WORLD HEAlTH ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU R~GIONAL OU PACIFIQUE OCCIDENTAL
•
ORGANlSATION MONDIALE DE LA SANTi
REG ION:.L COMMITTEE Twenty-fifth session Kuala Lumpur 2-10 September 1974
WPR/RC25/14 7 Sept ember 1974 ORIG IN1!L: ENGL .lSH
RERiRT OF THE SUB-COMMI TTEE ON PROGR;i.l\fME :JID BUOOET
1 2
Introduction .•...............•...••..•..•....•.• , ..•
1
Review of budget performance 1973 - direct service s to governments of the Region by subject · he~ding, ~ by oolmtry a nd by project •••••••••••••••••••••·••••••••• Modifications to the 1974 and 1975 regular progra.trl:ne and budget estimateS · ................ , .........•..... Review of the proposed programme and budget estL~ates for 1976 and 1977 .........•....•.•.. ·....... ~.. . • . • . . 4 .1 4 .2 4 .3
2
3
3 5 5 5
4
General observations • • • • • • • • • • • • • • • • • • • • • • • • • • • Regional D irector 1s Fro gramme Statement and Summar i es . . . . . . . . . . • • . . . . . . . . . • . . . • . • . . . . • .
Regional progra'llme and sub-programme statements, sununarized by programme and sources ·. ()£ funds· and schedules ........ , . .. .......•.......•. ,........ 4.4 Regional Office, Regional :.dvise!:s and WHO Representatives • • • • • • • • • • • • • • • • • • • • • • • • • • • • 4 .5 Field activities including int ercountry · proj e cts ........ , ......•.•...... , . . . . . . . . . • . . . • 4.6 Consideration of the List of :~dditional Proj ects for 1976 and 1977 ss well a s the r evised list fo r 1975 ~ ............. ,............ .. .......... 5 6
6
10 11 11
Consi der ation of t entat i ve projection for 1978 and 1979 •.•........•...................•.......•.•.•..•• Resolutions .... , ..................... , .•.... . •..... .
14 14
~JPR/RC25/14
page 1 1
Introduction
At its seventh session, the Regional Committee, in resolution WPR/RC7 .R7, decided~ "that the establishment of a. sub-c'ommitte.-: on programme and budget, consisting of six members plus the· Chairman of the Regional Committee, should become a routine activity of the ~egional Committee"; and recommended- that "the membership of. this sub-committee be rotated among the Representatives of various Members,· subject to the provision that any R:presentative desiring to be a me!T'.ber. of the SubCommittee should be entitled to participate". At its twenty-first 1 session, the membership·of. the Sub-Committee was increased to half the Members in the Region~ ' The Sub-Committee on Programme and Budget met on Wed.nesday afternoon, 4 September, and considered·its draft report on Saturday morning, 7 September, under the chairmanship of Tan Sri Data (Dr) .~dul ~~jid bin Ismail. The attendance was as follows: ~~robers
in accordance with the principle of rotation: Dr Nhonh Bun Yay Dr Emmanuel Fernandez
Khmer Republic Laos Malaysia
Dr Dr
Phouy Phoutthasak ~\itthikay Vilaihongs
Datuk Paduka (Dr )Abdul viahab bin Mohd. Ariff Dr i~a j a _Ahmad Noord in Mr Onn bin Kayat Dr Gurmukh Singh l'tr Cheong ~veng Hooi Dr Tai Yen Hooi Datuk (Dr) Abdul Khalid bin Sahan Dr G.. V. Denis Dr J. Dizon Dr D. Rivera Dr Rui Albuquerque·Ribeiro da Costa Pinhao Dr Longuinhos Monteiro Xavier Dr A .. G.Ko Chew Dr . Ng Kwok Choy Dr J.C .. King V1r F .s., Cruz Dr f•i. Kumang ai
Philippines Portugal Singapore United States of America
Western Samoa Papua New Guinea
Dr J oCo Thieme. Dr
i:.. Tarutia
"Half the llflembers" means. that half an odd number would b e the next higher full number - e.go' one half. of. 1'1 is 9o
1
t-JPR/RC25/14 page 2 me~~ers
Other
of the Committee also in attendance were: Dr :R. \v. Cumming Dr Peni Vuiyale
Australia
France Japan New Zealand Republic of Viet-Nam
Dr J. L(ligret Dr R. Okamoto Dr R. Dickie Dr Tran Quy Nhu Dr Pham Quang Tuan i::· Eguyen2-Viet-Danh D:- J ;A .B. tricholson
United Kingdom
The Ret;ional Director was also present. Dr Hesselv~k, Director of.Health Services, acted as Secretary. He was ass:.stcd by Mr Kakar; 3UdGet and Finance Officer. The Sub-Co:rJ]1li ttee ·had: be for~ it the tollo\'ring documents: HPR/RC25/··. c.::-::,..1. Add .1
Prop0scd proGra~me and budget estimates for 1976 and 1977 SuGgcrted guidelines for the SubCornmitte8 on Programme and Budget Dud;_;8t r;f'rform3.nce 1973 - Direct servic~,-; to governments of the Region b~· subject hcadi~g, by country and by project Proposed programne and budget estimates for 1976 a~d 1977· Tentative projections fOr 1978 and
WPR/RC25/P&B/l
l-1PR/PC25/Pc".:3/2
\lfFil/RC25/P&B/3
\-IPR/RC25/P&:B/4
1979 WPR/RC25/P&B/5
Proposed
progra~me
and budget estimates,
1976 and 1977 (Extra budgetary funds) 2 Revievr of budget performance 1973 - direct services to governments of the Region by subject heading, by country and by project (Document HPR/RC25/P&B/2)
Dr Hesselvik, Secretary, drew attention to Annex 1 of document WPR/RC25/P&B/2 •~h5.ch shovted by subject heading the original budget
WPR/RC25/14 page "3 estimates, those revised in the subsequent year~~d the obligations incurred. Although the percentages shown seemed in some places to indicate rather large deviations between the budgetted sum and the sum obligated, partictllarly for the smaller allp.cations·, large dir'ferences _were n~t apparent f~om the figures therns.elves. T~e overa,ll. implementation.picturewas reasonably close to the provisions originally made .•. That the total implementation figure was no higher than 88.7% was due to the fact that .the original allocation included ·an amount of over US$600 ,000. W:hich the D:i..rector~General did not in the end make available"'t6· the Re.g ioh. ·The differences between the planned programme and that ' cielive.red were ·ci~e to unforeseeable factors such as changes ·. in government requests and priorities, and unexpected delays in recruitment. >•
3
Modifications to the·1974 and 1975 regular programme and budget estimates (Paragraph 4 and Annexes 1 and 2 of document WPR/RC25/P&B/3)
The -Secretary drew·the attention of the Sub-Committee to paragraph 4 of ·document WPR/RC25/P&B/3 and Annexes 1 and 2 which contained information on the differences between_the 'original and the revised estimates for the twc:>" years:· It had been necessary to revise the estimates ' for both year'~ because provisions for the People Is Republic of China were no . fonger applicable.and because five classes of post adjustment had to be inc orpo rated in· the salar ie-s o.f professional staff decided by the Executive Board .
as
. The Representative ofAustralia referred to Paragraphs 4 . 2 and 4.3 of document WPR/RC25/P&B/3 and pointed out that the programme for the People's Republic of China was shown in the Official Recordsl as $1:000000 for 1975 and $900 000 fo~ 1974. . Mr Kakar, Budget and Finance Officer, stated that the comparison made ·in document \ofPR/RC25/P&B/3 was based on the budget presented 'to' the Twenty-fourth Regional Committee contained in document WPR/RC24/2.
4
Rev1ew. of the· pi'oposed pi'ogramme and budget estimates for 1976 ' and 1977 (Documents \-IPR/RC25/2 and Add.l and paragraphs 1, 2 and 3 of document WPR/RC25/P&B/3) General-observations
4.1
Tll:e ·_Sub-Committee noted that the form of presentation of the proposed programme and budget estimates bad been changed as a result of a resolution of the TWenty-sixth w'orld H~alth Assembly (WHA26.38) which had decided that ~'ever~ two years starting 1975 a proposed budget prepared by the Director-General covering the succeeding two years shall be placed before the Executive Board and the Assembly."
1 off. Rec. Wld Hlth Org., 1973,
~.
page 669.
WPR/RC25/14 page
4
Document WPR/RC25/2 contained information for 1974, the revised budget for 1975, and the proposals for 1976 and 1977. The document ,was essentially programme-oriented. · The Representative or Western Samoa ·asked what were the l .egS:i imp11ca.tions .of .introducing a biennial budget. in anticipat'ioh ·the approval of arnendrrlents ·to Articles· 34 and 55:· of the Constitution:
of
Mr Kakar, Budget .and .Finance Officer. ·explained that the pos;i.~ioq . had been clarified bY the.Tw~nty..:sixth World Health.Assembly in . reso,l,~tion WHA26.}8. 1 The ·legal position . w ·bul<i' ber·c overed by the World Heait~ · · Assembly approving an appro'p riation ~es: Olution concerning ·only one :· financial<year~ · ·· · · . ·· · · · · · . · ·· ·
The Sub-Committee noted that information was provided on the present situation, the objectives to be attained, and the m~a.ns . :to be emp.loyed to rea~ize .· the:~targets~ : · .T~ 1 ?p~ogramme .had· been estab1ished· in :S..c c.o rdance with the Fifth General Programme of '~fork for the Organization a· whole and the Fourth Regional Programme of Work adopted by the Regiona\ Committee at ft~ · twenty-first se.s sibn (resolution WPR/RC2l.R7), the recom~~ndations ·of ' the· Regiortal 'Qommittee at previous sessions, the decisiqns o~ . the ·Executive' Bo~rd ahd the. World Health A.$sembly, and the results t~f ~valuatin$ some . of the prog'ramrries. . .. . ' . '.. . ..
as
. .. Tne Organization was frequently . pl~c-ed in a. difficult situation. in its efforts to meet requests from MemberStates as these covered a generally wide range of health activities and it ~as not al\1ays PQ.ssible t-6 tit ·them into ·the limiteli. ·resources . avail~ble. · The problem was..how)?o strike .the correct balance . 'be~ween trie continuation of support to . acti:Vities already operation; in ' order' \o saf~guard: .t heir ultimate::'5~. cceas,'~.. . . . . . . ·' . . . • .. c . ' ·and . the sometimes bolder course of embarking on new ventures. The question could be raised as to wheth~r in fact it was justified to devot~ such a sizeable 'part of the avaii~ble funds to continuing projects. some!, cases, the ~swer was ~f 'Course , ~lear; fq~ e:lcample. it was ne~essary ' to continue support to :the malaria eradic~tion programmes until victory had been obtained and tl)us to safeguard the investment already made~ .. In ongoing· projects, important .irino'vations were frequently possible a;nd could fact be made. sometirii~s radically, changing.,the chat;'acter of the project. Such projects t<~ere severely s crutinized see whether continuation in their present for~ was jus tified.
in
:.in.
in
to
The trend in favour of intercountry ~ct 1vi.t ies as opposed . to . country projects was continuing. _ It was belieyed countries and . terr.i.tor~es . in . the ·RegiOI1 . were bec?ining inore 'i)rpgress!vely able to ·make . us~ .o(tbi.~ _.,,typ.e of assistance. • The 'group '~ educitiorial activi-ties 'proposed. would' be,ne, , eit' ., tl:le . , . . . . • ' . ·•v . ,, \ ) . whole. Regiori a considerabie part of ·it. The trend toi-Jar~s .th_e,.us~ .~f short-term :consultants rather than long~tenn fi~ld 's taff h~q al~o· , cori~inued.
or
1off. Rec. Wld Hlth Org., 1973~ 209, , page 21.
1tlPR/RC25/14
page
5
,It was against this general background that a budget had been prepared wh1chamounte:d to $9.7million. in l976andto $10.3 million in 1977. The 1977 figure was slightly more than 5. 5% above that for 1976. The Table on page ) provided information on the funds expected to be available to the Region from sources othcr.th~ the regular budget. There appeared to be a considerable decrease in this type of e.ssistance but this did not necessarily mean that the assistance would be as low as that shown. The different budgetary cycles of the organizations involved meant that firm approval mie;ht only com~ later. r·~ ~-::.::: ;:;·~r;ssc.l th:;.c it "~c.s the responsibility of Mel!lber counJc:oies themse:lves to m3.ke requests for assistance to the United Nations Devci.opment Progrmmne e.nd the United Nations Fund .for- Population Activities. The Representative of Hestarn Se.'t'oa asl~ed if the 'e.dditional cost of $369 000 in 1975 mentioned in ·Paragrz.~h 4.2 of doctrncnt \-JPR/RC25/P&B/3 was ·to cover the use of ave:~agas c-~d -if ·so. v:ould any ·savings in the operational year he available fo!' !.'~·--~.: ·_ ':'::;:.'::.:::m::.ns~ Mr Kakar, Budget end Finance Offic~r, stated tr.at the amount· of $369 000 111as :required to m~et th-:: co.£t o!: incorporatine; 5 classes of postadjustment into the ~ -:.).c>.rJ.es of th~ profe::;.sic!'l~l staff.
4. 2,
B~gionaJ. Director's Progra~1e S'tater~1~nt .2-.E~~)umrnaries (Doct'Jn~r!t H::R/RC25/2, pe.ger: iv-::: •!n;_l 3·12)
-Rcferrins to the statcm~mt th!it most of th'3 projects were continuing . projects,· ths Rcp:-·(~r.;entativc of the U~:l'.tc ::l St.c.tes of Ar.1erica expressed the hope that consider:ltion 1•;ould b~ g~v~n ta introducing new projects. He also rt:m:).r:~ed ths.t th~ increaz~ in int:::l'Cotm-~ry projects was really not so lart;c as ·~a.s r.~zntion~d in docum:::mt t>!PR/RC25/2. Th9. Represcnt<::.tive of ·.:8stc:r:'l Scrr.o<, \'T:>.nted to knm>~ the criteria for assistance to cour.t:-:-ias, particule:.!'\'i to t'"1'"' le<l.st develop-;d countries.
The ReGion8.l Dirccto:..' stated that th~!'e ·:~as a mandat~ to give special consideration to tha least C~t;veJ.opc d cOlJ.ntries r;:nd that WPRO endeavoured to abide by it. The ab.sorptio~ cr.pC\~)ty of ~:.he country and the assistance received by it from other s c.urces •::. ~ o .f c~··.l~·:-:e t.:.~~cn into consideration. The r.apr~ s~nt ativo cf l >)·,• Z3:;.:,land asked '"hY there "'ere no provisions in 1976 und9r cancer, cardiovascular diseases, a~d other chronic none o.rnmunicable diseases since ther·~ wao ~revision in ).977.
Mr Kakar, Eud~et and Pinance Office r, ::ooplied that the assistance provided was in th3 form of consultc.ntGhips. No raquests had been received for 1976 probably beca u se follo\·1-up action would not be required until 1977 on reports of consultn.nte \:ho would carry out assignments in
1975.
~lPR/RC25/14
page 6
4.3 Regional programme and sub-programme statements, summarized by progranune and sources of·funds and·schedules (Document WPR/RC25/2, pages 15-155) In reviewing the regional programme and sub-programme statements the Sub-Committee noted ·the following: Strength::ming of Health Services (pages 22-31} The gouls of this programme t1ere to .make health care accessible to the largest possible segment of the population and to ensure that the services provided were effective and effici·crit,' Emphasis had been placed on a more systematic approach the.!"l previously, and modern methods, such as opera.tional research and country health programming; were being promoted at different levels. In additiori to .the country :projects, workshops on basic health services, a:: ue11 as intercountry meetings oh hospital mam.gement and rehabilitatio~ - for \'>'hich it \.;as hoped to arrange UNDP funding - had been proposed. Tho sw:1.-:11.ry on page 31 showed that for the regular bt!dget, a certain increc.se for 1976 and 1977 as compared with 1974 and 1975 waG propos~d. The Representative of Australi~ corr~cnted on the very small increase in the 1976 provision over thst for 1975: j_ n 1977' there was· a decrease over
1976. Mr Kakar, Budget and Fin.::.nc'3 Officer, . said that this was because fiealth Ma.YlpoNer I;evzlopmznt ho.d absorbed some of the training activities previously budgetted under Strengthening of Hehlth Services. Health Laboratory Services (p~.g~s
32-35)
.The intercountry progr?:.ITine ~onsisted of as~istance in .the organizati('n of services, technical h::Jlp for th:a proJuction of vaccines and biologicals, and t~~ining. A sominar on blood transfusion services was proposed for 1976 and a course for l~boratory mP.thods blood transfusion
for.1977. Family Heal t!1 (pages 36-1~3)
in
This p:'ograrnm:: aimed c.t the clevclopment of :f:::n~.ly P~-~nning activities .as an · impor>.t ant and. integrated part of the general nealth services, · particularly .those directed at mothers and children, and the preparation of the he alth services to meet new nee ds res ulting from the introduction of family planning ... The family health programme, therefore, included maternal and child health,. f amily planning, nutrition and health education and :.'. i~:-ci. at an integrated app1.•oach with close collaboration between these areas and other components of the general he alth services. The major part of the activities was funded by the United Nations Fund for Populati<m Activities and i t t'fas hoped this support would continue.
WPR/RC25/14 page 7 Nutrition (pages 44-46) The insidi'o us nature of malnutrition often hindered apprec,_ : tation of the need for remedial action. In an effort to improve nutritional surveillance to encourage the formulation of national food and nutrition policies, and to promote staff training and' • the integration of nutrit.iQ.n· :tnto the general healthservices, it was proposed to create an intercountry nutrition advisory services project. '!'his would consist of a medical and a non-medical nutritionist whose services would be available to all countries of the Region at their request. Health Education (pages 47-50) Basically. each health worker should be encouraged to recognize his personal responsibility as a health educator. For this he needed training and support and the regional programme, primarilY geared towards integration of health education into other health activities, had that aim in view. Health Manpower Development (pages 51-56) This field had always been one of major WHO involvement. This remained so, although the ways in which Member countries wished to make use of the resources of the Organization were changing. The recent promotion of a systematic methodology for the estimation of manpower needs in _various fields was of particular interest. Another important trend was the . development of' national teacher training centres ['or which the lVHO Regional t'eaqher' Training Centl:'e in Sydney was serving as a model. Communicable Diseases (pages 57-60) Although morbidity _and mortality patterns varied very widely within the Reg1on, communicable diseases _were still very important health problems. as evidenced by malaria, tuberculosis, cholera, parasitic infections and dengue fever. The proposed ~egular . budget proviaion had been increased from approximately US$1.7 million to US$1.8 million. Epidemiological Surveillance (pages 61-63) Becat<se or lack of infomation on the incidence and prevalence of' diseases, it was difficult in many countries to plan logically for their prevention and control. The intercountry team, composed of an epidemiologist and an entomologist, would therefore .continue. , Malaria and Othel:' Parasitic Diseases (pages 64-70) The regional malnria programme aimed at (a) assisting eradication programmes by providing them with technical guidance and support 7 · (b) assisting countries and territo~ies where malaria .had been eradicated to maintain the malaria-free status and (c) assisting governments and territories where malaria eradication was not feasible at present to
WFR/RC25/14 page 8 plan, implement and evaluate their malaria control operations as an interim measure towards ultimate eradication. The proposed programme for malaria and other parasitic diseases for 1976 and 1977 foresaw activities on approximately the same level. Bacterial Diseases {pages 71-74) Attention would be paid to a variety of diseases such·as plague, cholera and other gastrointestinal diseases, diphtheria, pertussis and tetanus. To a large extent, the solution of the problems connected with thi.s group of diseases was one of environmental hygiene; in particular,· the provision of adequate water supplies, proper waste disposal and proper food sanitation. However, a radical decrease ln the importance of diseases preventable by immunization,. such as tetanus, should be possible using quite limited financial means. Assistance would be provided mainly by th~ intercou.,Y}t.ry epjdemiologica1 team. Leprosy (pages '75~76) _Although leprosy was lesa prevalent to4ay than previ~usly the nurnb~r of cases in certain CO'Untries in the Region was considerable. A~sistance would be provided undel" the individual country programmes. TUberculosis (pag~s
76-79)
Tuberculosis pres~nted a pictur~ o:f cor1trasts. Some· countr.tes in the Ree;i<>n had the low~st prevalence figure~ in .th~ world, other:s, the highest. Altho\J.gh most count"t"ies in the Region had an organized ·tuberc~losis ~antral serv!c~ in on~ ·foni'i Qr: ,another,. WHO assistance was still z:~quired, It was thus propos~d to maintain :_the ·regiorial tu'6erclliosis 'cont~ch ·' team, to ccinthlUe the regional tube~culosis courses and to assist the· reg1onal BCG vaccine labol"atory •. Vector Biology and Control (pages 86~88.) The scope and variety of problems caused by disease vectors was considerable but the technical means for. dealing with them were developing QUickly. Assistance would be given partly through the services of the intercoliritry epidemiological team, Partly on a country pz:_o_Ject basis. A r~g_1onal serrt:i.n.'ar bn the safe use Of pesticides was also P'I'Oposed. Non-CoJT.r.lUnicable Disease Prevent;i.on and Cont?-ol (pages 89-98) There was no doubt that a nwnber of chronic<iiseases such as cancer and cardiovascular a:t.lments were. oeco;nihg more important in. the Region. It logical to increase the.resources devoted to the. study and contl':'ol of this group"of diseases·; US$350 000 had been -propo.sed fbr i977 compared . . ·I •·•·· . . .>, with; just undel"·iJs$200 000 ·allocated. in 1974. The _progr~e. on can,cer would be' 'mainly devoted to a follow .uP in.1977 on a naticinal basis· of the
was
WPR/RC25/l4 page 9 working group on the organization of comprehensive cancer control programmes which would be helC:i.": in 1975. The programme in cariiiovascular diseases followed·a similar course. A second intercountry meeting was envisaged forl97!s and provi~:i.on for follow up at a national level proposed for 1977. Dental Health (pages 99-1?~) This was a;-long:-term programme aimed at the strengthening of national dental health services, especially in preventive dentistry, through increased coverage of vulnerable groups. Particular attention would be given to utilizing dental therapists. It was proposed to maintain the intercountry dental health auviser, to arrange for workshops in dental health education and to conduct yet another course in public health 4entistry. Mental Health (pages 102-103) The progr~e in this field was still very modest and it was clear that other prQbiems ha.d been given a higher prior:tty in rnany Member countries. Awareness of the importance of including mental health training in the basic ed.ucation of health staff was increas'ing. · .Fbr this reason, Provision had been made for consultant months and fellowships. Alcoholism and Drug Dependence and Abuse (pages 104-111) This was a field which was pre~occutJtng health authorities to an inc~easing degree. To respond to expressed needs and requests the ~egiopal progr_~e was expanding rapidJ,.y •. ·After- the working group on Preventive: meas:ur.es envisaged. ·for 1974, a ~pecialized officer, probably a psycbiatris.t,with special experience. in drug problems, would be employed t'rom 1975 onwa.rx:ls~ A working. group ~ri health education programmes for . Young people. as it concerned, drug abuse to be held in 1975 would be followed in 1976 andl977 by a working group on early inte~ention ·progranunes ·ahd a second work~ng group' on health education for young people as it concerned drug •. abuse. .. Promotion of Environmental·Health (pages 112-127) Population. growth, the increased ra~e
of urbanization and industriali-
zation had brou.ght :f'orth riew environmerital health problems
and
had aggra-
Vated traditional ones, Against just over US$8oO 000 in earlier years the programme no~.p;rop9sed.for 1976 and .1977 was planned at a level · US$200 .000 higher. · In. addition~ sheable 'support was expected from UNDP. Biomedical and Environmental Health Aspects of Ionizing Radiation (pages 128-131)
In the field of the biomedical and environmental health aspects of ionizing radiation, the programme was expanding rapidly because of the
WPR/RC25/14 page 10
increased use of X-ray or other, radiation""emitting equipment.~" It was pr<:)posed: to continue the services of .~.the intercountry' techrlician for training in mai,nt,~mance and repair of·X~ray. and other equipment and '' the radiation health advisory services team would be strengthened by the addition of a radiological technician tutor. Food Standards Programme (pages 135~136)
This · progr.amme consisted of the :.services of a consultant to· assist in problem identification and. progra.nune planning. Health Statistics (pages 137-141) The purpose here was to continue assistance towards developing the national structures and procedures required for.. the accurate and comprehensive recording and interpretation of data on national vital and health statistics. Increasing attention •·wuld be given to gathering relevant information for planning, managing and evaluating the health services. It was proposed to retain the services of the intercountry health statistician, to provide some conf3ultant months, and to convene a regional seminar on vital and health statistics with the sub-title "The Use of Computers for the Health Informa:tion System"
4.4 Regional Office (pages 162-166) Regional Advisers and WHO. Representatives (pages 3,..98~ 175}
A. limited in,crea.se in st~ff,ing was ·proposed, namely, one', adininistrative assistan:t in tne Bu.reau of .Healtb S~rvices ·and two typist·s in the stenographic pool. ·~',l;'hese addd,.~ions. were. deemed. necessary. ito handle the··.increased~. workload anQ. ·:w§!re 1 toget)ler :with, .:the.: auto~ti·c i. cost increases, 'responsible ' for· the ·i ncrease 111 the total,.,,for · : the.: .RegionaL Office ··from·~ about ·us$1: 34 million in l975 to ~VS$1~4.Tmill;top_·in l976:and US$1·~6omillion' in.l977·> No change was.propo~E?d in.t}:le I}Umber of Regional Advisers ~ and.the ' increase in cost ~CI.~ .e.n;t,ir~lyAue to -,the higher general cost level'. .It was proposed to add qn~ ..new post under: WHO .Rep~esentatives·•: namely that·. of a cd>untry programme manager. This, plus the automatic cost increases was responsible' forthe total going up from about US$470 000 to US$530 000 in 1976 and US$58o 000 in 1977 • The Representative of Western Samoar . requested details. of the new post . of country programme :manager.: The Secretary.-stated tbat in vie\-t·~ of the greater emphasis on ·country programming and t11e decentralization of activities at country level, it would become necessary to strengthen the WHO Representatives' offices; this was the first post included in the budget.
WPR/RC25/14 page 11 4.5 Field activities includL~g i ntercountry projects (Document WPR/RC25/2, pages 178-340) The Sub-Committee noted that the title of Annex IV should refer to countries and territories. These project.s .had been established as the result. of direct consultations between the governments concerned and the Regional Director and his staff. The intercountry projebts had been endorsed by governments.
4.6 Consideration of the List of Additional Projects for 1976 and 1977 as well as the revised list for 1975 (Documents WPR/RC25/2, pages 360-392 and Document WPR/RC25/2 Add.l) The Sub-Committe~ n~ted that requests .totalling US$2 204 580 for 1975 had had to be placed in the List of Additional Projects. They could not be accommodated in the budget estimates because of limitation of funds, although they were tech.n.ically valid. · The: ·Regional Director would naturally, to the extent that savings became available, do his best to accommodate these requests. · If they were considered to be urgent governments should review whether some other part qf the WHO-assistance provided :to them deserved lesser priority and could be relinquished. The following additional requests for assistance in 1975, 1976 and 1977 were presented during the meeting of the Sub-Committee:
HMO 01 - Fiji School of Medicine Adviser for three years starting. in 1975 in connexion ·with the course for medical assistants. Six 12-month fellowships in 1975 to take part in the course for medical assistants (firs t year) in Papua New Guinea .:. French Polynesia . HMO 99 - Health manpower development fellowships Three-month fellowship in dental health in each of the years 1975, 1976 and 1977. One-month fellowship in dosage for residual pesticides in 1975. CVD 01 - Cardiovascular diseases survey Consultant for two months in 1975.
WPR/RC25/14 page
12
One medical .o ffi cer for 1976. and 1977. Ti·lO ntU"s es . for 1976 ·and .1977 One consultant for two ·months ih 1976 24 fellowships (8 for nllrses, 8 for : anaesthetists and 8 for handling instrt.unents) Supplies and equipment fui1:!.:J2.toj"ect__: "Inte.ns ive- care_ · un.it.§. Two medical officers . (ot>.e· f ·o r·each -unit) for 1976·. and 1977 Two nurs es (one for each· unit) for 1976 and 1977 . . One . con::~tll;:ta.nt _ for two ,.months in-.1976 Supplies ..a nd e:gu:Lpment New ...groject ,;. F\ibllc health §.§rvic§§. Local costs in 1976 and 1977. to pay for ten· public health officers (one for ·each of the 'ten public health centres tc: be opene d). . . Note~
The request for consultants in health planning , statistics, health education and malaria· was not ed-and could be: met from intercountry projects and/or f~~m .the Rogion~f Of,fice.
NUT Ql - Nytrttiqn_advisor.y_§.ervices · uS~3500 for supplies and equiprneirt;. in 1975 ffi'ID Ol-=.Jigsl.th~!112Q'.fer development
12-month tell6wshi~ i~ 1975 ill$3500 for supplies and equipment in 1975 ESD 01 - Dis~§..~_m:.gygptiQ!l.__Q11\i_~ontrQJ..
four sets VHF type .Y!i ty Hoe and one generator in l 975 Ne~...J2r.Q.kct
- H ental health
Cons11ltant for thrse months in 1975 DHS__.Ql_::_.Vits!.L?.nd health st~tj.stic§.....adyisory ~§.!:YiC~.§.
One 12-month fellowshi p in health statistics for 1975 T£$'3500 for supplies i. and' equipment' in '1975
WPR/RC25/14 page 1'3 Malaysia STR 01 - Development of health services One consultant for four months in 1975 to complete the final draft of the Public Health Plan. One public health administrator for 1976 and 1977 3x2 consultant months for the intercountry health
planning course in 1976 and 1977 One 12-month fellowship in 1976 and 1977 One six-month fellowship in 1976 and 1977 VBC 01 - Vector control An adviser for the Vector Control Unit in 1976 and 1977 One 12-month fellowship in 1976 and 1977. Philippines HMD 01 - University of the Philippines One 18-month fellowship in health economics in 1975 MPD 01 - Malaria eradication programme The post of adviser on training (entomologist) to continue in 1976 and 1977. Republic of Viet-Nam MBD 02 - Leprosy control
A consultant for three months
1n 1975
SES 01 - Environmental health advisory services The second post for a sanitary engineer to continue in 1975 and 1976. Singapore New project A project manager for two years for the supervision of construction of a hospital of 1300 beds.
\vPR/RC25/14 page 14
5 ''
Consideration of tentative projection for 1978 and 1979 (Document V'JPR/RC25/P&B/4)
The Sub-Committee noted that the tentative projection had been prepared in· response. to the 'World He2i.lth. Assertib1y::resolution dealing inter.~ with biennial.prcigramming (resolution '~JHA22 ;53). For this purpose, . the. Dll-ect"or-General provided each ·. Region with a tentative allocation fer··. the two years .succeeding: the programme and budget years under· revimv •. The t-2ntative allocation for' the years 1978 and 1979 for this Region was,US$10 840:000 and US$11 <136:000 7 respectively. i-~.nnex 1 of document ~.VPR/RC25/P&B/4 had beenprepared on .th~ basis of t he priorities established. by governments for assistance in 1977.
S
rt.esolutions
The Sub-Committee recommended to the Regional Com.;nittee that it adopt the following resolutions:· (a) Budget performance 1973 - Direct services to governments (WPR/RC25/•vP/l5). 1-iodifkations made to the 1974' and 1975 programme and budget estimates (\11PR/RC25/\..JP/16) Proposed pro9rarrune and budget estimates for 1976 and 1977 WPR/HC25/~•;p/17)
(b)
(c)
(d)
Tentativ~ ..-projections of the budget · estimates for 1978 and 1979, (HPR/RC25/1tlP/18}