WORU) lIEAI11'JI OMABIZA'l'IO. RegioDal Office for tbe Western Pacific
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"ESTEIUt PACD'IC ADVISORl C<»4M1'l"1'EE OJ' MlmICAL RESEAlICH
Report of tbe '!'bird Sellsioa Kuala LUIIIlJU!', Malays 1a 2~-27 April 1978
MaaUa
5 J1IIIe 1978
WPR/ACMR/Q.1" Swnmary p;'f~e 1 SUMMARY The Main Outcomes of the third session of the Western PaCific Advisory Committee on Medical Research (WP'ACUD II I ) may be summarized nn und er seven headings: A - STRENGTHENING NATIONAL RESEARCH CAPABILITY B - CONTRIBUTION OF RESEARCH TO WHO'S PROGRAMMES OF TECHNICAL COOPERATION WITH HEKBER STATES
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C - DEVELOPMENT OF A CADRE OF RESEARCH WORKERS WITH EPIDEMIOLOGICAL SKILLS D - ACCESSIBILITY OF INFORMATION ON BIOMEDICAL AND HEALTH SERVICES RESEARCH E - COORDINATION OF WHO'S DRCENTRALTZED RESEARCH PROGRAMME F' -
RESEARCH OF BIREGIONAL INTEREST
G - MANAGEMENT OF RESOURCES FOR RESEARCH A. STRENGTHENING NATION,AL RESEARCH CAPABILITY
Three mechanisms were proposed by the Committee: First, a foundation for research support was proposed through the strengthening of research institutions in three countries: . the Institute for Medical Research in Malaysia (the "flagship") the Institute of Medical Research in Papua New Guinea The Wellcome Virus laboratory in Fi,ji. Second, research grant support was endorsed for three studies in the Philippines in order to support the development of an interdisciplinary research programme against Schistosoma japonicum. Third, coordination of national research activities was encouraged through natrOnal medical research councils, or equivalent bodies and, to this end, the Regional Director was urged to convene a meeting in 1980 of individual~ in Member States in the Region holding posts equivalent to the directors or leaders of national medical research councils. Fourth, wider distribution of WHO collaborating centres by discipline and bv country was called for and existing centres were encouraged to "collaborat"" with one another.
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WPR/ACMR/78. 10 SUIII!Iary page 2
B.
CONTRIBUTION OF RESEARCH TO WHO'S PROGRAMMES OF TECHNICAL COOPERATION WITH MEMBER STATES
Action proposed by the Committee in three areas illustrate this:
group,
First, the Committee endorsed the efforts being made, through a working to develop an interdisciplinary, multi country programme of research in diarrhoeal diseases.
Second, the Committee recommended to the Regional Direotor the establishment of an advisory panel on aoute respiratory infeotions to implement and help secure funding for an ambitious programme for halving premature mortality and morbidity from this diaease complex by the year 2000. Third, the Committee recommended that WHO should make expertise avaiJ~ble to help research workers who are inexperienced in the methodology of ~ealth services research so as to help them define proposals which will attract support from funding agencies. C. DEVELOPMENT OF A CADRE OF RESEARCH WORKERS WITH EPIDEMIOLOGICAL SKILL.';
Two intercountry training aotivities, and their subsequent follow-up . were planned by WPACMR Task Forces.
First, the 1978 New Zealand course in the community control of cardIovascular diseases would be followed, in 1980, by a longer course on the epidemiology of both oommunioable and noncommunicable diseases. Second, the 1978 Working Group on Health Services Research will be fc1lowert by national courses. D. ACCESSIBILITY OF INFORMATION ON BIOMEDICAL AND RESEARCH SERVICES RESEARCH
Practical steps for giving research workers in developing countries better access to literature on biomedical and health services research were proposed. These include a meeting of librarians to plan the indexing and abstracting of regional publica tiona and journals using standard Medline procedures so that they become accessible on a universal basis.
WPR/ACHRI78.10 Summary page 3
E.
COORDINATION OF WHO'S DEC!MTRALIZED RESEARCH PROGRAMME
Three mechanisms for achieving this were favourably reviewed: Firet, the establishment of a focal group of officers with responsibility ror tropical diseases within the Regional Office was considered by the Coaaittee to provide a basis for solid rapport with their counterparts in the WHO Special Prosra-ae for Research and Training in Tropical Diseases. Seoond, the representation of the Western Pacific Region at the ACHR .eeting of WHO's South-East Asian Region, and vice versa, was supported to help ensure coordination with agenoies which span the two regions.
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itilf and of an observer frca the United Nations University's World 'roars- was welcOlMtd. F. RESEARCH OF BIRBGIONAL INTEREST
Third, the strong representation at WPACKR III of both WHO Headquarters
Hun~er
Two areas of local researoh interest to South-Eaat Asia and the Western Pacific should, the Committee felt, be pursued by the Regional Offices. First, the participation of Virologists from the affected countries in the developaent of dengue virus vaccine within a laboratory of high technology wee supported in order to prepare for the day when a quadrivalent vaccine beoQles available for field study.
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~~~!~~r;:e~g~i~o~nl:a.!ll initiatives
s. G.
were encouraged for researoh in clonorchiasis
MANAGEMENT OF RESOURCES FOR RESEARCH
The Committee leant its full support to the Regional Director in seeking to accelerate the flow of funds for research, with two caveats: FIrst, that the WPACHR Seoretary should have the support to enable him to visit the fledgling research centrea and soientists. Seoond, that WHO Headquarters should explore the possibility of organizing training coursea in researoh managa.ent for national and WHO staff.
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CONTENTS Page
INTRODUCTION
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1 1 1
OPENING CER);l4ONY
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ADOPTION OF THE AGENDA ELECTION OF OFFICERS
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2 2
WIfO SPI!CIAL PROGRAMME FOR RESEARCH AlII> TRAINING IN TROPICAL DISEASBS . • .. .. .. . .. .. .. . • .. .. .. .. .. .. .. • .. . .. • . . . .. . . . .. • .. .. .. . . ..
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FIBLD RESEARCH CENTRES
Fiji ................................................. ,. ................................... . Pap.. New Qui n.. . ................................................................... ..
II
II
ETHICAL REVIEW
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,. . . . . . . ,. .. 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
5 6 6
WHO COLLABORATING CElTIIBS
IMPLEMENTATION OF WPACMR 1•
............................................................. II .......................................................
2.
WHO Special Programme tor Research and Training in Tropical Diseases .•..•••••••••••••.•• Multidisciplinary research procraame on sch1stosClIIliasis .......................... ~ ...................................... ..
6 7 8 8 8 9
3.
Halaria researoh progr.......................... . Filariasis Leprosy
,.......
.
II. 5. 6.
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7. 8. 9. 10. 11 • 12. 13. 14. 15. 16.
Review procedures: research contracts and research training grants •••••.........•••.••••.•. Cardiovascular disease•.•.•.•....•....•..•..•.... Information booklet on wao-supported bioaedical and health services research ..•..••.••••••••••••• Enteric diseasea ................................................................ . Study on N. fonorrhoea in the Philippines .••.•••• Study of acu respiratory diseases •••••••••..••. Study on the biological control of mosquitoes •••. Research study group meeting on development ot
9 10 10 11 11 11 11 12
e
dengue V1M18 vaccine
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Alternative approaches to health development in underserved communities, Tacloban, Philippines Report of the Task Foroe meeting on health aery! cea research .............. Biomedical research info~tion exchange •••••.••• 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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12 13 14 15
ACMR MEETINGS IN OTHER REnIORS .............................. . COOPERATION WITH NATIONAL RESEARCH COUNCILS
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WORLD HUNGER PROGRAMME
Pagr 16 17 17
............................. ,. ...... . JACQUES PARI SOT FOUNDATION AWARD .......................... RESEARCH ON HEALTH MANPOWER ................................ OTHER BUSINESS .............................................. ,. .... ResearCh budget 1978/1979 and 1980/1981 ......•••...•• Training of medical laboratory technicians ••.•••••..• Research management . • • . . • • • • • .. • • . . • • . • • . • . • • . • . . . • . • .
18 18 18 ,8 19 19 20 20 20
Provisional dates of WPACMR IV....................... REVIEW REPORTS SNAKE BITE
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ADOPTION OF REPORT CLOSING SESSION ANNEX 1 ANNEX 2 ANNEX 3 -
........................................... LIST OF MEMBERS AND OTHER PARTICIPANTS AGENDA
...
21
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27
LIST OF WORKING DOCUMENTS
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29
WPACMR III Report page 1 INTRODUCTION The third session of the Western Pacific Advisory Committee on Medic'll Research (WPACMR III) was held from 24 to 27 April lq78 at the Institute for Medical Research, Kuala Lumpur, Malaysia, which had recently been designated a WHO regional centre for research and training In tropica'. diseases and nutrition on the recommendation of the WHO Regional C~lttee. The list of members is attached as Annex 1, the agenda as Annex 2 and the list of working documents as Annex 1. OPENING CEREMONY (Item 1 of the Agenda)
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Dr G.F. de Witt, Director of the Institute, welcomed the members on behalf
or
the staff.
Dr Dy, WHO Regional Director, was represented by Dr L. Verstuyft, WHO Representative in Malaysia, who read a speech prepared by the Regional Dt~tor. The WHO regular budget for this year's research programme a.ouated to US$ 402 300 - a seven-fold rise over the funds available for 1977. Dr DJ noted. He also expressed thanks for a generous donation of ust 1eo TOO which the Regional Office received expressly for research in Auaust 1971 from the Japan Sh 1 .pbullding Industry Foundation.
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In bis speech (Agenda item 4) Dr Dy expressed the hope that the Relianal Centre would serve Member States of WHO's Western Pacific Region. The ..pbasis in WHO's regional research programme, he concluded, was to st~n nation research capablli.ties.
Tan Sri Chong Hon Nyan, Honourable Minister of Health, Malaysia, gave a special address to members stressing the need for a new international order in health in which the sick and the distressed become an international concern. He added that WHO's decision to convene the meeting or ita V&stern Pacific Advisory Committee on Medical Research at the ImlUtute for Medical Research further supported the regional and international standing of the Institute. ADOPTION OF THE .~GENDA (Item 2 of the Agenda) The provisional agenda (APR/ACMR/78.1 Rev.l) was adopted with tbe addition of an item (16a) on research related to snake bites.
WPACMR III Report paRe 2
ELECTION OF OFFICERS (Item 3 Of the Agenda) Professor Sir Gustav Nossal continued as ChaIrman and the following officers were elected: Vice-Chairman Rapporteur Dr N.I. Chandrasekharan Dr Hyung Jong Park WHO SPECIAL PROGRAMME FOR RESEARCH AND TRAINING IN TROPICAL DISEASES (Item 5 of the Agenda) Dr A.O. Lucas, Director, SpeCial Pro~ramme for Research and Trainin~ in Tropical Diseases, WHO, Geneva, outlined the strategy and policy for strengthening research and training in tropioal diseases with particular referenoe to the Western Pacific Region. He especially appreciated the contributions made by the Region in taking initiatives in the areas of malaria, sohistosomiasis, filariasis and leprosy. The Speoial Programme has two main aims; namely: the development or new tools for the control Of tropical diseases, and the strengthening or research oapabilities for studying the diseases. Programme polioy is determined by a joint coordinating board consisting or 30 representatives which inolude 12 from donor oountries, 12 from affected countries in the different regions plus three from the funding agencies (UNDP, WHO, IBRD) and three others. A scientific technical advisory committee and scientific working groups for each disease have responsibility for implementing the Programme. ~
Institution strengthening is promoted by providing training grants, making working linkages between institutions, conducting jOint research and exchanging stafr of institutions. Exchange of information is stimulated through a newsletter and an annual report. The Committee received this report from the Special Programme Secretariat and endorsed the broad sweep of the Programme. The Committee noted with a great deal of satisfaction that a basis for solid rapport had developed between the Western Pacific Regional Of rice and its of ricers interested in research in the tropical diseases, and their counterparts in the Special Programme. It was also pleased to note that regionalization of the Special Programme was proceeding at pace. Dr Lucas was pleased with the initiative that the Committee had taken in furthering research on Schistosoma japonicum which was a problem virtually oonrined to the Region.
WPACHR III Report page 3
In the debate on the Programme, various concerns were raised by the Committee. For example, it stressed the need for collaboration and information exchange between different institutes within the Region, and here the Committee noted with satisfaction that WHO has made provisions to appoint an officer of the Special Programme specifically to work within thp Western Pactfic Region. The Committee urged the Regional Director to consider information exchange and liberal movement within the Region as thp appointee's key duties. The person appointed will of course have the closest collaboration with the Committee's Secretariat. The Committee observed that the community of scholars and health administrators in WHO Member States was not yet as fully informed about the Special Programme and its scope as it could be and urged the Seoretariat to live continuing attention to the matter of information dissemination. Information needs to spread not only to the scientist but also to health administrators, who will eventually have the task of making available to citizens within their countries the tools that the Speoial Programme develops. The Committee recorded formally its thanks to Dr Lucas and Dr Barzelatto, for taking the trouble to such a this long distance to join the meeting and wished them well in their endeavours. Inclusion in the Special Programme of research relating to paragonom1asis and clonorchiasis was suggested in view of their significance in some areas in the Region. However it was agreed that support for such research should rather be pursued with the WHO Regional Office.
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The Committee welcomed the plan for interregional seminars and workshops sponsored by the Special Programme which aim to facilitate information exchange and collaboration between neighbouring Regions. WPACMR received a proposal that a course in paraSite immunology be held in 1979 in Australia. In view of the substantial interest in immunology research in Australia, a significant number of lecturers could be available. Financial sponsorship would chiefly be required to bring participants from the developing countries. The Committee enthusiastically endorsed the proposal. It noted that some funding might be available through the Australian Development Assistance Bureau and also that the Secretariat of the WHO Special Programme was keenly interested in the possibility of such a meeting and might be source of additional financial support. The WPACMR urged close oollaboration between the WHO Regional Office and the Special Prolramme Secretariat in the further develoPDent of this proposal.
WPACHR III Report page 4
FIELD RESEARCH CENTRES (Itea 6 o( the Agenda)
A proposal to strengthen the Wellcome Virus laboratory, Suva (WPR/ACHR/78.2.1) was introduced by WPACHR Chairman, Professor Sir Gustav Nossal. The Wellcome Laboratory appeals as a potential regional laboratory because o( its history, location and close links with the Colonial War Memorial Hospital, the Fiji Medical Sohool and the University o( the South PacUic. The WPACMR endorsed and supported the proposal that the Welloome Laboratory be strengthened. It was in agreement with the concept that (unding, in the (irst instance, should be sought (rom outside WHO and specislly from the Australian Development Assistance Bureau together with the Wellcome Trust, directly or indirectly through the New Zealand ~edical Research Council. It strongly urged the Secretary of the Committee to investigate ways and means whereby the development of this Laboratory would be of benefit to the Fiji Medical Sohool and, if outSide personnel were recruited to the Laboratory, they should be urged to consider a teaching involvement as being of equal importance to their research involvement. The Committee noted the fact that there exist in nearby Noumea and Tahiti other viral diagnostic laboratories and there is an opportunity for excellent collaboration between the three centres. Should outside funding avenues fail, the Regional Director himself might explore ways and means of providing at least a starter grant towards the implementation of this proposal, before the Committee looks into it again in one year's time. Papua New Guinea A field trip report (WPR/ACMR/78.2.2) was presented by Dr D. Macfadyen, WPACHR Secretary. Pneumonia is the leading cause of hospital admission, with high mortality espeCially in Childhood. According to the statistics, the mortality rate (or pneumonia/in(luenza in 1-4 year old children is n hundred fold higher in Papua New Guinea than in Australia. A proposal was made to strengthen the Institute of Medical Research in Goroka so that it could establish a pneumonia research unit. The Institute would need to recruit a senior epidemiologist, a post-doctoral fellow in microbiology, a laboratory technologist and a field research officer. Some 22 field investigators would have to be recruited and transport, laboratory equipment and small animal facilities provided. An initial grant to the Institute of some US$ 150 000 would be sufficient to provide these, and grants of up to $ 100 000 would be necessary for each of three subsequent years. ~
WPACMR III Report page 5 Another proposal for a parasitio survey in the Western Province of Papua New Guinea was presented by Dr A.A. Buck, Chief Medioal Offioer, Research Coordination Epidemiology and Training, Division of Malaria and Other Parasitio Diseases, WHO, Geneva. There were two oaveata made by the WPACMR in endorsing the proposals embodied in the doouaentation. Firstly the Committee strongly asserted its belief that a vaooine trial should not be considered at an early date by the Institute of Medioal Research but such a trial should be preoeded by a deeply based epidea!ological study of causes and influenoes of pneumonia and the Director of the Institute should be urged to reoruit teohnioal starr who would advise as to what place, eventually, pneumoooocal vaccine trials might have in planning a broadly based attaok on the disease in Papua New Guinea. It was supported pri.. rily as a proposal to strengthen the Institute and secondarily, later on, as a proposal for vacoine trials. The second admonition convened the parasitologioal half of the proposal. The Ca.ittee urged the Regional Direotor to pay special attention to the very grave needs of the Western Province of Papua New Guinea and further urged him to relllllin in the olosest collaboration with the Director of the Speoial Programme in relation both to strategy, and eventually to runding, problems. !TIIICAL REVIEW (It.. 1 of the Agenda) SaDe problaas related to the ethios of medical experimentation were highlighted by Dr J.F. Dunne, Secretary, WHO Seoretariat Committee on Researoh Involving Human Subjects (SCRIBS), Geneva. The WPACMR reviewed Dr Dunne's paper on the subjeot (WPR/ACMRI18.3.2) and noted the need for strict ethical review of research proposals whIch oome forward for WHO support from countries or areas within the Western Pacific Region. The WPACMR supports a 3-tier syst.. of review: first a review would be .ade bJ the sponsoring agency and seoond by the WHO Regional Office, sinoe the Committee believes that an sdequate mechanism now exists for'the teohnioal review of proposala by the Seoretariat. T~e final review of the proposal would be IIIIlda by SCRIHS. At each level, ethical aspeots of proposals would thus be csrefully oonsidered • • • Already this 3-tier system is in operation. Nevertheless it is necessary to extend the system further, and the Committee reoommended that the Regional Director urge Member States to set up appropriate codes and regulatory mechanisms in order to ensure that medical research is conducted according to ethical principles. It rurthermore urged the institutes with whioh WHO collaborates to set up institution-based review committees. This present urging is made in general terms to the Regional Direotor but an appropriate time for specific reoommendations will follow. when the Committee of the Council of International Organizations of Medioal Science (CIOMS), which is working on the matter, comes up with its final d~llberations. When available, the WPACMR Seoretary should ciroulate the
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WPACHR III Report page 6 CIOMS report and elicit the opinion of the Committee on it. If ratified h? the WPACHR, the Regional Director would then be in a position to inform Member States that this document is fully supported by the regional ACHR and that the Committee's recommendations should be implemented as speedily as possible. In summary, the Committee felt that the present ethical review mechanism is adequate. The Committee was, however, unhappy about the mechanism which is available to the person being funded, who may not have resources for careful review in his institution or at the national level, and it strongly urged action to establish institutional and national ethical review committees. WHO COLLABORATING CENTRES (Item 8 of the Agenda) Both the response to the questionnaire sent to WHO collaborating centres (WPR/ACHR/78.4) and the WPACMR agenda item on this subject were enthusiastically received. Suggestions made were: that WHO collaborating oentres should "collaborate" with ea~h
othpr;
that wider representation is required, both in terms of soientific dlscipline and geography and that WHO collaborating centres be designated in broader fields such as the newly designated centre for SIIok,ing and health and the proposed centre on health services research. The Committee noted that the WHO Executive Board is making a study of WHO collaborating centres and will make recommendations to the World Health Assembly. These conolusions should guide future decisions. Nevertheless, the Committee recognized the many advantages and the problems created by the designation of WHO collaborating centres. It was aoknowledged that many oentres are providing major servioes to WHO and many more are willing to do so, despite limited finanoial support. On the other hand in order to enoourage oollaborating oentres in developing countries, an active support polioy should be adopted. It was felt that proper definition of thp. requisites for designation, clearer terms of referenoe and a more systematic approach to identifying institutions for designation, could solve most, if not all, of the problems, while broadening the soope and number of centres within this useful network. The Committee weloomed the involvement of the Regional Office in the present designation prooedure. IMPLEMENTATION OF WPACMR II (Agenda Item q) 1. WHO Special Programme for Research and Training in Tropical Diseases
The Committee considered the establishment of a multidisciplinary focal group on the Special Programme at the Regional Office to be a significant and welcome development (WPR/TDR/FG/78.1 and 78.2).
WPACMR III Repo, " page 7 The current efforts of the Special Programme in institution strengthen1ng may reverse the trend in the proportion of funds going developed countries.
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The Committee felt that the Regional Offlce should be act1ve in putting forward names of experts to the Director of the Special Programme when he is deciding upon the membership of a Scientific Working Group. The Committee members expressed their appreciation for receiving the very informative newsletter and annual report, and requested that all reports of the scientific working KrOUps of the Special Programme be sent to WPACMR members and the Task Forces. 2. Multidisciplinary research programae on schistosomiasis
The thrse proposals recommended by the Steering Committee of the Regional Scientific Working Group were endorsed, namely those on: health knowledge, attitudes and practices; animal schistosomiasis; and tuba seed mollusciciding. All three studies will be implemented in Leyte Province, Philippines and a film "Snail Fever: Oriental Schistosomiasis" vas shown which highlights the problem of transmission in that area.l If the endorsement by the Coam1ttee'is supported by the Regional Director, then the three studies would be supported by funds availablp through the Regional Office, both from the regular budget and from the voluntary fund. The Committee was pleased to note that, in support o~ this series of studies, the Special Programme will fund a workshop on the epidemiology of schistosomiasis in a defined population, which is to be held in Manila in July-October 1978. Further support from the Special Programme was encouraged to assist this multidisciplinary research programme, especially in the area of institution strengthening as recommended by WHO consultant Professor H. Gilles in the background doc~ent provided (ICP/RPD/001 dated 18 January 1978). The Caamittee noted with satisfaction the Regional Director's initiative in accelerating the flow of funds for research, both regular and voluntary, which have made it possible to get a substantial programme established with a new multidisciplinary emphasis. Eventually, when proposals from many fields are competing for limited funds, difficult resource allocation deCisions will have to be made and the WPACMR wishes to indicate to the Regional Director its willingness to assist in devisin~ budgetary allocation strategies.
Tokyo Bun-Ei Films Inc., Koa Building, 22-38, Nishi Shinjuki F-chome Shinjuku-ku, Tokyo 160
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WPACMR III Report page R 3. Malaria research programme
The Committee greatly appreciated the scientific input to this top;c by the WHO Secretariat and by way of documentation (WPR/ACMR 78.5.1 and 5.2). The possibility of an upsurge in malaria is an alarming concern ~o sCientists, particularly the problem of drug resistance, whioh should h,ve research priority. The Committee urged the Regional Direotor to use his good offioes to alert nations to the importance of providing career struotures to young malariologists and parasitologists. The prinoiple recommended in train'ng for conteaporary and future malaria problems should be to provide broad and polyvalent training, seeking rather to provide well-trained epidemiologists with a particular orientation to malaria, who would be well qualified to undertake applied research. The present collaboration between the Regional Office and the Spec' "I Progra..e should be continued. 4. Filariasis
The Committee appreCiated the informatjve paper (WPR/ACMR 78.5.3) prepared by the Seoretariat, which was introduced by Dr Laigret. The n~ed for further research was expressed, partioularly in veotor biology and ecology but also in chemotherapy, prophylaxis, pathology and immunology. The Committee was reassured that a regional researoh programme had been funded but, as the programme develope'and expands, further finanoial resouroes will be required. The Committee was impressed by the potential of the Institute for Medical Research, Kuala Lumpur in filariasis researoh and remarked that runds will be necesaary to support the Institute to expand its efforts ;n this area. The Committee was pleased to note the probability of the Institute receiving support from the Special Programme on a pilot basi~. pending formulation of an entire programme. 5. Leprosy
The Committee was presented with a very interesting and controver~i~l paper prepared by Dr Murohashi on the cultivation of M. leprae on soli~ medium (WPR/ACMR 78.5.4). Dr Laing, of the Leprosy Researoh Unit, Sungei Buloh, Malaysia was asked to prepare a position paper reviewing Professor Murohashi's presentation and other literature in the field wh,ch should be forwarded to the Leprosy Unit of WHO Headquarters. The WPACMR Seoretary was asked to inform Dr Murohashi and members of the Task Foroe on Parasitic Diseases, chaired by Dr Guinto, of the response of WHO Headquarters.
WPACMR III Report page 9 If considered justified, the Task Force may, at its discretion, r',commend to the Regional Director that a SIIIall workshop be set up to pu rs ue the rna t ter further. The Secretary was also asked to elicit the assistance of Dr Guinto a·,<1 h's Task Force members in advising on the institutions in the Region whic nped to be strengthened for leprosy research. 6. Review procedures: research contracts and research training grants
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The Committee did not propose alteration of the review procedures established in the Regional Office (Handbook IX.7 and IX.8) until more experience is obtained on their operation and, in particular, did not wish to impose restrictions which would delay prompt processing. However the independence of the WPACMR was seen as an important resource to the WHO S~cretariat and the trend should be towards an even greater say by WPACMR .embers in the ultimate decision to fund or not to fund. Alternatives to be considered in the future are: submission of all proposals' by a deadline date that would allow rpview at WPACMR annual meetings; establishing independent review panels; priority allocation of resources between proposals by the WPACMR. Placement for research training should not be restricted to the countries of the Region. Instead, the more permissive provisions of the WHO Information Booklet on Research Training Grants (1978) should be adhered to, namely: "training should be arranged in the nearest suitable place of study to the applicant's home country, and workers from developing countries should, whenever possible, be trained in a country where simils'disease problems exist and preferably in a country in the area of the sam', WHO regional office as that in which the grantees resides" • 7. Cardiovascular diseases
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The Committee acknowledged with satisfaction that its Task Force on Cardiovascular Diseases had met all targets set at the second session of the WPACMR, including the detailed preparation of the Regional Course in the Epidemiology and Community Control of Cardiovascular Diseases to be held in Wellington from 4 to 20 October 1978. It strongly recommended to the Regional Director the work plan pr-oposed in the Report of the WPACMR Task Force on Cardiovasoular Diseasf',' which met on 22 April 1978, namely: to prepare for a general course on epidemiology and medical (1) statistics in 1980 covering problems related to both noncommunicable and communicable diseases;
WPACMR III Report page 10 (2) to coordinate the work of national centres collaborating with the WHO Regional Office in projects on the prevention and control of cardiovascular diseases by organizing regular workshop type meetings of the chief investigators involved; (3) to facilitate the development of relevant national research in prevention and control through short-term consultant visits whioh should result in new activities related to the overall regional programme in the area of cardiovascular diseases; (4) to improve the exchange of information on continuing projects in prevention and control of cardiovascular diseases by inviting experts from countries or areas in the Region to report to the Regional Office and to the WPACHR Task Force relevant publication in their national journals (a list of names is given in the annexed Task Force Report); (5) to enlarge the membership of the Task Force on Cardiovascular Diseases, taking into account the recommendations set out in the Task Forcp Report. 8. Information Booklet on WHO-Supported Biomedical and Health Services Research
The Committee suggested small emendations to this draft, namely, the addition of other WHO mechanisms for supporting scientists in the Region (WHO Headquarters should be asked to provide these) and the inclusion of a list of members of WHO expert advisory panels from the Region. 9. Enteric Diseases
The Committee reviewed a background paper describing recent progress in the field of diarrhoeal diseases (WPR/ACMR/78.5.5). This paper will also be used as background information for the Working Group on Enteric Diseases which is expected to plan a relevant programme of research. The Committee endorsed the efforts being made in the Region to develop an interdisciplinary programme of research in diarrhoeal diseases. It pOinted out that the concise paper of Professor Rowley did not refer to protozoan and helminthic agents and that less information than is available was reported on oral rehydration. There is a need to map the causative agents of diarrhoeal diseases in the Region and also to take account of the WHO collaborative study going on in the Region on enteroviruses. When attempting to define a programme of research in diarrhoeal diseases It i~ also important to give proper emphasis to the operational aspects of control measures. Particular attention should be devoted to the role of diagnostic laboratories and the need to establish reference laboratories for the study of different aspects of diarrhoea.
WPACHR III Report page 11 10. Study on Neisseria gonorrhoea in the Philippines
~
At the second session of the WPACMR, concern was expressed about the public health problem of gonorrhoea. Accordingly, a contractual technical service agreement haa been signed by WHO and the Philippine General Hospital of Manila for research in the area. The Committee considerptj the proposal submitted and in view of the concern in the Region about th,' ongoing epidemic of gonorrhoea, and especially the emergence of penicillinase producing Neisseria, encouraged such studies to be carried oUt and felt that this should be made part of a coordinated progr_e if, the Region by extending the links already established between Dr Tupasi-Ramos, who prepared the proposal, and the WHO CollaboratinF Centre for Venereal Disease Serology and Bacteriology in Singapore. It suggested a consultant visit to the Philippines and possibly also to the Republic of Korea, in order to establish a common protoool so as to pet sufficient cases to obtain meaningful results from chemotherapeutic studies. The opportunity should also be taken during the consultant·~ visit to establish some system of surveillance of penicillinase prodlicinF Neisseria in the Region. The study was endorsed, but modifications were suggested. 11. Study of acute respiratory diseaseq
A document prepared by Dr Robert M. Douglas, WHO Consultant, highlighted the importance of acute respiratory diseases. The Committee congratulated Dr Douglas for having produced such a comprehensive report and, having considered carefully his recommendations, suggested that the Secretariat be provided with written oomments on the report by the WPACMR Task Force on Comaunicable Diseases. It recommended to the Regional 0rfi~' the establishment of an adVisory-panel on respiratory diseases. The function of this panel would be to monitor the steps being taken to implement Dr Douglas' proposal, to survey their implementation and t( discuss mechanisms for getting finanCial support. The Committee enc""~age" the Regional Office to continue its dialogue with WHO Headquarters 011 establishing a global progr8lDllle on acute respiratory infections which woul,' be responsible, among other things, for deciding the proper organizational level for carrying out the aotivities recommended by Dr Douglas. 12. Study on the biological control of mosquitoes
When reviewing a report by WHO Consultant, Dr Pillai, on the site visit to the Republic of Korea in connexion with a research proposal on th~ biological control of mosquitoes, the Committee was pleased to learn of th~ support extended by the Special Programme to Dr Yu and his group. In vi.ft of Dr Yu's difficulties, expecially with transport, the Committee recommended that the Director, Special Programme oonsider financing the small additional amount of money needed from his emergency fund. 13. Research study group meeting on development of dengue virus vaccine
The Committee, having reviewed the report of the research study ~roup in New Delhi and also the review of Professor Miles (WPR/ACMR 78.9.1'. was pleased with with work being done on the development of a dengue virus vaccine at the Walter Reed Army Hospital and in Hawaii. It endorsed the proposal to strengthen institutes within the Region in antiCipation of the day when a quadrivalent dengue vaccine will be available for field trjal~
WPACMR III Report p~e 1~
and specially supported the proposal to look for virologists who would be available to work in laboratories where the vaccine is being developp.d. I! envisaged that there would be difficulty in finding such people and thou~h! that there might not be anybody available before 1979. It further suggested that sources of extrabudgetary funding be sought for supporting this work. The Committee stressed the need to coordinate with the Region8' Office for South-East Asia in the development of activities in this area. 14. Alternative a proaches to health development in underserved coamun es, ac 0 an, pp nes
The Committee reviewed the paper on the development of alternative approaches to health development in underserved communities and was pleased to learn of the initiative taken by the Philippines in getting an innovative programme of health manpower development and health services research off the ground. It notec particularly the progress made in involving the community in the trial and error phase of the study and had some specific proposals to make to the coordinating group of the study for when they are formulating the detailed protocol. These consist of outlining responsibilities within the organizational structure, defining the roles of all individuals involved, specifying a time-phased schedule for the implementation of the study and the evaluation procedure to be established. The Committee would be pl~~ed to have the progress of the study in Tacloban reported to the next meeting of the Task Force in Health Services Research. There was general discussion on the need to provide funding for health service research proposals and in particular it was felt that small-scale projects should be encouraged. The Committee was anxious to see further proposals submitted for support in the areas of primary health care (PHC) especially in terms of the evaluation of the effectiveness of PHC programmes. It realized the limited capability in the Region in this area and recommended that WHO should make available expertise to help define protocols so that they will be acceptable to funding agenCies. 15. Report of the Task Force meeting on Health Services Research, Kuala Lumpur, 20-21 April 1978 Mep.tin~
With regard to the matters raised in the Report of the Third of the Task Force (annexed), the WPACMR:
shared the Task Force's concern about the paucity of health services research (HSR) proposals and supported the recommendation that a small discretionary fund be vested on the Secretariat for the purpose of seeking out HSR in priority areas; agreed that the Secretariat should prepare guidelines to assist those preparing HSR proposals; noted the suggestion made concerning national strategies for the promotion of HSR and will follow these developments with interest;
WPACMR III page 13
Repo~t
accepted the suggestions made concerning the assessment of HSR proposals and the need to provide continuing supervision and support to inexperienced research workers; agreed that a panel of experts in HSR should be established to support research in the Region; noted the suggestion that administrators as well as research workers require training in HSR; - agreed that the development of a global focus for HSR should not he rushed and that a special programme is not required;
16.
noted with interest the plans and the programme for the Working Group on HSR to be held in Manila in August 1978; and approved the recommendations concerning the development of a regional HSR programme in the priority area of maternal and child health. . Biomedical research information exchange It
""'"
.
has been apparent from research proposals received that facilitie'-. for literature review are not easily available to medical research worker' in several countries of the Region. A practical plan for the systematic provision of information on biomedical and health services research was provided in the report of a WHO Opnsultant, Miss F. Flynn, and this was discussed by the Committee. The'tiaitations of the Index Medicus and the Rational Library of Medicine SyateD are emphasized in the report, particularly the limited coverage of PRC and the non-inclusion of many journals of local importance in the countries of the Region. The creatior. of national or regional systems for indexing journals that are not includpd in the Index Medicus is proposed. To facilitate this WHO could promote meetings and consultations between librarians • The following points were made by the Committee on reviewing Miss Flynn's report: (1) a working group should be convened of librarians of the larger medical libraries in the Region to start planning for a telex-linked library network to imporve the supply of literature or photocopies; (2) when the Medline service at WHO Headquarters was discontinued it was, decided in prinCiple, that Medline searches requested from devel~p,nc. countries from other Medline centres could be funded from the WHO Library/Geneva. This should be continued and the Regionai Director might consider taking over the cost of this important service for the Region; (3) the limitation of Index Hadicus as to coverage of the majority of the journals of the Region could most easily be remedied by t~e syatematic indexing and abstracting of these journals by a special group:_n the Region. By using the same indexing and data system as Medline, a regional file COuld then be easily accessible on a worldwide basis;
WPACMR III Report pap;e 1~ (~) the WHO Headquarters Health Services Project Register sholl'd b" continued and improved and possibly regionalized;
(5) a proposal was endorsed to print the Medline citations and abstracts related to the six diseases of the WHO Special Programme for Research and Training in Tropical Diseases and distribute them free or cost quarterly to interested scientists. The Committee urged the Regional Director to explore cooperation with Medline centres in Australia and Japan, as well as with the International Development Research Centre of Canada in relation to its information services. If an information sub-committee of the global ACHR is formed, the Western Pacific Region should be represented. ACMR MEETINGS IN OTHER REGIONS
(Item 10 of the Agenda) Dr S. Bergstrom, Consultant, Office of the Deputy Director-General, WHO Headquarters, who is also Chairman of the global ACHR, informed the meeting that most Regions seem to be giving priority to enteric diseases and health service research. He emphasized the importance of coordination and collaboration among Regions and countries, and especially noted the need for joint working groups between the WHO Western Pacific (WP) and South East Asia (SEA) Regions 1n research activities, because of their similar problems.
Dr B. Jayaweera, Research Promotion and Development, WHO Regional Office for South-East Asia, presented the activities of his Region in the field of medical and health service research. High priority was given at the second South-East Asia Advisory Committee Meeting fer Medical Research to communicable diseases, including malaria, filariasis, dengue fever, schistosomiasis, and also to nutrition, control of human fertility, envtronmental problems, delivery of health care, including primary health care, and chronic diseases, such as liver dtsease. Technical review papers and SCientific study group meetings were fourd to be very helpful in reviewing problems, identifying research areas, and drafting actual proposals for research to be carried out. In South-East Asia in the first two years, most efforts were devoted to setting priorities, identifying resources and drafting programme plans. Actual research activities would be more fully implemented from this year, now that more ample funds have become available. Lack of communication between government and scientists within a country. and indeed between research workers themselves, were common problems and coordinating mechanisae such as medical research councils or similar organizations were supported.
WPACMR III Report page 15
Collaboration between the Western Pacific and South-East Asia had been established &nd several examples were given in document WPR/ACMR/78.6. These were:
Rep,ion~
participation in 1978 of representatives from the Western Pacific Region in study groups of the South East Asia ACMR, for example in applied research in malaria, dengue haemorrhagic rever and diarrhoeal diseases; projected biregional meetings in 1978-1979, for example in Brugian filariasis (hosted by the Western Pacific Region), bancroftian filariasis (hosted by the South-East Asia), sohistosomiasis, parasitio immunology and dengue haemorrhagic fever;
.
a biregional research centre in the pathophysiology of dengue sited at Mahidol University, Bangkok and supported by WHO Headquarters, the South-Eaat Asia and Western Pacifio Regional Offices and the Australian Development Assistanoe Bureau; representation of each Region at the other's ACMR meeting to ensur~ coordination with agencies, such as SEAMEO/TROPMED, which span both Region~. After reviewing these activities, the Committee expressed its gratification with the cooperation on research between the South-East Asia and Western Pacific regions of WHO and urged further collaborative efforts. The Committee also believed that any artificial delineation in 'lllocating resources between planning and actual research activities did not seem to be necessary at this early stage of development. However, it was strongly recoamended that a high proportion of research funds should be available as they became more available for direct support to scientists and research workers •
,.......
COOPERATION WITH NATIONAL RESEARCH COUNCILS (Item 11 of the Agenda) The Committee recognized that the national medioal research councilor ita equiv'llent organization is extremely important in promoting research actIvities in the medical and health service fields in any country. In thp Western Pacific Region countries seemed to be divided into three groups: (1) countries with a long established national medical research council funded by the government, (2) countries with a national medical research council but which is recently established and where activity is not significant and (3) countries which have no council yet. The Committee resolved to urge the Regional Director to use his good offices in the Regional Committee to stress to Member States the extreme importance which the Committee attaches to the formation of national
WPACMR III Report page 16 medical research councils. The research supported by WHO in the Region demands the heavy involvement of Member States and the Committee believed n Member States will be able to perform research more effeotively if it is coorrlinated through some national mechanism akin to a medioal research council. Having stated its firm belief in the importanoe of national research councils, the Committee further recommended that an interface be established between the national councils - whatever their state of present evolution - and the WPACHR. In furtherance of this aim, the Committee reoommended to the Regional Direotor the holding of a meeting in 1980 of the most appropriate individuals in the Member States, holding posts equivalent to the direotors or leaders of national medioal researoh counoils, as proposed in dooument WPR/ACHR/78.7. The Committee recognized the problem in identifying the most suitable partioipants in certain Member States and, since 1980 is already late, the Committee urged its Secretary to give due and urgent attention to identifying the appropriate individuals and offered to collaborate with him in doing so. WORLD HUNGER PR,}RAMHE (Item 12 of the Agenda) The World Hunger Programme of the United Nations University was presented by Dr P.S. Venkataohalam of the University. The World Hunger Programme is presently organized into the following four sub-programmes, based on priority topics: (1) human nutritional requirements under conditions prevailing in developing oountries and how to meet these requirements through traditional diets; (2) development and promotion of better ways of conserving and utilizing food already prorluoert and reduotion of wastage through the application of simple technology; (3) introduction of food and nutritional oonsiderations into national planning and development; and (4) interrelations and interactions of agrioultural improvement programmes with food soience and nutrition. The programme emphasizes the strengthening of capabilities in developing oountries for ooping with serious food, nutrition and related health problems, and uses most of its resources directly in the field in support of fellows, researoh workers and institutions in developing countries engaged in nutrition and food soienoe researoh. The Committee felt that the olose ooordination between WHO and the World Hunger Programme established in the Memorandum of Understanding between the United Nations University and the World Health Organization continued. Information exchange between the two agenoies is most desirable. 1
The Committee expressed no view as to whether it is better to have a totally free standing medical researoh oouncil or whether to have a medical research component of a larger soientific counoil. Different nations will have different administrative meohanisms.
1
WPACMR III Report page 17
JACQUES PARISOT FOUNDATION AWARD (Item 13 of the Agenda) Professor Manuel Bonifacio of the Philippines was recommended unanimously in February 1978 by the WPACHR to go forward as the nominee for the award for 1979. The recOllllllendation was accepted by the Jacques Padsot Foundation Committee. Professor Bonifacio began his research in March 1978 and will present his results to the WHO Regional Director in March 197°, prior to addressing the World Health Assembly in May 1979. RESEARCH ON HEALTH MANPOWER (Item 1_ of the Agends) The Chairman amplified the information given in Professor Cox's b,ier background paper (WPR/ACMR/78.8) by explaining that the proposal came ["rom the Director of the WHO Regional Centre for the Training of Teachers or Health Personnel (RTTC) and was submitted for endorsement only, not for funding, which is being pursued with a private foundation. Speakers welcomed such a proposal, pointing out "hat research in this area was needed and that such research as is done is often characterized by poor methodology and low relevance with little resultant educational change. The proposal was endorsed, in principle, by the Committee. It was pointed out that the WHO Special Programme for Research an(' Training in Tropical Diseases was increasingly using WHO's Division of Health Manpower Development to help ensure the success of the trainin~ component of the Programme. Indeed, Professor Cox had been invited to join the Research StrengtheninR Group of the Special Programme at its meeting from 12 to 16 June 1978 • The Committee noted the potential contribution of the RTTC to res~arch in "health service manpower development". The view was expressed that health manpower development and health services research should be considered together, since the structure and performance of health serviceg are, in large part, determined by the nature of the training which the health manpower of the future receives. It was formally moved that the Director of the RTTC be invited to a brief technical presentation at the next session of the WPACMR. ma~e
-
,~
.
WPACMR III Report page 18 OTHER BUSINESS (Item 15 of the Agenda) Research budget 1978/1979 and 1980/1981 The Committee requested budgetary information on the regional research programme and was informed that the budget for each of the biennia 1978/1979 and 1980/1981 amounted to some US$ 1.2 million. The first-mentioned budget had been submitted to the twenty-eight session of the WHO Regional Committee and that for 1980/1981 would be submitted to the twenty-ninth session due to be held in August 1978. The Committee lent its full support to the Regional Director in securing these sUbstantial provisions for research in the regular budget. It was pointed out that they, together with the flow of funds through the Special Programme - especially those for tropical diseases - would increasingly make demands on the Regional Office. The Committee suggested to the Regional Director that the Office of Research Promotion and Development be strengthened so that funds could be fully and effectively programmed. Moreover it was essential that the regional research coordinator be free to make frequent site visits to the fledgling centres and to the research workers being sup,orted. It was therefore the strong and uniform view of the Committee that the Regional Director should ensure that the Office for Research Promotion and Development had the requisite support staff. Training of medical laboratory technicians This item was proposed by Professor Kosakai, who drew attention to the need for postgraduate training of technicians to the high standards required for research. The proposal generated wide interest among members and the Committee therefore resolved that a small subcommittee be set up to examine the problem and to report back to the Committee at its fourth session. Proposed members of the subcommittee were: Professor N. Kosakai (Chairman) Dr G.F. de Witt Professor K. Cox Dr D. Macfadyen It was pointed out that the subcommittee work, at least initially should be conducted' by correspondence. Research management The position paper on research management, requested at WPACMR II had not been prepared. Dr Rossi-Espagnet, who was representing the Re~,)arch Promotion and DeVelopment, WHO, Geneva was asked to explore in Geneva possibilities for mounting a training course in research management for WHO and na t.ional staff.
WPACMR III page 19 Provisional dates of WPACHR IV
Rep~"t
Final dates for the next session should be fixed within the next two months, in consultation with other WHO Regions and Headquarters. A three-day meeting was proposed and the tentative dates proposed to the Regional Director were 18-20 April 1979. REVIEW REPORTS (Item 16 of the Agenda) Six documents prepared for the meeting were scientific review articles specially commissioned by WHO from scientists in the Region for the meeting, namely: The Development and Potential Value of Dengue VaCCines (WPR/ACMR/78.9.1) A Review of cardiovascular Community Control Programmes (WPR/ACMR/78.9.2) Advances in Fertility Regulation (WPR/ACMR/78.9.3) Current Research on Malaria in the Western Pacific Region (WPR/ACMR/78.5.2) Cultivation of H. leprae (WPR/ACMR/78.5.4) Recent Progress in the Field of Diarrhoeal Diseases (WPR/ACMR/78.5.5) The Committee felt that, with the exception of the review article on Cultivation of H. leprae, on which a peer review was requested, the articles should receive wider circulation than the internal distribution they had had. The general body of opinion in the Committee favoured their publication, as a bloc, in a regular journal. Speakers suggested that th's could be done in the WHO Bulletin, as part of an annual exercise, so that the Editor could expect scientific articles from the regional ACMRs. However the Committee recognized that scientific journals had their own policies and wished therefore to give its Secretary a good deal of flexibility to negotiate the most appropriate publications, bearing in ml~d the opinions expressed at the meeting. The Coumittee welcomed the innovation as a way of promoting the interest of young scientists in socially relevant fields and of advertising the activities of the WPA~R to the scientific community. It therefore recommended that the Secretary schedule one major technical presentation for the 1979 meeting, perhaps on filariasis research in the Region, and two other minor scientifiC presentations, since this feature of the present meeting had been much appreciated.
WPACMR III Report page 20
SNAKE RITE (Item 16a of the Agenda) The Committee was informed of the increasing interest in snake bites in the Western Pacific, South-East Asia and Eastern Mediterranean Regions and recommended that some action be taken by WHO Headquarters, in collaboration with Member States. Research on active immunization agains', snake bites was suggested. A meeting on the subject was scheduled to be held in Japan in the autumn of 1978. ADOPTION OF REPORT (Item 17 of the Agenda) It was agreed that the report drafted during the meeting would be scrutinized by the Chairman, Rapporteur and Secretary, redrafted and despBtched - as a redraft - to WPACMR members for comments on Wednesday, 3 May 1978. Members would return their annotated redrafts to the Secretary within a month so that the final draft (WPR/ACMR/77.10) might be tabled by the Chairman at the global ACMR meeting "'Je to be held from 19 to 26 June 1978. CLOSING SESSION (Item 18 of the Agenda) The Chairman thanked all members of the Committee for their contributions and called attention to the fact that the time had now come to rotate the membership of the Committee. The procedure of rotation was established by the global ACMR, from which he himself had retired. He regretted that not all members therefore would participate in the Ca.mittee's fourth session, but hoped that retiring members would retain their interest in "world health" and in the World Health Organization. He paid tribute to the Institute for Medical Research which had kindly acted as host to the meeting - the first ever away from the hOllle base ir, Manila. The Institute was, he said, the "flagship" of the Region's research enterprise and, as a consequence of the present session, he looked forward to seeing a fleet of smaller research centres being built up in the Paciric. The Director-General of Health, Malaysia, Dr Raja Noordin, formally closed the session.
WPACMR III Report page 21 ANNEX LIST OF MEMBERS ANDOT"ER PARTICIPANTS MF.HBERS Dr N.I. Chandrasekharan 1
A ..oelate Proteasor Clin1ca1 DiagllO.tic LaboMtory Medical Center
University of Malaya Kuala Lllllpur Milaysla
• Dr R.S. Guinto American Leprosy Foundation (Leonard Wood Memorial) Cebu Skin Clinic Cebu City PhilIppines Dr [. Xobari Director Ramamatsu Medical Center 328 Tomitsuka-cho "IIIIIIIIDIltau 432 Japan
Dr N. [osakai Professor Juntendo University School ot Medicine "ongo, Tokyo Japan Dr J. Laigret Director
~~~~~t~~S~:l:e~ge;~hes Papeete French Polynesia
Medicales "Louis Malarde"
Professor Sir Gustav Nossal Director The Walter and Eliza Hall Institute of Medical Research Melbourne AustralIa
.Unable to attend.
WPACMR III Report page 22 Annex 1 Dr H.J. Park President Korea Health Development Institute Seoul Republic of Korea Dr I. Prior Director Epidemiology Unit Wellington Hospital Wellington Mew Zealand Professor S.S. Ratnam Head Department of Obstetrics and Gynaecology UniVersity of Singapore Singapore 8 • Dr Liu Shu-hsien Shanghai Institute of Parasitic Diseases Shanghai People's Republic of China Dr Byong-Seal Seo Professor ' Department of Parasitology College of Medicine Seoul National University Seoul 110 Republic of Korea TEMPORARY ADVISER Dr A. Laing Acting Director Leprosy Research Center Sungei Buloh, Selangor Malaysia Dr G.F. de Witt Director Institute for Medical Research Kuala Lumpur Ralaysia Dr P.S. Venkatachalam United Nations University Tokyo Japan
OBSERVERS
·Unable to attend.
WPACMR III Report page 23 Annex CONSULTANTS Dr A.C. Reyes 1450 Calumpang Street Dasmarinas Village Makati, Metro-Manila Philippines Dr G.C. Salmond Director Management Services and Research Unit Department of Health 1
WHO STAFF
Dr A.O. Lucas Director Special Programme for Research and Training in Tropical Diseases (TDR) WHO Headquarters Geneva Swi tzerland Dr S. Bergstrom Consultant Office of the Deputy Director-General WHO Headquarters Geneva Switzerland Dr J.F. Dunne Secretary . Secretariat Committee on Research Involving Human Subjects (SCHRIS) WHO Headquarters Geneva Switzerland Dr A.A. Buck Chief Meldical Officer Research Coordination, Epidemiology and Training, Division of Malaria and Other Parasitic Dlseases WHO Headquarters Geneva Switzerland Dr J. Barzelatto Office of Special Programme for Research and Training in Tropical Diseases WHO Headquarters Geneva Switzerland
WPACHR III Report page 24 Annex 1 Dr Z. Pisa Chief Cardiovascular Disease Unit WHO Headquarters Geneva Switzerland Dr A. Rossi-Espagnet Division of Strengthening of Health Services/Health Services Information Systems WHO Headquarters Geneva SWitzerland Dr L.R.L. Verstuyft WHO Representative Kuala LWllpur Malaysia Dr B. Jayaweera Office of Research Promotion and Development WHO Regional Office for South-East Asia New Delhi
India
Mr M. Subramanian Regional Adviser on Health Information WHO Regional Office for the Western Pacific Manila Phllippines Mr J. Abcede Public Information Officer WHO Regional Office for the Western Pacific ManUa phIlIppines Dr G. Nugroho Medical Officer Intercountry project on Primary Health Care WHO Regional Office for the Western Pacific ManUa PhIlIppines Mr S. Kolta Sanitary Engineer WHO Regional Malaria Team Kuala LWllpur Malaysia
WPACHR III Repo-t page 25/26 , 1.
Annex 1
Mr E.S. Thevasagayam Entamolog1st EHO Regional Malaria Teall Kuala Lumpur Milaysia Dr D.M. Macfadyen Medical Officer. Research Promotion and Development/Secretary. Western Pacific Advisory Committee on Medical Research WHO Regional Office for the Western Pacific Manila PhUippines
;'"""
WPACMR III page 27
Repo~t
• \.,
ANNEX 2
AGENDA Document number 1. 2. 3. Opening of' the session Adoption of' the Agenda Election of' of'f'icers: and Rapporteurs Vice-Chairman WPRIACMRI78. 1 Rev. 1
4.
Address by Dr F.J. 01, Regional Director, WHO Regional Of'f'ice f'or the Western Pacif'ic Regional Centre f'or Research and Training in Tropical Diseases and· Nutrition WHO Special Programme f'or Research and Training in Tropical Diseases: Institution Strengthening Field research centres Fiji: Proposal f'rom the WHO Centre f'or Virus Ref'erence and ~esearch, Australia Papua New Guinea: Field vi8it report Implementation of' proposals of' AOMR 19 Ethical surveillance of' research involving human subjects Ethics of medical experimentation involving human subjects
5.
TDR/AR( 1)/77.13
6.
WPRIACMR/78 .2. 1 WPRIACMRI78.2.2 ACMR 19/77.14 Repo~t
7.
:"",
WPRI AOMR/78 . 3. 1 WPR/ACMR/78.3.2 WPR/ACMRI7I\.4 WPR/ACMRI78.5 WPR/ACMRI78.6
8. 9. 10. 11.
WHO collaborating questionnaires
cent~es:
replies to
Implementation of' proposals of' WPACMR II ACMR meetings of' other regions - report on attendance at SEARO/ACMR Cooperation with National Research Councils Report of' f'ield visit to Australia and New Zealand Wo~ld
WPRlACMR178 •7
12.
Hunger Programme of' the United Naltions University
WPACMR III Report page 28 Annex 2
13. 14. 15. 16.
Jacques Parisot Foundation Award - Foundation's decision Research on health manpower - Proposal of Regional Teacher Training Centre (RTTC) in Sydney Other business Preparation of report: review reports WPR/ACMRI78. 9.1 WPlI/ACMRI78.9.2 WPR/ACMRI78.9.3 WPR/ACMRI78.8
report of meeting 17. 18. Adoption of report(s) Closing session
-
WPACMR III Report pale 29 ANNEX 3
LIST OF WORKING DOCUMENTS TDR/AR( I )77.13 Annual Report 1977: Research Capability Strengthening Working Group Prolra_e Area II! Proposal from the WHO Centre for Virus Reference and Research, Australia Report on a Field Visit to Papua New Guinea (17-26 'ebruary 1978) Report on the 19th session of the global Advisory Committee on Medical Research Ethicsl Surveillance of Research Involvinl Human SUbjects (replies to questionnaire) Ethics of Medical Experimentstion Involving Human SUbjects Dr J. Barzelatto
WPRIACMR 178 • 2. I
Dr X. Gust
WPRIACMRI78. 2 • 2
Dr D. Macfadyen
ACMR19177/111
WHO/HQ
WPR/ACMRI78.3. I
RPD/WPRO
WPRI ACMR178 .3.2 WPR/ACMRI78.4 WPR/ACMRI78.5 WPR/TDR/FGI78.1 WPR/TDR/FGI78.2 WPRISllGSJI77.6
Dr J.F. Dunne
WHO Collaborating Centres: replies to
RPD/WPRO RPD/WPRO RPD/WPRO RPD/WPRO RPDIWPRO
questionnaires
Implementation of Proposals of WPACMR I! Minutes of the first meeting of the WPRO/TDR Focal Group Minutes of the seoond meeting of the WPR/TDR Focal Group Report on the Meeting of the Scientific Working Group on ~ japonioUII Assignment Report (25 November-18 December 1971) Applied Field Research on Malaria Current Research on Malaria in the Western Paoific Region FilariaSis Studies
ICP/RPD/OOI WPR/ACMRI78.5. I WPR/ACMRI78.5.2 WPRI ACMRI78. 5.3
Dr H. Gilles
Dr W. van Dijk Dr M.J. Colbourne
Dr L.S. Self
WPACMR III Report page 30 Annex 3
WPR/ACMR/78.5.11
Cultivation of M. leprae United Nations University World Hunger Programme
Dr T. Muroh""hl Dr P.S. WHO/WPRO WHO/WPRO Dr I. Prior Ven~~tachn'em
WPRlHandbook IX.7 WPR/Handbook IX.S ICP/CVD/oal
Review procedures: research grants Review procedures: research training grants Assignment Report (Visit to Australia, New Zealand and Singapore, 11-30 November 1977)
-
ICP/CVD/OOl
Assignment Reports Dr S. Hatano (visit to Republic of Korea, (31 October - 5 November 1977), Japan (3-8 October 1977), Philippines (10-28 October 1977» Information Booklet on Btomedical and Health Service Research RPD/WPRO Dr D. Rowley
WPR/ACMRI78.5.5
Recent Progress in the Field of Dierrhoeal Diseases
Research proposal on the "Study Dr T.E. Tupasi-Ramos of N. gonorrhoea in the Philippines" ICP/RPD/OOl Assignment Report (visit to Fiji, Papua New Guinea and the Philippines, - 8 December 197720 January 1978) Dr R.M. DouFlas
SEA/RESI7 Report on the Research Study SEA/Haem. Fever/23 Group Meeting on Development SEUVaccine/91 of Dengue Virus Vaccines Research proposal on health services, "Towards Alternative Approaches to Health Development in Underserved Communities" ICP/RPD/001 Assignment Report (visit to Australia, Japen, Malaysia, Philippines, Singapore 18 February-22 March 1978) Report on Attendance at 1978 SEARO/ACMR
WHO/SEARO
Department of Health/ManilA Philippines Miss F. Flynn
WPR/ACMRI78.6
Dr D. Macfadyen
WPACMR III Report page 31 Annex 3
WPR/ACMRI78.7
Report on a Field Visit to Australia and New Zealand (27 February-10 March 1978) Summary of Research Proposal on Health Manpower by the Regional Teacher Training Centre The Development of Potential Value of Dengue Vaccines A Review in Cardiovascular Community Control Programs Advances in Fertility Regulation
Dr D. Macf?1ven
WPR/ACMRI78.8
Dr K.R.
COY
WPR/ACMRI78.9.1 WPR/ACMRI78.9.2 WPR/ACMRI78.9.3
Dr J.A.R. Miles Dr S.V. GU7man Dr S.S. Ratnam Dr R.N.V. f~asad
'"'""'