(WPR/RC17/Min/l Rev.1)
MINUTES OF THE FIRST MEETING WHO Conference Hall Ivednesday, 21 September 1966 at 9.00 a.m.
CHAIRMAN: later:
Dr Y.K. Clla Dr Thor Peng Thong
COJ.1TENTS 1 2
Opening of the seventeenth session of the Regional Committee •.•••.••••••••.••••.•..•.•...•.....•.....• Address by the Secretary of Health of the Philippines Address by the Representative of the Director-General Election of neVi Officers: and Rapporteurs
87
89 9v
3 4
Chairnlan, Vice-chairman
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5 6
Adoption of the agenda
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'" '" '" '" '" '" '" '" '" '" '" '" '" .. '" '" '"
statement by the Chairman of the Technical Discussions Statement by the Regional Director and Budget '"
97
7 8 9
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98 99
Establishment of the Sub-Committee on Programme '" '" '" '" '" '" '" '" '" '" '" '" .... '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" .. '" '" .. '" '" '" '" '"
Acknovledgement by the Chairman of brief reports received from governments on the progress of their health acti vi tie s "'" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" .. '" '"
99
10
Resolutions of regional interest adopted by the thirty-seventh session of the Executive Board and the Nineteenth Horld Health Assembly....................... Statements by representatives of inter-governmental and non-governmental organizations in official relations \..;1th
9>
11
,mo "' . '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" . '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" '" .. '" '" '" '" '" '" '" '" '" '" '" '" '" '" .. <II '" '" '" '" '" '"
104 110
...
12
Announcements
-~
-83-
mnlafAL COMMI1"!EE:
SEVEl'f'l'EElfl:H SESSICIf
First Meeting Wednesday, 21 September 1966 at 9.00 a.m.
I. Representatives of Member States AUSTRALIA Dr H.F.. Downes Dr R. Taureka 14.r D. W. Argall Dr Thor Peng Thong l4.r Ok Sam On Dr C.K. Chang Dr T.C. Hsu Medec1n-General M. Orsini Dr M. Matsuo l4.r K. Watanabe l4.r Y. Matsuda
CAMBODIA CHINA
FRANCF. JAPAU
"
LAOS MALAYSIA
Dr Koulteo Saycocie Dr L. W. Jayesuria
Dr R. Dickie Dr C.H. James Mr Abdul Adz bin Mohamed UF-I-l ZFALAND
Dr C.N.D. Taylor Dr A.H. Cruz Dr V. Gahol l4.r J .M. Morales Dr A.N. Acosta Ur R. Concepcion Mr V. Buencamino l-!r 1:1. nustre Mr I. Bantug MI.- B. Hizon Mr D. Gonzales Mr A. Asuncion Mr I. N1canor Mr T. Austria Dr Nuno Campelo de Andrade Dr Manuel Florentino Matias l4.r Carlos da Luz Nunes -, ~
PIIILIPPD'lF.s
PORl'UGAL
MO'IDl'ES
(F
THE FIRST MEETING
85
RFPUBLIC OF KORFA
Dr Y.K Cha Hr J.H. Suh Mr N.J. Choi Dr S.R. Sayampanathan Dr
SDTG.APORJ:i1
mIITBD KIlJGDOl·j UNITF:D STATF.S OF MfE!RICA
Dr P.R. Teng C.H. Gurd
Dr R.K.C. Lee Dr H. De Lien I,Ir iLK. Koizumi Dr Le-Nhan-'l'huan Dr Duong-Cam-ChuonG Dr J .C. Thieme
V'l:F-T-NAH vIFSTF..i1N SAMOA II.
Representatives of the United Nations and Specialized Agencies UNITF:D NATIONS
M:r W.R. Cornwell
III
Representatives of other intergovernmental organizations INTERNATIONAL COMlUTTFE OF
Lt Col B.C. Panganiban Dr G. Loison
MILITARY MEDICINF. AlID PHARl.fACY SOUTH PACIFIC COMMISSION
IV. .le
~resentatives
of non-governmental organizations Dr S.P. Lopez Hrs M. Ordonez llrs R.S. Diamante Dr B.B. Frana Dr F. Sison Dr F. Castillo Professor Han Su Shin Mr A. Dimalanta Dr Benjamin Roa Dr G.C. Caridad
INTFRNATIONAL ASSOCIATION FOR THB PRl!NBNTION OF BLINDNESS INTBRNATIONAL COMMITTBB OF CATHOLIC NURSBS INTFTINATIONAL COUNCIL OF NURSBS ~-
INTERNATIONAL DFNTAL FFJ)ERATION INTFRNATIONAL PLANNED
PARENTHOOD FEDERATION INTEP.NATIOUAL UNION OF ARCHITF-CTS -"
L.l!"",AGUE OF RRD CROSS SOCIFTIBS
86
SBV_:&#!IIdtH SESSI<Jl .
MEDICAL WOMEN'S INTERNATIOO'AL ASSOCIATION THE WORm MEDICAL ASSOCIATION
Dr T. Gomez Dr
J.e.
Denoga
v.
WHO Secretariat Dr P. M. Iraul
Assistant Director-General Dr Francisco J. Dy Regional Director
1
OPENING OF THE SEVENTEENTH SESSION OF THE REGIONAL COl\K[~:
Items 1 and 2 of the Provisional Agenda Dr CRA declared the session open and conveyed to all the greetin0s
of the Republic of Korea and its hope that the discussions would advance even further the Dr Kaul, who was struG~le
against disease and. suffering.
He also welcomed
attendJ..n~
the meetin", as Representative of the Director-
General, and Dr Gar.:.:ia, the Secretary of Health of the Philippines, whose presence at the openin:.., session was a L,reat honour. Governments in the
Western Pacific Region were particularly grateful to the Philippine Department of Health for the assistance J..t had given to the many seminars and meetin~s
held in Manila.
Dr Cha then referred to the openJ..nG of the sixteenth session of
the Committee in Seoul.
This had been a unique session made especially
gratifying by the participation of the Director-General, Dr Candau. The importance of the meeting, the first to be held in the Republic of Korea, had been fully recognized by the press and the reports made had encouraged the Korean people, who felt that progress was being made in the fight to overcome the diseases that burdened their lives and delayed the improvement of their standard of livinG. At the last session, the Regional Director, Dr I.C. Fang, had.
announced his retirement after fifteen years of distinguished and devoted service as Director. In his remarks to the Committee he had.
commented on the shortage of funds in the developing countries and. warned against ellibarldn!::, on new programmes unless there was adequate financial support to ensure good results. improvement in the budgetar~
There
had.
been some
situation but there were still insuf-
ficient funds to carry out all that could be accomplished with the
88
REGIONAL COMMl'l'rEE: BEVEN'MTH SESSICti
technical knowledge available.
It vas, therefore, necessary to give Funds tl~
caref'uJ. attention to health plannin:; and programme evaluation. must be invested where the results would be commensurate with investment.
There would be no improvement in the lives of the people i f populations increased too rapidly. For this reason governments were
becoming increasingly interested in measures to limit the birth rate. The implementation of a family plannins programme required a well organized health system and this type of programme fell naturally into the maternal and child health field. Technical assistance, from skilled
health experts, was needed i f family planninG proorammes weJ;"e to be effective. WHO, with its wide knowledge of maternal and child health,
was well suited to meet the current needs for technical assistance in this field. At the last session, the subject of health education had been discussed and excellent recommendations made. Among these was the
establishment of health education services as an essential and integral part of national health programmes. There had been some progress in
the traininG of health personnel for increased health education responsibilities and it was hoped that in the near future this recommendation would have been carried out in all countries. Communicable diseases continued to be major problems in the Region. The occurrence of Japanese encephalitis epidemics every year in several countries was particularly disquietinG because there were as yet no effective measures for its control. During the current seSSion, environmental sanitation would be discussed. This was an appropriate topic because it was of interest
MINU.I!ES OF THE FIRST MlmrING
89
to all countries. tion.
There had. been s10,' but steady improvement in sanita-
Substantial changes in this field, however, required the expendi-
ture of considerable sums of money so that it was important to give first priority to those undertakings in wldch - once again - the results would be commensurate with the investments. In clOSing, Dr Cha welcomed Dr Francisco Dy, who had been nominated
for the post of Regional Director at the last session of the Committee. He was confident that under Dr Dy's leadership and guidance there ,/Quld be renewed efforts to improve the health services for the peoples of the Region. The CHAIRMAN then invited Dr Garcia to address the meeting.
2
ADDRESS BY THE SECRETARY OF HEALTH OF THE PHILlPPINES Dr GARCIA, Secretary of Health, on behalf of his Government and
the Department of Health, welcomed the representatives to
~ila.
He
also congratulated the World Health Organization on the choice of a Regional Director for the Western Pacific. It was a source of pride
to his Government that the man selected had almost become a member -~
of the Department of Health in the Philippines in 1954.
He believed Be
that Dr Dy was the most capable man in the Region for this post. assured the Committee that his Government and the Department ;/Quld
give full support to the regional procramme and the Regional Director. Dr Garcia then referred to the speech made by the Chairman in
which he had emphasized the importance of environmental sanitation activities. His Government supported strongly this statement.
It was also prepared to accept family planning provided that
90
the individual had freedom of choice in connexion with the method used. He requested the Horld Health Organization to report the results of its observations on the usefulness of family planning in due time, so that when this :policy was adopted in the Phili:p:pines, health workers could be sure that all possible side--effects on the mothers would have been eliminated. In the course of the discussions during the Regional Committee, the Representatives of the Department of Health would re:port on the new four-year proGramme of the De:pa.rtment of Health. them full freedom to discuss the subject freely. Dr Garcia concluded by wishing the Committee a successful meetinL.
He had given ....
3
ADDRESS BY THE REPRESENTATIVE OF THE DIRECTOR-GENERAL: of the Provisional ~nda
Item 3
Dr KAUL, Assistant Director-General, stated that he had attended
three sessions of the Regional Committee, each of which had been notable occasions. The first had been at the time of the inaug~ation
of the
regional headquarters in 1958, the second at the meeting of the Committee in Wellington, New Zealand, and the present session was notable because it was the first session of the Committee since Dr Dy had become the Regional Director and leader of the Regional ot'fice. Director-General, r~
On behalf' of the
wished the Committee success in its deliberations. ~ortant
Dr Kaul then referred to some
developments and trends
in international health activities. Director-General had been sou-~ing
During recent months the a note of warning that the health In fact, in the developing
levels throughout the world were not rising.
countries, the health levels were actually falling in so far as certain
91
of
the cOllllllWlicable diseases were concerned.
This retrogression was due
to setbacks in the development of health services and to threats of resurgence of certain diseases previously considered to be well under control. The health situation would get 'fOrse in most developing somethin~
countries unless
could be done to counter the shortage of money
and trained manpower needed to tackle the growing problems due to industriali~ation
and the rush to the towns.
WHO had assiGned teaching staff to medical schools, pubUc health and other training institutions in many countries.
It had also helped
in planning the better use of health of
worl~rs
and in finding the resources
money urgently needed for such essential needs as the development of The
community water supply. systems.
rate of progress was still inade-
quate to meet the demonstrated needs for water supplies in the developing
..
countries, in spite of US$500 000 000 in loans from bilateral and international so-urces having already been invested in such programmes during the period 1958 to 1965. Efforts of Member countries to provide
adequate a.'1d safe water supplies and proper disposal of sewage were still hampered because of the d11'ficulties in obtaining the necessary capital for the construction of such facilities. vlHO had developed procedures
--
in consultation with the United Nations Development Programme, the International Bank for Reconstruction and Development and the International Development Association,for assisting Member countries to secure the necessary capital funds. These procedures had been success-
fully applied in a number of countries, but so far in the Western Pacific Region there vrcLS
only one such project which had been approved
by the United Nations Development Programme: assistance in the. initial sta6es of the sewerage disposal programme for the metropolitan area
92
of
Mmila.
The amount appropriated for this project by the United._ ~!
Nations Development Programme was US$714 000.
other countries in the
Region could also obtain this type of assistance and the Organization would certainly provide them with the necessary consultant services and other assistance to enable them to develop project requests for international financing.
An important financing institute had just been established - the Asian Development Bank. It was hoped that this bank would view
sympathetically the needs of Member countries for loans for the construction of water s~ly
and sewerage facilities.
The Inter-
American Development Bank, the first regional institution of this nature to be established, bad, from its inception, recognized the need for capital for this purpose. During a five-year period it bad
made loans to countries amounting to apprOximately US$250 000 000. This financing, together with national and local. funds, had provided for the construction of sixty projects covering urban and rural. populations of approximately thirty million in Latin America. Dr Kaul then referred to the resurgence of cholera El Tor, which had invaded new areas in the Western Pacific, South-East Asia and the
Eastern Mediterranean Regions.
WHO bad established a cholera vaccine
bank and had set up teams to help countries in emergencies and in preparing long-term control programmes. The Organization was promoting
research on the bioloGY and epidemioloGY of cholera, on the genetics of cholera vibrios, vibrio resistance to antibiotics, on the viability of vibrios, on carrier studies, and on finding and testing new and better vaccine. It bad also assisted in training personnel for
diagnosis of the disease and on improved methods of treatment of
MINUTES OF 'lHE FIRSi' MEE:nNG
93
cholera patients, ~~d effective methods of dealing with the cholera carriers. i'he present treatment of cholera, particularly scientifically
controlled rehydration, reduced the death rate to a low level. Two other diseases which had assumed considerable importance recently, particularly in the Western Pacific Region, were mosquitoborne haemorrhagic fever, first recognized in Manila in 1954, which had caused. a major epidemic in Bangkok in 1958, and which had since
been reported in Singapore, Republic of Viet-Nam, Malaysia and Eastern India. It had been observed that, after the first outbreak, the disease
tended to recur on the original site and to extend to other towns in the country. Simultaneously with a severe form of the disease,. the grada-
tion of minor cases and cases with a classical dengue fever syndrome had been observed. in the affected areas. While haemorrhagic fever
affected mainly children, the classical dengue fever syndrome had been observed at the same time in adults. At least four, and possibly six,
types of denGue virus and chikungunya virus had been isolated from patients and mosquitoes. Aedes aegypti had been found to be the main i'he control of the No
vector of both chikungunya and dengue viruses.
disease, apart from the control of the vector, was unsatisfactory. -+
vaccine had. yet been developed which was suitable for use in the areas of the outbreak. In order to develop an effective vector control
campaign, more information on the vector mosquito or mosquitoes, their distribution and density must be obtained. i'he Organization had initiated
a global survey on the distribution and density of Stegomya mosquitoes. In the Western Pacific and South-East Asia Regions, the distribution of
Aedes aegypti was probably broader than had been previously thought, and, as urbanization increased, the density of this species had also
increased.
In order to develop a control programme, t he Organization had ~
established an
Research Unit in Bangkok to undertake studies on the
popuJ.ation dynamics, ecology, distribution, vectorial capacity, behavtour and insecticide susceptibility ot the Aedes &egypti and A. albopictus.
Advantage was also being taken ot the WHO scheme tor the evaluation and testin~
at new insecticides to examine new larvicides and new larvicide
formulations which might have a substantial toxicity to Aedes larvae coupled with a suffiCiently low mammalian tOxiCity to enable them to be considered for application to drinking water, which ~s
the common
source of A. aegypti breeding.
Based on the genetiC and behavioural
studies which would be carried out by the Aedes Research Unit, consideration would also be given to the utilization at other control techniques, such as the sterile male technique and biological or genetic control. A programme at serological surveys was also being developed in order to obtain more detailed information 'about the geographical areas involved and those where the population was susceptible, through the system ot reference laboratories set up by WHO. WHO was supporting
studies for the production of non-infectiOUS antigens for chikungunya and dengue viruses.
When information on these studies became avail-
able it would be distributed to public health and hospital laboratories in the areas concerned so they cOUld perform simple serological tests
to determine the presence ot antibodies for these viruses in the popuJ.ation. The Organization had recently initiated a global epidemiological
surveillance progrnmme,and haemorrhagic fever had been selected as one of the tirst diseases for international surveillance. At the request
ot the Organization, some countries in the haemorrhagic fever belt, i. e., India, Burma, Thailand, Cambodia, Hong Kong, ~ys1a,
Republic
MINUTES CF THE FIRST MEETmG
95
." of Viet-~am and the Philippines, had ~urnished periodic reports on the incidence of haemorrhagic fever in the past one -and >ti.-half years . I t was clear from these reports that the information was sketchy. l.nco~lete
and
To get a clearer picture of the nature, prevalence and spread
of this disease, notification at the national levels in the countries already affected or potentially affected was urgently required, and it \las hoped that the countries in the Region would their notification system. Japanese encepllalitis was also of great public health in many of the countries in the Western Pacific Region. i~ortance i~roVe
and strengthen
The geographical
distribution of the Japanese encephalitis virus incidence extended from the USSR and Japan to India. Although it lTaS
estimated that acute
encephalitis occurred in less than 10 per cent. of infected persons,
.
mortality was ccses.
hi~h
- 20 to 50 per cent. - in clinically recognized
The control of the disease had been mainly directed to its pre-
vention by vaccination. vaccinated in Japan.
Since 1954 a large number of children had been
Although analysis of the incidence of encephalitis
in Japan showed that the attack rate in non-vaccinated persons had been much higher than in those who received the vaccine, there were difticulties in obtainine a proper assessment of the results, because the vaccine was given to all volunteers without controls. of
The production
a more purified vaccine was under way and control trials had been The results were
carried out with one of these vaccines in China. under a.nalysis at the moment.
Efforts were also being made to produce
vaccines with attenuated strains and recently a formaldehyde killed vaccine had been produced. Excellent immunological responses had been
REGIONAL CQl.l.fITrEE:SEVENTBENTH SESSION
obtained in animal.s and in a :limited number of human vol.unteers.
The
resuJ.ts to date encouraged the belief' that this product was superior to the killed vaccines previously used.
4 4.1
ELECTION OF NEIl OFFICERS: CHAIRMAN, VICE-CHAIRMAN AND Item 4 of the Provisional. Agenda Election of ~1airman
~PORTEURS:
Dr CRUZ (Philippines) nominated Dr THOR PENG THONG (Cambodia) as
Chairman; this was seconded by Dr JAYESURIA (M:l.laysia). Decision: Dr THOR PENG THONG was elected with acclamation.
Dr THOR PENG THONG expressed his thanks to the representatives
for having elected him as Chairman.
This ,.;as not only an honour for
himself' but also for the Cambodian delegation and the Cambodian Government. It \-TaS
,-
''lith a great feeling of' humility that he accepted
the decision as his experience was limited as far as the work of the Regional Committee was concerned. He would try to do his best to
deserve the trust placed in him and ,-rould rely on the assistance and co-operation of the Regional. Office.
He then proposed that the election of the other officers be resumed. 4.2 Election of Vice-Chairman Dr DOWNES (Australia) nominated Dr SAYAMPANATHAN (Singapore) -or
as Vice-Chairman; this was seconded by Dr MATSUO (Japan). Decision: Dr SAYAMPANATHAN was el.ected unanimously.
.Ml:N'I.11ES OF THE FIRST MEETING
97
4.3
Election of Rapporteurs Dr CRA (Republic
D-r
Korea) nominated Dr THIEME (Western Samoa)
as Rapporteur for the English language; this was seconded by Dr TAYLOR (New Zealand). Dr ORSINI (France) nominated Dr SAYCOCIE (laos) as Rapporteur
for the French language; this was seconded by Dr CHANG (China). Decision: Dr THIEME and Dr SAYCOCIE were unanimously elected Rapporteurs.
5
ADOPTION OF THE AGENDA: (Document l,VPRjRC17/l)
Item 6 of the Provisional Agenda
The CHAIRMAN moved the adoption of the agenda. Decision: adopted. In the absence of any comments, the agenda was
6
STATEMENT BY THE CHAIRMAN OF THE TECHNICAL DISCUSSIONS: Item 7 ot' the Agenda The CHAIRMAN announced that, in accordance with the resolution
adopted by the Regional Committee at its eleventh session .. the Regional Director, in consultation with the Chairman of the Regional Committee, had selected Dr A.H. Cruz, Director, Bureau of Health Services, Depart-
ment ot' Health, Philippines, as Chairman of the Technical Discussions.
Dr CRUZ (Philippines) thanked the Regional Director and the retiring Chairman ot' the Regional Committee for having selected him as Chairman of the Technical Discussions. The subject ot' the discus-
sions this year was "The Role of the Health Department in Environmental
98
Health Activities ".
This was a topic of great im;portance to all countries
in the Region and it ,nas hoped that as a result of. the discussions, cuidelines would be provided which would be of assistance to health departments throughout the Region. •
The first plenary session would be held on Friday, 23 September at
9.00 a.m.
Three working :papers would be presented, two of which had
been prepared by WHO Headquarters staff, one of whom, Mr J. lanoix, Chief of the Sanita.tion Services and Housing Unit, Division of Environmental Health, ,nas present today. Dr Cruz himself.
The third paper had been prepared by ,
Participants would then be divided into three discusA closing
sion groups which would meet also on the Saturday morning.
plenary session would take place on Monday morning when the summary reports of the groups would be presented and discussed, and conclusions reached. Questions and problems for discussion in the group meetings
had already been prepared but i f any Representatives wished to suggest others, these should be submitted to the Secretary of the Technical Discussions. (For consideration of the report at the Technical Discussions,
see minutes of the fifth meeting, section 4.)
7
STA!rEMENT BY THE REXlIONAL DIRECTOR
The REXlIONAL DIRECTOR stated that his first and most pleasant duty
was to welcome the Representatives to M3.nila.
Although as Director of
Health Services he had met many at them before, this would be the first time he welcomed them as Regional Director. He thanked them for their
confidence and assured them that he would do his utmost to carry on the work so ably started by his predecessor, Dr I.C. Fang, and would
99
serve the needs of the legion to the best of his ability.
He hoped that
he could count on the continuation of their close and cordial co-operation in the task which luy ahead of him.
8
ESTABLISHMENT OF THE SUB-COMMITTEE ON PROGRAMME AND BUDGET: Item 8.1 of the Agenda In accordance with the principle of rotation, it was agreed that
the membership should be composed of the Representatives of France, laos, MUaysia, Philippines, Portugal, Singapore, the United states of America and. Western Samoa. It was also agreed that the Sub-Committee
would meet at 2.30 p.m. on Friday, 23 September, and that, if necessary, discussions would continue cn Saturday afternoon. (For consideration
ot the report of the Sub-Committee, see minutes of the fifth meeting, section 2.) 9 ACKNOWLEDGEMElNT BY THE CHAIRMAN OF BRIEF REPORTS RECEIVED FROM GOVERNMENTS ON THE PROGRESS OF THEIR HEALTH ACTIVITIES: Item 9 of the Agenda The CHAIRMAN acknowledged reports on the progress of health
activities received from the following countries:
Australia, Cambodia,
China, Fiji, French Polynesia, Guam, Japan, Iaos, Mi.c&o, ltilaysia, New Caledonia and its Dependencies, New Zealand, Papua and New Guinea, Philippines, Republic of Rbrea, Timor, Viet-Nam and Western Samoa. (For
a further report acknowledged, see minutes of the fifth meeting, section 6.) 10 RESOWTIONS OF RIDIONAL INTEREST ADOPTED BY THE THIRTY-SEVENTH SESSION CF THE EXECUTIVE BOARD AND THE NINETEENTH WORLD HF..AIlrH ASSEMBLY: Item 10 of the Agenda (Document ~'TPR/RC17/3) The RIDIONAL DIRECTOR stated that document WPR/RCl7/3 contained
the resolutions of regional interest adopted by the thirty-seventh
1.00
r:
session of the Executive Board and the Nineteenth World Health Assembly. A note bad been added in connexion with a few resolutions as it was felt that the attention of the Committee should be specifically drawn to some of the operative paragraphs. He then stated that in view of the interest shown by the Committee
at previous sessions in the health aspects of world population and the role which \iHO could play in the field of family planning, he wished to make a brief reference to resolution vrnAl9.43 on '~rogramme
activities
in the health aspects of world population which might be developed by" WHO". The Director-General bad informed all reGional offices that WHO
could advise governments upon request in the development of programmes on a demonstration basis, where there was an organized health service, without impairing its normal preventive and curative activities. The
programme should include activities in the medical aspects of both sterility and of family planning as part of the overall functions· of local. health services, particularly of their maternal and child health services, special attention being paid to the training of professionals and non-professionals. WHO could only provide this advice upon request on condition that:
(a) a policy of family planning had already been established independently by the government concerned, (b) WHO accepted no responsibility for endorsing or promoting any particular population policy, (c) the problems of
hwnan reproduction "Tere recognized to involve the family unit as "Tell
as society as a whole and the size at the 1'am:Lly was. the free choice 01' each individual family, and (d) it was recognized that it was a matter for national administrations to decide whether and to what extent they should support the proviSion of information to their people on the health aspects of human reproduction.
MIMES CF THE FIRST MEE.'nNG
101
Health Aspects ot World Population (Resolution WHAl.9.43) Dr LEE (United States of .America) said that his delegation was
pleased to hear the Regional Director cite some of the policies established by the Director-General. He asked whether copies of this statement could
be made available to the Members of the Committee so that the points mentioned could be evaluated in the light of the resolutions adopted by the Committee at its fifteenth and sLxteenth sessions. The REGIONAL DIRECTOR agreed to this suggestion. Dr CHANG (China) stated that his Government strongly supported
WHOls policy with regard to the promotion of research on population growth and, most espeCially, its decision to render technical assistance to governments upon request. He believed that the problem was urgent
because it was directly related to the health of the mother and the child and he would, therefore, like to see the policy tra.nslated into action. His Government was grateful for the start which had already
been made by the two ilHO publications on intra-uterine devices and oral contraceptives. These were now being translated into Chinese for
distribution to all the medical personnel in his country. Dr SAYAMPANA.TlIP.N (Singapore), Vice-Chairman, said that he would
like to put on record his Governmentls pleasure at the Organizationls latest promise to help in family planning. His Government had just
inaugurated a national plan prepared by the Singapore Family Planning Board with the hope of reducing the birth the five-year period. appreciated. rat~
to about fifteen within
Any assistance which WHO could give would be much
102
Pro
amme and Bud et Estimates for 1 6 Health Promotion Resolution "l1HAl.9. 0
Fund for
Dr TENG (United Kingdom.) stated that the enited Kingdom. wished to
reiterate its established policy that it was opposed in principle to the creation of voluntary funds outside of the l'egular budget. There bad
been a tendency for voluntary-supported programmes to be transferred to the regular budget once they had become established, and in so far as the Organization was then committed to these programmes, this transference eroded the responsibility of the Executive Board and the Health Assembly for the proper control of the size and disbursement of the regular budget in the light of the priority projects competing for regular funds. Secretariat. The CHAIRMAN stated that the Committee had taken note of what had
He believed that this position was known to the WHO
been said by the Representative of the United Kingdom.. Health Aspects of World Population (Resolution vlHAl9.43) Dr LEE (United States of America) noted the additional background
information issued in connexion with this resolution.
It had not been T-
clear to him, when the Regional Director bad introduced this particular resolution, how the four points he had mentioned differed from. the content of the background information. The REGIONAL DIRECTOR said that the statement he had made earlier
was based on the resolution adopted by the Nineteenth World Health Assembly. The background information .rhich the Representative of the
United states of America had mentioned was an extract of the report of
the D1rector-General. to the Assembly.
In operative paragraph three on
page two of resolution WHAl.9.43, the folloldng statement was made: ",APPROVES the programme outlined in Part
In of the Director-General' s
report in pursuance of the operative part of resolution WHAl8. 49" • Part nI had been reproduced in the background information referred to by the Representative of the United states of America. Dr LEE stated that, in the light of the explanation given by the
Regional Director, he would like to talre time to review this particular resolution and tr~ resolutions adopted by the Committee at its fifteenth and sixteenth sessions.
He would bring this subject up again i t he
believed it pertinent and necessary.
..
stud of the nature and Extent of Health Problems of Seafarers and the Health Services Available to Them Resolution :1l!Al9. 8)
Dr TENG (United Kingdom) intormed the Committee that the United
Kingdom's policy on this subject was that full medical services were provided free of charge to all seafarers, irrespective of whether they were British or not. As the matter was to be discussed by the Joint
Committee of WHO and lLO at a seminar to be held later this year, his Government would await the results of the recommendations of the Joint Committee. Reports of E?q>ert Committees (Resolution vIHAl9.51) Dr TENG (United Kingdom) informed the Comm:l±.tee that the United
Kingdom did not propose, to establish national expert committees because its existing arrangements for the study of these reports were considered to be satisfactory.
104
ROOIONAL COMMITTEE: SEVEltl!EEI.'t:g!1 SESSION
The CHAIRMAN asked whether the United states Representative had any
more comments to make. Dr LEE (United States of America) said that, as he had indicated
earUer, he would like to discuss further resolution WHAl9.43 after he had had the opportunity of: reviewing previous resolutions on this subject.
(For continuation of: discussion, see minutes of: the second meeting, section 2. ) The CHAIBMAN stated that the Committee would take note of the
resolutions. 11
STMEMENTS BY REPRESENTAT~ (F INTER-GOVERNME:NTAL .AND BooGOVERNMENTAL ORGANIZATIONS IN· CFFICIAL ..REI..A!rIONS WITH WHO At the invitation of: the Chairma.n, the following Representatives
presented statements. 11.1 Representative of the International Committee of Military Medicine and Pharmacy Lieutenant-Co1onel PANGANIBAN brought greetings from the International Committee of: Military Medicine and Pharmacy and extended best wishes for a successful session. 11.2
Representative of the South Pacific Commission For the benefit of newcomers, Dr LOISON stated that the South
Pacific COmmission was an advisory body created in 1947 at a time when the World Health Organization was just beginning. The fact that the
Commission was then working in isolated territories ex.plained how it
had lived on in spite of: the existence of: the World Health Organization which, of: course, was more powerful and. had more technical and financial resources. The excellent relationship with WHO had continued and now
MJ:NUrES OF THE FIRST MEETING
that there was a llHO area office in Fiji, in the centre of activity of
.
the South Pacii'ic Commission, co-operation with the COmmission had been reini'orced.. In January
1966, for example, the South Pacii'ic Commission had
organized in Ilestern Samoa a seminar for training in maternal and child health and ;.TIm had provided two consul.tants for this meeting. Conversely,
in the same month he (Dr Loison) had been himself a consultant in a seminar organized by l'lliO on health education. In April the South Pacii'ic WHO had provided
Commission had orgru1ized a course on medical statistics. the services of its Regional Adviser as lecturer.
In the follOwing month,
in the Kingdom of Tonga, WHO and the South Pacii'ic COmmission had jOintly held a course on environmental sanitation. Thus, working relationships
were constant and continuous between their experts and there were now discussions to continue this co-operation in future years. One of the particular traits of the Commission was that, under the
same roof, it had, apart from its Health Section, a Section on Economic Development and a Section on Social Development. All these three sections
were working in close co-operation to improve the well-being of the populations living in the Pacii'ic Islands. aims ivere the same as those of WHO. In the end, the COmmission l s
The task was so vast and the
magnitude so iIIq>ortant that there was vork for all men of goodwill. In the name of the Secretary-General, Mr Forsyth, Dr !Dison
expressed to the Committee his best wishes for the success of the meeting. Commenting on Dr !Dison l s statement, Dr LEE (United States of America) expressed appreciation of the tremendous progress made in the relationships bet\reen the South Pacific Commission and the vlHO Secretariat in the past few years. There had been times in the past
when relationships had not been as free, constructive and excellent as just pointed out. For the record, he cO!llIllE:nded both the Secretariat of
the Regional Office a.nd" Dr Loison and his (ltd! for theco-orperation and success they had achieved. 1l.3 Representative of the International Dental Federation
Dr SISON referred to the basic objective of the International Dental Federation, lThich had been adopted by its General Assembly at a Special Session in Cologne on 8 July 1962. This }/as "to make dental health care
available to all citizens who need and ,re.nt it so that the total health of the individual and of the nation al"e best served." This objective was, however, handicapped by the follo,ring problems which were common to many developing countries throughout the world today: the laclt of
trained dentists especially in public health; inadequate dental auxiliaries, equipment and supplies to meximi ze dental productivity; the inadequacy of dental health services available to childrenj the lack of accepted preventive public health measures to prevent dental. caries and other dental diseases; and the lack of a dentist directing dental health activities within the Ministry of Health. This situation could. be improved i f (a) the lack
ot trained dentists
in public health were remedied by strengthening the course in public health in under-graduate dentistry, (b) fellollships were provided for advanced training in dental public health, (c) dentists were provided with sufficient dental equipment and supplies and (d) high-school graduates were trained as dental assistants. He suggested also that a regional
.
seminar on child dental health might be organized by the
mlO Regional
Offices so that a better and more effective programme aimed at selected priority age grOU?S could be developed.
-"
MINm'FS
<F THE FIRST MEm'ING
lCTi
Republic Act 3626, known as the Fluoridation law in the Philippines, had been passed in 1963, but because of the lack of sufficient funds, its
implementation had been delayed. on the part of the \IHO
Direct material and technical assistance
and other allied agencies would make this preventive
programme a reality.
A similar situz.tion probubly existed in other !-Ember
countries in the Uestern Pacific Region. The lack of a IIdentist directing dental health activities within
ministry of health II , as pOinted out by the WHO EJq>ert Collllllittee on Auxiliary Dental Personnel, vas a major drawback in many developing countries. ..~
Fortunately, this problem no longer existed in the Philip-
pines.
The Bureau of Dental Health Services had now been organized
under the Department of Health with a dentist as director. vital and significant step forward.
This was a
It vas hoped that the Bureau would
..
co-ordinate with assisting local and foreign agencies in the implementation of national dental public health programmes, particularly in the redirection of the current remedial dental care programme to one of preventi ve and maintenance care under the Department of Health. In concluding, Dr Sison stated that he had submitted to the F.egional
Director information received from the KOrean Dental Association on its 1968 programme. 11.4 Representative of the L~ternational Plar_~ed
Parenthood Federation
Professor SHIN sta.ted that the Interna.tional Pla.nned Parentbood Federation was an international, non-government",l, voluntary organization. Its main objectives were to educate the peoples of the world
in family planning and responsible parenthood, and to stimulate appropriate scientific research in the related subjects of human fertility.
100
RmICliAL COMMI'.r.rEE: ~SESSION
The
Federation had now thirty-eight member countries and many others helped to develop efficient organizations capable of guiding Consultative stutus had been granted to it by the The
were being
effective programmes.
United Nations EconOmic and Social Council, UNICEF, ILO and IIHO.
ultimate objectives of the Federation I s work in family planning was to enrich human life. People thought, however, of family planning only as
a population problem counting the number of people versus available food, and they were not aware about another aspect. which was to satisfy man's phySical, mental, emotional and spiritual needs. Family planning, based on the physical and mental realth of mother and child, should be an essential part of the comprehensive maternal and child health service. Good health practice started with the expectant
mother making regular visits to an ante-partum clinic for an initial health examination and for subsequent observation. It also required The
delivery attended by qualified professional personnel.
period of
pregnancy and post-partum offered unique opportunities to reach women vrhen the subject of conception and its control was clearly relevant. The
maternal health organization provided a basis for systematic education on matters pertaining to reproduction and family planning. family planning and maternal services were mutually related. He referred to the research being carried out by WHO on human In short,
reproduction and fertility control and said that it was desirable to strengthen this r~Ecarch
and to include family planning subjects
in the
educational programmes of medical schools.
Although there VIas inter-
national co-operation to resolve this lrorld-'vide problem, he could see no evidence that any mass family planning programme had been launched by any inter-governmental organization. He 1:::)ped that this meeting
--'
MJ:Nl.1rES CF THE FIRST MEJJ:rING
would mark another step forward in the goal to have healthy children and !)arents and that in the very near future modern technology \,ould increzse the number of families in which the situation complied with the human rights stated in the Constitution of mIO: "Health is a state of
complete physical, mental and social ,rell-being and not merely t'>e absence of disease. " 11. 5 Representative of the }'~dical
Homen I s International Association
Dr GOMEZ stated that the subject selected for this year's technical
discussions was as timely as it was wise, since it had been repeatedly heard that there were disease problems prevailing which could be easily minimized through improved environmental sanitation. The ~d1cal Viomen' s International Association was composed of membej,"s
from more than thirty countries in tile >Torld and. it joined HHO in striving to attain maximum health through improved environmental sanitation. 11.6 Representative of the World l~dical Association Dr DENOGA stated that the \-Torld ~dical
Association represented It 1'1Ould be This
the free professional medical associations of nations. holding its Twentieth Assembly in
Mmila in barely two months.
was the first time such a meeting had been he}d in the Westexn Pacific Region and the Philippine Medical Association would act as host. hoped that as many representatives as possible would attend this meeting. During the sessions of the Assembly, the problems besetting the medical profession throughout the world llOuld be discussed, also the ways and means by l1hich the physicians could play a vital role in shaping the health planning of countries. An opportunity would also
He
110
BmJ:CBAL CCHUi"J:EE: SEVpTEl!ilf.l:H SESSI<Jf
be provided to consolidate ideas regarding problem. areas in medicine in which both the Association and. WHO had sho.m great concern and interest. SUch areas included population dynamics, schistosomiasis and health programmes geared towards national health progress. The Association viaS also sponsoring the Third Horld Conference on co~rehensive
Medical Education, .vhich would be held. in New Delhi in November 1966# and the theme was "Medical Education - Factor in Socio-Economic Development". The World Health Organization was also supporting this conference. 11.7 Representative of the League of Bed Cross Societies Dr ROA stated that the Bed Cross considered it ~rative
that there
should be close co-ordination and co-operation among the various services dedicated to the health and ./ell-being of all peoples. The Begional
Committee offered rich opportunities for everyone present to be acquainted with each other in a spirit of humanity and Christian understanding in order to promote and co-operate in the implementation of the programmes of the Horld. Health Organization. He appealed, therefore,
to all in the spirit of greater service to develop that affection, sincerity and closeness so that more fruitful results would be achieved. (For further statements presented, see minutes of the second and third meetings, section 1.)
12
ANNOUNCEMENTS The CHAIRMAN suggested that the Committee should. follow its usual.
practice and meet from 9.00 a.m. to 12.00 nooD, with a short recess at about 10.30 a.m., and from 2.}0 to 5.00 p.m., with a short recess at
about }.}O p.m., subject to the proviso that these times could be altered if the progress of work required it.
It was so agreed.
The meeting rose at 11.35 a.m.
,.
•