WORLD HEA.L'IH ORGANIZATION REGIONAL COMt-1ITTEE
REGIONAL OFFICE FOR
THE WESTERN PACIFIC
WP/RCS/Min/3,
Rev.l 1 November 1954
Fifth Session Manila 10-16 September 1954
ORIGINAL:
ENGLISH
MINUTES OF THE 'IHIRD MEETING Manila at 9:00 a.m •
•
CHAIRMAN:
DR. F •
s. MACLFAN
CONTENTS 1
Address by the Chairman Review of the Aprroved Regional Programme and Budget for 1955 in the light of present budgetary adjustments and consideration of amendments proposed by member countries Adoption of resolutiont on the Annual Report of the Regional Director Statements by Observers
4
2
5 13 14
3 4
WP/RC5/Min/3, Rev.1 Page 2 Third Meeting
Saturday, 11 September 1954 at 9:00 a.m. Representatives present AUSTRtJ.L'~
Dr. H. E. Downes Dr. You Chhin Dr. Mam-Komsann Dr. J. Heng Liu Dr. C. H. Yen Medecin-Co1one1 Robert Augere Dr. Marcel Demange Dr. Takemune Soda Mr. l~kira Saita Dr. Haing In Paik Mr. Yun Young Lim Dr. Koukeo Saycocie Dr. Chao Souvath NEW GUINEl~
C.i'Jii:OODIA CHINA ( TAIW1ili) FR:i.NCE JAPi!.N KOREA LA.OS NETHERLI~NDS
Dr. J. Bierdrager Dr. F. S. Maclean
PHILIPPINES
Dr. Dr. Nr. Dr. Dr. Dr. Dr. Dr.
Rafael Tum.bokon Tranquilino Elicaiio Marcelo Angeles Demetrio Lacuna Clemente Gatmaitan Antonio Rodriguez Arsenio C. RegaJ.a antonio Ejercito
PORTUGM.
Dr. Joao llbino Ribeiro Cabral Dr. Dr. Dr. Dr. R. L. G. R. E. Anderson J. Clapham Graham-CUmming H. Blan:i
UNITED KINGDCM
UNITED STl~TES VIETNAM
Dr. Horace DeLien Dr. Richard K. C• Lee Dr. Le Van Khai
WP/RC5/Min/3, Rcv.l Page 3 Observers present BIOMETRIC SOCIETY FOREIGN OPERATIONS JJMINIS T&1 TION INTERNl.TIOI.:rliL OOMI'U'ITEE OF MILITaRY MEDICINE & HIARMACY IN~\TIONAL
Dr. Manuel M. Aycardo Dr. Bertha Moore Dr. i.~.rthur F. Raper Colonel Joaquin A. Sanchez
COUNCIL
Miss Annie Sand
OF NURSES
TI'l'l'ERN.L\TIONllL DENTAL FEDERATION INTERNI. .TION,\1 FEDERATION FOR HOUSING & TOWN PLANNING INTERNii.TIGNIJ. LABOUR ORGi:.:NIZATION ROCKEFELLER FOUNDATION SINGAPORE EPIDEMIOLOGICAL INTELLIGENCE STATION SOUTH PACIFIC CCIIMISSION UNC - OFFICE OF THE ECONOMIC CO-oRDINATOR FOR KOREA. UNITED NATIONS CHILDREN'S FUND (UNICEF) UNITED Nl~TIONS KOREAN RECmlS'IRUCTION AGENCY
Lt. Col. A. Zarate Dr. J. Nilo Gonzales Mr. i...nselmo T. I~lquinto
Kr. Juan L. Lanting Dr. O. R. Dr. M~Coy
w. w.
Yung
Dr. Guy Loison Colonel Ralph
v.
Plew
Dr. Franco Mortara Dr. F. Hennessey Mr. H. G. Keith Mr. E. R. Chadwick
UNI'IED NATIONS TECHNIC..U, ASSISTANCE BOARD WORLD MEDICAL ASSOCL\TION
Dr. Sixto 'YJilceda, Jr.
Members of Technical Discussions Panel present Dr. A. Dalisay Dr. H. Lara
Dr. O. R. McCoy Dr. J.S. Peterson Dr. A. F. Raper
WP/RC5/Min/3, Rev.l Page 4
1
ADDRESS BY THE CHAIRMAN 1 Item 3
ot the Apnd.a.
The CHAIRMAN expre seed hie ver:r groat appreciation ot the honour paS.4
to his countr,y and to himself in electing him to tho office of Chatrman. He assured the Committee that he would do his best to carry out the important duties of this responsible office to the satisfaction of the .Committee and that he lmew he could re]¥ on the support of the Secretary and on the cooperation of the Members of the Committee. Not the least of the valuable
work done by 14HO was the opportunity provided for meeting fellow workers from other countries, and receiving the stimulus and support of both the formal and informal discussions that took place. The CHAIRMAN welcomed es-
pecially Dr. Gear who had been very closely connected 'With the Organization, first as a delegate representing his country, then as a Member of the Executive Board, including the Chairmanship of the Board, and now as .A ssistant·-i>irectorGeneral.. The CHAIRMAN also extended a welcome to the Observers attending refer~d
the meeting who represented a large number of important international organizations in official relationship with the Organization, and in particular
to the representatives of the United Nations Children's Fund and tre United Nations Technical Assistance Board, both of wham worked in very close association with WHO. Despite the financial crisis which had necessitated a substantial review of the progranme in this and other Regions, tre year just past had been one of considerable achievement. Ultimate benefit might accrue from these financial difficulties as it was probably good to have to review the available financial :r;-esources occasionally, and see that every dollar was spent to good effect. As far as New Zealand was concerned, the CHAIRMAN felt that during the past year the relationship with WHO had been considerably strengthened. work of WHO prominently before the people of the country, and reference had been made in the press to the proceedings of the Seminar and to The
Dental Seminar held in Wellingtcn had provided an opportunity to bring the
tm
/work of WHO
WP/RC5/Min/.3, Rev.l Page 5
work of WHO generally.
It was apparent that the work of WHO both in this The most obvious achievements had been in the Other
Region and others, was peginning to produce results, in some cases in a most spectacular manner. mass . control of diseases such as Malaria, Venereal Diseases and Yaws.
activities such as Maternal and Child Welfare, Environmental Sanitation, Health Education and Training, ani the strengthening of Natioml Health Administrations wuld take longer to· come to fruition, and in the long run, it might be necessary to place more importance on these aspects. The full effectiveness of WHO's Wl7rk was shown by the statement in the detailed Bu~get
and Programme Proposals on the contributions of recipient
governments. When the total of all the sums spent by all the Governments was added up, the true function of WIO appeared to be to encourage other people to sperrl ~oney
and to show them how it could be spent so as to produce stim~ting,
the best results.
The CHAIRMAN then expressed the wish that all the repre-
sentatives attending the meeting would find it enjoyable and
and that they would depart with the finn conviction that the work of WHO in this region was becoming increasingly productive and that its ultimate achievement would depend in a large measure on the active co-operation of every Goverhment within the Region. REVIEW OF THE APPROVED REGIONAL PROGRAMME AND BUDGET FOR 1955 IN 'lHE LIGHT OF PRESENT BUDGETARY ADJUSTMENTS AND <DNSIDERA TION OF AMENDMENTS PROPOSED BY MEMBER OOUNTRIF.S 1 Item 9 of the Agenda.
In presenting document WP/RC5/.3, the SECRETARY stated that it was important to recall that during the Seventh World Health Assembly the Director-<leneral's proposed budget had been reduced by $811,100, ~nd at the same time the Technical Assistance funds did not reach the ceiling anticipated for 1953. This had necessitated adjusting a large programme into a much smaller budget allocation and the result had been achieved in the following ways: (a) in certain cases, projects, especially fellowships, had been
advanced from 1955 to 1954 and financed out of savings; /(b) in other
WP/RC5/Min/3, Rev.l Page 6 {b) in other cases, negotiations were conducted between Member Governments and the Regional Office for permission to postpone the implementation of certain projects until 1956, and (c) those projects, which in the opinion of Governments were not of
urgent importance, were assigned to a supplementary list which could be implemented when more funds became available. A comparative table of what had been done was contained in the docwnent entitled "Modifications in the 1955 Programme and Budget" which had just been distributed.
Dr. DeLIEN (USA) said it was essential to face the situation realisticall~ and facts and problems must be considered. He reported on the situation insofar as the United States of America was concerned, and stated that there were uncertaint.i es regarding the future amount and status of contributions to the
UN Technical Assistance Funds for 1955, 1956, and subsequent years so that it was not possible to predict the total amount which would be available. He therefore felt that it would be appropriate to pass the following resolution "WHEREAS there are uncertainties regarding the future amount and status of contributions to the UN Technical A.ssistance funds for 1955 and 1956 and subsequent years;
WHEREAS it is impossible to predict the total amount of these funds that will be available for these years; Because of the ~bove
circumstances the Regional Director should
designate such projects to be financed from UN Technical Assistance Funds so that they are at the absolute minimum permissible under existing commitments to Governments, the same consideration applying for 1956, Now therefore be it resolved them." The SECRETARY, in commenting on the proposed resolution, stated that at the last session of the COmmittee, the tentative amount allocated from /Technical Assistance funds th~t
the Rogional Committee direct
the Regional Director to take note of these facts and be guided by
WP/RC5/Min/3, Rev.l Page 7 Technical Assistance funds had been $850,000, which was based on the total contribution of about 20 million dollars. The total amount had, however, been decreased to 12 million, which reduced the WfRO allocation to ¢550,000 and the 1956 budget had been based on this figure. The situation had, however, ccnsiderably improved, and in July of the present year, the total amount had been increased to $14,000,000. In determining the budget, however, the conservative total of $550,000 had been used and it might not therefore be necessary to pass the proposed resolution. Dr. DeLIEN (USA) stated that as far as the United States representative
was concerned, it still appeared necessary to pass the resolution. The CHAIRMAN invited the United States representative to put his resolution into writing so that it might be studied in further detail. The SECRETARY then informed the Committee that the Regional Director had no authority to establish amounts when making a budget. The Health _ Assembly decided the amount available for the Regular Budget, the TechnicalAssistance Board approved the Technical Assistance allocation, and the Director-General then decided the allocations to each Region in accordance with the funds available. The llegional Director then acted on the instruction; from the Director-GPneral. Mr. SAI~
(Japan) said that he wished to ask two questions before con-
sidering the proposal of the United States representative: (l) As there was only ¢550,000 available for Technical Assistance programmes in 1955 and 1956, did the Regional Director consider that this was sufficient to implement all the projects listed under Priority I, II and III? (2) How soon would WHO be notified by the Technical Assistance Board regarding the funds allocated to the WHO programme? jT:ne SECRETARY stated
WP/RC5/Min/3, Rev.l Page 8 The SECRETARY stated that the amount of $550 1 000 was insufficient to implement all the programme requests. It had 1 therefore 1 been necessary to advance some projects into 1954 and to defer others. As far as the Regular Budget was concerned, the allocations were determined after the Health Assembly had met in Z.lay. In the past 1 the Technical Assistance allocations were not known until the beginning of the year, but a new pro_ cedure was to be introduced which would result in t~is
information being
available in November/December of the previous year.. The chances of overestimating the money available were therefore slight. Mr. SAI~ (Japan) asked the Secretary what the routine procedure was in regard to savings, and how these were made. The SECRETARY explained that savings were made on projects which it had not been possible to implement at the beginning of the year o!dng to delay in recruitment. It was not possible to foresee how much it would be possible to save at the beginning of the year and, therefore, most of the project savings became available only towards the end of the year. Mr. SAITA (Japan) stated that he was satisfied with the explanation given. Dr. REGALA (Philippines) referred to document WP/RC5/4, page one, on which were shown the amounts allocated for items in the adjusted programme and compared the figures with those given in Official Records 50. In the adjusted budget there was shown an increase of ~14,876 in the amount allocated to the Regional Office, whereas theve was a reduction of $90,755 in field projects. Although the Philippine Government was well satisfied with the amount allocated to the Regional Office, they were much concerned by the decrease in the allocation for field projects which were of primary importance to all governments. Dr. REGAIA therefore proposed that the following resolution be considered by the Committee: /"The Regional Committee
WP/RC5/Nin/J,. Rev.l
Page 9 11
The Regional Committee Having regard to the reduction of the ti:l.ceular Budget of WHO
for 1955 in the amount of $811,100, Recognizing the necessity for adjusting the progra.mme in the Region in order. to effect its total share of the reduction, Considering the adjustments made by the Regional Director in document l.JP/RC5/4, Believing that field activities for the Region are of urgent importance in developing and strengthening health services of Member States, REQUESTS the Regional Director:
(1)
to maintain in 1955 the level of staffing and allocation
in the Regional Office as given in Official Records No. 50, page 420; (2) to distribute the balance over and above this amount in
the adjustment made by the Regional Director to field a.ctivities." Dr. LEE (USA) asked the Secretary how much had been saved in the 1955 budget by advancing progranmes to 1954 and by deferring progr~s
until
1956. The SECRETi\RY drew attention to the comparison table distributed to the Committee, and stated that if the United States representative was interested in receiving information on the estimated amounts saved, this could be arranged. Dr. ynrr CHHIN (Cambodia) noted with satisfaction the assistance given to the Royal School of Medicine in Phnom-Penh and expressed appreciation of the agreement reached with the Faculty of Medicine in Paris inxegard to an exchange programme. It was however regretted that it had been necessary to suppress the post of tuberQulosis specialist, as this programme was an /extremely
WP/RC5/Min/3, Rev.l Page 10 extremely important one, and he hoped that this fact would be taken into account if any further adjustments were made. In replying to the remarks of the Philippine representative, the SECRETt\RY stated that there had in actual fact been no increase in the staff of the Regional Office, but that the increased amount shown in the budget was due to statutory increases which occurred every year. (WHO, Geneva) Dr. GEtJt/gave a brief resume of the background leading up to the changes which had been made and stated that i t had been the wish of the Health The Assemb~
that the reductions which had to be made should not inter-
fere with the standing obligations of the Organization towards its staff. Assemb~
had in fact suggested that the 1\frican and Western Pacific
Regional Offices should be strengthened. Dr. EJERCITO (Philippines) stated that if' there should have to be a reduction every year in field projects in order to meet such obligations, this sacrifice might be too great, and he should like to draw the attention both of the Regional Committee and WHO Headquarters to this point. In replying, Dr. GEAR assured the Philippine representative that Headquarters was fully aware of the importance of protecting field activities, and i f there were any savings, these were allocated for this purpose. The decision in regard to statutory obligations to staff members had been made by the Health Assembly and not by the Director-G0neral. The CHlilRi.'iAN suggested that the Philippine resolution appeared to be in direct conflict with that of the last Health Assembly, and it might be amended to include reference to the importance of keeping field activities at as high a level as possible. Dr. REGrJA (Philippines) stated that when the resolution was presented, there was no intention to weaken the Regional Office staffing, merely to /emphasize
WP/RC5/Min/J, Rev.l Page 11 emphasize the importance of field activities. It might therefore be
amended to include reference to the importance of keeping the Regional Office staff at the same level as suggested in the 1954 budget with the understanding that in 1955, the necessary statutory increases would be provided. The SECRETARY stated that the Regional Office had never intended to provide additional posts in view of the financial crisis, but the maximum desirable structure required to carry out effectively the various regional activities had not yet been achieved. If an organization is to be effective, it must confor.m to a basic pattern which would not be changed irrespective of additions or reductions in field activities • . Dr. DeLIEN (USA) stated that the United States resolution was now read~
and he would like to refer to the Senate Report 2268 of the Senate
Appropriations Committee which showed that it was not possible to conunit Congress, an:l emphasized the uncertainty insofar as future allocations to TAED were concerned. Dr. KOUKEO SAYCOCIE (Laos) drew the attention of the Committee to the fact that nothing had been provided in the 1955 and 1956 budgets for the continuation of the Yaws Control Project in his country. approve. Dr. DOWNES (Australia) drew attention to Resolution WP/RC4/Rl21 1955 Programme Priorities, which gave the Regional Director authority to establish priorities but did not qua lify this authority in any way. He felt that this had been a wise move and that the Regional Director had, with the liMited fup.ds a:t his disposal, presented a fine balance between
This did, however,
appear .in the supplementary budget which he hoped the Committee would
recipient countries. Dr. DOWNES suggested, on behalf of his Government, that if there were any further savings in 1954, these funds should be /appropriated
WP/RC5/Min/3, Rev.l Page 12 appropriated in favour of Cambodia, Laos and Vietnam in view of the situation which existed in these countries. Dr. REGALA (Philippines) endorsed the suggestion of the Australian representative, and suggested further that priority be given to projects in Cambodia, Laos and Vietnam from savings in 1955. Dr. YOU CHHIN (Cambodia) thanked the representatives of Australia and the Philippines for putting forward this suggestion. Dr. LE VAN KHAI (Vietnam) also expressed the thanks of his Government for the suggestion made an~
referred
to
page 42 of WP/RC5/4, Fellowships
under Technical Assistance. He asked that consideration might be given to the transfer of these fellowships to the Public Health Administration programme under the regular budget. The CHAIRMAN then asked the Committee to consider the resolution of ~he
USA representative who had made some minor amendffients to the text. Dr. TUMEOKON (Philippines) seconded the proposed resolution. Mr. SAITA (Japan) asked for cl.4rification on two points before voting: (1) As far as the 1955 budget was concerned, both the R8 gular
and Technical
A~sistance
programmes had been approved by the lioal.th Assembly.
Could the Regional Committee therefore take action as far as this budget was concerned? (2) UN Technical Assistance funds were voluntary contributions, and approval of the budget did not mean that it was obligatory to continue contributions to this fund. Dr. GEAR (WHO, Geneva) stated that the Technical Assistance programme adopted at the Seventh World Health Assembly did not represent an approved /progranune
WP/RC5/Min/3, Rev.l Page 13 programme in a budgetary sense. The Tochnical Assistance Board distributed
funds to the specialized agencies according to an approved pro-rata distribution, and programmes were only implemented insofar as funds were provided for every TA financial year. As far as the U& resolution was concerned, the general sentiment expressed in it was only in part within the control of the Regional Director, as the amount of funds that WHO would receive was dictated by the Technical Assistance Board. Mr. SAITA (Japan) asked the USA representative to comment on the second point he had raised. Dr. D&LIEN (USA) stated that the object of the resolution was to call the attention of the Regional Director to the uncertainty of the availability of Technical Assistance funds, so that he might assess with caution the fund trends and possible receipts from WHO, Geneva, and try to limit any tentative distribution of estima tod. allotments to the minimum re,:),uirements. The CHAIRMAN then asked the Committee whether they had any objections to the adoption of the resolution, . the purpose of which was to stress the need for caution in dealing with projects financed from Technical Assistance funds. The resolutio'n was then put to the vote. (WP/RC5.R2) Seven countries voted in its favour, one against, and there were five abstentions. resolution was therefore approved.
-
The
J
RESOLUTION ON THE ANNUAL REPORT OF 'IHE REGIONAL DIRECTOR The draft resolution on the. Regional Director's Annual Report was
then considered by the Committee. Dr. REGAIA (Philippines) asked when it would be possible to implement the post of Regional Statistician and Programme Evaluator. The SECRE~Rf
stated that this position might be reinstated in 1957, /provision
and if it were possible to do so earlier, it would need additional
WP/RC5/Min/3, Rev.l Page 14 provision from Headquarters. Dr. REGAIA (Philippines) suggested that a modification might be made in the 1956 budget to accommodate this post. The draft resolution was then adopted, the phrase "Regional.Director" in paragraph (c) having been amended to "Organization"• .,. (WP/H.C5.Rl)
The CHAIRMAN suggested that further discussion on item 9 be deferred until the next meeting of the Oommittee. This was agreed, and the all~IRMAN
then called on the following Observers to make a 'statement:
4
STATm-iENTS BY OBSERVERS Miss SAND (International Council of Nurses) expressed the gratitude
of the International Council of Nurses for the opportunity of attending the present session of the Committee, and stated how much her Organization had appreciated the choice of theme for World Health Day in 1954. Lt. Colonel ZARATE (International Dental Federation) stated that he had been interested to hear of the Dental Health Seminar which, however, appeared to be the only activity in this field. He suggested that the Organization might establish a fellowship programme in this field, a dental health programme, and appoint a dental consultant to the Regional Office, as in rural areas in the Region, dental health was taken care of by people other than dentists. Dr. PETERSON (WHO, Geneva) stated that the problem of dental health was at the moment being considered by Headquarters and that a meeting was scheduled for ~
September to
~ich
an observer of the International
Dontal Federation had been invited. It was hoped that a constructive programme might result from this meeting. The CHAIRMAN thapked the observers for their statements and declared the meeting adjourned. -o-