REGIONAL COMMITTEE Fifty-seventh Session Kurumba, Maldives 7-9 September 2004
SEA/RC57/14
9 September 2004
DRAFT REPORT OF THE FIFTY-SEVENTH SESSION OF THE WHO REGIONAL COMMITTEE FOR SOUTH-EAST ASIA
CONTENTS Part I Part II Part III INTRODUCTION.......................................................................................................... 1 INAUGURAL SESSION ................................................................................................ 2 BUSINESS SESSION................................................................................................... 3
SUB-COMMITTEE ON CREDENTIALS ......................................................................................... 3 ELECTION OF CHAIRMAN AND VICE-CHAIRMAN ....................................................................... 3 ADOPTION OF AGENDA AND SUPPLEMENTARY AGENDA, IF ANY ............................................ 3 DRAFTING GROUP ON RESOLUTIONS ...................................................................................... 4 THE WORK OF WHO IN THE SOUTH-EAST ASIA REGION: REPORT OF THE REGIONAL DIRECTOR – 1 JULY 2003 – 30 JUNE 2004 ........................................................ 4 PRESENTATION BY CHAIRMAN, SEA-ACHR .............................................................................. 7 STATEMENTS BY NONGOVERNMENTAL ORGANIZATION ......................................................... 7 REVIEW OF PROPOSED PROGRAMME BUDGET 2006-2007 ..................................................... 8 OUTLINE OF 11TH GENERAL PROGRAMME OF WORK 2006-2015..............................................10 REPORT OF THE JOINT EVALUATION OF A SPECIFIC INTERCOUNTRY PROGRAMME – INTENSIFICATION OF CROSS-BORDER COLLABORATION IN PRIORITY COMMUNICABLE DISEASES SUCH AS HIV/AIDS, POLIO, TUBERCULOSIS AND MALARIA, KALA-AZAR, DENGUE AND SARS ...........................................10 CONSIDERATION OF THE RECOMMENDATIONS ARISING OUT OF THE TECHNICAL DISCUSSIONS ON “EMERGENCY HEALTH PREPAREDNESS” ...................................................11 SELECTION OF A SUBJECT FOR THE TECHNICAL DISCUSSIONS TO BE HELD PRIOR TO THE FIFTY-EIGHTH SESSION OF THE REGIONAL COMMITTEE .............................12 REVIEW OF IODINE DEFICIENCY DISORDERS IN THE SOUTH-EAST ASIA REGION .................12 REVISION OF INTERNATIONAL HEALTH REGULATIONS...........................................................14 GLOBALIZATION, TRADE, INTELLECTUAL PROPERTY RIGHTS AND HEALTH ..........................15 ESTABLISHMENT OF REGIONAL COOPERATION ON AVIAN INFLUENZA PREVENTION AND CONTROL ...................................................................................................16 ADDRESS BY DIRECTOR-GENERAL, WHO................................................................................17 REGIONAL IMPLICATIONS OF THE DECISIONS AND RESOLUTIONS OF THE FIFTY-SEVENTH WORLD HEALTH ASSEMBLY AND THE 113TH AND 114TH SESSIONS OF THE EXECUTIVE BOARD ..........................................................................19 UNDP/WORLD BANK/WHO SPECIAL PROGRAMME FOR RESEARCH AND TRAINING IN TROPICAL DISEASES: JOINT COORDINATING BOARD (JCB) – REPORT ON ATTENDANCE AT 2004 JCB AND NOMINATION OF A MEMBER IN PLACE OF THAILAND WHOSE TERM EXPIRES ON 31 DECEMBER 2004...............................19 WHO SPECIAL PROGRAMME FOR RESEARCH, DEVELOPMENT AND RESEARCH TRAINING IN HUMAN REPRODUCTION: POLICY AND COORDINATION COMMITTEE (PCC) – REPORT ON ATTENDANCE AT 2004 PCC AND NOMINATION OF A MEMBER IN PLACE OF INDIA WHOSE TERM EXPIRES ON 31 DECEMBER 2004 .............................................................................................20 TIME AND PLACE OF FORTHCOMING SESSIONS OF THE REGIONAL COMMITTEE .................20
Part I INTRODUCTION THE FIFTY-SEVENTH session of the WHO Regional Committee for South-East Asia was held in Kurumba, Maldives, from 7 to 9 September 2004. It was attended by representatives of all the eleven Member States of the Region, UN and other agencies, nongovernmental organizations having official relations with WHO, as well as observers. A joint inauguration of the Regional Committee session and the Twenty-second Meeting of Ministers of Health was held at Male on 5 September 2004. His Excellency Mr Maumoon Abdul Gayoom, President of the Republic of Maldives, delivered the inaugural address. The Committee elected Mr Ahmed Abdullah (Maldives) as Chairman and Dr Bansidhar Mishra (Nepal) as Vice-Chairman of the session. The Committee reviewed the report of the Regional Director for the period 1 July 2003 to 30 June 2004. It considered the Proposed Programme Budget 2006-2007 and the recommendations arising out of the Technical Discussions on Emergency Health Preparedness, held during the 41st meeting of the Consultative Committee for Programme Development and Management in July 2004. The Director-General of WHO, Dr LEE Jong-wook, addressed the session. The Committee decided to hold its fifty-eighth session in Sri Lanka from 5-9 September 2005. A drafting group on resolutions comprising a representative from each Member State was constituted with Mrs Selina Ahsan as Convener. During the session, the Committee adopted ____ resolutions.
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Part II INAUGURAL SESSION A JOINT inauguration of the Twenty-second Meeting of Ministers of Health and the fifty-seventh session of the WHO Regional Committee for South-East Asia was held at Male, Maldives, on 5 September 2004. H.E Mr Ahmed Abdullah, Minister of Health, Republic of Maldives, extended a warm welcome to the Ministers, the WHO Regional Director and other representatives. Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia Region, welcomed H.E. Mr Maumoon Abdul Gayoom, President of the Republic of Maldives, Ministers of Health and representatives of Member States. He thanked the Government of Maldives for hosting the two meetings, and the Member States for reposing confidence in him. H.E. Mr Maumoon Abdul Gayoom, President of the Republic of Maldives, in his inaugural address, highlighted the importance of good health for prosperity and happiness by quoting an Arabian saying: “He who has health has hope; and he who has hope has everything.” He added that it would be impossible to achieve a 50% reduction in poverty, as required by the Millennium Development Goals (MDG), without a healthier population. Similarly, eliminating gender disparities and increasing school enrolment were vital for better results in health services and systems. His government was committed to achieving the MDGs. In view of the scarcity of resources and the multitude of competing demands, preventive strategies and healthy lifestyles were crucial for sustainability. In conclusion, the President stressed that “we must address our health sector challenges by acting locally, coordinating regionally and collaborating globally. And the greater the cooperation, the greater the chance of success”, he added. H.E Lyonpo Jigmi Singay, Minister of Health, Bhutan, proposed a vote of thanks on behalf of all the Ministers of the countries of the WHO South-East Asia Region. He placed on record the profound gratitude of the Health Ministers to the President of Maldives for gracing the inaugural ceremony.
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Part III BUSINESS SESSION IN THE ABSENCE of the Chairman of the fifty-sixth session, the Vice-Chairman, Professor Mya Oo, opened the meeting. He extended a warm welcome to the representatives and said that Member States had made significant achievements in health. However, concerted efforts were necessary to mobilize additional resources. At the same time, it was imperative to use the available resources most efficiently and effectively. He hoped that the deliberations of the Regional Committee would provide the necessary guidance in this regard.
SUB-COMMITTEE ON CREDENTIALS (Agenda item 2) A SUB-COMMITTEE on Credentials, consisting of representatives from Nepal, Sri Lanka and Timor-Leste was appointed. The Subcommittee met under the chairmanship of the representative of Sri Lanka and examined the credentials submitted by Bangladesh, Bhutan, DPR Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste. The credentials submitted by all countries except Timor-Leste were found to be in order, thus entitling the representatives to take part in the work of the Regional Committee.The Subcommittee noted that the representative of Timor-Leste had submitted a photocopy of the credentials. It, therefore, recommended that the representative of Timor-Leste be requested to present the credentials in original as soon as possible and that in the meantime he be authorized to take part in the work of the Regional Committee in all respects. The Committee accepted the report of the Sub-committee.
ELECTION OF CHAIRMAN AND VICE-CHAIRMAN (Agenda item 3) MR AHMED ABDULLAH (Maldives) was elected Chairman and DR BANSIDHAR MISHRA (Nepal) as Vice-Chairman. Dr Abdullah thanked the representatives for electing him Chairman, which he considered an honour for himself and his country. He recalled the address of the President of Maldives at the joint inauguration wherein he had broadly outlined the vision and thinking of the Region to combat disease and ensure better health for the people. He said that there were many challenges facing the Region in its quest for health and the biggest investment that the countries could make for their progress was on health. The collective will and commitment of Member States were more than necessary to provide improved health care and ensure better health for the people. He was confident that with the cooperation and support of all concerned, the Committee would successfully cover the agenda. He looked forward to the support of the Regional Director and his team.
ADOPTION OF AGENDA AND SUPPLEMENTARY AGENDA, IF ANY (Agenda item 4, document SEA/RC57/1 Rev.1) The Committee was informed that the Royal Government of Thailand had proposed two supplementary agenda items: (1) Globalization, trade, intellectual property rights and health, and (2) Establishment of regional cooperation on avian influenza prevention and control, which had been listed as Agenda items 11.3 and 11.4. In view of the time constraint both these items had been discussed by the Meeting of Health Secretaries, held in July 2004, and their observations and recommendations were contained in the report of the meeting. In addition, the Government of Sri Lanka had also proposed a supplementary agenda item on Control of
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Rabies. This subject had not been included in the Provisional Agenda since an intercountry meeting on the subject was proposed to be held in December 2004. The recommendations and observations made by this meeting would be submitted to the fifty-eighth session of the Regional Committee. The Committee thereafter adopted the Agenda as contained in document SEA/RC57/1 Rev.1.
DRAFTING GROUP ON RESOLUTIONS THE COMMITTEE constituted a drafting group on resolutions comprising one member from each Member State.
THE WORK OF WHO IN THE SOUTH-EAST ASIA REGION: REPORT OF THE REGIONAL DIRECTOR – 1 JULY 2003 – 30 JUNE 2004 (Agenda item 5, document SEA/RC57/2 and Inf.1 and Inf.2) INTRODUCING HIS report for the period 1 July 2003 to 30 June 2004, the Regional Director highlighted the progress made in various areas of WHO’s collaborative activities in the Member States. The main objective was to improve the health status of the people in the Region, particularly the poor and the marginalized, in the context of sustainable development. The Regional Director provided an overview of significant developments, the constraints as well as the measures taken to strengthen health development in the Region. The Report covered the broad areas of: Communicable Diseases; Noncommunicable Diseases and Mental Health; Family and Community Health; Sustainable Development and Healthy Environments; Health Systems Development, and Programme Planning and Management. The Regional Director said that in order to achieve the common goal of health for all, a bold vision was required by the international community to recognize health as a right for all, and not as a privilege for a few. Towards this goal it was necessary to strengthen solidarity and cross-country efforts, recognizing that no country could pursue national development in isolation. * * *
The Committee held comprehensive deliberations on the report of the Regional Director and made the following observations. Lauding the significant role played by WHO in the overall health development of the Region, the Committee acknowledged the new dynamism and vigour brought into its work by the Regional Director, Dr Samlee Plianbanchang. Some of the new initiatives included combating the outbreak of emerging diseases such as SARS and avian influenza by providing relevant technical support and information to all Member States; ensuring better health for people through health education, strengthening country capabilities and capacities, mobilizing additional resources and utilizing them effectively and forging stronger partnerships with Member States. The efforts made by WHO through several regional and national consultations to formulate national and regional inputs for the revised International Health Regulations (IHR) was appreciated. This was of particular significance and relevance against the backdrop of the recent outbreaks of SARS and avian influenza. The Committee noted with satisfaction that polio was on the threshold of eradication in the Region. A sharp decline was being witnessed in the number of cases of vector-borne diseases too. Efforts towards achieving the elimination of leprosy by 2005 seemed very much on track.
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The Committee noted that most Member States had already signed and ratified the Framework Convention on Tobacco Control (FCTC), while a few were striving to sign the Convention in the near future. Following the ratification, the countries of the Region had enacted laws to enforce a ban on tobacco advertisements; on smoking in public places and sale of tobacco to minors and within 100 metres of educational institutions. The Committee felt that sustainable development and healthy environment including occupational health and food safety were important areas which involved sectors other than health, and sought WHO’s assistance to tackle these issues. The Committee acknowledged the need to organize joint and coordinated initiatives among Member States sharing borders including those with countries in other regions, for implementing relevant cross-border health interventions. The Committee requested WHO for continued support in institutional capacity building; strengthening of health care delivery system; strengthening of country capabilities and regional networks; epidemiological surveillance; emergency preparedness and management including early warning system and response, and for mitigating the impact of emerging infectious diseases like SARS. The Committee felt that family and community health, adolescent health and research in human reproduction were other important areas where WHO’s continued support would be welcome. In view of the fact that maternal mortality and infant mortality continued to remain a major cause of concern in many countries, a more equitable allocation of human resources for health between rural and urban areas was required. For sustainable human resource development, it was important to enhance workforce skills. In order to augment health systems development, WHO’S support was vital in training doctors and nurses. Adolescents, forming a big proportion of the population, were at risk for major diseases such as HIV/AIDS, and required increased attention. A regional strategy needed to be developed for adolescent health. The Committee recognized that communicable diseases, particularly HIV/AIDS, tuberculosis and malaria would remain the biggest challenge in the foreseeable future. The “3 by 5” initiative was valid even beyond the 2005 target. Country offices had to be equipped for scaling up activities through the provision of additional staff, training and technical guidelines. Considering the demands of Member States to develop outbreak alert and response capacity in the wake of SARS, avian influenza and dengue outbreaks, it was proposed to move technical support from the Regional Office to the country level by setting up a sub-regional centre for outbreak alert and response in Bangkok. In order to build partnerships for communicable disease control, the Regional Office was moving forward with the development of a bi-regional strategy for emerging communicable diseases with the Western Pacific Region. The Committee noted that noncommunicable diseases and mental health had been recognized as important areas and WHO would move forward to implement the Global Strategy for Diet, Physical Activity and Health which had been endorsed by Member States. The Global Health Promotion Conference, proposed to be held in Bangkok in November 2005, would provide a forum for taking this strategy forward. The Committee was informed that the awareness programme for this year’s World Health Day theme, viz. “Road Safety is No Accident” was a success. The Committee commended WHO’s initiatives in the areas of iodine deficiency disorders and supply of safe drinking water. The Committee appreciated that as part of the public health initiative, a Regional Advisory Group on Nursing and Midwifery Workforce Management had been established to strengthen the capacity of allied health workers in the Region. There was a need to mobilize
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additional resources to ensure deployment of qualified allied health personnel in the countries. Recognizing the need to deal with the impact of globalization and TRIPS in particular, the Regional Office had developed a model legislation to enable countries to formulate appropriate legislation to ensure full use of the provisions contained in the Doha Declaration for public health emergencies such as HIV/AIDS. The Committee was informed that efforts had been made to improve the quality and utilization of Country Cooperation Strategies (CCS) to strengthen WHO country operations. These strategies were meant to identify the most effective support that WHO could provide to countries based on their needs as well as the role of WHO and other key health partners. The CCS should also be the basis for determining the human resource requirements in the country office, and for developing WHO technical assistance plans. The Regional Director assured the Committee that initiatives to strengthen country operations would not be at the expense of programme activities. The Committee appreciated the Organization’s decentralization policy and commended the Regional Director for delegating more authority to WHO Representatives. The purpose of this initiative was to enable WHO country offices to become more responsive to the needs of the countries and to simplify administrative procedures for the implementation of countryspecific activities. Decentralization to country offices would be accompanied by increased transparency and accountability. The Committee recognized the importance of developing public health infrastructure, taking advantage of some WHO programmes, such as HIV-AIDS, TB control and disease surveillance. It was necessary to ensure that health staff in the country received adequate training in public health. There was a need for reasonable balance between medical and public health education in developing health manpower. WHO was willing to collaborate with nongovernmental organizations such as the World Federation of Medical Education in this regard. The Committee noted with satisfaction WHO support in terms of provision of financial resources, as well as medical supplies during floods in three countries of the Region, in addition to assisting in the mobilization of extrabdugetary resources. The Committee was informed about the regional strategy developed in the area of Occupational Health. A bi-regional meeting had been organized between the South-East Asia and the Western Pacific Regions in an attempt to further strengthen collaboration. With regard to food safety, the emphasis was on prevention, with the focus on a ‘farm to table’ approach for reducing food-borne diseases. An awareness programme using information material for street vendors had been developed and translated into 14 regional languages. The Committee, after discussing the Report, noted with satisfaction the progress made during the period under review in the implementation of WHO’s collaborative programmes and activities in the Region. It congratulated the Regional Director and his staff for bringing out a clear and comprehensive report. * * *
The Committee appreciated the presence of Dr Richard Feachem, the Executive Director, Global Fund for AIDS, Tuberculosis and Malaria (Global Fund), who participated at the recently-held 22nd meeting of Health Ministers. The Committee acknowledged the high burden of three diseases affecting the countries of the Region for which the Global Fund had approved proposals worth US dollars one billion over a five-year period. However, it was noted that this was only 11% of the total resources provided by the Fund which was not sufficient to meet the Region’s needs. Thus, WHO and the Global Fund needed to work
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closely with Member States to mobilize additional funds, both from external and internal sources, and to speed up its utilization. The Committee also stressed the need for the Board member representing the Region on the Global Fund to convey the voice of the Region at the Board meeting in November 2004. Two important issues are on the agenda of the next Board meeting: (a) to agree on and suggest other approaches for launching Round Five, and (b) to ensure commitment by donors for the proposed budget for 2005 and beyond.
PRESENTATION BY CHAIRMAN, SEA-ACHR PROFESSOR N.K. GANGULY, Chairman, South-East Asia Advisory Committee on Health Research (SEA-ACHR), reported on the discussions, conclusions and recommendations at the 29th session of SEA-ACHR, held in Myanmar from 14-16 June 2004. The large and highdensity population in the Region coupled with environmental and socioeconomic conditions made the countries vulnerable to emerging infectious diseases (EIDs). This situation was further aggravated due to the mixing of animal and human pathogens as well as due to the high volume of international travel. The situational analysis highlighted the broad areas of research and development in the Region for combating EIDs. The social, behavioural and economic impact of EIDs was analysed with due consideration of policy and management issues involved in EIDs prevention and control. With regard to surveillance, the ACHR discussed the types of studies that needed to be undertaken, the mechanisms to be used, the expected outcome and its time-frame, the benefits of research, and the actors and countries involved in these activities. It also discussed other areas of research including development of new diagnostic tools, discovery of new vaccines and drugs and studies aimed at strengthening laboratories. The ACHR recommended that health research should be an indispensable means to the effective development of health systems and urged Member States to develop and strengthen their capacities for health systems research (HSR) in order to achieve MDGs. It also recommended that health research in EIDs should lead to: (i) strengthening and development of effective integrated disease surveillance; (ii) networking of public health and biomedical laboratories, and (iii) capacity-building and budgetary and financial support. The ACHR urged WHO to promote and support the development and dissemination of tools and methodologies (both qualitative and quantitative) that were crucial for extending HSR beyond conventional approaches. The ACHR also recommended that a coordinating centre (within WHO) be established to: (i) coordinate the work of existing disease surveillance network; (ii) facilitate capacity-building; (iii) conduct situational analysis; (iv) provide necessary support for strengthening capacity for disease surveillance and health research; and (v) improve epidemic alert and response by Member States. In relation to prevention and control of EIDs, WHO should facilitate (i) the use of new framework and cutting edge instruments in implementing effective and efficient health research systems; (ii) public policy analysis including economic analysis; (iii) health research focusing on public and media perception and public responses; (iv) development of work plans within the framework of Asia-wide disease surveillance strengthening, and (v) resource mobilization and implementation.
STATEMENTS BY NONGOVERNMENTAL ORGANIZATION PROFESSOR ARJUNA P.R. ALUWIHARE, (World Federation of Medical Education – WFME), stated that the objective of the Federation was to work towards the provision of competent medical and health service personnel for the community and to assure the highest scientific and ethical standards in medical and paramedical education. The Federation had recently developed and endorsed standards in undergraduate and postgraduate education,
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which were being incorporated in national standards and accreditation procedures in many countries. WFME had special interest in questions related to global standards and accreditation of educational institutions and programmes. Physicians from the countries of the South-East Asia Region accounted for a major share of medical professions in the developed countries such as UK and USA. PROF. M.G. KARMARKAR, (International Council for Control of Iodine Deficiency Disorders – ICCIDD), said that, ICCIDD, a non-profit nongovernmental organization, had pledged its technical expertise for tracking progress towards sustainable elimination of IDD. ICCIDD had the mandate to promote collaboration with stakeholders and national governments in a spirit of partnership. Iodine deficiency disorders adversely affected the learning abilities of children and denied them the opportunity of attaining their full mental and physical potential. ICCIDD was providing technical assistance for public distribution of iodized salt to families below the poverty line, thereby helping to counter macro and micronutrient deficiency. DR V. OKETANI (World Organization for Animal Health – OIE) said that OIE’s missions had become increasingly important and its mandate had been expanded to meet requirements from all over the world. In view of the worldwide demand for improved food safety, OIE sought to work with other relevant organizations in reducing food-borne risks to human health in consideration of the identified need to expand its scientific standard setting activities into safety of animal food. The OIE hoped to achieve its goal in collaboration with the WHO, FAO and their subsidiary bodies. This was obvious from the joint collaborative consultations held in the wake of the recent instances of avian flu and animal influenza which posed hazards to the health and lives of humans and animals. OIE offered to work further with Member States as well as with the regional offices of WHO and FAO for animal diseases and zoonoses control and food safety. OIE proposed to launch later in the year specific programmes such as the Global Framework for Progressive Control of Transboundary Animal Diseases (GF-TADs) with a view to assisting countries in establishing control programmes against avian influenza and other specific animal diseases.
REVIEW OF PROPOSED PROGRAMME BUDGET 2006-2007 (Agenda Item 7, document SEA/RC57/7) The Committee was informed that the Proposed Programme Budget 2006-2007 was the fourth successive biennial programme budget based on an Organization-wide, results-based approach, within the framework of 36 Areas of Work. This was the product of joint efforts by the countries, the regional offices and WHO headquarters. It reflected the Director-General’s proposal to increase the overall level of the budget by 12.8% as compared to the previous biennium. It also contained some new policy directions and major features, as well as key issues affecting the regional and country level allocations. It reflected an increase of 17.4% in the budgetary allocation to the SEA Region, comprising 12.5% from assessed contributions (AC) and 19.8% from voluntary contributions (VC). There was a need to determine the basis for distribution of these resources between countries of the Region and between Areas of Work. The first stage of preparation of the programme budget by Organization-wide Area of Work statements and resource requirements for 2006-2007 had been under way since January 2004. The budget proposal of the Director-General as of July 2004 had been reviewed by CCPDM. The WHO integrated budget represented assessed contributions, miscellaneous income and voluntary contributions. The implementation of WHA resolution WHA51.31 that resulted in shifting of some Regular Budget allocations during the past three biennia was under review. As decided by the World Health Assembly (WHA 57(10), the Director-General had been requested to prepare, in consultation with the Member States, guiding principles for the allocation of all funds to countries and regions for consideration by the Executive Board in January 2005. The Committee was informed of the policies involved in the preparation of the 20062007 programme budget, its major features, and key issues affecting the South-East Asia
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Region. It noted that there had been an increase in the budget allocation for all regions, but a slight decrease in the budget allocation for WHO headquarters. It was also noted that budget increases were highest for certain Areas of Work in the SEA Region, including epidemic alert and response, surveillance, prevention and management of chronic noncommunicable diseases, HIV/AIDS, making pregnancy safe, child and adolescent health, and planning, resource coordination and oversight. These Areas of Work received more funds based on recent resolutions of the governing bodies and to support the achievement of the Millennium Development Goals. The Committee noted with appreciation that the Regional Director had established a working group to: (a) review options and approaches which could be adopted globally in the allocation of funds from all sources to countries and regions, as a successor arrangement to resolution WHA51.31, (b) propose guiding principles to be applied in the distribution of any additional funds to countries of the Region in 2006-2007 resulting from an increase in Assessed Contributions, and (c) recommend ways and means of replacing the existing ICP II mechanism, to continue intercountry activities and promote horizontal collaboration. The Committee endorsed the Group’s work programme in anticipation of its recommendations prior to the meeting of the Executive Board in January 2005. The Committee appreciated the results-based management approach, the concept of a unified budget and increased allocation of funds at the country level. The Committee was informed about the large proportion of funding from voluntary contributions. The voluntary contributions could be expected to increase to over 80% by 2015 if assessed contributions are maintained at the current level. Since there were other restrictions on the use of voluntary contributions, the flexibility provided by the Regular Budget was needed and a 9% increase in assessed contributions was proposed in the budget. In the absence of this increase, WHO’s collaborative activities and expected results would have to be reduced or scaled back. From the 2006-2007 biennium, WHO would have an integrated budget encompassing both assessed and voluntary contributions. Voluntary contributions should be used for activities already planned under the integrated budget. Collaborative programmes at the country level would be supported from all funding sources and additional voluntary contributions would be sought for short falls in budgets. The Committee expressed concern that the South-East Asia Region had received the lowest proposed increase of voluntary contributions in percentage terms as compared to other Regions. However, the Committee was informed that the budget proposed by the Region was based on consultations with countries and was felt to be a realistic estimate of the resources needed to achieve the expected results in 2006-2007. Furthermore, when all regional proposals were consolidated into the global budget, the SEA Region received full funding while other regions received less than what they had requested. The Committee was informed that more than 59% of voluntary contributions in the Region were for polio eradication. The other major donor-supported programmes include tuberculosis control, disease surveillance, emergency humanitarian assistance and HIV/AIDS. Once the polio programme was scaled down, efforts would be needed to ensure that continued support from donors is achieved for other priority health programmes in the Region. Furthermore, country offices should be strengthened to improve capacity for resource mobilization in line with their needs. The Committee noted the Proposed Programme Budget 2006-2007, with the above observations. A resolution on the subject was adopted (SEA/RC57/___).
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OUTLINE OF 11TH GENERAL PROGRAMME OF WORK 2006-2015 (Agenda item 8, document SEA/RC57/8) THE COMMITTEE was informed that, according to Article 28(g) of the WHO Constitution, the General Programme of Work (GPW) was the policy guide to WHO’s programme development covering a specific period and formed the basis for programme budgets. The 11th GPW would cover a period of ten years, thereby providing a long-term vision on global public health, covering not only WHO but international health in general. It would use the tools for “futures” thinking and action, involving forecasting of trends, exploring alternative scenarios, and establishing and formulating strategies to achieve the goals in the light of these scenarios. Its development would involve WHO staff at all levels, as well as consultation with Member States, partners and experts from outside WHO. The Committee commended WHO for its intention to develop a visionary document providing a roadmap for international health over the next 10 years and guiding principles for Member States and WHO. It also mentioned that the GPW might not be compatible with some national health development plans. On the contrary, the GPW should be seen as a a visionary document inspiring national health plans rather than restricting the direction of individual countries. The Committee felt that the GPW should be related to the Millennium Development Goals (MDG) as this was an important international commitment. However, the GPW should go beyond the MDG since there were other key issues, such as emerging and noncommunicable diseases, human resources for health and globalization that were likely to be important in the coming 10-year period. The deliberations of the Regional Committee would be sent to the GPW drafting committee as inputs. There would be extensive consultations with Member States regarding the GPW between now and May 2005 as the document undergoes changes. The Committee noted that the draft GPW would be reviewed at the next session of the Regional Committee in 2005, prior to its adoption by the World Health Assembly in May 2006.
REPORT OF THE JOINT EVALUATION OF A SPECIFIC INTERCOUNTRY PROGRAMME – INTENSIFICATION OF CROSS-BORDER COLLABORATION IN PRIORITY COMMUNICABLE DISEASES SUCH AS HIV/AIDS, POLIO, TUBERCULOSIS AND MALARIA, KALA-AZAR, DENGUE AND SARS (Agenda item 9, document SEA/RC57/9) THE COMMITTEEE emphasized that intercountry collaboration should not only be confined to geographical borders or bordering areas but also should be extended to programmes involving common concerns between countries of the Region. The Committee commended WHO’s role in combating outbreaks of SARS and avian influenza. It urged WHO to assist Member States in taking measures to form cross-border local committees representing bordering countries to facilitate smooth collaboration. Intercountry collaboration was a difficult goal as it not only involved different countries but also sectors other than health. Such collaboration, therefore, needed to be based on intensive consultations within and among countries. WHO’s role was crucial in further mobilizing and developing human resources, besides training the existing health professionals along border areas. There was also a need to delegate authority from the centre to border districts so as to accelerate the implementation process. The Committee urged WHO to proactively share the detailed findings of the joint evaluation thereby creating awareness of various issues involved in cross-border collaboration. WHO’s role was crucial in further mobilizing and developing human resources, besides training the existing health professionals along border areas.
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The Committee was informed that WHO was making all-out efforts to intensify crossborder collaboration with countries in other regions as well as with ASEAN and SAARC. The Regional Committee, having reviewed and discussed the Report of the 41st meeting of CCPDM on the Joint Evaluation of a Specific Intercountry Programme: Intensification of Cross-border Collaboration in Priority Communicable Diseases such as HIV/AIDS, Polio, TB and Malaria, Kala-azar Dengue and SARS, noted with satisfaction the progress made during the year in the intensification of cross-border collaboration in priority communicable diseases in the Region, and endorsed its recommendations.
CONSIDERATION OF THE RECOMMENDATIONS ARISING OUT OF THE TECHNICAL DISCUSSIONS ON “EMERGENCY HEALTH PREPAREDNESS” (Agenda item 10.1, document SEA/RC57/11) PROFESSOR AZRUL AZWAR, Chairman of the Technical Discussions, presented the report and recommendations contained in document SEA/RC57/11. The Committee was informed that the Technical Discussions had focused on the broad strategies to strengthen emergency health preparedness, viz. development of norms and policies; capacity building of institutions and human resources; coordination and liaison with other sectors and mobilization of resources; research and development, and promoting community involvement. The Committee felt that risk management was the core component for the development of effective and efficient emergency health preparedness and response activities and should be incorporated in all development planning activities so that emergency and disaster management was well linked to sustainable development. Member States should strengthen political will by developing policies and enact legislation to promote and incorporate risk management, vulnerability assessment and risk mitigation into national and local health and development activities and provide resources to support the implementation of such policies. The Committee stressed that a clear capacity-building strategy should be developed according to the actual needs of each country on risk management, risk communication, emergency preparedness, information management etc. in collaboration with other relevant sectors. The Committee emphasized that coordination mechanisms should be developed for facilitating inter- and intra-collaboration and enhancing networking and mapping of resources among partners. It was felt that informed decisions should be promoted based on evidence and lessons learnt and that communities should be he involved in the development and implementation of disaster risk reduction efforts. The following discussion points emerged: (a) (b) (c) Mass media can play a significant role in mobilizing the political commitment that was needed to set the framework for policy and action. Intersectoral cooperation is vital can be achieved through the identification of focal points in other sectors and by ensuring coordination with them. Besides intersectoral and intercountry cooperation among Member States which is crucial, community participation in all emergency-related activities is another key element; Capacity building and human resource development are important to ensure the adequate capacity of the health sector, as an essential prerequisite to deal with emergency situations using mock drills, if appropriate.
(d)
The Committee was informed that WHO had recently responded to emergency situations like floods in some countries. The recent outbreak of SARS and avian influenza
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had also been successfully handled. The Committee felt that concerted efforts were necessary to strengthen the existing systems to ensure a better and swift response to such situations. The Committee recognized the need to set up an Emergency Fund in order to be able to respond quickly to emergency situations in the countries. The Committee was informed that such a Fund would not cut into the budget allocations for other programmes. The Committee felt that establishment of national focal points in all Member States would ensure efficient management of emergencies, and also facilitate similar operations in other countries, if required. The Committee urged WHO to provide technical support to Member States in establishing adequate laboratory facilities as well as train staff in different types of emergencies. For this purpose, it was essential to identify the type of training required for specific emergencies. Countries could also benefit from the services offered by specialized emergency-related centres available in the Region. There should be a mechanism for coordination so that the health sector could play an effective role, not only during emergencies, but also during the pre- and post-emergency periods. There is a need to establish appropriate communications systems to ensure immediate dissemination of information to the appropriate authorities to enable them to initiate prompt action in all types of emergencies. The Committee urged WHO to provide technical assistance to develop standard operating procedures (SOPs) where they have not been prepared, in risk assessment, management and communication. In case health facilities and hospitals are affected by a disaster, other alternatives such as mobile hospitals should be taken into consideration. The Committee discussed the report of the Technical Discussions and endorsed the recommendations contained therein. A resolution on the subject was adopted (SEA/RC57/ )
SELECTION OF A SUBJECT FOR THE TECHNICAL DISCUSSIONS TO BE HELD PRIOR TO THE FIFTY-EIGHTH SESSION OF THE REGIONAL COMMITTEE (Agenda item 10.2, document SEA/RC57/6) RECOGNIZING the persistent high level of maternal mortality in countries of the Region and the low level of coverage by skilled birth attendants during the ante-natal period and childbirth, the Committee decided to hold Technical Discussions on “Skilled care at every birth”, during the 42nd meeting of the Consultative Committee for Programme Development and Management (CCPDM), to be held prior to the fifty-eighth Session of the Regional Committee in 2005. It urged the Member States to participate fully in the Technical Discussions and requested the Regional Director to take steps for the preparation and conduct of the discussions.
REVIEW OF IODINE DEFICIENCY DISORDERS IN THE SOUTH-EAST ASIA REGION (Agenda item 11.1, document SEA/RC57/Inf.3(Rev.1)) THE COMMITTEE was informed that the subject had been discussed at the Ninth Meeting of Health Secretaries in July 2004, and that the summary of discussions was available in the report of that meeting. The Committee noted that Iodine Deficiency Disorders (IDD) programmes were at various stages of development in countries of the Region. While some countries were close to achieving IDD elimination by the end of 2005, others were far from the goal. Although
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sufficient salt was being produced for consumption in some countries, all of it was not being adequately iodized. Apart from the visible effect of IDD, in the form of goitre, its other alarming effects on human brain development including cognitive losses were not generally known. While noting the commitment of Member States to the prevention of IDD, the Committee stressed the urgent need to strengthen prevention and control programmes in order to achieve the goal of IDD elimination. The Committee recognized IDD as a serious public health problem and although aware of the various effects, confirmed the need for further research. Stringent quality control measures to ensure adquate iodization of salt needed to be put in place, and monitored closely. It was essential to enhance community awareness at all levels, using electronic and print media such as posters and leaflets translated into local languages. Social marketing campaigns, particularly at the district level, would help in raising community awareness about the health benefits of using iodized salt. Involvement of schoolchildren in educational campaigns on the advantages of iodized salt would also be useful. Regulatory mechanisms were necessary to ensure adequate availability of iodized salt. Member States should also ensure community involvement in the control of IDD. The Committee was informed that Member States had developed national strategic plans for control of iodine deficiency disorders. Efforts were ongoing to integrate iodine definciency disorders and universal salt odization into health curricula. Similarly, control of other micro-nutrient deficiencies such as anaemia and developing national strategies on infant and young child feeding also merited attention. The Committee expressed satisfaction that, in addition to the IDD control programme, Member States were also according importance to nutrition,in maternal and child health care programmes. The Committee was informed that while iodization of salt had generally been adequate, the optimum household coverage as the WHO recommendations had not been achieved due to inequitable distribution. The Committee, therefore, stressed the need to ensure sustainable and uniform availability of iodized salt in all countries The Committee emphasized the need to have an inbuilt monitoring and evaluation system for assessing the use of iodized salt as well as the progress achieved towards meeting the targets set for 2005. The Committee also noted that steps needed to be taken to prevent loss of iodine at manufacturing stage and during transportation, for which appropriate logistic arrangements should be made. It was recognized that active multisectoral collaboration was essential for the success of the IDD prevention and control programme. The Committee noted with satisfaction the efforts being made by Member States but emphasized that in order to achieve the target of IDD elimination by 2005. However, efforts were needed to be further accelerated. WHO would be willing to assist Member States in enhancing advocacy and awareness measures in this regard. As requested by the Health Secretaries in their last meeting held in July 2004, WHO would assist Member States by establishing a Regional Technical Group to provide technical guidance to WHO and Member States on the IDD elimination programmes. The Committee endorsed the recommendations made by the Ninth Meeting of Health Secretaries and adopted a resolution on the subject (SEA/RC57/R__).
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REVISION OF INTERNATIONAL HEALTH REGULATIONS (Agenda item 11.2, document SEA/RC57/Inf.4) THE COMMITTEE was informed that this subject had been discussed at the Ninth Meeting of Health Secretaries, and that the summary of discussions was available in the report of that meeting. The Committee noted that regional consultations on the subject, held earlier, had reached a consensus that the revised International Health Regulations (IHR) would significantly contribute to the strengthening of national surveillance system and in ensuring global health security. Apart from identifying issues and concerns of major interest to Member States, the consultations also outlined the need for a continuing dialogue by all Member States with various stakeholders in order to prepare themselves for the deliberations of the Intergovernmental Working Group, scheduled to be held in November 2004. The Committee also noted the importance of strengthening national core capacity for communicable diseases surveillance and response for implementation of the revised IHR. The Committee noted that Member States fully supported the revision of IHR. The significance of providing WHO technical assistance for strengthening the national disease surveillance systems, particularly in the peripheral and border areas was highlighted. Networking of public health laboratories was another area where technical assistance from WHO would be needed. Learning from the experience gained during the SARS outbreak, it was felt that efforts should be aimed at enhancing bi-regional collaboration. The Committee emphasized that additional financial and human resources would be needed for implementing the revised IHR. A multisectoral approach involving all the stakeholders was of crucial importance. WHO was requested to help mobilize additional external resources in this regard. With regard to the visit of WHO teams to Member States for outbreak verification, the Committee was informed that such missions would be fielded only after close consultation with, and concurrence of, the Member States concerned. It was noted that information on any disease outbreak should, however, be promptly shared with other countries so that effective and timely control measures could be undertaken. It was clarified to the Committee that there were established procedures for settlement of disputes in the revised IHR. Accordingly, any disputes arising out of implementation of the revised IHR, would be resolved in compliance with these provisions, with the full involvement of the parties concerned. Some of the related issues would be further discussed in the forthcoming meeting of the Intergovernmental Working Group in November 2004, while preparing the final draft of the revised IHR for submission to the World Health Assembly in 2005. The Committee underscored the need to have IHR focal points in all countries of the Region, and to convene national workshops and consultations aimed at sensitization and capacity-building. Networking of regional experts and sharing of information among Member States were crucial for implementing the revised IHR. The Committee felt that WHO should play a leadership role in facilitating smooth implementation of the revised IHR, promoting international, inter-regional and inter-agency collaboration. The Committee was informed that WHO was committed to strengthen the capacity of Member States to implement IHR and provide relevant technical support in its adoption and implementation. WHO proposed to establish a regional mechanism in consultation with Member States, for outbreak alert and response while fully collaborating with the global outbreak alert and response network. WHO’s close collaboration with Member States in dealing with the recent SARS outbreak had clearly demonstrated the benefits that could be derived by Member States from such collaboration.
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Additional financial resources would be required for effective implementation of the revised IHR. In this regard, the Committee was informed that WHO headquarters had already mobilized considerable resources and would continue efforts towards mobilization of additional resources. The Committee was informed about the development of a regional strategy for integrated disease surveillance, which involved the assessment of an existing national surveillance system and the preparation of national plans of action in order to develop necessary capacity at country level. The Regional Office was also developing a Vision Document for emerging and re-emerging diseases. An important element of this document was the strengthening of intercountry cooperation both within and outside the Region. The Committee endorsed the recommendations on the subject made by the Ninth Meeting of Health Secretaries.
GLOBALIZATION, TRADE, INTELLECTUAL PROPERTY RIGHTS AND HEALTH (Agenda item 11.3, document SEA/RC57/Inf.5) THE COMMITTEE was informed that this subject had been discussed at the Ninth Meeting of Health Secretaries, and that the summary of discussions was available in the report of that meeting (SEA/HS.Meet/9). The Committee acknowledged that globalization, trade and health were a complex issue and required actions beyond the health sector. While some countries had established national multisectoral coordinating mechanisms and identified focal points, others needed to develop similar mechanisms for stronger coordination and collaboration among the various ministries and civil society, in order to share solid evidence of the health implications of multilateral trade agreements. The Committee felt that WHO should facilitate the preparation of a common regional perspective focusing on the burden of diseases and related health research and development, IPR and public health, other incentives for innovation, traditional systems of medicine and capacity-building, to be presented to the WHO Commission on IPR, to support its work. The Committee urged WHO to work closely with special committees, task forces and working groups established under the regional economic groupings and free trade areas, to develop an appropriate legislative framework and to help ensure that health was taken into account when trade policies were framed. The Committee noted that Member States had accorded very high priority to resource mobilization and technical support and capacity-building for traditional medicines. The Committee expressed concern about the issues of patent act and licensing, particularly relating to the export of drugs manufactured by a particular country, and emphasized on the need for Member States to reflect the decisions included in the Doha Declaration in this regard. It called upon WTO members from least-developed countries in the Region to expedite the enactment of appropriate legislation so that they were not deprived of the benefits of liberalization and globalization. The Committee was informed that some countries tended to enter into bilateral agreements with other countries on TRIPS Plus. Ministries of health should actively look into such agreements in order to ensure that efforts at improving access to medicines were not compromised. The Committee welcomed the establishment of the WHO Commission on Intellectual Property Rights. It further noted that the issue of globalization, trade and intellectual property rights required very active consultation and collaboration between WHO and Member States
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as well as with other stakeholders, in order to evolve a common strategy for universal access and notification. The Committee endorsed WHO’s initiative to establish a network of information and knowledge management, through the fullest utilization of centres of excellence and expertise, including WHO collaborating centres, which had already generated and accumulated evidence-based information on the subject. It urged WHO to share country, regional and global experiences, and to facilitate public debates, seminars and workshops for training health personnel who would be involved in the negotiation process of these bodies. The Committee noted the report and recommendations of the Ninth Meeting of Health Secretaries on the subject.
ESTABLISHMENT OF REGIONAL COOPERATION ON AVIAN INFLUENZA PREVENTION AND CONTROL (Agenda item 11.4, document SEA/RC57/Inf.6 (Rev.1) THE COMMITTEE was informed that this subject had been discussed at the Ninth Meeting of Health Secretaries and a summary of the discussion was available in the report of that meeting. The Committee noted that recent epidemics of highly pathogenic avian influenza (H5N1) and SARS had clearly shown that emerging and re-emerging diseases posed a real threat to human welfare and socioeconomic development. It felt that with the ever-changing nature of pathogens, fast population growth, increasing urbanization and growing international tourism, travel and trade, the spread of infectious diseases would continue to pose mounting challenges to health and well-being of humankind. While globalization had boosted opportunities for growth and socioeconomic development, it had also created potential problems arising out of restriction of international trade, due to outbreak of emerging and re-emerging diseases. Challenges posed by emerging and re-emerging infectious diseases were very often difficult to be handled by individual countries without the cooperation of other Member States, agencies etc. Intercountry and inter-regional cooperation by pooling of expertise and resources is essential to combat the spread of infectious diseases. The experiences of and lessons learnt by the Global Outbreak Alert and Response Network (GOARN) had shown that technical collaboration to combat the spread and containment of infectious diseases was feasible and effective. Countries of the Region which were affected by the recent outbreaks had accumulated a wealth of experience on which cooperation could be built. The presence of centres of excellence in surveillance, research, laboratory services and training in some countries was an added advantage. Research in this field required sophisticated and costly laboratory equipment, manpower and resources, which not every country could afford to have; neither was it necessary or costeffective, to have such a centre in each country of the Region. The presence of three Member States of the SEA Region (Thailand, Indonesia and Myanmar) in ASEAN also had the potential for mobilizing resources and expertise for such interregional cooperation. Moreover such cooperation could also contribute to research and development in other areas of emerging diseases. The Committee noted at the Ninth Meeting of Health Secretaries had recommended four major areas of collaboration: (i) to create an appropriate mechanism for regional collaboration on avian influenza prevention and control; (ii) to strengthen existing technical cooperation among Member States in terms of provision of necessary training and support for laboratory investigation during outbreaks; (iii) to intensify collaboration between Member States with WHO and other UN agencies, such as FAO, OIE, as well as with the donor community, to mobilize support for national efforts and (iv) to enhance intercountry and interregional cooperation with the Western Pacific and other WHO regions in the prevention and control of avian influenza and other emerging and re-emerging diseases.
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While noting the recommendations made by the Ninth Meeting of Health Secretaries, the Committee urged WHO to play a coordinating role in establishing intercountry and interregional collaboration. It also urged WHO to play key role in establishing collaboration with other agencies like OIE and FAO. It noted the training expertise available in Thailand and technical and laboratory expertise available in India for early diagnosis and supported formation of a surveillance network for emerging infectious diseases. The Committee stressed that in order to avoid duplication of efforts there was a need to harmonize WHO advocacy issues with other international agencies. With the above observations the Committee endorsed the recommendations on the subject made by the Ninth Meeting of Health Secretaries.
ADDRESS BY DIRECTOR-GENERAL, WHO (Agenda Item 6) Dr LEE Jong-wook, Director-General, thanked the Government of Maldives for hosting the meeting in Kurumba, which he considered an excellent environment for clear thinking and decision-making. He congratulated Dr Samlee for providing excellent guidance to the countries of the South-East Asia Region. The Director-General suggested security, equity and unity as reference points for discussion at the Regional Committee. Security in health work meant protecting people from disease, disability and premature death. Equity had been WHO’s fundamental principle from the very beginning. This aspect needed to be strongly reasserted now as the health effects of extreme disparities between communities became more and more evident. Unity was indispensable for effective action and it required Member States to work more closely than ever before with partners. He said that the proposed Programme Budget 2006-2007, had built on results-based budgeting and the lessons learnt from the 2003-2004 Programme Budget and reflected the priorities of Member States. It also reinforced and accelerated the decentralization process initiated last year and proposed an overall increase of 12.8% to be allocated to countries and regions. This increase was accompanied by measures to ensure maximum efficiency in the use of resources. He had proposed an increase of 9% in assessed contributions from Member States since essential activities could not depend on resources provided by donors. The increase represented a break with the past practice of zero nominal growth in the regular budgets, which had been gradually turning WHO into an organization that depended mainly on voluntary contributions. A significant regular budget was needed to formulate and carry out a well-balanced global policy. The question of budget became urgent in the context of WHO’s General Programme of Work for 2006-2015 which set the Organization’s longer-term objectives and thereby defined its role in the world. The input provided by the Regional Committee was important since the next session of the Executive Board would be deliberating on the Programme Budget and the General Programme of Work. Dr LEE said that the International Health Regulations, which were designed to minimize danger from major epidemics, was under revision. The revision process had benefited from a high level of input from regional consultations. It was hoped that the Regulations would be adopted by the World Health Assembly in 2005. The longer-term challenge would be to ensure that the revised Regulations were followed. The Director-General expressed his satisfaction at the timely and well-managed response to outbreaks of avian influenza in the South-East Asia and the Western Pacific regions. However, the process of building an adequate global outbreak alert and response system was still at an early stage.
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Commending the rapid response of national health services in the recently-occurred floods in Bangladesh, Dr LEE said that the immediate task of relief agencies was to save and sustain lives. The special responsibility of WHO was to do this in a way that built up essential health services for the long term. Expressing his concern at the lack of access to AIDS treatment and prevention methods, he said that inequity was the root cause of the danger faced by the world today. Some parts of the SEA Region faced the danger of an expanding HIV epidemic, while some other areas had a wealth of experience and practical information on the effective action that needed to be taken. This presented a great opportunity for solidarity and cross-border learning within the Region. Prevention and treatment must be integrated in a comprehensive way. With the fall in the prices of drugs, HIV treatment was now financially within reach of more people than ever before. He stressed the need to improve human resource capacity to support HIV treatment and strengthen activities across the health sector. Social mobilization was also a key to achieving the goals in the South-East Asia Region. The Director-General said that intensified eradication efforts launched in India had brought polio to the verge of elimination in the Region. Sustained efforts in India, and continued high quality surveillance and routine vaccination in all countries of the Region would be the next great success in this historic effort. Dr LEE expressed satisfaction at the progress in tuberculosis control in the Region. The target of an 85% cure rate was now nearly achieved while the case detection rate was now 46%. DOTS expansion had been rapid and effective in the countries. The provision of sustainable financing and strengthening of human resources at the primary health care level was an urgent need to control TB in the Region. Major efforts were under way to improve the malaria situation. These aimed at increasing people’s access to insecticide-treated bednets and widespread use of effective treatment regimens based on artesunate combination therapy. Dr LEE said that the WHO Framework Convention on Tobacco Control, aimed at tackling social and economic determinants of health, was proceeding well towards coming into force. He urged the countries that had not already ratified it to do so. Unity was the key to achieve security and equity that the world so desperately needed. In the coming months, WHO’s focus on maternal and child health would provide special opportunities to achieve it. Of particular concern was the high rate of neonatal mortality and low birth-weight infants in the SEA Region. The focus on maternal and child health was reinforced by WHO’s country-specific cooperation strategies, whose principal aim was to strengthen health systems. He commended the process of decentralization, through the single WHO country plan and budget, which was working well in the Region. In conclusion, Dr LEE stated that the Regional Committee had been a powerful means to build unity between Member States. The means of solving health problems themselves to should transcend any boundaries. Solidarity was the key to disease control, especially those linked to poverty. The Committee commended the Director-General for his leadership. It congratulated him for his thought-provoking address and expressed full support for initiating decentralization of WHO resources at regional and country levels. Pledging its support in implementing WHO’s policies and programmes in the Member States, it urged the DirectorGeneral to address the issue of disparity in regional representation across the Organization. In response to the statements made by the representatives, the Director-General stated that measures would be taken to ensure flow of more funds to the countries. The Organization was bound to provide services to Member States. With regard to the delisting of five anti-
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retroviral drugs from WHO’s list of pre-qualified drugs, the Director-General informed the Committee that this was done to ensure transparency in the process of quality control of medicines, particularly in the context of the “3 by 5” initiative.
REGIONAL IMPLICATIONS OF THE DECISIONS AND RESOLUTIONS OF THE FIFTY-SEVENTH WORLD HEALTH ASSEMBLY AND THE 113TH AND 114TH SESSIONS OF THE EXECUTIVE BOARD (Agenda Item 12, document SEA/RC57/10) The Committee was informed that only those resolutions and decisions that were relevant to the Region had been selected and included in the working paper, which highlighted the actions to be taken by Member States and WHO. The Committee noted the important subjects covered in the working paper namely, road safety and health, reproductive health, genomics and world health, HIV/AIDS, diet, physical activity and health, and human organ and tissue transplantation. It also noted with satisfaction the major recommendations made by CCPDM. The Committee acknowledged the importance and relevance of resolutions relating to road safety and ARV. The need to strengthen capacity-building and planning in Member States for proper implementation of these resolutions was emphasized. Adequate steps should be taken to contain road accidents. Priority should be accorded to this area through multi-sectoral collaboration aimed at establishing sound surveillance systems for road safety programmes. The Committee emphasized the need for proper identification and availability of affordable generic ARV drugs of assured quality as well as for finding ways and means to scale up the “3 by 5” activities. This would involve establishing an effective health infrastructure comprising adequately trained human resources. The Committee took note of the regional implications of the decisions and resolutions of the above governing bodies and asked the Member States and WHO to take appropriate follow-up actions as noted and proposed by the 41st meeting of CCPDM.
UNDP/WORLD BANK/WHO SPECIAL PROGRAMME FOR RESEARCH AND TRAINING IN TROPICAL DISEASES: JOINT COORDINATING BOARD (JCB) – REPORT ON ATTENDANCE AT 2004 JCB AND NOMINATION OF A MEMBER IN PLACE OF THAILAND WHOSE TERM EXPIRES ON 31 DECEMBER 2004 (Agenda item 13.1, document SEA/RC57/3) THE COMMITTEE was informed that representatives from India, Myanmar and Thailand had attended the deliberations of the 27th session of JCB held on 28-29 June 2004, and had reported to the 41st meeting of CCPDM. The Committee took note of the progress made in the working of JCB and noted that TDR would continue to be involved in vaccine research and development. The Committe noted the observations and recommendations of the 41st meeting of CCPDM on this subject. The Committee nominated Bangladesh as a member of JCB for a period of three years with effect from 1 January 2005 and requested the Regional Director to inform WHO headquarters accordingly.
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WHO SPECIAL PROGRAMME FOR RESEARCH, DEVELOPMENT AND RESEARCH TRAINING IN HUMAN REPRODUCTION: POLICY AND COORDINATION COMMITTEE (PCC) – REPORT ON ATTENDANCE AT 2004 PCC AND NOMINATION OF A MEMBER IN PLACE OF INDIA WHOSE TERM EXPIRES ON 31 DECEMBER 2004 (Agenda item 13.2, document SEA/RC57/5) THE COMMITTEE was informed that representatives from India and Sri Lanka had attended the deliberations of the 17 th meeting of PCC, held in June 2004, and had reported to the 41st meeting of CCPDM. The Committee was informed of the PCC’s role, overall policy and strategy to undertake planning and execution of the special programmes. The Committee noted UNDP’s decision to actively participate as a co-sponsor of the programme. The Committee noted the observations and recommendations of the 41st meeting of CCPDM on the subject. The Committee nominated Nepal as a member of PCC for a period of three years from 1 January 2005 and requested the Regional Director to inform WHO headquarters accordingly.
TIME AND PLACE OF FORTHCOMING SESSIONS OF THE REGIONAL COMMITTEE (Agenda item 14, document SEA/RC57/4) THE COMMITTEE decided to hold its fifty-eighth session in Sri Lanka in September 2005, in conjunction with the Meeting of Ministers of Health. The exact date and venue to be confirmed later. The Committee also noted the invitations of the Governments of Bhutan, Bangladesh and Nepal to host the sessions in 2006, 2007 and 2009 respectively. It further noted that the sixty-first session in 2008, being an election year for the Regional Director, will be held in the Regional Office. The Committee noted the invitation of the Government of India to host the Meeting of the Health Ministers in conjunction with the sixty-first session of the Regional Committee.