(WPR/RC29/5R/2)
5UHHAllY RECORD OF THE SECOND MEETING
WHO Conference Hall, Manila Monday, 21 August 1978 at 2.30 p.m. CHAIRMAN: Dr A.N. Acosta (Philippines) CONTENTS
1. 2. 3.
Nomination of the Reaional Director •••••••••••••••••••••••• l •• olution of appreciation for the
133 133 134
work of the aeaional Director •••••••••••••••••••••••••••••• Report of the Rea10nal Director ••••••••••••••••••••••••••••
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REGIOKlL COMMITTEE:
TWENTY-NIRTH SESSION
For the List of Representative, at the twenty-ninth session,
!!! pages 39-46 of the present volume.
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SUMHAaY RECORD OF THE SECOND MEETING
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1.
NOMINATION OF THE REGIONAL DIRECTOR: (Document WPl/RC29/6)
Item 9 of the Agenda
The meetina wa. held in private from 2.30 p.m. until 3.25 p.m. and re.umed in public .e•• ion at 3.45 p.m. At the reque.t of the CHAIIMAN, Dr TAaUTIA (Papua New Guinea), Rapporteur, read out the re.olution that had ju.t been adopted by the l.aional Committee in private •••• ion. "Th. lelional COIIIIIlittee, Condderinl Article 52 of the Con.tf.tution; and In accordance with lule 51 of ita lule. of Procedure; 1. NOMINATES in the order of preference a. indicated by the order of their election the name. of the following persons for the post of Regional Director for the Western Pacific: Dr Hiroshi Nakajima Dr Raja Ahmad Noordin DECIDES that those names shall be submitted to the 2, Executive Board; and 3. REQUESTS the Director-General to propose to the Executive Board that it authorize him to issue a contract to the legiona1 Director for a period of five years from 1 July 1979." 2. RESOLUTION OF APPRECIATION FOIl THE WOIlK OF THE REGIONAL DIRECTOR
Mr CHANG SOUK KIM (Republic of Korea) said he was sure that, in view of the Regional Director'. forthcoming retirement, lepresentatives would wish to express their appreciation for his long and successful leadership of public health activities in the Western Pacific Region of WHO. He therefore proposed that the Committee adopt the following draft resolution: "The Regional COIIIIIlittee, Considering that Dr Francisco J. Dy is leaving the World Health Organization on 30 June 1979, after serving for more than twenty-nine years, thirteen as legional Director, 1. EXPRESSES its appreciation to Dr Dy for his efficient leadership and management of the Regional Office for the Western Pacific, for his contribution to international public health, and for his tact in the promotion of international understanding; 2. DECLARES Dr Francisco J. Dy Regional Director Emeritus of the World Health Organization,"
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Dr FAAIUASO (Samoa), seconding the proposal, paid tribute to the achievements of the Regional Director who, despite budgetary difficulties, had always responded to requests from Member States. Dr TANAKA (Japan) expressed wholehearted support for the draft resolution. For the past twelve years Dr Dy had displayed his able leadership and vitality in promoting health in the Region. He was fully devoted to the cause of WHO, and it was to be hoped he would continue to advise on regional activities after his retirement. Dr DIZON (Philippines) fully supported the draft resolution in recognition of the Regional Director's valuable services. Dr NOORDIN (Malaysia), supporting the draft resolution, paid tribute not only to the Regional Director's remarkable record of achievement but also to his human qualities. Mr NGUYEN VAN TRONG (Socialist Republic of Viet Nam) expressed his warmest gratitude for the most tmportant contribution the Regional Director had made to his country in the difficult times that had followed the war and the reunification of Viet Nam. Dr NICHOLSON (United Kingdom), referring to Dr Dy's valuable contribution to health in the Region, expressed support for the draft resolution. Decision: Amid applause, the draft resolution was adopted (see resolution WPR/RC29.R2). The REGIONAL DIRECTOR expressed his deep appreciation for the kind sentiments voiced by Representatives and earlier by the Director-General. Although the tasks of a regional director were not easy, he had been fortunate during his period of office in having understanding Member Governments, a sympathetic Director~ General, and a loyal and hard-working staff. 3. REPORT OF THE REGIONAL DIRECTOR: (Document WPR/RC29/7) Item 10 of the Agenda
The REGIONAL DIRECTOR said that this year his report was· a brief one following the decision to present only significant matters and developments in even-numbered years, when the programme budget estimates were being considered, and a comprehensive report covering the previous biennium in odd-numbered years. The present report covered the period 1 July 1977 to 30 June 1978. Progress had been made in promoting country health programming and medium-term programming and in developing the information systems to support them. MUch effort had been expended on encouraging countries to think in terms of technical cooperation among developing countries. Both developed and developing countries had an important role to play in that endeavour. The idea of appropriate technology for health was also receiving increasing attention in the Region.
SUMMARY RECORD OF THE SECOND MEETING
135
The Regional Director was particularly pleased to report the progress made with the research programme. On 8 August 1978 the agreement had been signed between the Government of Malaysia and WHO for the initial phase of development of the Institute for Medical Research, Kuala Lumpur, as a regional centre for research and training in tropical diseases and nutrition. In response to a resolution, WHA29.72, adopted by the Twenty-ninth World Health Assembly, which asked the Director-General to intensify efforts to develop the concept of integrated health services and manpower development, a global study was being initiated. The resolution adopted by the Committee at the twenty-eighth .ession on changing trends in training had been a step towards taking practical action to implement the Health Assembly resolution and had resu1ted in the organization of a conference to be held early in 1979. l It wa. hoped that the action and discussions at national level which would follow the conference would make a valuable contribution to the study. A report would be presented to the thirtieth session of the Regional Committee. It was expected that the agreement between the Government of Malaysia and WHO for the establishment of the Western Pacific regional centre for promotion of environmental planning and applied studies (PEPAS) would be signed soon. The first staff members were expected to take up their positions before the end of the year. The Regional Director asked for clarification from the Committee of operative paragraph 7 of resolution WPR/RC28.R13 which provided for the Advisory Committee of PEPAS to meet biannually, when in fact the general feeling among the Secretariat had been that the intention was for the Advisory Committee to meet once every two years. Introduction Dr HSU SHOU-JEN (China) congratulated the Regional Director on his report, which gave a comprehensive picture of health activities in the Region. Great efforts would be needed to achieve the goal of "health for all by the year 2~': all potential would have to be utilized, all resources harnessed. Traditional medicine could make an outstanding contribution to the prevention and treatment of diseases, and China had accumulated a rich fund of knowledge and experience in that field. Chinese traditional medicine, which had its'own theoretical system, was being integrated with Western medicine to create a new Chinese medicine and pharmacology. He hoped the Regional Office would devote more attention to traditional medicine; his country was willing to cooperate in the exchange of scientific knowledge in that field with the Regional Office and other interested States. Regional Committee Dr CHRISTMAS (New Zealand) asked what steps had been taken with regard to the prevention of road traffic accidents, which were a particular problem in his country.
lSee resolution WPR/RC28.R16, Handbook of Resolutions and Decisions of the WHO Regional Committee for the Western Pacific, Volume II, 1978, page 27.
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TWENTY-NINTH SESSION
Dr HAN (Director, Manpower Development and Family Health) said that a multidisciplinary working. group had been set up at the Regional Office to approach the problem, not only from the health aspect but also from the social and behavioural aspects. One of the group's tasks was to collect basic information on that subject in the Region. A short-term consultant had been engaged, from October 1978, to help in drawing up a questionnaire and evolving other means of collecting information. It was planned to develop, in 1979, a pilot study in a country in which road traffic accidents were an increasing problem, using a behavioural science approach. The programme in road traffic accidents would be developed further in the light of the information collected later in 1978 and in the early part of 1979. The subject was new, and the Regional Office for Europe had been delegated to act as a focal point for it on a global basis. The Regional Office for the Western Pacific was keeping in touch with the global programme, which was still at an embryonic stage, and would attempt to keep pace with it. Technical Cooperation among Developing Countries There were no comments. Medium-Term Programming Dr ANGARA (Philippines), noting that environmental health had b.en allotted a lower priority than certain other fields for the preparation of medium-term programmes, pointed out that morbidity and mortality from such factors as insanitary wastes disposal were widely prevalent in the developing countries of the Region. She asked Whether the decision had been taken because water supply and wastes disposal had already been dealt with under the heading of health services development; whereas other factors, such as pollution, justifiably had a lower priority. Dr HIRSHMAN (Director, Programme Management) said that the preparation of a medium-term programme in environmental health was complex and had required the services of a consultant from Headquarters as well as considerable work from the Regional Office staff. The ~portance of environmental health was fully realized, and the lower pri~rity alloted to it was only in terms of time, not of importance. Country Health Programming Dr CHRISTMAS (New Zealand) said that country health programming was a fundamental process in the planning of health services for any community. He asked for further details and wondered whether, at the next Regional Committee, some time could not be set aside for discussion and commentary on the subject. New Zealand would be interested to learn of the experiences and problems of other countries in drawing up such programmes. Dr ANGARA (Philippines) said that, in her country, the national health plan approved as part of national development was already in operation and its targets had been established over the period of the plan. She asked what· country health programming could be expected to accomplish once the national health plan had been drawn up.
SUMMARY RECORD OF THE SECOND MEETING
D7
The REGIONAL DIRECTOR, in reply to the point raised by Dr CHRISTMAS, said that country health programming would be included in the agenda of the next Regional Committee. Dr HIRSHMAN (Director, Programme Management), replying to Dr ANGARA's question, remarked that various countries had embarked on national health planning in the past and a number of rather broad and philosophical health plans existed. Country health programming, to which WHO attached great importance, was essentially a national effort and had to be carried out by the countries themselves with their own resources, though with the collaboration of WHO if needed. The Philippines had wisely decided to embark on such a country health programme as an amplification of its health plan, with its own resources and the cooperation of WHO. It would be much more detailed than the national health plan and would, it was hoped, lead to the establishment of a collaborating centre where other Member States of the Region could see the progress of the plan and learn from it. He emphasized that that decision had been a national one. The REGIONAL DIRECTOR remarked that a national health plan would be more meaningful where country health programming had been undertaken. Information Systems Programme National Health Service Information Support There were no comments. Research Promotion and Development Dr TRAVERS (Australia) asked whether the Regional Director's development programme would be affected by the redistribution of its funds in order to increase the research programme. The REGIONAL DIRECTOR explained that the purpose of the Development Programme we. to have fund. allocated by the Director-General available for various activities and not to keep thea in the Progr..... Funds available to the Regiqn in 1978 had been allocated to bolster, stimulate," and initiate research programmes identified in consultation with governments. Dr TARUTIA (Papua New Guinea) said that his Government would shortly submit an official request for WHO cooperation in connexion with the proposed establishment of a research unit for pneumonia in Papua New Guinea. Dr FAAIUASO (Samoa) said it was encouraging to note that research grants were increasingly being awarded within the Region, rather than having to depend on WHO Headquarters in far-away Geneva. The DIRECTOR-GENERAL replied that he had increasingly been making efforts, together with the Regional Directors, to make WHO one organization. It was for that very reason that, for the first time in history, research had been decentralized to the regional level, always bearing in mind that every Region had a responsibility
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TWENTY-NINTH SESSION
to the global whole of the Organization. It was therefore immaterial whether resources were located in Geneva, Manila, or elsewhere: what counted was the priorities that Member States themselves decided upon. Some of those priorities might have a regional flavour, but all of them were significant for the global collection of information. Thus it did not matter whether the funds were allotted from the regular regional allocation or from extrabudgetary funds, such as those available in the Special Programme for Research and Training in Tropical Diseases, as long as those funds were shared"from the stand~ point that the Organization was an indivisible whole. It would be seen from the forthcoming study on the structures of WHO in the light of its functions that the unity of the Organization was very important. There could no longer be a divorce between Headquarters research activities and those of the Regions, or any question of Regions' not doing research because they were not properly equipped for it. On the contrary, it was hoped that an aggressive input from the regional side would make an important difference to the research programme of WHO as a whole. Primary Health Care Dr FAAIUASO (Samoa) expressed the appreciation of his Government for the opportunity to participate in the International Conference on Primary Health Care to be held in Alma Ata. The primary health care concept was being encouraged in his country and village health aides were being trained. It was expected that training in many areas would be completed during 1978. . UNDP would be further ' supporting the village health aide programme from 1980-82, and WHO cooperation would undoubtedly be welcome. The coneept of primary health care was uniquely suited to Samoan society and its social structure and the Government looked forward hopefully to WHO's cooperation in strengthening the primary health care training programme. Dr ANGARA (Philippines) stated that, as emphasized by the Director-General earlier, the individual, the family and the community had to recognize that they were responsible for their own health protection. Though health personnel often approached local communities for support in their eagerness to sell programmes, they often missed theopportuBity to impress this fact upon the population. Mr NGUYEN VAN TRONG (Socialist Republic of Viet Nam) pointed out that rural populations needed a health network which was rather expensive, so that community participation was indispensable. After centuries of explOitation, the Vietnamese people had welcomed a health policy based on a community health budget. The budget, which covered the establishment of health centres, salaries for health personnel, etc., was drawn up at the local level, according to needs, by the executive board of the corresponding cooperative. Appropriations were approved by the People's Council. Health activities were carried out with the cooperation of the Women's Federation, which helped in such fields as family planning, use of medicinal plants and promotion of hygiene, as well as of the Ho Chi Minh Organization of Young Labourers and other patriotic movements entrusted with the task of mobilizing the population.
SUMMARY RECORD OF THE SECOND MEETING
The school curriculum included the teaching of hygiene, prevention of diseases, first aid and environmental health, while school children engaged in other health work such as growing medicinal plants. Moreover, one member of every family belonged to the Red Cross Society and, after a course of 10 to 14 days, took on various responsibilities in the field of health and hygiene. While participation of the masses in this way was indispensable in developing countries, it was not sufficient: health equipment and drugs were also necessary. WHO had a very useful part to play in this regard. (For continuation of discussion, see the third meeting, section 2.)
The meeting rose at 4.50 p.m. r