Advocacy for the International Health Regulations (2005) carried out, and the functions and capacities of National IHR Focal Points and Points of Entry strengthened. Indicator Number of Member States participating in annual IHR communication exercises. Baseline 2012 20 Target by 2013 27 Achievement to date On Track/Fully Achieved Remarks

1

21 On 5 and 6 December, the annual IHR exercise 'Crystal' was conducted by DSE. 26 of the 27 IHR State Parties in the Region confirmed their participation in the exercise with 21 Member States actively participating in the scenario for

Strategic Objective 1

WPR/RC64/3 page 47 Annex 1 testing IHR communication capacity, risk assessment and notification process. 2 Number of Member States supported for public health emergency contingency planning at designated international airports/ports. 3 7 4 BRN, CHN (CO), MNG (CO), VNM (CO)

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The International Health Regulations entered into force on 15 June 2007. They require countries to report certain disease outbreaks and public health events to WHO and to have minimum national core public health capacities functioning throughout their territories by June 2012. Sharing of information among countries via IHR event communication between Member States and WHO has been significantly improved over the past years. The formally established networking of the National IHR Focal Points (NFP) and the WHO IHR Contact Points linked all the WPR countries and the international community in face of a public health emergency of international concern. This mechanism helps timely sharing of information, joint risk assessments and harmonization of public health responses. This channel of communication has also been widely used effectively during recent important public health events, including Cambodia HFMD event in 2012. NFPs' roles were strengthened through regular meetings/workshops/exercises and were involved in APSED implementation to meet the core capacity requirements under IHR. On 5 and 6 December 2012, the annual IHR exercise 'Crystal' was conducted in the Western Pacific Region. Twenty-one of the 27 IHR State Parties in the Region actively participated in the exercise for testing IHR communication capacity, risk assessment and notification process. Active involvement for professional and general ESR staff was required for interacting with the Member States through short text messaging service (SMS), email and telephone. More

Strategic Objective 1

WPR/RC64/3 page 48 Annex 1 than 1000 email messages were exchanged between the Division and Member States over two days. WHO has developed the Guide for Public Health Emergency Planning at Designated POEs, after a consultative process with Member States and experts. The guide has been piloted in BRN and PHL, and revised with their comments and a further meeting in Japan. The guide is now available for use by Member States to develop generic public health emergency contingency plans at POEs to lead responses to all public health emergencies. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Despite all efforts, many WHO Member States in the WPR have formally notified WHO that they were unable to meet the core capacity requirements set out by the IHR by the June 2012 deadline. These countries can request and receive a two-year extension by submitting an implementation plan. In WPR, 14 countries in the Region (52%, n=14/27) had requested an extension, 13 (48%) had indicated that they are not requesting extension. All extension requests were submitted with an implementation plan for the two years, thus all 14 countries have been granted extensions. PIC face unique national and local capacity-development challenges due to multiple factors, including small population size, geographical isolation, and limited infrastructure and resources. Specific consideration and a tailored approach are needed to meet the IHR core capacity requirements in the Pacific. This includes use of a subregional Pacific approach to ensure that national core capacities required under IHR (2005) are in place and that the current global IHR core capacity monitoring tool is being applied in the Pacific setting. SUMMARY OF ACTIONS REQUIRED Member States have made further commitments to implement APSED (2010) as an effective tool towards meeting IHR core capacity requirements. Many countries have now developed or updated their national workplansfor emerging diseases and public health emergencies. National workplans serve as helpful tools for countries to prioritize activities, facilitate stakeholder planning and collaboration, coordinate support from donors and partners, and improve resource mobilization. However, ensuring effective implementation of national workplans requires a sustainable national investment and technical and financial support from external sources. This is particularly vital for those countries that requested a two-year extension to meet the IHR core capacity requirements. Countries that have obtained a twoyear extension should ensure increased national resource allocation and should maximize the Strategic Objective 1

WPR/RC64/3 page 49 Annex 1 use of external technical and financial assistance to support further development of national core capacities. Countries that have not requested an extension should continue their efforts to maintain IHR core capacities and collaborate with and provide financial assistance to those countries that most need external support. More predictable investment is needed in the gaps between emergencies, rather than only during emergency situations. For Pacific, many national capacities can be strengthened and enhanced at the subregional Pacific level through collective effort and resource sharing by the PIC. This includes the strengthening of the Pacific-wide syndromic surveillance system, the enhancement of Pacific laboratory networks and ensuring countries can access existing regional and international resources in managing rare public health events and emergencies.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.7 Member States and the international community equipped to detect, assess, respond to and cope with major epidemic and pandemic-prone diseases (e.g. influenza, meningitis, yellow fever, haemorrhagic fevers, plague and smallpox) through the development and implementation of tools, methodologies, practices, networks and partnerships for prevention, detection, preparedness and intervention. Performance Indicators Number of Member States having national preparedness plans and standard operating procedures in place for readiness and response to major epidemic-prone diseases. Baseline 2012 158 Target by 2013 Status by end 2012

1.7.1

185 According to IHR Core capacity monitoring questionnaire 2012, question #4.1.1.2, 22 countries in WPR have public health emergency response management procedures established (out of 25 countries that responded). 9 NA

1.7.2

Number of international coordination mechanisms

8

Strategic Objective 1

WPR/RC64/3 page 50 Annex 1 for supplying essential vaccines, medicines and equipment for use in mass interventions against major epidemic and pandemicprone diseases. 1.7.1 Number of severe emerging or re-emerging diseases for which prevention, surveillance and control strategies have been developed. 8 10 In WPR, the capacitybuilding strategies are horizontal (APSED) rather than vertical (hazard specificapproach).

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INDICATORS AND TARGETS RER 01.007.WP01 Support Member States to achieve minimum capacities for preparedness, detection, assessment of and response to emerging diseases and other public health emergencies, as required under IHR (2005), through implementing the updated APSED (2010). Indicator Number of countries and areas supported for strengthening national and local capacities required for surveillance and response in line with APSED (2010) and IHR (2005) Baseline 2012 9 Target by 2013 15 Achievement to date On Track/Fully Achieved

Remarks

1

9 CHN, KHM, LAO, MYS, MNG, PHL, PIC, PNG and VNM

Strategic Objective 1

WPR/RC64/3 page 51 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE In KHM, Laboratory Information System has been rolled-out; infection prevention and control training conducted; outbreak investigations carried out in coordination with Ministry of Health (MOH) counterparts; MoU on Zoonosis between Ministry of Health and Ministry of Agriculture, Forestry and Fisheries has been signed; the 2nd Applied Epidemiology Training cohort have graduated in August. CHN has worked on strengthening risk assessment, surveillance evaluation, system analysis for zoonotic diseases (e.g. rabies). At the same time prepared for projects and collaboration with the Ministry of Health and national institutions to assess challenges and needs for infection control. The public health laboratory and antimicrobial resistance (AMR) risk assessment guideline close to completion; the rabies advisory and technical board to promote best practices for elimination in CHN has been established; focus has been expanded on other APSED focus areas, which include infection control, laboratory strengthening, Points of Entry (POE) and zoonoses. In LAO, National Emerging Infectious Diseases workplan is being effectively implemented across all core components to meet minimum requirements of IHR (2005). LAO requested and was granted IHR extension to 2014, by the WHA. In MNG, risk assessment is carried out for every public health event, including foodborne, chemical poisoning and emergencies. Risk assessment procedure has been drafted and includes risk assessment and management of chemical incidents, foodborne and zoonotic events and initial rapid assessment to be used during health emergencies. Communication protocols on the operational communication, clearance and public announcement approved and applied: weekly electronic report and feedback was provided to provincial and district risk communications team, including Emergency Management Agency, State Specialized Agency, Ministry of Foreign Affairs, National Centre for Infectious Diseases with natural foci, Department of Health, and Ministry of Health. Standard Operating Procedures for deployment of Rapid Response Teams (RRT) and outbreak investigation guidelines have been drafted by Field Epidemiology Training Programme (FETP). A national rapid response team was trained, sub-national RRT established in 21 provinces. MOH established advisory committee to ensure programme sustainability; the Mongolian FETP was institutionalized. In the PICs, in-country outbreak response workshops were held and continuous work to strengthen response quality and timeliness is ongoing.

Strategic Objective 1

WPR/RC64/3 page 52 Annex 1 In PNG, good progress was seen overall in enhanced implementation of surveillance, assessment and response to communicable diseases of public health importance, in line with APSED. In VNM, an international consultant was recruited to provide training on business continuity planning for 50 government staff from ministries of Health, Defense, Agriculture and Rural Development, Industry and Trade, and Finance. The training on H5N1 surveillance and response for provincial preventive medicine staff has been conducted. The training for border health quarantine staff on surveillance and response to common cross-border communicable diseases has been conducted. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Regular planning and review meetings at country-level are critical, as they provide an opportunity to facilitate prioritization and harmonization of various activities, and help avoid duplication. Unfortunately, such country-level APSED monitoring and evaluation mechanisms have not yet been formally established in all countries that have requested IHR deadline extension. SUMMARY OF ACTIONS REQUIRED Health security threats will continue to occur. Collective and sustainable actions are required to ensure a safer and more secure Region. Through the common regional strategy of Asia Pacific Strategy for Emerging Diseases (APSED), the countries in the Region worked with WHO and partners to improve their capacities to detect and response to disease outbreaks. With the existing progress, it is important to ensure close linkages between focus areas for the overall success of APSED implementation. For sustainable development, it is critical to improve coordinated and collective efforts among countries and partners for regional health security. It would maximize benefits and minimize gaps, and can subsequently optimize investment for managing emerging infectious diseases and public health emergencies in line with APSED framework.

Strategic Objective 1

WPR/RC64/3 page 53 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.8 Regional and global capacity coordinated and made rapidly available to Member States for detection, verification, risk assessment and response to epidemics and other public health emergencies of international concern Performance Indicators Number of WHO locations with the global eventmanagement system (EMS) in place to support coordination of risk assessment, communications and field operations for headquarters, regional and country offices. Baseline 2012 129 Target by 2013 Status by end 2012

1.8.1

140 On Track 10 offices (WPRO and all the country offices with ESR staff can access EMS.)

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.008.WP01Regional system and capacity enhanced for detection, verification, monitoring, risk assessment and response to emerging diseases and other public health emergencies. Indicator Percentage of ESRrelated EMS events with carried out risk assessment. Baseline 2012 3% Target by 2013 5% Achievement to date On Track/Fully Achieved Remarks

1

94% Out of 16 events in EMS in 2012, 15 of these had a risk assessment recorded in the EMS. 0 In 2012, internal policy for DSE stockpile and Emergency Operation Centre (EOC) SOP was drafted (not yet

2

Regional rapid response mechanism and standard operating procedures (SOPs) established and strengthened.

0

1

Strategic Objective 1

WPR/RC64/3 page 54 Annex 1 finalized). 3 Number of bulletins/articles related to surveillance, response and preparedness published. Number of institutions in the Western Pacific Region participating in the Global Outbreak Alert and Response Network (GOARN). 20 60 69 69 articles were published in the online Western Pacific Surveillance and Response Journal 43 AUS-11; CHN-5; JPN-13; KHM-1; KOR-1; MYS-2; NEC-1; NEZ-1; PHL-2; PNG-1; SGP-5

4

39

50

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Under the framework of APSED, a regional system was established to provide early detection, verification and risk assessment of public health emergencies. These include establishment of a regional event-based surveillance system monitoring, regular publication of regional surveillance information of priority diseases, regionalization of GOARN, and development of an open access journal Western Pacific Surveillance and Response (WPSAR)(). In 2012, 69 articles were published in WPSAR, which have been indexed in Medline in June 2012. Under APSED (2010) framework, public health emergency preparedness is included as a new focus area for capacity-building. Building on lessons learned from the pandemic response, a step-by-step approach will be used to improve regional capacity. This includes the establishment of effective national and local health emergency command and response structure using the Incident Command System (ICS) as a tool and supported by a functional EOC. The EOC at the WPRO are being upgraded in 2012 quarter 4 and EOC in several Member States are being established with support from WPRO. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Closer cooperation and coordination among countries is required given the unique nature of acute public health security threats. No country would be safe and secure without the enhanced capacity of other countries and the Region as a whole. In addition, no one country

Strategic Objective 1

WPR/RC64/3 page 55 Annex 1 alone, regardless of national capacity and wealth, can effectively prevent, detect and respond to public health risks and emergencies and protect the health of its population without the cooperation of its neighbours. SUMMARY OF ACTIONS REQUIRED Regional Preparedness, Alert and Response has been included as a new focus area for capacity-building under APSED (2010). Under this area, WHO would provide a common operational platform for health emergency response. Working together with a broad spectrum of partners, WPRO is involved in a host of closely related public health activities, including surveillance and data banking, disease prevention and control, provision of standards and technical guidance, research, monitoring and evaluation, and resource mobilization. The role of the WPRO is to act as a catalyst and advocate for collective and coordinated actions at all levels, from local to regional, on health issues of public concern.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.9Effective operations and response by Member States and the international community to declared emergencies situations due to epidemic and pandemic prone diseases. Performance Indicators Proportion of Member States' requests for assistance that have led to effective and timely interventions by WHO, delivered using a global team approach, in order to prevent, contain and control epidemic and other public health emergencies. Baseline 2012 99% Target by 2013 Status by end 2012

1.9.1

99% On track 4/4 (HFMD in KHM; Cholera in the PHL; Sendong related leptospirosis in the PHL; Bopha response in the PHL)

Strategic Objective 1

WPR/RC64/3 page 56 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.009.WP01 Effective operations and response by Member States and the international community to declared emergency situations due to epidemic- and pandemic-prone diseases. Indicator Proportion of Member State’s requests for assistance that have led to timely WHO’s assistance in order to prevent, contain and control epidemic and other public health emergencies. Baseline 2012 80% Target by 2013 90% Achievement to date On Track/Fully Achieved Remarks

1

100% HFMD in KHM; cholera in the PHL; Sendong related leptospirosis in the PHL; Bopha response in the PHL

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE With the foundations laid out and the significant achievements made over the past years, the WPR has much more confidence in managing emerging disease outbreaks, and other public health emergencies. As required and when requested from the WPRO, support was provided to outbreak situations in 2012 including, cholera in the PHL in June 2012, HFMD in KHM in July 2012, post-flooding leptospirosis in Aug to Sep 2012 and supporting health response following typhoon Pablo in the PHL in December 2012. At the PHL Country Office, main achievements included provision of technical assistance on surveillance and response during the post-typhoon Sendong outbreak of leptospirosis and preparedness for the post-Habagat flooding. Another significant delivery is the final issuance of national laboratory framework for networking as Department of Health (DOH) administrative order followed by advocacy and dissemination forum to major stakeholders with the document published. In VNM, FETP supported the Ministry of Health in responding to major public health events, such as human influenza A(H5N1), HFMD and Idiopathic Palmoplantar Eccrine Hidradenitis (IPPH) syndrome; presented nine papers in training programmes in epidemiology and public Strategic Objective 1

WPR/RC64/3 page 57 Annex 1 health interventions network (TEPHINET) conference; two papers were published in peerreviewed journals; an event-based surveillance was piloted; the joint human FETP was launched; and applied veterinary epidemiology training (AVET) was conducted in 15 provinces. Cholera, PHL, June 2012: Following the declaration of an outbreak of cholera in Catanduanes Province in Region V of the Philippines in June 2012, GOARN was used to recruit two international experts with clinical management expertise as requested by the DOH. HFMD, KHM, July 2012: A risk communications expert from WHO HQ and two epidemiologists from WPRO were deployed. Leptospirosis, post-flooding, Aug to Sep 2012: Following the heavy rainfall in the PHL on 7 and 8 August 2012 due to the southwest monsoon brought about by tropical storm Haikui, extensive flooding occurred in the National Capital Region (NCR) and Regions I, III and IVA of the PHL. WHO has supported the response to the increased number of leptospirosis, in the areas of risk assessment protocols and practice for detected events; disease surveillance through enhancement of links to existing surveillance systems. Support was provided following typhoon Pablo, PHL, Dec 2012: Typhoon Pablo was the most powerful storm to hit the PHL in 2012, and which passed through the southern PHL from Mindanao to Palawan. As of 10 December 2012, the typhoon had left 647 deaths, 1482 injured and 780 people still missing. It also affected 487 364 families (5 412 140 persons) in 287 cities and municipalities, 30 provinces. The focus of the health response was on establishing an early warning system to detect diseases and prevent deaths using the Surveillance in Post Emergency and Extreme Disaster (SPEED) system, providing mental and psychosocial services and supporting the rehabilitation of damaged health facilities. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE There is a need for capacity-building for risk assessment of acute public health events. This should provide for more effective management of public health emergency preparedness and response and would improve regional pandemic response capacity.

Strategic Objective 1

WPR/RC64/3 page 58 Annex 1 SUMMARY OF ACTIONS REQUIRED Informed decision-making is extremely important for effective risk management in both government agencies and private sectors. This will require national and subnational risk assessment systems and capacity, as well as interagency and departmental collaboration. Risk assessment for acute public health events is a relatively new area and WHO plays a key role in developing guidance and tools. Under APSED (2010) framework, public health emergency preparedness is included as a new focus area for capacity-building. Building on lessons learned from the pandemic response, a step-by-step approach will be used to improve regional capacity. This includes the establishment of effective national and local health emergency command and response structure using the ICS as a tool supported by a functional EOC.

Strategic Objective 1

WPR/RC64/3 page 59 Annex 1 STRATEGIC OBJ ECT IV E 2 TO COMBAT HIV/AIDS, TB AND M ALARIA EXPECTED RESULT 02.001 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS CHN, FJI, FSM, KIR, MNG, PHL, PIC, PNG, SLB, VNM and VUT DCC and RDO CHN, FJI, KHM, KIR, LAO, MNG, MYS, PHL, PIC, PNG, SLB and VNM DCC, DHS and DPM CHN, KHM, LAO and TUV DCC and DHS CHN, LAO, MNG, PHL, PNG, VNM and WSM DCC PHL, TON and VNM DCC and DPM CHN, MYS, PNG, and SLB DCC and DHS TOTAL 13

02.002

15

02.003

6 8 5 6

02.004

02.005

02.006

Strategic Objective 2

WPR/RC64/3 page 60 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE WHO MVP unit in the WPRO actively supported malaria programmes in 10 endemic countries and areas and collaborated with government departments, partners, and WHO CCs to implement relevant strategic interventions and increased coverage of at risk populations. Implementation of the Regional Framework for Action (2013–2015) of the Emergency Response to Artemisinin Resistance in the Greater Mekong Subregion was initiated, with grant support from the Bill and Melinda Gates Foundation and the Australian Agency for International Development (AusAID). This framework is a multipronged approach designed to ultimately eliminate artemisinin-resistant malaria parasite in the Region. Scaling up of long lasting insecticidal nets (LLINs) distribution, rapid diagnostic tests and treatments have led to the reduction of malaria prevalence rates in PNG which has the highest burden of malaria in the Region. National malaria diagnosis quality assurance workshops were organized in CHN, KHM and VNM to draft a plan of action to strengthen malaria diagnosis. Strong commitment to fight malaria in the Asia-Pacific Region was mobilized through the Malaria 2012 — Saving Lives in the Asia Pacific Conference in Sydney, Australia and the Seventh East Asia Summit in Phnom Penh, Cambodia. The Tuberculosis (TB) meeting for the PIC was organized in close collaboration with WHO Division of Pacific Technical Support (DPS) and two technical partners in the Pacific: Secretariat of the Pacific Community (SPC) and Centres for Disease Control and Prevention (CDC). TB staff members from all PIC were informed and consulted about (the evidence base for) new WHO policies and guidelines and the operational consequences for TB control in the Pacific. In addition, technical partners met to discuss coordination of technical assistance (TA) in the Pacific. Policy, technical and coordination support was provided to countries and areas for the implementation of global operational guidelines 2011–2015. Monitoring and TA was provided to CHN, FSM, LAO and MHL. Financial support was given to CHN, KHM and LAO. A meeting of national programme managers (NPMS) was held at the Regional Office and a full-time Leprosy staff was recruited. WPRO HIV/AIDS unit (HSI Team) is recognized by regional partners as the leading health sector response to human immunodeficiency virus (HIV). Five Regional Guidance documents were developed. The major priorities are to lead health sector interventions to address the rampant HIV, Sexually Transmitted Infections (STI) and hepatitis epidemics among men having sex with men (MSM) and people who inject drugs. Tools towards increasing HIV testing which should include partner testing and linkage to care to improve

Strategic Objective 2

WPR/RC64/3 page 61 Annex 1 prevention and treatment metrics have been developed. Platforms include: Regional Interagency Meetings, Regional thematic working groups on Treatment and Care, MSM, Sex Worker, Young Key Population and Prevention of Mother to Child Transmission. Biregional (WPRO-SEARO) Treatment 2.0 Taskforce has been established in Yangon, Myanmar in conjunction with the Joint United Nations Programme on HIV/AIDS (UNAIDS). This will include a workplan under the UNAIDS-WHO Joint Operational Plan and plans for resource mobilization. Collaboration with TB, maternal and child health (MCH) and gender teams have increased.

CHALLENGES/ISSUES Despite high economic growth achieved by many countries and areas in the WPR and thus attaining middle-income status, high levels of inequality, poverty and geographic diversity persists that contribute to the risk of HIV/AIDS, malaria and TB. Due to relatively large population and weakness of health systems in some Member States, the burden of communicable diseases remains high although overall rates are declining. New tools and strategies that have been developed provide a great opportunity to consolidate gains in communicable disease control and achieve globally mandated targets. However, the challenge of sustainable financing and reaching at risk populations remain. Additional challenges in the Region include the emergence of multiple drug resistant strains of malaria and TB, and rampant increase of newly emerging HIV epidemics in at-risk populations such as MSM/transgender people and injecting drug users. It is of note that hepatitis C prevalence, among people who inject drugs, and hepatitis B burden are very high.

SUMMARY OF ACTIONS REQUIRED Effective implementation of national plans with sustainable national investment, technical and financial support from external sources is vital if the IHR (2005) requirements are to be met. More predictable financial resources are needed not only during emergency situations but also in the gaps between emergencies. In addition, PIC faces unique challenges and would require tailored approaches to implement IHR. Many national capacities can be enhanced at the subregional level in the Pacific through collective effort and resource sharing. An organization-wide corporate approach for resource mobilization and advocacy should be further developed and strengthened.

Strategic Objective 2

WPR/RC64/3 page 62 Annex 1 Close collaboration with Member States and WHO country offices for bottom-up planning should continue. Intensified levels of activity, support and political commitment are needed to maintain disease control and achieve set goals. In less developed countries and areas, low technical capacity and human resources of national programmes are a challenge to programme implementation in certain areas. WHO should tap on middle-income Member States and WHOCCs for support. In the current environment of resource constraints, DCC will need to prioritize activities in its portfolio. Many bottlenecks in the implementation of DCC programmes lie in weak health systems. This can be addressed in part by strengthening interdivisional collaboration. Other interdivisional collaborations such as with Reproductive, maternal, newborn and child health (MNCH), disabilities and climate change assist in synergizing actions.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 2.1 Guidelines, policy, strategy and other tools developed for prevention of, and treatment and care for patients with, HIV/AIDS, TB and malaria, including innovative approaches for increasing coverage of the interventions among poor people, and hard-toreach and vulnerable populations. Performance Indicators Number of low and middle income countries and areas that have achieved 80% coverage for (a) antiretroviral therapy and (b) the prevention of mother-to-child transmission services. Proportion of endemic countries and areas that have achieved their national intervention targets for preventing malaria. Baseline 2012 a) 8 and b) 13 Target by 2013 a) 35 and b) 45 Status by end 2012 At risk

2.1.1

2.1.2

50%

60% On track

Strategic Objective 2

WPR/RC64/3 page 63 Annex 1 2.1.3 Number of Member States that have achieved the targets of at least 70% case detection and 85% treatment success rate for TB. Number of countries and areas among the 27 priority ones with high burden of multidrug-resistant TB that have detected and initiated treatment under the WHOrecommended programmatic management approach, for at least 70% of estimated cases of multidrug-resistant. Proportion of high burden Member States that have achieved the target of 70% of persons with sexually transmitted infections diagnosed, treated and counselled at primary point-of-care sites. 45 50 On track

2.1.4

5

10 At risk

2.1.5

Not available

90% At risk

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 02.001.WP01 Regional guidelines, policies, strategies and other tools developed for prevention, treatment and care for STI and HIV/AIDS, malaria and TB (incl. innovative approaches for increasing coverage of the poor, hard-to-reach and vulnerable populations). Indicator Number of targeted countries and areas with costed mediumterm strategic plans in response to STI and HIV/AIDS, TB and malaria. Number of WHO regional policies, strategies or Baseline 2012 STI and HIV/AIDS: 9; Malaria: 10; TB: 7 Target by 2013 STI and HIV/AIDS: 9; Malaria: 10; TB: 7 Achievement to date STI and HIV/AIDS: 9 Malaria: 10 TB: 7 On Track/Fully Achieved

Remarks Malaria: All endemic countries and areas have costed strategies, some are reviewing programmes and will update strategies

1

2

STI and HIV/AIDS: 6; Malaria:

STI and HIV/AIDS: 8; Malaria:

STI and Malaria: Regional HIV/AIDS : Strategy on 4 Malaria: 6 Emergency Strategic Objective 2

WPR/RC64/3 page 64 Annex 1 guidelines for STI and HIV/AIDS, malaria and TB control developed, updated or adapted. 5; TB: 7 9; TB: 8 TB: 1 Response to Artemisinin Resistance for GMS developed;

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Continuous progress has been made, with all planned activities implemented and expected results achieved. Close collaboration between Regional Office and country office staff has resulted in effective country consultation for policy development and smooth dissemination of new guidelines and policies. All malaria endemic countries and areas have costed strategies; some are reviewing programmes and will update strategies. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Close collaboration and coordination with Member States is required to operationalize and implement the regional guidelines on HIV/AIDS, TB and malaria. Monitoring and impact evaluation and key elements of the strategies are required for improvement of interventions and sustainability of programmes. The emergency response to contain and eliminate artemisinin-resistant malaria requires a rapid response and the support of the relevant Member States to ensure its success. Cross-cutting issues such as surveillance, working across borders and research requires working in collaboration with different sectors within and outside of WHO, including community-based organizations. SUMMARY OF ACTIONS REQUIRED STI and HIV/AIDS: Implementation of regional guideline or guidance documents is important. Moreover, countries and areas and WHO country offices need to work closely with the civil societies and community-based organizations in implementing these guides.

Strategic Objective 2

WPR/RC64/3 page 65 Annex 1 Malaria: The 'One WHO' principle is required to facilitate the efficient and effective implementation of the Regional Framework for Action (2013–2015) of the Emergency Response to Artemisinin Resistance in the Greater Mekong Subregion. TB: Development and dissemination of guidelines and strategies requires close collaboration with partners and long-term follow-up to facilitate correct and successful implementation and evaluation. The latter should be documented through well-designed operational research and/or surveillance.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 2.2 Guidelines, policy, strategy and other tools developed for prevention of, and treatment and care for patients with, HIV/AIDS, TB and malaria, including innovative approaches for increasing coverage of the interventions among poor people, and hard-to-reach and vulnerable populations. Performance Indicators Number of targeted Member States with comprehensive policies and medium-term plans in response to HIV, TB and malaria. Proportion of high-burden countries and areas monitoring provider initiated HIV testing and counselling in sexually transmitted infection and family planning services. Number of countries and areas among the 63 ones with a high burden of HIV/AIDS and TB that are implementing the WHO 12Baseline 2012 HIV: 158 TB:119 Malaria: 92 Not available Target by 2013 HIV: 131/131 TB: 148 Malaria: 70/70 75% At risk Status by end 2012 On track

2.2.1

2.2.2

2.2.3

43

45 On track

Strategic Objective 2

WPR/RC64/3 page 66 Annex 1 point policy package for collaborative activities against HIV/AIDS and TB.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 02.002.WP01 Countries and areas implemented prevention, treatment and care interventions for STI, HIV/AIDS, malaria and TB and scaling-up to reach the most in need (incl. integrated training and service delivery; wider provider networks; strengthened lab capacities, etc.). Indicator Number of targeted countries and areas that have developed and are implementing integrated/coordinated policies on STI and HIV/AIDS and/or malaria and/or TB. Baseline 2012 8 Target by 2013 8 Achievement to date STI and HIV/AIDS: 8 Malaria: 5 TB: 11 On Track/Fully Achieved

Remarks Malaria: Under the AusAID flexible funding support, the three programmes worked together to develop integrated proposals in CHN, KHM, LAO, PHL and PNG Malaria: KOR will undergo a programme review towards intensified strategic interventions for malaria elimination

1

2

Number of supported countries and areas verified to have expanded interventions identified in their national STI and HIV/AIDS, malaria and TB control plans.

STI and HIV/AIDS: 6; Malaria: 9; TB: 11

STI and HIV/AIDS: 8; Malaria: 10; TB: 11

STI and HIV/AIDS: 8 Malaria: 5 TB: 11

Strategic Objective 2

WPR/RC64/3 page 67 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE HSI, MVP and Stop TB and Leprosy Elimination (STB) units in the WPRO continue to provide technical support to countries and areas with focus on national capacity building to ensure sustainability. Activities/expected results are mostly on track (32 of 36 reported OSERs). Three are at risk and one in trouble. Those at risk and in trouble are primarily delayed due to lack of funds. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Sustained effort is needed to reach populations most at risk for HIV/AIDS, malaria and TB and ensure access to quality-assured treatment. High coverage of disease interventions requires broad collaboration and partnerships with multiple sectors, including the private sector and civil society. Health system strengthening can assist in developing integrated approaches to treatment and prevention for sustainability of programmes. Malaria: WHO in-country presence and collaboration between WHO and Member States are important. Continuity of WHO TA is critical to delivering as planned. Capacity strengthening of country programmes to optimally absorb increasing amount of resources will be crucial. SUMMARY OF ACTIONS REQUIRED STI and HIV/AIDS: Close follow-up and timely communications are necessary for many of the interventions implemented in countries and areas. Continued support from WHO is required for many activities ranging from close monitoring to supporting specific additional interventions. Malaria: Continuous engagement with partners and stakeholders in planning, implementation, monitoring and evaluation is required. Resource mobilization efforts need to be intensified develop proposals and promote utilization of resources. Participate in Partners' meeting. Continue to support the implementation of the Emergency Response to Artemisinin Resistance (ERAR) Strategy –containment in the affected countries and areas and Artemisinin Resistance (AR) prevention in the entire Region, including accelerated recruitment of WHO Strategic Objective 2

WPR/RC64/3 page 68 Annex 1 ERAR team and facilitated WHO processes of the 'emergency' response. Continue to monitor therapeutic efficacy of antimalarial medicines and support evidence for policy/guideline review where necessary. TB: National TA planning and recruitment through the TB Technical Assistance Mechanism (TB TEAM) is successful in meeting country needs and preventing divergence and overlap of TA activities and outcomes. Regional Office and country office staff have complementary TA roles, which combined, put WHO in a very strong position with a comparative advantage over other agencies.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 2.3 Global guidance and technical support provided on policies and programmes in order to promote equitable access to essential medicines, diagnostic tools and health technologies of assured quality for the prevention and treatment of HIV/AIDS, TB and malaria, and their rational use by prescribers and consumers, and, in order to ensure uninterrupted supplies of diagnostics, safe blood and blood products, injections and other essential health technologies and commodities. Performance Indicators Number of new or updated global norms and quality standards for medicines and diagnostic tools for HIV/AIDS, TB and malaria. Number of priority medicines and diagnostic tools for HIV/AIDS, TB and malaria that have been assessed and pre-qualified for United Nations procurement. Number of targeted countries and areas receiving support to increase access to affordable essential medicines for Baseline 2012 41 Target by 2013 Medicines: 105 Status by end 2012 On track

2.3.1

2.3.2

300

350

On track

2.3.3

HIV/AIDS: 73 TB: 111

HIV/AIDS: 50 TB:107 Malaria:77

On track

Strategic Objective 2

WPR/RC64/3 page 69 Annex 1 HIV/AIDS, TB and malaria whose supply is integrated into national pharmaceutical systems (the number of targeted countries and areas is determined for the sixyear period). 2.3.4 Number of Member States implementing qualityassured HIV/AIDS screening of all donated blood. Number of Member States administering all medical injections using sterile single use syringes. Malaria: 64

109

125

NA

2.3.5

180

193 NA

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 02.003.WP01 Guidance and support provided for equitable access to essential medicines of assured quality for STI/HIV/AIDS, malaria and TB; and their rational use by prescribers and consumers; and uninterrupted supply of quality diagnostics, safe blood and essential commodities. Indicator Number of countries and areas supported to improve forecasting, procurement and supply management systems for STI and HIV/AIDS, malaria and TB medicines and other essential commodities. Baseline 2012 STI and HIV/AIDS: 5 Malaria: 9 TB: 23 Target by 2013 STI and HIV/AIDS: 5 Malaria: 9 TB: 27 Achievement to date On Track/Fully Achieved

Remarks

1

STI and KOR and MYS HIV/AIDS: 7 currently use MAL: 8 national resources to procure and TB: 23 supply.

Strategic Objective 2

WPR/RC64/3 page 70 Annex 1 2 Number of countries and areas supported in the monitoring of the quality of drugs and other commodities for STI and HIV/AIDS, malaria and TB prevention and control, and in the screening of blood. STI and HIV/AIDS: 5; Malaria: 9; TB: 23 STI and HIV/AIDS: 5; Malaria: 10; TB: 27 STI and HIV/AIDS (7) MAL (9) TB (23) KOR will soon undergo comprehensive malaria programme review.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE STI and HIV/AIDS: Continuous progress has been made to ensure supply of quality antiretroviral and other essential commodities for diagnosis and treatment. Malaria: Nine of ten endemic countries and areas use artemisinin-based combination therapy (ACT) and were supported to improve forecasting, procurement and supply management systems for antimalarial medicines. Access to recommended medicines improved in most endemic countries and areas. TB: Forecasting and supply management was supported. Regional Office assisted countries and areas to access pre-qualified TB drugs. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Drug resistance is a major issue, with multidrug resistant TB, artemisinin-resistant malaria, and drug-resistance to HIV all posing risks reducing their morbidity and mortality. Assuring quality and rational use of medicines are needed, and require strong collaboration with other sectors, including the private sector. WHO will continue to support Member States in ensuring adequate supply of medicine and diagnostics through evidence-based planning and monitoring.

Strategic Objective 2

WPR/RC64/3 page 71 Annex 1 Malaria: Huge gaps exist in country level operational funds and for WHO TA in at risk countries and areas that are not currently covered under the ERAR Project. Changes in donors' landscape makes financial predictability uncertain. SUMMARY OF ACTIONS REQUIRED STI and HIV/AIDS: It is important for the national AIDS programme to take action in phasing out more toxic d4T (stavudine, Zerit) and introducing less toxic but more effective antiretroviral. This needs strong advocacy from the international communities including WHO and civil societies. Malaria: In 2013, all ten endemic countries and areas will conduct gap analysis of all commodities required to achieve universal access as required for the WHA 2015 set target. This will be reviewed during the regional malaria programme managers meeting in May 2013 for effective planning and resource mobilization. Under the Regional Framework for Action (2013–2015) of the Emergency Response to Artemisinin Resistance in the Greater Mekong Subregion, a major component is drug quality monitoring which will be done through provision of TA at regional and country levels. TB: Laboratory inventory will be updated in 2013. The introduction of new WHO approved diagnostics requires intensified support.

Strategic Objective 2

WPR/RC64/3 page 72 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.4 Global, regional and national systems for surveillance, evaluation and monitoring strengthened and expanded to keep track of progress towards targets and allocation of resources for HIV/AIDS, TB and malaria control and to determine the impact of control efforts and the evolution of drug resistance. Performance Indicators Number of Member States providing WHO with annual data on surveillance, monitoring or financial allocation data for inclusion in the annual global reports on control of HIV/AIDS, TB or malaria and the achievement of targets. Number of Member States reporting drug resistance surveillance data to WHO for HIV/AIDS, TB or malaria. Baseline 2012 HIV: 157, TB: 208; Malaria: 105 Target by 2013 Status by end 2012

2.4.1

HIV/AIDS: 130 On track TB: 198 Malaria: 107

2.4.2

HIV: 61, TB: 127, Malaria: 73

HIV/AIDS: 75 TB: 130 Malaria: 107

On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 02.004.WP01 Regional and national surveillance, evaluation and monitoring strengthened and expanded to monitor progress towards targets and resource allocations for STI and HIV/AIDS, malaria and TB control, incl. drug and insecticide resistance and impact of control efforts. Indicator Number of countries and areas that regularly collect, analyse and report STI and Baseline 2012 STI and HIV/AIDS: 9; Malaria: 10; TB: 36 Target by 2013 STI and HIV/AIDS: 9; Malaria: 10; TB: 36 Achievement to date STI and HIV/AIDS (9), MAL (10), TB (36) On Track/Fully Achieved

Remarks All ten endemic countries and areas collected and reported annual malaria

1

Strategic Objective 2

WPR/RC64/3 page 73 Annex 1 HIV/AIDS, malaria and TB surveillance data and coverage, using WHO's standardized methodologies, including appropriate age and sex disaggregation 2 Number of countries and areas that regularly collect and report STI and HIV/AIDS, malaria and TB programme monitoring and evaluation data (including financial data) and core indicators and targets. Number of countries and areas reporting on surveillance and monitoring of STI and HIV/AIDS, malaria and TB drug resistance. STI and HIV/AIDS: 9; Malaria: 10; TB: 36 STI and HIV/AIDS: 9; Malaria: 10; TB: 36 STI and HIV/AIDS (9), MAL (10), TB (36) surveillance data to the Regional Office based on WHO standard. Monthly surveillance data are available at country level.

All endemic countries and areas reported programme monitoring and evaluation (M&E) data on core indicators using WHO (World Malaria Report (WMR) standard.

3

STI and HIV/AIDS: 4 (HIV); 10 (STI); Malaria: 10; TB: 18

STI and HIV/AIDS: 5 (HIV); 10 (STI); Malaria: 10; TB: 23

HSI (9), CHN, KHM, and MAL (4), TB VNM conducted (34) Therapeutic Efficacy Survey (TES) in 2012. While LAO carried over from 2011 in 2012. Four are scheduled for 2013. KOR and MYS are yet to be active on the Antimalarial Drug Resistance Monitoring Network.

Strategic Objective 2

WPR/RC64/3 page 74 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE STI and HIV/AIDS: All priority countries and areas in the Region continue to provide surveillance and response data on HIV and STI to WHO and other UN agencies. Malaria: Surveillance and programme data from all endemic countries and areas were summarized in 2012, using the malaria indicators from the Global Malaria Programme and the Regional Action Plan for Malaria Control and Elimination in the Western Pacific (2010–2015). Annual country and regional malaria profiles were produced including data on drug resistance. TB: Data collection covers all countries and areas including on Drug Resistant (DR) TB and vulnerable groups. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Importance of surveillance, monitoring and evaluation are emphasized in regional and country plans, however more effort are required in establishing high-quality systems, and integrating them into the broader health system. Malaria: Improvement is required in quality, completeness and timely submission of surveillance data in many countries and areas. SUMMARY OF ACTIONS REQUIRED STI and HIV/AIDS: Further attention should be paid to the emerging and fast growing HIV epidemic among MSM and transfer people in the Region.

Strategic Objective 2

WPR/RC64/3 page 75 Annex 1 Malaria: Support to countries and areas is required to ensure timely, quality assured surveillance data are gathered and periodically reported in epidemiological bulletins; reports including annual country programme and project reports, should be prepared and shared; intensive therapeutic efficacy studies across the Region should be conducted; conduct comprehensive malaria programme review in KOR and PNG; and follow up on the KHM review. Sub-national level assessment of surveillance, monitoring and evaluation capacities are required and findings translated to necessary training or re-training (including hands-on data management in the field). Malaria drug resistance monitoring needs to be intensified throughout the Region. TB: Training on recording and reporting for clinical staff will improve quality. Making TB a notifiable disease will give the legal backing to improve reporting coverage in countries and areas, such as China.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 2.5 Political commitment sustained and mobilization of resources ensured through advocacy and nurturing of partnerships on HIV/AIDS, TB and malaria at country, regional and global levels; support provided to countries and areas as appropriate to develop or strengthen and implement mechanisms for resource mobilization and utilization and increase the absorption capacity of available resources; and engagement of communities and affected persons increased to maximize the reach and performance of HIV/AIDS, TB and malaria control programmes. Performance Indicators Number of Member States with functional coordination mechanisms for HIV/AIDS, TB and malaria control. Number of Member States involving communities, persons affected by the diseases, civil-society organizations and the Baseline 2012 HIV: 152, TB:122 and Malaria: 76 HIV: 147, TB: 100 and Malaria: 76 Target by 2013 Status by end 2012

2.5.1

HIV/AIDS: 131 On track TB: 120 Malaria: Not available HIV/AIDS: 131 TB: 87 Malaria: 70 On track

2.5.2

Strategic Objective 2

WPR/RC64/3 page 76 Annex 1 private sector in planning, design, implementation and evaluation of HIV/AIDS, TB and malaria programmes.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 02.005.WP01 Political commitment and resource mobilization through advocacy and nurturing partnerships at all levels; support to countries and areas to develop/implement mechanisms for resource mobilization and utilization; engagement of communities and affected persons. Indicator Number of targeted countries and areas that receive WHO support in accessing financial resources or increasing absorption of funds for STI and HIV/AIDS, malaria and TB control. Number of targeted countries and areas with verifiable active involvement of communities, people living with HIV/AIDS, mostat-risk populations, civil society organizations and the private sector in planning, design, implementation and evaluation of STI and HIV/AIDS, Baseline 2012 STI and HIV/AIDS: 7; Malaria: 8; TB: 17 Target by 2013 STI and HIV/AIDS: 7; Malaria: 8; TB: 17 Achievement to date STI AND HIV/AIDS: 9; MAL: 10; TB: 17 On Track/Fully Achieved

Remarks Eight out of ten were supported by WHO to access increased funds. All endemic MAL (ten) countries and areas showed increasing funds absorption capacities.

1

2

STI and HIV/AIDS: 9; Malaria: 10; TB: 12

STI and HIV/AIDS: 9; Malaria: 10; TB: 14

STI and HIV/AIDS: 9; MAL: 10; TB: 14

In all endemic countries and areas, there is increasing engagement of the at risk communities.

Strategic Objective 2

WPR/RC64/3 page 77 Annex 1 malaria and TB programmes.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE STI and HIV/AIDS and TB: TB and HIV remain high on the agenda of high priority countries and areas, with renewed commitment at the UN High-Level Meeting in 2011 and other regional events. Malaria: Strong commitment to fight malaria in the Asia-Pacific Region was mobilized through the Malaria 2012 Saving Lives in the Asia Pacific Conference in Sydney, Australia and the Seventh East Asia Summit in Phnom Penh, Cambodia. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Challenges remain in resource mobilization in view of the current constrained economic environment and reduction of aid from donors. WHO will continue to provide technical advice and support for preparation of applications for the new funding mechanism for Global Fund for AIDS, TB, and Malaria. Sustaining the efforts for the progress in reducing HIV/AIDS, TB and malaria, as well as reaching mandated targets for elimination, requires continued support from external partners and Member States. Malaria: Sustaining the increasing malaria profile, redeeming pledges from partners and partnership coordination will require dedicated effort of WHO and ownership by Member States.

Strategic Objective 2

WPR/RC64/3 page 78 Annex 1 SUMMARY OF ACTIONS REQUIRED STI and HIV/AIDS: WHO needs to work with partners and Member States to continue to advocate for narrowing the gap of prevention and treatment in countries and areas, in terms of political commitment and investment. Malaria: WHO should support and follow up on the priority actions signed during the Malaria 2012 — Saving Lives in the Asia Pacific Conference in Sydney; - the signed declaration on regional responses to malaria control and; addressing resistance to antimalarial medicines in the Seventh East Asia Summit in Phnom Penh. WHO needs to support countries and areas in planning their programme implementation to reach the 2015 targets of 75% reduction of malaria incidence and mortality rates. This support should include the implementation of the Regional Framework for Action (2013-2015) for the Emergency Response to Artemisinin Resistance to GMS. Country gap analysis will be part of these activities. Regional public private policy/guideline needs to be developed. TB: Further evidence is needed to inform and strengthen the dialogue with national governments and partners.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 2.6 New knowledge, intervention tools and strategies developed and validated to meet priority needs for the prevention and control of HIV/AIDS, TB and malaria, with scientists from developing countries and areas increasingly taking the lead in this research. Performance Indicators Number of new and improved tools or implementation strategies for HIV/AIDS, TB or Baseline 2012 17 Target by 2013 Status by end 2012 13 On track

2.6.1

Strategic Objective 2

WPR/RC64/3 page 79 Annex 1 malaria implemented by the public sector in at least one developing country. 2.6.2 Proportion of peer-reviewed publications arising from WHO-supported research on HIV/AIDS, TB or malaria and for which the main author’s institution is based in a developing country. 61% 60% On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 02.006.WP01 Operational research for the prevention and control of STI and HIV/AIDS, malaria and TB supported and research capacity strengthened in target countries and areas. Indicator Number of new operational research projects in the field of STI and HIV/AIDS, malaria and TB prevention and control supported by WHO in the Region Baseline 2012 STI and HIV/AIDS: 4; Malaria: at least 12; TB: at least 6 Target by 2013 STI and HIV/AIDS: 6; Malaria: at least 10 (1/country); TB: 10 Achievement to date STI and HIV/AIDS: 6 Malaria: 4, TB: 7 On Track/Fully Achieved Remarks HIV: (CHN, KHM, VNM) service delivery, HIV testing strategy to pregnant women, and Treatment as Prevention (TasP). Malaria: 3 Drug Efficacy Studies (CHN, KHM, VNM), primaquine study in KHM. TB: WPRO TB Operational Research Grants in CHN (5), PHL (1) or in VUT (1).

1

2

Number of countries and areas actively pursuing operational research

STI and HIV/AIDS: 5;Malaria: 10; TB: at

STI and HIV/AIDS: 5;Malaria:

STI and STI and HIV/AIDS: HIV/AIDS: CHN, 3, Malaria: KHM, and VNM. Malaria: All Strategic Objective 2

WPR/RC64/3 page 80 Annex 1 in the field of STI and HIV/AIDS, malaria and TB with verifiable involvement of local institutions. least 6 10; TB: 10 10, TB:3 malaria endemic countries and areas. TB: CHN, VUT, and PHL.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE As a regional strategy all three programmes supported research, with partners. Six research studies were implemented on HIV. STB supported seven studies via TB Operational research grants. Malaria programme supported three drug efficacy studies in CHN, KHM and VNM; a primaquine safety study in KHM. DCC developed a Regional Research Framework to Strengthen Communicable Disease Control and Elimination in the Western Pacific 2013-2017 through an interunit collaboration. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Operational research remains a core function of WHO. Plans for the strengthening of research in the WPR require the support of external partners and Member States. SUMMARY OF ACTIONS REQUIRED STI and HIV/AIDS: WHO country and Regional Office staff members have to engage in writing and reporting against competitive proposals to external donors. Malaria: Research capacity and coordination needs to be strengthened in most countries and areas. For example, KHM as the epicentre of antimalarial drug resistance attracts many scientists and research institutions, and support is needed to coordinate research activities. Further involvement of other research institutions, networks and WHOCCs is important to identify national research priorities as well as to implement research components of the Regional Action Plan for Malaria Control and Elimination in the Western Pacific (2010–2015). Translation of research findings to programmes remains a huge task that needs to be strengthened. Improved intersectoral collaboration is an important prerequisite to integrate data on climate change studies and this should also be strengthened.

Strategic Objective 2

WPR/RC64/3 page 81 Annex 1 TB: A scientific writing workshop is planned in the near future, which will assist researchers in finalizing their reports and journal articles. Close coordination is also required for future rounds to ensure that a diversity of projects is funded from various countries and areas.

Strategic Objective 2

WPR/RC64/3 page 82 Annex 1 STRATEGIC OBJECTIVE 3

TO PREVENT AND REDUCE DISEASE, DISABILITY AND PREMATURE DEATH FROM CHRONIC NONCOMMUNICABLE DISEASES, MENTAL DISORDERS, V IOLENCE AND INJ URIES AND V ISUAL IMPAIRMENT EXPECTED RESULT 03.001 03.002 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS DHP, FJI, MNG, PIC, RDO, TKL and VUT CHN, COK, DHP, FSM, KHM, KIR, LAO, MNG, MYS, PHL, PIC, PNG, and VNM DHP, MNG, PHL, PIC, SLB, and TON CHN, DHP, MNG, and MYS DHP, MNG, MYS, PIC, and VNM BRN, DHP, FJI, FSM, MNG, MYS, NRU, PHL, PIC, SLB, TON, VNM, and WSM TOTAL 7 13 6 4 5 13

03.003 03.004 03.005 03.006

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Noncommunicable diseases (NCD) prevention and control has become a regional and national priority in most Member States. Member States have scaled up and expanded surveillance, prioritized risk reduction and strengthened health systems for NCD prevention and management in primary health care. Progress has also been achieved in the area of mental health, although much more effort needs to be in place especially to raise the profile and awareness of this issue. Innovative work has also taken place in the area of suicide prevention. Momentum is picking up for the area of blindness prevention, disability and rehabilitation as both are relatively new programmes in the Region. Regional programmes on violence and injury prevention will continue to scale up following the first regional committee resolution on the topic in 2012. CHALLENGES/ISSUES Prevention and control of NCDs and their risk factors remain the major public health issue/challenge. The NCDs, mainly cardiovascular diseases, cancer, diabetes and chronic

Strategic Objective 3

WPR/RC64/3 page 83 Annex 1 respiratory diseases impose a major and growing burden on health and development in the WPR. NCDs have to be recognized as a health and development issue. Almost half of NCD deaths in low- and middle-income countries and areas of the Region occur prematurely, below the age of 70 years. NCDs are driven by risk factors such as tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol — all of which are preventable. Globalization, rapid and unplanned urbanization and an ageing population contribute to the rise in NCDs. Health systems in low- and middle-income countries and areas are not oriented to chronic care and the continuum of care. There is also limited social and financial protection for people with NCDs as well as limited capacity for prevention and control of NCDs in countries and areas. Member States have to develop and strengthen national multisectoral mechanisms with a ‘whole—of—Government’ approach to address risk factors. Targets for NCD prevention and control, depending on the local context, have to be set aligned to the set of voluntary global targets. Primary care services need strengthening with a defined package of services. An estimated 90 million people have visual impairment in the Region, with over 10 million people blind and 80 million people with low vision. Visual impairment can be debilitating to individuals and their families. An estimated 80% of visual impairment is avoidable and can be treated or prevented. Educational opportunities, gainful employment and productivity are severely compromised by the loss of sight and poor vision. These problems are more pronounced among the poor who do not have access to basic eye care. The issue also affects older people and is expected to increase as a public health problem due to population growth and longer life expectancy in the Region. Recent statistics show that depression is the leading cause of disability worldwide. More than 225 000 people commit suicide every year in the WPR and 80% of people with mental disorders in developing countries and areas do not receive treatment. Disability prevalence is high and growing. In the WPR, there are an estimated 270 million people living with a disability. This prevalence is increasing due to the significant increases in population ageing, chronic disease and injuries. Disability disproportionately affects vulnerable groups and people with disabilities face widespread barriers in accessing services such as health, rehabilitation, education, employment and transportation, and they generally have worse health and socioeconomic outcomes.

Strategic Objective 3

WPR/RC64/3 page 84 Annex 1 In more specific terms, the work under this Strategic Objective (SO) focuses on the following: policy development, implementation of prevention programmes, strengthening of health and rehabilitation systems, capacity-building, and monitoring and evaluation. The areas under the SO are NCDs, visual and hearing impairment, mental, behavioural and neurological disorders, including those related to psychoactive substance use, injuries due to road traffic crashes, drowning, burns, poisoning, falls, violence in the family and the community and disabilities of all types. SUMMARY OF ACTIONS REQUIRED There is a need to generate reliable and timely NCD data on mortality, morbidity, risk factors and national system response; expand and intensify interventions to reduce risk factors and prevent NCDs; promote policy, regulatory and fiscal interventions to reduce risk factors and to promote healthy behaviours; strengthen the health systems to prevent and manage NCDs. For mental health, there is a need to set up or strengthen leadership and coordination mechanisms for strategic planning, needs assessment, multisectoral collaboration and service evaluation; mainstream mental health and the rights of people with mental disorders into all health and other sector policies and strategies; build up community-based mental health services including outreach services, home care, rehabilitation and supported housing; ensure the availability and the rational use of essential medicines for mental disorders at all levels of the health system; and to develop comprehensive national strategies for the prevention of suicide, with special attention to high-risk groups based on the local context. For blindness prevention, there is a need for national policies, plans and programmes for eye health to be developed or strengthened and that eye health is integrated at the primary care level. In disability and rehabilitation, there is a need to support national disability policy dialogue and mainstreaming of disability into all systems and services, strengthen the rehabilitation sector planning, coordination and service delivery and to expand coverage and quality of CBR Services. Key areas of work for scaling up action in violence and injury prevention including road safety include advocacy, legislation and policies, enforcement, capacity building and professional development, social marketing and communications, and interventions and evaluation. There is also a need to assist countries and areas to strengthen data systems to efficiently capture injury events and timely and appropriate responses to victims of trauma and injury. Strategic Objective 3

WPR/RC64/3 page 85 Annex 1 There are no foreseeable reallocations or reprogramming of funds expected. There is a huge momentum in the work of NCD in this Region as well as a very strong commitment to the work of prevention of blindness and disability and rehabilitation. Thus implementation of activities in these areas under this SO are expected to intensify for 2013.

Strategic Objective 3

WPR/RC64/3 page 86 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATOR TARGETS OWER 3.1 Advocacy and support provided to increase political, financial and technical commitment in Member States in order to tackle chronic noncommunicable diseases, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 3.1.1 Number of Member States whose health ministries have a focal point or a unit for injuries and violence prevention with its own budget. The world report on disability and rehabilitation published and launched, in response to resolution WHA58.23. Number of Member States with a mental health budget of more than 1% of the total health budget. Number of Member States with a unit in the ministry of health or equivalent national health authority, with dedicated staff and budget, for the prevention and control of chronic noncommunicable diseases. 164 170 On track

3.1.2

The report was published in six languages

deleted in 2012/13

3.1.3

100

110 on track

3.1.4

165

152

on track

Strategic Objective 3

WPR/RC64/3 page 87 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 03.001.WP01 Increased political, financial and technical commitment in Member States in order to tackle chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness. Indicator Number of Member States whose health ministries have a focal point or unit for injuries and violence prevention with its own budget. Baseline 2012 25 Target by 2013 Achievement to date On Track/Fully Achieved

Remarks CHN, FJI, KHM, LAO, MNG, MYS, NEZ, PHL, SLB, TON, TUV, VNM, and VUT. An official request for nomination of focal persons will be sent out again to Member States as part of the preparations for the regional meetings on Violence and Injury Prevention in November 2013. FJI, KHM, LAO, and MNG are undertaking specific activities in relation to recommendations in the World Report on Disability and Rehabilitation.

1

27 13 Focal persons are identified in 13 countries and areas with feedback still pending from remaining offices

2

Follow-up of the publication and launch of the World Report on Disability and Rehabilitation, in response to resolution WHA58.23. Number of Member States with a mental health budget of more than 1% of the total health

Report launched

Implement ation of recommend ations started in six countries and areas

Implementati on of recommendat ions started in four countries and areas

3

2

6

4 KHM and MNG reported significant increases of investment for Strategic Objective 3

WPR/RC64/3 page 88 Annex 1 budget. 4 Number of Member States with a unit in the ministry of health or equivalent national health authority, with dedicated staff and budget, for the prevention and control of chronic noncommunicable conditions. 12 14 mental health. 14 AUS, CHN, COK, FJI, JPN, KOR, MNG, MYS, NRU, PHL, SGP, TON, VUT and WSM Two countries (CHN and MYS) have strengthened the national unit for NCD prevention and control with multisectoral engagement.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Member States have prioritized NCD prevention and control. Impact of NCDs including economic impact has been an important consideration in the national health and development process. Mental health has been identified as one of the top priorities by Pacific health ministers and existing networks for mental health remain active. The Pacific Community-Based Rehabilitation network has been established. Regional wheelchair training was conducted in Hong Kong (China) (HOK) in September 2012. A Pacific regional CBR training was conducted in FJI in June 2012. WHO provided technical input to the development of the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) Incheon Strategy, Decade for Action for Disability. The World Report on Disability was launched in 2012 in Cambodia (KHM), the Lao People’s Democratic Republic (LAO) and Mongolia (MNG) at the Pacific Disability Ministers’ meeting and an executive summary was translated into respective languages. It was also shared at regional events (e.g. Pan-Pacific Rehabilitation World Blind Union Global Conference, Beijing Disability Forum). Member States deliberated on injury and violence prevention at the 63rd Regional Committee Meeting and a resolution (WPR/RC63.R3) was passed urging WHO to support Member

Strategic Objective 3

WPR/RC64/3 page 89 Annex 1 States in their efforts to strengthen or develop and implement national policy and action plans to strengthen violence and injury prevention; to provide assistance in building technical capacity at all levels in order to strengthen the response to violence and injuries, including surveillance, evidence-based practice and evaluation; and to facilitate sharing of best practices across sectors, countries and areas. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE There is a general lack of capacity for mental health advocacy in WHO country offices and in ministries of health in Member States. Staffing levels and financial resources for violence and injury prevention are particularly low when considering the burden of disease and economic impact. Advocacy is needed to place NCD as a health and development agenda item and to receive adequate resources for its prevention and control. SUMMARY OF ACTIONS REQUIRED For mental health, there is a need to support capacity building for leadership and advocacy for government focal points for mental health.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATIONWIDE EXPECTED RESULTS, INCLUDING INDICATOR TARGETS OWER 3.2 Guidance and support provided to Member States for the development and implementation of policies, strategies and regulations in respect of chronic noncommunicable diseases, mental and neurological disorders, violence, injuries and disabilities together with visual impairment, including blindness. Performance Indicators Baseline Target by Status by end 2012 2013 2012 3.2.1 Number of Member States that have national plans to prevent unintentional injuries or violence. Number of Member States that have initiated the process of developing a 133 94 On track

3.2.2

56

64 On track

Strategic Objective 3

WPR/RC64/3 page 90 Annex 1 mental health policy or law. 3.2.3 Number of Member States that have adopted a multisectoral national policy on chronic noncommunicable diseases. Number of Member States that are implementing comprehensive national plans for the prevention of hearing or visual impairment. 121 105 On track

3.2.4

59

130

On track CHN, FJI, KHM, LAO, MNG, PHL, PNG, SLB, and VNM

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 03.002.WP01 Enhanced capacity of Member States for the development and implementation of policies, strategies and regulations in respect of chronic noncommunicable conditions, mental and neurological disorders, violence, injuries and disabilities. Indicator Number of Member States that have national plans to prevent unintentional injuries or violence. Baseline 2012 8 Target by 2013 12 Achievement to date On Track/Fully Achieved

Remarks

1

19 About 19 countries and areas in the Region have some form of strategy for injury/violence prevention as a whole or for individual injury or violence types (road safety, drowning, and violence against women. These are AUS, BRN, CHN, COK, KHM, FJI, JPN, KIR, KOR, LAO, MHL, MYS, NEZ, PHL, PLW, SGP, TON, VNM and WSM.

Strategic Objective 3

WPR/RC64/3 page 91 Annex 1 2 Number of Member States that have initiated the process of developing a mental health policy or law. Number of Member States that have adopted a multisectoral national policy on chronic noncommunicable conditions with linkage to overall national health and development plan. Number of Member States that have developed and implemented national plans for the prevention of blindness and visual impairment, integrated into Strategic Health Plans and National Development Plans. 10 14 12 National mental health strategic plan endorsed in LAO and ongoing work on mental health policy in FSM. 15 AUS, CHN, COK, FJI, FSM, JPN, KIR, KOR, MNG, MYS, NRU, SGP, TON, VUT, and WSM.

3

13

15

4

4

9

9 CHN, FJI, KHM, LAO, MNG, PHL, PNG, SLB, and VNM.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Multisectoral action for NCD prevention and control has been taken up as a priority and two countries, CHN and MYS, have already developed a multisectoral plan with the engagement of multiple ministries. Efforts are ongoing in four countries: BRN, KHM, LAO and VNM to develop a multisectoral plan for NCDs. In the PHL, a draft policy on implementing the essential NCD package for primary health care was developed with the Department of Health. In VNM, the development of the National Overarching Policy (NOP) for NCD prevention and control 2013–2020 is in progress. At the request of the Ministry of Health, WHO has Strategic Objective 3

WPR/RC64/3 page 92 Annex 1 completed the preparation of comprehensive recommendations for priority approaches under the NOP. Improved national plans for blindness prevention as a result of reviews and technical planning support provided to CHN, FJI, KHM, LAO, MNG, PHL, SLB and VNM. WPR has an action plan for the prevention of blindness that is under development and will be presented to the sixty-fourth session of the World Health Organization Regional Committee for the Western Pacific in 2013. Technical support was provided to national programmes for the control and elimination of trachoma in the Mekong countries and some PIC. CHN adopted its first Mental Health Law. A number of countries are developing/updating mental health (FSM, LAO and MNG) and alcohol-related (KHM, LAO, MNG and VNM) plans, policies and laws. The government of LAO endorsed its first National Strategic Plan for Mental Health. MYS launched a national strategy on suicide prevention. In CHN, KHM and VNM, the Road Safety in Ten Countries (RS10) project continues to show excellent progress. In all those three countries, national and provincial workplans for 2012 focusing on key areas such as legislation, enforcement, social marketing and advocacy and capacity building, were fully implemented. In VNM, enforcement activities on child helmet wearing were implemented between September and December 2012 in five districts of Ho Chi Minh City. Over this time, police issued more than 3500 infringements or warnings to adults carrying children over 6 years of age without a helmet. Associated with the police presence, helmet wearing in children has increased by 16% (22%–38%). SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Many countries and areas in the Region have not yet developed national eye health plans. Where plans exist, regular reviews and progress evaluations are important, yet commonly not carried out. Mental health remains largely isolated from mainstream health services and from efforts related to mental health care by other sectors. Multisectoral collaboration for injury and violence prevention needs to be strengthened. Strategic Objective 3

WPR/RC64/3 page 93 Annex 1 Building national capacity is needed for developing and implementing NCD prevention and control through multisectoral actions. SUMMARY OF ACTIONS REQUIRED There is a need to support establishment of coordination mechanisms at country level. Member States are requested to develop comprehensive national eye health plans that include budgets. Where plans exist, national eye care programmes are requested to regularly review and evaluate progress towards achieving national eye health targets. Building national capacity, especially among non-health sectors, to address NCD prevention and control through development of policies and implementation of programmes.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATIONWIDE EXPECTED RESULTS, INCLUDING INDICATOR TARGETS OWER 3.3 Improvements made in Member States’ capacity to collect, analyse, disseminate and use data on the magnitude, causes and consequences of chronic noncommunicable diseases, mental and neurological disorders, violence, injuries and disabilities together with visual impairment, including blindness. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 3.3.1 Number of Member States that have submitted a complete assessment of their national road traffic injury prevention status to WHO during the biennium. Number of Member States that have a published document containing national data on the prevalence and incidence of disabilities. Number of low- and middleincome Member States with basic mental health indicators annually reported. 175 180 On track

3.3.2

193

168 On track

3.3.3

110

120

On track

Strategic Objective 3

WPR/RC64/3 page 94 Annex 1 3.3.4 Number of Member States with a national health reporting system and annual reports that include indicators for the four major noncommunicable diseases. Number of Member States documenting, according to population-based surveys, the burden of hearing or visual impairment. 101 155 On track

3.3.5

47

42 On track

CHN, FJI, KHM, LAO, MNG, PHL, PNG, and VNM

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 03.003.WP01 Enhanced capacity of Member States to collect, analyse, disseminate and use data on magnitude, causes and consequences of chronic noncommunicable conditions, mental and neurological disorders, violence, injuries and disabilities, visual impairment and blindness. Indicator Number of Member States that have submitted a complete assessment of their national road traffic injury prevention status to WHO during the biennium. Baseline 2012 0 Target by 2013 27 Achievement to date On Track/Fully Achieved

Remarks

1

25 The following countries and areas have completed data collection for the 2nd global report on road safety: AUS, BRN, CHN, COK, FJI, JPN, KHM, KIR, KOR, LAO, MHL, MNG, MYS, NEZ, NIU, PHL, PLW, PNG, SGP, SLB, TON, VNM, VUT and WSM. 7 NEZ and VNM are the two additional countries and areas that have a

2

Number of Member States that have a published document

5

20

Strategic Objective 3

WPR/RC64/3 page 95 Annex 1 containing national data on the prevalence and incidence of disabilities. published document containing national data on the prevalence and incidence of disabilities. 5 7 7 Combined report on mental health indicators based on hospital statistics and survey results available for CHN, FJI, KHM, LAO, MNG, MYS, and TON. 15 Two countries (MNG and PHL) have regular reporting of NCDs and their risk factors. Countries were supported for developing and strengthening national NCD surveillance systems as per the global monitoring framework. 6 CHN, KHM, FJI, LAO, MNG, PHL, and VNM are currently undertaking a national blindness survey. Survey is planned for PNG but uncertain whether to be achieved.

3

Number of lowand middleincome Member States that annually report basic mental health indicators.

4

Number of Member States with a national health reporting system and annual reports that include indicators for the four major noncommunicable diseases.

13

15

5

Number of lowand middleincome Member States documenting, according to population based surveys, the burden and causes of visual impairment, including blindness.

3

8

Strategic Objective 3

WPR/RC64/3 page 96 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE WHO STEPwise approach to surveillance (STEPS) survey analysis and reporting was completed in three countries and areas: COK, FSM and PYF. In TON, NCD risk factors STEPS report was published by the Ministry of Health and WHO in September 2012. An intercountry workshop was held in Seoul, Republic of Korea (KOR) to support Member States (KHM, LAO, MNG, PHL and VNM) on surveillance and monitoring of NCDs. Cancer registration has been identified as a component of a national surveillance framework and KHM was supported to start hospital-based cancer registry. Stroke registry was initiated in MNG. LAO utilized the Washington Group Questions in upcoming census – 2013 for disability and rehabilitation. Data collection for the Global Status Report on Alcohol and Health was completed by all Member States. Data collection for the 2nd global status report on road safety was completed by all Member States with results being compiled for global and regional reporting in early 2013. Training and technical advice on the International Classification of Functioning, Disability and Health were provided in MNG. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE While ad-hoc surveys provided important information on the magnitude of mental health related problems and resources available for mental health service, it is imperative to develop relevant indicators and measures to be reported as a part of routine practices. When reported, the status report results will serve as a baseline assessment by which progress in achieving the objectives of the United Nations Decade of Action for Road Safety will be measured. There is a lack of epidemiological survey data for visual impairment in PIC. This is a barrier to evidence based planning of eye care interventions.

Strategic Objective 3

WPR/RC64/3 page 97 Annex 1 Comprehensive surveillance systems are essential for monitoring the trends and assessing progress made in the implementation of national strategies and plans on NCDs, especially the attainment of the set of voluntary global targets for the prevention and control of NCDs. SUMMARY OF ACTIONS REQUIRED Member States are encouraged to carry out epidemiological surveys to establish the prevalence and main causes of visual impairment to either collect baseline data or assess change over time. Systematic review of mental health indicators applied and reported in Member States. Recommend basic indicators for mental health based on review and experiences from ad-hoc surveys. Develop and strengthen comprehensive surveillance systems for NCD prevention and control aligned to the proposed global NCD monitoring framework.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATIONWIDE EXPECTED RESULTS, INCLUDING INDICATOR TARGETS OWER 3.4 Improved evidence compiled by WHO on the cost-effectiveness of interventions to tackle chronic noncommunicable diseases, mental and neurological and substance-use disorders, violence, injuries and disabilities together with visual impairment, including blindness. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 3.4.1 Availability of evidencePublished and based guidance on the disseminated for effectiveness of 12 interventions interventions for the management of selected mental, behavioural or neurological disorders including those due to use of psychoactive substances. Availability of evidencebased guidance or guidelines on the effectiveness or costPublished and disseminated for 6 interventions Published and disseminated for 14 interventions On track

3.4.2

Published and disseminated for eight

On track

Strategic Objective 3

WPR/RC64/3 page 98 Annex 1 effectiveness of interventions for the prevention and management of chronic noncommunicable diseases. interventions

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 03.004.WP01 Evidence and knowledge base available on costeffectiveness of interventions to tackle chronic noncommunicable conditions, mental & neurological & substance-use disorders, violence, injuries & disabilities together with visual impairment, including blindness. Indicator Availability of evidence-based guidance on the effectiveness of interventions for the management of selected mental, behavioural or neurological disorders including those due to use of psychoactive substances. Availability of evidence-based guidance or guidelines on the effectiveness or costeffectiveness of interventions for the prevention and management of chronic noncommunicable diseases. Baseline 2012 3 Target by 2013 5 Achieveme nt to date On Track/Fully Achieved

Remarks

1

5 Guidelines produced for management of postpartum depression (CHN) and for monitoring and interventions of child psychological development.

2

WHO NCD manageme nt guidelines piloted in one setting in one country

Five settings in five countries to introduce WHO NCD package

14 Fourteen countries CHN, COK, FJI, FSM, KHM, KIR, LAO, MHL, PHL, SLB, TON, VUT, VNM, and WSM have partially adapted and introduced the WHO package of essential NCD interventions (PEN).

Strategic Objective 3

WPR/RC64/3 page 99 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Fourteen countries have adapted the WHO PEN: CHN, COK, FJI, KHM, KIR, LAO, MHL, the FSM, the PHL, WSM, SLB, TON, VUT and VNM. Work on rolling out of PEN in Member States is likely to intensify. For example, the PEN interventions are being piloted in one province in SLB. WPRO supported translation and dissemination of WHO reports and guidelines: Mental Health Gap Action Programme (mhGAP) intervention package in CHN, LAO and VNM; dementia report in CHN. A resource kit was developed to support consultations with media on mental health and suicide prevention in HOK, KOR, the PHL and VNM. Two training courses for community health workers on Cognitive Behavioural Therapy (CBT) to mental disorders were successfully held in Guanxi and Inner MNG in 2012. Approximately 108 participants were trained on the basic theory and concepts of CBT, and gained related knowledge and skills of CBT on interventions for depression and suicide prevention and treatment. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Application of mental health intervention package requires more supporting tool and additional resources for adaptation, training of trainers, etc. SUMMARY OF ACTIONS REQUIRED Further prioritize metal health conditions of high impact for inclusion in training for general and primary health workers and other activities.

Strategic Objective 3

WPR/RC64/3 page 100 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATIONWIDE EXPECTED RESULTS, INCLUDING INDICATOR TARGETS OWER 3.5 Guidance and support provided to Member States for the preparation and implementation of multisectoral, population-wide programmes to promote mental health and to prevent mental and behavioural disorders, violence and injuries, together with hearing and visual impairment, including blindness. Performance Indicators Baseline Target by Status by end 2012 2013 2012 3.5.1 Number of guidelines published and widely disseminated on multisectoral interventions to prevent violence and unintentional injuries. New indicator text: Number of countries and areas in which health ministries have begun scaling up services for mental neurological and substance-use disorders. Number of Member States implementing strategies recommended by WHO for the prevention of hearing or visual impairment. 15 18 On track

3.5.2

8

20 On track

3.5.3

78

130 On track

AUS, CHN, FJI, KHM, KIR, LAO, MNG, PHL, PNG, SLB, VNM and WSM.

Strategic Objective 3

WPR/RC64/3 page 101 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 03.005.WP01 Enhanced capacity of Member States for preparing and implementing multisectoral population-wide programmes to promote mental health and to prevent mental and behavioural disorders, violence and injuries, together with hearing and visual impairment, including blindness. Indicator Number of Member States that have initiated community-based projects during the biennium to reduce suicides. Number of guidelines published and widely disseminated on multisectoral interventions to prevent violence and unintentional injuries. Baseline 2012 4 Target by 2013 6 Achievement to date On Track/Fully Achieved

Remarks

1

7 MYS launched a national plan for suicide prevention; JPN and the KOR are strengthening community based suicide projects. 5 Five regional fact sheets were developed and distributed on 1) drowning; 2) falls; 3) road safety; 4) Violence Against Women plus regional publication: Injury and Violence Prevention in the WPR. A report on the regional results for the 2nd Global Status Report on Road Safety will also be developed in 2013.

2

3

4

Strategic Objective 3

WPR/RC64/3 page 102 Annex 1 3 Number of Member States implementing strategies recommended by WHO for the prevention of hearing or visual impairment. 12 15 12 AUS, CHN, FJI, KHM, KIR, LAO, MNG, PHL, PNG, SLB, VNM, and WSM.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE CHN, KHM and MNG are making steady progress in scaling up mental health services through outreach programmes and integration into general health care. In VNM, as part of the Road Safety (RS10) programme, five provinces (BacNinh, Ha Nam, NinhBinh, VInhPhuc and QuangNinh) are implementing comprehensive measures for prevention of drunk driving and promotion of using quality helmets. Social marketing campaigns for both risk factors have been implemented nationally. In KHM, the National Road Safety and Action Plan 2011-2020, developed and approved by the inter-ministerial meeting and awaiting Prime Minister’s endorsement. Partnerships established and technical support provided to strengthen trachoma control and elimination activities in SLB. A strategic meeting was convened at the Regional Office for KHM, LAO and VNM to plan for trachoma mapping and elimination programmes. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE One issue of increasing importance in the Region, and in particular in PIC, is diabetes-related blindness. Strategies exist to effectively screen for and treat diabetic retinopathy to prevent blindness. Lack of human resource in the secretariat for mental health has impeded WHO in fulfilling its convening power and coordinating potential for multisectoral partnership and collaboration for mental health.

Strategic Objective 3

WPR/RC64/3 page 103 Annex 1 SUMMARY OF ACTIONS REQUIRED Member States are requested to ensure that eye health programmes are linked with diabetes programmes to ensure periodic eye examinations for all people with diabetes. Exploring innovative approaches for resource mobilization for mental health is needed.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATIONWIDE EXPECTED RESULTS, INCLUDING INDICATOR TARGETS OWER 3.6 Guidance and support provided to Member States to improve the ability of their health and social systems to prevent and manage chronic noncommunicable diseases, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness. Performance Indicators Baseline Target by Status by end 2012 2013 2012 3.6.1 Number of Member States that have incorporated trauma-care services for victims of injuries or violence into their health-care systems using WHO trauma-care guidelines. Number of Member States implementing CBR programmes. Number of low- and middleincome Member States that have completed an assessment of their mental health systems using the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS). Number of low- and middleincome Member States implementing primary healthcare strategies for screening of cardiovascular risk and integrated management of noncommunicable diseases 70 32 On track

3.6.2

34

41 On track

3.6.3

80

88 On track

3.6.4

36

55 On track

Strategic Objective 3

WPR/RC64/3 page 104 Annex 1 using WHO guidelines. 3.6.5 Number of Member States with tobacco cessation support incorporated into primary health care. 65 67 On track AUS, BRN, COK, JPN, KHM, KOR, MYS, NEZ, PLW, PNG, SGP, and SLB

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 03.006.WP01 Enhanced capacity and ability of Member States' health and social systems to prevent and manage chronic noncommunicable diseases, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness. Indicator Number of lowand middleincome Member States implementing primary health care strategies for screening of cardiovascular risk and integrated management of NCD using WHO guidelines. Number of Member States implementing CBR programmes. Baseline 2012 13 Target by 2013 16 Achievement to date On Track/Fully Achieved

Remarks

1

15 Two countries (FJI and PHL) have expanded PEN for nationwide application.

2

4

6

4 So far initiatives have built on current CBR programmes. New CBR in the Pacific will commence in 2013. 12 AUS, BRN, CHN, JPN, KHM,

3

Number of countries and

8

12

Strategic Objective 3

WPR/RC64/3 page 105 Annex 1 areas that have improved health workforce, infrastructure and essential medicines for tobacco control. 4 Number of Member States that have incorporated trauma-care services for victims of injuries or violence into their health care systems using WHO trauma-care guidelines. 0 3 MAC, MNG, MYS, NEZ, PHL, KOR, and SGP

6 WHO provided support to KHM, LAO, MYS, MNG, PHL and VNM for trauma care activities.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE CBR capacity development was undertaken in FJI, KHM, LAO, MNG and SLB. A train-the-trainer workshop on tobacco cessation in primary care was conducted in KHM. The package of essential NCD interventions was partially adapted and implemented in 14 countries (CHN, COK, FJI, FSM, KHM, KIR, LAO, MHL, PHL, SLB, TON, VNM, VUT and WSM). Availability of a package of essential NCD interventions facilitated this. Training to establish tobacco quit-lines was provided to cities from eight countries and areas (BRN, CHN, JPN, KOR, MAC, MYS and PHL). In MYS, training of family medicine specialists in cognitive behaviour therapy for chronic illnesses was completed. Implementation of second track is in progress—technical support/workshop was provided to develop a module on orientation and mobility for core trainers. In the PHL, essential NCD package for primary health care based on WHO PEN was developed. Support to training of Department of Health’s technical staff, primary care physicians and public health nurses on WHO PEN were provided. Study on NCD and social Strategic Objective 3

WPR/RC64/3 page 106 Annex 1 determinants conducted and development of national NCD multisectoral plan was supported. Technical advice on development of outpatient benefit package (medicines for hypertension, diabetes and hypercholesterolemia) was provided to Philhealth. Terms of reference for drowning prevention project were developed. Technical advice on effectively implementing the national helmets law was provided to the Department of Transportation and Communication and to key national stakeholder; support for advocacy meetings was also provided. In VNM, adaptation of WHO guidelines and development of training package for management of NCDs and mental health are nearly completed. Training course for cancer registry was conducted. Training courses for basic and advance palliative care have been implemented in Hue, Da Nang, Thai Nguyen. In WSM, preparations for STEPS were almost completed. Follow-up activities were in progress with regards to finalizing and endorsing of food regulations. NCD prevention activities were ongoing with highlights around NCD and Healthy Lifestyle Week. Workplans were completed and funding was being processed for implementation of Healthy Lifestyle and Prevention of Childhood Obesity in specified schools around the country. In VNM, the adaptation and implementation of WHO guidelines on pre-hospital trauma care were being evaluated — examining various impacts of early intervention and the provision of onsite care by trained responders SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE It is a challenge to develop or adapt instruments for mental health while more countries and areas are considering inclusion of mental health component in STEP survey. Most health professionals do not receive training on tobacco cessation during their education, and provision of brief advice and assistance to quit is not established as part of primary health care in most countries and areas. While a few middle- and high-income countries and areas have established tobacco quit lines, the availability of more intensive cessation services, including pharmacotherapy, is still lacking in most countries and areas. Primary care services should be able to offer a package of services for early detection, management and referral of NCDs.

Strategic Objective 3

WPR/RC64/3 page 107 Annex 1 SUMMARY OF ACTIONS REQUIRED Organization of basic training on epidemiological investigation of mental disorders and mental health problems is needed. The training workbook for tobacco cessation needs to be disseminated to key partners and lessons learnt from training of trainers should be disseminated to other countries and areas that are ready to conduct similar training. The utilization of a child health expert and further collaboration with members of the Asia Pacific Child and Family Health Alliance for Tobacco Control are needed to sustain impetus for the activities carried out in 2012 to build capacity for tobacco cessation. Member States can develop/strengthen a package of services for NCD prevention and control at the primary care level to improve access and coverage.

Strategic Objective 3

WPR/RC64/3 page 108 Annex 1 STRATEGIC OBJ ECT IV E 4 TO REDUCE MORBIDITY AND M ORTALITY AND IMPROVE HEALTH DURING KEY STAGES OF LIFE, INCLUDING PREGANCY, CHILDBIRTH, THE NEONATAL PERIOD, THE CHILDHOOD AND ADOLOSCENCE, AND IMPROVE SEXUAL AND REPRODUCT IVE HEALTH AND PROM OTE ACT IVE AND HEALTHY AGEING FOR ALL INDIV IDUALS EXPECTED RESULT 04.001 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS COK, LAO, MNG, PNG, VNM and VUT DHP, DPM, RDO MNG, MYS and VNM CHN, FJI, KHM, KIR, LAO, NRU, PHL, PIC, PNG, SLB, TON and VNM DHP PHL and VNM DHP CHN, FJI, KHM, KIR, LAO, MNG, PHL, SLB, TON and VNM DHP LAO, MNG, MYS, PNG and VNM DHP CHN, LAO, MNG, PHL, VNM and WSM DHP MNG DHS TOTAL 9 3 13

04.002

04.003

3 11 6 7 2

04.004 04.005

04.006

04.007

04.008

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The year 2012 has been a challenging and successful year for child and reproductive health programmes with many projects achieved which will provide a strong foundation for the programme in the coming years. The draft Regional Action Plan for Healthy Newborn in the Western Pacific 2014–2018 has been formulated to address the alarming figure of 209 000 newborn deaths in the Region every year.

Strategic Objective 4

WPR/RC64/3 page 109 Annex 1 The Essential Newborn Care Course was also introduced in the Region, particularly in priority countries such as KHM, PHL and VNM. The course was designed to create changes in values and social norms through creation of enabling social and political environment for newborn to have a healthy start. The First Embrace is an essential package of sequential immediate newborn care steps for creating an enabling environment for newborn to have a healthy start. Systems to improve prevention and care for pre-term and sick newborn have also been introduced in CHN, KHM, PHL and VNM. The Regional Framework for Reproductive Health and the brochure Experiences in Expanding National Reproductive Health Programmes were finalized. A leaflet on newborn care was developed. A plan of a series of activities to strengthen Maternal Death Review was developed, targeting four countries: LAO, PNG, PHL and VNM. A desk review of the Maternal Death Review programmes was started. Minimum Initial Service Package for Reproductive Health in Crisis Situations (MISP) was promoted in CHN, PHL and VNM through regional and country workshops in collaboration with the DSE. An analysis of the Demographic Health Survey (DHS) data in multiple countries and areas in the WPR on the public health burden and underlying causes of undesired pregnancies and underuse of modern methods of contraception is being developed.

CHALLENGES/ISSUES High maternal mortality ratios and under-five mortality rates in countries, especially CHN, KHM, LAO, PHL, PNG, SLB and VNM and low coverage of skilled care at birth in countries with highest maternal mortality rate (MMR)–LAO and PNG. High proportion of neonatal mortality: 54% of all under-five deaths in the Region. Slow increase in coverage of key interventions that provide the most impact on maternal and child survival. There is a low level of financial and logistic resources for maternal and child health.

Strategic Objective 4

WPR/RC64/3 page 110 Annex 1 SUMMARY OF ACTIONS REQUIRED Follow-up actions required for the activities that are already going on and continue dialogues with the counterparts from the ministries of health, particularly in the analysis of MCH health services. Have key stakeholders on board for regional initiatives such as the WHO/UNICEF Action Plan Towards Healthy Newborn in the WPR (2014–2020) and frameworks such as the Regional Framework for Reproductive Health in the Western Pacific 2013. It is important to convene countries and areas to come to a consensus on priority interventions that need to be scaled up and the most feasible strategies to ensure universal access and coverage. It is important to discuss barriers to implementation of available guidelines and to seek solutions in the long and short term. Look for potential donors who would be interested to support MCH posts in countries and areas, to address the diminishing human resource support to the programme in country offices. Collaborate with other partner agencies who may give additional support (financial or human resource) to country activities.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 4.1 Support provided to Member States to formulate a comprehensive policy, plan and strategy for scaling up towards universal access to effective interventions in collaboration with other programmes, paying attention to reducing gender inequality and health inequities, providing a continuum of care throughout the life course, integrating service delivery across different levels of the health system and strengthening coordination with civil society and the private sector. Performance Indicators Baseline Target by Status by end 2012 2013 2012 4.1.1 Number of targeted Member States that have an integrated policy on universal access to effective interventions for improving maternal, newborn and child health. Number of Member States that have developed, with 72 60 On track

4.1.2

63

50 On track

Strategic Objective 4

WPR/RC64/3 page 111 Annex 1 WHO support, a policy on achieving universal access to sexual and reproductive health.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 04.001.WP01 Enhanced capacity of Member States to develop integrated policies, strategies, and plans towards universal access to effective interventions for improving maternal, newborn, child, adolescent and reproductive health. Indicator Number of target countries and areas supported for developing integrated policies, strategies and plans on universal access to effective interventions for improving maternal, newborn, child, adolescent and reproductive health. Baseline 2012 4 Target by 2013 8 Achievement to date On Track/Fully Achieved

Remarks

1

6 KHM, LAO, MNG, PHL, PNG, and SLB

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The long term goal is to enhance capacity of Member States through the development of the Regional Strategic Action Plan to support rapid reduction in women and children's mortality in the WPR. The Regional Action Plan for Healthy Newborn and tools are being developed to support implementation. The Regional Action Plan for Healthy Newborn is based on a social marketing approach which will be piloted in two countries–LAO and PHL.

Strategic Objective 4

WPR/RC64/3 page 112 Annex 1 Five countries—LAO, MNG, PNG, PHL and SLB—submitted country roadmaps along the Commission on Information and Accountability (COIA) guidelines. Mechanisms for partnership coordination are going on. In line with this, the Asia Pacific Leadership and Policy Dialogue on Women's and Children's Health was hosted by the WPRO in November 2012 in collaboration with the Partnership for Maternal, Newborn and Child Health. In MNG, in collaboration with the United Nations Children's Fund (UNICEF) and the United Nations Population Fund (UNFPA), a UN joint working group on maternal and newborn health was established to identify the gaps and mobilize resources. In PNG, strengthening of the National Department of Health capacity to improve implementation of child survival intervention, targeting malaria, pneumonia, diarrhoea and malnutrition were done. Rolling out of Integrated Management for Childhood Illness (IMCI) programme was initiated. In VNM, the equity analysis of health Millennium Development Goals (MDG) was conducted. Also, analysis of MCH health services data was conducted. A regional consultation was held on neonatal health to allow countries and areas to share their experience in addressing issues related to neonatal deaths SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Financial and human resources available to support activities are limited, particularly in countries and areas. Key positions in countries and areas supporting maternal and child health are at risk of being discontinued due to lack of funding. SUMMARY OF ACTIONS REQUIRED Follow-up action is required for the activities that are already in progress. Communication lines should be strengthened in dialogues with the counterparts from the ministries of health, particularly in the analysis of MCH health services. More proactive steps need to be taken to seek out potential donors who would be interested to support MCH posts in countries and areas.

Strategic Objective 4

WPR/RC64/3 page 113 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 4.2 National research capacity strengthened as necessary and new evidence, products, technologies, interventions and delivery approaches of global and/or national relevance available to improve maternal, newborn, child and adolescent health, to promote active and healthy ageing, and to improve sexual and reproductive health. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 4.2.1 Number of research centres that have received an initial grant for comprehensive institutional development and support. Number of completed studies on priority issues that have been supported by WHO. Number of new or updated systematic reviews on best practices, policies and standards of care for improving maternal, newborn, child and adolescent health, promoting active and healthy ageing or improving sexual and reproductive health. 12 10 On track

4.2.2

60

34 On track

4.2.3

89

50 On track

Strategic Objective 4

WPR/RC64/3 page 114 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 04.002.WP01 Research capacity strengthened & new evidence, technologies, interventions & approaches of global/national relevance available to improve maternal, newborn, child & adolescent health; promote active/healthy ageing, & improve sexual & reproductive health. Indicator Number of completed studies supported on priority issues related to reproductive, maternal, newborn, child and adolescent health. Baseline 2012 4 Target by 2013 8 Achievement to date On Track/Fully Achieved

Remarks

1

6 MNG and VNM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Activities in countries and areas are ongoing to support improvement in Maternal, Newborn, Child and Adolescent Health (MNCAH) through new evidence, technologies, interventions and approaches In MNG, research methodology trainings and sharing of finding were conducted with key stakeholders. In MYS, training for analysis of Global Student School-based Health Survey (GSHS) was completed. In VNM, an operational research to study causes of child mortality, morbidity and mortality has been discussed with the Ministry of Health and Hanoi Paediatric Hospital. In KHM, LAO, PHL, training and support to mapping of time to health facilities vis-à-vis health indicators undertaken.

Strategic Objective 4

WPR/RC64/3 page 115 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Human resource support in the regional and country offices towards maternal, newborn and child health is limited. Research is a long process that can be costly and usually requires staff to dedicate a significant amount of their time hence a passive approach is usually observed. With very limited funds, other urgent activities are being prioritized. SUMMARY OF ACTIONS REQUIRED Activities in countries and areas are ongoing to support improvement in MNCAH through new evidence, technologies, interventions and approaches. Collaboration with other partner agencies to fund activities of common interest is required.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 4.3 Guidelines, approaches and tools for improving maternal care applied at the country level, including technical support provided to Member States for intensified action to ensure skilled care for every pregnant woman and every newborn, through childbirth and the postpartum and postnatal periods, particularly for poor and disadvantaged populations, with progress monitored. Performance Indicators Baseline Target by Status by end 2012 2013 2012 4.3.1 Number of Member States implementing strategies for increasing coverage with skilled care for childbirth. 66 70 On track

Strategic Objective 4

WPR/RC64/3 page 116 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 04.003.WP01 Capacity within Member States strengthened for implementing national plans for the reduction of maternal and newborn mortality, including achieving skilled care for every birth. Indicator Number of countries and areas supported for implementing strategies for increasing coverage of skilled care for birth. Baseline 2012 0 Target by 2013 5 Achievement to date On Track/Fully Achieved Remarks

1

5 KHM, LAO, PHL, PNG, and VNM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The activities for country adaptation and implementation of evidence-based guidelines for 2012 are on track. In LAO, the National Skilled Birth Attendants plan is currently ongoing. In the PHL, in addition to the Newborn Protocol completed in 2010, work on Clinical Practice Guidelines for Intrapartum and Immediate Post-partum care has been developed using grade methodology. In PNG, the Maternal Deaths Review Committee has been established and the National Maternal Deaths Register has been launched during the Sexual and Reproductive Health (SRH) Stakeholders meeting held in POM on 11 December 2012. In VNM, ASEAN guidelines for midwifery and life-saving skills manual for skilled attendants under development; social mobilization activities for maternity waiting homes (MWHs) conducted in Bao Lam and Bao Lac; data collection form distributed to Cao Bang province.

Strategic Objective 4

WPR/RC64/3 page 117 Annex 1

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE There is limited financial and human resources available to support activities, particularly in countries and areas. Key positions in countries and areas supporting maternal and child health are at risk of being discontinued due to lack of funding. SUMMARY OF ACTIONS REQUIRED Follow-up actions required for the activities that are already going on. Communication lines should be strengthened in dialogues with the counterparts from the ministries of health, particularly in the analysis of MCH health services.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 4.4 Guidelines, approaches and tools for improving neonatal survival and health applied at country level, with technical support provided to Member States for intensified action towards universal coverage, effective interventions and monitoring of progress. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 4.4.1 Number of Member States implementing strategies for increasing coverage with interventions for neonatal survival and health. 56 57 On track

Strategic Objective 4

WPR/RC64/3 page 118 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 04.004.WP01 Strengthened technical capacity in Member States for accelerated action towards the achievement of universal access to the essential package of interventions for newborn survival, including improvement of quality of care. Indicator Number of countries and areas supported for implementing coordinated strategies for newborn survival. Baseline 2012 3 Target by 2013 7 Achievement to date On Track/Fully Achieved

Remarks

1

5 CHN, KHM, LAO, PHL, and SLB

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The regional team supported the implementation of the First Embrace in at least six priority countries of the Region. The Regional Action Plan for Healthy Newborn is the Region's first response to the general sub-optimal immediate newborn care that could potentially save 88 200 lives annually. In VNM, the national guidelines to strengthen newborn care along the continuum developed and being reviewed by the Ministry of Health. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE One key challenge in the acceptance and implementation of the WHO/UNICEF Action Plan Towards Healthy Newborn in the WPR (2014–2020) is changing the old norms that the hospitals and health workers have been used to. For priority countries like CHN, KHM, PHL and VNM, human resource support is crucial to fully implement activities on maternal and newborn care such as the Regional Action Plan for Healthy Newborn.

Strategic Objective 4

WPR/RC64/3 page 119 Annex 1 SUMMARY OF ACTIONS REQUIRED Key stakeholders have to be brought on board for the First Embrace. It is important to convene countries and areas to come to a consensus on priority interventions that need to be scaled up and the most feasible strategies to ensure universal access and coverage. It is important to discuss barriers to implementation of available guidelines and to seek solutions in the long and short term. In the PHL, under the Department of Health-AusAID-UN Joint Programme on Maternal and Neonatal Health, antenatal care clinical practice guidelines shall be developed with other UN agencies.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 4.5 Guidelines, approaches and tools for improving child health and development applied at the country level, with technical support provided to Member States for intensified action towards universal coverage of the population with effective interventions and for monitoring progress, taking into consideration international and human-rights norms and standards, notably those stipulated in the Convention on the Rights of the Child. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 4.5.1 Number of Member States implementing strategies for increasing coverage with child health and development interventions. Number of Member States that have expanded coverage of the integrated management of childhood illness to more than 75% of target districts. 79 60 On track

4.5.2

54

50 On track

Strategic Objective 4

WPR/RC64/3 page 120 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 04.005.WP01 Strengthened technical capacity in Member States for accelerated action towards the achievement of universal access to the essential package of interventions for child survival, including improvement of quality of care. Indicator Number of countries and areas supported for implementing coordinated strategies for increasing coverage and improving quality of child health interventions. Number of countries and areas supported for expanding geographical coverage of IMCI to more than 75% of target districts. Baseline 2012 4 Target by 2013 8 Achievement to date On Track/Fully Achieved

Remarks

1

8 LAO, PNG, SLB, and VNM

2

4

6

6 LAO and SLB

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Community IMCI implementation is being supported in LAO and SLB. Hospital assessment in Oudomxay and Phongsaly, LAO were supported. Technical assistance was provided to PNG and VNM related to tracking progress of programme implementation. Tool development for evaluating quality of intrapartum and postpartum care was undertaken by the Centre of International Child Health.

Strategic Objective 4

WPR/RC64/3 page 121 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE There is limited financial and human resources available to support activities, particularly in countries and areas. Key positions in countries and areas supporting maternal and child health are at risk of being discontinued due to lack of funding. SUMMARY OF ACTIONS REQUIRED Follow-up with countries and areas on progress and provide technical assistance as needed.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 4.6Technical support provided to Member States for the implementation of evidencebased policies and strategies on adolescent health and development, and for the scaling up of a package of prevention, treatment and care interventions in accordance with established standards. Performance Indicators Baseline Target by Status by end 2012 2013 2012 4.6.1 Number of Member States with a functioning adolescent health and development programme. 74 55 On track

Strategic Objective 4

WPR/RC64/3 page 122 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 04.006.WP01 Enhanced Member States' capacity for implementing evidence-based strategies, norms and standards for the prevention and care of diseases and health compromising behaviours in adolescents. Indicator Number of countries and areas supported for implementing evidence-based strategies for the protection and care for the health of the adolescents. Baseline 2012 2 Target by 2013 5 Achievement to date On Track/Fully Achieved

Remarks

1

5 LAO, PNG, and VNM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE In LAO, a rapid programme review for Adolescent (ADFHS) was conducted. Recommendations were made to integrate ADFHS into primary health care services. In MYS, framework and guidelines were developed to improve management of children and adolescent with nutrition problems through dietary therapy in community. Mental health intervention package for adolescents at the primary care setting developed. In PNG, consensus achieved on adolescent health strategies and implementation plan. Strong support of the National Department of Health on the Youth and Adolescent Health Policy was received. . SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE There are limited financial and human resources available to support activities, particularly in countries and areas. Key positions in countries and areas supporting maternal and child health are at risk of being discontinued due to lack of funding. Technical Officer for Adolescent Health in the Regional Office was discontinued.

Strategic Objective 4

WPR/RC64/3 page 123 Annex 1 SUMMARY OF ACTIONS REQUIRED Desk review of adolescent and youth information from six priority countries is required to inform regional actions. Collaborate with other partner agencies that may have the human resource needed. Evaluation of how WHO, within its mandate and comparative advantage, can better support countries and areas to improve adolescent health.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 4.7 Guidelines, approaches and tools made available, with provision of technical support to Member States for accelerated action towards implementing the strategy to accelerate progress towards the attainment of international development goals and targets related to reproductive health, with particular emphasis on ensuring equitable access to goodquality sexual and reproductive health services, particularly in areas of unmet need, and with respect for human rights as they relate to sexual and reproductive health. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 4.7.1 Number of Member States implementing the WHO reproductive health strategy to accelerate progress towards the attainment of international development goals and targets related to reproductive health agreed at the 1994 International Conference on Population and Development (ICPD), its five-year review (ICPD+5), the Millennium Summit and the United Nations General Assembly in 2007. 4.7.2 Number of targeted Member States having reviewed their existing national laws, 20 15 On track 60 50 On track

Strategic Objective 4

WPR/RC64/3 page 124 Annex 1 regulations or policies relating to sexual and reproductive health.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 04.007.WP01 Enhanced capacity and ability of Member States for On Track/Fully accelerated action towards the achievement of universal access to Achieved reproductive health, including improvement of quality of care. Indicator Number of countries and areas supported for implementing strategies to accelerate progress towards the attainment of international development goals and targets related to reproductive health. Number of target countries and areas supported for reviewing and implementing evidence-based guidelines and tools on key elements of reproductive health. Baseline 2012 0 Target by 2013 6 Achievement to date Remarks

1

4 KHM, LAO, PNG, and PHL

2

0

3

3 CHN, PHL, and VNM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The implementation of activities in countries and areas of evidence-based guidelines for increasing coverage of reproductive health services for the year of 2012 are on track. The main activities were publication and distribution; country workshops to promote the Minimum Initial Service Package (MISP) were held and; secondary analysis of DHS data on reproductive health was undertaken.

Strategic Objective 4

WPR/RC64/3 page 125 Annex 1 Minimum Initial Service Package for Reproductive Health in Crisis Situations (MISP) was promoted in CHN, PHL and VNM through regional and country workshops in collaboration with the Division of Health Security and Emergencies/WPRO. Printing and distribution of reproductive health related WHO publications (Family Planning—A global handbook for providers). A guide to family planning for community health workers and their clients were carried out in accordance with requests from countries and areas. Secondary analysis of the Demographic Health Survey (DHS) Data in multiple countries and areas in the WPR on the public health burden and underlying causes of undesired pregnancies and underuse of modern methods of contraception is being developed SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The progress of MDGs 4 and 5 is uneven among and within countries and areas. About 9% of births in the Region remain unattended by skilled birth attendants, where the poorest groups tend to have lowest access. Universal access to reproductive health remains unachieved. 54% of under-five child deaths occurred during the neonatal period (the first 28 completed days of life) in 2010. There are limited financial and human resources available to support activities, particularly in countries and areas. Key positions in countries and areassupporting maternal and child health are at risk of being discontinued due to lack of funding. SUMMARY OF ACTIONS REQUIRED Follow-up action required for the activities that are already going on. The WHO/UNICEF Action Plan Towards Healthy Newborn in the WPR (2014–2020) and the Regional Framework for Reproductive Health in the Western Pacific 2013 were developed. Both the Plan and the Framework incorporated global and regional guidance, including nutrition and health systems strengthening. They were developed through wide consultation with Member States and partners to improve coordination. Goals and targets were agreed upon in the Plan for elimination of preventable newborn mortality through the provision of quality early essential newborn care and increased coverage of Skilled Birth Attendance at birth.

Strategic Objective 4

WPR/RC64/3 page 126 Annex 1 Mobilize support from potential donors who would be interested to support MCH posts in countries and areas.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 4.8 Guidelines, approaches, tools, and technical assistance provided to Member States for increased advocacy for consideration of ageing as a public health issue, for the development and implementation of policies and programmes aiming at maintaining maximum functional capacity throughout the life course and for the training of health-care providers in approaches that ensure healthy ageing. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 4.8.1 Number of Member States with a functioning active healthy ageing programme consistent with WHA58.16 “Strengthening active and healthy ageing”. 33 30 On track

Strategic Objective 4

WPR/RC64/3 page 127 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 04.008.WP01 Capacity strengthened in the Region and Member States to develop policies and programmes to address population ageing. Indicator Number of countries and areas initiating activities to develop policies and programmes to address population ageing. Baseline 2012 0 Target by 2013 4 Achievement to date 0 On Track/Fully Achieved Remarks

1

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE No specific support in countries and areas were provided in 2012 but there are plans in 2013 to field technical support missions to at least two countries (CHN and VNM) as part of an ongoing in-depth policy analysis for four countries and for a broader range of countries and areasacross the Region, in general. This analysis will provide information on the situation in various WPRO countries and areas. It will result in policy recommendations and inform the development of a regional action framework to be presented to Member States at this year’s RCM in discussions for an agenda item on ageing and health. Intensive activity on healthy ageing was undertaken around World Health Day in April 2012, including dissemination of information through new webpages on ageing and World Health Day; the development of products such as information and fact sheets, stories, posters, a media release, a video, and two video statements; an event in the Regional Office; and the provision of support to country offices. Analysis was initiated on the health of older persons and on policies related to ageing and health in selected countries and areasin the Region, in preparation for an anticipated agenda item on ageing at the 64th Session of the Western Pacific Regional Committee in 2013.

Strategic Objective 4

WPR/RC64/3 page 128 Annex 1 New webpages were created for ageing and World Health Day and regularly updated. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE WHO capacity at the regional and country level to work on this important emerging issue is limited. SUMMARY OF ACTIONS REQUIRED Work in this area is now starting up. Various activities are planned to build its momentum. Member States are showing increasing awareness and demand for support in this area. Developing a body of analytical work and consulting with Member States once the results are available can form the basis for developing a framework for action in this area of work. Partnerships are vital, since much of the work is led by other stakeholders.

Strategic Objective 4

WPR/RC64/3 page 129 Annex 1 STRATEGIC OBJ ECT IV E 5 TO REDUCE THE HEALTH CONSEQUENCES OF EM ERGENCIES, DISASTERS, CRISES AND CONFLICTS, AND M INIM IZE THEIR SOCIAL AND ECONOM IC IM PACT EXPECTED RESULT 05.001 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS CHN, COK, DHP, DSE, KHM, KIR, LAO, MNG, MYS, NIU, NRU, PHL, PIC, PNG, RDO, SLB, TKL, TON, VNM, VUT, WSM CHN, DSE, PHL, PIC, VNM TOTAL 21

05.007

5

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The WPR is prone to emergencies and disasters that result in enormous loss of life and serious damage and destruction to health infrastructure and health systems. Despite the encouraging improvements made in preparedness and response capacities of Member States and the international community, many challenges remain, including the need for improving health cluster coordination and national capacity for disaster risk management. Over past year, much effort has been made to address the challenges as well as support Member States in health sector response to acute emergencies including floods in FJI in March 2012 and typhoons Saola and Haikui in the PHL in July/August and typhoon Bopha in December 2012. In October 2011, the sixty-second session of the WHO Regional Committee for the Western Pacific reviewed the lessons learnt from recent disaster responses and called for actions to strengthen national health emergency risk management capacities for disasters. In 2012, a series of technical consultations were conducted to identify strategic directions and possible actions in various technical areas including hospitals safe from disasters, information and needs assessments, and health service preparedness. Building on the outcomes of previous consultations and country experiences a draft regional framework of action for health emergency risk management for disasters was developed. The framework will guide national capacity strengthening and the regional and national health cluster for the next five to 10 years.

Strategic Objective 5

WPR/RC64/3 page 130 Annex 1 CHALLENGES/ISSUES The Regional Framework for Action calls for a radical change in the approach to disasters focusing on risk management related to all hazards going much beyond traditional emergency response. This shift represents a challenge for governments and ministries of health, requiring permanent structures and full-time senior and medium-level managers working around the emergency risk management continuum of prevention, to preparedness, response and recovery. While the political commitment of Member States and Territories is a prerequisite, a concerted international effort has to be done by different international organizations, and by WHO, in particular, in promoting and scaling up the health sector emergency risk management specific programs and activities.

SUMMARY OF ACTIONS REQUIRED Continued action is needed to ensure adoption, country adaptation, and implementation of the regional framework of action for health emergency risk management for disasters at country level. This will require establishing stronger partnerships for health emergency risk management at national and international levels, ensuring that health emergency risk management is recognized as an essential public health function and integrated into multisectoral emergency risk management policies and plans as well as increasing investment in developing the necessary core capacities in all countries and areas. Policy and strategy development: finalization of the Regional Framework for Health Emergency Risk Management of Natural Disasters, policy paper on regional approach for health sector recovery after large natural disasters; Capacity building: revision and update of all the modules of the Public Health Emergency Management and Preparedness (PHEMAP) training package, and pilot training in priority countries and areas; Emergency and Humanitarian Action (EHA) preparedness: stockpiling of essential items for health relief operations and field coordination in large crisis, revision of Standard Operating Procedures, internal capacity building on Geographic Information System (GIS) and mapping and telecommunication systems in emergency situation; and Undertake advocacy / fundraising / partnership building at regional level.

Strategic Objective 5

WPR/RC64/3 page 131 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 5.1 Establishment and implementation of national health emergency risk management plans and WHO readiness plans. Performance Indicators Percentage of countries and areas that have completed a health risk assessment and have, at a minimum, initiated the safe hospitals component of a national risk reduction programme for health. Percentage of countries and areas that have conducted an emergency health response simulation at least once during the biennium. Percentage of WHO country offices that conducted an emergency health response simulation according to a written contingency and business continuity plan at least once during the biennium. Baseline 2012 Target by 2013 Status by end 2012

5.1.1

n/a

n/a

On track

5.1.2

n/a

n/a

On track

5.1.3

n/a

n/a

On track

Strategic Objective 5

WPR/RC64/3 page 132 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 05.001.WP01 Establishment and implementation of national health emergency risk management plans and WHO readiness plans. Indicator Number of countries and areas that have safe hospitals activities implemented. Number of countries and areas that have national health sector contingency plans established and/or strengthened. Percentage of key Country Office staff trained in the revised WHO/WPRO emergency procedures. 0 100% Baseline 2012 Target by 2013 Achievement to date On Track/Fully Achieved Remarks

1

4

6

MNG initiated Safe Hospital dialogue in 5 addition to KHM, LAO, PHL and VNM

2

0

5

2 LAO and TON

3

All WHO Representatives and Country Liaison Officers (WRs/CLOs) were briefed on new Emergency Response 50% Framework (ERF) including simulation exercise during WR/CLO meeting in 2012. Training of country focal points is pending.

Strategic Objective 5

WPR/RC64/3 page 133 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Over past year, many countries and areas in the Western Pacific have seen a paradigm shift from reactive health emergency management to proactive health emergency risk management. This is an important development considering historical focus on acute emergency response and relatively little attention and investment in prevention, preparedness and recovery from disasters. Another important development has been a closer collaboration of various actors involved in health emergency risk management. The generic capacities developed or currently being developed under the IHR (2005) provide a good foundation for health emergency risk management. Some of these capacities are cross-cutting and can be utilized not only for managing acute public health events and emergencies, but also for natural hazards, such as event-based surveillance system, EOC within the Ministry of Health, response logistics and risk communication. The Secretariat has provided support to Member States in the development and revision of national emergency risk management plans. A number of countries and areas including the LAO and MNG are also supported by the Secretariat in establishing and/or strengthening capacities for emergency risk management including establishment of EOC in the ministries of health, in synergy with the implementation of the activities related to Asia Pacific Strategy for Emerging Diseases (APSED) framework, in strengthening the national capacities in dealing with and be prepared for public health emergencies other than natural disasters. Hospitals Safe from Disasters initiative gained momentum in a number of countries and areas including the PHL. However, a number of countries and areas have not yet succeeded in integrating the initiative into overall national emergency and disaster risk management in a sustainable manner. The Secretariat's effort at country level over the past year aimed at facilitating dialogue and acting as a catalyst for change (for example, multisectoral support for Safe Hospitals was initiated in MNG in 2012), as well as documenting lessons learnt and seeking strategic approaches and priority actions for moving Safe Hospital agenda from advocacy to sustainable action. A series of technical consultations were conducted to identify strategic directions and possible actions in various technical areas including hospitals safe from disasters, information and needs assessments, and health service preparedness. Based on the outcomes of previous Strategic Objective 5

WPR/RC64/3 page 134 Annex 1 consultations and experiences of countries and areas, a draft regional framework of action for health emergency risk management for disasters was developed. The framework was crafted to contribute to an all-hazards approach to emergency risk management through a step-by-step approach, focusing on natural hazards, and gradually building strong synergies within the risk management capacities of countries and areas related to other public health threats that are already in place, as required under IHR (2005). The framework will guide national capacity strengthening and the regional and national health cluster for the next five to 10 years. On the front of Secretariat's own readiness for health crises, the ERF was developed, tested and rolled-out following extensive global, regional and country consultation. In the Western Pacific, operational mechanisms to support ERF functioning are being put in place.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The Regional Framework for Action for Health Emergency Risk Management of Natural Hazards has been agreed during the regional consultation in December 2012. Priority action for each of the four strategic components of the framework (governance, policy and coordination, information and knowledge management, health service delivery and resources) have been outlined, but developing concrete plans at the level of countries and areas remains a challenge.

SUMMARY OF ACTIONS REQUIRED The main steps for 2013 will be to discuss and formulate concrete plans for the implementation of priority activities for each of the framework’s strategic components. The role and capacities of the WHO WPR will be crucial in supporting Member States in this undertaking.

Strategic Objective 5

WPR/RC64/3 page 135 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 5.7 Coordinated health sector response and recovery in humanitarian emergencies. Performance Indicators Percentage of humanitarian emergencies with a coordinated risk assessment and initial health sector response plan within 72 hours of onset. Baseline 2012 Target by 2013 Status by end 2012

5.7.1

80%

90% On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 05.007.WP01 Coordinated health response and recovery in emergencies and disasters implemented. Indicator Percentage of humanitarian emergencies supported by WHO within 72 hours of request for assistance. Baseline 2012 Target by 2013 Achievement to date On Track/Fully Achieved Remarks

1

80%

90%

100% FJI and PHL

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The WPR is prone to emergencies and disasters that result in enormous loss of life and serious damage and destruction to health infrastructure and health systems. The past year has seen several major disasters including massive floods in FJI in March 2012 and typhoons Saola and Haikui in the PHL in July/August and typhoon Bopha in December 2012. In all emergencies, Member States have taken action to save lives and alleviate suffering of affected population. In both FJI and the PHL, these efforts have been supported by humanitarian Strategic Objective 5

WPR/RC64/3 page 136 Annex 1 coordination mechanisms such as the Pacific Humanitarian Team in FJI and tri-cluster in the PHL. The Secretariat provided active support to the Member States in health sector response to acute emergencies including floods in FJI in March 2012 and in the PHL in August 2012, and typhoon Bopha in the PHL in December 2012. Health cluster coordination at country level ensured timely response and coordinated action by all stakeholders to support national emergency relief and recovery effort. Lessons learnt following floods in the Philippines were documented, in particular for the fast and effective adoption of Surveillance in Post Extreme Emergencies and Disasters (SPEED), and for the effective response and control of the Leptospirosis epidemics detected in its early stage through SPEED. At regional level, the Secretariat provided back-up to country emergency response and recovery operations as well as technical guidance to ensure coordinated risk assessment and coherent health sector response including roll-out of the SPEED in the PHL—a mobile-based early warning system to detect common health conditions in an emergency. Important milestone over past year was convention of the second regional Health Cluster Forum in December 2012. The Secretariat facilitated alignment of international humanitarian health cluster efforts ("3+1" framework) with national health sector health emergency risk management framework for disasters.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The Emergency Response Framework (ERF) has been recently approved and adopted by the three levels of the organization, as a key document outlining the different roles and responsibilities, and the modalities to respond to crisis. But still specific existing regional SoPs related to emergency response need to be aligned with the new rules introduced by the ERF. In addition, the key players within WHO also need to have a common understanding and common language in this area of work, which still need to be built. Another challenge is the inclusion of the ERF as one of the step of the overall HERM Framework for all hazards. ERF has been developed one year in advance in respect to the HERM framework, and different departments/divisions and teams of the organization in HQ as well in the Regional Level have specific approaches to the risk management of different hazards that still need to be harmonized, and to which correspond very active structures that also have to work more in synergy

Strategic Objective 5

WPR/RC64/3 page 137 Annex 1 SUMMARY OF ACTIONS REQUIRED Finalization of the global and regional frameworks for Health Emergency Risk Management for all hazards, update of emergency SOPs, revision of training packages for WHO Head of Country Office and WHO Response Coordinator on ERF, revision of the Public Health Emergency Management for Asia and Pacific training modules and material, and scaling up of the training of the health sector senior and middle level managers of Member States.

Strategic Objective 5

WPR/RC64/3 page 138 Annex 1 STRATEGIC OBJ ECT IV E 6 TO PROMOTE HEALTH AND DEVELOPMENT, AND PREVENT OR REDUCE RISK FACTORS FOR HEALTH CONDITIONS ASSOCIATED WITH USE OF TOBACCO, ALCOHOL, DRUGS AND OTHER PSYCHOACTIVE SUBSTANCES, UNHEALTHY DIETS, PHYSICAL INACTIVITY AND UNSAFE SEX EXPECTED RESULT 06.001 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS BRN, CHN, FJI, LAO, NIU, PHL, PIC, PNG, RDO, SLB, TON, TUV, VNM and VUT DHP FJI, FSM, MNP, MYS, PNG and WSM DHP CHN, COK, FJI, FSM, KHM, KIR, LAO, MHL, MNG, NIU, PHL, PIC, PNG, TKL, VNM and WSM DHP FJI, KHM, MNG, MYS, NRU, PIC and VNM DHP FJI, MHL, MNG, PIC, TUV and VNM DHP DCC TOTAL 15

7 17

06.002 06.003

8 7 1

06.004 06.005

06.006

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Strengthened surveillance and monitoring of NCD risk factors through appropriate framework tools and technical support. Strengthened implementation and scaling up of Healthy Settings to contribute to improvements in daily living conditions through Leadership Programmes, City-to-City learning, training courses and development of advocacy and guidance documents. Regional meeting on improving healthier dietary options for children was held in Saitama, Japan. An informal dialogue with the food industry was held in Manila, Philippines, regarding options for reducing salt and implementation of the WHO set of recommendations on marketing of food and non-alcoholic beverages to children

Strategic Objective 6

WPR/RC64/3 page 139 Annex 1 CHALLENGES/ISSUES The following six risk factors: use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diet, physical inactivity and unsafe sex together with rapid and unplanned urbanization contribute to premature death, disease and disability in the WPR. Four of these risk factors are contributing to the increase of major NCDs in the Region, such as diabetes, cardiovascular diseases, cancer and chronic respiratory diseases at alarming rates in the region. In order to promote health and development, there is a need to address the behavioral and social determinants of poor health by creating healthy environments and health in all policies, to support individuals to make healthy decisions. Therefore this strategic objective focuses on integrated, comprehensive, multisectoral and multidisciplinary health promotion and disease prevention strategies across all relevant WHO programmes. The WPR supported Member States in developing and implementing strategies and policies to prevent and reduce these risk factors by providing guidance for health promotion and health service development.

SUMMARY OF ACTIONS REQUIRED As a cross-cutting approach, the health promotion programme in the WPRO needs to be further strengthened in order to better address the issues and challenges posed by the risk factors.

Strategic Objective 6

WPR/RC64/3 page 140 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 6.1 Advice and support provided to Member States to build their capacity for health promotion across all relevant programmes, and to establish effective multisectoral and multidisciplinary collaborations for promoting health and preventing or reducing major risk factors. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 6.1.2 Number of cities that have implemented healthy urbanization programmes aimed at reducing health inequities. 34 40 On Track

FJI, KHM, LAO, and MNG

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 06.001.WP01 Strengthened health promotion capacity in countries and areas across all relevant programmes, and to establish effective multisectoral and multidisciplinary mechanisms and collaborations to promote health and prevent and reduce behavioural and structural risk factors. Indicator Number of countries and areas supported to develop national outcome-oriented health promotion strategies and/or activities. Baseline 2012 4 Target by 2013 6 Achievement to date On Track/Fully Achieved

Remarks

1

9 CHN, FJI, KHM, LAO, MNG, NIU, PHL, TOK, and VNM

Strategic Objective 6

WPR/RC64/3 page 141 Annex 1 2 Number of countries and areas supported to develop and/or expand methods/ mechanisms to sustain financing of health promotion. 3 4 5 LAO, SLB, VNM, VUT and WSM

3

Number of partnerships and networks strengthened at (a) country level and (b) regional level for promoting health and preventing major risk factors.

(a) 10 (b) 3

(a)12 (b)4

(a) 12 (b) 4 (a) Partnerships and networks strengthens in KHM, LAO and VNM; (b) KOR (working towards the first national technical network on urbanization and health to feed into the planned regional network).

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Health promotion activities including healthy cities, health promoting schools were successfully implemented in collaboration with stakeholders in Member States There was good collaboration with the National Patriotic Health Campaign Committee to advocate healthy city and healthy village initiatives in CHN. Cities in both the eastern and western parts of CHN were keenly interested to participate. WSM is in the process of establishing a Health Promotion Foundation. SLB has developed a Tobacco Control Bill. VNM has a Law on Prevention and Control of Tobacco Harms, which includes a provision on the establishment of the “Fund of Prevention and Control of Tobacco Harms”. The LAO has a Law on Tobacco Control which includes a part on the establishment of a “Tobacco Control Fund”. Strategic Objective 6

WPR/RC64/3 page 142 Annex 1 VUT has a Tobacco Control Act and is working towards including a part on the establishment of a Health Promotion Foundation. Collaboration and multisectoral actions across units in WHO and ministries of health, and other ministries in countries and areas have been strengthened. Activities to scale up Healthy Settings approaches have taken place and include (i) Training workshops for Smoke-free Cities and Health Promoting Schools, (ii) Leadership Program (Study Tour) and Leadership courses (iii) Guidance and advocacy documents, (iv) National accreditation systems, (v) development of web resources such as Urbani School Health Kit. WHO is also working on (i) strengthening health promotion infrastructure through the establishment of Health Promotion Foundations, (ii) supporting the drafting of Health Promotion Foundation legislations and (iii) preventative health strategy. Countries and areassupported include CHN, FJI, KHM, LAO, MNG, NIU, PHL, SLB, TKL, VNM, VUT and WSM. Training has been provided to support the use of the Urban Health Equity Assessment and Response Tool (HEART) to support cities in making decisions on viable and effective strategies, interventions and actions that should be used to reduce inter- and intra-city health inequities. The joint project of WHO and the Ministry of Health on “Strengthening Healthy Eating and Physical Activity in School Children in Tonga” had been successfully initiated and proceeding smoothly. In the PHL, development of health education and advocacy materials for physical activity and exercise for the elderly population was developed. A Health Promoting Schools (HPS) Workshop was completed in Singapore and has helped countries and areas initiate and scale up implementation of HPS in CHN, KHM, LAO and VNM. Technical support provided to countries and cities to plan, implement and scale up Healthy Settings. Healthy City Best Proposals have been selected, recognized and supported to encourage cities to continue to innovate and demonstrate effective and efficient ways of promoting and protecting the health of urban populations. Healthy Cities Advocacy and multisectoral action planning workshops have been implemented in KHM and LAO.

Strategic Objective 6

WPR/RC64/3 page 143 Annex 1 Technical support was provided to develop a national accreditation system for Healthy Cities.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Many of the determinants of health and health inequities in populations have social and economic origins that are distant from the direct influences of the health sector and health policies. • Health is created in the environments of our everyday lives, however, the potential to promote and protect health in urban areas, schools and workplaces is not yet fully realized. • In many settings throughout the WPR health risks remain unnecessarily high and action must be taken to reduce these risks. • The health sector remains critically underfunded, and with the increase in NCDs in the Region the demand for health services is outpacing the ability to finance and deliver them. • Now more than ever before governments must establish health promotion infrastructure and sustainable financing mechanisms to ensure adequate funding for national and subnational efforts to promote health and prevent disease.

SUMMARY OF ACTIONS REQUIRED As a cross-cutting approach, the health promotion programme should support governments, communities and individuals to cope with and address health challenges by: • • • Building and strengthening capacity for healthy urbanization. Supporting city-to-city learning and sharing of experiences. Promoting, advocating and building capacity for a settings approach for NCD prevention and control and reducing health inequities. • Building capacity to strengthen national and subnational health promotion policies and programmes.

Strategic Objective 6

WPR/RC64/3 page 144 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 6.2 Guidance and support provided in order to strengthen national systems for surveillance of major risk factors through development and validation of frameworks, tools and operating procedures and their dissemination to Member States where a high or increasing burden of death and disability is attributable to these risk factors. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 6.2.1 Number of Member States with a functioning national surveillance system for monitoring major risk factors to health among adults based on the WHO STEPwise approach to surveillance. Number of Member States with a functioning national surveillance system for monitoring major risk factors to health among youth based on the Global school-based student health survey methodology. 94 88 On track

6.2.2

72

73

On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 06.002.WP01 Strengthened risk factors surveillance by developing, validating and disseminating programme and evaluation frameworks, tools & procedures to countries and areas with high or increasing burden of premature death and disability due to behavioural risk factors. Indicator Number of target countries and areas supported that have a functioning national surveillance system for, and regularly reports Baseline 2012 0 Target by 2013 5 Achievement to date On Track/Fully Achieved

Remarks

1

5 KHM, LAO, MNG, PHL and VNM

Strategic Objective 6

WPR/RC64/3 page 145 Annex 1 on, major risk factors in adults.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Countries and areas in the Region have taken up efforts to strengthen NCD surveillance and monitoring. Adult and youth risk factor surveys using WHO tools such as STEPS and GSHS have been widely utilized.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Surveillance systems in countries and areasneeds to be further strengthened.

SUMMARY OF ACTIONS REQUIRED Sustained capacity building at national level for NCD surveillance and monitoring and facilitation of use of data for planning and evaluation is needed.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 6.3 Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed, and technical support provided to Member States with a high or increasing burden of disease and death associated with tobacco use, enabling them to strengthen institutions in order to tackle or prevent the public health problems concerned; support also provided to the Conference of the Parties to the WHO Framework Convention on Tobacco Control for implementation of the provisions of the Convention and development and implementation of protocols and guidelines. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 6.3.1 Number of Member States having comparable adult tobacco prevalence data available from recent national representative surveys, such as the Global Adult Tobacco Survey 78 92 On track Baseline: ASM, AUS, BRN, CHN, COK, FJI, GUM, HOK, JPN, KHM, KOR, Strategic Objective 6

WPR/RC64/3 page 146 Annex 1 (GATS) or STEPS. MYS, NEZ, NIU, MNP, PHL, SGP, TON, TUV, VNM and VUT By end 2012: LAO 6.3.2 Number of Member States with comprehensive bans on smoking in indoor public places and workplaces. 31 33 On track Baseline: AUS, MHL, NRU, NEZ By end 2012: BRN 6.3.3 Number of Member States with bans on tobacco advertising, promotion and sponsorship. 20 21 On track Baseline: None By end 2012: VNM

Strategic Objective 6

WPR/RC64/3 page 147 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 06.003.WP01 Capacity building training and advocacy support provided to countries and areas with a high and increasing burden of disease and death associated with tobacco use to strengthen institutions in order to address and/or prevent public health problems concerned. Support provided to the Conference of the Parties to the WHO Framework Convention on Tobacco Control for implementation of the provisions of the Convention. Indicator Number of countries and areas that have improved policies consistent with the WHO Framework Convention on Tobacco Control. Baseline 2012 24 Target by 2013 27 Achievement to date On Track/Fully Achieved

Remarks

1

24 AUS, BRN, CHN, COK, FJI, HOK, JPN, KHM, KOR, LAO, MAC, MYS, MHL, FSM, MNG, NRU, NEZ, PHL, PNG, SGP, SLB, TON, VNM and WSM 12 AUS, BRN, CHN, JPN, KHM, KOR, MAC, MNG, MYS, NEZ, PHL and SGP

2

Number of countries and areas that have improved health workforce, infrastructure and essential medicines for tobacco control. Number of countries and areas that have established or reinforced a national coordinating mechanism for comprehensive tobacco control.

8

12

3

20

25

20 AUS, BRN, CHN, COK, FJI, JPN, KHM, KIR, KOR, LAO, MYS, MNG, NEZ, PLW, PHL, PNG SGP, TON, VNM and WSM

Strategic Objective 6

WPR/RC64/3 page 148 Annex 1 4 Number of countries and areas with comparable national youth tobacco use prevalence data disaggregated by age and sex. 32 36 32 ASM, AUS, BRN, CHN, COK, FJI, FSM, GUM, HOK, JPN, KHM, KIR, KOR, LAO, MAC, MYS, MHL, MNG, NRU, NEC, NEZ, NIU, PLW, PHL, PNG, SGP, SLB, TON, TUV, VNM, VUT and WSM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Countries and areashave increased capacity to strengthen tobacco control to achieve full implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC) and its guidelines. Countries and areashave strengthened tobacco control by adopting increased tobacco taxes and tobacco control laws. The Asia Pacific Child and Family Health Alliance for Tobacco Control was established. Technical support on plain packaging of tobacco products. Seven countries and areas in the Region, namely: BRN, CHN, HOK, KHM, MYS, MNG, NEZ, including countries from other regions, participated in a two-day technical meeting in BRN. Cities from BRN CHN, JPN, MAC, MYS, KOR, MNG and the PHL were trained to establish tobacco quit-lines. Technical support to identify issues in tobacco trade and collaborative actions for the health and trade sectors was provided to representatives from ministries of trade and health from AUS, BRN, CHN, FJI, HOK, JPN, KHM, KOR, MYS, NEZ, PHL, SGP, SLB, VNM and WSM at consultation on tobacco and trade. Technical support for Global Youth Tobacco Survey (GYTS) implementation and analysis was provided to BRN, CHN, the FSM, GUM, KHM, LAO, MNG, MNP, NEC, PHL, PNG, PYF, SGP, TON and VNM.

Strategic Objective 6

WPR/RC64/3 page 149 Annex 1 Technical support for the analysis of National Adult Tobacco Survey was provided to LAO. Technical support to develop effective tobacco control policy and measures was provided to CHN, KHM, LAO, MYS, MNG, PHL, PNG, SLB and VNM at the first regional Johns Hopkins Tobacco Control Leadership Institute training workshop held in Manila in January 2012.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Many PIC are characterized as having some of the highest incidence of disease and death associated with tobacco use, but lack the capacity in one of the most critical areas of tobacco control, the ability to counter tobacco industry interference with tobacco control policies. Both legal and technical expertise is needed to assist governments in their efforts to overcome industry interference. There is also a need to provide countries and areas with clear and current information that will encourage signing and ratification of the Protocol on the Elimination of Illicit Trade in Tobacco Products.

SUMMARY OF ACTIONS REQUIRED Strong multisectoral partnership and technical assistance are key factors to the success of tobacco control, as is the support of civil society. Close collaboration with WHO SP and COs is critical to ensure agreement on key actions that need to be taken on tobacco control. A typology based on where each country and area is in terms of the tobacco epidemic and the extent of policy implementation should inform the type of technical assistance and actions taken.

Strategic Objective 6

WPR/RC64/3 page 150 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 6.4 Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed, and technical support provided to Member States with a high or increasing burden of disease or death associated with alcohol, drugs and other psychoactive substance use, enabling them to strengthen institutions in order to combat or prevent the public health problems concerned. Performance Indicators Baseline Target by Status by end 2012 2013 2012 6.4.1 Number of Member States that have developed, with WHO support, strategies, plans and programmes for combating or preventing public health problems caused by alcohol, drugs and other psychoactive substance use. Number of WHO strategies, guidelines, standards and technical tools developed in order to provide support to Member States in preventing and reducing public health problems caused by alcohol, drugs and other psychoactive substance use. 57 55 On track

6.4.2

16

17 On track

Strategic Objective 6

WPR/RC64/3 page 151 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 06.004.WP01 Improved capacity of Member States with a high or increasing burden of risk factors and disease in order to strengthen institutions to prevent public health problems associated with alcohol, drugs and other psychoactive substance use. Indicator Number of countries and areas supported that have developed policies, plans and programmes for preventing public health problems caused by alcohol, drugs and other psychoactive substance use. Baseline 2012 4 Target by 2013 7 Achievement to date On Track/Fully Achieved

Remarks

1

8 Intensive support provided to KHM, LAO, MNG and VNM in situation analysis, stakeholders consultation, awareness raising, and development of policy, plan and programme

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Alcohol related harm is considered a public health challenge in an increasing number of countries and areas. CHN, KHM, LAO, MNG, VNM are addressing the issue through development of national policies and plans or through integration into other programmes such as NCD prevention and control and road safety. MNG is working on the 2nd national programme on alcohol. The draft law on alcohol prevention and control and national programme for alcohol prevention and control will be presented to the parliament in January 2013. LAO and VNM are conducting national review and consultations for alcohol legislation. In FJI, the Cabinet approval for review of legislation of alcohol for public health perspective has been attained. The Regional Office organized two regional meetings on NCD and alcohol: the Regional Meeting on NCD prevention and control through reduction of alcohol-related harm in April 2012 in HOK, CHN; and the biregional (SEARO and WPRO) workshop on building capacity for reducing the harmful use of alcohol at country level in coordination with NCD prevention and control in Bangkok, Thailand in October 2012.

Strategic Objective 6

WPR/RC64/3 page 152 Annex 1 Priority countries and areaswere supported to attend the Global Alcohol Policy Conference in February 2012. Technical and financial support provided for policy and plan development. Technical briefing on Amphetamine-type stimulants (ATS) has been developed. In KHM, WHO provided technical support for the community-based drug treatment programme (CBTx) with counterparts from the Ministry of Health and relevant stakeholders. In MYS, technical support was provided to produce guidelines and training modules to prevent and control ATS abuse. The workshop to develop guidelines for management of inhalants at primary health care (PHC) settings is due for implementation in 2013. Technical support was also provided for the development of Screening Brief Intervention and Referral to Treatment to prevent and reduce alcohol-related harm (SBIRT) guidelines along with national training on implementation of SBIRT for community cadre/volunteers. Technical support was provided for training and implementation of Strategic Health Communication on alcohol harm reduction including integration into settings in PIC. In VNM, WHO supported the Social Affairs Committee of the National Assembly to provide technical information on alcohol related harm for the members of the National Assembly.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Reduction of harmful use of alcohol represents one of most difficult areas in public health arena as the result of high burden, low priority, poor public awareness, limited resource allocation, and strong resistance from economic operators.

SUMMARY OF ACTIONS REQUIRED Strengthening technical capacity of the secretariat and setting up leading agency/organization at country level is the initial step to leverage changes in control of harmful use of alcohol.

Strategic Objective 6

WPR/RC64/3 page 153 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 6.5 Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed and technical support provided to Member States with a high or increasing burden of disease or death associated with unhealthy diets and physical inactivity, enabling them to strengthen institutions in order to combat or prevent the public health problems concerned. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 6.5.1 Number of Member States that have adopted multisectoral strategies and plans for healthy diets or physical activity, based on the WHO Global Strategy on Diet, Physical Activity and Health. Number of WHO technical tools that provide support to Member States in promoting healthy diets or physical activity. 79 68 On track

6.5.2

22

24 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 06.005.WP01 Improved evidence and knowledge base to inform policy development in countries and areas with a high or increasing burden of disease or death associated with unhealthy diets. Indicator Number of countries and areas supported by WHO that have developed and implemented policies, plans and programmes for improving diets and physical Baseline 2012 4 Target by 2013 6 Achievement to date On Track/Fully Achieved

Remarks

1

6 Salt reduction is ongoing in COK, FJI, FSM, LAO, KHM, MNG, NRU, SLB, TON and VNM. Physical activity promotion carried out in BRN and Strategic Objective 6

WPR/RC64/3 page 154 Annex 1 activity, including adoption of the Global Strategy on Diet, Physical Activity and Health CHN.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE MNG has already shown reduction of salt content in bread. Technical support was provided for salt reduction in KHM, LAO, MNG and VNM; and in six PIC – COK, FJI, FSM, NRU, SLB and TON. Support was provided to MNG and the PHL to carry out study on outdoor advertisement of unhealthy food near schools. Support was provided to MYS to initiate studies on marketing of food and non-alcoholic beverages to children. The effectiveness of a programme on physical activity promotion in school (Happy 10) was studied in CHN. A symposium was completed on BRN’s National Physical Activity Guidelines for Physical Education Teachers and Consultative Workshop on Increasing Physical Activity amongst School Children in BRN. TUV was supported for Healthy Workplace programme (Biggest Loser Wins). Training package for primary health care workers on counseling for diet and physical activity to control blood glucose and pressure was completed in VNM.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Unhealthy diet, especially products which are high in salt, have been identified as a priority area for action. Marketing of food and non-alcoholic beverages to children is another priority area recognized by countries and areas.

Strategic Objective 6

WPR/RC64/3 page 155 Annex 1 SUMMARY OF ACTIONS REQUIRED Stronger advocacy efforts and generation of evidence to guide policy is required.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 6.6 Evidence-based and ethical policies, strategies, interventions, recommendations, standards and guidelines developed and technical support provided to Member States to promote safer sex and strengthen institutions in order to tackle and manage the social and individual consequences of unsafe sex Performance Indicators Baseline Target by Status by 2012 2013 end 2012 6.6.1 Number of Member States generating evidence on the determinants and/or consequences of unsafe sex. Number of Member States generating comparable data on unsafe sex indicators using WHO STEPS surveillance tools. 22 12 On track

6.6.2

5

7

On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER06.006.WP01 Evidence-based and ethical policies, strategies, interventions, standards and guidelines developed, and provide support to countries and areas to promote protected sex and strengthen institutions to address and manage social and individual consequences of unsafe sex. Indicator Number of countries and areas supported by WHO that have initiated or implemented new or improved interventions at Baseline 2012 0 Target by 2013 5 Achievement to date On Track/Fully Achieved

Remarks

1

4 KHM, MNG, PHL and PNG have been supported to conduct HIV and STI programme reviews.

Strategic Objective 6

WPR/RC64/3 page 156 Annex 1 individual, family and community levels to promote safe sexual behaviours to prevent unintended pregnancy and to prevent infectious diseases.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Four countries (KHM, MNG, PHL and PNG) have been supported by WHO to conduct HIV and STI programme reviews, which include promotion of safe sexual behaviours at individual and community levels for prevention of STI and HIV infections. An HIV and STI Programme Managers Meeting for Asian Countries is planned to be organized on 25–27 February 2013, and a STI/HIV Programme Managers Meeting for the PIC will be conducted in June 2013. In these two meetings, guidelines, policies and experiences of countries and areas will be shared on structure and community interventions to promote safe sex and reduce the consequence of unsafe sex, including HIV and STI. Countries and areas are encouraged to strengthen the linkages of HIV and STI services with sexual and reproductive health wherever possible and appropriate. The WHO-UNDP Asia Pacific training package which is now available supports access to services for men who have sex with men, and promotes safe sex at individual and community level in this population. This training package was pilot tested in CHN in 2012 and planned to be tested in MYS in 2013.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Little resources (both human and funding) have been specified for this area in the past, and is expected to shrink further in the future.

SUMMARY OF ACTIONS REQUIRED There is the need to intensify resource mobilization efforts in this area.

Strategic Objective 6

WPR/RC64/3 page 157 Annex 1 STRATEGIC OBJ ECT IV E 7 TO ADDRESS UNDERLYING SOCIAL AND ECONOM IC DETERM INANTS OF HEALTH THROUGH POLICIES AND PROGRAMMES THAT ENHANCE HEALTH EQUITY AND INTEGRATE PRO-POOR, GENDERRESPONSIV E, AND HUMAN RIGHTS-BASED APPROACHES EXPECTED RESULT 07.001 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS CHN, KIR, LAO, MNG, PNG and VUT DHS FSM and MYS DHS KHM, MYS and VNM DHS DHS LAO, PHL, PIC and SLB DHS TOTAL 7

07.002

3 4 1 5

07.003 07.004 07.005

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Programme implementation under this SO is on track overall. Increasing awareness and demand for technical support are seen across the Region on social determinants of health, reducing health inequities, promoting gender equality and mainstreaming gender perspectives into health policies and programmes, and promoting a human rights-based approach to health. Programme implementation has focused mainly on building capacity, providing technical support and strengthening the evidence base.

CHALLENGES/ISSUES The crucial challenges are: (i) to strengthen capacity on the equity-focused health policy, social determinants of health, gender analysis and actions, and ethics and human rights at global, regional and country levels and to support Member States in collecting and acting on relevant data; (ii) to ensure that all levels of the Organization reflect the perspectives of social determinants, equity, gender, ethics and human rights into their work; and (iii) to effectively measure and monitor progress.

Strategic Objective 7

WPR/RC64/3 page 158 Annex 1 SUMMARY OF ACTIONS REQUIRED Equity is the key remaining health and development challenge in the Region. Recent decades have seen increasing health inequities within and among countries and areas, despite medical and technological progress. Reversing this trend requires action on the social determinants of health through an intersectoral approach as well as equity-focused policies and actions within the health sector. The Millennium Development Goals (MDGs) underscore the links between health and development and the importance of addressing poverty and gender inequality. Ministries of health must integrate equity-enhancing, pro-poor, gender-responsive, ethically sound approaches into health-sector policies and programmes. Human rights offer a unifying conceptual framework for these strategies and standards by which to evaluate success. The implementation approaches adopted have been effective and will generally be continued, based on demand for support and windows of opportunity. The ability to achieve planned outcomes will depend critically on available resources.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 7.1 Significance of social and economic determinants of health recognized throughout the Organization and incorporated into normative work and technical collaboration with Member States and other partners. Performance Indicators Baseline Target by Status by end 2012 2013 2012 7.1.1 Number of WHO regions with a regional strategy for addressing social and economic determinants of health as identified in the Report of the Commission on the Social Determinants of Health endorsed by the Director-General. 5 6 On track

Strategic Objective 7

WPR/RC64/3 page 159 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 07.001.WP01 Support provided to strengthen the capacity of the Organization and Member States to reduce health inequities, address socioeconomic determinants of health and promote more equitable and pro-poor policies, programmes and interventions. Indicator Number of countries and areas supported within the biennium to adopt effective tools, methods and strategies for action. Baseline 2012 3 Target by 2013 6 Achievement to date On Track/Fully Achieved

Remarks

1

6 FJI, LAO, MNG, PHL, PNG and VUT

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Activities included technical support, capacity-building, technical documents and resources development regionwide as well as in/for the LAO, MNG, PNG, PHL and VUT. A national training workshop on equity analysis of national health data was completed and follow-up action taken to prepare a national report on equity for the health of women and children in the PHL. A roadmap was developed for achieving MDGs 4 and 5 targeting vulnerable mothers and children especially in western region in MNG. A focus on social determinants, Health in All Policies (HiAP) and gender was integrated into and sessions conducted at a workshop on national health plans, strategies and policies in LAO. Technical support was provided to PIC on HiAP, through a workshop with WHO Kobe Centre in FJI on Island HEART (adaptation of the Urban HEART tool) and participation in a regional research symposium on social determinants of health and HiAP. Draft country profiles for PNG and VUT on equity, gender and human rights issues in health were updated, revised, and finalized. Selected Country Cooperation Strategy (CCS) documents were reviewed from the perspective of equity, gender and human rights. Strategic Objective 7

WPR/RC64/3 page 160 Annex 1 Selected modules in the regional publication series Integrating Poverty and Gender into Health Programmes: A Sourcebook for Health Professionals were translated into Chinese, Khmer, Mongolian and Vietnamese

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Although capacity in Member States and technical programmes is still weak, steadily increasing interest and demand for support have been observed.

SUMMARY OF ACTIONS REQUIRED There is a need for continued support and using windows of opportunity. The Rio Political Declaration on the Social Determinants of Health and the accompanying WHA resolution urging WHO to support Member States in implementing the Declaration comprises one such enabling opportunity.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 7.2 Initiative taken by WHO in providing opportunities and means for intersectoral collaboration at national and international levels to address social and economic determinants of health, including understanding and acting upon the public health implications of trade and trade agreements, and to encourage poverty-reduction and sustainable development. Performance Indicators Baseline Target by Status by end 2012 2013 2012 7.2.1 Number of published country experiences on tackling social determinants for health equity 28 38 On track

Strategic Objective 7

WPR/RC64/3 page 161 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 07.002.WP01 Opportunities created and mechanisms used to facilitate action across sectors to reduce health inequities and address the socioeconomic determinants of health. Indicator Number of countries and areas whose health policies target the social and economic determinants of health on an intersectoral basis, incl. through actions on trade and health, extend of actions across sectors to reduce health inequities. Number of countries and areas that increased their understanding of the issues at the interface of trade and health with assistance from WHO. Baseline 2012 3 Target by 2013 6 Achievement to date On Track/Fully Achieved Remarks

1

2 FJI, LAO

2

1

1

1 Ongoing work in VNM on Trans Pacific Partnership Agreement (TPPA) and pharmaceutical industry/trade issues

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Activities included technical support, capacity building, technical document and resources development regionwide as well as in/for LAO. A focus on social determinants, HiAP and gender was integrated into and sessions conducted at a workshop on national health plans, strategies and policies in LAO.

Strategic Objective 7

WPR/RC64/3 page 162 Annex 1 With HQ, a brief on social protection was published in the Social Determinants of Health (SDH) Sectoral Briefing Series, and a draft prepared on energy. Two-pagers were prepared for two sectoral briefs. A Global Strategy and Plan of Action on SDH were drafted jointly by HQ and regions. In preparation for the 8th Global Conference on Health Promotion (with the theme health in All Policies), a book on HiAP was reviewed and analysis of regional approaches to HiAP initiated through literature reviews and case studies. With HQ and the Government of South Australia, a training manual on HiAP was drafted. A new webpage on the WPRO website was created for social determinants of health and regularly updated.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Although capacity in Member States and technical programmes is still weak, steadily increasing interest and demand for support have been observed.

SUMMARY OF ACTIONS REQUIRED There are opportunities for convergence with the work on health promotion, urban health and multisectoral action for NCD prevention and control. Demand from the Pacific for support in this area seems to be increasing. There is a need for continued support and using windows of opportunity.

Strategic Objective 7

WPR/RC64/3 page 163 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 7.3 Social and economic data relevant to health collected, collated and analysed on a disaggregated basis (by sex, age, ethnicity, income, and health conditions, such as disease or disability). Performance Indicators Baseline Target by Status by end 2012 2013 2012 7.3.1 Number of country reports published during the biennium incorporating disaggregated data and analysis of health equity. 46 50 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 07.003.WP01 Support provided to strengthen country capacity to collect, analyse and use information on health and social determinants that is disaggregated by various relevant indicators of social exclusion, such as sex, age, ethnicity, income, or location. Indicator Number of countries and areas supported within the biennium to analyse and use information on health and social determinants that is disaggregated by various relevant indicators of social exclusion Baseline 2012 3 Target by 2013 6 Achievement to date On Track/Fully Achieved

Remarks

1

7 FJI, KHM, LAO, PHL, PNG, VNM and VUT

Strategic Objective 7

WPR/RC64/3 page 164 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Activities included technical support, capacity building, technical document and resources development regionwide as well as in/for, KHM, FJI, LAO, PHL, PNG, VUT, and VNM. A national training workshop on equity analysis of national health data was completed and follow-up action taken to prepare a national report on equity for the health of women and children in the PHL. Draft country profiles for PNG and VUT on equity, gender and human rights issues in health were updated, revised and finalized. Material on equity issues was developed for the regional MDG progress report. Collaboration was undertaken with Health Services Development (HSD) unit on mainstreaming an equity focus into ongoing health sector strategies review.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Awareness and technical capacity in Member States as well as technical programmes within the Organization on the need and methods for equity-focused measurement and monitoring of health policies, programmes and outcomes is relatively weak.

SUMMARY OF ACTIONS REQUIRED Increasing interest and demand for assistance by Member States should be supported by the Region. Guidance and normative work from WHO Geneva is needed on indicators and methods to conduct equity-focused measurement and monitoring of health policies, programmes and outcomes.

Strategic Objective 7

WPR/RC64/3 page 165 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 7.4 Ethics- and rights-based approaches to health promoted within WHO and at national and global levels. Performance Indicators Number of tools produced for Member States or the Secretariat giving guidance on using a human rightsbased approach to advance health. Number of tools produced for Member States or the Secretariat giving guidance on use of ethical analysis to improve health policies. Baseline 2012 37 Target by 2013 Status by end 2012 45 On track

7.4.1

7.4.2

16

19 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 07.004.WP01 Support provided to strengthen the capacity of the Organization and Member States to promote ethical humanrights based approaches to health. Indicator Number of countries and areas supported within the biennium to adopt effective tools, methods and strategies for action. Baseline 2012 3 Target by 2013 6 Achievement to date On Track/Fully Achieved Remarks

1

3 KHM, PNG and VUT

Strategic Objective 7

WPR/RC64/3 page 166 Annex 1 2 Number of technical programmes supported within the biennium to adopt effective tools, methods and strategies for action 2 4 2 Disabilities and Health Services Development

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Activities included technical support, capacity building, technical document and resources development regionwide as well as in/for KHM, PNG and VUT. Technical review and other inputs were provided to health in prisons work in KHM. Selected CCS documents were reviewed from the perspective of equity, gender and human rights. With colleagues in health service development and disabilities, a technical document on mainstreaming disabilities into health systems was drafted. Human Rights Day was observed in the Regional Office jointly with the disabilities unit with a brown bag and dissemination of audio-visual materials and country offices were supported to observe the day. A new webpage on the WPRO website was created for human rights and regularly updated.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Awareness and technical capacity in Member States as well as among technical programmes within the Organization is relatively weak and needs strengthening.

SUMMARY OF ACTIONS REQUIRED Increasing interest and demand for support is observed. There is a need for continued support and using windows of opportunity. It is expected that the work of the new Gender Equity and Human Rights (GER) team in WHO Geneva, whose mandate is to strengthen the institutional dimensions of equity, gender and human rights mainstreaming, will provide an enabling environment to support programmatic mainstreaming in Member States and with technical programmes within the Organization.

Strategic Objective 7

WPR/RC64/3 page 167 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 7.5 Gender analysis and responsive actions incorporated into WHO’s normative work and support provided to Member States for formulation of gender-responsive policies and programmes. Performance Indicators Number of WHO tools, documents (developed or updated) and joint activities with WHO technical units to promote gender responsive actions into the work of WHO Number of gender mainstreaming activities conducted in Member States supported by WHO Baseline 2012 98 Target by 2013 Status by end 2012 90 On track

7.5.1

7.5.2

189

190 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 07.005.WP01 Support provided to strengthen the capacity of the Organization and Member States to promote more genderresponsive health policies, programmes and interventions. Indicator Number of countries and areas supported within the biennium to adopt effective tools, methods and strategies for action Baseline 2012 3 Target by 2013 6 Achievement to date On Track/Fully Achieved Remarks

1

4 KHM, LAO, PNG and VUT

Strategic Objective 7

WPR/RC64/3 page 168 Annex 1 2 Number of technical programmes supported within the biennium to adopt effective tools, methods and strategies for action 2 4 3 RPH; Injuries and Violence Prevention; Health Services Delivery

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Activities included technical support, capacity building, technical document and resources development regionwide as well as in/for KHM, LAO, PNG, SLB and VUT. Support on gender-based violence and institutional gender mainstreaming was provided in KHM, LAO and PNG. With HSD unit, a focus on social determinants, HiAP and gender was integrated into and sessions conducted at a workshop on national health plans, strategies and policies in LAO. Gender mainstreaming capacity building was conducted in KHM and PNG. Draft country profiles for PNG and VUT on equity, gender and human rights issues in health were updated, revised and finalized. Selected CCS documents were reviewed from the perspective of equity, gender and human rights. Joint work was undertaken with colleagues in IVP and Reproductive Health/women’s health on violence against women to prepare for an agenda item on injuries and violence during the meeting of the Regional Committee for the Western Pacific in 2012. The regional working group on gender, women health met. WHO Regional Learning Committee and WHO Core Voluntary Contribution (VC) proposals for gender mainstreaming training of Regional Office and country office staff were submitted. International Women’s Day was jointly observed with RPH/women’s health, and an information product and media release published and uploaded to our webpages. International

Strategic Objective 7

WPR/RC64/3 page 169 Annex 1 Day for the Elimination of Violence against Women was observed during the Consultation of WHO Representatives (WRs) and Country Liaison Officers (CLOs) in November 2012. Selected modules of the Sourcebook series were translated into Chinese, Khmer, Mongolian and Vietnamese. A new webpage on the WPRO website was created for gender and regularly updated.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Capacity in Member States and technical programmes is still weak. However, increasing interest and demand for support is observed. There is a need for continued support and using windows of opportunity.

SUMMARY OF ACTIONS REQUIRED There is a need for continued support and using windows of opportunity. It is expected that the work of the new GER team in WHO Geneva, whose mandate is to strengthen the institutional dimensions of equity, gender and human rights mainstreaming, will provide an enabling environment to support programmatic mainstreaming in Member States and with technical programmes within the Organization

Strategic Objective 7

WPR/RC64/3 page 170 Annex 1 STRATEGIC OBJ ECT IV E 8 TO PROM OTE A HEALTHIER ENV IRONM ENT, INTENSIFY PRIMARY PREVENT ION AND INFLUENCE PUBLIC POLICIES IN ALL SECTORS SO AS TO ADDRESS THE ROOT CAUSES OF ENV IRONMENTAL THREATS TO HEALTH EXPECTED RESULT 08.001 08.002 08.003 08.004 08.005 08.006 COUNTRIES CONTRIBUTING TO RESULTS FJI, KHM, KIR, LAO, MNG, PHL, PIC, VNM CHN, FSM, LAO, MNG, NRU, PNG, SLB, TUV, VNM CHN, MNG, PHL, PIC, VNM LAO TON CHN, FJI, KHM, LAO, MNG, MYS, PHL, PIC, VUT TOTAL 8 9 5 1 1 9

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE WHO/WPRO has continued supporting Member States in strengthening environmental health programme in the Region through enhancing evidence-based studies and development of national policies and standards in various areas of environmental health. Water, Sanitation and Hygiene: WPRO supported Member States to develop national policies and institutional frameworks to protect and improve drinking water quality through (1) water safety plans; (2) household water treatment and safe storage (HWTS); (3) National drinking water quality standards; (4) active involvement in regional forums in the sector such as East Asia Ministerial Conference on Sanitation and Hygiene; (5) active participation in the MDG 7 global and regional reports on water and sanitation; and (6) providing assistance in the Water and Sanitation Sector Assessment Process. National Environmental Health Action Plan: WPRO supported Member States to develop their own National Environmental Health Action Plan (NEHAP) or equivalent plans to promote inter- and multisectoral cooperation and collaboration to strengthen environmental health programmes at the national level. In addition, WPRO has provided support in priority areas identified in NEHAP such as: (1) water and sanitation; (2) chemical and hazardous Strategic Objective 8

WPR/RC64/3 page 171 Annex 1 substances including establishment of poison centres; (3) solid and hazardous waste management, particularly health care waste management; (4) health—impact assessment; (5) health in other sectors such as transport, agriculture, energy, industries etc.; and (6) children environmental health. Regional Forum on Environment and Health: WHO (WPRO and SEARO) and UNEP serve as secretariat for the Regional Forum on Environment and Health in Southeast and East Asian Countries and supports the following activities: (1) organization of the Ministerial Regional Forums; (2) organization of High-Level Officials' Meetings; (3) the Advisory Board of the Regional Forum; (4) organization of Scientific Conferences; (5) the Regional Thematic Working Groups (Air Quality; Water Supply, Sanitation and Hygiene; Solid and Hazardous Waste; Toxic Chemicals and Hazardous Substances; Climate Change, Ozone Layer Depletion and Ecosystem Changes; Contingency Planning and Preparedness and Response in Environmental Health Emergencies; and Health Impact Assessment). Climate Change: WHO-WPRO has collaborated with Member States in implementing the Regional Framework for Action to Protect Human Health from the Effects of Climate Change in the Asia-Pacific Region. More specifically, WPRO supported Member States in the following areas: (1) health vulnerability assessment; (2) development and implementation of national strategies/action plans of health adaptation due to climate change; (3) capacity building in health adaptation to climate change; (4) promotion of co-benefits (i.e. reducing greenhouse gas emissions and improving health) approach in different sectors (e.g. transport, agriculture, energy, etc.). Occupational Health: WHO-WPRO collaborated with Member States in implementing the Regional Framework for Action for Occupational Health, but due to limited funds, this was mainly focused on the regional programme on asbestos and asbestos related diseases and Health Impact Assessment (HIA). It is a neglected area of focus.

CHALLENGES/ISSUES Environmental health risks and threats are among the most serious public health issues in the WPR. The environmental burden of disease accounts for approximately 2.7 million deaths, or 25% of total deaths, and 53.6 million disability-adjusted life years (DALYs), or 22% of the

Strategic Objective 8

WPR/RC64/3 page 172 Annex 1 total DALYs lost in the Region1. More than 90% of the disease burden and associated deaths occur in developing countries and areas in the Region, with women and children working and living in polluted and fragile ecosystems being the most affected. While some of the risks are long-standing, such as unsafe water and poor sanitation, many are emerging threats, such as indoor and outdoor air pollution, toxic and hazardous chemicals and waste, radiation, climate change and poor occupational conditions. Some of these problems arise naturally; many others have been caused by rapid economic growth, urbanization and industrialization.

SUMMARY OF ACTIONS REQUIRED Prioritization of areas of work to match funding available for this programme needs to be undertaken. The aim is to realign resources to focus on key activities.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 1.1 Evidence-based assessment made, and norms and standards formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic fields, radon, poor-quality drinking-water and waste-water reuse). Performance Indicators Number of Member States with proven capacity to conduct assessments of specific environmental threats to health, in order to quantify, with WHO technical support, the environmental burden of disease, so as to add sustainability to MDG 4, 5 & 6 achievements Baseline 2012 Target by 2013 Status by end 2012

8.1.1

44

58

1

Updated Data for 2004, from "Preventing Disease through Healthy Environments", WHO 2006

Strategic Objective 8

WPR/RC64/3 page 173 Annex 1

8.1.2 Number of new or updated WHO norms, standards or guidelines on occupational or environmental health issues published during the biennium

20

24

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 08.001.WP01 Health impact or risk assessments made, and norms and standards formulated and updated on major environmental hazards (e.g. poor air quality, chemical substances, electromagnetic force, radon, drinking-water and waste-water reuse). Indicator Number of Member States that have conducted assessments of specific environmental threats to health or have quantified the environmental burden of disease with WHO technical support during the biennium Baseline 2012 0 Target by 2013 7 Achievement to date On Track/Fully Achieved

Remarks

1

24 WPRO: 24 AUS, BRN, CHN, FJI, FSM,JPN, KHM, KIR, KOR,LAO,MHL, MNG, MYS, NEZ, NRU, PHL, PLW, PNG, SLB, TON, TUV, VUT, VNM, WSM

Strategic Objective 8

WPR/RC64/3 page 174 Annex 1 2 Number of new or updated norms, standards or guidelines on occupational or environmental health issues developed during the biennium 0 3 6 WPRO: 6 LAO: Revised National Drinking Water Quality Standards; KHM: Health care waste management guidelines; MNG: Essential environmental health standards for health care facilities; MNG: Guidelines for diagnosis and treatment of mercury poisoning

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE (1) Assessments or studies on various environmental hazards carried out during the first year of the biennium were as follows: (a) National asbestos profiles were carried out for CHN, JPN, KOR, LAO, MYS, MNG, PHL, PLW and VNM; (b) Water and sanitation sector assessment for VNM; (c) Global Annual Assessment of Sanitation and Drinking Water (GLAAS) for KHM, MNG, PHL and VNM; (d) Country profiling on health care waste management for AUS, BRU, CHN, FJI, FSM, JPN, KHM, KIR, KOR, LAO, MHL, MNG, MYS, NRU, NZL, PHL, PLW, PNG, SLB, TON, TUV, VNM and VUT. (2) In addition, a study was carried out in MNG to assess the background level of mercury amongst the Mongolian population. (3) National standards and guidelines on various environmental health aspects were improved or established in the following countries:

Strategic Objective 8

WPR/RC64/3 page 175 Annex 1 (a) In LAO, further development of the revised National Drinking Water Quality Standards was undertaken; (b) In KHM, progress was made with finalization of the health care waste management guidelines and in the PHL, the 2nd edition of the health care waste management manual was reviewed and the 3rd edition was prepared. (c) In MNG, the following guidelines were further developed or strengthened: (i) (ii) (iii) Guidelines on essential environmental health standards for health care facilities; Guidelines for diagnosis and treatment of mercury poisoning; and Guidelines for surveillance of chemical poisoning.

(d) In VNM, standards on indoor air quality were developed.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE (1) For asbestos and other occupational health issues, the biggest challenge is the development of policies and national action plans; (2) For health care waste management, the challenge is to continue supporting developing countries and areasin the Region to improve their health care waste management systems; (3) For the Global Annual Assessment of Sanitation and Drinking Water (GLAAS), the challenge is to scale-up the participation of other Member States in the Region; (4) For estimates on access to safe drinking water and basic sanitation the challenge is to reach consensus with some Member States in relation to the difference between their national estimates and the estimates reported by the WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation.

Strategic Objective 8

WPR/RC64/3 page 176 Annex 1 SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE WHO/WPRO would continue working on: • Engaging with Member States to develop policies and national action plans on occupation health; • • Country profiles and update on health care waste management; Engaging with Member States on harmonization of national reports and JMP for Water Supply and Sanitation.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 8.2 Interventions for reduction of environmental hazards Performance Indicators Number of Member States implementing with WHO technical support, primary prevention interventions to reduce pneumonia in children, diarrhoeal and noncommunicable diseases in at least one of the following settings: homes, workplaces, or urban settings Baseline 2012 Target by 2013 Status by end 2012

8.2.1

52

66

Strategic Objective 8

WPR/RC64/3 page 177 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS 08.002.WP01 Enhanced capacity of Member States for strengthening national occupational and environmental health risk management systems, functions and services. Indicator Number of Member States implementing primary prevention interventions for reducing environmental risks to health, with WHO technical support, in at least one of the following settings: workplaces, homes or urban settings Baseline 2012 5 Target by 2013 12 Achievement to date On Track/Fully Achieved Remarks

1

17 COK, KHM, KIR, LAO,MNG, MYS, PHL, PNG, SLB, TON, TON, VUT, VNM, WSM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE WHO/WPRO continued to promote successfully the use of primary prevention interventions to tackle the environmental and occupational determinants of health. The following are the major achievements in the Member States of the Region: (1) Drinking water quality at community or household levels: (a) (b) Training Manual on HWTS; MNG: Translation of Manual on Water Safety Planning for Small Community Water Supplies into Mongolian Language; (c) (d) (e) LAO, PHL, VNM: Phase-2 Water Safety Plans (WSP) implemented; MYS: Development of National Strategic Plan on Water Safety Plan; CHN: Capacity-building on water safety plans for two provinces; Strategic Objective 8

WPR/RC64/3 page 178 Annex 1 (f) COK, KHM, LAO, MNG,PHL, PIC, TON, VNM,VUT,WSM: Commencement of Phase-3 Water Safety Plans Programme; (g) PNG: Environmental health interventions in Maternal Child Health and Nutrition (MCN) programmes; (h) (i) LAO: Essential environmental health interventions in health care facilities; MNG: Integrated primary health care services and water and sanitation hygiene improvement in selected rural disadvantaged soums (districts); (j) PHL: Final Draft National Policy on water safety plans and household water treatment and safe storage (2) Health care waste management (HCWM): (a) MNG: Basic training on health care waste management for provincial health departments; (b) (c) (d) LAO: Training on HCWM; MNG: Two model hospitals for sound health care waste management; MNG: Distance learning on HCWM for 6 months for health care waste managers of secondary and tertiary level hospitals; (e) VNM: National Action Plans for health care waste management; training on Guidelines of Monitoring and Surveillance of Healthcare Waste; (f) (3) MNG: Database for Health Care Waste Management was created at MOH.

Improvement in the management of poisons/chemicals: (a) (b) COK, KIR, SLB,TON and WSM: Poison information network; MNG: Pilot intervention for removal of arsenic in drinking water of 1 province and one slum/town (c) VNM: developing Guidelines on Safe Use of Mercury in Healthcare Facilities

SUMMARY OF ISSUES/CHALLENGES Strategic Objective 8

WPR/RC64/3 page 179 Annex 1 (1) WHO/WPRO’s work on safe drinking water through the water safety plan process and household water treatment and safe storage intervention is successful. The challenge is to scale-up these interventions, especially at the primary health-care and community levels. (2) The work on poison network is important but hampered by lack of resources for their sustainability.

SUMMARY OF ISSUES WHO/WPRO’s work on safe drinking water through the water safety plan mechanisms and household water treatment and safe storage intervention is successful. The challenge is to scale-up these interventions, especially at the primary health—care and community levels. The work on poison network is important but is hampered by lack of resources for its sustainability.

SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE WHO/WPRO will continue working Member States in strengthening primary preventions in various sectors. They are as follows: strengthening drinking water quality at community or household levels thorough the WSP and HWTS); continue work on environmental health interventions to strengthen maternal and child health programmes in the selected Member States; strengthening management of health care waste in the health care settings; strengthening the poison information network

Strategic Objective 8

WPR/RC64/3 page 180 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 8.3 Policy, planning and services for occupational and environmental health Performance Indicators Number of Member States that have implemented, with secretariat support, national action plans/policies for the management of occupational health risks, such as in relation to WHO's global plan of action on workers' health 2008–2017 Baseline 2012 Target by 2013 Status by end 2012

8.3.1

72

87

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS 08.003.WP01 Enhanced capacity of Member States for strengthening national occupational and environmental health risk management systems, functions and services. Indicator Number of Member States that have implemented national action plans and/or policies for the management of occupational and environmental health risks with support from WHO Baseline 2012 7 Target by 2013 10 Achievement to date On Track/Fully Achieved Remarks

1

9 CHN, JPN, KOR, LAO, MNG, MYS, PHL, PLW, VNM

Strategic Objective 8

WPR/RC64/3 page 181 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE During the first year of the biennium, WPRO provided support to Member States for the development and strengthening of their national or local environmental health action plans and for occupational health and safety improvement programmes, focusing on asbestos. The progress made is as follows: (1) Strengthened Member States’ NEHAPs or similar plans. To date the following countries and areas have NEHAPs or similar plans: BRN, CHN, JPN, KHM, KOR, LAO, MNG, MYS, PHL, SGP and VNM, (2) Almost all work in occupational health is related to asbestos. These include: (a) Preparation of a national profile of asbestos for CHN, JPN, KOR, LAO, MNG, MYS, PHL, PLW and VNM; (b) Supported selected Member States to participate in the Asian Asbestos Initiative International Seminar (AAI5) - KHM, LAO, MNG, PHL, PLW and VNM. (c) Supported CHN to develop city profiles on occupational health in Chongqing municipality and Guangxi province; (d) In-country training on inspection and abatement of asbestos exposure for specialists on occupational safety, health and inspectors and preparation of handbook on prevention and control of asbestos related diseases for exposed workers in MNG. MNG also developed a documentary video for the community on asbestos and provided training for exposed workers; (e) Study on mesothelioma and asbestos exposure history in three hospitals in VNM. VNM also carried out a survey on working conditions, occupational diseases and work-related accidents in selected factories (chemicals, mines and construction) in six provinces. (3) Engaging with Member States on HIA: VNM has developed training guidelines on HIA.

Strategic Objective 8

WPR/RC64/3 page 182 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The development of NEHAP by Member States is very important to improve coordination between the environment and other relevant sectors with the health sector at both the national and provincial levels. It is very important for WHO/WPRO to continue this support and engagement with Member States to ensure the acceptance and adoption of NEHAP by all Member States in the Region. For those Member States with NEHAP, the challenge is to develop or establish measurable and manageable indicators and targets for environmental health risks identified in their NEHAPs.

SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE WHO/WPRO will continue providing support to Member States for the development and strengthening of their national or local environmental health action plans and for occupational health and safety improvement programmes especially related to asbestos.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 8.4 Environmental health policy, and assessment Performance Indicators Baseline 2012 8.4.1 Number of Member States implementing WHOsupported initiatives to reduce noncommunicable and communicable diseases through healthy agriculture, energy, and transportation policies 72 Target by 2013 86 Status by end 2012

Strategic Objective 8

WPR/RC64/3 page 183 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS 08.004.WP01 Development of evidence and knowledge base including plans and programmes to support the health sector in influencing policies in other sectors to allow policies that improve health, the environment and safety to be identified and adopted. Indicator Number of Member States that have implemented health-related policies and/or frameworks in other sectors, with technical support from WHO, during the biennium Baseline 2012 0 Target by 2013 7 Achievement to date On Track/Fully Achieved

Remarks

1

2 (a) LAO: Technical assistance to develop plans of Environmentally Sustainable and Healthy Urban Transport (ESHUT); (b) KHM: technical assistance provided to strengthen intersectoral management of pesticides.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Technical support was provided to health sectors of Member States to influence policies in other sectors in their countries and areas: (1) Transport: Environmentally Sustainable Transport (EST) and ESHUT. LAO: Technical assistance to develop plans of ESHUT; (2) Agriculture on pesticides management: KHM: technical assistance provided to strengthen intersectoral management of pesticides

Strategic Objective 8

WPR/RC64/3 page 184 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE There are various regional initiatives that could be implemented at the country level to strengthen the cooperation between the health sectors and other sectors such as transport, energy etc. The challenge is lack of financial resources for this support.

SUMMARY OF ACTIONS REQUIRED WHO/WPRO will continue supporting the health sector of Member States to influence policies in other sectors, especially the transport, energy and environment sectors.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 8.5 Health sector leadership for healthier environment. Performance Indicators Number of studies or reports on new and re-emerging occupational and environmental health issues published or co—published by WHO Number of reports published or jointly published by WHO on progress made in achieving water and sanitation objectives of major international development frameworks, such as the Millennium Development Goals Number of high-level regional forums on environment and health issues organized or technically supported by WHO biennially Baseline 2012 Target by 2013 Status by end 2012

8.5.1

17

21

8.5.2

10

12

8.5.3

10

8

Strategic Objective 8

WPR/RC64/3 page 185 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS 08.005.WP01 Leadership for a healthier environment & policies to tackle causes of environmental threats to health, thru responding to emerging & re-emerging consequences of development on environmental health & altered patterns of consumption & production, etc. Indicator Number of studies or reports on new or re-emerging occupational and environmental health issues published or copublished by WHO during biennium Baseline 2012 0 Target by 2013 4 Achievement to date On Track/Fully Achieved

Remarks

1

2 (1) HWTS Training Manual; (2) National Profile of Asbestos and supported Member States in data collection and management for the UN Global Annual Assessment of Sanitation and Drinking Water. 1 (b) Sanitation and Hygiene in East Asia

2

Number of reports published or jointly published by WHO on progress made in achieving water and sanitation objectives of major international development frameworks, such as the Millennium Development Goals during the biennium

0

2

Strategic Objective 8

WPR/RC64/3 page 186 Annex 1 3 Number of highlevel forums on environmental and/or occupational health that have been organized or technically supported by WHO biennially 0 3 7 (a) Sixth Highlevel Officials’ on Environment and Health for Southeast and East Asian Countries. (b) Sixth Advisory Board Meeting on Environment and Health for Southeast and East Asian Countries; (c) Task Force Meeting on Environment and Health; (d) Third East Asia Ministerial Conference on Sanitation and Hygiene (EASAN3); (e) Fifth Asian Asbestos Initiative International Seminar (f) Thematic Working Group Meeting on Water, Sanitation and Hygiene (g) Thematic Working Group Meeting on HIA

Strategic Objective 8

WPR/RC64/3 page 187 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Major achievements in the environmental-health sector leadership of Member States during the first year of the biennium are as follows: (1) Regional Forum: Together with WHO—SEARO and UNEP, WHO—WPRO serve as secretariat to the Regional Forum on Environment and Health in Southeast and East Asian Countries and support the following activities: (a) Sixth High-level Officials’ Meeting on Environment and Health for Southeast and East Asian Countries and had involved CHN, JPN, KHM, KOR, LAO, MYS, PHL and VNM. (b) Sixth Advisory Board Meeting on Environment and Health for Southeast and East Asian Countries and had involved CHN, KOR, MYS and PHL; (c) Task Force Meeting on Environment and Health and had involved KOR, MNG, MYS; (d) Third East Asia Ministerial Conference on Sanitation and Hygiene (EASAN3) had involved CHN, KHM, LAO, MNG, MYS, PHL and VNM; (e) KHM, LAO, MNG, PHL, VNM: Fifth Asian Asbestos Initiative International Seminar In addition, WHO—WPRO has provided the secretariat support of the Thematic Working Group (TWG) Meeting of the Regional Forum. The following TWG meetings were supported: (a) Thematic Working Group Meeting on Water, Sanitation and Hygiene and had involved CHN, KHM, LAO, MNG, PHL and VNM: (b) Thematic Working Group Meeting on HIA and had involved MNG, CHN, LAO, KHM, PHL and VNM: (2) The following draft publications and reports have been produced: (a) HWTS Training Manual; (b) Sanitation and Hygiene in East Asia (c) National Profile of Asbestos and supported Member States in data collection and management for the UN Global Annual Assessment of Sanitation and Drinking-Water.

Strategic Objective 8

WPR/RC64/3 page 188 Annex 1 (3) Technical support to the Asia-Pacific Water Safety Plan Network.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The challenge is to sustain the Regional Forum on Environment and Health and to ensure it stays focused. It is a real challenge for WHO/WPRO to provide the necessary secretariat supports for seven thematic working groups.

SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE WHO/WPRO will continue providing supports for the health-sector leadership through active participation in the Regional Forum on Environment and Health for Southeast and East Asian Countries and active involvement in the Regional Thematic Working Groups such as TWG Water Sanitation and Hygiene; TWG Health Impact Assessment and TWG Climate Change.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 8.6 Climate change Performance Indicators Number of studies or reports on the public health effects of climate change published or co- published by WHO Number of countries and areasthat have implemented plans to enable the health sector to adapt to the health effects of climate change Baseline 2012 Target by 2013 Status by end 2012

8.6.1

39

35

8.6.2

30

50

Strategic Objective 8

WPR/RC64/3 page 189 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS 08.006.WP01 Evidence and knowledge base to inform policy On Track/Fully available to enable Member States in identifying, preventing and Achieved tackling public health problems resulting from climate change. Indicator Number of studies or reports on the public health effects of climate change published or co-published by WHO Number of countries and areasthat have implemented plans to enable the health sector to adapt to the adverse effects on health of climate change Baseline 2012 8 Target by 2013 12 Achievement to date Remarks

1

4 Climate change and vectorborne diseases in KHM; MNG; and PNG; Climate change and water-scarcity and waterborne diseases in MNG 13 COK,FSM, KIR,MHL, NIU, NRU,PLW, VUT, PHL, SLB, TON, TUV, VNM

2

3

6

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Major achievements on climate change and health during the first year of the biennium are as follows: (1) Plans and strategies: (a) National climate change and health action plans (NCCHAPs) for the following countries and areas: COK,FSM, KIR, MHL, NIU,NRU,PLW, SLB, TON, TUV, VUT; (b) The year two workplan of the Global Environment Facility (GEF) on climate change adaptation to protect human health continued in CHN; (c) Sustainability plans for climate change and health project in the PHL; Strategic Objective 8

WPR/RC64/3 page 190 Annex 1 (d) Guidelines for development of action plans for provincial level response to climate change in VNM; (e) Annual Forum (fourth forum in 2012) on Climate Change and Health discussed progress report of the health sector and implementation of the NCCHAPs for 2013 in MNG. (2) Capacity building programmes: (a) Training course on vulnerability assessment on climate change and related health impacts in CHN; (b) Handbooks on prevention and control of water-borne diseases and water-scarcity due to climate change effects in MNG; (c) Training manuals on climate change and health printed and distributed in the PHL. (3) Strategies/studies: (a) Implementation of national strategies and action plans on climate change and vectorborne diseases in KHM (b) Vulnerability assessment on climate change, water-scarcity and waterborne diseases in MNG. (4) Legal: (a) Administrative order on climate change and health and its operational guidelines approved by DOH in the PHL. Through the financial support of the Governments of Japan and Republic of Korea, WPRO provided the necessary technical support and advice to Member States on health vulnerability studies and heath adaptation plans due to climate change. This was important because funds for climate change that are available at the Member State levels are not provided for the health sector. WPRO provided the necessary convening roles in the inception workshops and meetings for the initiation, preparation of workplan and implementation of activities for the KOICA-funded projects on Climate Change and Vectorborne Diseases in KHM, MNG and PNG. Strategic Objective 8

WPR/RC64/3 page 191 Annex 1 WHO South Pacific Office (WRSP/DPS) has also played convening roles in implementing the Global Environment Facility-funded (GEF) project on Piloting Climate Change Adaptation to Protect Human Health (PCCAPHH) in FJI, one of only seven countries and areas globally taking part. The other country under this GEF global health project within WPRO is CHN.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE With good progress made by Member States in this Region on climate change and health vulnerabilities and plans for health sector adaptation, the challenge is to define future plans. Following the Executive Board (EB), WHO-HQ is having discussions with all the Regional Offices on the future structure of the climate change workplan and reporting. The current workplan states that the activities will be completed in 2013. In the last EB, CHN requested the Secretariat to prepare a new workplan. WHO-HQ has had some informal discussions with supportive countries and areaswho would like to ensure that the work is continued, but there were suggestions for a simpler mechanism, e.g. renewal of the workplan under the current structure. WHO-WPRO is working very closely with WHO-HQ in this consultation process.

SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE WHO will continue engaging Member States to develop and implement the climate change and health adaptation plans. The most important milestone for 2013 is to prepare the Climate Change and Health Synthesis Report.

Strategic Objective 8

WPR/RC64/3 page 192 Annex 1 STRATEGIC OBJ ECT IV E 9 TO IMPROVE NUTRITION, FOOD SAFET Y AND FOOD SECURIT Y, THROUGHOUT THE LIFE-COURSE, AND IN SUPPORT OF PUBLIC HEALTH AND SUSTAINABLE DEVELOPMENT EXPECTED RESULT 09.001 09.002 09.003 09.004 09.005 09.006 COUNTRIES CONTRIBUTING TO RESULTS CHN, COK, LAO, MHL, MNG, NIU, PHL, TON KHM, LAO, MNG LAO, MNG, MYS, VNM, WSM CHN, FSM, KHM, KIR, LAO, NRU, PNG, VNM KIR, LAO, SLB, VNM FJI, LAO, PIC, VNM, VUT TOTAL 8 3 5 8 4 9

Table 1: Countries and areas contributing to Results under SO 9 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE At the WHO 63rd Regional Committee (RC) Meeting, Nutrition was a main agenda item for the first time in 20 years, since the Joint FAO/WHO International Conference on Nutrition (FAO/WHO ICN). As part of the Nutrition session, a High—Level Panel on Joint Action to Achieve Food and Nutrition Security in the WPR was held. The Regional Directors of Food and Agriculture Organization (FAO), United Nations Children's Fund (UNICEF), World Food Programme (WFP), World Health Organization (WHO) and the USA Executive Board Member attended the high—level panel which aimed to help strengthen collaboration among governments, UN agencies and development partners, leading to nutrition policies and programmes being scaled-up, with a multisectoral approach. WPRO drafted a plan for Implementation of the WHO Comprehensive Plan in the WPR and summary of key actions needed. Undoubtedly, all Member States are in the process of strengthening their national food safety and control systems and are using the Western Pacific Regional Food Safety Strategy 2011– 2015 to develop relevant strategic actions.

Strategic Objective 9

WPR/RC64/3 page 193 Annex 1 CHALLENGES/ISSUES Work under this strategic objective focuses on nutritional quality and safety of foods; promotion of healthy dietary practices throughout the life-course, starting from pregnancy, breastfeeding to appropriate complementary feeding, and considering diet-related chronic diseases; prevention and control of nutritional disorders, including micronutrient deficiencies, especially among vulnerable groups, with emphasis on emergencies, and in the context of HIV/AIDS epidemics; prevention and control of zoonotic and non-zoonotic foodborne diseases; stimulation of intersectoral actions promoting the production and consumption of, and access to, food of adequate quality and safety; and promotion of higher levels of investment in nutrition, food safety and food security at global, regional and national levels. The achievement of Millennium Development Goals (MDG) 1, 4 and 5 in high—burden countries and areas will require nutrition interventions to be scaled up, and this is intimately linked to the need to strengthen national capacities and increase financial resources for implementation in these countries and areas. During the Regional Committee Meeting of the WPR of WHO, in Hanoi, on 25 September 2012, a High—Level Panel on Joint Action to Achieve Food and Nutrition Security in the WPR was held, with the Regional Directors of FAO, UNICEF, WFP and WHO and the USA Executive Board Member. This served to strengthen the collaboration among Governments, UN Agencies and development partners, leading to nutrition policies and programmes being scaled—up, using a multisectoral approach. Member States adopted resolution WPR/RC63.R2 committing further resources to help achieve the six global targets of the comprehensive plan, by 2025; and to regularly report on progress. Currently, providing exact estimates of foodborne disease is not possible due to the limited surveillance systems in place in Member States of the Western Pacific. However, based on diarrhoeal rates and foodborne disease estimates from developed countries and areas, we can conclude that foodborne disease continues to be a significant public health issue. The limited regulatory oversight, the food production and processing procedures currently in place and the absence of consumer education across the Region also supports this conclusion that food safety remains a public health concern. Overall, significant work has occurred to establish food control coordination mechanisms, regulatory frameworks, and inspection services. Tasks like training and public awareness, Strategic Objective 9

WPR/RC64/3 page 194 Annex 1 improved food data, and management of food safety incidents appear to be a priority for most Member States. However, there are considerable differences in size, complexity and effectiveness of food safety and control systems between developed and less developed states. A key challenge for the Member States is a lack of access to financial capital. Significant public funding is needed to access adequate technical and administrative expertise and scientific resources like staff, laboratories, and equipment. Effective governments, adequate legislation and good relationships between government agencies, food industries, and consumer groups are also challenges.

SUMMARY OF ACTIONS REQUIRED Based on the findings, the actions needed in order to accomplish the objectives are as follows: • • • Nutrition policies need to be higher on the development agenda of governments; Nutrition programmes need to be scaled up and inequities need to be addressed; Sustained financing of long-term inter-sectoral plans is required, as these plans are investments in the economic productivity of countries and areas; • Solid data, evidence and information systems on food and nutrition should guide all Member States’ policies and programmes; • • The impact of such programmes and actions must be monitored and evaluated. Provide expertise in developing food safety laws, regulations, standards and facilitating regional harmonization and understanding • Support local, regional and international collaboration such as CODEX programmes and International Food Safety Authorities Network (INFOSAN) activities • Assist in development of food safety policies which will provide a focused approach to addressing food safety as well as improve coordination at a national level through the development of enhancing linkages between the health, and agriculture, industries and trade sectors • Support the Member States in the establishment of risk-based food inspection systems and Food Safety Emergency Systems or Plans

Strategic Objective 9

WPR/RC64/3 page 195 Annex 1 • Improve food safety consumer education and develop consumer awareness enhancing programmes. Most of all, above actions should be implemented by reflecting the priority in each Member State.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 9.1 Partnership, leadership and coordination in nutrition and food safety. Performance Indicators Number of Member States that have functional institutionalized coordination mechanisms to promote intersectoral approaches and actions in the area of food safety, food security or nutrition Number of Member States that have included nutrition, food-safety and foodsecurity activities and a mechanism for their financing in their sectorwide approaches or Poverty Reduction Strategy Papers Baseline 2012 Target by 2013 Status by end 2012

9.1.1

125

100 On Track

9.1.2

35

35 On Track

Strategic Objective 9

WPR/RC64/3 page 196 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 09.001.WP01 Partnerships formed and support provided to countries and areas to increase political, financial and technical commitment to addressing nutrition, food safety and food security through intersectoral action. Indicator Number of countries and areas implementing nutrition, food safety and food security interventions with integrated intersectoral approaches through national policies and plans of action which receive government funding Baseline 2012 0 Target by 2013 10 Achievement to date On Track/Fully Achieved

Remarks

1

9 CHN, PHL, LAO, MNG, TON, WSM, FSM, FJI, VNM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE At the WHO Regional Committee Meeting, Nutrition was a main agenda item for the first time in 20 years, since the FAO/WHO ICN. As part of the Nutrition session, a High-Level Panel on Joint Action to Achieve Food and Nutrition Security in the WPR was held. To help implement the WHO Comprehensive Plan on Maternal, Infant and Young Child Nutrition, a regional action plan is being developed by WPRO, in collaboration with country office, other UN agencies and partners. NUTRITION: KHM: The 2nd National Workshop on Food Security was held in KHM, with the Prime Minister opening the meeting and the participation of the regional directors of the UN agencies, and with the Deputy Prime Minister closing the meeting. The recommendations called for a nutrition strategy and plan to accelerate the reduction of acute and chronic malnutrition in KHM, which has been stalling for some years.

Strategic Objective 9

WPR/RC64/3 page 197 Annex 1 LAO: Capacity has been improved through staff training in evaluation techniques for the weekly iron folic acid supplementation programmes. Two MOH staff were trained at the International Centre for Diarrhoeal Disease Control and Research, Bangladesh in the management of severe malnutrition. Infant and young child feeding guidelines were developed. VNM: The expansion of the weekly iron and folic acid supplementation programme for the prevention and control of anaemia, combined with deworming, has led to the inclusion of this new approach in the national nutrition strategy and to the publication of a paper showing that population-based interventions can efficiently and effectively reduce anaemia and practically eliminate iron deficiency anaemia and moderate to heavy soil transmitted helminth infections, maintaining them below the level of public health concern. TON: National Sub-committee of Healthy Eating is currently working on food security and food safety to draft the Food Act in TON. WHO has organized and/or contributed to various meetings and activities at the regional level with UN agencies responsible for Nutrition and Food Security (FAO, UNICEF – United Nations Children’s Fund, WFP – World Food Programme, WHO – World Health Organization) and with other partners (Save the Children, World Vision, Global Alliance for Improved Nutrition and others). This emphasized the need for multisectoral interventions to improve food and nutrition security; the role of each sector; and the role of the MOH in advocating for nutrition interventions and monitoring progress FOOD SAFETY: There has been an increased understanding of the importance of producing safe food and also the impact of unsafe food globally because of the international trade of food. Additionally there has been an improved understanding of the need for improved collaboration throughout the food chain continuum. In KHM and LAO, technical support was provided for the Mekong Rainbow project. The focus is on urban areas and schools, intervening through the healthy cities and healthy schools channels to improve diets, food and water safety and quality. Partnerships have been formed and strengthened with international and regional organizations (e.g. FAO, UNICEF, SPC – South Pacific Commission, PIFS - Pacific Islands Forum Secretariat, APEC - Asia-Pacific Economic Cooperation, ASEAN - Association of Southeast Asian Nations, World Organization for Animal Health (OIE), Pacific Island Health Officers Strategic Objective 9

WPR/RC64/3 page 198 Annex 1 Association (PIHOA), NPEHA - Northern Pacific Environmental Health Association, regional coordinators for CCASIA - FAO/WHO Coordinating Committee for Asia and CCNASWP - Coordination Committee North America South West Pacific). The Food Safety Coordination Working Group was established to facilitate cooperation between FAO, OIE, APEC, ASEAN and WPRO. Support has been provided to countries and areas to develop national food strategies and policies on the roles and responsibilities of authorities.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Most countries and areas in the Region have national nutrition polices, strategies and plans. However, there is a need to periodically assess their implementation, establishing a virtual cycle of review of progress in achieving the targets, communication of results and identification of gaps, assessing the additional action needed and budget required to meet the goals. Most countries and areas in the Region involve multiple agencies to manage the food control system, but there is still a lack of role clarity and the issue of coordination between agencies needs to be addressed to make food safety effective. In general, food safety policy in most countries and areas is either non-existent or need strengthening with the exception of a few Member States. All Member States have implemented some level of coordination mechanisms to oversee food safety throughout the food chain continuum including imported food. However, the scope and scale of these mechanisms range from highly developed and comprehensive regulation systems to more basic systems. It is also reported that a lack of technical and administrative expertise within relevant agencies made it difficult to implement a comprehensive and effective food control system throughout the food chain continuum. Less developed states noted the lack of funding available for food safety control and coordination in food-related laws and policies. Summary of actions required, including risk management for those RERs at risk, lessons learned and replication of success factors where applicableTo make progress in addressing the double burden of malnutrition, there is a need to periodically review, map and discuss remaining challenges, as well as achievements and successful approaches adopted by countries and areas. This will serve as a basis for planning the scaling up of nutrition interventions.

Strategic Objective 9

WPR/RC64/3 page 199 Annex 1 WPRO should expand its support for the national Codex Alimentarius Commission (CODEX) programmes and INFOSAN activities while improving current partnership and collaboration with other local, regional, and international partners. This would result in strengthening regional and international food control information exchange and collaborating activities.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 9.2 Assessment, and response to malnutrition and foodborne diseases Performance Indicators Number of new nutrition and food-safety standards, guidelines or training manuals produced and disseminated to Member States and the international community Number of new norms, standards, guidelines, tools and training materials for prevention and management of zoonotic and nonzoonotic foodborne diseasesBaseline 2012 Target by 2013 Status by end 2012

9.2.1

05

5 On track

9.2.2

0

30 On track

Strategic Objective 9

WPR/RC64/3 page 200 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 09.002.WP01 Evidence-based norms, assessments & guidance developed, adapted & disseminated to enable countries and areas to implement cost-effective interventions responding to all forms of malnutrition & foodborne diseases, & to promote healthy dietary practices. Indicator Number of countries and areas where costeffectiveness has been demonstrated in relation to nutrition programmes Baseline 2012 0 Target by 2013 2 Achievement to date On Track/Fully Achieved

Remarks

1

2 1) The cost— effectiveness of the programme for the prevention and control of anaemia in women of reproductive age (WRA) has been shown in Viet Nam. One paper has been published on this topic. 2) A report on interventions to achieve the prevention and control of anaemia across

2

Number of new guidance doc/manuals developed, adapted, where appropriate, & disseminated to enable countries and areas to implement cost— effective interventions responding to all forms of malnutrition, foodborne diseases, & to promote healthy

0

2

2 - A novel approach is being introduced in countries and areas where infant formula sales have increased in recent years, for governments to improve code implementation, by better understanding how infant formula companies operate.

Strategic Objective 9

WPR/RC64/3 page 201 Annex 1 dietary practice

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE NUTRITION: A novel approach is being introduced in countries and areas where infant formula sales have increased in recent years, for governments to improve code implementation, by better understanding how infant formula companies operate. A review of the status of Breastfeeding Protection, Promotion and Support (BF PPS) in six countries (CHN, KHM, LAO, PHL, PNG and VNM) is being conducted (phase 1), followed by support for developing or reviewing budgeted plans for BF PPS in the same countries and areas(phase 2). After two years of work, a website was launched in the PHL (October 2012) to report Code violations online, by text messaging and email. Promotion of this new tool will take place in the PHL and other countries and areas, monitoring effectiveness. FOOD SAFETY: An increase in the development of food standards has provided Member States a level for businesses involved in the production of food throughout the food chain continuum to comply with, leading to safer food being produced if adequately enforced Development of Guidance materials related to food safety include: 1) draft guidance on food standards for smaller island states have been developed and are currently being reviewed; 2) food recall guidelines were reviewed by WPRO and have been finalized by HQ; 3) guidelines on risk-based food inspection have been drafted; 4) templates to complement the global FAO/WHO guidelines on risk analysis in emergency situations have been developed and used in capacity building; and 5) guidance on data requirements for evidence based policy and summary of issues affecting programme/performance have been initiated. New nutrition guidelines and approaches to address problems have been introduced by WHO HQ and WPRO, in recent years. These now need to be communicated and adapted to specific situations in countries and areas.

Strategic Objective 9

WPR/RC64/3 page 202 Annex 1 Many countries and areas still do not have well developed systems of standards development. In some countries and areas, voluntary standards and technical regulations have been prepared but the role of them should be resolved. A whole of food chain approach is yet to be developed in the Region. Linkages and integration of food safety and quality into the agriculture sector need to be facilitated. Implementation of Good Agriculture Practices (GAP) can be an example. Also food handler training and consumer education is an area which requires renewed attention, including utilizing other education programmes.

SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE In order to improve nutrition and reduce the double-burden of undernutrition and inappropriate nutrition/overweight in WPR countries and areas, in addition to producing guidelines and standards, there is a need for greater investment by governments and partners in increasing staff numbers and training, in the health sector and other sectors contributing to food security and nutrition. This will improve the adoption, adaptation and use of the guidelines at national level. The development of food safety policies in the Member States should be emphasized. This will eventually provide a focused approach to address food safety as well as improve coordination at a national level through the development of enhancing linkages between the health, agriculture, industries and trade sectors. In less developed Member States, under the currently existing regulatory framework, undertaking food safety activities is often hampered by the lack of additional technical expertise and human resources required. In this regard, providing expertise in the drafting of food safety laws, regulations, standards considering enhanced regional harmonization and understanding should be supported.

Strategic Objective 9

WPR/RC64/3 page 203 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 9.3 Monitoring, surveillance and nutrition assessment Performance Indicators Number of Member States that have adopted and implemented the WHO Child Growth Standards Number of Member States that have nationally representative surveillance data on major forms of malnutrition Baseline 2012 Target by 2013 Status by end 2012

9.3.1

85

90 On track

9.3.2

142

135 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 09.003.WP01 Improved capacity in countries and areas to collect, analyse, disseminate and use data on the magnitude, causes and consequences of under-nutrition and nutrition-related chronic diseases, diet and physical inactivity. Indicator Number of countries and areas that have adopted and implemented the WHO Child Growth Standards Number of countries and areas conducting periodic nutrition surveys and using the results as a basis for planning interventions to improve the nutrition situation Baseline 2012 0 Target by 2013 2 Achievement to date On Track/Fully Achieved

Remarks

1

0 MYS and SLB

2

0

2

2 GUM and MNG

Strategic Objective 9

WPR/RC64/3 page 204 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Following the outcome and recommendation of the Pacific Food Summit, further steps were taken for strengthening Food and Nutrition Surveillance Systems in the Pacific In GUM, in collaboration with United States Centers for Disease Control (USCDC), completion of the iodine deficiency survey on 720 elementary school children and 290 pregnant women. The findings are expected to help promote salt iodization in the Pacific. In WSM, a new standard for iodized salt was introduced; and iodine excretion is being measured for the first time, together with sodium excretion, through the NCD STEPS survey. In MNG, the Nationwide Study on Vitamin D and Other Micronutrients Status among Mongolian Working Age Adults survey is close to being completed and recommendations on measures to prevent Vitamin D deficiency in the population are expected. An exploratory study towards developing comprehensive food security indicators across sectors and in two Pacific countries (FJI and TUV) was conducted for WHO by Massey University. Evaluation conducted on the effectiveness of weekly iron and folic acid supplementation (WIFS) in Yen Bai, VNM, after 72 month of programme implementation in 250 000 WRA. The report of a meeting on anaemia prevention across the life cycle was published in VNM. In LAO, new infant and young child feeding guidelines have been developed Strengthening the Food and Nutrition Surveillance Systems in the Pacific

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE There are serious gaps in information on nutritional status, especially with regard to micronutrient deficiencies, dietary and physical activity patterns in the Region. These are due to a combination of limited investment in collecting nutrition information, limited technical capacity in many WPR countries and areas, and little interest of partners institutions and donors in supporting data collection in small countries (as in the Pacific) or even in larger countries.

Strategic Objective 9

WPR/RC64/3 page 205 Annex 1 SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE There is a need for greater advocacy for the collection of essential data to assess and monitor the nutritional status of populations. Support in this area will be particularly needed for the smaller (Pacific) countries where there is a major lack of staff, infrastructure and funding to periodically collect and analyze data.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 9.4 Plans, policies and programmes for nutrition Performance Indicators Number of Member States that have implemented at least three high- priority actions recommended in the Global Strategy for Infant and Young Child Feeding Number of Member States that have implemented strategies to prevent and control micronutrient malnutrition Number of Member States that have implemented strategies to promote healthy dietary practices for preventing diet-related chronic diseases Number of Member States that have included nutrition in their responses to HIV/AIDS Baseline 2012 97 Target by 2013 Status by end 2012

9.4.1

105 On track

9.4.2

77

80 On track

9.4.3

80

80 On track

9.4.4

59

65 On track

Strategic Objective 9

WPR/RC64/3 page 206 Annex 1 9.4.5 Number of Member States provided with support to optimize nutrition in emergencies (covering the preparedness planning, emergency response and recovery phase)

47

50 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 09.004.WP01 Enhanced capacity of Member States for the development, strengthening and implementation of nutrition programmes aimed at improving nutrition throughout the lifecourse, in stable as well as humanitarian crisis situations. Indicator Number of targeted countries that have developed and implemented at least three highpriority actions recommended by the Global Strategy for Infant and Young Child Feeding Number of countries that have developed and implemented strategies to prevent and control micronutrient malnutrition Number of countries that have developed and implemented strategies to promote healthy dietary practices in order to prevent diet-related Baseline 2012 0 Target by 2013 4 Achievement to date On Track/Fully Achieved

Remarks

1

4 KHM, LAO, PHL, VNM

2

0

3 3

LAO, PHL, VNM

3

0

2

2 FIJ, WSM

Strategic Objective 9

WPR/RC64/3 page 207 Annex 1 chronic disease 4 Number of countries that have included nutrition in their responses to HIV/AIDS and other epidemics Number of countries that have strengthened national preparedness and responses to nutritional emergencies 0 2 2 KHM, VNM

5

0

2

2 KHM, LAO

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Planning of a strategy aiming to virtually eliminate iron deficiency anaemia (IDA) throughout the life cycle and identify other causes of anaemia, aiming to progressively address these as well. The plan is based on evidence (now published) that IDA can be virtually eliminated in WRA by long-term use of WIFS combined with deworming, in a province of North VNM, over 5 years; and on a workshop on Anaemia Prevention along the Life Cycle reviewing existing interventions as a basis for developing a strategy to eliminate IDA in VNM. In CHN, key child nutrition improvement interventions and guidelines developed and piloted, and the national scaling up initiated. Technical support to priority countries and areas was provided for all the above mentioned and other activities.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Action on nutrition requires work with other sectors, and this can be difficult to achieve. Strategic interventions are needed to address broad determinants of nutrition. Food security and food systems can be improved through policies related to trade, agriculture, urban development and land use. gender equality and education of women is key to effectiveness at the household level.

Strategic Objective 9

WPR/RC64/3 page 208 Annex 1 SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE There is a need to further promote and support multisectoral action, development and implementation of standards for healthy foods and physical activity, and legislative and regulatory interventions to create environments that will facilitate healthy choices. Stronger efforts are needed to build capacity to regulate marketing of infant formula as well as unhealthy foods and beverages for children. WHO's main platform for action includes a) national nutrition plans, based on good evidence; b) optimal breastfeeding and complementary feeding; c) improving women's nutrition and health; d) preventing vitamin and mineral deficiencies through fortification, supplementation and improved diets; e) promoting safe and quality food, and f) promoting physical activity.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 9.5 Foodborne diseases and food hazards prevention and control Performance Indicators Number of Member States that have established or strengthened intersectoral collaboration for the prevention, control and surveillance of foodborne zoonotic diseases Number of Member States that have initiated a plan for the reduction in the incidence of at least one major foodborne zoonotic disease Baseline 2012 Target by 2013 Status by end 2012

9.5.1

75

80 On track

1.5.2

80

80 On track

Strategic Objective 9

WPR/RC64/3 page 209 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 09.005.WP01 Foodborne disease surveillance and food contamination monitoring programmes strengthened regionally and in targeted countries and areas. Indicator Number of target countries and areas that have initiated action on foodborne disease surveillance and food contamination monitoring as defined by reports available Baseline 2012 0 Target by 2013 3 Achievement to date On Track/Fully Achieved Remarks

1

3 CHN, MYS, PHL

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Progress in countries and areas There was an increased understanding of the importance of utilizing a risk—based approach to food control management and therefore a greater demand to have systems in place to provide data to use for such approaches. These systems relate to both food contaminant monitoring and foodborne disease. Secretariat’s contributions Ongoing support in several countries and areas towards strengthening surveillance on foodborne disease, establishment of a major project to develop a mechanism to assess laboratories and foodborne disease surveillance systems and to develop associated action plans, development of a project on Whole Genome Sequencing, steps taken to establish a Global Foodborne Infections Network (GFN) regional coordinator to assist in laboratory and foodborne disease surveillance capacity, national Global Environment Monitoring System (GEMS) Centres were appointed in several countries and areas, steps taken to prepare for a Chemical risk analysis capacity-building activity in 2013 and capacity-building in laboratory analysis of pathogens in powdered infant formula. Strategic Objective 9

WPR/RC64/3 page 210 Annex 1 Initial progress towards achieving the objectives has commenced. Most Member States have either developed and implemented National Food Safety Emergency Response (FSER) plans or are in the process of developing one.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE In most Member States, only limited data on foodborne diseases, food contaminants, and status of AMR in the food supply are available and the linkage of food contamination to foodborne diseases have not been sufficiently explored. In addition, there can be a big deviation found between the developed Member States and less developed Member States in the comprehensiveness of FSER plans. Most Member States reported that they have progressed less in this objective or task in comparison to the others. All developed Member States have established effective links between food safety coordination mechanisms and public health systems. Collection and analysis of data on food-borne disease is common, but many less developed Member States reported difficulties establishing the networks that allow them to share the information with public health stakeholders, but that they had not yet been able to develop one.

SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE The actions to be taken in order to improve current status are to: Develop tools and training materials to assist food safety and quality control activities Advocate the importance of foodborne disease surveillance information including antibiotic resistance, to public health officials and promoting the importance of integrated surveillance to relevant agencies and support in establishing such programmes Support countries and areas in establishment of risk-based food inspection systems including risk-based import control systems Provide targeted training for food safety officials and technical staff (food safety managers, food inspectors, and food analysts) in carrying out their respective duties.

Strategic Objective 9

WPR/RC64/3 page 211 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 9.6 Foodborne diseases risk assessment and control systems Performance Indicators Number of selected Member States receiving support to participate in international standard-setting activities related to food, such as those of the Codex Alimentarius Commission Number of selected Member States that have built national systems for food safety with international links to emergency systems Baseline 2012 Target by 2013 Status by end 2012

9.6.1

85

70 On track

9.6.2

70

80 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 09.006.WP01 National capacity built to enable countries and areas to set up food-control systems based on risk-analysis principles, and to operate food-safety emergency response systems with links to international systems. Indicator Number of countries and areas that have revised their laws, regulations or standards such that they are more in line with Codex and/or FAO/WHO guidance Baseline 2012 0 Target by 2013 5 Achievement to date On Track/Fully Achieved

Remarks

1

6 KIR, LAO, PHL, MHL,MNG, WSM

Strategic Objective 9

WPR/RC64/3 page 212 Annex 1 2 Number of countries and areas that have initiated action to introduce food emergency response systems and have strengthened their INFOSAN networks 0 10 10 BRU, CHN, FJI, KHM, LAO, MNG, MYS, PHL, SLB, VNM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Progress in countries and areas Significant steps towards strengthening national food control systems were undertaken, in an effort to reduce foodborne disease. Secretariat’s contributions Several countries and areas have revised their laws, regulations or standards such that they are more in line with Codex and/or FAO/WHO guidance. Codex capacity-building was provided for 10 PIC. A training workshop understanding regional standards was provided for eight WPRO Member States of Asia. As countries and areas adopt new laws, regulations and standards, there is an increasing need for inspectors to be appropriately trained for them to enforce the legislation effectively and efficiently. In support of this, risk-based food inspection capacity building was provided to several Member States and food inspection equipment was provided. Guidelines on risk-based food inspection and associated standard operating procedures are underdeveloped and will be reviewed by interested stakeholders. Food safety was also enhanced through collaborative action on food safety education and on setting-based community action. With WHO technical advice, an information campaign was provided in the Federated States of Micronesia and China. School based projects were initiated in KHM, LAO and MNG. The Five Keys to Safer Food was translated into four new languages and new promotional materials were developed using these key messages. Strategic Objective 9

WPR/RC64/3 page 213 Annex 1 On risk management associated with mass gatherings, technical advice was provided to SLB in association with the Pacific Arts Festival. Assistance in developing FSER Plans was provided and a simulation to test the LAO FSER was undertaken. Food safety support was provided to LAO and VNM for several outbreaks and to FJI during the April floods. A meeting to enhance participation in INFOSAN, provide capacity building in risk assessment, management and communication during food safety incidents and emergencies was provided to eight Member States of WPRO. A strategy was developed and agreed to enhance participation in INFOSAN by Asian countries.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Many countries and areas still do not have well-developed systems of standards development. Even though some voluntary standards and technical regulations have been developed, the roles between them need to be resolved. Moreover, test facilities to test as per international standards are lacking. In many cases the equipment is available through one time donors funding bust tests cannot be sustained. Also, food safety emergency response systems vary between countries and areas, although there is a widespread interest to further develop such systems.

SUMMARY OF ACTIONS REQUIRED, INCLUDING RISK MANAGEMENT FOR THOSE RERS AT RISK, LESSONS LEARNED AND REPLICATION OF SUCCESS FACTORS WHERE APPLICABLE Emphasis is required to: Support countries and areas in developing Food Safety Emergency Response Systems or Plans and linking these to food recall and rapid alert systems. Support in establishment of food safety controls and assurance systems across the food chain.

Strategic Objective 9

WPR/RC64/3 page 214 Annex 1 Improve food safety consumer education through sharing best practices and integrating with other education activities.

Strategic Objective 9

WPR/RC64/3 page 215 Annex 1 STRATEGIC OBJ ECT IV E 10 TO IMPROVE HEALTH SERV ICES THROUGH BETTER GOVERNANCE, FINANCING, STAFFING AND M ANAGEMENT, INFORM ED BY RELIABLE AND ACCESSIBLE EV IDENCE AND RESEARCH EXPECTED RESULT 10.001 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS CHN, COK, KIR, LAO, MHL, MNG, MYS, NIU, NRU, PHL, PIC, TON, VNM, VUT and WSM DHS, RDO FJI, KHM, KIR, PHL, SLB, TUV and VNM DHS FSM, KOR, MNG, PIC, PNG and VNM DHS, DPM CHN, KIR, LAO, MNG, PIC, PNG, TON, VNM and VUT DHS CHN, FSM, MYS, PHL, PNG and SLB DHS MNG, MYS, VNM and VUT DHS PHL DHS CHN, PIC and SGP DHS ASM, FJI, FSM, GUM, KHM, KIR, LAO, MHL, MNG, PHL, PIC, PLW, PNG, SLB, TON, TUV, VNM and VUT DHS, DPM CHN, KHM, LAO, MNG, PHL, PIC, PNG and VNM DHS KIR, PHL, VNM and VUT DHS FSM, MYS, PIC, TON and TUV DHS MNG, MYS and PHL DHS TOTAL 17

10.002

8 8 10 7 5 2 4 20

10.003

10.004

10.005

10.006

10.007

10.008

10.009

10.010

9 5 6 4

10.011

10.012

10.013

Strategic Objective 10

WPR/RC64/3 page 216 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE There is an ongoing regional review of six health systems strategies. There was the development of subnational strategy and planning development in CHN and the PHL. Emphasis on quality was highlighted through the joint publication of the WPRO, the WHO Regional Office for South-East Asia, the Organisation for Economic CO-operation and Development (OECD) and the OECD/Korea Policy Centre the "Health at a Glance: Asia Pacific 2012", the presidential order for a national AMR working group in the PHL and the translation of Patient Safety guidelines in local languages. There were Health systems strengthening activities supporting PHC in many countries. Development of an online training course on National Health Policies, Strategies and Plans (NHPSP) in addition to in-country training. Mainstreaming of Global Health Initiatives (GHIs) supported diseases programmes in health service provision. Undertaking public health law assessments in countries to review health sector regulation and governance. The web publication of health service delivery profiles of over half the Western Pacific Regional Office. HEALTH CARE FINANCING (HCF): High level policy dialogue was held on universal health coverage in VNM and technical support to revise its social health insurance law and develop its social health insurance road map. Technical support was provided to MNG in developing its long-term national health insurance strategy. Technical support for health systems reform in LAO. Facilitation of country consultations to verify National Health Accounts data for the 2013 World Health Statistics publication. Strategic Objective 10

WPR/RC64/3 page 217 Annex 1 Technical support was provided to KHM in developing its health financing policy and health financing charter. Updates of country health financing profiles were undertaken across the Region. HUMAN RESOURCES FOR HEALTH (HRH): Technical support and guidance was provided for high-level HRH policy and planning meetings, policy advancement. There was continued technical support and capacity-building, contributions to educational innovations via cross-border (between educational National Teacher Training Centres or NTTCs) and in-country mechanisms. Capacity-building using World Health Organization tools for workforce inequalities, labor market analyses. Continued advancement of nursing/midwifery leadership, skill development via subregional networks; biregional networks and associated leadership and research training funded by the AusAID. The HRH country profiles and updates of nursing/midwifery data banks undertaken are contributing to improved knowledge generation and dissemination as well as improved tracking of HRH indicators. HEALTH INFORMATION, EVIDENCE AND RESEARCH: Through contributions from all technical units within regional and country offices, the Health Information and Intelligence Platform (HIIP) of the Western Pacific Region was developed and publicly launched. HIIP provides an important new way to improve better access, visualize, and use health information for decision-making at country, regional, and global levels. Through joint work with multiple development partners, new commitments were made to develop well-functioning civil registration and vital statistics (CRVS) systems in Asia and the Pacific by 2020 by mobilizing political will and leadership at a high-level multisectoral meeting on improvement of CRVS held in December 2012 and development of regional action plan. Strategic Objective 10

WPR/RC64/3 page 218 Annex 1 CHALLENGES/ISSUES In the area of health services, challenges include expanding health coverage of the population, expanding access to appropriate and quality health services, aligning disease programmes within general health services in order to increase sustainability and effectiveness, improving capacity for national health policy, strategy, planning, regulation and governance, aligning government and development partners’ programmes and facilitating patient safety and infection control programmes. From a health financing’s perspective, establishment of universal health coverage as the vision of Member States’ national health system and health financing reforms to improve availability and accessibility of effective interventions remains a serious concern. Other issues include the development of equitable, efficient, and sustainable health financing systems, promotion of evidence generation and its usage in the policy-making process, mobilization of funding to health, particularly from domestic public sources, and coordination and consolidation of different health funding sources, improvement of the equity of health services and access. The strategic objective also addresses issues on workforce capacity-building for universal access across the lifespan, taking into account country-specific population health indicators of priority countries – including maternal, neonatal and child health, NCD-related health needs and emerging diseases, outbreaks and disasters. Health information systems (HIS) remain fragmented by function, disease or condition, donor, or global health initiatives. Health indicator reporting is unreliable and incomplete with little data sharing or integration and limited analytical skills to access or use the information effectively for policy-making and planning. One specific area of focus in the Western Pacific Region is better understanding of the distribution and stratification of actual burden of diseases captured by accurate mortality statistics derived from functioning CRVS systems. With few exceptions, most tasks are on track and have been implemented. Those at risk are due to insufficient capacity in Member States to undertake the activities in time and most of them have been deferred to 2013. Shortage of Health Systems Strengthening (HSS) staff is of main concern for implementing the workplan and responding to countries' requests.

Strategic Objective 10

WPR/RC64/3 page 219 Annex 1 SUMMARY OF ACTIONS REQUIRED Facilitation of an efficient recruitment process for country office staff is of major priority.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.1 Management and organization of integrated, population-based health-service delivery through public and non-public providers and networks improved, reflecting the primary health care strategy, scaling up coverage, equity, quality and safety of personal and population-based health services, and enhancing health outcomes. Performance Indicators 10.1.1 Number of Member States that have regularly updated databases on numbers and distribution of health facilities and health interventions offered. Baseline 2012 73 Target by 2013 Status by end 2012 40 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATOR TARGETS RER 10.001.WP01Improved management and organization of health service delivery, through public and non-public providers and networks, reflecting principles of integrated PHC with increased coverage, equity, and quality of health services leading to better health outcomes. Indicator Number of countries and areas provided technical assistance for improving coverage, access to and quality of health services. Baseline 2012 12 Target by 2013 12 Achievement to date On Track/Fully Achieved

Remarks

1

13 Most countries in the WPR receive technical assistance for HSS, either directly from the Country Office/Regional Office or through Agreement of Performance Work (APW) with Strategic Objective 10

WPR/RC64/3 page 220 Annex 1 individuals or institutions. 2 Number of countries and areas with plans and actions for embedding sustainable disease-specific programmes within general health services to increase sustainability and effectiveness. 4 8 6 Countries that have been assisted by the Global Alliance for Vaccines and Immunization (GAVI) and the Global Fund to Fight AIDS, TB and Malaria (GFATM) are using their HSS grants systems to strengthen service delivery.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE HSS activities are being implemented by 13 countries, Division of Health Sector Development (DHS), DPS and the Office of the Regional Director (RDO). By the midbiennium, most activities are on track with three out of 20 only starting in 2013: community outreach guidelines development in Marshall Islands (MHL) and service delivery guidelines development in Nauru (NRU) postponed to 2013 on request of the respective governments. Capacity-building for global health diplomacy has been initiated in CHN; Health systems and PHC capacities were strengthened in KIR, MHL, MNG, TON, the PHL and VUT by emphasizing supervision, community outreach, developing model districts, mapping emergency care and appointing key PHC people; Quality of care and medicines is being addressed in CHN and VNM, respectively; LAO has embarked on a broad-based sector reform programme with support from the DHS in the Regional Office HRH development through under/post graduate training in ASM, COK and NIU. WPRO has published service delivery profiles of 17 countries: AUS, COK, FJI, HOK, JPN, KHM, KIR, KOR, LAO, MNG, NEZ, PHL, PNG, SLB, TON, VNM and VUT; while five more are in progress: BRU, CHN, MYS, SGP and WSM;

Strategic Objective 10

WPR/RC64/3 page 221 Annex 1 The WPR is undertaking a review of six of its regional HSS strategies on Medicines, Traditional Medicine, HSS and PHC, HCF, HRH and Laboratories; The Organisation for Economic Co-Operation and Development/WHO South East Asian Regional Office//WHO Western Pacific Regional Office published a joint publication that had a large chapter on quality of care: "Health at a Glance: Asia Pacific 2012" and organized a biregional meeting subsequently to establish a regional network on Quality of Care.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Current HSS grant for GHIs (GAVI and GFATM) will run to 2014 and 2015. With increasing socio-economic development, most countries will graduate to become Middle Income Countries and may no longer be eligible for GHI support and may need to acquire more domestic resources. Health system profiles have been prepared for service delivery, health care financing, health information, human resources, pharmaceuticals and traditional medicine. These need to be consolidated in comprehensive health sector profiles. The health sector reform process in LAO is a lengthy process and is in need of sustained support by development partners and WHO alike for many years to come.

SUMMARY OF ACTIONS REQUIRED Activities especially of those that were delayed, mostly due to late submission of project proposals in-country due to be implemented only in 2013 will be closely monitored for timely implementation. The HSS support in remaining years will be focused on mainstreaming of GHI/HSS activities into general health services. All health system profiles need to be stored in single country files to have access to a full picture of a country’s health sector.

Strategic Objective 10

WPR/RC64/3 page 222 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS,INCLUDING INDICATORS AND TARGETS OWER 10.2 National capacities for governance and leadership improved through evidence-based policy dialogue, institutional capacity-building for policy analysis and development, strategy-based health system performance assessment, greater transparency and accountability for performance, and more effective intersectoral collaboration. Performance Indicators 10.2.1 Number of Member States that have in the last five years developed comprehensive national health planning processes in consultation with stakeholders. 10.2.2 Number of Member States that conducted a regular or periodic evaluation of progress, including implementation of their national health plan, based on a commonly agreed performance assessment of their health system. Baseline 2012 108 Target by 2013 Status by end 2012

115 On track

69

75 On track

Strategic Objective 10

WPR/RC64/3 page 223 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.002.WP01 Improved capacities and practices for governing, steering and health sector regulating through (i) evidence-based policy dialogue, (ii) policy analysis, (iii) greater transparency and accountability for performance, and (iv) effective intersectoral collaboration. Indicator Number of countries and areas provided technical assistance to improve institutional capacity for policy analysis and formation, for strategic planning, and for regulation Baseline 2012 4 Target by 2013 8 Achievement to date On Track/Fully Achieved

Remarks

1

8 Indicator measures NHPSP capacity building: one course was held in LAO and a One Health costing tool course was health in KHM. In VNM, WHO assisted with the annual review of the health sector plan. KIR government was assisted though delayed with a consultant to develop the national health plan. 6 KHM had a commission for accountable Information for Women and children workshop and the PHL has established links to the league municipalities.

2

Number of countries and areas provided technical assistance to improve accountability for performance and that show evidence of increase part. of civil society, community, consumers and professional org. in shaping policy and its implementation

4

8

Strategic Objective 10

WPR/RC64/3 page 224 Annex 1 3 Number of countries and areas provided technical assistance and used it to make revisions or changes in law, regulation, policy formulation and policy implementation Number of countries and areas provided technical assistance to assess or establish effective intersectoral collaboration mechanisms, including the private sector, to improve health systems performance for improved health outcomes 4 6 6 Law assessment undertaken in KHM and increased engagement between the Government and health partners in Solomon Islands

4

2

4

2 Private sector engagements are starting in MYS and VNM, no achievements to report as yet

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Various health policy and capacity building developments have been undertaken in FJI (monitoring and evaluation capacity development), KHM (one health tool workshop), KIR (sector assessment drafted) and SLB (sector governance and national policy dialogue). Public health Law assessment has been undertaken in KHM. Preparations are in progress for other health law assessments supported by Regional Office-based technical assistance and off-site support from Yonsei University, Republic of Korea. Technical support provided for health policy development, health care financing, civil registration, routine monitoring and quality monitoring by both Regional Office and Country Office staff.

Strategic Objective 10

WPR/RC64/3 page 225 Annex 1 The WPR in collaboration with WHO Headquarters has engaged a web development firm and a content editor to develop an online NHPSP course, which will be shared globally

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The Public health law assessments in-country are hampered by lack of trained legal experts that can undertake such assessments. Little support was provided to national health planning initiatives as most countries are half way the current health sector plan timeframe. Capacity building for NHPSP has been delayed in MNG due to government changes.

SUMMARY OF ACTIONS REQUIRED To work with countries to run NHPSP workshops, MNG, PNG and CHN (both country office and potentially the Western Areas Health Initiative provinces). Five more countries (LAO, MNG, MYS, PNG and SLB) have expressed willingness to undertake public health law reviews. To improve the capacity of local researchers, WHO will organize a training workshop at Yonsei University in the Republic of Korea in June 2013. Strengthening of health policy and legislative support in TUV will be undertaken in 2013.

Strategic Objective 10

WPR/RC64/3 page 226 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.3 Coordination of the various mechanisms (including donor assistance) that provide support to Member States in their efforts to achieve national targets for health-system development and global health goals improved. Performance Indicators 10.3.1 Number of Member States where the inputs of major stakeholders are harmonized with national policies, measured in line with the Paris Declaration on Aid Effectiveness Baseline 2012 52 Target by 2013 Status by end 2012 35 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.003.WP01 Improved coordination of the various mechanisms (including donor assistance) that support Member States in their efforts to achieve national targets for health system development and global health goals. Indicator Number of countries and areas that have harmonized the inputs of major stakeholders with national policies in line with Paris Declaration. Baseline 2012 2 Target by 2013 4 Achievement to date 2 On Track/Fully Achieved

Remarks

1

Strategic Objective 10

WPR/RC64/3 page 227 Annex 1 2 Number of countries and areas that have documented the methods of coordination of inputs from the multiple stakeholders in the health sector, including donors. 4 8 3

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Six countries in the Region (KHM, LAO, MNG, PNG, SLB and VNM) are recipient of HSS grant support from GAVI. All projects are being implemented with no issues reported. A biregional workshop on the implementation and monitoring of the GAVI HSS grants was held in Bangkok to introduce GAVI reforms to grant receiving countries; critical reviews of these lead to changes in the proposed policies. WPRO provided online monitoring of the progress on GAVI/HSS supported countries (KHM, LAO, MNG, PNG, SLB and VNM). GFATM HSS (Global Fund) grant first phase implemented in MNG and support was provided to revise the second phase grant proposal. Extensive support was provided for the establishment of national indicators and monitoring and evaluation systems for PNG and VNM.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Current HSS grant for GHIs (GAVI and GFATM) will run into 2014 and 2015. With increasing socio-economic development, most countries will graduate to become Middle Income Countries and may no longer be eligible for GHI support and may need to acquire more domestic resources. Furthermore funding constraints could lead to unhealthy competition for resources.

Strategic Objective 10

WPR/RC64/3 page 228 Annex 1 SUMMARY OF ACTIONS REQUIRED Re-convene a meeting of MHL health sector stakeholders as that was postponed on the government request to 2013. Closely follow the development of the new funding mechanisms of both GAVI and GFATM to prepare countries for resource withdrawals or alternative funding mechanisms.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.4 Country health-information systems that provide and use high-quality and timely information for health planning and for monitoring progress towards national and major. Performance Indicators 10.4.1 Proportion of low- and middle-income countries with adequate health statistics and monitoring of health-related Millennium Development Goals that meet agreed standards Baseline 2012 48% Target by 2013 Status by end 2012

60% On track

Strategic Objective 10

WPR/RC64/3 page 229 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.004.WP01 Strengthened country health information systems that provide and use high-quality and timely information for health planning and for monitoring progress towards national and major international goals. Indicator Number of countries and areas that have developed national plans for health information systems and defined core health indicators to facilitate health monitoring and reporting Baseline 2012 5 Target by 2013 10 Achievement to date On Track/Fully Achieved

Remarks

1

10 Support on improving national HIS plan, indicator, and data collections to countries, such as CHN, FJI, KHM, LAO, MNG, NRU, PHL, SLB, VNM and VUT.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Technical and financial support have been provided to countries, including CHN, FJI, KHM, LAO, MNG, PHL, SLB and VNM based on needs. Progress has been made for improving routine health information system completeness, timeliness, and quality in CHN, FJI, KHM, LAO, MNG, PHL, TON and VNM leading to better evidence for decision-making and outcomes. Improved HIS country ownership and leadership in the PHL through revitalizing the coordination mechanism and supporting subnational HIS forums to promote better governance and multisectoral coordination. In the PHL, Country Office, Regional Office and Headquarters support has been provided to improve health information systems and monitor and evaluate the three thrusts of the Aquino Agenda on universal health care.

Strategic Objective 10

WPR/RC64/3 page 230 Annex 1 Through the work of the Commission on Information and Accountability of Women's and Children's Health (CoIA), technical support in HIS and civil registration and vital statistics (CRVS) systems strengthening provided to CHN, KHM, LAO, PHL, PNG, SLB and VNM. Production of the annual Health Statistics report in LAO facilitated by WHO. Systematic review of recommendations on health data standards, HIS interoperability, and selection of core indicators has been undertaken in the PHL. HIS and CRVS short-course training were provided in collaboration with the University of Queensland for health information officers from COK, FJI, KIR, MYS, PLW, PNG, SLB, TON, VNM, VUT and WSM.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Health information system strategies and plans should be revisited periodically and adjusted as needed. Standardization of health data definitions and metadata is needed and lack of capacity for improving the interoperability between systems persists.

SUMMARY OF ACTIONS REQUIRED Ongoing long-term HIS planning and implementation support working with country office and country partners to further strengthening health information system is necessary. Rationalizing current and emerging health priorities and achieving more reliable health information collected, analyzed, and used still requires developing detailed and costed activities to achieve the intended outcomes.

Strategic Objective 10

WPR/RC64/3 page 231 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.5 Better knowledge and evidence for health decision-making assured through consolidation and publication of existing evidence, facilitation of knowledge generation in priority areas, and global leadership in health research policy and coordination, including with regard to ethical conduct. Performance Indicators 10.5.1 Proportion of countries for which high quality profiles with core health statistics are available from its openaccess databases 10.5.2 Number of countries in which WHO plays a key role in supporting the generation and use of information and knowledge, including primary data collection through surveys, civil registration or improvement or analysis and synthesis of health facility data for 10.5.3 Effective research for health coordination and leadership mechanisms established and maintained at global and regional levels Baseline 2012 98% Target by 2013 Status by end 2012

90% On track

36

45 On track

Global research for health strategy established at WHO Headquarters. Regional strategies established in AFRO, AMRO, EMRO and SEARO

Mechanisms operating at global and all regional levels

On track

Strategic Objective 10

WPR/RC64/3 page 232 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.005.WP01 Better knowledge and evidence for health decisionmaking through consolidation and publication of existing evidence, facilitation of knowledge generation in priority areas and leadership in health research policy and coordination, incl. ensuring ethical conduct. Indicator Number of countries and areas in which the Regional Office for Western Pacific plays a key role in supporting the generation and use of information and knowledge, including promotion of standards such as the International Classification of Diseases Baseline 2012 15 Target by 2013 19 Achievement to date On Track/Fully Achieved

Remarks

1

37 Actions to improve the application of International Classification of Diseases conducted in LAO, CHN, KHM, KOR, PHL VNM, etc. All 37 countries and areas in the Region through the Country Health Information Profiles (CHIPs) annual data call and product. 6 Regional health research portal launched in March 2012 in CHN, FJI,KHM, PHL, SLB, TON

2

Number of coordination and leadership mechanisms established and maintained at the regional level to improve knowledge and evidence for health-related decision-making

3

4

Strategic Objective 10

WPR/RC64/3 page 233 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Better compilation of health research information and improving health research governance underway in CHN, FSM, LAO, MNG, PHL, PNG, SLB, VNM and VUT. Health Statistics Annual Report produced in LAO and SLB under the support from WHO for better use health information and statistics. Computer-based Health Research portals were established through WHO support in LAO, MNG and VNM. Technical assistant provided to develop national health statistics annual report in LAO and SLB. Asia Pacific Observatory on Health Systems and Policies released Health in Transitions (HiTs) sector reviews in FJI, MYS and the PHL that provide objective assessments of the health sectors’ progress towards attaining national health goals. The Asia Pacific Observatory initiated an additional 15 HiTs in countries across the Asia Pacific Region, and provided technical support for national capacity development. The Asia Pacific Observatory produces Policy Briefs that provide up-to-date evidence on issues of cross-cutting policy significance in the Asia Pacific Region. At regional level, regional health research portal was developed to support better manage the health research at regional level and providing practical model for countries. Produced the regional Country Health Information Profiles (CHIPs) containing health and demographic data from national surveys, reports, policy documents, and databases. The Health Information and Intelligence Platform (HIIP) was developed with analytical tools and features and easy access to country health data and indicators.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Policy makers need better understanding and support the direct link between HIS strengthening with policy improvements and achieving their priority health outcomes. Demand for reliable health information and research for decision-making is sparse due to lack of confidence in existing HIS solutions and the incomplete, lagging, and poor quality and consistency of the data being collected routinely. Lack of or incomplete national health Strategic Objective 10

WPR/RC64/3 page 234 Annex 1 information policy for data and research exists also among Member States. Stronger multisectoral engagement and coordination is needed to treat health information as a national asset.

SUMMARY OF ACTIONS REQUIRED Establishment of health information and research governance mechanisms will promote accountability and sustainable gains in HIS improvements. Better dissemination and use of health information through multiple channels and feedback mechanisms within countries and reported out of countries should be advocated for with increasing investments in health information and research. Specific actions may focus on stronger capacity and retention of health information officers from the points of data collection upwards through the health system with improved supervision, quality improvements, and incentives for timely and consistent reporting.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.6 National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society. Performance Indicators 10.6.1 Proportion of low- and middle-income countries in which national healthresearch systems meet internationally agreed minimum standards Baseline 2012 40% Target by 2013 Status by end 2012

20% On track

Strategic Objective 10

WPR/RC64/3 page 235 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.006.WP01 National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society. Indicator Number of countries and areas that have systems to provide oversight and track national health research activity and investments Number of lowand middle-income countries and areas with designated organizational entities at national level for health research governance and management Baseline 2012 0 Target by 2013 5 Achievement to date On Track/Fully Achieved Remarks

1

6 CHN, LAO, MNG, PHL, VNM and VUT

2

0

5

5 FJI, KHM, LAO, MNG and PHL

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Better compilation of health research information and improving health research governance underway in CHN, FJI, KHM, LAO, MNG, PHL, PNG, VNM and VUT. The Regional Office developed web-based tools for integrated governance and management of health research including management of review of health research by Ethics Review Committees, an important component of health research governance in most of the countries. These tools were provided to the countries and further technical assistance was provided to KHM, LAO, FJI and the PHL to customize these tools to specific policy and procedural context of these countries.

Strategic Objective 10

WPR/RC64/3 page 236 Annex 1 Technical support provided to selected countries (LAO, PHL, VNM and VUT) to improve policies related to national health research and management. Technical support provided to PNG to set health research priorities and improve health research governance. LAO and VNM developed their health research portal enabling them to track the progress of research and improving the quality of research.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Few developing countries have committed domestic funds for health research, and majority of the current research being externally funded by a diverse group of donors, universities and development partners. There is a still a low domestic priority (both in terms of human and financial resources) given to appropriate management of research to improve access to and its impact on health policies and outcomes. However, the supply of external funding for health research has increased much faster than the supply of responsible researchers in the developing countries. The programmes to build capacity in health research remain very limited with continued dependence on the external researchers especially for data analysis.

SUMMARY OF ACTIONS REQUIRED Continued advocacy efforts are needed in developing countries to improve the appreciation of appropriate management of health research, improving domestic capacity in the health research even when the actual research is externally funded. In addition, continued technical support will be required especially in low- and middle-income countries to help them develop right policies in health research, holistic systems to improve access and use of health research and right capacity-building programmes.

Strategic Objective 10

WPR/RC64/3 page 237 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.7 National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society. Performance Indicators 10.7.1 Number of Member States adopting knowledge management policies in order to bridge the “knowhow” gap particularly aimed to decrease the digital divide 10.7.2 Number of Member States with access to electronic international scientific journals and knowledge archives in health sciences as assessed by the WHO Global Observatory for eHealth biannual survey 10.7.3 Proportion of Member States with e-Health policies, strategies and regulatory frameworks as assessed by the WHO Global Observatory for eHealth biannual survey Baseline 2012 Not available Target by 2013 Status by end 2012

110 On track

162

180 On track

75

90 On track

Strategic Objective 10

WPR/RC64/3 page 238 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.007.WP01 National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society. Indicator Number of countries with evidence of improved, up-todate, reliable health workforce databases/sets with standardized workforce data templates Number of countries with funded HRH plan addressing population health needs and priority HRH areas Baseline 2012 3 Target by 2013 6 Achievement to date On Track/Fully Achieved Remarks

1

4 CHN, FJI, KHM and LAO

2

3

6

4 FJI, KHM LAO, and PHL

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The implementation is in progress and on track, in general. However, acceleration in implementation may be needed in some budget centres. Two regional e-Health technical networks developed or strengthened its functions through WHO support including Pacific Health Information Network (PHIN), Asia e-Health and Health Information Network (AeHIN) to strengthen the technical capacity of countries through peer learning approach. Increased access to knowledge generated outside the country and available in their own context. Technical guidance and operational support were provided through WHO to strengthen the function of the regional technical networks and make sure the proper functioning of those networks.

Strategic Objective 10

WPR/RC64/3 page 239 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Multisectoral engagement, coordination, and governance of e-Health is an ongoing challenge in organizing and addressing development of comprehensive e-Health strategies and plans. Scaling and sustainability of innovative and proven e-Health solutions is an issue, as most eHealth interventions are project-based and not adequately integrated into long-term health information or health sector plans and activities. Lack of awareness and support with implementing appropriate e-Health standards (data, information technology) and strategic reuse of solutions that work remains a challenge.

SUMMARY OF ACTIONS REQUIRED Countries in the Region will be supported to develop comprehensive national e-Health strategic plans with the use of new tools and guides available from WHO and the International Telecommunications Union (ITU). Knowledge and technical transfer will be promoted through networks of e-Health professionals to support reuse of technical resources and solutions. Training on implementing specific e-Health standards will be supported.

Strategic Objective 10

WPR/RC64/3 page 240 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.8 Health-workforce information and knowledge base strengthened, and country capacities for policy analysis, planning, implementation, information-sharing and research built up Performance Indicators 10.8.1 Number of countries reporting two or more national data points on human resources for health within the past five years, reported in the Global Atlas of the Health Workforce 10.8.2 Number of Member States with an national policy and planning unit for human resources for health Baseline 2012 127 Target by 2013 Status by end 2012

100 HQ to input from Global Health Workforce Atlas

90

55 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.008.WP01 Support provided to strengthen health-workforce information and knowledge base, to build up capacity of countries and areas for policy development and planning, and to enhance research, networking and information-sharing. Indicator Number of countries with evidence of improved, up-todate, reliable health workforce databases/sets with standardized workforce data templates Baseline 2012 3 Target by 2013 6 Achievement to date On Track/Fully Achieved

Remarks

1

4 CHN, FJI, KHM and LAO

Strategic Objective 10

WPR/RC64/3 page 241 Annex 1 2 Number of countries with funded HRH plan addressing population health needs and priority HRH areas 3 6 4 FJI, KHM, LAO and PHL

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The HRH country profiles are being developed in a number of countries. The HRH plan development is in progress in PNG, SLB and VUT. The efforts and consultations are ongoing to develop or update HRH plans in KIR and VUT. Capacitybuilding for HRH planning will be undertaken in FSM, KIR, MHL, PLW and the PHL. The implementation of the plan in LAO continues successfully. An analysis of health workforce inequalities is ongoing in countries: KHM, LAO and the PHL. The assessment of HRH information in LAO and SLB. HRH database has been improved in MNG. Technical support is provided to HRH research and capacity-building project funded by CHN Medical Board and involving 11 universities from Western provinces of CHN. Pacific Human Resources for Health Action Alliance has refocused core business priorities. An increased frequency of contact, communications with WHO country office staff as well as partner network supporting HRH development at country level. Strengthened and closer collaboration has been achieved between DHS and other divisions across the Regional Office. Shared review of DHS and other divisions’ new strategies and action plans. Improved collaboration with other partners.

Strategic Objective 10

WPR/RC64/3 page 242 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The countries in the Region face a number of HRH challenges including shortages, maldistribution, quality, relevance and performance of health workers. In addressing these challenges, insufficient HRH information remains as an important gap. Additionally, it is observed that the implementation of HRH plans also follows a slow pace due to a number of factors including weak HRH governance capacities.

SUMMARY OF ACTIONS REQUIRED Continuing and accelerated implementation.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.9 Technical support provided to Member States, with a focus on those facing severe health-workforce difficulties in order to improve the production, distribution, skill mix and retention of the health workforce. Performance Indicators 10.9.1 Proportion of 57 countries with critical shortage of health workforce, as identified in The world health report 2006 with a multi-year HRH plan 10.9.2 Proportion of 57 countries with critical shortage of health workforce, as identified in The world health report 2006 which have an investment plan for scaling up training and education of health workers Baseline 2012 42% Target by 2013 Status by end 2012

46% On track

24%

30% On track

Strategic Objective 10

WPR/RC64/3 page 243 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.009.WP01 Competent support provided to countries and areas to improve the production, distribution, skill mix, retention and the management of their health workforces. Indicator Number of countries with 2.3 health workers per 1,000 population or better (taking only doctors, nurses and midwives) Number of countries with evidence of formulation/implementation of professional competencies and standards, quality assurance Number of countries with evidence of existing, active HRH partners and networks with products/outputs addressing workforce efficiency and effectiveness Baseline 2012 3 Target by 2013 6 Achievement to date 0 On Track/Fully Achieved Remarks

1

2

3

6

7 AUS, HOK, JPN, KOR, NEZ, PHL, WSM

3

3

7

7 KHM, MHL, MNG, PHL, PLW, SLB, TUV

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Education development centres in LAO and KHM are evolving. The first batch of students has completed the masteral programme in Health Professions Education at the KHM Education Development Centre. A national exam for licensure of some health professions (dentists, pharmacists and nurses) was supported by the Regional office. Nursing and midwifery capacities are improved through Asia Pacific Emergency and Disaster Nursing Network and some country-level activities in KIR, MNG and PNG. An AusAIDsupported project on strengthening midwifery education and practice is ongoing.

Strategic Objective 10

WPR/RC64/3 page 244 Annex 1 Capacity-building activities were initiated and are also ongoing through fellowships, especially in PIC (including ASM, FJI, FSM, KIR, MHL, PLW, TOK, TON and TUV). Pacific Opening Learning Health Network (POLHN) activities, supporting continuous professional development, continue. Collaboration with Association of Medical Education in Western Pacific Region (AMEWPR), Asia-Pacific Action Alliance on Human Resources for Health (AAAH) and Pacific Human Resources for Health Alliance (PHRHA) has improved. Fellows under the Health Leadership and Development Initiative (HLDI) were supported and they have been deployed to FJI, KHM and VNM country offices. The implementation is on track in all budget centres, except one budget centre with slight delay, but the product is expected to be completed in 2013. Increased frequency of contact, communications with WHO country office staff as well as partner network supporting HRH development at country level. Strengthened and closer collaboration between DHS and other divisions across the Regional Office. Shared review of DHS and other divisions’ new strategies, action plans. Improved collaboration with other partners, benefiting from their forums to share experiences and developments.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The challenges with health professional education capacities, deployment and retention of health workers in rural areas are a continuing challenge faced in Member States. It is important to maintain sustainable support and technical cooperation with the Member States.

SUMMARY OF ACTIONS REQUIRED Continuing and accelerated implementation is necessary.

Strategic Objective 10

WPR/RC64/3 page 245 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.9 Evidence-based policy and technical support provided to Member States in order to improve health-system financing in terms of the availability of funds, social and financial-risk protection, equity, access to services and efficiency of resource use. Performance Indicators 10.10.1 Number of Member States provided with technical and policy support to raise additional funds for health; to reduce financial barriers to access, incidence of financial catastrophe, and impoverishment linked to health payments; or to improve social protect 10.10.2 Number of key policy briefs prepared, disseminated and their use supported, which document best practices on revenueraising, pooling and purchasing, including contracting, provision of interventions and services, and handling of fragmentation in systems Baseline 2012 Target by 2013 77 20 during the biennium Status by end 2012 On track

24 technical briefs, over 75 information products of other types

15 technical briefs

On track

Strategic Objective 10

WPR/RC64/3 page 246 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.010.WP01 WP01 Health system financing improved in terms of the availability of funds, social and financial risk protection, equity, access to services and efficiency of resource use. Indicator Number of countries and areas provided with technical support on developing national health financing policy and strategies Baseline 2012 10 Target by 2013 15 Achievement to date 14 On Track/Fully Achieved Remarks

1

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Progress has been made to improve health system financing in FJI, KHM, LAO, MNG, PHL, PNG, VNM and WSM. Technical support was provided by WPRO to KHM for the development of its health financing strategy and charter. Several consultations and ongoing technical support have been provided to LAO for its health systems reform, the proposal of which has been endorsed by the National Assembly in December 2012. In addition, several workshops between the Ministry of Health, Secretariat, and other development partners were conducted to build consensus on the health reform. Technical support was provided to MNG for the development of its long-term strategy of social health insurance. In the PHL, Country Office, Regional Office and Headquarters, support has been provided to improve health information systems and monitor and evaluate the three thrusts of the Aquino Agenda on universal health care. Facilitation of high-level policy dialogue on universal health coverage and shared learning with other WPR countries was achieved in VNM.

Strategic Objective 10

WPR/RC64/3 page 247 Annex 1 Technical support was provided to CHN for the generation of evidence on the financial burden of health payments High-level policy dialogue on universal health coverage in VNM included shared experiences from CHN, JPN and KOR.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Work in KHM on the development of the health financing strategy and charter was completed by a consultant in health financing. Having a longer-term health financing focal point and continuity of the work are important to the policy-making process.

SUMMARY OF ACTIONS REQUIRED WPRO is to complete the current recruitment of a fixed-term position for health financing in the KHM Country Office.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.11 Norms, standards and measurement tools developed for tracking resources, estimating the economic consequences of illness, and the costs and effects of interventions, financial catastrophe, impoverishment, and social exclusion, and their use supported and monitored. Performance Indicators 10.11.1 Key tools, norms and standards to guide health financing policy development and implementation for universal coverage developed, disseminated and their use supported. 10.11.2 Number of Member States provided with technical support for using WHO tools relating to health Baseline 2012 Tools and frameworks modified, updated and disseminated as necessary Target by 2013 Tools and frameworks modified, updated and disseminated as necessary Status by end 2012

70 20 during the biennium

On track

Strategic Objective 10

WPR/RC64/3 page 248 Annex 1 financing for universal coverage.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.0011.WP01 Norms, standards and measurement tools used to On Track/Fully track resources (National Health Accounts), estimate the financial burden Achieved of health payments and barriers to access for households, and estimate the costs and effects of interventions. Indicator Number of country reports and analytical papers on health financing, based on applications of WHO norms, standards and measurement tools Baseline 2012 8 Target by 2013 12 Achievement to date Remarks

1

9 CHN, FJI,KHM LAO, MNG, PHL, VNM and VUT.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Progress on National Health Accounts has been achieved in FJI, LAO, MNG, PHL, VNM and VUT. Slower progress has been made in KIRdue to the recent staff turnover in the Ministry of Health and Medical Services (MHMS) and budget reallocation. LAO conducted its first National Health Accounts study and drafted a final report for review. CHN, KHM, LAO, MNG, PHL and VNM generated evidence on the financial burden of health payments and access to health services. OneHealth and Macrohealth costing tools were applied in KHM and on a study on the impact of Global Fund reductions, respectively. The Country Office, Regional Office and the Headquarters provided technical support to KHM for its OneHealth workshop

Strategic Objective 10

WPR/RC64/3 page 249 Annex 1 WPRO conducted a comparative study on the financial burden of health payments and access to health services in CHN, KHM, LAO, MNG, PHL and VNM and drafted a report for publication. WPRO conducted a study on the impact of Global Fund reductions using Macrohealth for KHM, LAO and VNM.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The introduction of OneHealth in KHM may have been timed better with the national budget planning process. Slower progress in some PIC, such as KIR, on National Health Accounts was due to lack of funding or lack of local capacity.

SUMMARY OF ACTIONS REQUIRED Better coordination among stakeholders, including donors, external experts and government agencies. WPRO will coordinate with the Country Office and Headquarters to provide support to KIR and potentially other PIC on National Health Accounts through training and building of local capacity.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.12 Steps taken to advocate additional funds for health where necessary; to build capacity in framing of health-financing policy and interpretation and use of financial information; and to stimulate the generation and translation of knowledge to support policy development. Performance Indicators 10.12.1 WHO presence and leadership in international, regional and national partnerships. Baseline 2012 WHO participation in 5 partnerships and support on long-term financing options provided to 46 Target by 2013 Member States and capacity building in financial policy and analysis in 20 countries Status by end 2012 On track

Strategic Objective 10

WPR/RC64/3 page 250 Annex 1 countries 10.12.2 Number of Member States provided with support to build capacity in the formulation of health financing policies and strategies and the interpretation of financial data. Annual updates of health expenditures produced after consultation with Member States. Capacity building in one or more of the WHO tools provided to 67 countries Technical support provided to 75 countries, and annual updates of health expenditures to all Member States, together with new information on the incidence of catastrophic expenditures in 20 countries On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.0012.WP01 Health financing data, information and evidence used for developing, implementing and monitoring health financing policies and strategies Indicator Number of countries and areas supported and trained by WHO to develop capacity in the area of health financing Baseline 2012 12 Target by 2013 15 Achievement to date On Track/Fully Achieved Remarks

1

20 FJI, FSM, KHM, LAO, MNG MYS, PHL, , SLB, TON, TUV, VNM,VUT and WSM

Strategic Objective 10

WPR/RC64/3 page 251 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Progress has been made in capacity-building of health financing issues in CHN, FJI, KHM, MNG, MYS, PHL and WSM. Slower progress has been made in the FSM, TON, TUV and VUT. SLB plans to start its NHA study in early 2013, while KIR is currently in discussions. CHN, KHM, LAO, MNG, PHL, PNG and VNM participated in the National Health Accounts training workshop in Manila, Philippines on the new system of health accounts in 2011. Consultants from HOK and FJI and one regional staff member attended the training of trainers' workshop for NHA in Geneva, Switzerland. The OneHealth costing tool was introduced to Cambodian MCH Ministry officials and WHO staff. Technical support was provided to MYS for the Strategic Communications for MYS Health System Reform. Capacity-building and discussions on National Health Accounts and evidenced-based planning have been supported in FJI, FSM, TUV, VUT and WSM.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Slower progress was made on NHA in several PIC either due to lack of funding, other more urgent priorities taking precedent, or lack of capacity.

SUMMARY OF ACTIONS REQUIRED As mentioned in the Regional Expected Result 10.11, WPRO will coordinate with the Country Office and Headquarters to provide support to several PIC on NHA through training and building of local capacity.

Strategic Objective 10

WPR/RC64/3 page 252 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 10.13 Evidence-based norms, standards and measurement tools developed to support Member States to quantify and decrease the level of unsafe health care provided. Performance Indicators 10.13.1 Key tools, norms and standards to guide policy development, measurement and implementation disseminated and their use supported. 10.13.2 Number of Member States participating in global patient safety challenges and other global safety initiatives, including research and measurement Baseline 2012 6 standards and 15 tools Target by 2013 4 global safety standards and 40 major supporting tools Status by end 2012 On track

69

90 On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 10.013.WP01 Implementation of norms, standards and measurement tools by Member States to quantify and decrease the level of unsafe health care provided and to improve the quality of the health care system. Indicator Number of countries and areas supported and trained by WHO to develop capacity in the area of health financing Baseline 2012 6 Target by 2013 9 Achievement to date On Track/Fully Achieved

Remarks

1

12 Six countries are reporting nationwide rollout of surgical safety checklist: AUS, KHM, MYS, NEZ, PHL and TON.

Strategic Objective 10

WPR/RC64/3 page 253 Annex 1 2 Number of countries and areas that actively participate in each new global patient safety challenge 4 8 10 Countries that have signed the pledge: AUS, CHN, HOK, JPN, KOR, MNG, MYS, PHL, SGP and VNM.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Extensive quality assurance (QA) and Patient Safety (PS) activities undertaken in few countries only: MNG, MYS, PHL and VNM. The HQ AMR assessment tools were reviewed, and using the tool, a country situational analysis was conducted for the PHL. A National Stakeholder Meeting on AMR was held, which lead to an AMR coordinating body set up by presidential executive order. In MNG, quality managers and other senior staff were trained to undertake comprehensive quality assessments, and identify gaps at selected health facilities In order to facilitate patient safety trainings and activities, the WHO patient safety curriculum guide was translated into local languages for KHM, LAO and VNM with support from WPRO. The PHL was also assisted with the additional development and production of IEC materials, including appropriate training materials.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The Patients Safety (PS) activity in MYS was reprioritized to support health technology guidelines. Despite the Government’s request the VNM County Office did not see the need for PS capacity-building activities in the country and this has been postponed indefinitely. Not all countries have signed the PS pledge.

Strategic Objective 10

WPR/RC64/3 page 254 Annex 1 SUMMARY OF ACTIONS REQUIRED More advocacy needs to be undertaken to and in countries to highlight PS and AMR issues. AMR assessments will be undertaken in KHM and possibly VNM.

Strategic Objective 10

WPR/RC64/3 page 255 Annex 1 STRATEGIC OBJ ECT IV E 11 TO ENSURE IMPROVED ACCESS, QUALIT Y AND USE OF MEDICAL PRODUCTS AND TECHNOLOGIES EXPECTED RESULT 11.001 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS FJI, KHM, LAO, MNG, MYS, NRU, PHL, PIC, PNG, RDO, SLB, TON, TUV, VNM and VUT DHS BRN, CHN, KIR, LAO, MNG, MYS, PHL, PIC, PNG and VNM DHS LAO, MYS, PHL, PIC and SLB DHS TOTAL 16

11.002

11 6

11.003

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The Regional Framework for Action on Access to Essential Medicines in the Western Pacific (2011–2016) was launched and disseminated to countries and partners to provide clear guidance for specific actions by Member States and WHO in identified priority areas of policy and access, quality assurance and rational use. The framework introduced a set of indicators and targets at country and regional level to monitor progress. Strong and sustained technical support to develop and implement policies that would improve access to essential medicines was provided in several priority countries including KHM, CHN, LAO, PIC, PNG and VNM in the areas of essential medicines selection, procurement and supply chain management, medicines financing, regulatory strengthening, increasing pharmaceutical sector capacity to produce good quality medicines. WHO supported national efforts to increase transparency and accountability in the pharmaceutical sector through provision ofsupport to the national Medicine Transparency Alliance initiatives in the PHL and Good Governance in Medicine programme in LAO, MNG and the PHL. In KHM, the WHO Country Office supported the drafting, in close collaboration with the Joint United Nations Programme on HIV/AIDS (UNAIDS), of the Law on Compulsory Licensing and Public Health to prepare KHM to utilize Agreement on Trade-Related Aspects

Strategic Objective 11

WPR/RC64/3 page 256 Annex 1 of Intellectual Property Rights (TRIPS) flexibility for the access of generic medicines when the country will be obliged to observe patents. WHO Country Office for KHM supported the drafting of the second National Pharmaceutical Sector Strategic Plan (2013–2016) and the revision and printing of drug management guidelines and the seventh edition of the national Essential Medicine List. WHO Country Office for VNM has been closely working together with national counterparts in the development of key policies affecting medicines access including the Socio-Economic Development Plan; Pharmaceutical law; Local production policy; Drug Price control, the New National Medicines Policy; and the National Pharmaceutical Policy. Training to increase the performance of national and hospital drug and therapeutic committees to monitor utilization of medicines and ensure rational use of drugs was held in selected PIC in collaboration with the United Nations Population Fund (UNFPA). The Regional Office hosted the training of pilot countries from three WHO Regions for the introduction of the global Rapid Alert System (RAS) to monitor spurious/substandard/falsified/falsely-labeled/counterfeit (SSFFC) products. KHM, MYS, PHL and VNM participated, with CHN as observer. A major biregional conference, the Asia Pacific Conference on National Medicines Policies (APCNMP 2012) was held in Sydney, Australia in May 2012. About 23 countries received support from the Regional Office to participate: ASM, BRN, CHN,COK, FJI,theFSM, JPN, KHM, KOR, , , LAO, MNG,MYS, NIU, NRU,PHL,PLW, PNG, SLB, TON, TUV,VNM,VUT andWSM. This meeting set the agenda for the coming years to work in key priority areas where different medicine policies affecting financing, regulation and rational use of medicines need to be developed, refined and effectively implemented. An in-depth country situation analysis and policy dialogue on combating AMR was supported both from the essential medicines and laboratory services programme in the PHL. The result of the policy dialogue is a multisectoral national policy (Executive Order) to combat and contain AMR in the PHL. KHM, LAO and MYS have developed national policy, strategies on traditional medicine clearly identifying actions to promote Traditional Medicine (TM) as part of their national health system and primary health care.

Strategic Objective 11

WPR/RC64/3 page 257 Annex 1 The Regional Strategy for TM in the Western Pacific was advocated and disseminated in 14 countries of the Region: AUS, BRN, CHN, HOK, JPN, KIR, KOR, LAO, MAC, MNG, MYS, PHL, SGP and VNM). Traditional medicine service delivery profiles have been developed for 12 countries: AUS, FJI, HOK, JPN, KHM, KOR, LAO, MNG, NEZ, PHL, PNG and VNM.

CHALLENGES/ISSUES The main challenges remaining in several priority countries of the Region are related to effective implementation of national medicine polices, operationalizing policies to ensuring the availability and access to quality-assured medicines and using financing mechanisms (public financing, health insurance-based) that could reduce out-of-pocket payments and increase equity in access especially for the poor. Rising pharmaceutical expenditures also require introduction of more systematic and efficient policies for cost containment. Regulatory strengthening to improve quality of medicines and medical products is critical in several countries especially when poor quality significantly contributes to major public health threats such as artemisinin-resistant malaria. The national laboratory services often receive little attention or priority in countries with respect to financing, planning or service delivery. In order to provide good quality health services it is essential that public health laboratories are strengthened to provide critical inputs into good quality clinical care and health service delivery. The number of laboratories in the Region as well as their capacity requires assessment to identify laboratory system areas that need strengthening. Establishment of national blood programs to provide safe blood transfusion services and blood products collected through voluntary, non-remunerated low-risk blood donors is still a challenge in a number of countries. The assessment of the usefulness of health technologies used in many countries is also a challenge in many countries, which are mainly a mix of high and middle income countries. AMR, despite being flagged as an Organization-wide priority in 2011, is still a public health challenge in many countries of the Region. Some national networks for surveillance of AMR Strategic Objective 11

WPR/RC64/3 page 258 Annex 1 exist in developed countries, and there are few fragmented attempts towards regional AMR surveillance, however, there is no regional network ensuring comprehensive surveillance of AMR in the countries of the Region. Government commitment to traditional medicine is inadequate in many countries. In addition, there is lack of resources including human resources and finance.

SUMMARY OF ACTIONS REQUIRED Strengthening of national regulatory authority capacity is a priority. Future allocations of funds should be prioritized for specific activities to create a regional forum for national regulatory authorities to support information exchange, capacity development and regulatory convergence within the Region. Enhancing national capacity for evidence-informed decision making on which medicine should be covered at what cost will as countries move towards universal health coverage is also a priority in several countries. Support is also needed to develop and implement policies that would promote rational use of quality assured antimicrobials to contain AMR, especially in case of emerging public health threats in the Region such as artemisinin-resistant malaria. The creation of a regional database of laboratories would help prioritize capacity-building initiatives in the Region. Strengthen quality systems in the laboratories in the Region as a step towards laboratory accreditation to strengthen the reliability of laboratory test results as well as a cross-cutting initiative. Strengthen blood transfusion services and safety through capacity development and awareness-raising about blood transfusion at the national level within the Region. Strengthened AMR surveillance in the Region requires collaboration amongst networks and countries at the regional level. Development and enforcement of national policies and strategies as well as strengthening of regulatory capacity are priority actions for future allocation of funds and resources.

Strategic Objective 11

WPR/RC64/3 page 259 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 11.1 Formulation and monitoring of comprehensive national policies on access, quality and use of essential medical products and technologies advocated and supported. Performance Indicators 11.1.1 Number of Member States receiving support to formulate and implement official national policies on access, quality and use of essential medical products or technologies. 11.1.2 Number of Member States receiving support to design or strengthen comprehensive national procurement or supply systems. 11.1.3 Number of Member States receiving support to formulate and/or implement national strategies and regulatory mechanisms for blood and blood products or infection control. 11.1.4 Publication of a biennial global report on medicine prices, availability and affordability, based on all available regional and national reports. Baseline 2012 118 Target by 2013 Status by end 2012

136 On track

68

84 On track

68

71 On track

1 report published (2011)

1 report published (2013)

Strategic Objective 11

WPR/RC64/3 page 260 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.001.WP01 National policies to improve access, quality and use of essential medicines developed, implemented, monitored or revised. Indicator Number of countries that have received WHO support to develop, implement, monitor or revise comprehensive policies on access, quality and use of essential medicines. Baseline 2012 21 Target by 2013 24 Achievement to date On Track/Fully Achieved Remarks

1

23 Following Member States were provided support on the area of national medicines policies: ASM, BRN, CHN, COK, FJI, FSM, JPN, KHM, KOR, LAO, MNG, MYS, NIU, NRU, PHL, PLW, PNG, SLB, TON, TUV, VNM, VUT and WSM. 5 In 2010–2011, this indicator on national procurement or supply system was incorporated in indicator 1 on national policies on essential medicines; hence the input value of only five. For 2012–2013, so far, support in this area was provided to FJI, FSM, PLW, PNG and VNM.

2

Number of countries that have received WHO support to design or strengthen comprehensive national procurement or supply systems.

16

18

Strategic Objective 11

WPR/RC64/3 page 261 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE National medicines policy development and revision has been supported in KHM, FJI, FSM, MNG, MYS, PLW, PNG, SLB, TON, TUV, VNM and VUT. Target of 100% distribution of medical kits in PNG is on track. Inventory management training and drug usage data collection for national forecasting has commenced and is ongoing. Support to the national drug and therapeutic committees training for PIC to improve the rational use of medicines through more effective medicines management practices overseen by these committees (COK, FJI, KIR, PLW, PNG, , SLB, TON, VUT and WSM). Technical support for policy development and policy dialogue regarding the revision and development of national medicines policies is supported by Country Office technical staff in FJI, PHL and VNM in collaboration with the Regional Office. The WHO Country Office supported the pharmaceutical sector strategic planning in KHM. About 23 countries (ASM, BRN, CHN, COK, FJI, the FSM, JPN, KHM, KOR, LAO, MNG, MYS, NIU, NRU, PHL, PLW, PNG, SLB, TON, TUV, VNM, VUT and WSM) were supported to participate in the APCNMP 2012 and the Regional Office was one of the major organizers of this event. In collaboration with subregional office in Suva, technical support was provided to the national drug and therapeutic committees training for nine PICs (COK, FJI, KIR, PLW, PNG, SLB, TON, VUT and WSM).

Strategic Objective 11

WPR/RC64/3 page 262 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The effective implementation of national medicine polices, operationalizing policies to ensuring the availability and access to quality-assured medicines and using financing mechanisms (public financing, health insurance-based) that could reduce out-of-pocket payments and increase equity in access especially for the poor is a main challenge in KHM, LAO, PHL and VNM. Rising pharmaceutical expenditures also require introduction of more systematic and efficient policies for cost containment in BRN, CHN, MYS and other countries. Regulatory strengthening to improve quality of medicines and medical products is critical in several countries especially when poor quality significantly contributes to major public health threats such as artemisinin-resistant malaria in the Mekong countries. Counterfeit medicine detection and enforcement actions to reduce their availability and sales are important across the Region.

SUMMARY OF ACTIONS REQUIRED Enhancing national capacity for evidence-informed decision-making on which medicine should be covered at what cost as countries move towards universal health coverage is also priority in several countries. Support is also needed to develop and implement policies that would promote rational use of quality assured antimicrobials to contain AMR, especially in case of emerging public health threats in the Region, such as artemisinin-resistant malaria.

Strategic Objective 11

WPR/RC64/3 page 263 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.001.WP02 Revised national policies to improve access, quality and use of blood products, medical devices and laboratories. Indicator Number of countries and areas receiving support to formulate and implement official national policies on access, quality and use of blood products, medical devices and laboratories. Baseline 2012 9 Target by 2013 9 Achievement to date On Track/Fully Achieved Remarks

1

9 CHN, COK, FJI, FSM, KHM, KIR, MNG, NRU, PHL

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE In the context of laboratory and medical technologies, national public health laboratory capacity was strengthened in FJI and PNG. National policy on laboratory framework was launched and disseminated to all stakeholders in the PHL.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Though the Asia Pacific Strategy for Strengthening Health Laboratory Services (2010–2015) exists, there is no clear regional/national implementation plan in most Member States. There is a lack of harmonization of global safety standards for safe blood transfusions as per regional needs. There is an absence of national policies on combating AMR in most Member States.

Strategic Objective 11

WPR/RC64/3 page 264 Annex 1 SUMMARY OF ACTIONS REQUIRED Regional/national implementation plan for the Asia Pacific Strategy for Strengthening Health Laboratory Services (2010–2015) is required in most Member States. Harmonization of global safety standards for safe blood transfusions is required as per regional needs. National policies on combating AMR established in Member States.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.001.WP03 Strengthened policies and programmes on traditional medicine using the Regional Strategy for Traditional Medicine in the Western Pacific as a guide. Indicator Number of countries and areas receiving support to develop and implement national policies on traditional medicine Baseline 2012 17 Target by 2013 17 Achievement to date On Track/Fully Achieved Remarks

1

17 Workshop on the implementation of the Regional Strategy: AUS, BRN, CHN, HOK, JPN, KHM, KOR, LAO MAC, MNG, MYS, PHL, SGP and VNM. New regional strategy in CHN, KHM, LAO, MNG and VNM.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Two interregional workshops on Regulation of Traditional Medicine (TM)/Complementary Medicine (CAM) products and on registration and qualified practice of TM/CAM were conducted to strengthen capacity on regulation of traditional medicine practice and products in CHN, HOK, MAC, MYS and the PHL.

Strategic Objective 11

WPR/RC64/3 page 265 Annex 1 KHM and LAO developed and endorsed national strategies on traditional medicine; MYS drafted national policy on use of traditional medicine in primary health care; and FJI endorsed policy on traditional medicine as a part of national medicines policy. Newly-endorsed Regional Strategy for Traditional Medicine in the Western Pacific (2011– 2020) disseminated and advocated in 14 countries of the Region (AUS, BRN, CHN, HOK, JPN, KIR, KOR, LAO, MAC, MNG, MYS, PHL, SGP and VNM) through convening two regional meetings on the implementation of the new Regional Strategy. Translated versions (Khmer, Lao, Chinese, Mongolian and Vietnamese) of the Regional Strategy were finalized and disseminated.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The critical issues in the Region are: levels of presence and acceptance of traditional medicine in the National health system vary greatly within the Region; commitment of government and allocated resources are inadequate and in most of Member States not sufficient.

SUMMARY OF ACTIONS REQUIRED Consistent advocacy of WPRO strategy for traditional medicine to promote proper commitment and action of government towards ensuring safe and quality of traditional medicine practice and products for the health benefits of population.

Strategic Objective 11

WPR/RC64/3 page 266 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 11.2 International norms, standards and guidelines for the quality, safety, efficacy and cost-effective use of medical products and technologies developed and their national and/or regional implementation advocated and supported. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 11.2.1 Number of new or updated global quality standards, reference preparations, guidelines and tools for improving the provision, management, use, quality, or effective regulation of medical products and technologies. 11.2.2 Number of assigned International Nonproprietary Names for medical products. 11.2.3 Number of priority medicines, vaccines, diagnostic tools and items of equipment that are prequalified for United Nations procurement. 11.2.4 Number of Member States for which the functionality of the national regulatory authorities has been assessed or supported. Additional 61 30 per biennium

8552

8650

320 (274 300 medicines, medicines, 35 40 APIs, 15 APIs, 11 diagnostic tools, diagnostic tools, 140 vaccines 134 vaccines) 102 125 On track

Strategic Objective 11

WPR/RC64/3 page 267 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.002.WP01 Internationally accepted norms, standards and guidelines for the quality, safety, efficacy and cost-effectiveness of essential medicines implemented, and national regulatory and quality assurance systems strengthened. Indicator Number of countries that have received WHO support to implement internationally accepted norms, standards and guidelines for quality, safety, efficacy and costeffectiveness of essential medicines, and to strengthen national regulatory and quality assurance system. Number of priority medicines that are prequalified for United Nations procurement. Baseline 2012 20 Target by 2013 21 Achievement to date On Track/Fully Achieved

Remarks

1

20 Support provided to CHN, COK, FJI, FSM, KHM, KIR, LAO, MNG, MYS, NIU, NRU, PHL, PLW, PNG, SLB, TON, TUV, VNM, VUT and WSM. Activities of other targeted countries for implementation in 2013.

2

3

5

4 Indicator show number of prequalified products, not countries. All prequalified products were manufactured in CHN.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE NRA capacity has been assessed in the PHL and strengthened in CHN, LAO, PLW, PHL, PNG, SLB and VNM through support to improve capacity to review efficacy, safety and quality of products, conduct Good Manufacturing Practice (GMP) inspections, enhance performance of quality assurance systems and improve medicines safety through strengthened pharmacovigilance systems. Strategic Objective 11

WPR/RC64/3 page 268 Annex 1 Training in the use of the new global RAS to report on suspected incidence of SSFFC medicines and medical products was held in Western Pacific Regional Office by WHO Headquarters with participants coming from Croatia, Georgia, Indonesia, KHM, Kyrgyzstan, MYS, PHL, Russian Federation, Ukraine, VNM and observers were CHN, Georgia and the United States. WHO Country Offices provided technical support to CHN and LAO to strengthen the capacity of pharmaceutical inspection system to monitor adherence to GMP. WHO headquarters and Country Offices provided technical support to regulatory capacity development in CHN. Training in the use of the new global RAS to report on suspected incidence of SSFFC medicines and medical product was held in WPRO by WHO headquarters.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE WHO’s capacity and the available resources from donors and government in priority countries are insufficient to implement systematic and sustainable capacity building actions that would bring national regulatory authorities to a level similar to well-established stringent regulatory authorities in developed countries. This poses a risk not only to these countries but also regionally and globally and will require new strategies to achieve significant and sustainable improvements in regulatory performance

SUMMARY OF ACTIONS REQUIRED Strengthening of NRA capacity is a priority and future allocations of funds should be prioritized for specific activities to create a regional forum for national regulatory authorities to support information exchange, capacity development and regulatory convergence within the Region.

Strategic Objective 11

WPR/RC64/3 page 269 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.002.WP02 Improved regulatory and quality assurance systems for blood products, medical devices and laboratories. Indicator Number of countries and areas supported to improve the regulation and quality assurance systems for blood products, medical devices and laboratories. Baseline 2012 5 Target by 2013 5 Achievement to date On Track/Fully Achieved Remarks

1

2 Support provided to LAO and PHL on medical device regulation. Other targeted countries to implement activities in 2013.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Public health laboratory capacity enhancement through capacity development and training of laboratory staff in KIR. National capacity strengthening to deliver laboratory services for early diagnosis and treatment was supported in LAO, MNG and PNG. WPRO provided technical support to LAO and the PHL on regulation of medical devices.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Except for disease-specific laboratory networks, the absence of regional quality assurance programme for laboratories in the Region. Quality of laboratory results variable in many Member States. Lack of clearly-identified cost-effective health technologies in the Region.

SUMMARY OF ACTIONS REQUIRED Strengthened capacity of laboratory staff in the countries of the Region to apply best practices for ensuring quality and credibility of laboratory results. Strategic Objective 11

WPR/RC64/3 page 270 Annex 1 Streamlined standards for safe blood transfusions as per regional needs. Collaborative initiatives to strengthen external quality assurance in public health laboratories of the Region. Sustained support, both technical and financial to targeted countries in the Region to ensure implementation of strategic plans in the area of health technologies. PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.002.WP03 The quality, safety, efficacy of herbal medicines secured and regulations on traditional medicine improved. Indicator Number of countries and areas supported to improve the regulation and quality assurance system for traditional medicines Baseline 2012 9 Target by 2013 11 Achievement to date On Track/Fully Achieved Remarks

1

9 KHM and LAO National quality assurance and control frameworks; 2012 Government Forum on Traditional Medicine, Seoul, Republic of Korea (CHN, HOK KHM, KOR, LAO, MNG MYS, PHL, VNM)

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Strengthened capacity to establish / improve quality management and regulation system for traditional medicine in KHM and LAO. Cooperative and consolidated efforts and contributions of AUS, CHN, JPN and KOR to develop chapter 23 on traditional medicine for International Classification of DiseasesVersion 11 (ICD-11).

Strategic Objective 11

WPR/RC64/3 page 271 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The critical issues in the Region are to ensure the quality and safety of traditional medicine practice and products. Lack of essential legislation framework and the capacity are the major challenges.

SUMMARY OF ACTIONS REQUIRED Further constant actions to strengthen the capacity through promoting cooperation and collaboration to exchange knowledge and experiences within the region are required.

PROGRESS OF THE CONTRIBUTION TO ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 11.3 Evidence-based policy guidance on promoting scientifically sound and costeffective use of medical products and technologies by health workers and consumers developed and supported within the Secretariat and regional and national programme. Performance Indicators Baseline Target by Status by 2012 2013 end 2012 11.3.1 Number of national or regional programmes receiving support for promoting sound and costeffective use of medical products or technologies. 11.3.2 Number of Member States using national lists, updated within the past five years, of essential medicines, vaccines or technologies for public procurement or reimbursement. 78 97 On track

125 (94% of reporting countries)125

99% or On track reporting countries

Strategic Objective 11

WPR/RC64/3 page 272 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.003.WP01 Evidence-based, scientifically sound and costeffective use of essential medicines by health workers, practitioners and consumers promoted. Indicator Number of countries and areas that have received WHO support to promote evidencebased, scientifically sound and cost-effective use of essential medicines by health workers, practitioners and consumers. Number of countries that have received WHO support to use national lists, updated within the past five years, of essential medicines, for public procurement or reimbursement. Baseline 2012 24 Target by 2013 25 Achievement to date On Track/Fully Achieved Remarks

1

24 Support provided to: ASM, BRN, CHN, COK, FJI, FSM, JPN, KHM, KOR, LAO, MNG, MNP, MYS, NIU, NRU, PHL, PLW, PNG, SLB, TON, TUV, VNM, VUT, WSM.

2

10

12

10 Support provided to: COK, FJI, KIR, MHL, PLW, PNG, SLB, TON, VUT, WSM.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Twenty three countries were supported to participate in discussion and workshops on policy guidance and interventions to improve rational and cost-effective use of medicines by health workers and consumers in the Asia Pacific Conference on National Medicines Policies in Sydney, Australia. Nine PIC (COK, FJI, KIR, PLW, PNG, WSM, SLB, TON and VUT) were provided with training on how to promote rational use of medicines by health workers through effective Medicine and Therapeutic Committees.

Strategic Objective 11

WPR/RC64/3 page 273 Annex 1 WPRO contributed to the organization of the Asia Pacific Conference on National Medicines Policies where promoting rational use of medicines was the main theme. WPRO delivered training for members of Medicine and Therapeutic Committees in PIC on how to monitor, assess and improve the rational use of medicines.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Irrational and irresponsible use of medicines is a common problem across countries causing major inefficiencies/wastages and harm, especially when the consequences are public health threats such as AMR. Quality of care is compromised because of irrational use, yet little attention and resources are directed to interventions that can improve this.

SUMMARY OF ACTIONS REQUIRED There is a need to more strongly promote and advocate actions to deal with problems of irrational drug use and WHO needs to mobilize resources on larger scale to adequately support countries in this area. PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.003.WP02 Improved evidence-based and cost-effective use of blood products, medical devices and laboratories. Indicator Number of countries and areas supported to promote evidencebased scientifically sound and costeffective use of blood products, medical devices and laboratories. Baseline 2012 7 Target by 2013 7 Achievement to date On Track/Fully Achieved Remarks

1

8 Support provided on implementation of laboratory quality standards in: COK, FJI, FSM, KIR, MHL, NRU, SLB, VUT

Strategic Objective 11

WPR/RC64/3 page 274 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE National policy for laboratory framework and health laboratory network was developed and launched in the PHL. Support for laboratory strengthening and enhancing quality management system was provided to the PIC. Country Offices provided technical support to development of national regulatory frameworks, establishment of quality management systems, and personnel capacity building for health laboratory services of selected PIC (COK, FJI, FSM, KIR, MHL, NRU, SLB and VUT). Country Office supported the development and dissemination of the national policy on laboratory network framework in the PHL

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The total number of laboratories in the Region and their capacity are not known. The cost-comparisons of the cost-effectiveness of blood transfusion services are not available. The National health technology assessments are not available.

SUMMARY OF ACTIONS REQUIRED The regional database of health laboratories in the Region was developed. The cost comparisons of blood transfusion practices in the Region was assessed. The efficacy and cost-effectiveness of medical technology was assessed through national health technology assessments.

Strategic Objective 11

WPR/RC64/3 page 275 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 11.003.WP03 Evidence-based, scientifically sound and cost-effective use of traditional medicine by practitioners and consumers promoted Indicators Number of countries and areas that have received WHO support to promote evidence-based, scientifically sound, and cost-effective use of traditional medicine by practitioners and consumers Baseline 2012 10 Target by 2013 10 Achievement to date On Track/Fully Achieved Remarks

1

10 Health service delivery profiles including TM service delivery for AUS, HOK JPN, KHM KOR, LAO, MNG, MYS, NEZ, PHL, VNM

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Traditional medicine service delivery profiles of 12 countries (AUS, FJI, HOK, JPN, KHM, KOR, LAO, MNG, NEZ, PHL, PNG and VNM) were finalized as part of overall service delivery profiles. Household Baseline Survey on the Traditional Medicine practice and needs in selected remote communes in VNM were conducted.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Lack of strong scientific evidence, information and recorded knowledge behind traditional medicine interventions are the major challenges to be tackled.

SUMMARY OF ACTIONS REQUIRED Continuous support to Member States required to strengthen research capacity, in particular, research methodology for carrying and producing reliable research results. Compiling reliable information and knowledge on traditional medicine to guide policymakers and researchers.

Strategic Objective 11

WPR/RC64/3 page 276 Annex 1 STRATEGIC OBJ ECT IV E 12 TO PROV IDE LEADERSHIP, STRENGTHEN GOVERNANCE AND FOSTER PARTNERSHIP AND COLLABORAT ION W IT H COUNTRIES, THE UNITED NAT IONS SYSTEM, AND OTHER STAKEHOLDERS IN ORDER TO FULFIL THE M ANDATE OF W HO IN ADVANCING THE GLOBAL HEALTH AGENDA AS SET OUT IN THE ELEVENTH GENERAL PROGRAMME OF W ORK EXPECTED RESULT 12.001 12.002 COUNTRIES CONTRIBUTING TO RESULTS DPM, RDO CHN, FJI, FSM, KHM, KIR, KOR, LAO, MNG, MYS, PHL, PNG, SLB, TON, VNM, VUT, WSM DPM FJI RDO DPM TOTAL 1 17

12.003

2 1

12.004

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The sixty-third session of the RCM was successfully held in Hanoi, Viet Nam in September 2012. All senior officials of Member States of WPR participated in the RCM. All proposed resolutions were adopted by the RCM. Two WRs/CLOs meetings, one regionwide meeting and one regionwide workshop of the Programme Management Officers (PMO) were held in 2012. In the PMOs' workshop held from 27 to 30 November 2012, programme management staff were trained in a variety of subject areas, including: (a) Management process based on logical framework/approach and WHO's results-based structure for Programme Budget (PB) 2014–2015; (b) value-for-money study methodology and findings; (c) project risk analysis and management, and; (d) award/resource management. To facilitate staff in programme planning and implementation, budgeting and award management, and monitoring and assessment, an initiative was undertaken by the Programme Development and Operations (PDO) unit in 2012 to develop a Programme Management User Handbook. With the contribution of experienced programme and budget management, and administrative staff from both Regional and country offices, the User Handbook was

Strategic Objective 12

WPR/RC64/3 page 277 Annex 1 completed at the end of 2012. It is expected that the User Handbook will be printed and distributed in the first quarter of 2013. The Awards Oversight Group (AOG) was formed in early 2012 to oversee and strengthen Regional and country monitoring of awards and finances. Since June 2012, the AOG was formally incorporated into the regular Regional PMO Network to form the new PMO-AOG Network. The PMO-AOG Network meets regularly, usually before every Regional Programme Committee meeting. Since the establishment of the AOG, awards management has improved with lesser funds unbudgeted and undistributed and the amount of expired but unutilized awards has also been reduced significantly. All major budget centres (BCs), i.e. CHN, KHM, LAO, MNG, PHL, PNG and VNM, including all WPRO technical divisions and DPS, have all organized BC-specific programme committees/senior management group meetings to regularly review issues related to the BC's awards management, donor reports, programme implementation and monitoring, and resource mobilization. In collaboration with the WHO Headquarters (HQ), the Country Support Unit (CSU) piloted a format that would make the CCS more useful and strategic in programme planning and priority setting. The CCS process and tools have been re-developed and, based on the new tools, all WPRO CCSs have been reviewed and assessed. Since the beginning of the current biennium, three CCSs have been renewed and launched, namely, LAO, the PHL and WSM. The end-to-end e-guide on resource mobilization for assisting BCs and staff to deal with resource mobilization issues both in and outside of the Global Management System (GSM) was developed and distributed. Progress reports on resource mobilization and expected resources to be provided by donors are now regularly monitored and reported to the AOG.

CHALLENGES/ISSUES The crucial challenge is to provide more sustained and predictable technical and financial resources for health, based on a common health agenda that responds to the health needs of and priorities of Member States in the Region.

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WPR/RC64/3 page 278 Annex 1 SUMMARY OF ACTIONS REQUIRED Following a review of the achievement of the last biennium and year 2012, the required actions are the following: To enhance accountability and synergy of WHO's work, HQ formed a task force in December 2012 to look at the roles and functions of the three levels of the Organization. The work of delineating the roles and functions at the three levels needs to be started immediately to ensure its inputs into the PB 2014–2015. To align its CCS with the country’s priorities and development cycle and harmonize its work with the United Nations and other development partners within relevant frameworks, such as the United Nations Development Assistance Framework, Poverty Reduction Strategy Papers and Sector-Wide Approaches. To provide more sustained and predictable technical and financial resources for health based on a common health agenda that responds to the health needs of and priorities of Member States in the Region. This work has not made much progress. In the meantime, a WHOdonors dialogue meeting will be held in Geneva in June 2013. WHO country presence is effectively led at the country level, harmonized with other development partners and guided by CCS that supports the national health agendas of Member States in the context of the Eleventh General Programme of Work. In the new biennium, the role of CCS in WHO programme planning needs to be examined and CCS should be integrated into the WHO planning process. Essential multilingual health knowledge and advocacy material made accessible to Member States, health partners and other stakeholders through the effective exchange and sharing of knowledge. Information products and their effective use are supported within a Knowledge Management System (KMS) need to be delivered. Specific plans to achieve efficiencies and cost reductions: • Reduction of human resources (HR) in administrative areas where their functions have been taken over by the Global Service Centre (GSC). • More effective monitoring, management and utilization of awards.

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WPR/RC64/3 page 279 Annex 1 • Operationalization of CCSs through their integration into the WHO results-based planning process. • Sunset or drop programmes and outputs that have been or cannot be achieved.

Continue to reform the Organization to achieve better results. Rational alignment between WHO country strategies and national priorities. Improve coordination between WHO and development partners to reduce duplication of efforts.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 12.1 Effective leadership and direction of the Organization exercised through enhancement of governance, and the coherence, accountability and synergy of WHO’s work. Performance Indicators 12.1.1 Percentage of documents submitted to governing bodies within constitutional deadlines in the six WHO official languages Baseline 2012 95% Target by 2013 80% Status by end 2012 100%

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 12.001.WP01Coherence and synergy between the work of the different parts of the Organization. Indicator Proportion of concerned Regional Committee Member States who take action based on RCBaseline 2012 Unknown Target by 2013 100% Achievement to date 100% On Track/Fully Achieved Remarks

1

Strategic Objective 12

WPR/RC64/3 page 280 Annex 1 endorsed resolutions, strategies and action plans.

RER 12.001.WP03Support for adoption of resolutions that focus on policy and can be implemented at regional and country level. Indicator Percentage of resolutions submitted to RCM that have been approved without major revision Baseline 2012 90% Target by 2013 100% Achievement to date

On Track/Fully Achieved Remarks

1

100% All submitted resolutions were approved by RCM without major revision

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE With regard to the Governing Body meetings (Regional Committee/Programme Subcommittee), all documents were delivered well in advance before the meetings. Governance has been strengthened through regular and ad hoc Cabinet meetings, Programme Committee meetings, Programme Management Network and Awards Oversight Group teleconferences/meetings. Following the guidance of the Regional Office, large country budget centres have formed country-specific programme committees/senior management groups to regularly review their programme and financial issues. This development has significantly enhanced the governance, effectiveness and accountability of the Organization at the country level. In the past four years, continuous and consistent efforts have been made to transform WHO in the Western Pacific Region into a more efficient and agile organization that effectively and promptly responds to the needs of its Member States. At the same time, WPRO has been a front-runner in the implementation of global organizational reform. A full report on achievements is available as part of the document "Reforms in the WHO Western Pacific Region".

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WPR/RC64/3 page 281 Annex 1 Mechanisms to ensure that RCM resolutions can be implemented at regional and country level have been streamlined and coordinated throughout the two tiers (regional and country) of the Organization. Efforts have also been made to ensure that Executive Board/World Health Assembly (EB/WHA) resolutions and RCM resolutions are harmonized and adopted appropriately.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Inadequate dissemination of approved policies and resolutions to the country level to ensure follow up and implementation.

SUMMARY OF ACTIONS REQUIRED Clear delineation of roles and functions of the three levels of the Organization is urgently needed to ensure that resolutions and policies drafted and approved at the highest level will trickle down to the country level for proper and coordinated implementation.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 12.2 Effective WHO country presence established to implement WHO country cooperation strategies that are aligned with Member States’ health and development agendas, and harmonized with the United Nations country team and other development partners. Performance Indicators 12.2.1 Number of Member States where WHO is aligning its country cooperation strategy with the country’s priorities and development cycle and harmonizing its work with the United Nations and other development partners within relevant frameworks, such as the United Nations Development Assistance Baseline 2012 33 of the 145 country cooperation strategies updated/revised Target by 2013 Status by end 2012

38 of the 145 3 additional country countries in 2012 cooperation strategies updated/revised

Strategic Objective 12

WPR/RC64/3 page 282 Annex 1 Framework, Poverty Reduction Strategy Papers and Sector-Wide Approaches 12.2.2 Percentage of WHO country offices which have reviewed and adjusted their core capacity in accordance with their country cooperation strategy 70% 80% 100% reviewed/assessed but adjustment data not available at the moment

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 12.002.WP01 Effective WHO country presence established to implement WHO country cooperation strategies that are aligned with Member States' health & development agendas, and harmonized with the United Nations country team and other development partners (Countries). Indicator Number of country offices with available HR strategy in line with the Country Cooperation Strategies and Country Strategic Frameworks and is reviewed on a sixmonthly basis according to resource availability Baseline 2012 0 Target by 2013 8 Achievement to date 4 On Track/Fully Achieved

Remarks

1

Strategic Objective 12

WPR/RC64/3 page 283 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE In 2012, three more countries have launched or renewed their CCSs which included LAO, the PHL and WSM. All three CCSs are aligned with the Member States' health priorities and development agendas and are harmonized with the work of the sister agencies of the United Nations and other development partners. WHO staff members continued to provide strong support to ministries of health and other key counterparts and stakeholders, in order to provide essential technical assistance to Member States to implement their CCSs and Country Strategic Frameworks (CSFs), to ensure coherence with policy orientation and accountability of the work of the Organization and to strengthen the partnership and leadership on health. The Regional Office has provided substantial technical backstopping for countries and areas where WHO presence is absent or inadequate. To enhance performance at country level and to make a difference by WHO where it matters most, an initiative has been taken in 2012 to conduct an external assessment of the roles and functions of WHO in three WPR countries, namely, KHM, PNG and Solomon Islands (SLB).

SUMMARY OF ISSUES Progress on the CCS and CSFs are dependent on increased availability of financial and human resources.

SUMMARY OF ACTIONS REQUIRED Continuing support from senior management is required to actively engage in CCS renewal, WHO performance assessment and joint planning and review of WHO programmes. The observations provided by the external evaluations have the potential for changing the way WHO works in the future and should be factored into organisational reform planning.

Strategic Objective 12

WPR/RC64/3 page 284 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 12.002.WP01 Effective WHO country presence is established to implement WHO country cooperation strategies that are aligned with Member States' health and development agendas, and harmonized with the United Nations country team and other development partners in WPR. Indicator Number of country offices in the Region that have reviewed and adjusted their core capacity in accordance with the Country Cooperation Strategies during the biennium Baseline 2012 0 Target by 2013 8 Achievement to date 4 On Track/Fully Achieved

Remarks

1

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE CCS renewed and launched in WSM and PIC. External assessments were undertaken in three country offices: KHM, PNG and SLB.

SUMMARY OF ISSUES Most CCS are not fully-aligned with the country priorities and have yet to be renewed given the appropriate financial and human resources to achieve this.

SUMMARY OF ACTIONS REQUIRED Continue CCS renewal process and assessment exercise. Assessment should be built in the Organization as a culture.

Strategic Objective 12

WPR/RC64/3 page 285 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 12.3 Global health and development mechanisms established to provide more sustained and predictable technical and financial resources for health on the basis of a common health agenda which responds to the health needs and priorities of Member States. Performance Indicators 12.3.1 Number of health partnerships in which WHO participates that work according to the best practice principles for Global Health Partnerships 12.3.2 Proportion of health partnerships managed by WHO that comply with WHO partnership policy guidance 12.3.3 Proportion of countries where WHO is leading or actively engaged in health and development partnerships (formal and informal), including in the context of reforms of the United Nations system Baseline 2012 45 Target by 2013 40 Status by end 2012 7

100%

100%

100%

80%

90%

Not available

Strategic Objective 12

WPR/RC64/3 page 286 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 12.003.WP01WHO is leading or actively engaged in health and development partnerships (formal and informal), including in the context of reforms of the United Nations system in WPR. Indicator Number of active partnership MoUs signed between WPRO and partners to support more effective programmatic delivery Baseline 2012 5 Target by 2013 15 Achievement to date 7 On Track/Fully Achieved Remarks

1

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE An end-to-end e-guide on resource mobilization has been produced by the Regional Office to assist staff in managing various stages of their resource mobilization process. To enhance predictability of the flow of resources, tracking of proposals submitted to donors and monitoring of clearance/approval of Memorandum of Understanding / Letters of Agreement (MoUs/LOAs), amount of fund flow, and awards creation are regularly carried out and reported to the regionwide PMO-AOG Network. Good progress has been made in resource mobilization efforts in the Region with 90% of the resource requirements for PB 2012–2013 already met. All 15 countries with WR/CLO offices present are leading or actively engaged in health and development partnerships, including in the context of reforms of the UN system. These countries are: CHN, FJI, the FSM, KIR, KHM, , LAO, MNG, MYS, PHL, PNG, SLB, TON, VNM, VUT and WSM (in the One UN Initiative). WHO collaboration with other UN agencies, intergovernmental bodies, nongovernmental organizations and other partners in various health areas continued to be strengthened in 2012. All seven new partnerships in 2012, managed by WHO, complied with WHO partnership policy guidance. Countries involved in the partnership are CHN, JPN, KOR and the PHL.

Strategic Objective 12

WPR/RC64/3 page 287 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Progress has been slow in establishing regional health and development mechanisms to provide more sustained and predictable technical and financial resources for health on the basis of a common agenda to respond to the health needs and priorities of Member States.

SUMMARY OF ACTIONS REQUIRED WHO should ensure that collaborations with entities outside the health sector should be looked into especially in addressing human resources for health challenges, which require a multisectoral approach.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 12.4 Essential multilingual health knowledge and advocacy material made accessible to Member States, health partners and other stakeholders through the effective exchange and sharing of knowledge. Performance Indicators 12.4.1 Average number of page views/visits per month to the WHO headquarters’ web site Baseline 2012 Target by 2013 Status by end 2012

7 million

7 million

Not applicable

12.4.2 Number of pages in languages other than English available on WHO country and regional offices’ and headquarters’ web sites

More than 80 000

80 000

Not available

Strategic Objective 12

WPR/RC64/3 page 288 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 01.004.WP02 Policy and technical support provided to Member States to enhance their capacity to carry out vaccine-preventable diseases surveillance and monitoring and strengthen laboratory networks. Indicator Access to journal articles based on average monthly hits on the WPRIM web page Access to records on the institutional repository based on average monthly hits Number of HINARI training and advocacy activities Visibility of and access to regional information products based on monthly hits on the publications web page Baseline 2012 Target by 2013 Achievement to date 40 123 On Track/Fully Achieved

Remarks

1

30 000 At least 5% above the baseline

2

0

40 000

11 430

3

3

6

0

4

67 500 At least 5% above the baseline

1 200 734

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Progress in implementation of planned activities, focusing specially on quality control at the production stage for publications and on dissemination and preservation of WPRO information products via the Institutional Repository and the Global Health Library. As part of the reform carried out at the WHO Western Pacific Region, a Regional communications strategy was developed in 2012 and it is currently in the process of being finalized. The Regional Director’s report for 2012 was produced and distributed during the

Strategic Objective 12

WPR/RC64/3 page 289 Annex 1 sixty third session of the Regional Committee. In the meantime, MNG and the PHL have produced their first WR reports, with other country offices to follow in 2013. All key Regional Committee documents have been translated from English to French and Chinese and made accessible to the Member States in a timely manner.

SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Information products have yet to be digitised to make dissemination and shipping more costeffective. Capacity of staff at both regional and country office levels need to be enhanced through training on publication procedures and RC documentation preparation. Inadequate financial resources for HINARI training, HINARI is a programme that is aimed at training for Member States to access medical journal for free. Financial resources are to be provided by the Organization for that free access.

SUMMARY OF ACTIONS REQUIRED Training for regional and country offices on the publication procedures, mission reports and Regional Committee document preparation. Support from senior management. Progress the digitization of all information products (for both Library and Publications units) to right-size to new space and to save on shipping costs and facilitate dissemination. Development and dissemination of a comprehensive graphic style guide to standardize branding and improve the overall look of publications. Two trainings for HINARI are planned by the end of the biennium.

Strategic Objective 12

WPR/RC64/3 page 290 Annex 1 STRATEGIC OBJ ECT IV E 13 TO DEVELOP AND SUSTAIN W HO AS A FLEX IBLE, LEARNING ORGANIZAT ION, ENABLING IT TO CARRY OUT ITS M ANDAT E MORE EFFICIENTLY AND EFFECT IV ELY EXPECTED RESULT 13.001 13.002 13.003 13.004 13.005 COUNTRIES AND OFFICES CONTRIBUTING TO RESULTS PDO BFO PER ITO CHN, FJI, FSM, KHM, KIR, KOR, LAO, MNG, MYS, PHL, PNG, SLB, TON, VNM, VUT, WSM ASO, SAO ASO 18 TOTAL 1 1 1

13.006

1

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Implementation of the Organization’s reforms, specifically HR reform, through the improvement of the recruitment and selection process and the creation of generic post descriptions. Maintained close monitoring of outputs and financial checks to ensure that audit requirements are met in a robust internal control framework in all offices. Successful implementation of International Public Sector Accounting Standards (IPSAS) leading to timely and accurate financial data feeding into global financial reporting, managerial monitoring tools and quality donor reporting. Continued focus on safety and security through the implementation of business continuity planning, earthquake analysis and mitigation and electrical re-cabling to provide redundant power supply. The construction of a new modern library and professional level studio room to provide efficient support to WHO communication activities.

Strategic Objective 13

WPR/RC64/3 page 291 Annex 1 CHALLENGES/ISSUES The key challenge is to sustain the momentum of change brought about by the new organizational reforms, with the back drop of financial and human resource constraints.

SUMMARY OF ACTIONS REQUIRED A significant amount of work has been initiated and while some have been concluded, others will be in progress beyond the current biennium. These are activities that are required for WPRO to progress its organizational reform: Continued prioritization and cost-cutting measures to match expenditures to expected income in SO12 and 13. Implementation of audit recommendations. Continued IPSAS implementation concentrating on full asset and inventory management accounting. Continued implementation of information technology (IT) initiatives in line with global direction and with respect to regional and country office needs. Continued monitoring of HR salary plans through Programme Committee. Continued implementation of the regional mobility policy and the General-Service Staff (GS) rotation policy for WPRO. Continued active monitoring and regular follow-up of Performance Management and Development System (PMDS) compliance. Implementation of the reforms on selection and recruitment process. Continued effective implementation of the reorganization of each unit under Administrative and Finance (DAF) division. Continued work on technical evaluation, monitoring, target rationalization and others.

Strategic Objective 13

WPR/RC64/3 page 292 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 13.1 Work of the Organization guided by strategic and operational plans that build on lessons learnt, reflect country needs, are elaborated across the Organization and used to monitor performance and evaluate results. Performance Indicators Baseline 2012 Target by 2013 Status by end 2012

Percentage of country workplans that have been peer-reviewed with respect 13.1.1 to their technical quality, that they incorporate lessons learnt and reflect country needs Percentage of OfficeSpecific Expected Results (OSERs) for which progress 13.1.2 status has been updated within the established timeframes for periodic reporting

95%

100% On track

85%

90% On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 13.001.WP01Work of the Organization guided by strategic and operational plans that build on lessons learnt, reflect country needs, are elaborated across the Organization and used to monitor performance and evaluate results. Indicator Baseline 2012 Target by 2013 Achievement to date On Track/Fully Achieved

Remarks

1

Percentage of OSERs identified as major outcomes/outputs in the Country and Technical Strategic Frameworks

90%

100%

Although in the initial plan almost 100% of the planned outputs 90% were derived from the CSFs and Technical Strategic Frameworks

Strategic Objective 13

WPR/RC64/3 page 293 Annex 1 (TSFs), subsequent implementation, influenced by donors' earmarked contributions to some nonCSF/TSF programme activities has made reaching 100% target difficult.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE In 2012, a number of programme management enhancement activities were carried out in line with WHO's ongoing reform activities aiming at enhancing the results-based programme management process and to improving the quality of programme planning, implementation and monitoring. Overall, the delivery of activities are on track, although further work is expected in 2014 and beyond. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Strengthened and adequate staffing is necessary in order to fully support the planned improvements in programme management. Various initiatives have been undertaken and work is ongoing in building the capacity of programme management staff and filling up vacant positions in order to achieve the required level of skills and competencies in this area. Likewise, work is in progress in determining how to assess the performance of the Programme Management Network and the budget centres in programme-related aspects of WHO’s work and contribute to the achievement of better results. SUMMARY OF ACTIONS REQUIRED Recruitment of both general service and professional staff as soon as possible, will help ease the current work overload problem in Programme Development and Operations (PDO) unit. With the completion of the Programme Management User Handbook, the next step is to conduct training on its use.

Strategic Objective 13

WPR/RC64/3 page 294 Annex 1 PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 13.2 Sound financial practices and efficient management of financial resources achieved through continuous monitoring and mobilization of resources to ensure the alignment of resources with the programme budgets. Performance Indicators Baseline 2012 Target by 2013 First fully compliant IPSAS annual financial statements presented to the Sixty-sixth World Health Assembly in May 2013 US$ 400 million Status by end 2012

Degree of compliance of WHO with International 13.2.1 Public Sector Accounting Standards

systems and opening accounts fully compliant

On track

Amount of voluntary contributions that are 13.2.2 classified as fully and highly flexible

US$ 235 million

On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 13.002.WP01 Efficient and effective accounting and financial reporting and internal control, country imprest management, cash management. Management of budget and budget allocations, and support for budget implementation. Indicator Percentage of transactions reviewed for quality and compliance assurance Baseline 2012 10% Target by 2013 20% Achievement to date On Track/Fully Achieved

Remarks

1

18% Compliance team reviews all travel requests for duty travels, meetings and other group activities. eImprest returns are reviewed on a monthly basis as well as the general ledgers and bank reconciliation.

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WPR/RC64/3 page 295 Annex 1 2 Average number of days required to respond to Budget Centres on all budgetary matters, including preparation of period budget analysis, timely distribution of resources to approved workplans and reporting to donors and management 3 2 2 Budget and Finance Officer’s (BFO's) response on requests depends on completeness of information and documentations provided by the budget centre concerned.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Close coordination with country offices and regular meetings with the Programme Management Officers allowed proper planning and monitoring of implementation programmes resulting to better evaluation and improvement of performance. Provided efficient, timely financial and budgetary support services to all budget centres. Regular monitoring of implementation of all sources of funds and submission of financial reports to the senior management for information and decision-making. Implemented financial controls in the Regional Office and country offices. Efficiency entails providing timely financial services and close monitoring of all budget centres within the Region while keeping strict financial controls and adherence to audit recommendations. Financial resources were managed and administered in accordance with WHO financial rules and regulations and IPSAS. The senior management was regularly provided with reliable information on regional performance and achievements through regular coordination of programme budget allocation, implementation, monitoring and reporting. The successful implementation of the e-Imprest system and smooth integration of various system upgrades have significantly enhanced the compliance and quality assurance of transactions across the Region, from the Regional Office in Manila to the Country :iaison

Strategic Objective 13

WPR/RC64/3 page 296 Annex 1 Office in Vanuatu. A compliance check was also put in place to help country offices with accurate recording of transactions and timely monthly closure of e-Imprest accounts. Internal financial controls continued to be strengthened with the establishment of Budget and Finance unit as the travel quality specialist in the GSM, utilizing its expertise in assisting budget centres to accurately process all types of travel requests in compliance with the latest policies. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Additional human and financial resources are required to ensure a sustained effort in meeting the expected results. SUMMARY OF ACTIONS REQUIRED 1) Continuous training required for the successful implementation of the new processes in GSM. 2) Monitoring of open audit recommendations and to ensure that they are closed in a timely manner. 3) Proactive follow ups of HR issues with the budget centres to facilitate the resolution of Oracle Labour Distribution issues. This will also help the timely management of HR issues, such as establishment of posts, contract extensions, etc.

Strategic Objective 13

WPR/RC64/3 page 297 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 13.3 Human resource policies and practices in place to attract and retain top talent, promote learning and professional development, manage performance, and foster ethical behaviour. Performance Indicators Proportion of offices with 13.3.1 approved HR plans for a biennium Number of staff assuming a new position or moving to a 13.3.2 new location during a biennium (delayed until biennium 2010–2011) Proportion of staff in compliance with the cycle 13.3.3 of the Performance Management Development System Baseline 2012 100% Target by 2013 Status by end 2012 7 On track

700

400 On track

Fully achieved in HQ and WPRO (more than 90%)

85%

On track

PROGRESS OF THE CONTRIBUTION TO REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 13.003.WP03Human resources operations effectively managed. Indicator Increased compliance and effective utilization of the performance management development tool and improved recruitment processing Baseline 2012 95% Target by 2013 100% Achievement to date 95% On Track/Fully Achieved Remarks

1

Strategic Objective 13

WPR/RC64/3 page 298 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The continued efforts in streamlining HR service delivery through alignment of HR policies with strategic direction of WPRO have led to some major changes in the Personnel area. A full set of generic post description for technical staff has been developed and are now being used across the Region. There are several advantages of using these standard job descriptions, but most importantly, they allow management to work more efficiently in recruiting staff and support regional efforts on staff mobility. Compliance with performance monitoring is maintained by the use of online performance development tool (ePMDS) where both the management and staff have benefited. The tool enables a comprehensive assessment of staff member contributions to the goals of the Organization as well as in assessing the individual development needs. The roll-out of the new Recruitment and Selection process resulted in a reduction of the average recruitment period by half. A number of new actions have been introduced, ranging from shortening the decision-making process to a hands-on training in recruitment skills for all involved staff. Ongoing review and close monitoring of the HR process in line with the HR reform of the Organization. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Continued close monitoring of creation of new posts and extensions of contracts is essential given the unpredictable and highly earmarked nature of voluntary contributions funding. Although initial action has been taken, more work remains to be done. In particular: coherent succession planning and career development, consistency in the implementation of the approved HR policies, improving the quality controls in staff performance evaluation and instituting a more appropriate system of awards, motivations and sanctions. SUMMARY OF ACTIONS REQUIRED As the streamlined recruitment and selection process has been rolled out, an ongoing review and assessment of other processes is required, to ensure that HR services are provided and improved when necessary.

Strategic Objective 13

WPR/RC64/3 page 299 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 13.4 Management strategies, policies and practices in place for information systems that ensure reliable, secure and cost-effective solutions while meeting the changing needs of the Organization. Performance Indicators Number of information technology disciplines 13.4.1 implemented Organizationwide according to industrybest-practices benchmarks Baseline 2012 Target by 2013 Status by end 2012

5

7

On track

Proportion of offices using 13.4.2 consistent real-time management information

Headquarters, 5 regional offices and associated country offices

All relevant WHO locations, including sub country and field offices, where appropriate

On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 13.004.WP01 Information technology operations: Local ICT infrastructure and support maintained. Indicator Declared and agreed servicelevel objectives for all elements of the information technology infrastructure at Western Pacific Regional Office. Baseline 2012 10% Target by 2013 70% Achievement to date 70% On Track/Fully Achieved Remarks

1

Strategic Objective 13

WPR/RC64/3 page 300 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The activity is on track, with enhancements and renewals of end-user workstations throughout the Region, upgraded network bandwidth and infrastructure, and enhanced account processes and monitoring overall. The year saw major planning and coordination activities in the deployment of Windows 7 and Office 2010 in the Region. The IT group had been involved in the development of the Emergency Operations Centre, the migration of the Region’s web presence to a new global platform among other infrastructure projects. Major initiatives included: the deployment of a new server infrastructure and updated email services throughout the Region; enhancement of network connectivity in several country offices to meet growing needs and; the implementation of a global solution to ensure remote connectivity of staff to WPRO and other global services. Several health technical projects have been developed throughout the year, including a lead technical role in the implementation of the Health Information Intelligence Platform (HIIP), the development of administrative dashboards and applications, and the implementation of web-based collaboration solutions. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Lack of funding to support information technology (IT) projects, especially at the county level, is of utmost concern. High demand of IT jobs led to a high turnover of IT staff at country level, which resulted in lack of sufficient IT support in country offices. SUMMARY OF ACTIONS REQUIRED Secure a more concrete and increased financing to support the various information technology projects in the Regional Office and country offices. Increase training opportunities for IT staff, particularly at country level.

Strategic Objective 13

WPR/RC64/3 page 301 Annex 1

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 13.5 Managerial and administrative support services necessary for the efficient functioning of the Organization provided in accordance with service-level agreements that emphasize quality and responsiveness. Performance Indicators Proportion of services delivered by the Global 13.5.1 Service Centre according to published Service Level Indicators (SLIs) Percentage of transactions 13.5.2 rejected. Baseline 2012 Target by 2013 Status by end 2012

85%

100%

3.5%

3%

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 13.005.WP01 Provision of administrative services and business support cost (courier services, transportation, utilities expenses, records and archiving, printing, meeting rooms and support costs). Indicator Percentage of service-level agreements to ensure delivery of administrative services. Baseline 2012 50% Target by 2013 60% Achievement to date 60% On Track/Fully Achieved Remarks

1

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE Administrative and procurement services are on track. Various enhancements to process IPSAS have been implemented Regionwide. Renovation and rehabilitation projects have been launched, aimed at increasing security and the functionality and use of the various office buildings. Indicators show an improvement in service delivery across the various areas.

Strategic Objective 13

WPR/RC64/3 page 302 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE Procurement of service contracts are not functioning at optimum levels. SUMMARY OF ACTIONS REQUIRED Development of a consultant recruitment portal is underway which will serve as the site for calls for proposals as well as the consultant database. A standardized monitoring template for monitoring performance of service contractors has been developed and should be disseminated to budget centres for use in their respective offices. PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 13.005.WP02 Provision of business support and services for country programme implementation. Indicator Rates of AC programme implementation as a proxy to the services provided by the country offices to programme implementation Baseline 2012 monthly Target by 2013 monthly Achievement to date On Track/Fully Achieved Remarks

1

monthly There is a close monitoring of programme implementation as coordinated between the country offices and the Regional Office.

SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE There is a continuous and close coordination between the country offices and the Regional Office. Regular meetings are held with country focal points through the Administrative Network and information dissemination in terms of policy updates and guidance have been instrumental in ensuring that programme and process implementation are up-to-date.

Strategic Objective 13

WPR/RC64/3 page 303 Annex 1 SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE There is insufficient funding to fully support the maintenance of country offices. SUMMARY OF ACTIONS REQUIRED Maintaining the exchange of information and maximizing the various forms of technology are essential in the success of both the country office and Regional Office implementation.

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF ORGANIZATION-WIDE EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS OWER 13.6 Working environment conducive to the well-being and safety of staff in all locations. Performance Indicators The percentage of offices which are Minimum 13.6.1 Operating Security Standards (MOSS) compliant. The percentage of offices 13.6.2 which are MOSS compliant. Baseline 2012 Target by 2013 Status by end 2012

70%

95% On track

70%

95% On track

PROGRESS OF THE CONTRIBUTION TO ACHIEVEMENT OF REGIONAL EXPECTED RESULTS, INCLUDING INDICATORS AND TARGETS RER 13.006.WP01 Building and security: Safety and security of WPRO staff and premises provided (security operations and compliance to UNDSS requirements). Indicator Extent of working environment conducive to the safety and security of staff and premises. Baseline 2012 60% Target by 2013 80% Achievement to date 80% On Track/Fully Achieved Remarks

1

Strategic Objective 13

WPR/RC64/3 page 304 Annex 1 SUMMARY OF ACHIEVEMENTS/PROGRAMME PERFORMANCE The year saw a renewed focus on safety and security. Planning was completed for the implementation of a business continuity plan, together with a renewed focus on earthquake analysis, water proofing, and electrical re-cabling to support power redundancy in case of failure. Given these continued efforts, and ongoing planning for revamped Closed-circuit television (CCTV) and access system, the Regional Office was rated fully security compliant in a recent evaluation by the UN Department of Safety and Security. A significant portion of the year was devoted to streamlining office workspaces, including the public information office, by enhancing the office space layout and reducing document space through scanning and archiving. A new modern library, built in a previously unused space was completed and a new professional level studio room was opened to support WPRO communications activities. The unit was also closely involved in the construction of a modern Emergency Operations Centre. SUMMARY OF ISSUES AFFECTING PROGRAMME/PERFORMANCE The challenge is the provision of adequate financial and human resources to sustain and build on current achievements. SUMMARY OF ACTIONS REQUIRED Continuous assessment and maintenance, where applicable. Further upgrade of CCTV and access control required.

Strategic Objective 13