Coordination of the work of the World Health Assembly, the Executive Board and the Regional Committee

WORLD HEALTH ORGANIZATION

ORGANISATION MONDIALE DE LA SANTE

REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL

REGIONAL COMMITTEE Fifty-third session Kyoto, Japan 1620 September 2002 Provisional agenda item 17

WPR/RC53/11 1 August 2002 ORIGINAL: ENGLISH

COORDINATION OF THE WORK OF THE WORLD HEALTH ASSEMBLY, THE EXECUTIVE BOARD AND THE REGIONAL COMMITTEE

Four resolutions adopted by the Fifty-fifth World Health Assembly are presented with an explanation of their implications for the work of WHO in the Western Pacific Region. Members of the Regional Committee are requested to express their views on the relevance of these resolutions to WHO’s programme of cooperation with countries and areas in the Region. World Health Assembly resolutions directly related to other items on the provisional agenda of the current session of the Regional Committee are mentioned in and annexed to the documents covering those individual agenda items.

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WORLD HEALTH ASSEMBLY RESOLUTIONS OF INTEREST TO THE REGION

The Fifty-fifty World Health Assembly adopted 25 resolutions, which are listed at the end of this paper (Annex 1). The attention of the Regional Committee is drawn to four in particular: resolution WHA55.10 on Mental health: responding to the call for action, resolution WHA55.14 on Ensuring accessibility of essential medicines, resolution WHA55.19 on WHO’s contribution to achievement of the development goals of the United Nations Millenium Declaration, and resolution WHA55.25 on Infant and young child nutrition. These are discussed below. WHA55.10 – Mental health: responding to the call for action WHO’s global action programme for mental health builds on the significant attention devoted to mental health during 2001, when both World Health Day and the World Health Report were devoted to mental health. Attention is drawn to operative paragraph (1), which urges all Member States to support the global action programme. The global action programme has four key elements: information for better decisions; integrated policy and service development; advocacy against stigma and discrimination; and

enhanced research capacity. These themes are central to WHO’s support for mental health in the Region and complement the regional strategy for mental health1 endorsed by the Regional Committee at its fifty-second session.2 Since the fifty-second session, WHO has worked with Member States to improve mental health across a range of areas, linking global action, the regional strategy, and national activities: • Advocacy. The mental health strategy was presented at many regional forums, including meetings in Australia, China, Japan, and the Republic of Korea. A journalists’ encounter brought journalists from 11 countries to Brunei Darussalam, Cambodia, and Malaysia to receive technical briefings on mental health and to observe mental health programmes, a process of engaging the voices that influence the public and policy-makers.

1 2

Document WPR/RC52/14. Resolution WPR/RC52.R5.

WPR/RC53/11 page 3 • Service provision. In China, WHO supported the development of education and training materials for doctors and psychiatrists. Over 100 psychiatrists were trained in Viet Nam. Courses for psychiatric nurses were held in Cambodia. • Mental health promotion. A comprehensive analysis of mental health needs, encompassing both mental health promotion and mental health service provision, is being undertaken. This could serve as a good model for other countries in the Pacific and beyond. • Policy, legislation, and the development of a research culture and capacity. Mental health needs assessment was supported in the Lao People’s Democratic Republic and support was also provided to Tonga for an assessment of the prevalence of psychiatric disorders and other problems related to mental health. • Suicide prevention. A study in under way is Viet Nam, supported by WHO Headquarters, to assess the prevalence and outcomes of suicide attempts and to set up an intervention to improve coping by the person concerned and their family and carers. The global action programme and the regional strategy for mental health provide a framework that Member States can use to guide their own national policies on mental health. WHO will continue to work with Member States to adapt these global and regional initiatives to national circumstances, bearing in mind the particular situations of individual countries. WHA55.14 – Ensuring accessibility of essential medicines Attention is drawn to operational paragraph 1, which urges Member States to take a number of actions to ensure access to essential medicines. The quality, safety and efficacy of essential medicines need to be assured; they need to be made affordable to patients and/or the healthcare system; and they should be rationally used. In the Western Pacific Region, many populations do not yet have regular access to essential medicines of sufficient quality. There are a number of reasons for this, including limited financial resources, high prices of some medicines, inefficient regulation, poor selection and management systems, and geographical factors. Over the years WHO has worked closely with Member States to improve access to highquality essential medicines and to ensure that they are used rationally. In particular, WHO has advocated the formulation and effective implementation of national drug policies and essential drug lists. WHO’s work on pharmaceuticals is guided primarily by the WHO medicines strategy which was adopted by the Fifty-fourth World Health Assembly (resolution WHA.54.11). The strategy aims to

WPR/RC53/11 page 4 help save lives and improve health by closing the huge gap between the potential that essential drugs have to offer and the fact that medicines are often unavailable, unaffordable, unsafe, of poor quality and improperly used. Within the strategy, four factors have been identified as crucial for securing and expanding access to essential medicines: (1) rational selection and use of essential medicines, (2) affordable prices, (3) sustainable financing, and (4) reliable health and pharmaceutical supply systems. In the Region, WHO will continue work with Member States to implement both resolution WHA55.14 and the WHO Medicines Strategy. As part of this process, there will be an expert meeting in early 2003 to develop a regional strategy to improve access to essential medicines in the Region. The meeting will analyse the situation in the Region, explore various options for improving access to essential medicines and draw up a draft regional strategy. WHA55.19 – WHO’s contribution to achievement of the development goals of the United Nations Millennium Declaration The United Nations Millennium Declaration, adopted by the United Nations General Assembly in September 2000, outlines the Millennium Development Goals. The goals cover peace, security and disarmament; development and poverty eradication; protecting the common environment; human rights, democracy and good governance; protecting the vulnerable; and meeting the special needs of Africa. Three of the goals relate directly to health and there is a health dimension to all the others. For each goal, there is one or more specific targets and specific social, economic and environmental indicators have been identified to track progress. The goals, targets and indicators are given in Annex 2. The primary responsibility for achieving the goals rests with the Member States. The United Nations Secretary-General will report annually to the General Assembly on selected goals, covering all of them over the next few years. This year’s report will focus on the treatment and prevention of diseases. The health-related goals relate closely to several priority areas of work in the Region. However, poverty and lack of access to basic health and social services pose a real challenge to their achievement. Attention is drawn to operative paragraph 1, which urges Member States to take various actions in order to achieve the goals set out in the United Nations Millennium Declaration.

WPR/RC53/11 page 5 Attention is further drawn to operative paragraphs 2-4, which call upon developed countries and the international donor community to increase official development assistance to developing countries and to increase investments in the health sector in line with the recommendations of the Commission on Macroeconomics and Health. WHO will continue to support Member States to select priority areas in order to ensure more rapid progress towards achieving the goals. The Regional Office is also initiating a process to track progress in achieving the goals in the Region. Monitoring progress will be easier for some indicators than for others and good data for some indicators are not yet available for several Member States. This underscores the need to strengthen national capacity to compile essential data.

WHA55.25 – Infant and young child nutrition The draft global strategy for infant and young-child feeding was prepared at a meeting in WHO Headquarters in March 2000 and reviewed at seven country consultations (two of which took place in the Region, in China and the Philippines) and at six regional consultations, with representatives of more than 100 Member States, the Food and Agriculture Organization of the United Nations (FAO), the International Labour Organisation, the United Nations Children’s Fund (UNICEF), and key international nongovernmental organizations (NGOs) such as the International Baby-Food Action Network (IBFAN), the International Lactation Consultant Association (ILCA), and the World Alliance for Breastfeeding Action (WABA). The regional consultation for the Western Pacific Region took place in Malaysia in October 2001, with representatives of 19 countries, resource persons from universities and partner agencies (FAO, the World Bank) and key NGOs (IBFAN, ILCA, WABA and Malaysian NGOs). It was organized jointly by the Regional Office and the UNICEF Regional Office for East Asia and the Pacific, with funding from WHO Headquarters and in collaboration with the Departments for Nutrition and Child and Adolescent Health at WHO Headquarters. UNICEF Headquarters was also represented at the meeting. The Malaysian Ministry of Health helped to organize the meeting and provided valuable technical input. Resolution WHA55.25 endorsed the global strategy. The attention of Member States is drawn to operative paragraph 2, which urges Member States, as a matter of urgency, to take a number of important actions to implement the global strategy. Implementation of the global strategy will be supported by WHO, in collaboration with other international organizations and bodies, in particular FAO, ILO, UNICEF, the Office of the United

WPR/RC53/11 page 6 Nations High Commissioner for Refugees (UNHCR), the United Nations Population Fund (UNFPA) and the Joint United Nations Programme on AIDS (UNAIDS). Funding from donors to support the measures that need to be taken will also be sought. The Regional Office has developed a plan to support countries to develop and implement national plans of action on infant and young-child feeding that are integrated with all relevant sectors and programmes. The first national workshop to review and refine a national plan will be conducted in Cambodia in September 2002, with support from UNICEF and WHO. Support for national plans has also been discussed in China, Mongolia and Viet Nam. Member States will be encouraged to work with WHO and other partner agencies in implementing the global strategy, and in monitoring and evaluating its impact.

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ANNEX 1

RESOLUTIONS ADOPTED BY THE FIFTY-FIFTH WORLD HEALTH ASSEMBLY Resolution number WHA55.1 WHA55.2 WHA55.3 Title of resolution Centenary of the Pan American Health Organization Health conditions of, and assistance to, the Arab population in the occupied Arab territories, including Palestine Financial report on the accounts of WHO for 2000-2001; report of the External Auditor; and comments thereon made on behalf of the Executive Board; report of the Internal Auditor Members in arrears to an extent which would justify invoking Article 7 of the Constitution Arrears in payment of contributions: Azerbaijan Arrears in payment of contributions: The Dominican Republic Miscellaneous Income Real Estate Fund Revolving Sales Fund Mental health: responding to the call for action Health and sustainable development Contribution of WHO to the follow-up of the United Nations General Assembly special session on HIV/AIDS Protection of medical missions during armed conflict Ensuring accessibility of essential medicines Smallpox eradication: destruction of Variola virus stocks Global public health response to natural occurrence, accidental release or deliberate use of biological and chemical agents or radionuclear material that affect health Dengue fever and dengue haemorrhagic fever prevention and control Quality of care: patient safety WHO’s contribution to achievement of the development goals of the United Nations Millenium Declaration Salaries of staff in ungraded posts and of the Director-General Amendments to the Staff Regulations Reimbursement of travel expenses for members of the Executive Board Diet, physical activity and health The need for increased representation of developing countries in the Secretariat and in Expert Advisory Panels and Committees Infant and young child nutrition

WHA55.4 WHA55.5 WHA55.6 WHA55.7 WHA55.8 WHA55.9 WHA55.10 WHA55.11 WHA55.12* WHA55.13 WHA55.14 WHA55.15 WHA55.16

WHA55.17 WHA55.18 WHA55.19 WHA55.20 WHA55.21 WHA55.22 WHA55.23* WHA55.24 WHA55.25

*Annexed to the document covering the agenda item on this topic

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 8

WHA55.1 14 May 2002

Centenary of the Pan American Health Organization The Fifty-fifth World Health Assembly, Bearing in mind that the Pan American Health Organization is the oldest international health organization in existence, since it was founded by the republics of the Americas in December 1902, and has worked uninterruptedly on behalf of the health of their peoples since that time; Recalling that since 1949 the Pan American Health Organization has served as the Regional Office for the Americas of the World Health Organization; Considering the role played by the Pan American Health Organization in the past 100 years in the noteworthy improvement that can be seen in health in the Region of the Americas; Aware of the leadership displayed by the Pan American Health Organization, together with Member States, in the eradication of smallpox and poliomyelitis, and in the significant reduction of measles, which is close to elimination, among other achievements in the Americas in the course of the last 100 years, RESOLVES: (1) to congratulate the Pan American Health Organization on attaining the first centenary of its foundation in this year 2002; (2) to congratulate the Member States of the Americas on the improvements in their peoples’ health achieved during the past century; (3) to encourage the Member States of the Pan American Health Organization to redouble their efforts to achieve equity in health matters, in the spirit of unity that has characterized panamericanism of the Region during the past 100 years;

WPR/RC53/11 page 10 Annex 1 (4) to thank the Pan American Health Organization and the World Health Organization for their close cooperation, dedication, leadership and contributions to the health of the peoples of the Americas.

Third plenary meeting, 14 May 2002 A55/VR/3 = = =

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 18

WHA55.2 17 May 2002

Health conditions of, and assistance to, the Arab population in the occupied Arab territories, including Palestine The Fifty-fifth World Health Assembly, Mindful of the basic principle established in the WHO Constitution, which affirms that the health of all peoples is fundamental to the attainment of peace and security; Recalling all its previous resolutions on the health conditions in the occupied Arab territories; Convinced that the basis of negotiations and of achieving a just and lasting peace should be United Nations Security Council resolutions 242 (1967), 338 (1973), other relevant United Nations resolutions, the principle of the inadmissibility of acquisition of others’ territory by force, the need for every State in the area to be able to live in security, and the principle of “land for peace”; Reaffirming the inalienable, permanent and unqualified right of the Palestinian people to selfdetermination, including their right to establish their sovereign and independent Palestinian State, and looking forward to the early fulfilment of this right; Expressing deep concern at the deterioration of health conditions as a result of the Israeli military acts against the Palestinian people since 28 September 2000, acts such as firing on civilians, deliberate extrajudicial killing, which caused hundreds of deaths and tens of thousands of injuries among Palestinians, including a large number of children; imposition of siege on Palestinian areas, thus preventing medicines and food from reaching towns, villages and refugee camps; obstruction of ambulances, injuring a number of ambulance crew members; and denial of access of injured people to hospitals, thus condemning them to death; Gravely concerned at the continued deterioration of the situation in the occupied Palestinian territory and at the gross violations of human rights and international humanitarian law, in particular, acts of extrajudicial killing, closures, collective punishments, persistence in establishing settlements, arbitrary detentions, besieging of Palestinian towns and villages, shelling of Palestinian residential districts using warplanes, tanks and the Israeli war machine, continued incursions into towns and camps and the mass killing of men, women and children living there as happened recently in the camps of Jenin, Balata, Khan Younes, Rafah, Ramallah, Gaza, Nablus, Al-Bireh, Al-Amari, Jabaliya, Bethlehem and Dheisheh;

WPR/RC53/11 page 12 Annex 1

Gravely concerned at the continued violence which has caused large-scale death and injury among Palestinians, the toll of casualties having reached thousands killed and over 40 000 wounded since 28 September 2000; Emphasizing the urgent need for full implementation of the Declaration of Principles and subsequent Accords between the Palestine Liberation Organization and the Government of Israel; Expressing grave concern at the ongoing Israeli settlement policies in the Palestinian occupied territory, including East Jerusalem, and other violations of international law, of the Fourth Geneva Convention (1949) and of relevant United Nations resolutions; Stressing the integrity of the entire occupied Palestinian territory and the importance of guaranteeing the freedom of movement of persons and goods within the Palestinian territory, including the removal of restrictions of movement into and from East Jerusalem, and the freedom of movement to and from the outside world, bearing in mind the adverse consequences of the continued closure of the Palestinian territory on the health sector, hindering the vaccination programmes in particular for more than eight months, leading to high risk of infectious diseases and epidemics, whereas vaccination and immunization against infectious diseases constitute a basic right of every child in the world; Noting with deep anxiety and concern the deterioration resulting from the excessive use of force by the Israeli occupation forces against civilians, including medical teams, and its negative impact on health programmes, especially on mother-and-child-related programmes, vaccination, reproductive health, family planning, epidemic control, school health, control of drinking-water safety, insect control, mental health and health education; Deeply concerned at the serious deterioration of the economic situation in the Palestinian territory, which has become a serious threat to the Palestinian health system, aggravated by the withholding by Israel of funds due to the Palestinian Authority, including health insurance income; Affirming the need to increase health support and assistance for Palestinian populations in the regions under the control of the Palestinian Authority and for the Arab populations in the occupied territories, including Palestinians and the population in the occupied Syrian Golan; Reaffirming the right of Palestinian patients and medical staff to benefit from health facilities available in the Palestinian health institutions in occupied East Jerusalem; Affirming the need to provide international protection for the Palestinian people and health assistance to the Arab populations in the occupied territories, including the occupied Syrian Golan; Having considered the reports on health conditions of, and assistance to, the Arab population in the occupied Arab territories, including Palestine,1 1. RECOGNIZES that the Israeli occupation is a serious health problem because of the serious threat it poses to the health and lives of Palestinian citizens; 2. STRONGLY CONDEMNS the Israeli military invasion of Palestinian towns and camps, which has resulted so far in the death of hundreds of Palestinian civilians, including women and children; 1

Documents A55/33 and A55/33 Add.1.

WPR/RC53/11 page 13 Annex 1

3. STRONGLY CONDEMNS the aggression of the Israeli army of occupation against hospitals and sick persons and the use of Palestinian citizens as human shields during Israeli incursions into Palestinian areas; 4. STRONGLY CONDEMNS firing on ambulances and paramedical personnel by the Israeli army of occupation, preventing ambulances and cars of the International Committee of the Red Cross from reaching the wounded and the dead in order to transport them to hospitals, thus leaving the wounded bleeding to death in the streets; 5. STRONGLY CONDEMNS the refusal by the Israeli occupation army to allow the burial of Palestinians, thus obliging their families to bury the bodies of their loved ones in available space around their homes and in hospital grounds; 6. AFFIRMS the need to support the efforts of the Palestinian Ministry of Health to continue to provide emergency services, deliver health and disease prevention programmes, receive further casualties in the future, and deal with thousands of cases suffering from physical and mental disabilities; 7. CALLS ON Israel to release all funds due to the Palestinian Authority, including health insurance dues; 8. URGES Member States and intergovernmental, nongovernmental and regional organizations to extend urgent and generous assistance to bring about health development for the Palestinian people and meet its urgent humanitarian needs; 9. THANKS the Director-General for her efforts, and requests her: (1) to visit the occupied Palestinian territories as soon as possible in order to examine the facts related to their health situation; (2) to reinstate a fact-finding committee on the deterioration of the health situation in the occupied Palestinian territory, which shall submit annual reports to the Director-General, and to the Health Assembly until the end of the Israeli occupation of said territory; (3) to take urgent steps in cooperation with Member States to support the Palestinian Ministry of Health in its efforts to overcome the current difficulties, in particular so as to guarantee the free movement of those responsible for health, of patients, of health workers, and of emergency services, and the normal provision of medical goods to Palestinian medical premises, including those in Jerusalem; (4) to continue to provide both the necessary technical assistance to support health programmes and projects for the Palestinian people, and emergency humanitarian assistance to meet needs arising from the current crisis; (5) to take the necessary steps and make the contacts needed to obtain funding from various sources, including extrabudgetary sources, to meet the urgent health needs of the Palestinian people;

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(6) to continue her efforts to implement the special health assistance programme, taking into consideration the health plan of the Palestinian people, and adapt it to the health needs of the Palestinian people; (7) to report on the implementation of this resolution to the Fifty-sixth World Health Assembly.

Eighth plenary meeting, 17 May 2002 A55/VR/8 = = =

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 15.1

WHA55.3 17 May 2002

Financial report on the accounts of WHO for 2000-2001; report of the External Auditor, and comments thereon made on behalf of the Executive Board; report of the Internal Auditor The Fifty-fifth World Health Assembly, Having examined the Financial report and audited financial statements for the period 1 January 2000 – 31 December 2001 and the Report of the External Auditor to the Health Assembly;1 Having noted the first report of the Administration, Budget and Finance Committee of the Executive Board to the Fifty-fifth World Health Assembly,2 ACCEPTS the Director-General’s Financial report and audited financial statements for the financial period 1 January 2000 – 31 December 2001 and the Report of the External Auditor to the Health Assembly.

Eighth plenary meeting, 17 May 2002 A55/VR/8 = = =

1 2

Documents A55/25, A55/25 Add.1 and A55/25 Corr.1. Document A55/38.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 15.2

WHA55.4 17 May 2002

Members in arrears to an extent which would justify invoking Article 7 of the Constitution The Fifty-fifth World Health Assembly, Having considered the second report of the Administration, Budget and Finance Committee of the Executive Board to the Fifty-fifth World Health Assembly on Members in arrears in the payment of their contributions to an extent which would justify invoking Article 7 of the Constitution;1 Noting that, at the time of opening of the Fifty-fifth World Health Assembly, the voting rights of Afghanistan, Antigua and Barbuda, Armenia, Azerbaijan, Bosnia and Herzegovina, Central African Republic, Chad, Comoros, Dominican Republic, Georgia, Guinea-Bissau, Iraq, Kazakhstan, Kyrgyzstan, Liberia, Nauru, Niger, Nigeria, Republic of Moldova, Somalia, Tajikistan, Turkmenistan and Ukraine remained suspended, such suspension to continue until the arrears of the Member State concerned have been reduced, at the present or future Health Assemblies, to a level below the amount which would justify invoking Article 7 of the Constitution; Noting that, in accordance with resolution WHA54.5, the voting privileges of Belarus, Djibouti, Democratic Republic of Congo, Guinea, Suriname and Togo have been suspended as from 13 May 2002 at the opening of the Health Assembly, such suspension to continue until the arrears have been reduced to a level below the amount which would justify invoking Article 7 of the Constitution; Noting that Argentina, Gabon, Paraguay and Solomon Islands were in arrears at the time of the opening of the Fifty-fifth World Health Assembly to such an extent that it was necessary for the Health Assembly to consider, in accordance with Article 7 of the Constitution, whether or not the voting privileges of these countries should be suspended at the opening of the Fifty-sixth World Health Assembly; Having been informed that as Gabon and Solomon Islands had subsequently paid their arrears in full they would no longer be included on the list of Members in arrears in the payment of their contributions to an extent which would justify invoking Article 7 of the Constitution, DECIDES: (1) that in accordance with the statement of principles in resolution WHA41.7 if, by the time of the opening of the Fifty-sixth World Health Assembly, Argentina and Paraguay are still in 1

Document A55/26.

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arrears in the payment of their contributions to an extent which would justify invoking Article 7 of the Constitution, their voting privileges shall be suspended as from the said opening; (2) that any suspension which takes effect as aforesaid shall continue at the Fifty-sixth and subsequent Health Assemblies, until the arrears of Argentina and Paraguay have been reduced to a level below the amount which would justify invoking Article 7 of the Constitution; (3) that this decision shall be without prejudice to the right of any Member to request restoration of its voting privileges in accordance with Article 7 of the Constitution.

Eighth plenary meeting, 17 May 2002 A55/VR/8 = = =

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 15.2

WHA55.5 17 May 2002

Arrears in payment of contributions: Azerbaijan The Fifty-fifth World Health Assembly, Having considered the second report of the Administration, Budget and Finance Committee of the Executive Board on Members in arrears in the payment of their contributions to an extent which would justify invoking Article 7 of the Constitution, with respect to the request of Azerbaijan for the settlement of its outstanding contributions, and the terms of that proposal as set forth in the report of the Director-General to the Administration, Budget and Finance Committee.1 1. DECIDES to restore the voting privileges of Azerbaijan at the Fifty-fifth World Health Assembly; 2. ACCEPTS that Azerbaijan will pay its outstanding contributions, totalling US$ 4 194 273, in 10 annual instalments (with a minimum payment of US$ 100 000 per year) payable in each of the years 2002 to 2011, subject to the provisions of Financial Regulation 6.4, in addition to the annual contributions due during the period; 3. DECIDES that, in accordance with Article 7 of the Constitution, voting privileges will be automatically suspended again if Azerbaijan does not meet the requirements laid down in paragraph 2 above; 4. REQUESTS the Director-General to report to the Fifty-sixth World Health Assembly on the prevailing situation; 5. REQUESTS the Director-General to communicate this resolution to the Government of Azerbaijan.

Eighth plenary meeting, 17 May 2002 A55/VR/8 = = =

1

Annex 3 of document EBABFC17/2, contained in document A55/26, Annex 1.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 15.2

WHA55.6 17 May 2002

Arrears in payment of contributions: The Dominican Republic The Fifty-fifth World Health Assembly, Having considered the second report of the Administration, Budget and Finance Committee of the Executive Board on Members in arrears in the payment of their contributions to an extent which would justify invoking Article 7 of the Constitution, with respect to the request of the Dominican Republic for the settlement of its outstanding contributions, and the terms of that proposal as set forth in the report of the Director-General to the Administration, Budget and Finance Committee,1 1. DECIDES to restore the voting privileges of the Dominican Republic at the Fifty-fifth World Health Assembly; 2. ACCEPTS that the Dominican Republic should settle its outstanding contributions for the period 1993-2001, totalling US$ 957 988, in 10 annual instalments as follows: 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Total US$ 95 788 95 800 95 800 95 800 95 800 95 800 95 800 95 800 95 800 95 800 957 988

payable in each of the years 2002 to 2011, subject to the provisions of Financial Regulation 6.4, in addition to the annual contributions due during the period; 3. DECIDES that, in accordance with Article 7 of the Constitution, voting privileges will automatically remain suspended if the Dominican Republic does not meet the requirements laid down in paragraph 2 above; 1

Annex 4 of document EBABFC17/2, contained in document A55/26, Annex 1.

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4. REQUESTS the Director-General to report to the Fifty-sixth World Health Assembly on the prevailing situation; 5. REQUESTS the Director-General to communicate this resolution to the Government of the Dominican Republic.

Eighth plenary meeting, 17 May 2002 A55/VR/8 = = =

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 15.3

WHA55.7 17 May 2002

Miscellaneous Income The Fifty-fifth World Health Assembly, DECIDES that the interest earned in respect of regular budget funds for the year ending 31 December 2001 shall be apportioned among Member States in accordance with the provisions of resolution WHA41.12; however, in lieu of being credited to Member States in the financial period 2004-2005, it shall be applied in like manner in the financial period 2002-2003, DECIDES that the total amount to be apportioned among Member States in 2002-2003 should be US$ 21 976 333.

Eighth plenary meeting, 17 May 2002 A55/VR/8 = = =

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 15.4

WHA55.8 17 May 2002

Real Estate Fund The Fifty-fifth World Health Assembly, Having considered the report of the Director-General on revolving and other long-term funds, 1. EXPRESSES appreciation to the Swiss Confederation and to the Republic and Canton of Geneva for the continued expression of their hospitality; 2. AUTHORIZES the Director-General to proceed with the construction of a new building at headquarters at a cost currently estimated at CHF 55 000 000, of which WHO’s share is estimated at CHF 27 500 000, on the understanding that if WHO’s share were likely to exceed by more than 10% the aforementioned amount, further authority would be sought from the Health Assembly; 3. APPROVES the use of the Real Estate Fund for the repayment over a 50-year period of the WHO share of the interest-free loan to be provided by the Swiss authorities with effect from the first year of the completion of the building; 4. NOTES that negotiations are under way with the Swiss authorities with a view to reducing WHO’s share of the loan to be provided by the Swiss authorities by the value of compensation for the demolition of the V building; 5. REQUESTS the Director-General to report at appropriate intervals to the Executive Board and the Health Assembly on progress in the construction of the new accommodation at headquarters and on related costs; 6. AUTHORIZES the construction of an extension to Building 2 and the construction of a new four-storey building to provide additional office accommodation and car parking in the Regional Office for the Western Pacific, to be financed from the Real Estate Fund.

Eighth plenary meeting, 17 May 2002 A55/VR/8 = = =

WPR/RC53/11 page 27 Annex 1

FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 15.4

WHA55.9 17 May 2002

Revolving Sales Fund The Fifty-fifth World Health Assembly, Noting the proposals on the Revolving Sales Fund contained in the report of the DirectorGeneral on revolving and other long-term funds, 1. DECIDES that paragraphs 4 and 5 of resolution WHA22.8 shall be superseded by the paragraphs below so that the following conditions shall govern the operations of the Revolving Sales Fund: 4. … (i) the Fund shall be used for the purpose of financing the cost of printing and reprinting additional copies of WHO publications for sale, of producing additional copies of WHO films, filmstrips, other visual media, of the production of any other item which the Organization may produce for sale, of sales promotion, of staff exclusively engaged in such sales, and the distribution and mailing costs; (ii) proceeds of all such sales shall be credited to the Fund;

(iii) expenditure incurred in accordance with paragraph 4(i) shall be debited to the Fund; (iv) the transactions during the year and the status of the Fund shall be included in each financial report of the Director-General; 5. AUTHORIZES the Director-General, at the end of each financial period, to transfer to Miscellaneous Income any surplus standing to the credit of the Revolving Sales Fund; 2. DECIDES further that the provisions of this resolution shall become effective as from the financial period 2002-2003.

Eighth plenary meeting, 17 May 2002 A55/VR/8 = = =

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.13

WHA55.10 18 May 2002

Mental health: responding to the call for action The Fifty-fifth World Health Assembly, Recalling resolutions WHA28.84 and EB61.R281 on the promotion of mental health, resolution WHA29.21 on psychosocial factors and health, resolutions WHA32.40, WHA33.27 and EB69.R9 on alcohol- and drug-related problems, resolution WHA30.38 on mental retardation, resolution WHA39.25 on prevention of mental, neurological and psychosocial disorders, resolution EUR/RC51/R5 on the Athens Declaration on Mental Health, Man-Made Disasters, Stigma and Community Care and resolution EB109.R8 on strengthening mental health; Bearing in mind World Health Day 2001, the ministerial round tables at the Fifty-fourth World Health Assembly, The world health report 2001 on mental health, and the multitude of activities initiated during 2000-2002 related to advocacy, policy and programme development, legislation, and research; Considering the imperative need to pursue and accelerate such activities worldwide in order to improve the mental-health status of populations, especially the most vulnerable groups; Welcoming the definition in The world health report 2001 of the activities related to promotion, prevention and care and to the protection of the human rights of people with mental illness and their families that all Member States can implement according to their level of priorities and resources in mental health; Recognizing that the toll of mental health problems is very high and rising worldwide, that such problems cause significant disability, heighten the risk of social exclusion, and increase mortality, that stigmatization and discrimination are major problems obstructing the path to care, and that the human and economic costs are staggering; Noting the existence of programmes which can prevent the occurrence of a significant proportion of these problems and thus reduce their negative social impact and human suffering; Further recognizing the need to maintain the momentum on mental health to raise public and professional awareness of the real burden of mental disorders, to protect the human rights of people with mental illness as an integral component of mental-health policies, and to implement strategies, programmes and policies as proposed in WHO’s global action programme for mental health, 1

The world health report 2001. Mental health: new understanding, new hope. Geneva, World Health Organization

2001.

WPR/RC53/11 page 30 Annex 1

URGES Member States: (1) (2) to reaffirm the provisions of resolution EB109.R8; to provide support to WHO’s global action programme for mental health;

(3) to increase investments in mental health both within countries and in bilateral and multilateral cooperation, as an integral component of the well-being of populations; (4) to strengthen action to protect children from and in armed conflict.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.3

WHA55.11 18 May 2002

Health and sustainable development The Fifty-fifth World Health Assembly, Having considered the report on the World Summit on Sustainable Development;1 Recalling Principle 1 of the Rio Declaration on Environment and Development, namely, “Human beings are at the center of concerns for sustainable development. They are entitled to a healthy and productive life in harmony with nature” and Chapter 6 on health of Agenda 21, adopted at the United Nations Conference on Environment and Development (Rio de Janeiro, Brazil, 1992); Welcoming the report of the WHO Commission on Macroeconomics and Health2 and noting the references to the resources needed to scale up the coverage of essential interventions to achieve desired health outcomes; Recognizing that sustainable development aims at improving the quality of life of all the world’s present generation, without compromising that of future generations; Further recognizing that achieving this objective requires integrated action towards economic growth; the assurance that no individual or nation is denied the opportunity to benefit from development; management and conservation of natural resources; protection of the environment; and social development; Aware that these pillars are mutually supportive, creating synergy for sustainable development and good health; Bearing in mind the contribution that poverty reduction makes to health, and health to sustainable poverty reduction; that sustainable global and local environments make to health; and that viable health services uniquely make to sustainable development; Aware of the need for a comprehensive approach to health and of the intersectoral nature of health problems and solutions;

1 2

Document A55/7. Macroeconomics and health: investing in health for economic development. Geneva, World Health Organization,

2001.

WPR/RC53/11 page 32 Annex 1

Noting with concern that, despite much social and economic progress, health continues to be severely compromised in many countries by inadequacies in the implementation of required measures in all areas of sustainable development, 1. URGES Member States: (1) to address the link between health and sustainable development at the World Summit on Sustainable Development (Johannesburg, South Africa, 2002); (2) to provide timely and effective support to the health programme as envisaged in the New Partnership for Africa’s Development (NEPAD) as a means of achieving sustainable development in Africa, and to similar initiatives in other regions; (3) to reaffirm internationally agreed development goals, including those contained in the United Nations Millennium Declaration; (4) to implement the United Nations Declaration of Commitment on HIV/AIDS and internationally and regionally agreed targets for the reduction of the disease burden; (5) to encourage countries in development to prepare and implement sustainable strategies to reduce poverty and to include in such strategies plans to address the unacceptable burden of communicable and noncommunicable diseases; (6) to encourage developed countries that have not done so to make concrete efforts towards the target of allocating 0.7% of GNP as official development assistance to developing countries and 0.15% to 0.20% of GNP of developed countries to least developed countries, as reconfirmed at the Third United Nations Conference on Least Developed Countries, and to encourage developing countries to build on progress achieved in ensuring that official development assistance is used effectively to help achieve development goals and targets; (7) to apply the 20:20 principle whereby not less than 20% of official development assistance and not less than 20% of countries’ own budgets are allocated to social sector spending; (8) to dedicate funds for health research, particularly for development of new drugs and vaccines for preventing and treating diseases of poverty; (9) to adopt policies that create healthy workplaces, protect workers’ health and, consistent with national and international law, prevent transfer of hazardous equipment, processes and materials; 2. REQUESTS the Director-General: (1) to provide support to countries to implement strategies and interventions to achieve the internationally agreed development goals, including those contained in the United Nations Millennium Declaration, and scale up their efforts in health to the level required; (2) to provide technical support to countries to frame policies and to implement national commitments and action plans that promote consumption patterns at individual and national levels that are sustainable and health promoting; (3) to accelerate development of an action plan to address the ethical recruitment and distribution of killed health-care personnel, and the need for sound national policies and strategies for the training and management of human resources for health;.

WPR/RC53/11 page 33 Annex 1

(4) to provide support to countries further to develop effective disease surveillance and health information systems; (5) to provide support to countries to establish and strengthen on the basis of a multisectoral approach existing programmes of action, to empower people to protect and promote their health and well-being; (6) to report to the Fifty-sixth World Health Assembly on the World Summit on Sustainable Development and on progress made in implementing this resolution.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.5

WHA55.12 18 May 2002

Contribution of WHO to the follow-up of the United Nations General Assembly special session on HIV/AIDS The Fifty-fifth World Health Assembly, Deeply concerned that the global HIV/AIDS pandemic, through its devastating scale and impact, constitutes a global emergency and one of the most formidable challenges both to human life and dignity and to the effective enjoyment of human rights, and undermines social and economic development throughout the world which affects all levels of society: national, community, family and individual; Noting with profound concern that HIV continues to spread unabated around the world and that in many countries, in particular in Eastern Europe and Asia, infection rates have risen dramatically during 2001, so that by the end of 2001, 40 million people worldwide were living with HIV/AIDS, 90% of them in developing countries, and 75% in Africa; Recalling and reaffirming the previous commitments on HIV/AIDS made through the Declaration of Commitment on HIV/AIDS adopted at the special session of the United Nations General Assembly on HIV/AIDS (27 June 2001), the United Nations Millennium Declaration (8 September 2000), and the United Nations Secretary-General’s road map towards its implementation1 as well as resolution WHA54.10 on scaling up the response to HIV/AIDS; Acknowledging WHO’s special role within the United Nations system to combat and mitigate the effects of HIV/AIDS, and its responsibility in the follow-up of the Declaration of Commitment on HIV/AIDS and as a cosponsor of UNAIDS; Recognizing the essential role of the health sector in the response to HIV/AIDS and the need to strengthen health systems and make them more effective so that countries and communities may contribute maximally to the fulfilment of the global targets set out in the Declaration of Commitment on HIV/AIDS; Recognizing that the full realization of human rights and fundamental freedoms for all is an essential element in a global response to the HIV/AIDS pandemic that includes prevention, care,

1

General Assembly document A/56/326.

WPR/RC53/11 page 36 Annex 1

support and treatment, reducing vulnerability to HIV/AIDS, and preventing stigmatization and related discrimination against people living with, or at risk of, HIV/AIDS; Commending the efforts of the Director-General to enhance and strengthen WHO’s response to the HIV/AIDS pandemic and further to develop and extend the role of WHO as a key cosponsor of UNAIDS, 1. URGES Member States: (1) to act upon the political commitment expressed at the United Nations General Assembly special session on HIV/AIDS, by operationalizing the Declaration of Commitment on HIV/AIDS and by allocating significantly increased resources to the health sector so that it may play an effective role in prevention, care, support and treatment of HIV/AIDS; (2) to foster mechanisms to increase global resources for the response to HIV/AIDS;

(3) to establish and strengthen monitoring and evaluation systems, including epidemiological and behavioural surveillance and assessment of the response of health systems to the epidemics of HIV/AIDS and sexually transmitted infections, to enhance programming of interventions by learning from success and failure and to optimize the allocation of resources; (4) to establish or expand counselling services and voluntary, confidential HIV-testing in order to encourage health-seeking behaviour and to act as an entry point for prevention and care; (5) to increase access to care, including by making prophylactic and therapeutic drugs affordable according to the availability of resources and assuring that they are safely and effectively used in the proper context of existing systems; (6) to build and strengthen partnerships between health-care providers, both public and private, and communities, including nongovernmental organizations, in order to mobilize and empower communities in the response to HIV/AIDS; (7) to scale up significantly programmes to increase coverage of interventions intended to reduce the spread of HIV and increase the quality and length of life of those living with HIV/AIDS, on the basis of scientific evidence and lessons learned; (8) to advocate the reduction of stigmatization and discrimination against people living with or at risk of HIV/AIDS and to mitigate the impact of HIV/AIDS on vulnerable groups, especially women and children; 2. REQUESTS the Director-General: (1) to continue to ensure that WHO plays a key role in providing technical leadership, direction and support to the health system’s response to HIV, within the United Nations systemwide response, as a cosponsor of UNAIDS; (2) to provide support to countries in order to maximize opportunities for the delivery of all relevant interventions for prevention, care, support and treatment of HIV/AIDS;

WPR/RC53/11 page 37 Annex 1

(3) to provide support to countries in order to strengthen the health sector so that it may play a more effective and catalytic role in relation to other relevant sectors with a view to achieving a well-coordinated, multisectoral and sustainable response to the epidemic; (4) within the framework of strengthening the health system’s response to HIV/AIDS, to provide support to countries, as part of their national strategies, in the areas of prevention, care, support and treatment in order to meet the commitments and goals agreed at the United Nations General Assembly special session on HIV/AIDS, in particular as they: (a) take effective measures, within a supportive environment, to ensure that people everywhere, particularly young people, have access to the information and services necessary to enable them to protect themselves from HIV; (b) intensify and expand action to achieve the goal of the special session of lowering the proportion of infants infected with HIV through reduction of HIV transmission in women of reproductive age, access to family-planning information and services for HIVinfected women, and provision of interventions that reduce transmission from mother to child; (c) develop national strategies and actions on care and support for people living with HIV/AIDS, including prevention and treatment of opportunistic infections and provision of palliative care and psychosocial support; (5) to continue broad-based consultations with countries and partners on the global healthsector strategy, which will comprise tools and approaches for scaling up effective, feasible and sustainable interventions; (6) to provide support for research on new technologies and approaches to prevent and treat HIV/AIDS, such as vaccines, microbicides, standard and simplified regimens for antiretroviral treatment and monitoring, and for operational research on service delivery; (7) to submit a report on WHO’s work on HIV/AIDS, including the global health-sector strategy to the Executive Board at its 111th session and the Fifty-sixth World Health Assembly.

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WPR/RC53/11 page 39 Annex 1

FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.2

WHA55.13 18 May 2002

Protection of medical missions during armed conflict The Fifty-fifth World Health Assembly, Recalling and reiterating resolution WHA46.39 entitled “Health and medical services in times of armed conflict”; Reaffirming the need to promote and ensure respect for the principles and rules of international humanitarian law, and guided in this respect by the relevant provisions of the Geneva Conventions of 1949 and their Additional Protocols of 1977, as applicable; Aware that, over the years, considerations based on international humanitarian and humanrights law have resulted in improved protection for medical personnel and for their recognized emblems during armed conflict; Deeply disturbed by recent reports of increasing attacks on medical personnel, establishments and units during armed conflicts; Alarmed by the extent to which civilian populations are being affected by the lack of medical care as a consequence of attacks directed at health and other humanitarian personnel, and health establishments, during armed conflicts; Aware of the adverse effects of such conflicts on high-priority public health programmes, such as the Expanded Programme on Immunization and control of malaria and tuberculosis; Recognizing the benefits of ceasefires brokered for national immunization days as appropriate; Convinced, in accordance with international law, that it is indispensable to protect against attacks directed at health personnel, hospitals, health facilities and infrastructures, ambulances and other medical vehicles and communication systems used for humanitarian purposes, 1. CALLS on all parties to armed conflicts fully to adhere to and implement the applicable rules of international humanitarian law protecting civilians and combatants who are hors de combat as well as medical, nursing and other health and humanitarian personnel, and to respect provisions that regulate the use of Red Cross and Red Crescent emblems and the protective status they have under international humanitarian law; 2. URGES Member States to condemn all attacks directed at health personnel, especially those that impede ability of such personnel to carry out their humanitarian function during armed conflicts;

WPR/RC53/11 page 40 Annex 1

3. ALSO URGES Member States, organizations of the United Nations system, other intergovernmental and nongovernmental bodies active in the humanitarian or health fields to promote actions that ensure the safety of health personnel; 4. ALSO URGES parties to conflict and humanitarian relief organizations to assure that ambulances, other medical vehicles, health facilities or other structures which facilitate the work of health personnel are utilized for humanitarian purposes only; 5. REQUESTS the Director-General: (1) to promote the protection of and respect for health personnel and establishments;

(2) to liaise closely with the competent organizations of the United Nations system, including UNICEF, the Office for the Coordination of Humanitarian Affairs, the Office of the High Commissioner for Refugees, and the Office of the High Commissioner for Human Rights, together with the International Committee of the Red Cross, the International Federation of Red Cross and Red Crescent Societies and other relevant intergovernmental and nongovernmental bodies in order to promote implementation of this resolution; (3) to disseminate this resolution widely.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.8

WHA55.14 18 May 2002

Ensuring accessibility of essential medicines The Fifty-fifth World Health Assembly, Welcoming adoption of the “Declaration on the TRIPS agreement and public health” at the Fourth WTO Ministerial Conference (Doha, 14 November 2001), supportive of the rights of countries to protect public health and, in particular, to promote access to medicines for all; Recalling discussions and proposals reported by Member States in their regional meetings before the Fifty-fifth World Health Assembly, mainly at the 53rd session of the Regional Committee for the Americas (September 2001)1 and the Forty-eighth session of the Regional Committee for the Eastern Mediterranean (October 2001)2 and, additionally, the thorough discussion of the Executive Board at its 109th session; Reaffirming resolution WHA54.11, emphasizing WHO’s medicines strategy and its requests to Member States and the Director-General of WHO; Aware of the need to assure the continuity of updating WHO’s Model List of Essential Drugs in light of evidence-based, scientific information; Underlining the feasibility of addressing comprehensively the impact of international trade agreements on equitable access to all drugs, particularly essential drugs; Conscious of the responsibility of Member States to support solid scientific evidence, excluding any biased information or external pressures that may be detrimental to public health; 1. URGES Member States: (1) to reaffirm their commitment to increasing access to medicines, and to translate such commitment into specific regulation within countries, especially enactment of national drug policies and establishment of lists of essential medicines based on evidence and with reference to WHO’s Model List, and into actions designed to promote policy for, access to, and quality and rational use of, medicines within national health systems; (2) to establish the necessary mechanisms for essential medicines lists that are science-based, independent of external pressures, and subject to regular reviews; 1 2

See document CD53/5. See resolution EM/RC48/R.2.

WPR/RC53/11 page 42 Annex 1

(3) in addition to health policies and actions, to implement complementary measures to ensure that national lists of essential medicines are supported by standard clinical guidelines, preferably national therapeutic formularies, with the aim of promoting rational prescription; (4) to reaffirm, within the national drug policies, WHO’s concept of essential medicines as those medicines that satisfy the priority health care needs of the population, reflecting also availability, quality, price and feasibility of delivery, and reemphasizing the evidence base for overall national discussions; (5) to continue monitoring the implications on access to medicines of recent patent-protection laws and compliance with WTO’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS); 2. REQUESTS the Director-General: (1) to strengthen the Expert Committee on the Use of Essential Drugs, ensuring its independence from external pressures at all times, the use of science-based criteria for revision and updating, and receipt, when appropriate and as required, of the necessary inputs from all relevant stakeholders; (2) to ensure that WHO’s medicines strategy addresses the important issue of the impact of international trade agreements on access to medicines and to reflect, in the relevant reports to WHO’s governing bodies, progress in its comprehensive endeavour; (3) to advocate the necessary action worldwide to promote market-based differential pricing for essential medicines between high-, middle-, and low-income countries, and to provide technical support, especially to developing countries, to establish drug-pricing policies; (4) to advocate the concept and policies of essential medicines as a tool for implementing rational prescription of medicines; (5) to continue to work on the methodology for computerized databases on reference prices of essential medicines worldwide; (6) to pursue all diplomatic and political opportunities aimed at overcoming barriers to access to essential medicines, collaborating with Member States in order to make these medicines accessible and affordable to the people who need them; (7) to join with and support nongovernmental organizations in the process of implementing initiatives that are compatible with public health priorities.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.16

WHA55.15 18 May 2002

Smallpox eradication: destruction of Variola virus stocks The Fifty-fifth World Health Assembly, Recalling resolution WHA52.10 on smallpox eradication; Having considered the report on smallpox eradication;1 Noting that the research programme will not be completed by the end of 2002, 1. DECIDES to authorize the further, temporary, retention of the existing stocks of live Variola virus at the current locations specified in resolution WHA52.10, for the purpose of enabling further international research, on the understanding that steps should be taken to ensure that all approved research would remain outcome-oriented and time-limited and periodically reviewed and a proposed new date for destruction should be set when the research accomplishments and outcomes allow consensus to be reached on the timing of destruction of Variola virus stocks; 2. REQUESTS the Director-General: (1) to continue the work of the Advisory Committee on Variola Virus Research with respect to the research involving Variola virus stocks and to ensure that the research programme is conducted in an open and transparent manner; (2) to ensure that regular biosafety inspection of the storage and research facilities is continued in order to confirm the strict containment of existing stocks and to ensure a safe research environment for work with Variola virus; (3) to ensure that research results and the benefits of this research are made available to all Member States; (4) to report annually the progress in the research programme and relevant issues to the World Health Assembly, through the Executive Board. Ninth plenary meeting, 18 May 2002 A55/VR/9

1

Document A55/21.

=

=

=

WPR/RC53/11 page 45 Annex 1

FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.15

WHA55.16 18 May 2002

Global public health response to natural occurrence, accidental release or deliberate use of biological and chemical agents or radionuclear material that affect health The Fifty-fifth World Health Assembly, Underlining that the World Health Organization focuses on the possible public health consequences of an incident involving biological and chemical agents and radionuclear material, regardless of whether it is characterized as a natural occurrence, accidental release or a deliberate act; Having reviewed the report on the deliberate use of biological and chemical agents to cause harm: public health response;1 Seriously concerned about threats against civilian populations, including those caused by natural occurrence or accidental release of biological or chemical agents or radionuclear material as well as their deliberate use to cause illness and death in target populations; Noting that such agents can be disseminated through a range of mechanisms, including the food- and water-supply chains, thereby threatening the integrity of public health systems; Acknowledging that natural occurrence or accidental release of biological, chemical agents and radionuclear material could have serious global public health implications and jeopardise the public health achievements of the past decades; Acknowledging also that the local release of biological, chemical and radionuclear material designed to cause harm could have serious global public health implications and jeopardize the public health achievements of the past decades; Recalling resolution WHA54.14 on global health security: epidemic alert and response, which stresses the need for all Member States to work together, with WHO and with other technical partners, in addressing health emergencies of international concern, and resolution WHA45.32 on the International Programme on Chemical Safety, which emphasized the need to establish or strengthen national and local capacities to respond to chemical incidents;

1

Document A55/20.

WPR/RC53/11 page 46 Annex 1 Recognizing that one of the most effective methods of preparing for deliberately caused disease is to strengthen public health surveillance and response activities for naturally or accidentally occurring diseases, 1. URGES Member States: (1) to ensure they have in place national disease-surveillance plans which are complementary to regional and global disease-surveillance mechanisms, and to collaborate in the rapid analysis and sharing of surveillance data of international humanitarian concern; (2) to collaborate and provide mutual support in order to enhance national capacity in field epidemiology, laboratory diagnoses, toxicology and case management; (3) to treat any deliberate use, including local, of biological and chemical agents and radionuclear attack to cause harm also as a global public health threat, and to respond to such a threat in other countries by sharing expertise, supplies and resources in order rapidly to contain the event and mitigate its effects; 2. REQUESTS the Director-General: (1) to continue, in consultation with relevant intergovernmental agencies and other international organizations, to strengthen global surveillance of infectious diseases, water quality, and food safety, and related activities such as revision of the International Health Regulations and development of WHO’s food safety strategy, by coordinating information gathering on potential health risks and disease outbreaks, data verification, analysis and dissemination, by providing support to laboratory networks, and by making a strong contribution to any international humanitarian response, as required; (2) to provide tools and support for Member States, particularly developing countries, in strengthening their national health systems, notably with regard to emergency preparedness and response plans, including disease surveillance and toxicology, risk communication, and psychosocial consequences of emergencies; (3) to continue to issue international guidance and technical information on recommended public health measures to deal with the deliberate use of biological and chemical agents to cause harm, and to make this information available on WHO’s web site; (4) to examine the possible development of new tools, within the mandate of WHO, including modelling of possible scenarios of natural occurrence, accidental release or deliberate use of biological, chemical agents and radionuclear material that affect health, and collective mechanisms concerning the global public health response to contain or mitigate the effects of natural occurrence, accidental release or deliberate use of biological, chemical agents and radionuclear material that affect health.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.14

WHA55.17 18 May 2002

Dengue fever and dengue haemorrhagic fever prevention and control The Fifty-fifth World Health Assembly, Recalling resolution WHA46.31 and resolutions CD31.R26, CD33.R19 and CD43.R4 of the Directing Council of the Pan American Health Organization on dengue prevention and control; Concerned that an estimated 50 million dengue infections occur annually and that the geographical spread, incidence, and severity of dengue fever and dengue haemorrhagic fever are increasing in the tropics; Recognizing the growing burden of disease, particularly among children, and the social and economic impact of dengue epidemics; Acknowledging the progress made in reducing the case-fatality rates of dengue haemorrhagic fever in some countries; Appreciating that significant advances have been made in the development of dengue vaccines, although they are not yet available for public health use; Recognizing that prevention or reduction of dengue viral transmission entirely depends on control of the mosquito vector Aedes aegypti and, to a lesser extent, A. albopictus and other secondary vector species; Aware that dengue vector-control programmes have had considerable success in the past, but that sustained suppression of vector populations today largely depends on commitment of governments and community participation in both planning and intervention strategies and implementation of control measures to prevent breeding of A. aegypti; Further acknowledging that, at the International Conference on Dengue and Dengue Haemorrhagic Fever (Chiang Mai, Thailand, 20-24 November 2000), more than 700 public health specialists from 41 countries recommended that all countries at risk of dengue viral transmission should develop and implement sustainable prevention and control programmes,

WPR/RC53/11 page 48 Annex 1

1.

URGES Member States: (1) to advocate increased commitment and allocation of additional human and other resources for improved and sustained prevention and control efforts and for strengthened research; (2) to build and strengthen the capacity of health systems for management, surveillance, prevention, control and management of dengue fever and dengue haemorrhagic fever; (3) to strengthen the capacity of diagnostic laboratories, taking into account the fundamental importance of laboratory diagnosis to confirm etiology and to strengthen clinical and epidemiological surveillance for dengue fever and dengue haemorrhagic fever; (4) to promote active intersectoral partnerships involving international, regional, national and local agencies, nongovernmental organizations, foundations, the private sector, community and civic organizations; (5) to pursue, encourage and support the development, application, evaluation and research of new and improved tools and strategies for prevention and control of dengue fever and dengue haemorrhagic fever; (6) to strengthen health measures at borders for vector control and opportunities for diagnosis and treatment in order to optimize regional resources;

2. URGES other specialized agencies, bodies and programmes of the United Nations system, bilateral development agencies, nongovernmental organizations and other concerned groups to increase their cooperation in dengue fever prevention and control, through both continued support for general health and social development and specific support to national and international prevention and control programmes, including emergency control; 3. REQUESTS the Director-General: (1) to develop further and support implementation of the global strategy for prevention and control of dengue fever and dengue haemorrhagic fever through integrated environmental management; (2) to continue to seek resources for advocacy and research on improved and new tools and methods for dengue fever prevention and control and their application; (3) to study the need for and feasibility of incorporating the surveillance and research of other arthropod-borne viral infections, such as Japanese encephalitis, West Nile, and other emerging diseases, in the surveillance system for dengue haemorrhagic fever; (4) to mobilize financial resources to be spent on vector control and research into vaccines.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.9

WHA55.18 18 May 2002

Quality of care: patient safety The Fifty-fifth World Health Assembly, Having considered the report on quality of care: patient safety;1 Concerned that the incidence of adverse events is a challenge to quality of care, a significant avoidable cause of human suffering, and a high toll in financial loss and opportunity cost to health services; Noting that significant enhancement of health systems’ performance can be achieved in Member States by preventing adverse events in particular, and improving patient safety and health care quality in general; Recognizing the need to promote patient safety as a fundamental principle of all health systems, 1. URGES Member States: (1) to pay the closest possible attention to the problem of patient safety;

(2) to establish and strengthen science-based systems, necessary for improving patients’ safety and the quality of health care, including the monitoring of drugs, medical equipment and technology. 2. REQUESTS the Director-General in the context of a quality programme: (1) to develop global norms, standards and guidelines for quality of care and patient safety, the definition, measurement and reporting of adverse events and near misses in health care by reviewing experiences from existing programmes and seeking inputs from Member States, to provide support in developing reporting systems, taking preventive action, and implementing measures to reduce risks; (2) to promote framing of evidence-based policies, including global standards that will improve patient care, with particular emphasis on product safety, safe clinical practice in compliance with appropriate guidelines and safe use of medicinal products and medical devices taking into consideration the views of policy-makers, administrators, health-care providers and consumers; 1

Document A55/13.

WPR/RC53/11 page 50 Annex 1

(3) to support the efforts of Member States to promote a culture of safety within health care organizations and to develop mechanisms, for example through accreditation or other means, in accordance with national conditions and requirements, to recognize the characteristics of health care providers that offer a benchmark for excellence in patient safety internationally; (4) to encourage research into patient safety, including epidemiological studies of risk factors, effective protective interventions, and assessment of associated costs of damage and protection; (5) to report on progress to the Executive Board at its 113th session and to the Fifty-seventh World Health Assembly.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.2

WHA55.19 18 May 2002

WHO’s contribution to achievement of the development goals of the United Nations Millennium Declaration The Fifty-fifth World Health Assembly, Having considered the note by the Director-General;1 Recalling the commitments made in the United Nations Millennium Declaration adopted by the United Nations General Assembly in September 20002 and the United Nations Secretary-General’s road map towards its implementation;3 Recalling in particular the goals set out in the Millennium Declaration to have reduced, by the year 2015, maternal mortality by three-quarters, and under-five mortality by two-thirds, of their 1990 levels; Recognizing that increased access to good-quality primary health care information and services, including reproductive health, is critical for attainment of the development goals contained in the United Nations Millennium Declaration;4 Recalling and recognizing the Programme of Action adopted at the International Conference on Population and Development, commitments made at the Copenhagen Social Summit, the World Summit for Children, and the Beijing Declaration and Platform for Action and the Declaration on the Elimination of Violence against Women, and their recommendations and respective follow-ups and reports; Mindful of WHO’s functions, as set out in its Constitution, which include to promote maternal and child health and welfare; Recalling that the Constitution of the World Health Organization states that enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without 1 2 3 4

Document A55/6. United Nations General Assembly Resolution 55/2. General Assembly document A/56/326.

It is understood that “primary health care services” do not include abortion except when consistent with national and, where applicable, local law, and with full respect for the various religious and ethical values and cultural backgrounds.

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distinction of race, religion, political belief, economic or social condition, recognizing the equal rights of men and women, and noting that progress towards realization of those rights should involve access to good-quality reproductive-health care, including family planning services that are effective, affordable and acceptable; Recognizing also the importance of the Convention on the Rights of the Child as a framework for addressing child and adolescent health and development; Recognizing that maternal, child and adolescent health and development have a major impact on socioeconomic development, and that achievement of the global targets for the coming decades will require renewed political commitment and action; Concerned that, because of poverty and lack of access to basic health and social services, close to 11 million children under five years of age, nearly four million of them within the first month of life, die every year of preventable diseases and malnutrition, and that complications related to pregnancy and childbirth kill more than half a million women and adolescent girls every year, and injure and disable many more; Concerned also by global inequities which lead to women dying during pregnancy and childbirth from conditions that are readily preventable and treatable, such as severe bleeding, infections, obstructed labour, hypertensive disorders, as well as from unsafe abortions; Convinced that concerted action to make pregnancies and childbirth safer will have a beneficial impact on the survival of women and neonates, and will contribute to the health and development of children and adolescents and to the well-being of families; Welcoming the report of the Commission on Macroeconomics and Health,1 which provides a useful approach to achievement of the Millennium Development Goals, and other internationally agreed development goals, including those contained in the United Nations Millennium Declaration; Recognizing, as concluded by the Commission on Macroeconomics and Health, that improvements in maternal and neonatal health and survival are vital contributions to poverty reduction; Further recognizing that the development goals contained in the United Nations Millennium Declaration cannot be achieved without a renewed commitment of the international community, and aware of Health Assembly leadership in this context; Reaffirming resolution WHA48.10 on reproductive health: WHO’s role in the global strategy, 1. URGES Member States: (1) to strengthen and scale up efforts to achieve the development goals of the Millennium Declaration and other internationally agreed goals and targets; (2) to strengthen and expand efforts to meet, in particular, international development goals and targets related to reduction of maternal and child mortality and malnutrition and to improve 1 Macroeconomics and health: investing in health for economic development. Geneva, World Health Organization, 2001.

WPR/RC53/11 page 53 Annex 1 access to primary health care services, including reproductive health, with special attention to the needs of the poor and underserved populations;1 (3) to continue to advocate as public health priorities safe pregnancy and childbirth, breastfeeding, neonate, child and adolescent health and development, and elimination of violence against women; (4) to include in efforts to develop health systems, plans of action for making pregnancy safer, based on cost-effective interventions for good-quality maternal and neonatal care; (5) to ensure that primary health care facilities strive for full coverage of their neonate, child and adolescent populations with interventions known to be effective, including those that help families and communities care for their children and young people; (6) to support the negotiations towards an effective framework convention on tobacco control; (7) to encourage the pharmaceutical industry and other relevant partners and organizations to make essential drugs more widely available and affordable by all who need them in developing countries; 2. ENCOURAGES developed countries that have not done so to make concrete efforts towards the target of allocating 0.7% of GNP as official development assistance to developing countries and 0.15% to 0.2% of GNP of developed countries to least developed countries, as reconfirmed at the Third United Nations Conference on the Least Developed Countries, and encourages developing countries to build on progress made in ensuring that official development assistance is used effectively to help achieve development goals and targets; 3. CALLS upon the international donor community to increase its assistance to developing countries in the health sector, taking into account the recommendations of the Commission on Macroeconomics and Health; 4. FURTHER CALLS upon countries and other partners in development to increase their investments in the health sector, where appropriate, in line with the recommendations of the Commission on Macroeconomics and Health; 5. REQUESTS the Director-General to lead an international drive to generate resources and investments for research to improve health in developing countries, particularly in relation to neglected diseases, taking into account the recommendations of the Commission on Macroeconomics and Health; 6. URGES the Director-General to facilitate a process to consider, together with Member States, the recommendations of the Commission on Macroeconomics and Health and their follow-up, through intergovernmental, bilateral, national and other mechanisms, recognizing that these recommendations are based on a partnership approach between developed and developing countries, and that actions cannot be undertaken at national level without coordinated and simultaneous action at international level;

1 It is understood that “primary health care services” do not include abortion except when consistent with national and, where applicable, local law, and with full respect for the various religious and ethical values and cultural backgrounds.

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7.

FURTHER REQUESTS the Director General: (1) to report to the Executive Board at its 111th session and to the Fifty-sixth World Health Assembly on WHO’s strategy for child and adolescent health and development, together with WHO’s planned follow-up to the United Nations General Assembly special session on children; (2) to develop a strategy for accelerating progress towards attainment of international development goals and targets related to reproductive health, and to submit a progress report to the Executive Board at its 111th session and to the Fifty-sixth World Health Assembly; (3) to promote reporting on progress towards internationally agreed goals and targets in the area of reproductive health as part of WHO’s contribution to the Secretary-General’s report to the United Nations General Assembly on progress towards attainment of the development goals of the Millennium Declaration.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 16.2

WHA55.20 18 May 2002

Salaries of staff in ungraded posts and of the Director-General The Fifty-fifth World Health Assembly, Noting the recommendations of the Executive Board with regard to remuneration of staff in ungraded posts and of the Director-General, 1. ESTABLISHES the salary for ungraded posts at US$ 158 353 per annum before staff assessment, resulting in a modified net salary of US$ 108 379 (dependency rate) or US$ 98 141 (single rate); 2. ESTABLISHES the salary for the Director-General at US$ 213 892 per annum before staff assessment, resulting in a modified net salary of US$ 142 813 (dependency rate) or US$ 127 000 (single rate); 3. DECIDES that those adjustments in remuneration shall take effect on 1 March 2002.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 16.2

WHA55.21 18 May 2002

Amendments to the Staff Regulations The Fifty-fifth World Health Assembly, 1. NOTES the amendments to the Staff Rules made by the Director-General and confirmed by the Executive Board at its 109th session concerning, inter alia, contractual reform and the system for performance management and development; 2. ADOPTS the amendment proposed to Staff Regulation 4.5 for the purpose of ensuring consistency between the Staff Regulations and the Staff Rules, and that proposed by the Administration, Budget and Finance Committee; 3. DECIDES that the amendments to Staff Regulation 4.5 shall take effect on 1 July 2002.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 17

WHA55.22 18 May 2002

Reimbursement of travel expenses for members of the Executive Board The Fifty-fifth World Health Assembly, Recalling resolution WHA30.10, DECIDES that: (1) from May 2002, the maximum reimbursement of travel expenses of members of the Executive Board shall be based on WHO travel entitlements as set out in the applicable rules and restricted to the equivalent of one business class or equivalent return ticket for those members whose travel time between the capital city of the Member State to the place of meeting, including necessary stopovers, exceeds six hours; (2) all other provisions of paragraphs 1 and 2 of resolution WHA30.10 shall remain applicable, including those for travel of members whose travel time is six hours or less.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.11

WHA55.23 18 May 2002

Diet, physical activity and health The Fifty-fifth World Health Assembly, Having considered the report on diet, physical activity and health;1 Recalling resolution WHA53.17 on prevention and control of noncommunicable diseases that reaffirmed that the global strategy for the prevention and control of noncommunicable diseases and the ensuing implementation plan were directed at reducing premature mortality and improving the quality of life; Recalling The world health report 2001,2 which indicates that mortality, morbidity and disability attributed to the major noncommunicable diseases, currently account for approximately 60% of all deaths and 43% of the global burden of disease, and are expected to rise to 73% of all deaths and 60% of the global burden of disease by 2020; Noting that already 79% of the deaths attributed to noncommunicable diseases occur in the developing countries; Alarmed by these rising trends that are a consequence of the demographic and epidemiological transition, including those in diet and physical activity, and the globalization of economic processes; Recognizing, however, the vast body of knowledge and experience that exists in this domain, and the need to reduce the level of exposure to the major risk factors of unhealthy diets, physical inactivity and tobacco use; Mindful also that these major behavioural and environmental risk factors are more amenable to modification through implementation of concerted essential public health action, as has been demonstrated in several Member States; Recognizing the importance of the proposed framework for action on diet and physical activity within the integrated prevention and control of noncommunicable diseases, including the support of healthy lifestyles, facilitation of healthier environments, provision of public health services, and the major involvement of the health, nutrition and other relevant professions in improving the lifestyles and health of individuals and communities; 1 2

Document EB109/14. The world health report 2001. Mental health: new understanding, new hope. Geneva, World Health Organization,

2001.

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1. URGES Member States to collaborate with WHO in developing a global strategy on diet, physical activity and health for the prevention and control of noncommunicable diseases, based on evidence and best practices, with special emphasis on an integrated approach to improving diets, and increasing physical activity, in order: (1) to promote health and reduce the common risks of chronic noncommunicable diseases that stem from poor diet and physical inactivity by essential public health action and integration of preventive measures in the functions of health services; (2) to encourage, as part of health sector reform, incorporation in national plans of action for nutrition as they are updated, of strategies for diet, physical activity and health involving all sectors, including civil society and the food industry; (3) to monitor scientific data and to support research in a broad spectrum of related areas, including human genetics, nutrition and diet, matters of particular concern to women, and development of human resources for health; 2. FURTHER URGES Member States to celebrate a “Move for Health Day” each year to promote physical activity as essential for health and well-being; 3. REQUESTS the Director-General: (1) to develop a global strategy on diet, physical activity and health within the framework of the renewed WHO strategy for the prevention and control of noncommunicable diseases and, in consultation with Member States, and with the bodies of the United Nations system and professional organizations concerned, to give priority to providing support to Member States for establishment of corresponding national policies and programmes; (2) to support further research on effective implementation of different means leading to healthier lifestyles; (3) to ensure that a multidisciplinary and multisectoral approach is a governing idea of the global strategy; (4) to ensure, while developing the strategy, an effective managerial mechanism for collaboration and technical support involving all programmes concerned at different levels of the Organization and WHO collaborating centres, emphasizing the introduction and strengthening of global and regional demonstration projects; (5) to strengthen collaboration with other organizations of the United Nations system, and other partners, including the World Bank, international nongovernmental organizations, and the private sector for implementation of plans at global and interregional levels and to promote capacity-building at national level; (6) to submit a progress report on integrated prevention of noncommunicable diseases to the Executive Board at its 113th session and the Fifty-seventh World Health Assembly.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 16.1

WHA55.24 18 May 2002

The need for increased representation of developing countries in the Secretariat and in Expert Advisory Panels and Committees The Fifty-fifth World Health Assembly, Guided by the Purposes and Principles of the Charter of the United Nations, in particular the principle of the sovereign equality of its Member States; Reaffirming the principle of equitable participation of all Members of the Organization in its work, including that of the Secretariat and various committees and bodies; Bearing in mind Article 35 of the Constitution; Recalling its resolution WHA4.51 adopting the Staff Regulations of the Organization and its subsequent resolutions amending these regulations; Recalling its resolution WHA50.15 on recruitment of international staff in WHO: geographical representation; Further recalling its resolution WHA35.10 approving the Regulations for Expert Advisory Panels and Committees and its subsequent resolutions amending these regulations; Concerned that the developing countries are underrepresented in the Secretariat, in the professional category, including at headquarters; Also concerned at the limited representation of developing countries on expert advisory panels and committees, 1. UNDERLINES that the Secretariat of WHO is a common secretariat for all Member States and should therefore reflect the composition of its membership, a majority of which are developing countries; 2. STRESSES, in this context, adherence to the principle of equitable geographical representation and gender balance at all levels in the Secretariat, especially at headquarters, in order to improve its representative character;

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3. EMPHASIZES the principles of transparency, fair selection, objectivity, competence and merit in appointments both in the Secretariat and to expert advisory panels and committees; 4. UNDERLINES that country ranges for appointments in the Secretariat should, in principle, be based on membership, equitable geographical representation, population criteria, and balance between developed and developing countries, with less emphasis on financial contributions to the Organization; 5. REQUESTS the Director-General to ensure that the principles of equitable geographical representation, gender balance and a balance of experts from developed and developing countries are respected in making appointments in the Secretariat and in establishing expert advisory panels or expert committees; 6. FURTHER REQUESTS the Director-General to consult with health authorities concerned when appointing experts to advisory panels, to circulate information on all appointments made to these panels to Member States and to encourage developing countries to send nominations for the panels; 7. DECIDES to amend the Regulations for Expert Advisory Panels and Committees in light of this resolution, as per the Annex to this resolution; 8. REQUESTS the Director-General to submit a report to the Fifty-sixth World Health Assembly on implementation of this resolution, including different alternatives to the current representation formula in the Secretariat.

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ANNEX AMENDMENTS TO THE REGULATIONS FOR EXPERT ADVISORY PANELS AND COMMITTEES Amendment to Regulation 3.1 Add at the end: Information on all appointments made to these panels shall be circulated to all Member States. The Director-General shall encourage the developing countries to send nominations for the panels.

Amendment to Regulation 3.2 Replace the last sentence with the following: He/she shall encourage nomination of experts from developing countries and from all regions and shall be helped in this task by Regional Directors.

Amendment to Regulation 4.2 Replace with the following: As a general rule, the Director-General shall select from one or more expert advisory panels the members of an expert committee on the basis of the principles of equitable geographical representation, gender balance, a balance of experts from developed and developing countries, representation of different trends of thought, approaches and practical experience in various parts of the world, and an appropriate interdisciplinary balance. The membership of expert committees shall not be restricted by consideration of language, within the range of languages of the Organization.

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FIFTY-FIFTH WORLD HEALTH ASSEMBLY Agenda item 13.10

WHA55.25 18 May 2002

Infant and young child nutrition The Fifty-fifth World Health Assembly, Having considered the draft global strategy for infant and young-child feeding; Deeply concerned about the vast numbers of infants and young children who are still inappropriately fed and whose nutritional status, growth and development, health and very survival are thereby compromised; Conscious that every year as much as 55% of infant deaths from diarrhoeal disease and acute respiratory infections may be the result of inappropriate feeding practices, that less than 35% of infants worldwide are exclusively breastfed for even the first four months of life, and that complementary feeding practices are frequently ill-timed, inappropriate and unsafe; Alarmed at the degree to which inappropriate infant and young-child feeding practices contribute to the global burden of disease, including malnutrition and its consequences such as blindness and mortality due to vitamin A deficiency, impaired psychomotor development due to iron deficiency and anaemia, irreversible brain damage as a consequence of iodine deficiency, the massive impact on morbidity and mortality of protein-energy malnutrition, and the later-life consequences of childhood obesity; Recognizing that infant and young-child mortality can be reduced through improved nutritional status of women of reproductive age, especially during pregnancy, and by exclusive breastfeeding for the first six months of life, and with nutritionally adequate and safe complementary feeding through introduction of safe and adequate amounts of indigenous foodstuffs and local foods while breastfeeding continues up to the age of two years or beyond; Mindful of the challenges posed by the ever-increasing number of people affected by major emergencies, the HIV/AIDS pandemic, and the complexities of modern lifestyles coupled with continued promulgation of inconsistent messages about infant and young-child feeding; Aware that inappropriate feeding practices and their consequences are major obstacles to sustainable socioeconomic development and poverty reduction; Reaffirming that mothers and babies form an inseparable biological and social unit, and that the health and nutrition of one cannot be divorced from the health and nutrition of the other; Recalling the Health Assembly’s endorsement (resolution WHA33.32), in their entirety, of the statement and recommendations made by the joint WHO/UNICEF Meeting on Infant and Young

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Child Feeding held in 1979; its adoption of the International Code of Marketing of Breast-milk Substitutes (resolution WHA34.22), in which it stressed that adoption of and adherence to the Code were a minimum requirement; its welcoming of the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding as a basis for international health policy and action (resolution WHA44.33); its urging encouragement and support for all public and private health facilities providing maternity services so that they become “baby-friendly” (resolution WHA45.34); its urging ratification and implementation of the Convention on the Rights of the Child as a vehicle for family health development (resolution WHA46.27); and its endorsement, in their entirety, of the World Declaration and Plan of Action for Nutrition adopted by the International Conference on Nutrition (resolution WHA46.7); Recalling also resolutions WHA35.26, WHA37.30, WHA39.28, WHA41.11, WHA43.3, WHA45.34, WHA46.7, WHA47.5, WHA49.15 and WHA54.2 on infant and young-child nutrition, appropriate feeding practices and related questions; Recognizing the need for comprehensive national policies on infant and young-child feeding, including guidelines on ensuring appropriate feeding of infants and young children in exceptionally difficult circumstances; Convinced that it is time for governments to renew their commitment to protecting and promoting the optimal feeding of infants and young children, 1. 2. ENDORSES the global strategy for infant and young-child feeding; URGES Member States, as a matter of urgency: (1) to adopt and implement the global strategy, taking into account national circumstances, while respecting positive local traditions and values, as part of their overall nutrition and childhealth policies and programmes, in order to ensure optimal feeding for all infants and young children, and to reduce the risks associated with obesity and other forms of malnutrition; (2) to strengthen existing, or establish new, structures for implementing the global strategy through the health and other concerned sectors, for monitoring and evaluating its effectiveness, and for guiding resource investment and management to improve infant and young-child feeding; (3) to define for this purpose, consistent with national circumstances: (a) (b) national goals and objectives, a realistic timeline for their achievement,

(c) measurable process and output indicators that will permit accurate monitoring and evaluation of action taken and a rapid response to identified needs; (4) to ensure that the introduction of micronutrient interventions and the marketing of nutritional supplements do not replace, or undermine support for the sustainable practice of, exclusive breastfeeding and optimal complementary feeding;

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(5) to mobilize social and economic resources within society and to engage them actively in implementing the global strategy and in achieving its aims and objectives in the spirit of resolution WHA49.15; 3. CALLS UPON other international organizations and bodies, in particular ILO, FAO, UNICEF, UNHCR, UNFPA and UNAIDS, to give high priority, within their respective mandates and programmes and consistent with guidelines on conflict of interest, to provision of support to governments in implementing this global strategy, and invites donors to provide adequate funding for the necessary measures; 4. REQUESTS the Codex Alimentarius Commission to continue to give full consideration, within the framework of its operational mandate, to action it might take to improve the quality standards of processed foods for infants and young children and to promote their safe and proper use at an appropriate age, including through adequate labelling, consistent with the policy of WHO, in particular the International Code of Marketing of Breast-milk Substitutes, resolution WHA54.2, and other relevant resolutions of the Health Assembly; 5. REQUESTS the Director-General: (1) to provide support to Member States, on request, in implementing this strategy, and in monitoring and evaluating its impact; (2) to continue, in the light of the scale and frequency of major emergencies worldwide, to generate specific information and develop training materials aimed at ensuring that the feeding requirements of infants and young children in exceptionally difficult circumstances are met; (3) to strengthen international cooperation with other organizations of the United Nations system and bilateral development agencies in promoting appropriate infant and young-child feeding; (4) to promote continued cooperation with and among all parties concerned with implementing the global strategy.

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Annex 2

MILLENNIUM DEVELOPMENT GOALS (MDGS)

The goals and targets are based on the United Nations Millennium Declaration and have been approved by the United Nations General Assembly. The United Nations Development Programme worked with other UN departments, funds and programmes, the World Bank, the International Monetary Fund and the Organization for Economic Cooperation and Development to identify over 40 quantifiable indicators to assess progress.

Goals GOAL 1: Eradicate extreme poverty and hunger

Targets Target 1. Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day

Indicators 1. Proportion of population whose income is less than US $1/day (purchasing power parity (PPP) values) 2. Poverty gap ratio (incidence x depth of poverty) 3. Share of poorest quintile in national consumption

Target 2. Halve, between 1990 and 2015, the proportion of people who suffer from hunger

4. Prevalence of underweight children (under 5 years of age) 5. Proportion of population below minimum level of dietary energy consumption 6. Net enrolment ratio in primary education 7. Proportion of pupils starting grade 1 who reach grade 5 8. Literacy rate of 15–24 year olds

GOAL 2: Achieve universal primary education

Target 3. Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling Target 4. Eliminate gender disparity in primary and secondary education, preferably by 2005 and to all levels of education no later than 2015

GOAL 3: Promote gender equality and empower women

9. Ratio of girls to boys in primary, secondary and tertiary education 10. Ratio of literate females to males among 15–24 year olds 11. Share of women in wage employment in the non-agricultural sector 12. Proportion of seats held by women in national parliament

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Goals GOAL 4: Reduce child mortality

Targets Target 5. Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

Indicators 13. Under-five mortality rate 14. Infant mortality rate 15. Proportion of one-year old children immunized against measles

GOAL 5: Improve maternal health

Target 6. Reduce by threequarters, between 1990 and 2015, the maternal mortality ratio Target 7. Have halted by 2015, and begun to reverse, the spread of HIV/AIDS

16. Maternal mortality ratio 17. Proportion of births attended by skilled health personnel 18. HIV prevalence among 15-24 year old pregnant women 19. Contraceptive prevalence rate 20. Number of children orphaned by HIV/AIDS

GOAL 6: Combat HIV/AIDS, malaria and other diseases

Target 8. Have halted by 2015, and begun to reverse, the incidence of malaria and other diseases

21. Prevalence and death rates associated with malaria 22. Proportion of population in malaria-risk areas using effective prevention and treatment measures 23. Prevalence and death rates associated with TB 24. Proportion of TB cases detected and cured under DOTS

GOAL 7: Ensure environmental sustainability

Target 9. Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources

25. Proportion of land area covered by forest 26. Land area protected to maintain biological diversity 27. GDP per unit of energy use (as proxy for energy efficiency) 28. Carbon dioxide emissions (per capita) [Plus two figures of global atmospheric pollution: ozone depletion and accumulation of global warming gases]

Target 10. Halve, by 2015, the proportion of people without sustainable access to safe drinking water

29. Proportion of population with sustainable access to an improved water source

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Annex 2

Goals

Targets Target 11. Have achieved by 2020, a significant improvement in the lives of at least 100 million slum-dwellers

Indicators 30. Proportion of people with access to improved sanitation 31. Proportion of people with access to secure tenure (Urban/rural disaggregation of several of the above indicators may be relevant for monitoring improvement in the lives of slum dwellers) Some of the indicators listed below will be monitored separately for the least developed countries (LDCs), Africa, landlocked countries and small island developing states

GOAL 8: Develop a global partnership for development

Target 12. Develop further an open, rule-based, predictable, non-discriminatory trading and financial system Includes a commitment to good governance, development, and poverty reduction—both nationally and internationally Official Development Assistance (ODA) Target 13. Address the special needs of the LDCs. Includes: tariff and quota free access for LDC exports; enhanced programme of debt relief for heavily indebted poor countries (HIPC) and cancellation of official bilateral debt; and more generous ODA for countries committed to poverty reduction

32. Net ODA as percentage of Development Assistance Committee (DAC) donors’ gross national income (targets of 0.7% in total and 0.15% for LDCs) 33. Proportion of ODA to basic social services (basic education, primary health care, nutrition, safe water and sanitation) 34. Proportion of ODA that is untied 35. Proportion of ODA for environment in small island developing states 36. Proportion of ODA for transport sector in landlocked countries

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Goals

Targets

Indicators

Market Access Target 14. Address the special needs of landlocked countries and small island developing states (through Barbados programme and 22nd General Assembly provisions) 37. Proportion of exports (by value and excluding arms) admitted free of duties and quotas 38. Average tariffs and quotas on agricultural products and textiles and clothing 39. Domestic and export agricultural subsidies in Organization for Economic Cooperation and Development (OECD) countries 40. Proportion of ODA provided to help build trade capacity Debt Sustainability Target 15. Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term 41. Proportion of official bilateral HIPC debt cancelled 42. Debt service as a percentage of exports of goods and services 43. Proportion of ODA provided as debt relief 44. Number of countries reaching HIPC decision and completion points Target 16. In cooperation with 45. Unemployment rate of 15-24 year developing countries, develop and olds implement strategies for decent and productive work for youth Target 17. In cooperation with pharmaceutical companies, provide access to affordable, essential drugs in developing countries Target 18. In cooperation with the private sector, make available the benefits of new technologies, especially information and communications 46. Proportion of population with access to affordable essential drugs on a sustainable basis

47. Telephone lines per 1000 people 48. Personal computers per 1000 people

* The selection of indicators for Goals 7 and 8 is subject to further refinement