he World Health Orgnnlzolion · the specialized agency of the United Nations ~ ·tern responsibl f r int •mAtionr~ l health. It formally came into existence on 7 April 194 . Th objectiv •o Wl I is the attainment by all peoplesofthehighest possible level of health. By means of tcchnico l coopcrnlion \ lth its 168 Member States, and by stimulating collaboration among th •m, WH rrornot '!o th • • • • • • • Development of comprehensive health services Prevention and control of diseases. Improvement of environmental conditions Development of human resources for health Advancement of biomedical and health research Planning and implementation of health programmes
In practice, WHO activities • • • • • • • • Promote and protect the health of peoples everywhere Combat malnutrition Facilitate the transfer of health technology Promote mass immunization Improve mental health Provide safe water and basic sanitation Strengthen health administrations Train health personnel
WHO also contributes to better health by fostering international cooperation in such matters as: • • • • • Establishing international standards for biological substances, pesticides and pharmaceuticals Formulating environmental health criteria Recommending international nonproprietary names for drugs Revising the International Classification of Diseases, Injuries, and Causes of Death Collecting and disseminating health statistical information
WHO operates on a regular programme budget funded by Member States and on extrabudgetary resources provided by governments, nongovernmental organizations, UN agencies and other donors. WHO has its headquarters in Geneva, Switzerland, and six regional organizations, each consisting of a Regional Committee and a Regional Office, headed by a Regional Director. The Regional Offices are for Africa (BmZZlluille); the Americas ( Washington, D.C.); South-East Asia (New De/It,'); Europe (Copenhagen ); Eastern Mediterranean <AI~xandria); and Western Pacific <Manila).
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he success of community activities depends largely on the par_.. troi:pation and involvement of the individual members of the community. We have seen this in health work that faltered because the people did not take part in the process. Information is a key. Cooperation comes easier to people who are kept informed. People who know and understand how and what it takes to keep in good health could be expected to be more active in community health undertakings. In this respect, health promotion and advocacy assume major roles. Everyone should know why they should- and how they can - improve their own health. People should understand the effects of their own behaviour not only on their own health but on others as well. Everyone should be an advocate for health. For this reason I have placed health promotion as one of the priority concerns of WHO in the Region during this decade. Equally important are our thrusts on human resources for health, environmental health, eradication of selected diseases, exchange of information and experience, and management skills. Together they make up the profile of WHO's work in the immediate years ahead. These priority areas are outlined in this pamphlet. I hope that readers will have a grasp of the international cooperative efforts for the health of all peoples in the Region. We also present an overview of WHO as an organization and its leadership role in international health. An understanding of WHO and its programmes should enable readers to appreciate the value of international cooperation in health matters.
S.T. Han, MD, Ph.D. Regional Director
September 1991
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he Western Pacific Region of WHO is spread over a vast area, extending from China and the Republic of Korea in the north to New Zealand in the south, from Malaysia and Singapore in the west to Cook Islands and French Polynesia in the east. Covering nearly a third ofthe world's population, the Western Pacific is perhaps the most culturally and socially diverse of the six regions of WHO. The Region embraces some of the world's least developed countries as well as its most rapidly growing economies. It includes countries as varied as Australia, with its federation of six states; Japan, with its industrial might; Papua New Guinea, with its abundance of natural resources; and Tonga, a kingdom built amidst coral atolls. The following are the WHO Member States in the Region:
Australia Brunei Darussalam Cambodia People's Republic of China Cook Islands Fiji France (responsible for French Polynesia, New Caledonia, and Wallis and Futuna Islands) Japan Kiribati Lao People's Democratic Republic Malaysia Republic of the Marshall Islands Federated States of Micronesia New Zealand Papua New Guinea Philippines Portugal (responsible for Macao)
Republic of Korea Samoa Singapore Solomon Islands Tonga United Kingdom (responsible for Hong Kong) United States of America (responsible for American Samoa, Guam, Commonwealth of the Northern Mariana Islands, and Republic of Palau) Vanuatu VietNam Associate Member Tokelau
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The work of WHO in the Western Pacific is the responsibility of the Regional Committee and the Regional Office. The Regional Committee, composed of represen tatives of all Member States in the Region, fornmlates policies of a regional character and reviews th e activities of the Regional Office. The Regional Office began operations in Manila, Philippines, in 1951. Headed by the Regional Director, it is responsible for the execution of WHO programmes and for monitoring regional activities. In addition to the staff based in Manila, WHO Representatives hold office in many countries, where they represent the Regional Director in the coordination of WHO programmes at the country level. Past Regional Directors have been: Dr I.C. Fang, China (1951-1966); Dr Francisco J. Dy, Philippines (1966-1979); and Dr Hiroshi Nakajima, Japan (1979-1988); The present Regional Director is DrS.T. Han of the Republic of Korea. He assumed the post on 1 February 1989, succeeding Dr Nakajima who took office in July 1988 as Director-General of WHO. Dr Han holds an MD and Ph.D. in Medical Science from Seoul National University, and a Master of Public Health (MPH) Degree from the University of Minnesota, USA. In the Western Pacific Region of WHO, Dr Han served in various positions since 1967, including those of Director, Programme Management (1979-1988) and Special Representative of the DirectorGeneral (July 1988-January 1989).
The WHO Western Pacific Region
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THE FUTURE OF PARTNERSHIP IN HEALTH IN A REGION OF RAPID CHANGE
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any of the emerging health issues are linked to the fast pace of insmalization and urbanization in the Western Pacific. In many ys, social and economic changes have brightened the outlook for health;.however, these have also brought about new environmental hazards, changing disease patterns and spiralling health care costs.
The handling and disposal of hazardous wastes, for instance, will remain a critical concern for many years. Noncommunicable diseases have gone up in developing countries, so with threats such as HIV infection and AIDS. People now live longer. In itself an indicator of progress, this has resulted in a growing proportion of elderly people. All these place an even larger demand on what already are overstretched resources for health.
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The coming years will see major advances in technology for disease prevention, diagnosis, treatment and rehabilitation. With the successful development of Hepatitis B vaccine, many countries and areas have included this with the six other antigens in their national immunization programmes. (Childhood diseases targeted by the Expanded Programme on Immunization are: diphtheria, measles, pertussis, poliomyelitis, tetanus and tuberculosis.) With the use of multidrug therapy, health officials now think in terms of eliminating leprosy in some Western Pacific countries. New technologies alone cannot ensure the provision of efficient and equitable health care. For this reason, increasing attention has been- and will remain- focused on the organization, planning and !llanagement of health services, particularly at the district level. WHO sees its role as promoting and stimulating technical cooperation in such areas as health workforce planning, programme monitoring and evaluation, and developing health management information systems. The last forty years have shown that much can be done by countries working together towards common health goals. Such a partnership has become even more indispensable, as countries intensify their efforts and mobilize their resources to achieve Health for All by the year 2000.
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These six areas will receive priority action in the Region before the end of the century. • Human Resources for Health • Health Promotion • Environmental Health • Eradication of Selected Diseases • Exchange of Information and Experience • Management Skills
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eople with the right skills are the cornerstone of any health system. When health personnel are well-trained, adequately motivated and equitably distributed, all other resources for health can be efficiently utilized. The traditional emphasis has been on the education and training of health professionals. Now, greater emphasis has been placed on the planning and management of the health workforce. This came about with the recognition that the need was for personnel of the right type and in the right quantity. Among the specific activities under this programme are: developing innovative approaches to training personnel; convening seminars and workshops on health workforce planning and management; and providing opportunities for research and professional growth through the Regional Fellowship Programme. The main thrust will be the orientation of health personnel towards community service and primary health care.
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any health problems arise from the way people behave and the lifestyles they choose. Cancer, heart disease, diabetes, and AIDS (acquired immunodeficiency syndrome) are, to a large and increasing extent, "diseases of choice". Along with accidents, they have replaced infectious diseases as the leading causes of illness and death among adults in much of the developing world. Health promotion means helping people protect and improve their health by maintaining a healthy lifestyle. It means making people aware that they are responsible for their own health. It also means keeping people informed so that they can take action on their own, or with others, to confront health problems. Promoting healthy lifestyles involves government policy-makers, community leaders, and the mass media.lt calls for new approaches and innovative strategies which respond to the unique setting and conditions of each locality. Among WHO's activities in this area are: promoting better nutrition, including breastfeeding; minimizing mental and neurological disorders, as well as alcohol and drug abuse; enhancing the health and safety of workers; and protecting the health of mothers and children.
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he link between health and the environment has become all too / eV,ident in the Western Pacific. .
Industrial growth and the continuing influx of peopl to the cities have generated a wide range of health hazard . Housing, safe water supplies, sanitation and garbage disposal systems bareIy keep up with the p ace of development. Keeping food safe has become far more complex, owing to the emergence of issues such as chemical contamination, labelling and advertising, shelf life and storage. Air and water pollution are growing problems, as are the handling and disposal of hazardous wastes. On the positive side is the increasing awareness of the need to preserve, protect and enhance the health of our planet. WHO works closely with Member States to fight environmental hazards and to maintain the health of planet Earth. WHO promotes policies and activities to: improve drinking water supplies and basic sanitation, control environmental health hazards, assess the health risk of potentially toxic chemicals, enhance food safety, and integrate environmental health concerns with rural and urban development.
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he disappearance of poliomyelitis before the end of the century "V~ll represent a major triumph for public health. It will be matched only by the global elimination of smallpox in the 1970s. In this Region, the target is to achieve polio eradication by 1995. Special efforts are being undertaken by the six remaining polioendemic countries to increase immunization coverage, intensify surveillance and institute outbreak control measures. Polio eradication also calls for improvements in the handling and storage of vaccines, the training of district health personnel, and the establishment of laboratory referral services. Multidrug therapy was introduced in 1983. It is now possible to plan the eventual elimination of leprosy* in certain countries and areas of the Western Pacific. Multidrug therapy can cure the paucibacillary form of leprosy in six months, using two drugs, and the multibacillary forms of leprosy in two years, using three drugs. It has been shown to be highly effective against the disease. As of 1990, about six out of every ten patients in the Region were undergoing such treatment.
.. Defined in epidemiological terms as a prevalence rate of less than one per 10,000 population and an incidence rate of less than one per 100,000 population.
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ealth is increasingly seen as a concern that knows no national borders; countries should therefore strive to learn from one another. The sharing of information, ideas and experience provides the key to improved policies, programmes and strategies for health. WHO plays a significant part in making Technical Cooperation among Developing Countries (TCDC) a reality by ensuring equal access to information on health matters. As the agency responsible for international health work, WHO encourages countries of differing political and economic systems to confront together the many health problems that continue to afflict humanity. Meetings of health leaders, scientists and expert groups from around the globe are convened. Their findings or recommendations are made available, through WHO publications, to all countries. Meetings organized by WHO are held in a spirit of frankness and trust, openness and understanding. They cover a wide range of health topics with one common objective: the pursuit of know ledge that would allow the attainment by all people of the highest possible level of health.
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ince the late 1970s it has become clear that national health sy~,tems needed to be reorganized and reoriented to achieve the essential elements of primary health care. Progress in the direction of primary health care has been slow in a number of countries. The reason for this lies not so much in logistical difficulties or scarcity of resources as in weaknesses in the organization, planning and management of health services. In simple words, good proactive managers can move mountains whereas managerial incompetence makes everything impossible. WHO Member States have increased management training activities at all levels of the health system. Work has shifted in recent years to the intermediate level of the health system, commonly made up of districts, counties and sub-provinces.
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romoting and conducting research are constitutional obligations of WHO. Research in the field of health, whether on health systems or biomedical and social concerns, is a sine qua non for the prevention of diseases, care of the sick, and delivery of essential health services. WHO does not establish research institutions on its own.lt maintains close working relationships with existing institutions of high scientific and technical standing. Officially designated as WHO Collaborating Centres, these institutions together make up a vast collaborative network with the broad objective of developing and sharing technology for health within and outside the Region. WHO Collaborating Centres perform a wide variety of tasks: developing new vaccines and diagnostic reagents; studying the effects of radiation on humans; identifying ways to strengthen health care delivery and health information systems; disseminating information on herbal medicines and acupuncture; and other functions. WHO Collaborating Centres also provide valuable training opportunities in their respective areas of specialization. As of July 1991, there were 195 WHO Collaborating Centres in the Western Pacific Region.
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he Centre for the Promotion of Environmental Planning and Applied Studies (PEP AS) began operations in January 1979. Based in Kuala Lumpur, Malaysia, the Centre serves as a technical arm in environmental health of WHO's Western Pacific Regional Office. PEP AS activities are in the areas of community water supply and sani- _ tation, environmental health in rural and urban development, solid waste management, management of toxic and hazardous substances, air and water quality management, noise control and food safety. Specifically, it collaborates with Member States in: * Developing policies for environmental health and resource enhancement; * Strengthening national environmental institutions; * Education and training of environmental health personnel; * Providing technical information on environmental planning and engineering, and human ecology; * Monitoring, collection and processing of information for environmental planning purposes; * Solving problems related to the improvement of environmental conditions and the protection of natural resources against pollution; and * Identifying and promoting low-cost, appropriate technology.
An Advisory Committee meets biennially to review and provide guidance on the various programmes of the Centre.
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WHO publishes books and journals on a wide range of topics relevant to public health. The technical publications make available the advice of international expert groups convened by WHO, the results of WHO-supported scientific studies and information collected from Member States. Increasing emphasis is placed on primary health care materials, including training manuals, policy guides and documents on new approaches to health care and services. · Periodicals published by WHO include: World Health, a highly readable illustrated magazine available in eight languages; and World Health Forum, a quarterly journal in six languages, providing a forum for discussions and exchanges of information on health and development issues. WHO publications may be purchased from appointed sales agents; from major booksellers and subscription agencies; or from the Distribution and Sales Office, WHO Regional Office for the Western Pacific, P.O. Box 2932, 1099 Manila, Philippines. Buyers from countries and areas in the Western Pacific Region, except Australia, Japan and New Zealand, are eligible for a discount of 30 per cent from the established Swiss franc price. All direct orders may be paid for in local currency. A catalogue of WHO publications is available on request.
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World Health Organization Regional Office for the Western Pacific P.O. Box 2932 1099 Manila, Philippines WHO Representative United Nations Building 2 Dongqijie , Sanlitun 100600 Beijing People's Republic of China WHO Representative P.O. Box 113 Suva, Fiji WHO Representative P.O. Box343 Vientiane Lao People's Democratic Republic WHO Representative P.O. Box 12550 50782 Kuala Lumpur, Malaysia WHO Representative P.O. Box 5896 Boroko, NCO, Papua New Guinea WHO Representative P.O. Box 2932 1099 Manila, Philippines WHO Representative Central P.O. Box 540. Seoul, Republic of Korea WHO Representative P.O. Box77 Apia, Western Samoa WHO Representative Newton P.O. Box 31 Singapore 9122, Republic of Singapore
WHO Representative P.O. Box 52 Hanoi Socialist Republic of VietNam WHO Country Liaison Officer House 120 Street 228 Sankat Chadomuk Khan Daun Penh Phnom Penh Cambodia WHO Country Liaison Officer P.O. Box210 Bikenibeu Tarawa, Kiribati WHO Country Liaison Officer P.O. Box22 Honiara, Solomon Islands WHO Country Liaison Officer P.O. Box70 Nuku'alofa, Tonga WHO Country Liaison Officer P.O. Box 177 Port Vila, Vanuatu PEPAS
P.O. Box 12550 50782 Kuala Lumpur, Malaysia
WHO Technology Transfer Programme Office 6th Floor, National Medical Centre 1-21-1 Toyama, Shinjuku-ku Tokyo 162, Japan
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