WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU R~GIONAL DU PACIFIQUE OCCIDENTAL
•
ORGANISATION MONDIALE DE LA SANTE
REGIONAL COMMITTEE Thirty-fourth session Manila 5 to 9 September 1983 Provisional agenda item 14.1
WPRfRC34/8 29 July 1983 ORIGINAL: ENGLISH
CORRELATION OF THE WORK OF THE WORLD HEALTH ASSEMBLY, THE EXECUTIVE BOARD AND THE REGIONAL COMMITTEE Consideration of resolutions of the Thirty-sixth World Health Assembly and the Executive Board at its seventy-first session
Resolutions adopted by the Thirty-sixth World Health Assembly of interest for the work of WHO in the Western Pacific Region are hereby presented to the Regional Committee for comment, together with short analyses of their implications for Member States of the Region and for WHO's programme of cooperation. Resolutions directly related to other items on the provisional agenda of the current session of the Regional Committee form part of the documentation for those individual agenda items. A resolution adopted by the Executive Board at its seventy-first session in January 1983 is also included. Other resolutions of that session of the Board are reflected in the resolutions of the Health Assembly. Of the three resolutions adopted by the Executive Board at its seventy-second session in May 1983, none is of direct relevance to the work of the Regional Committee for the Western Pacific Region.
WPR/RC34/8 page 2
1.
Alcohol consumption and alcohol-related problems: policies and (rogrammes (resolution WHA36.12) Attention is drawn to operative paragraphs 1 and 2.
development of national
At its thirty-third session in September 1982, the Regional Committee adopted resolution WPR/RC33.R15 on alcohol as a major public health problem, urging Member States to formulate comprehensive, continuous and long-term national policies on alcohol-related problems, with prevention as a priority. World Health Assembly resolution WHA36.12 recognizes that an effective strategy to tackle these problems calls for the development of comprehensive national policies, which in turn necessitates a concerted effort involving the adoption of a wide variety of preventive measures, appropriate management services geared to the primary health care approach, supporting research and evaluation. Thus operative paragraph 2 of the resolution emphasizes the need for Member States to develop mechanisms to coordinate programmes and activities for reducing alcohol-related problems on a planned, continuous and long-term basis. WHO for its part will need to intensify its cooperation with Member States in their efforts to reduce alcohol-related problems and to develop activities in programme areas such as school health education, the training of general health workers and the promotion of health research. A workshop on alcohol-related problems is to be convened in Manila in August 1983 with participants from ten countries or areas. of the Region. It is expected that, during the workshop, a framework will be prepared for the design, implementation and evaluation of programmes for the prevention and control of alcohol-related problems at regional and national levels. 2. International Drinking-Water Supply and Sanitation Decade (resolution WHA36.13) Attention is drawn to operative paragraph 2. Member States have been urged to accelerate the preparation of their national sector plans, which need to be supported by well-conceived policies and strategies. National plans should provide for the integration of primary health care activities in a comprehensive aprroach to water supply and sanitation which will respond particularly to the needs of the rural and the peripheral urban populations. National planners need to recognize the intersectoral and multidisciplinary nature of the water supply and sanitation sector to ensure coordination of activities among the health and public works agencies and local organizations. In the area of manpower development, Member States will need to change their current aprroaches to training by developing more comprehensive programmes for human resources development on the basis of broader planning and management methods. Particular attention needs to be given to the development of manpower at the community level, where the basic infrastructures have to be maintained, operated and repaired over a lohg period of time. Finally, Member States should rrovide stronger support by allocating the necessary financial resources to meet their Decade goals. Intensified effort wiU be needed to secure international and bilateral resources to supplement national funds.
WPR/RC34/8 page 3
WHO technical cooperation to the health and other agencies within the sector, in support of national plan development, will continue. In the area of human resources development, WHO will support the development of national programme plans to en com pass both the training and the management aspects. Regional training courses will be organized and cooperation provided to national training activities related to water supply and sanitation in general, as well as to specific technical and management areas that are of importance to construction activities, and to the long-term operation, maintenance and repair of rural facilities. In the area of financial support, WHO will continue to stimulate and to cooperate in coordinating the contributions of the international banking institutions, the United Nations agencies and bilateral agencies so that a greater flow of resources can be generated to help Member States attain their Decade goals. It will be noted from operative paragraph 3 that the regional committees are invited to review the Decade's progress at their 1983 sessions if possible. Because of the time constraint it was not possible to place such a review on the agenda of the. current session of the Regional Committee. Steps had, however, already been taken to provide a summary of progress in the Report of the Regional Director on the Work of WHO in the Western Pacific Region. I 3. Oral health in the strategy of health for all (resolution WHA36.14) Attention is drawn to operative paragraphs 1 and 2. Major changes wiU be needed in the oral health service philosophies of Member States, from providing basicaHy curative services for patients to providing services structured to invQlve other relevant sectors and aimed primarily at reducing and preventing oral diseases among the healthy. To help reverse the deteriorating oral health situation, developing countries will need to gather epidemiological data for the rational planning of manpower requirements and programmes. In most of these countries, the kind of manpower that will be required is riot the highly skilled clinician but rather the primary health care type of worker who will perform simple routine clinical procedures; the promotion of oral health through health education will be an important function of such a worker. For the immediate future, the International Collaborative Oral Health Development Programme will help those countries who are really in need of qualified dental surgeons; however, the ready availability of such manpower could eventually hamper the recruitment of national staff and the development of appropriate manpower and preventive programmes. WHO cooperation, which has focused mainly on fellowships, will shift in emphasis. More active support should be given to field projects for prevention by providing the services of consultants as well as supplies and equipment. At the intercountry level, em(ilasis will need to be placed on the development of managerial skills in order to increase staff productivity and programme effectiveness.
1Document WPR/RC34/3, pages 64-66.
WPR/RC34/8 page 4
Steps have already been taken to organize a workshop at which national staff will be trained to conduct simple surveys and encouraged to introduce and deveJo p preventive programmes, which are necessary if the "health for all" goals are to be met by the year 2000. 4. Reference substances for ualit control of dru s (facilitation of their de from and entry into Member States {resolution WHA36.15) rture
Attention is drawn to the second preambular paragraph and to the fact that the Director-General has been requested to study the question of facilitating the customs clearance of reference substances for the quality control of drugs. 5. Collaboration within the United Nations system: General matters Contribution of the World Health Organization to the participation of women in promoting international peace, cooperation and health {resolution WHA36.21) A ttent.ion is drawn to operative pa.ragra ph 1. This resolution requests the Director-General to take certain measures to ensure that women's health interests are included in the implementation of the Global Strategy for Health for All by the Year 2000; to ensure WHO's active participation in the studies being prepared for the Conference marking the end of the United Nations Decade for Women in 1985; and to encourage the full and equal participation of women in the activities of national health services. Governments are becoming increasingly aware of the special requirements of women for their own health protection and of the need to ensure their full participation in national health services and activities. Most governments now have special offices or departments dealing with women's concerns, the staff of which have access to aU ministries, thus ensuring intersectoral coordination of activities and monitoring of progress. WHO is cooperating with the United Nations in preparing for the World Conference to Review and Appraise the Achievements of the United Nations Decade for Women, to be held in 1985.o The United Nations is preparing a questionnaire on the review and app-aisal of progress made by governments in the implementation of the World Plan of Action and the Programme of Action for the second half of the United Nations Decade for Women; WHO is the lead agency for the preparation of questions for the topic "Health, including nutritional aspects" included in Part II of the questionnaire, "Sectoral and topical issues", and the Regional Office has assisted in this task. Member States of the Region will soon be asked to respond to this questionnaire. A study is at present being carried out to develop a profile on the health status of women in countries or areas of the Western Pacific Region. It is hoped that a picture will emerge from this health profile which will enable the Organization to direct its efforts towards priority areas of the health needs of women. 6. Tuberculosis control in the world -situation analysis {resolution WHA36.30) Attention is drawn to operative paragraph 1.
WPR/RC34/8 page 5
Many countries or areas in the Region will need to intensify efforts to extend tuberculosis case-finding, treatment and preventive services to the whole population. Close collaboration will be necessary between those responsible for the development and organization of the health system infrastructure based on primary health care and those in charge of tuberculosis control activities. Ideally tuberculosis control should be integrated with the general health services. In particular, all health care personnel, especially those working at the periphery, must be motivated to take an active part in the tuberculosis control programme, that is in sputum microscopy of symptomatic individuals, p-oper follow-up and regular treatment of cases, adequate record-keeping and widespread BCG vaccination. WHO will continue to cooperate in the development and strengthening of tuberculosis control p-ogrammes as component parts of primary health care. 7. Prevention and control of cardiovascular diseases (resolution WHA36.32) Attention is drawn to operative paragraphs 2 and 3. Comprehensive cardiovascular community control programmes are at present in operation in certain parts of China and the Phillppines in line with the WHO global programme. Other Member States will need to intensify their efforts to develop and implement such p-ogrammes as integral parts of their national health plans, and the ministries of health are urged to establish responsible units or at least focal points for this purpose. In countries or areas where diabetes mellitus is also a major health problem, control activities should be combined with those of the comprehensive cardiovascular community control programmes in view of certain risk factors common to the two diseases. The control p-ogrammes should be incorporated into primary health care and support extended for the training of health personnel at all levels, but particularly primary health care workers. The promotion of operational research for the prevention, early detection and treatment of cardiovascular diseases, as well as epidemiological studies, should be intensified. Finally, the activities of the comprehensive cardiovascular community control programmes should be expanded to cover the population nationwide. WHO will endeavour to provide technical cooperation in the planning of national activities and for health manpower development programmes; and to promote operational research as well as epidemiological studies on the prevention and control of cardiovascular diseases. It will also intensify its efforts to mobilize all possible sources of financial support for these activities. 8. Methodology and content of the Seventh Report on the World Health Situation in relation to the monitorin and evaluation of the Global Strate for Health for All resolution WHA36.35 Attention is drawn to operative paragraphs 1, 2 and 3. The regional report on monitoring of progress in implementing the strategies for health for all by the year 2000, being considered by the Regional Committee at the current session, and the regional report on evaluating the strategies, to be considered by the Regional Committee in 1985, will constitute the core of the regional components of the Seventh Report on the World Health Sitution.
WPR/RC34/8 page 6
The means by which information for evaluation of the strategies and additional information for compilation of the Seventh Report will be gathered is being discussed within the Secretariat and will be conveyed to Member States in due course. 9. Policy on feJlowships (resolution EB71.R6) Attention is drawn to operative paragraph 3. The fellowship programme, in order to be purposeful, needs to be an integral part of the national health manpower planning process. A few countries in the Region have initiated manpower planning studies, reflecting serious attempts to make a systematic approach to manpower development and their fellowship Jrogrammes. However, it wiU be necessary to improve coordination to ensure that fellowships are relevant to national "health for aU" strategies. This can be achieved through the following means: (a) a more critical selection of fields of study in accordance with carefully determined priorities in manpower requirements (e.g. more training in community health or medicine and less in the bioclinical sciences); a more extensive use of national training capabilities, which will, in addition, contribute further to the existing pool of valuable national experience in the area of primary health care; a more output-oriented selection procedure to ensure better utilization of the trainees on their return home, as well as optimal impact on the health services.
(b)
(c)
National fellowship officers must become the coordinators at the different stages of implementation of feJlowship programmes and their role needs to be dearly defined. If necessary, they should acquire managerial skills and competence in health manpower planning and utilization. Pursuant to the review of the fellowship programme by the Regional Committee at its thirty-second session in 1981, a meeting of national feJlowship officers of the Region will be convened in Manila in October 1983 to discuss resolution EB71.R6 and its related regional implications in depth.
THIRTY·SIXTH WORLD HEALTH ASSEMBLY
WHA36.12 13 May 198l
ALCOHOL CONSUMPTION AND ALCOHOL-RELATED PROB:t.EMS: OF NATIONAL POLICIES AND PROGllAMMES
DEVELOPMENT
The Thirty-sixth World ijealth Assembly, Recalling pr~vious. resolutions, particularly re1wlutions WHA32 .40, concerning the development of· WHO's programme: on.alcohol-related problems; Reiterating its firm conviction that alcohol-related t,)roblems rank among the world's major public health concerns and constitute a serious hazard for human welfare, and that it
is therefore necessary.· for ·the Member States and for WHO to.intensify.their efforts to reduce these problems; Seriously concet-ned by the worldwide trends in alcohol consumption and alcohol-related problems, and by the promotional drives for the increasing consumption of alcohol, especially in countries and· .in populat:f.:on. groups in which its use was not previously widespread; Believing that increasing alcohol consumption and alcohol•rel;ited problems are. incompatible with achieving health for all by the year 2000, and hence policies to reduce them must ··form an integral· part of the s.trategy ·for health for all; Recognizing that an effective strategy to tackle the alcohol-related problems necessitates comprehensive .nati.onal: alcohol. .policies; Mindful that effective national alcohol policy requires a concerted effor~ consisting of a wide variety of measures torptevention, appropriate services for management with emphasis on the p-,:imary. health. c·ar~ <Jpproacb, and supporting research and evalua~ion, giving high priority to prevent:t.on by: reducing. the availability of a.nd demand for alcohol; Noting with satisffction that the>report of the WHO Expert Committee on Problems related providas .,a thorough and authoritative suaunary ·of current knowledge applicable in thiS field and contains a number of important reconunendations for WHO and Member States; to Alcohol ConsumptiQn
Appreciating the work already carried out by WHO, and recogn1.z1.ng the important contribution of the Technical Discussions held at the Thirty-fifth World Health Assembly on "Alcohol consumption and alcohol-related problems 11 for future developments; 1. URGES Member States to identify the actual and anticipated problems associated with alcohol consumption; 2.
RECOMMENDS that Member States: (1) formulate comprehensive national policies, with prevention as a priority, and with attention to populations at special risk, within the framework of the strategy for health for all;
1
WHO Technical Report Series. No. 650, ;~80 •.
WHA36.12 page 2 (2) 4evelop mecbaniams :to coordinate programmes and activities for reducing dcohol• related problems on a planned, continuous and long•term bae:i.s; (3) give$ serious consideration in their nation<1l alcohol palicy to . all measuref:l suggested in its report by the WHO Expert Coll1llittee on Problems related to Alcohol Consumption; 1 (4) implement the policy adopted and evaluate its effectiveness with a view to further policy development; 3. REQUESTS the Executive lk>ard to monitor and .evaluate the development of WHO's alcohol programme; 4. REQUESTS the Director-General: (1) to continue and intensify WHO's prograume on alcohol-related problems as · an integral part of the strategy · for health for all through a phmary health care approach, as envisaged in the S. e ventb General PrograiiiDe of Work, and, in accordance with resolution WHA32.40:
(a) to str•ngthen further WHO's capacity tci respond to requests from -Member States to support their efforts in dealing. with alcohol-related problems; (b) to carry out studies on factors affecting alcohol consumption patterns and on measures to influence these patterns; (c) to . prC)IDC)te further joint <consicleration -by the organizations of the United Nations system and nog.governuiental or_ g anizations of the problems ~asociated with alcohol and their alleviation; • (d) to seek additional funds .from relevant United Nations governmental and nongovernmental sources; bodie~J ~s
well as
(2) to ensure that necessary organizational, staffing and budgetary •implications for tl:le orsanization are takeri into account in the preparation of .the progr81llllle budget for 1986.,.1987; (3) to use all possible mechanisms for drawing attention and giving publicity to health problems- related to alcphol consumption, for example by selecting this topic as a theme for a future WoJ;ld Health Day;
(4)
to report on the progress made to the
Thirty~eighth
World Health Assembly.
Twelfth Plenary Meeting, l3 May 1983 A36/VR/12
1
WHO Technical Repart Series, No. 650, 1980.
.
..
..
TlfiRTY·SIXTH WORLD HEAtrtr•A'SSfi!IIIBL'Y
WHA36.13 13 May 1983
INTERNATIONAL DRINKING WATER SUPPLY The Thirty-sixth World HealthAssembly,
ANn
SANITATIO~
PECADE
Noting with appreciation the rep()rt l of th~ Director~.Genera~ relating to the International DrinkingWater Supply and Sanitation Decade (1981:.1990); Recalling resolution WHA34.25 and particularly its emphasis on the Decade approach and its reconnendation to Member States that they concentrate water ' suppl)' and .sanitation prograinllles on their priority healthproblems; Noting with concern., that, . desi;>ite the progress made.. includ~ns the increased externa 1 technical and financial s _ u pport, ~i.th a,lmost a quarte.r of thi Decade already gone, countries are encounte,ritli di~Uculties in ac.hieving the goal~ thin and, ~lte :~'C;ade have set and in accelerating th,eir De~de.. prog;z;acames; Con~:>idering th,at in . th.is resp~ct the n4tional heaUh ag-nci~li ,have a. s~cial role to play in promoting the Decade and in ·contributing to thE! attainment ofits &ims · as pai'tof primary health care activities, .and particularly the training and use of COUIJlunity~based workers, health education and public infot'l&lltion, and tbestrengthen~ng of the health infrastructure;
Noting that, despite . the gene tal acknowle<lgement of the importance of ;lnter.s ect!>ral cooperation and action, many national and ititernatianaLagencies hav~ nc)t yet taken steps to introduce . the changes of approach that the Decade requiJ;"es; Recognizing that i t is essential to seize now the opportunity of improving health through the provision of safe drinking water supplies and adequate sanita,t ion services;
l. CALLS for a vigorous effort by all concerned to ensure substantial progress towards the goals of the Decade; 2.
URGES Member States to pursue the following plan of action: (1) to accelerate the ~Q_opt1,o.nof natio~l polic,ies and the drawin,g:-uP. of sound plans through which pdo;r:. i .fy can be given to uti.ders~rved urban and rural populations. bearing in mind that improved sanitati® shouta' go hancf in hand with the provision of safe water;
( 2) to promote, as ,. p.roposed by the Direc.tor:~Gener,al~ the concept of safe drinkingwater supply and sanitation as an essential CO!Nlone_ nt of primary health care; · (3)
c;o ens~re th~t ,their . nationa.l agencies ~"ke practical, steps and allocC!te the neccs.sary resources a'nd manpoWer t~ inlplement the abov~ concept; 1 Document
A36/S.
WHA36 .13 page 2 (4) to ensure that l\ll ageiu:ies with operational respCinsib.iUty for wc1t:er supply and sanitation, .including, where applicable~ ' ministries of hea~th, develop:
(a) progralillile.s to extend coverage to the whole population .with priority to underserved urban and rural groups; (b) institutional structures that will enable communit.:i:es· to ·assume responsibility for important tasks in planning and implementation, and, more particularly, in operation and maintenance; (c) hwnan resources with particular emphasis on middle-level and basic manpower;
(d) the use of the health system's capacity for community and public health education; {e) (f) 3. low-cost technology for drinking"'water supplyand sanitation; arrangements for drinking-water quality survei Hance <~.nd
contr.ol;
INVITES Regional Committees
(l) tp review the Decade's progress at their meetings, in 1983 if possible, in the light of the regional health-for-all strategies, and to propose measures that nal;ional health agencies call take to ensure tha adoption and implementation 'o f the abovementioned national plans of action, and to include relevant parts of these plans in reviews by countries of the utilization of resources for primary health drrc; (2) to adopt regional measures to support countries in strengthening their activities; 4. URGES the multilateral and bilateral agencies concerned (l) to support health oriented nation(ll Decade plans iri accordance 'With resolution WHA34.25; ~cade
(2) to participate in efforts to coordinate external contributions activities at country level;
to ~ Decade
(3) to. pay particular attention to supporting infrastructural improvements and measures to enable countries to absorb external support more fulfy 'and use i t more effectively.
s.
REQUESTS the Direci:or.;General
(1) to conti,nue to collaborate both with health agencies and with ~;>ther agencies concerned in carr)ting out their tasks B.nd activities in support of the above:.mentioned plan of action,, paying special attention to obtaining the greatest possible benefits to health, extending coverage to the underserved, and ensuring that sanitation develops pari passu with water supply; (2) to strengthen the Organization's technical cooperation., particularly in r.e gard to human resources, evaluation, research, · information exchange and techn9logical development, arid, . in collaboration with all the bilateral and international agencies concerned, to try to obtain · a substantial increase. in support forMember States in these respects;
WHA3fi.l3 page 3
(3) to continue to cooperate with multilateral and bilateral agencies by keeping them informed on needs for external cooperation, persuading them to direct more of their resources towards the crucial needs of Member States in regard to infrastructural improvement, and ensuring that their support is of the greatest possible benefit to health; (4) to continue to collaborate with the other agencies of the United Nations system in the Steering Committee for the Decade, and specifically with UNDP Resident Representatives in their focal role at country level, and to use these means to ensure that the Decade has the greatest possible impact on progress towards health for all; (5) to prepare a mid-Decade review of progress for submission to the Thirty-ninth World Health Assembly.
Twelfth Plenary Meeting, 13 May 1983 A36/VR/12
1'1liRTY-SlXTH WORLD HEALTH ASSEMBLY
WHA36.l4 13 May 1983
ORAL HEALTH Hf THE STRATEGY :OF HEALTil The Thirty-sixth World Health Assembly,
~OR ·
ALL
Recognizing that oral health is deteriorating in devt:loping cou~tries, despite tqe availability of effective 'preventive methods which have markedly improved, and continue to improve, ora}: health in many .indus.trialized countries; Recognizing that bilateral cooperation focused on measures to a~;rest the deterioration in oral health in developing countries and to ensure pel"DDilnent inal.ntenance of 'any improvements adtieved is not only possible but. is particu~~rly called for at, th-e present time; Apprecia.til\S the cJ,ear: and practical· .strategy ayailablel. for·'ach:i.eving b.etter oral health on a worldwide . scale;
1. CALLS upon all Member States to follow the available strategy when developing ·their national oral h~a.lth~,strat.e~es;
2. URGES all Member States to use the facilities" £o,r coordinat~on and collaboration available through WHO and in particula,r its International Collabor.oative Oral ·Health Deydopmen.t Progra11111e Jl.)!ilntioned in the attached str41tegy; J. REQUESTS the Director-General:
(i) to mobilize available resources in setting up the In.t ernational Collaborative Oral Health Development Programme in order to respond effectively torequests from Member States regarding all aspects of their nat i onal oral health strategies, . thus taking advantage of a special opportunity to redeploy human and other resources to achieve health for all; lii) to report on progress to future World Health Assemblies . through his biennial
report.
Twelfth Plenary
Me~ting,
13 May 1983
A36/VR/12
1
See Annex.
WHA36.14 page 2
ANNEX
ANNEXl FOUR· POINT COUNTRY ACTION PROGRAMME 1. Establish a coordinated planning process in oral health, using the standard WHO system for analysingoral health ·situations. Within national plans thus formulated, emphasb:e prevention at the primary health care level and integrate oral health into the general health infrastructure including a relevant referral system. Identify obstacles to achievement of national plans. Use the WHO Internat:i..onal Collaboratj.ve Qral Health Development Progr&nllle mentioned below to overr.ome those obstacles.
2.
3. 4.
ROLE, OF WHO IN 1.
SU~ORT
OF COUNTRY ACTION PROGRAMMES
Establish a WHo International Collaborative Oral Health Development Programme, as outlined in docume(lts EB71/19a3/REC/2. pages 175-176 and A36/INF.DOC./2, page 3, incorporating the optimal deployment of all resources available to the Organization. Collaborate withMEt~rl;itatel:l inperfot'DJi,ng situation analyses, in- developing natioi:\a-1 policies, g08ls; plans and progt:ammes in the light of these analyses ancl in .identifying obstacles ' to achievement of those goal$~ Partici,pate w;lth.:governments in identifying activities required and the !')upport needed through the WHO lnternational Collaborative 0\"d .Health Development Progranne. Promote and coordinate health services . research and other resear.ch required to . ensure the achievement of country goals in oralhealth.
2.
3.
4.
1
Strategy for Oral Health sUIIIIIS.rized from
""
PB/8~-85
.
and A36/INF.DOC./2.
THIRTY·SIXTH
WORLD HEALTH ASSEMBLY
WHA36.15 13 May 1983
REFERENCE SUB.STANCES FOR QUALITY OONTROL OF DRUGS (FACILITATlON OF THEIR DEPARTURE FROM AND .ENTRY INTO ~MBE~ STATES)
The Thirty-sixth World Health Assembly, Recognizing the importance of the .a vailability the quality control of drugs; ofhigh·quality , refer~nc:e
atandards for
Noting the difficulties presently encountered in hayf.ng reference materials · delayed or lost in transit or held up .unduly,while awaiting customs clearance •• and being stored i.n conditions that could .adversely aff~ct the quality of .t he reference sub$tances, REQUESTS the Director-General to study the quest:ion a11d to tilke appropriate measures, in the light of the. Organization's constitutional functions and rdated practices, and to inform Member States of such measures.
TWelfth .Plenary Meeting, 13 A36/VR/l2
May
1983
THIRTY-SIXTH WORLD HEALTH ASSEMBLY
WHA36.21 13 May 1983
COLLABORATION WITHIN THE UNITED NATIONS SYSTEM:
GENERAL MATTERS
Contribution of the World Health Organization to the Participation of Women in Promoting International Peace, Cooperation and Health The Thirty-sixth Worlq Health Assembly, Welcoming the valuable contribution made by the World HealthOrganization towards the attainment of the objec_ t ives of the United Nations Decade for Women: Equ.ality, Development and Peace; Referring to the close connexion between .the equality of women and the protection of health, as noted in resolution WHA28.40;
their
Recalling the principle laid down in the Constitution of the .w orld Health Organization that health, the attainment of peace and international cooperation are interdependent; Emphasizing the significance of .WHO's cooperation With its Member States, other specialized agencies within the United Nations system, and international governmental and nongovernmental organizations in implementing the object.ives of the United Nations Decade for Women; Underlining the necea!Jity to further imprqve preventive medical care and support for women in many Member States; Recognizing the contribution made by women towards -the preservation and promotion of health in their own families a~:~ medical and social .w orkers as well as in the political and social sphere; Emphasizing the constantly growing role of women in implementing the Global Strategy for Health for All by the Year 2000 ·in .all 1-fember States; 1. TAKES note of the adoption of the Declaration on the Participation of Women in Promoting International J?eace and Cooperation by the United Nations General Assembly at its thirty-seveJJ,th sessionl as a step towards achieving the objectives set for the United Na•ions· Decade for Women;
2.
REQUESTS the Director•General (1) to give high priority to well oriented and appropriate measures aimed at strengtherling the provision ·of hea.l i:h care foJ: women and enhancing their state of health in the implementation of WHO's. Global Strategy; (2) to ensure the Organization's active participation in the prepaJ;"ations for .the World Conference to Review and Appraise the Achievements of - the United Na~ions Decade .. for Women to be. held in 1985£ ·
(3) to work towards the full integrationof women and their cooperation on an equal basis in the activities ofhealth ser:vices in Member States.
Twelfth plenary meeting, 13 May 1983 A36/VR/12 1
United Nations General Assembly resolution 37/63.
THIRTY·SIXTH WQJW? .REALTH ASSEMBLY
WHA36.30 16 May 1983
'ruBERCULOSIS CO!fPWL IN THE WORLD - SITUATION ANALYSIS
The Thirty·sixth World Health Assembly, Recalling r~solution WHA3~.26;
Having considered theDir~tor-General's report on tuberculosi~ con~r~l; Noting that tuberculosis continues to be an impOrtant health prQblem in the world, particularly in developing countries~ wnere little improvement has be~n a~;leved in the· last two decades; Recognizing that improvement in socioeconomic cOnditions will have a beneficial effect on the tuberculosis situation; Emphasizing that progress in tuberculosis control requires a sustained effort and that the programme must be integrated into comprehensive health systems based on primary health care; Co~vinced that the sociaL target of alleviating human suffering and preventing death and disability from tuberculosis is achievable in the context of primary health care and in accordance with the goal of health for all by the year 2{)()();
Recognizing that the epidemiological target of interrupting tuberculosis transmission and substantially reducing the magnitude of the tuberculosis problem in the world can only be achieved gradually; Expressing its appreciation .of the collaboration of the International Union against Tuberculosis and other nongovernmental organizations in furthering the general policy of WHO in tuberculosis control; 1. URGES Member States to intensify their efforts to extend tuberculosis diagnostic, treatment and prevention service. s to the whole population, . and to do this by promoting close collaboration between those responsible for the development and organization of health system infrastructure based on primary health care and those responsibie for tuberculosis control;
2.
REQUESTS the Director-General: (1) to continue to collaborate with Member States in the development and strengthening of tuberculosis control programmes as a component of primary health care, and to ensure that expertise in tuberculosia control remains available to the international and national communities; (2) to continue to support BCG vaccination in children within the Expanded Progranme on Immunization in accordance with the present policy of the Organization; (3) to promote sociological and health systems research in order to establish baselines for programme planning and evaluation and to determine the most efficient ways of delivering the appropriate technologies through the health system infrastructure and of ensuring community partici.p ation;
"\ffl.A3. 6 • 30 paae 2
(4) to promote fund-.ental and technological t;'EUlearch, particularly 11.1 tfut fields of ~pidemiology a~ :1..1-.uRolo&Y, aaed at pt;'o. v iding Jll()re eff~ctive :pE"eventive "pd
diagnostic methodil; (5) to promote collaboration between tuberculosis progr8DIDies and prograaes concerned with the organization of health systems based on prilliary health care, health laboratoxy technology prograamies, drug actionprogranmes, and prograumes in public information and health education; (6) to promote the development and strengthening of training programmes on the technical and management aspects of tuberculosis control . asan integral part of the curricula for the training of all categories of health personnei; (7) to make all possible efforts, through collaboration between the action progranme on essential drugs and the phai'1baceutical industry; to ensure that the most effective chemotherapeutic regimens become more widely accessible to developing countrie.s;
(8) to keep the Executive Board and the ' Health Assembly infoi'med of global progressin tuberculosis control.
Thirteenth plenary meeting, 16 May 1983
A36/VR/13
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THIRTY-SIXTH WORLD HEALTII ASSEMBLY
W'liA.36.32
16 Hay 1983
PUVENTION AND CONTROL OF CARDIOVASCULAR DISEASES
The Thirty-sixthWorld Health Assembly, Recalling resolution WHA29.49, which invited the Director-General to prepare a long-term programme of the OrganiZation in the field of cardiovascular diseaseswith special emphasis on promotion of research on prevention, etiology, early diagnosis, tr. e atment and rehabilitation, as well as on coordination of international cooperative activities in the field of cardiovas -. cular diseases; Recognizing cardiovascular diseases as the main cause of morbidity and 1110rtality in virtually all industrialized countries, and aware of. their increasing significance as a cause of ill health and death in many developing countries; Considering that appropriate technology now exists to prevent aild control a growing nul!lber of cardiovascular diseases such as rheumatic heart disease in children, · coronary heart disease and cerebrovascular accident resulting from hypertension; Encouraged by .the repor.t of the Expert Colamit:.tee on Prevention of Coronary Heart Diseasel, which gave detailed guidance for the development of nationalstrategies for the prevention an~ control of such disease; Concurring with the recommendation of the Seventy-first session o.f the Executive Board to allocate additional funds to the Cardiovascular disease programme with particular reference to accelerating the i'Jilplementation of the programme strategy . for the prevention of coronary heart disease; 1. APPROVES the lines of action of the Organization's long•term pro.gramme in cardiovascular diseases, which was developed in response to resolution WHA29.49, and notes with appreciation the results since achieved; 2. URGES Member States to pay particular attention to the wide possibilities for prevention and control of cardiovasculardiseases as an integral part of their national health plans; 3, REQUESTS those Member States which have the capacity to do so to provide financial and technical support to dcweloping countries in implementing their programmes; 4. REQUESTS the Director--General
(1) to continue and further strengthen the activities of the Organization in the field of cardiovascular diseases as · formulated in its long-term progr&llllle and impleq~.ented during i:he Sixth General Programme of Work, and as approved in the Seventh Gene. r al Prograume of Work, (2) to take appropriate action to further mobilize extrabudgetary support for global, interregional, regional and national activities within. the programme and to use. when necessny. funds from the Director-General's Development Programme and from the Dev(!lopment Programmes of . the Regional Directors concerned; 1
WHO Technical Report Series No. 678.
WHA36.32
page 2 (3) to pro.,te ~ithin theOrgani~ation c;10 se ttehnic.al ~oUaWnti.on amons the va~ious prog&-...es supporti"e of these goals, and further coordinate. the developant artd iapleJiletlqtion of the cardlova$cular.·diseaeee progr8111111e with acti~ities carded out by appropriate non-' governmental organizations, other international organizations and leading scientific institutes,
(4) to report periodically on the progress achieved through his annual reports to the World Health. Assembly.
Thirteenth Plenary Meeting, 16 }lay . 1983 A36/VR/13
THIRTY-SIXTH WORLD HEAL'lll ASSEMBLY
WHA36.35
16 May 1983
METHODOLOGY AND CONTENT OF THE SEVENTH REPORT ON . THE WORIJ) HEALTH SITUATION IN RELATION TO THE MONITORING AND EVAWATION OF THE GLOBAL STRATEGY FOR HEALTH FOR ALL The Thirty-sixth World Health Assembly,
1 Noting. the record of the seventy-first session of the Executive Board on its debate on the methodology and content of the Seventh Report on the World .Health Situation in relation to the monitoring and evaluation o.f the Global Strategy for He!l.l.th . for All; Having considered the report
2
of the Director-General on this $u]:)ject;
Recalling resolutions WHA23.59 and WHA29.22 in which the need was reiterated for the Organization to publish an .analysis and evaluation of the inf'ormatton on · the state of. health of the world population anc:J on .enviro0111ental health; Appreciating the opportunity to finprove the relevance 'o f . the Seventh Report by buU(ling it on the basis of reports on monitoring and evaluation of the Global . Strategy for Health for All which the Member Stat;es are preparing in 1983 and 1985 in accordance with the plan of action adopted in resolution WHA35.23; Recognizing the need to associate WHO's governing bodies as closely as possible with the monitoring and evaluation of die Global Strategy as well as with "the preparation of the Seventh Report on the World Health Situation. 1.
DECIDES that: (1) · the Seventh Report on theWorld Health Situation should be prepared on the basis of the first global repttrt on the evaluation of the Strategy for Health for All Which will be reviewed by the Health Assembly in Ma)' 1986;
(2) one global report together with six regional health situation reports, based on the first reports on the evaluation of the regional strategies for health for all j including country reviews. should be published in the six official languages in tht! second half of 1986, and entitled 11Evaluation of the Strategy for Health for All by the Year 2000 - Seventh Report on the World Health Situation 11 ;
(3) the other proposals contained in the report of the Director-General be implemented; particularly with respect to the content of the Seventh Report; 2. URGES the Member States t ,o develop or improve mechanisms for monitoring· and evaluating their strategies for health for all, collecting rele vant information and using it ·to assess their health system. analysing health situation and trends, and thus providing a sound basis for epidemiological surveillance and for decision-making for health development;
1
Document EBH/1983/REC/2, pp. 2.67-269. A36 30.
z Document
I
WHA36~35
page · 2
3. INVITES the WHO regional CORIIlittees to evaluate the action undertaken at national an<l regional levels for monitoring and evaluating the implementation of the strategies for health for all by ·the year 2000 at these levels so as to use these proceasesaa a tool for: (a) improving these strategies;
(b) improving the national and regional capability in the field of monitoring and evaluation, assessing health situation and trends, and generating the information required for national. health management and WHO programme development; (c) guiding the WHO Secretariat in the preparation o£ the regional components of the Seventh Report on the World Health Si.tuation;
4.
RECOMMENDS that the Executive Board guide, through its Programme Committee, the DirectorGeneral in the preparation of the Seventh Report;
5.
REQUESTS the Director-General: ( 1) to ensure the preparation of the Seventh Report on the World Health Sittption in accordance with this resolution; (2) to take the provisional results of the Seventh Report on the World Health Situation into consideration in the preparation and discussion of the Proposed Progralllme Budget for 1986-1987; to supportMember States in their endeavours at monitoring and evaluating their for health for all, at assessing their health situation and trends, and at generating a,nd uSing .e ssential information to these ends• strateg~es
(3)
Thirteenth .Plenary Meeting, 16. May 1983
A36/VR/13
Seventy-first Sessisn
EB7l.R6 19 January 1983
POLicY ON FELLoWsHIPS The Executive Board, Taking into account the need foJ:: '"U .ae:tivities in wijJ,ch .the contribute to the achievement of health for all by the year 2000; Recognizing the contribution ma.de QY WHO in Member States; fell~i)ll$
Ql'ganiza~ion
col-l.,rates to
,.to the
<ieve~pme11t of.he~lth
manpower
Convinced J:hat fellQWf1!bi.p$ :should con~inue tp be used as one of a n\UQber of mechanisms for training the manpower required to implement the Global Strategy for Health for All by the Year 2000; Recalling resolution WHAll. 37 on the fellowships programme; 1.
WELCOMES the Director... (;eneral' s report on fellowships; ENDORSES the RPU.cus set;. out in that report; URGES Member States: (1) to develop national health manpower development policies and strategies in accordance with resolutions WHA24.59, WHA25.42 and WHA29.72, and as part of their national strategies for bealth for all; (2) to develop, within thesenational health manpOWer development strategies, plans for the most effective use of the wide variety of training mechanisms available to them, emphasizing for priority attention such alternatives as institutional support grants, grants for local training activities, grants for academic courses, on-the-job training, counterpart training, resource support to national health manpower d~velopment programmes, visiting scientist grants, research training grants, study tours, and re-entry grants, together with fellowships; (3) to request WHO fellowships, whether for study at home or abroad, or for a combination of the two, only when it is clear. that a fellowship is the most appropriate means .of achieving clearly defined objectives whose realization will have a positive impact. on t:he attainment of health for all, and where the appropriate employment of the fellow on return is assured; (4) for the purp.o!le of selecting WHO fellowship candidates, once a fellowship has been determined as the most appropriate means of training, to use, or establish where necessary, an adequate selection 'IJlechanism such as a properly constituted selection committee composed of representatives of the national health adtninistration, the appropriate national body concerned with the education of medical and health personnel, and the appropriat:e professional .group, i f applicable, and to consult with WHO in the process of selection;
2. 3.
Elll.a6 page 2
(S' _to monitor •• .evaluate peri94hallj th~ ta~p.ct of health ,.aapoWeJ: 4.,_lop~~em, i.OCludift& -f•U~iJl• • ;oe. r1ad~q~- ll~l,th deve'!.«>JIIMil~ .•/ .i.J\ c.oUalJoraCiOI\ wtttt :wo •.aD4, when necessary, the government of the receiving-country; 4. REQUESTS the Director--General and the Regional Directors, in compliance with resolution WHA33.17, to respond favourably to goverlltJlent requests for f~llQWships only if: (1) these are in strict conformity with the Organization's policy on fellowships, relevant to the health '!llanpower needs of the country, and so designed as to have a po$itive impact on the achievement of- health £9~ all by the year 2000;
(2) nominations are made in accordance with the arrangements outlined in paragraph 3(4) above;
5. RECOMMENDS that the Director-Gneral and the Regional Directors, in coopert!lti.o'A with Member States: (1)
continue to :Laprove reporting procedures on fellowships;
(2) carry out systematic evaluations of the implementation of WHO's health manpower development programme, including fellowships, and its contribution to national health sy.stems;
(3)
report on this matter to the Executive Board at least once every six years.
'!Velfth _.,ting, 19 Jiln\iaty l98l EB71/SR/12
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