WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL COMMITTEE Fifty-ninth session Manila, Philippines 22–26 September 2008 Provisional agenda item 9
WPR/RC59/3 7 August 2008 ORIGINAL: ENGLISH
PROGRAMME BUDGET, 2006–2007: BUDGET PERFORMANCE (FINAL REPORT)
This document presents the final report on the implementation by area of work of the regular budget for 2006–2007 biennium. Information is also provided on funding from extrabudgetary sources. In monetary terms, the implementation of the regular budget amounted to US$ 74 748 000 or 100% of the revised working allocation for the period 1 January 2006 to 31 December 2007. In addition, the activities implemented utilizing extrabudgetary funds amounted to US$ 101 425 481 as at 31 December 2007. The total implementation for all funds was US$ 176 173 481 as at 31 December 2007 (Annexes 2, 3 and 3A). The analyses of implementation by categories of expenditures are shown in Annex 3 for the regular budget and Annex 3-A for other sources of funds. Information on outcomes is provided in Annex 4 of this report. The information is based on the end of biennium assessment exercise and covers the period 1 January 2006 to 31 December 2007. An interim report on the implementation of the regular budget and extrabudgetary funds for 2006–2007 was presented to the fifty-eighth session of the Regional Committee. The Regional Committee may now wish to review and discuss the final implementation figures.
WPR/RC59/3 page 2
These reports on budget performance for the biennium 2006–2007 as of 31 December 2007 (Annexes 2, 3 and 3A) serve as the final reports to the Regional Committee on the implementation of the regular budget and other sources of funds. The analysis of expenditures in Annexes 3 and 3A shows the categories of expenditure in implementing the approved programme budget. The programme budget 2006–2007 followed a results-based approach. A key feature of results based budgeting is that it compels WHO to submit itself to self scrutiny and to compare actual accomplishments to expected results. The outcomes in Annex 4 cover the period 1 January 2006 to 31 December 2007 and include information from the end of biennium assessment exercise conducted by regional areas of work and country offices. The Regional Overview of the Proposed Programme Budget 2006–2007 was presented to the Regional Committee at its fifty-fifth session in September 2004. The Global Programme Budget 2006–2007 was approved at the Fifty-eighth World Health Assembly in May 2005. The regular budget that was approved by the Health Assembly amounted to US$ 76 505 000 (a 6.2% increase from the 2004–2005 approved programme budget of US$ 72 036 000), and since then a number of important changes have been made: (1) In November 2005, the Director-General established the initial working allocation at 97.6% of the 2006–2007 approved programme budget (US$ 1 836 000, or 2.4% was withheld by Headquarters) due to projected delayed payment of assessed contributions. In addition, the Director-General decided to reduce the regular budget provisions of all regions under appropriation section 3 (determinants of health) to ensure adequate funding for the first session of the Conference of the Parties for WHO Framework Convention on Tobacco Control (FCTC). The resulting reduction for the Western Pacific Region was US$ 358 000. As a result, the initial working allocations released to the Western Pacific Region amounted to US$ 74 311 000 (Annex 1). (2) However, in April 2007, the Director-General returned US$ 54 000 unused balance of the US$ 358 000 provided for the first session of the Conference of the Parties for WHO/FCTC, and in June 2007 the Director-General released US$ 383 000 of the US$ 1 836 000 withholding mentioned above. The revised working allocation as at 31 December 2007 was Annex 2 gives the final financial
US$ 74 748 000 (Annexes 1 and 2, column 2). implementation report by each area of work.
WPR/RC59/3 page 3
(3)
The programme budget was implemented in accordance with the Organization-wide areas of work. As at 31 December 2007, US$ 74 748 000 or 100% of the regular budget revised working
allocation had been obligated (Annex 2, columns 3 and 4). Other sources of funds implemented by area of work for regional and country activities appear in Annex 2, column 7. The total amount of extrabudgetary funds obligated as at 31 December 2007 was US$ 101 425 481. Annex 2, columns 9 and 10 show the total implementation of all funds and by area of work as a percentage of all funds implemented. Annex 3 shows the obligated amounts by category of expenditure and organizational level under the regular budget. For each organizational level, the percentage of the revised working allocation by category of expenditure is also reflected. Annex 3A shows the amount obligated for each category of expenditure under funds from other sources and percentage to the total allotted funds by organizational level. WHO receives its funding principally through assessed contributions from Member States and voluntary contributions. Assessed contributions are gradually becoming a smaller proportion of the total resources received, and in 2006–2007, the assessed contributions were 42% of total expenditure. Reliance is increasing on voluntary contributions provided by a limited number of partners. Financing the programme budget requires efficient management of the different sources of income; a key challenge is ensuring alignment between the activities planned and resources mobilized. A significant constraint during the 2006–2007 biennium concerned the specificity of much of the funding provided to the Region with consequent under-funding of certain activities despite overall robust funding. Although income grew substantially in 2006–2007 relative to 2004–2005, it was not an even growth across all areas of work and countries and areas, so that there was incomplete alignment of available resources with the programme budget. Strategic steps have been taken by the Organization to achieve more balanced implementation across the Organization. During 2006–2007 the Advisory Group on Financial Resources (AGFR) was established with permanent membership of all Assistant Directors-General and regional Directors of Programme Management. A key tool of the AGFR in its work was the establishment of corporate accounts. In 2006–2007, these corporate accounts had fully flexible resources or resources earmarked only at the area of work level. Their distribution within the Organization was based on dialogue
WPR/RC59/3 page 4
across global areas of work networks to support implementation of approved programme budget priorities, with oversight within the Region by the Regional Programme Committee. Through donor dialogue it is aimed to increase the proportion of flexible funds in coming bienniums. Building on the positive experience of the Organization-wide corporate account, a core voluntary contribution fund has been established. This is managed in a transparent and accountable manner, ensuring financing of priority funding gaps to achieve better results and improve the performance of WHO in the Region. The monitoring and evaluation framework of the Organization is an integral part of its results-based management framework. The framework ensures that the WHO Regional Office for the Western Pacific continues to improve the effectiveness of financing and better integration of all sources of funding. This will facilitate informed policy development and more effective
implementation of WHO's collaborative programmes in the Western Pacific Region. Annex 4 contains information on outcomes for intercountry and country programmes by the expected results for the 36 areas of work. These expected results are based on the proposed
programme budget 2006–2007 that was approved by the Regional Committee at its fifty-sixth session. Detailed information on WHO activities in the Region during the biennium is contained in The Work of WHO in the Western Pacific Region: 1 July 2006–30 June 2007 and 1 July 2007–30 June 2008. The Organization-wide Programme Budget 2006–2007 Performance Assessment Report is available on the WHO Regional Committee for the Western Pacific Internet page
http://www.wpro.who.int/internet/files/rcm/rc59/PBPA_0607.pdf
WPR/RC59/3 page 5 ANNEX 1
Changes to the 2006-2007 Regular Budget as at 31 December 2007
Changes made (US$)
Total (US$)
Column reference in Annex 2
I.
Regular programme budget estimates presented to the Regional Committee at its fifty-sixth session and to the Fifty-eighth World Health Assembly 76 505 000 2.4% of budget withheld by the Director-General as contingency reserve Share in the cost of the First Session of the Conference of Parties for WHO/FCTC (1 836 000) 1
( 358 000)
(2 194 000) 74 311 000
II.
Initial working allocation 0.5% release of withheld budget by the Director-General Refund of unused balance of funds for the First Session of the Conference of Parties for WHO/FCTC 383 000
54 000
437 000 74 748 000 2
III.
Revised working allocation
WPR/RC59/3 page 6
WPR/RC59/3 page 7 Annex 2 Final financial implementation - regular budget and funds from other sources for the biennium 2006-2007 as at 31 December 2007 Regular budget or Assessed contribution Percentage of revised working allocation implemented (3)/(2) (4) Other sources 2006-2007 2004-2005 All funds implemented Increase (decrease) 2006-2007 vs 2004-2005 (9)-(11) (12) % of increase (decrease) vs 20042005 (12)/(11) (13)
Areas of Work
Approved budget based on WHA 58.4
Revised working allocation
Actual expenditures/ obligations
Approved Programe Budget
Alloted funds
Actual expenditures/ obligations
Percentage of allotted funds implemented (7)/(6)
All funds implemented (3)+(7)
Percentage of all funds implemented by area of work
All funds implemented
(1) 01 Essential health intervention Child and adolescent health Communicable disease prevention and control Emergency preparedness and response Epidemic alert and response HIV/AIDS Immunization and vaccine development Making pregnancy safer Malaria Mental health and substance abuse Reproductive health Surveillance, prevention and management of noncommunicable diseases Tuberculosis Sub total 2 242 000 1 095 000 450 000 5 316 000 1 123 000 1 564 000 2 038 000 2 402 000 1 174 000 102 000 4 611 000 1 731 000 23 848 000
(2)
(3)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
2 475 000 1 188 000 462 000 4 682 000 897 000 1 795 000 1 913 000 2 272 000 994 000 253 000 4 012 000 1 392 000 22 335 000
2 333 889 1 304 801 403 887 4 576 805 886 318 1 702 993 1 753 323 2 794 816 994 950 168 494 3 883 715 1 531 009 22 335 000
94.30 109.83 87.42 97.75 98.81 94.87 91.65 123.01 100.10 66.60 96.80 109.99 100.00
7 008 000 7 405 000 4 762 000 10 684 000 14 945 000 12 614 000 4 082 000 8 098 000 2 026 000 2 918 000 4 228 000 11 269 000 90 039 000
2 572 151 5 394 488 2 243 930 35 680 923 18 831 960 20 137 481 504 240 7 518 481 2 487 386 1 268 241 1 690 593 9 015 663 107 345 537
1 741 529 3 739 668 2 038 985 15 320 123 12 026 097 15 630 065 317 180 5 663 563 1 278 451 1 045 557 981 709 6 259 374 66 042 301
67.71 69.32 90.87 42.94 63.86 77.62 62.90 75.33 51.40 82.44 58.07 69.43 61.52
4 075 418 5 044 469 2 442 872 19 896 928 12 912 415 17 333 058 2 070 503 8 458 379 2 273 401 1 214 051 4 865 424 7 790 383 88 377 301
2.31 2.86 1.39 11.29 7.33 9.84 1.18 4.80 1.29 0.69 2.76 4.42 50.16
3 118 570 5 970 894 2 089 889 13 288 155 13 900 126 15 044 271 1 169 539 16 069 874 1 646 683 1 623 226 3 385 396 11 180 422 88 487 045
956 848 ( 926 425) 352 983 6 608 773 ( 987 711) 2 288 787 900 964 ( 7 611 495) 626 718 ( 409 175) 1 480 028 ( 3 390 039) ( 109 744)
30.68 (15.52) 16.89 49.73 (7.11) 15.21 77.04 (47.36) 38.06 (25.21) 43.72 (30.32) (0.12)
WPR/RC59/3 page 8 Annex 2 Regular budget or Assessed contribution Percentage of revised working allocation implemented (3)/(2) Other sources 2006-2007 2004-2005 All funds implemented Increase (decrease) 2006-2007 vs 2004-2005 (9)-(11) % of increase (decrease) vs 20042005 (12)/(11)
Areas of Work
Approved budget based on WHA 58.4
Revised working allocation
Actual expenditures/ obligations
Approved Programe Budget
Alloted funds
Actual expenditures/ obligations
Percentage of allotted funds implemented (7)/(6)
All funds implemented (3)+(7)
Percentage of all funds implemented by area of work
All funds implemented
02 health policies, systems and products Essential health technologies Essential medicines Health financing and social protection Health information , evidence and research policy Health systems policies and service delivery Human resources for health Policy-making for health in development Sub total 03 Determinants of health Communicable disease research Food safety Gender equity, women and health Health and environment Health promotion Nutrition Tobacco 0 837 000 39 000 3 757 000 1 226 000 489 000 1 957 000 0 1 073 000 15 000 3 429 400 1 561 600 462 000 1 481 000 0 1 077 486 2 399 3 465 887 1 608 088 511 006 1 353 494 0.00 100.42 15.99 101.06 102.98 110.61 91.39 300 000 2 663 000 961 000 6 643 000 3 654 000 1 861 000 3 243 000 336 000 1 564 097 177 876 1 843 527 1 305 711 520 800 2 541 931 239 177 1 386 723 123 939 1 274 857 943 645 360 221 1 507 022 71.18 88.66 69.68 69.15 72.27 69.17 59.29 239 177 2 464 209 126 338 4 740 744 2 551 733 871 227 2 860 516 0.14 1.40 0.07 2.69 1.45 0.49 1.62 100 766 1 593 767 89 102 4 776 178 2 097 157 1 427 283 2 206 474 138 411 870 442 37 236 ( 35 434) 454 576 ( 556 056) 654 042 137.36 54.62 41.79 (0.74) 21.68 (38.96) 29.64 929 000 1 746 000 1 392 000 1 784 000 5 392 000 7 742 000 0 18 985 000 1 546 000 1 889 000 1 715 000 1 914 000 5 050 000 6 657 000 85 000 18 856 000 1 663 032 1 826 980 1 687 793 2 002 782 4 991 572 6 607 616 76 225 18 856 000 107.57 96.72 98.41 104.64 98.84 99.26 89.68 100.00 1 439 000 3 254 000 5 108 000 4 816 000 4 865 000 3 970 000 2 000 000 25 452 000 3 076 434 3 738 102 2 667 386 799 826 5 256 135 3 544 136 488 362 19 570 381 1 401 771 3 067 640 1 489 158 527 900 2 825 650 1 863 544 246 013 11 421 676 45.56 82.06 55.83 66.00 53.76 52.58 50.38 58.36 3 064 803 4 894 620 3 176 951 2 530 682 7 817 222 8 471 160 322 238 30 277 676 1.74 2.78 1.80 1.44 4.44 4.81 0.18 17.19 2 998 054 3 934 692 2 560 413 3 086 413 5 629 177 9 422 761 958 660 28 590 170 66 749 959 928 616 538 ( 555 731) 2 188 045 ( 951 601) ( 636 422) 1 687 506 2.23 24.40 24.08 (18.01) 38.87 (10.10) (66.39) 5.90
WPR/RC59/3 page 9 Annex 2 Regular budget or Assessed contribution Percentage of revised working allocation implemented (3)/(2) Other sources 2006-2007 2004-2005 All funds implemented Increase (decrease) 2006-2007 vs 2004-2005 (9)-(11) % of increase (decrease) vs 20042005 (12)/(11)
Areas of Work
Approved budget based on WHA 58.4
Revised working allocation
Actual expenditures/ obligations
Approved Programe Budget
Alloted funds
Actual expenditures/ obligations
Percentage of allotted funds implemented (7)/(6)
All funds implemented (3)+(7)
Percentage of all funds implemented by area of work
All funds implemented
Violence, injuries and disabilities Sub total 04 Enabling programme delivery Budget and financial management Direction External relations Governing bodies Human resources management in WHO Infrastructure and logistics Knowledge management and information technology Planning, performance monitoring and evaluation Sub total 05 WHO's core presence in countries WHO's core presence in countries Sub total 06 Other Real estate fund
434 000 8 739 000
450 000 8 472 000
453 640 8 472 000
100.81 100.00
2 274 000 21 599 000
1 488 608 9 778 550
666 901 6 502 485
44.80 66.50
1 120 541 14 974 485
0.64 8.50
877 444 13 168 171
243 097 1 806 314
27.71 13.72
1 082 000 1 719 000 1 063 000 414 000 733 000 4 789 000 2 617 000 944 000 13 361 000
911 000 1 687 000 772 000 406 000 695 000 4 567 000 2 537 000 1 793 000 13 368 000
892 979 1 680 621 925 658 424 660 659 493 4 189 679 2 741 482 1 853 428 13 368 000
98.02 99.62 119.90 104.60 94.89 91.74 108.06 103.37 100.00
544 000 102 000 714 000 25 000 651 000 5 493 000 3 833 000 50 000 11 412 000
830 077 76 801 3 982 082 610 244 1 097 855 2 507 764 3 825 313 29 400 12 959 536
830 077 76 801 2 046 926 610 244 798 615 2 507 764 3 806 234 29 400 10 706 061
100.00 100.00 51.40 100.00 72.74 100.00 99.50 100.00 82.61
1 723 056 1 757 422 2 972 584 1 034 904 1 458 108 6 697 443 6 547 716 1 882 828 24 074 061
0.98 1.00 1.69 0.59 0.83 3.80 3.71 1.07 13.67
1 419 206 1 772 000 3 677 480 874 404 1 206 971 6 941 235 1 627 882 998 502 18 517 680
303 850 ( 14 578) ( 704 896) 160 500 251 137 ( 243 792) 4 919 834 884 326 5 556 381
21.41 (0.82) (19.17) 18.36 20.81 (3.51) 302.22 88.57 30.01
11 478 000 11 478 000
11 625 000 11 625 000
11 625 000 11 625 000
100.00 100.00
7 848 000 7 848 000
6 685 680 6 685 680
6 344 362 6 344 362
94.89 94.89
17 969 362 17 969 362
10.20 10.20
17 379 856 17 379 856
589 506 589 506
3.39 3.39
94 000
92 000
92 000
100.00
6 000
408 596
408 596
100.00
500 596
0.28
6 002 530
( 5 501 934)
(91.66)
WPR/RC59/3 page 10 Annex 2 Regular budget or Assessed contribution Percentage of revised working allocation implemented (3)/(2) Other sources 2006-2007 2004-2005 All funds implemented Increase (decrease) 2006-2007 vs 2004-2005 (9)-(11) % of increase (decrease) vs 20042005 (12)/(11)
Areas of Work
Approved budget based on WHA 58.4
Revised working allocation
Actual expenditures/ obligations
Approved Programe Budget
Alloted funds
Actual expenditures/ obligations
Percentage of allotted funds implemented (7)/(6)
All funds implemented (3)+(7)
Percentage of all funds implemented by area of work
All funds implemented
Sub total Total
94 000 76 505 000
92 000 74 748 000
92 000 74 748 000
100.00 100.00
6 000 156 356 000
408 596 156 748 280
408 596 101 425 481
100.00 64.71
500 596 176 173 481
0.28 100.00
6 002 530 172 145 452
( 5 501 934) 4 028 029
(91.66) 2.34
WPR/RC59/3 page 11 ANNEX 3 2006-2007 Regular Budget implementation by type of expenditures as at 31 December 2007
Expenditures and % of implementation to Revised working allocation Country/Office/Area Approved budget Revised working allocation 91 895 39 453 1 983 591 6 742 481 395 402 923 055 45 463 14 990 8 000 394 481 71 209 2 076 245 8 515 779 172 281 561 351 352 2 566 847 98 179 47 053 0 66 020 45 273 10 115 22.34 39 879 60.40 7 030 9 592 10.65 21.19 2 093 3 300 3.17 7.29 10 022 7 300 15.18 16.12 6 996 14 966 10.60 33.06 2 832 436 767 0.81 17.02 37 841 76 200 10.77 2.97 5 808 0.75 100 628 12.91 1 666 15 929 886 418 0.42 22.37 42.69 27 715 1.33 130 885 8 515 193 115 175 829 116 344 345 810 6 658 6.30 100.00 24.78 62.45 33.11 13.47 6.78 38 532 105 335 656 135 57 784 47 053 13.69 29.98 25.56 58.86 100.00 122 524 48 000 74 500 508 720 13 836 15.72 17.05 21.20 19.82 14.09 348 355 19 200 14 500 489 161 19 900 44.71 6.82 4.13 19.06 20.27 54 054 2.11 8 742 1.12 21 468 5.44 14 990 8 000 92 531 100.00 100.00 23.46 138 946 47 576 323 638 35.22 66.81 15.59 402 119 19.37 69 567 17.64 66 550 7 704 269 903 16.87 10.82 13.00 35 566 1.71 3 753 0.95 41 395 4.48 1 299 755 60 640 65.53 0.90 13 700 35 090 125 715 3 574 61 375 34.72 1.77 1.86 0.90 6.65 Staff costs US$ American Samoa Brunei Darussalam Cambodia China Cook Islands Fiji French Polynesia Guam Japan Kiribati Korea, Republic of Lao People's Democratic Republic Macao (China) Malaysia Marshall Islands Micronesia Mongolia Nauru New Caledonia New Zealand Niue Northern Mariana Islands 123 000 45 000 2 200 000 6 744 000 460 000 1 107 000 45 000 45 000 35 000 438 000 45 000 1 970 000 45 000 950 000 320 000 545 000 2 190 000 107 000 45 000 36 000 109 000 45 000 % Consultants US$ % Fellowships/study tours US$ 78 606 17 910 950 1 472 679 238 603 305 858 % 85.54 45.40 0.05 21.84 60.34 33.14 5 822 87 772 587 129 14 876 158 332 2 912 14.76 4.42 8.71 3.76 17.15 6.41 277 737 1 660 520 52 047 155 482 10 000 14.00 24.63 13.16 16.84 22.00 274 296 2 420 950 84 043 197 868 32 551 13.83 35.91 21.26 21.44 71.60 Supplies and equipment US$ % Direct financial contribution US$ 4 503 % 4.90 Contracts and service agreements US$ % Others US$ 8 786 2 021 7 991 414 848 2 259 2 745 % 9.56 5.12 0.40 6.15 0.57 0.30 US$ 91 895 39 453 1 983 591 6 742 481 395 402 923 055 45 463 14 990 8 000 394 481 71 209 2 076 244 8 515 779 172 281 561 351 352 2 566 847 98 178 47 053 0 66 020 45 273 Total % 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 0.00 100.00 100.00
% of Total expenditures versus approved budget 74.71 87.67 90.16 99.98 85.96 83.38 101.03 33.31 22.86 90.06 158.24 105.39 18.92 82.02 87.99 64.47 117.21 91.76 104.56 0.00 60.57 100.61
WPR/RC59/3 page 12 Annex 3 Expenditures and % of implementation to Revised working allocation Country/Office/Area Approved budget Revised working allocation 97 769 2 709 577 2 111 330 835 903 32 925 1 120 556 102 511 784 471 112 691 1 016 019 4 806 030 30 760 019 11 523 006 42 283 025 32 464 975 74 748 000 644 716 1 060 325 6 979 385 11 104 200 18 083 585 28 293 225 46 376 810 63.46 22.06 22.69 96.37 42.77 87.15 62.04 67 549 198 980 971 747 22 249 993 996 241 359 1 235 355 6.65 4.14 3.16 0.19 2.35 0.74 1.65 4 925 252 3 737 4 928 989 11.65 0.01 6.59 473 0.06 91 363 11.65 342 556 30.57 1 648 413 470 908 60 784 60.84 22.30 7.27 64 433 26 258 9 743 2.38 1.24 1.17 Staff costs US$ Palau Papua New Guinea Philippines Samoa Singapore Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam Sub-total WR/CLO Office Sub-Total Countries RO/ICP Total 129 000 2 580 000 1 798 000 1 148 000 45 000 1 420 000 107 000 877 000 135 000 1 079 000 4 440 000 31 407 000 11 338 000 42 745 000 33 760 000 76 505 000 % Consultants US$ % Fellowships/study tours US$ 82 769 25 036 89 399 338 393 32 925 431 726 33 164 212 967 55 988 90 388 285 335 4 925 252 % 84.66 0.92 4.23 40.48 100.00 38.53 32.35 27.15 49.68 8.90 5.94 16.01 128 466 9 589 111 479 33 606 12 428 729 735 4 036 773 394 530 4 431 303 1 671 563 6 102 866 11.46 9.35 14.21 29.82 1.22 15.18 13.12 3.42 10.48 5.15 8.16 5 687 229 81 792 5 769 021 13.45 0.25 7.72 143 215 19 770 196 000 16 000 175 612 981 646 5 687 229 12.78 19.29 24.98 14.20 17.28 20.43 18.49 41 741 23 865 145 283 7 097 25 326 1 475 439 7 324 233 1 533 7 325 766 1 173 710 8 499 476 3.73 23.28 18.52 6.30 2.49 30.70 23.81 0.01 17.33 3.62 11.37 74 572 835 400 494 835 894 999 589 1 835 483 1.55 2.72 0.00 1.98 3.08 2.46 32 851 16 123 26 907 2.93 15.73 3.43 413 191 193 522 116 293 15.25 9.17 13.91 380 125 232 704 137 209 14.03 11.02 16.41 Supplies and equipment US$ % Direct financial contribution US$ % Contracts and service agreements US$ 15 000 154 799 1 060 492 112 888 % 15.34 5.71 50.23 13.50 23 580 38 047 60 593 0.87 1.80 7.25 Others US$ % US$ 97 769 2 709 577 2 111 330 835 903 32 925 1 120 555 102 511 784 472 112 691 1 016 019 4 806 032 30 760 019 11 523 006 42 283 025 32 464 975 74 748 000 Total % 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00
% of Total expenditures versus approved budget 75.79 105.02 117.43 72.81 73.17 78.91 95.80 89.45 83.47 94.16 108.24 97.94 101.63 98.92 96.16 97.70
WPR/RC59/3 page 13 ANNEX 3-A 2006-2007 Other Sources implementation by type of expenditures as at 31 December 2007
Country/Office/Area
Allotted funds 2006-2007
Staff costs
Consultants
Fellowships/ study tours % 0.27 1.62 US$ 45 479 64 831 % 0.40 0.42
Supplies and equipment US$ 600 062 360 929 387 % 5.22 2.32 0.64 0.05 13.27 19.86
Direct financial contribution US$ 3 109 012 2 841 348 % 27.05 18.25
Contracts and service agreements US$ 1 024 085 2 634 858 60 000 % 8.91 16.93 99.36
Others
Total
US$ Cambodia China Fiji Korea, Republic of Lao People's Democratic Republic Mongolia Nauru Papua New Guinea Philippines Solomon Islands Vanuatu Viet Nam Sub-total WR/CLO Office Sub-total Countries Regional & Intercountry Total Country & RO/ICP 11 491 706 15 566 183 60 387 334 285 3 813 109 986 351 10 240 5 336 212 2 291 283 255 425 50 267 13 533 914 53 729 362 7 487 063 61 216 425 95 531 855 156 748 280 2 497 158 12 996 421 3 120 573 16 116 994 24 918 592 41 035 586 1 847 560 317 595 12 618 322 856 848 562 12 286 2 396 847 4 740 939
% 20.86 30.46
US$ 31 228 252 414
US$ 38 296 176 312
% 0.33 1.13
US$ 7 245 009 11 071 631 60 387 323 039
% 63.04 71.13 100.00 96.63 51.66 29.51 0.00
96.58 22.25 1.25 40 920 1.07 50 0.00
183 505 998 195 859
360 923 34 735
9.47 3.52
210 783 48 118
5.53 4.88
2 719
0.07
1 969 955 290 998
34.62 13.86 4.94
47 690 ( 451)
0.89 ( 0.02)
25 705
0.48
356 922 641 042 14 019
6.69 27.98 5.49 (7.88) 11.55 7.88 54.46 13.58 9.56 11.13
308 133 12 760 12 088 5 800 725 375 7 410 174 38 758 7 448 932 7 487 070 14 936 002
5.77 0.56 4.73 11.54 5.36 13.79 0.52 12.17 7.84 9.53
290 817 445 837 49 317 1 245 1 257 875 6 022 935 195 671 6 218 606 10 479 235 16 697 841
5.45 19.46 19.31 2.48 9.29 11.21 2.61 10.16 10.97 10.65
37 984 831
0.71 0.04
2 914 811 1 417 614 88 042 24 597
54.61 61.88 34.47 48.94 46.83 59.08 100.00 64.09 65.09 64.71
21 513 18.45 24.19 41.68 26.33 26.08 26.18 527 899 3 631 655 4 159 554 134 585 527 899
42.80 0.99 0.98 16 391 152 456 0.12 0.28
( 3 961) 1 562 897 4 234 337 4 077 356
145 159 401 301 54 705 456 006 6 005 160 6 461 166
1.07 0.75 0.73 0.74 6.29 4.12
6 339 440 31 745 523 7 487 063 39 232 586 62 192 894 101 425 481
0.86 3.80 2.65
152 456 540 327 692 783
0.25 0.57 0.44
8 311 693 9 130 855 17 442 549
WPR/RC59/3 page 14
WPR/RC59/3 page 15 ANNEX 4 OUTCOMES (1 January 2006–31 December 2007)
1. Immunization and vaccine development Regional expected results 1. Support provided for research, partnership building, and enhancement of research and development capacity to strengthen infectious-diseases vaccine development. Achievement of expected results as measured by indicators •
Support for sentinel surveillance of bacterial meningitis and encephalitis was provided to eight countries (Cambodia, China, the Lao People's Democratic Republic, Mongolia, Papua New Guinea, the Philippines, Solomon Islands, and Viet Nam). The data collected will support informed decision-making processes for Haemophilus influenza type B, pneunococcal and Japanese encephalitis vaccines.
•
Support for human papillomavirus disease burden assessment was provided to two countries (Fiji and Tonga).
•
Sentinel surveillance for rotavirus was ongoing in six low-income countries supported by the Programme for Appropriate Technologies in Health (PATH) and the United States Centers for Disease Control and Prevention (CDC).
2.
Support provided for the development of capacity in countries and areas to implement policies and ensure that immunization programmes use vaccines of assured quality and safe injection practices are implemented.
•
China and Viet Nam made significant progress towards utilization of vaccines of assured quality. WHO provided technical assistance to both countries to strengthen their national regulatory authorities and strengthen surveillance of adverse events following immunization.
3.
Support provided for the development of the capacity of countries and areas to ensure the security of vaccine supply and to increase the financial
•
The share of the total cost of basic vaccines financed from government resources increased for the seven countries eligible for support from the Global Alliance for Vaccines and Immunization (GAVI), as shown in their Financial Stability Plans. The Philippines, Papua New Guinea and
WPR/RC59/3 page 16 Annex 4 Regional expected results sustainability of national immunization programmes. Achievement of expected results as measured by indicators Viet Nam are fully financing their basic vaccines, including hepatitis B vaccine. Cambodia and Mongolia have increased their financing of basic vaccines. The Government of the Lao People's Democratic Republic for the first time allocated funds towards the purchase of basic vaccines. In addition to progress in the countries eligible for support from GAVI, China passed legislation that mandates that all Expanded Programme on Immunization (EPI) vaccines be provided without charge. The Philippines committed full domestic funding for hepatitis B vaccine through 2010, and is now supporting the cost of all EPI vaccines. The loss of donor financing of EPI vaccines in some countries (Cambodia, the Lao People's Democratic Republic and Mongolia) placed significant pressure on these countries to find domestic resources. Increased advocacy at the regional level and the development of a regional goal for hepatitis B control facilitated increased government commitment in China, the Philippines and Viet Nam. 4. Support provided for the strengthening of the capacity of countries and areas to ensure effective monitoring of immunization systems and assessment of the disease burden related to vaccine-preventable diseases. 5. Support provided to countries and areas for maximizing access to new and underutilized vaccines, and for accelerating disease-control efforts that effectively contribute to building • •
The WHO Regional Office for the Western Pacific has intensified its assistance to Member States to strengthen their monitoring capacity of immunization programmes. Technical assistance has been provided for supplementary immunization activities throughout the Region. Focus is being put on "silent" countries that have not been able to fully develop their surveillance reporting at the district level. All target countries have systems and policies to deliver a birth dose of hepatitis B vaccine within 24 hours of birth for at least the hospital births. It is estimated that 75% of countries have ≥80% DPT3 immunization coverage. In relation to maternal and neonatal tetanus (MNT) elimination, Cambodia's goal is the end of 2008; the
WPR/RC59/3 page 17 Annex 4 Regional expected results capacity from the district level upwards. Achievement of expected results as measured by indicators Philippines, China and the Lao People's Democratic Republic have set targets in 2010; and Papua New Guinea has not yet set a target date. Supplementary immunization activities (SIAs) with tetanus toxoid (TT) were implemented in 2007 in five high-risk districts of Cambodia. 6. Support provided to countries and areas to assure poliomyelitis-free status. • •
The Western Pacific Region continues to maintain its polio-free status. Surveillance and immunization coverage performance were maintained at "certification" levels and the status was assessed annually by the Regional Certification Committee. Detailed feedback was provided to the National Certification Committees and national EPI programmes.
•
In several countries of the Region, acute flaccid paralysis (AFP) surveillance systems were expanded to other EPI surveillance activities, including measles control and neonatal tetanus elimination. The Pacific island countries and areas, the Philippines and Papua New Guinea now operate active hospital-based EPI surveillance systems.
2. Communicable disease prevention and control Regional expected results 1. Regional or biregional collaboration and cooperation to enhance policy development and capacity-building for scaling up parasitic disease control and sustainable prevention strategies for human-behaviour-change programmes, as reflected in national programmes. Achievement of expected results as measured by indicators •
Significant progress has been made to complete a dengue strategic regional plan through the logframe approach. Follow-up steps agreed upon during the September 2007 biregional dengue programme managers meeting are on schedule. Similar progress was attained in the development of the regional strategic research plan in communicable diseases. Both plans will serve as tools to develop national operational plans for advocacy and for mobilization of resources.
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Regional expected results
Achievement of expected results as measured by indicators •
The first draft of the integrated vector management (IVM) plan was completed. IVM is already an integral component of the dengue strategic plan.
•
Eighteen countries (American Samoa, Brunei Darussalam, Cambodia, Cook Islands, Fiji, French Polynesia, Kiribati, the Lao People's Democratic Republic, Malaysia, Niue, Papua New Guinea, the Philippines, Samoa, Tonga, Tuvalu, Vanuatu, Viet Nam and Wallis and Futuna) have active lymphatic filariasis (LF) elimination programmes.
•
Six countries (Cambodia, Kiribati, the Lao People's Democratic Republic, the Philippines, Vanuatu and Viet Nam) have deworming programmes.
•
Viet Nam attained at least 80% coverage of the population at risk with each round of mass drug administration (MDA).
2.
Coordination of parasitic disease-control activities improved and sustained.
•
The Global Alliance for the Elimination of Lymphatic Filariasis held its fourth meeting in Fiji in March 2006. All countries endemic for lymphatic filariasis in the Western Pacific Region (both Mekong-Plus and PacELF) participated in the meeting.
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The 7th Regional Network for Asian Schistosomiasis Workshop was held in September 2007.
3.
Support provided for case management, dissemination of dengue guidelines, training, epidemiological surveillance, and outbreak preparedness and response.
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The Asia–Pacific Dengue Strategic Plan (2008-2015) addresses and provides clear guidance on case management, vector control, training, epidemiological surveillance, social mobilization, and outbreak preparedness and response.
•
The Research Strategic Plan in Communicable Diseases including Neglected Tropical Diseases provides a framework for the research activities coordinated by WHO while proposing new strategies to fill in programmatic gaps based on integrated, intersectoral approaches to control and eliminate communicable diseases.
WPR/RC59/3 page 19 Annex 4 Regional expected results 4. Public health benefits of deworming promoted among all stakeholders and the development of a pool of experts to scale up and expand the knowledge of soil-transmitted helminth control supported. 5. Supported coordination of schistosomiasis control programmes through the Regional Network for Research, Surveillance and Control of Asian Schistosomiasis or other networks, and national plans adapted to the epidemiological situation of the disease. 6. Sufficient epidemiological data to evaluate the geographical distribution and define the characteristics of at-risk groups for foodborne trematodes collected and diagnostic methods validated; efficacy of existing drugs assessed; and in-depth behavioural research conducted. 7. Operational research supported to expand the evidence base; to modify, validate or improve existing strategies; and to meet local needs for vectorborne disease-control programmes. • • • •
Achievement of expected results as measured by indicators •
Cambodia, Kiribati, the Lao People's Democratic Republic and Vanuatu have reached the WHO global target for deworming.
Training courses were organized for 40 county-level epidemiological professionals on the methods, data analysis for surveillance and epidemiological surveys on schistosomiasis prevention and control in Jiangxi Province. Training courses were organized for 20 high-level officials on the administration, coordination and technical management on the prevention and control of schistosomiasis. Three countries (Cambodia, the Lao People's Democratic Republic and Viet Nam) updated national programmes for the prevention and control of major foodborne trematodes infection with WHO's support.
Multidisease-based interventions were implemented – lymphatic filariasis, soil-transmitted helminths (STH) and others in the Philippines; and lymphatic filariasis, STH and vitamin A supplementation in Cambodia and Viet Nam.
WPR/RC59/3 page 20 Annex 4 Regional expected results 8. Countries and areas enabled to achieve or sustain leprosy elimination at the national level. Achievement of expected results as measured by indicators •
The WHO Regional Office for the Western Pacific assisted the successful launch of the global appeal to end stigma of leprosy in 2007 in Manila. The global appeal was signed by the Sasakawa Foundation and persons affected by leprosy worldwide.
•
After a lengthy postponement, the Workshop on Sustaining Leprosy Services in the Pacific was conducted in April 2007, with participation from 13 countries and areas in the Pacific (American Samoa, Fiji, French Polynesia, Kiribati, the Marshall Islands, the Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, Nauru, Palau, Papua New Guinea, Samoa, Solomon Islands and Vanuatu).
•
China successfully eliminated lymphatic filariasis as a public health problem. The Republic of Korea enrolled in a WHO verification process for lymphatic filariasis elimination.
9.
Support provided to countries and areas that have eliminated leprosy to implement the postelimination Strategy to Sustain Leprosy Services.
•
The Marshall Islands and the Federated States of Micronesia were supported in leprosy elimination activities, including screening of high-endemic pockets; training; preparation of information, education and communication (IEC) materials; and strengthening of technical and managerial skills.
•
Workshops that relate to implementing the biregional strategy on leprosy were conducted in four countries that have significant endemic pockets of leprosy, namely Cambodia, China, the Philippines and Viet Nam. Followup workshops were conducted in these countries at subnational levels.
WPR/RC59/3 page 21 Annex 4 Epidemic alert and response Regional expected results Achievement of expected results as measured by indicators •
1.
Policy and technical support provided to Member States for strengthening national communicable disease surveillance and response systems, including early warning systems, in accordance with the core capacity requirement for surveillance and response under the revised IHR (2005).
Country assessments revealed specific variations in the capacity of some countries to meet the minimum requirements of the International Health Regulations (IHR 2005). Ongoing support was provided to countries for testing and validating pandemic influenza preparedness plans, developing and strengthening capacity for responding to avian influenza outbreaks, preparing for pandemic influenza rapid containment operations and improving pandemic response.
2.
Enhanced capacity for outbreak alert and response and for coordination in response to public health emergencies of international concern at regional and country levels.
•
By the end October 2007, there were 134 officially confirmed cases of H5N1 avian influenza virus in the Region, of which 71 were fatal.
•
Systems assessment, mapping and gap analyses with achievable, sustainable and realistic communication systems are strengthened to develop core risk communication capacity and address the urgent needs posed by the H5N1 avian influenza threat.
3.
Strengthened regional and national laboratory capacity for emerging diseases, known epidemics and other public health emergencies.
•
Most countries affected by the outbreak of avian influenza, including China, the Lao People's Democratic Republic and Viet Nam, received support for laboratory diagnostic testing, provision of reagents and transportation of samples to WHO H5N1 reference laboratories for diagnostic testing.
4.
Enhanced national infection prevention and control programme as well as antimicrobial resistance monitoring capacity.
•
WHO worked closely with the United Nations Children's Fund (UNICEF) and with the Food and Agriculture Organization of the United Nations (FAO) in organizing behaviour change communication workshops. Training on infection control (IC) was completed. The IC guidelines are being revised with new strategies.
WPR/RC59/3 page 22 Annex 4 Regional expected results Achievement of expected results as measured by indicators •
Ministries of health distributed IEC materials during suspected and/or confirmed poultry outbreaks and national festivals.
5.
Strengthened influenza surveillance and control programmes and pandemic preparedness at national and regional levels.
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The first part of the pandemic plan (prevention and control for phase 3 activities) was finalized and officially endorsed.
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The "Panstop 2007 Rapid Containment Exercise", was conducted with the purpose of evaluating the decisionmaking, communications and logistical elements required in rapid containment.
•
The "Panstop II Rapid Containment Exercise" was conducted with the purpose of assessing the effectiveness of the Lao PDR National Protocol for Rapid Containment of Pandemic Influenza, and to identify strengths and opportunities for improvement in planning and operational capabilities.
6.
Enhanced national and regional capacity and coordinated action for zoonosis prevention and control along the length of the production and food chain.
•
At least six countries in the Region (Cambodia, Fiji, Mongolia, Papua New Guinea, Tuvalu and Viet Nam) conducted assessments of their capacity using the Asia Pacific Strategy for Emerging Diseases (APSED) Baseline Data Collection Checklist. In the meantime, Viet Nam strengthened its intersectoral collaborative mechanism for zoonotic diseases and established the national committee on avian influenza control and preparedness.
4. Malaria Regional expected results 1. Improved malaria programme management supported to ensure that resources are more efficiently utilized and better Achievement of expected results as measured by indicators •
WHO staff at the Regional Office and in eight malaria-endemic countries (Cambodia, China, the Lao People's Democratic Republic, the Philippines, Papua New Guinea, Solomon Islands, Vanuatu and Viet Nam)
WPR/RC59/3 page 23 Annex 4 Regional expected results outcomes are achieved. Achievement of expected results as measured by indicators continued to provide technical support to improve capacity of national programmes. The Asian Collaborative Training Network for Malaria (ACTMalaria) set up an important regional training network especially for middle-level programme staff. It also implemented regional microscopy quality assurance activities. ACTMalaria continued to operate the Malaria Resource Center, a web-based information sharing tool. 2. Early diagnosis of malaria and appropriate treatment for malaria supported in all malaria endemic countries. •
Access to diagnosis and treatment for malaria has significantly increased for populations at risk, largely due to the increased availability of resources for case management through the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and other sources, e.g. United States Agency for International Development (USAID). The quality of treatment continues to be of concern, especially in the unregulated private sector. Quality assurance of microscopic diagnosis as well as of malaria rapid diagnostic tests has been significantly moved forward by the activities of this Region.
3.
Country programme strengthened so it is able to provide adequate malaria control in poor and marginalized populations at high risk of malaria.
•
With significant funding from GFATM, malaria-endemic countries are scaling up vector control among at-risk populations, largely by switching to long-lasting impregnated nets (LLINs). Challenges remain to improve access to malaria prevention for underserved and/or neglected populations, e.g. remote, mobile and ethnic minority populations. Appropriate strategies still need to be developed to reach mobile populations. Increasingly, indoor residual spraying is being re-introduced for intensified malaria control.
•
Malaria in pregnancy is a high priority issue especially in the Pacific. A regional strategy for Pacific island countries and areas needs to be developed.
4.
Malaria surveillance and epidemic preparedness and
•
Malaria surveillance, based on the regional "Kunming
WPR/RC59/3 page 24 Annex 4 Regional expected results response strengthened in all endemic countries. Achievement of expected results as measured by indicators indicator" framework, is in place. However, reporting of some indicators, especially "probable malaria", is insufficient. With the availability of a revised set of Global Malaria Programme indicators, a revision will be undertaken in 2008. •
Malaria programme monitoring and evaluation is chronically weak, both in routine monitoring as well as in the conduct of indicator surveys. Cambodia and the Lao People's Democratic Republic carried out exemplary indicator surveys. Strengthening of monitoring and evaluation is high on the agenda for the 2008-2009 biennium. This activity will involve competent partners like the Malaria Consortium and USAID’s Monitoring and Evaluation to Assess and Use Results (MEASURE) programme and will be based on the regional experience.
5. Tuberculosis Regional expected results 1. Countries with a high burden of TB are enabled to achieve or sustain case detection rates and treatment success rates at least within the regional targets and to ensure high-quality DOTS implementation in all areas. • •
Achievement of expected results as measured by indicators •
The Western Pacific Region continues to exceed the global tuberculosis (TB) control targets of detecting 70% of estimated cases and successfully treating 85% of these cases. It is the only Region to have achieved these targets. Four out of seven countries with a high burden of TB continue to have case detection and treatments success rates above the global targets. All countries with a high burden of TB have been carrying out activities to improve drug supply management. About 71% of the Region's 6100 TB microscopy centres have undergone quality assurance assessment in 2006-2007.
WPR/RC59/3 page 25 Annex 4 Regional expected results 2. Countries are enabled to introduce and implement at the national level the 2006–2010 WHO TB control strategy, which includes initiating and/or scaling up responses to special issues of TB-HIV, MDR-TB, publicprivate mix DOTS and related health systems issues. • •
Achievement of expected results as measured by indicators •
All countries with a high burden of TB are implementing their national TB control plans for 2006–2010, in line with the Strategic Plan to Stop TB in the Western Pacific 2006–2010, which was endorsed by the Regional Committee in 2006. Countries affected by multidrug-resistant tuberculosis (MDR-TB) have taken steps toward the programmatic management of MDR-TB; however, several countries need to accelerate their efforts. The public-private mix (PPM) approach to TB care and control has been expanded in at least two countries, and initiated or piloted in at least three more.
•
With support from WHO, US$ 370 million was secured from GFATM and other sources for TB control in countries with a high burden of TB and in Pacific island countries and areas. More than 50% of the funds were generated in the last biennium.
6. HIV/AIDS and STI Regional expected results 1. Support provided to countries and areas for advocacy and for the revision, adaptation and development of national policies, strategies and plans for the provision of HIV/AIDS and STI prevention and care programmes relevant to the global health sector strategy on HIV/AIDS. Achievement of expected results as measured by indicators •
Many norms and guidelines were developed, adapted and/or revised at regional and country levels in HIV and STI prevention, care, treatment and support. Further advocacy with the ministries of health is required to ensure the implementation of these guidelines according. to country context. Specifically, a Regional STI Strategic Action Plan was developed and discussed at length during a meeting in Malaysia. As a result, 13 countries and areas (Cambodia, Fiji, Kiribati, the Lao People's
WPR/RC59/3 page 26 Annex 4 Regional expected results Achievement of expected results as measured by indicators Democratic Republic, Malaysia, the Federated States of Micronesia, the Philippines, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga and Vanuatu) developed action plans for STI prevention and control. 2. Normative guidance and technical support provided to all countries and areas that need to implement and scale up HIV/AIDS prevention and care strategies, including access to ARV, and specific approaches for vulnerable populations, in particular among injecting drug users, sex workers and their clients. •
Much progress was made in HIV prevention, care, treatment and support and in capacity-building of national staff. Cambodia, the Lao People's Democratic Republic and Viet Nam have developed national plans for harm reduction. The 100% condom use programme has been launched in four districts in Beijing, two cities in Inner Mongolia, 11 provinces in the Lao People's Democratic Republic and 10 districts in Ulaanbaatar. As of the end of 2007, Cambodia managed to cover 87% of the people living with HIV who are in need of antiretroviral therapy (ART). Collaboration with partners and donors is needed to ensure continuation of the momentum of effective prevention and care interventions. There is still a need for HIV and STI progammes to strengthen links to other public health services. While ART is being scaled up, a system to monitor, support and improve the performance and quality of care and treatment services need to be established and strengthened.
3.
Technical support provided to all countries and areas that need a strengthened HIV surveillance system for better planning, monitoring and evaluating interventions, including specific ARV resistance surveillance in selected countries
•
Fifteen countries (Cambodia, China, Fiji, Kiribati, the Lao People's Democratic Republic, Malaysia, Mongolia, the Philippines, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu and Viet Nam) have developed adequate HIV surveillance systems. In Cambodia, data management and patient tracking systems were set up. Key achievements included capacity-building of staff through regional training and meetings, and provision of technical support to national
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Regional expected results
Achievement of expected results as measured by indicators consensus meetings. Four countries (Cambodia, China, Papua New Guinea and Viet Nam) have prepared their national HIV drug resistance prevention and assessment plan for 2008. Since countries are expected to report on various indicators, the reporting systems need to be harmonized with other agencies.
7. Surveillance, prevention and management of chronic, noncommunicable diseases Regional expected results 1. Transitional economies in the Western Pacific Region set up integrated noncommunicable diseases prevention (NCD) and control programmes. Achievement of expected results as measured by indicators •
Three publications were produced: (1) Integrating poverty and gender into health programmes: a sourcebook for health professionals: module on noncommunicable diseases; (2) Noncommunicable disease and poverty: the need for pro-poor strategies in the Western Pacific Region; and (3) Plan of Action for the Western Pacific Declaration on Diabetes 2006–2010 (short version).
•
A review of the STEPwise approach to surveillance (STEPS) data and interventions targeting NCD in the countries and areas of the Pacific was conducted in July 2007 to ascertain the status of STEPS surveys in the Pacific and to identify the programmes, policies and campaigns that have worked or appear to be working to encourage government officials and community leaders to take action against NCD.
2.
A sustainable regional NCD database is in operation.
•
Many countries and areas in the Pacific and some in Asia have been conducting STEPS surveys and collecting, analysing and publishing data on the burden of NCD, as a basis for advocacy on NCD plans and interventions. Collaboration with the University of Sydney is improving capacity for collaborative data analysis and comparability of results.
WPR/RC59/3 page 28 Annex 4 Regional expected results 3. Demonstration projects in NCD prevention and control take up a formal evaluation component. Achievement of expected results as measured by indicators •
Ten countries and areas (China, Cook Islands, Fiji, French Polynesia, Mongolia, Palau, the Philippines, Samoa, Tonga and Viet Nam) have community demonstration projects focusing on nutrition, physical activity, and tobacco and alcohol use, based on WHO guidelines. The Philippines completed an impact evaluation of two pilot community-based projects on NCD prevention.
4.
Secondary prevention programmes are evaluated for impact.
•
Country activities in the area of prevention of blindness and deafness are limited to those undertaken by WHO collaborating centres in Australia, China and Japan.
5.
A regional NCD network is formally operating.
•
In Mongolia, the national cancer prevention and control programme (2007–2017), based on WHO guidelines, was introduced to all stakeholders with the facilitation of a WHO consultant.
6.
Support given to countries and areas in the development of national and regional responses to NCD.
•
At a meeting in Vanuatu in March 2007, the Pacific ministers of health called on countries to build capacity in behavioural change campaigns with regard to NCD risk factors (diet, physical activity, tobacco and alcohol use), as well as capacity to advocate for NCD prevention. In response, a Training Course in Strategic Health Communication and Marketing for NCD was held in Nadi, Fiji in November 2007, with participants from 13 Pacific island countries (Cook Islands, Fiji, Kiribati, the Marshall Islands, the Federated States of Micronesia, Nauru, Niue, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu). The participants evaluated current health education and promotion activities through strategic health communication and marketing techniques; learnt skills in applying the 10-step planning process of Integrated Marketing Communication (IMC)/Communication for Behavioural Impact (COMBI) and STEPS survey data to NCD prevention and control programmes; and reviewed the
WPR/RC59/3 page 29 Annex 4 Regional expected results Achievement of expected results as measured by indicators strategic outline of the IMC/COMBI plan for implementation
8. Mental health and substance abuse Regional expected results 1. Support provided to countries and areas in advocating the value of mental health and fighting stigma and discrimination. Achievement of expected results as measured by indicators • A series of activities contributed to the achievement of this expected result: the Pacific Islands Mental Health Network (PIMHnet) logo and slogan competitions; the official launching of PIMHnet during the Meeting of Ministers of Health for the Pacific held in Vanuatu in March 2007; and the first PIMHnet meeting held in Samoa in June 2007. 2. Information and support given to countries and areas in formulating and implementing policies and plans on mental health and substance use. • Support was provided for developing a mental health service model for rural populations in China; implementing the WHO Assessment Instrument for Mental Health Systems (AIMS) in China, Mongolia, the Republic of Korea, Malaysia and the Philippines (Cambodia and Fiji joined recently); carrying out epidemiological studies of mental disorders and alcohol use-related disorders in China and Mongolia; and developing mental health policy in PIMHnet member countries. WHO also conducted a regional survey on alcohol consumption, alcohol policy and the impacts of alcohol use on health. 3. Mental health services organization, delivery and evaluation supported at national and local levels. • Fourteen countries and areas (American Samoa, Cook Islands, the Commonwealth of the Northern Mariana Islands, Fiji, Kiribati, the Marshall Islands, the Federated States of Micronesia, Nauru, New Zealand, Palau, Samoa, Tokelau, Tonga and Vanuatu) received ongoing support for human resources evaluation and planning. The development of mental health plans was facilitated
WPR/RC59/3 page 30 Annex 4 Regional expected results Achievement of expected results as measured by indicators by the conduct of the first PIMHnet meeting. WHO was directly involved in developing a mental health plan for Cambodia and Vanuatu. A review of the draft information package for mental health services was started. The two-to-three month fellowship programmes on community mental health, based in Australia and the Republic of Korea, provided training opportunities for 14 fellows from five countries (Cambodia, China, Malaysia, Mongolia and Samoa). 4. National suicide prevention strategy and programmes supported. • The Suicide Trends in At-Risk Territories (START) study received increased attention. A preliminary report on suicide behaviours in the Region was presented at international conferences. A paper on the characteristics of suicide was prepared and an operational manual of the project was developed. Discussions and consultations on the possibility of launching a regional initiative on suicide prevention are underway. 5. Support provided for the development, implementation and evaluation of effective strategies and programmes for reducing the negative health and social consequences of the harmful use of alcohol in countries and areas. • Following an endorsement of the Regional Strategy to Reduce Alcohol-related Harm, national focal points for the control of alcohol-related harm were nominated in 27 countries and areas (Australia, Cambodia, China, Cook Islands, Fiji, Hong Kong [China], Japan, Kiribati, the Lao People's Democratic Republic, Macao [China], Malaysia, the Federated States of Micronesia, Mongolia, New Caledonia, New Zealand, Niue, the Commonwealth of the Northern Mariana Islands, Palau, Papua New Guinea, the Philippines, the Republic of Korea, Samoa, Singapore, Solomon Islands, Tonga, Tuvalu and Vanuatu). A five-year action plan has been drafted and is ready for consultation. A resource kit on the
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Regional expected results
Achievement of expected results as measured by indicators development of national strategies and plans is expected to be available early 2008. Preparations are underway for a regional meeting on reducing alcohol-related harm in the Western Pacific Region
9. Health and environment Regional expected results 1. Evidence-based normative and good practice guidance developed or updated and promoted to effectively support countries and areas in assessing health impacts and in making decisions across sectors in key environmental health areas, including water, sanitation and hygiene, air quality, workplace hazards, chemical safety, radiation protection, and environmental change. 2. Countries and areas adequately supported for building capacity to manage environmental health information, and to implement intersectoral policies and interventions for protecting health from immediate and longer-term environmental threats. • • Six countries (Cambodia, China, the Lao People's Democratic Republic, Mongolia, the Philippines and Viet Nam) were supported to develop and implement national action plans on environmental health. Eleven countries (Cambodia, China, Cook Islands, Fiji, Lao People's Democratic Republic, Mongolia, Palau, the Philippines, Tonga, Vanuatu and Viet Nam) were supported to strengthen health sector capacity to manage environmental risk factors. • Achievement of expected results as measured by indicators • Nine countries (Cambodia, China, Fiji, the Lao People's Democratic Republic, Mongolia, the Philippines, Papua New Guinea, Solomon Islands and Viet Nam) conducted assessments of key environmental health risks. Guidelines and manuals related to environmental health were developed in four countries (Fiji, the Lao People's Democratic Republic, Mongolia and Viet Nam).
WPR/RC59/3 page 32 Annex 4 Regional expected results Achievement of expected results as measured by indicators • Fourteen countries (Australia, Brunei Darussalam, Cambodia, China, Fiji, Japan, the Lao People's Democratic Republic, Malaysia, Mongolia, New Zealand, the Philippines, the Republic of Korea, Singapore and Viet Nam) were supported to participate in various workshops and meetings to accelerate achievements of regional or international goals on environment and occupational health. 3. Environmental health concerns of vulnerable and high-risk population groups (particularly children, workers and the urban poor) addressed by regional and country-level initiatives that are implemented through effective partnerships, alliances and networks of centres of excellence. • The following regional meetings addressed key environmental The following regional meetings addressed key environmental and occupational health concerns in the Region through effective partnerships: − The First Ministerial Regional Forum on Environment and Health in South-east and East Asian Countries was convened in Bangkok, Thailand in August 2007, in collaboration with the United Nations Environment Programme (UNEP). − The First East Asia Ministerial Conference on Sanitation and Hygiene was convened in Beppu, Japan in December 2007, in collaboration with UNICEF and the World Bank Water and Sanitation Programme. − The Second Meeting on Occupational Health and Safety was convened in Kuala Lumpur, Malaysia in November 2007, in collaboration with the International Labour Organization (ILO).
10. Health promotion Regional expected results 1. Increased guidance for integrating health promotion into health plans, including healthy Achievement of expected results as measured by indicators • The Regional Framework for Health Promotion was being updated in harmony with the Medium-term Strategic Plan and the draft Global Health Promotion
WPR/RC59/3 page 33 Annex 4 Regional expected results diet, physical activity, ageing and oral health. • Achievement of expected results as measured by indicators Framework. The updated Regional Framework, which focuses on three priorities for capacity-building, will be finalized in the upcoming biennium. 2. Support provided to strengthen capacity for governance, planning and implementation of multisectoral health promotion policies and programmes at country and regional levels. Fifteen countries (Brunei Darussalam, Cambodia, Fiji, the Lao People's Democratic Republic, Malaysia, the Marshall Islands, the Federated States of Micronesia, Mongolia, Nauru, New Zealand, the Philippines, the Republic of Korea, Singapore, Tonga and Tuvalu) provided updates on progress with health-promoting schools. Three countries of the Western Pacific Region (Brunei Darussalam, Papua New Guinea and the Philippines) validated the capacity-mapping methodology and the measurement tool was used in 12 countries (Brunei Darussalam, Cambodia, China, Fiji, India, Malaysia, Mongolia, the Philippines, the Republic of Korea, Singapore, Tonga and Viet Nam) to assess health promotion capacity. 3. Evidence validated and disseminated on the effectiveness of health promotion strategies and interventions to tackle communicable and noncommunicable diseases. • Two health promotion skills-development projects were initiated to help build health promotion evidence in the Region. They aimed to: (1) develop a generic change communication tool and materials to support improvements in water, sanitation and hygiene behaviours in Cambodia; and (2) develop and test a generic evaluation tool in the context of NCD in Viet Nam. The latter project is under revision. 4. Support provided for new and innovative approaches applied to sustainable financing of health promotion interventions and capacity-building at national, local and community levels. • • Health promotion foundations continued to serve as catalysts and facilitators for launching new initiatives, securing new sources of funding for health promotion and engaging multiple sectors in outcome-oriented health promotion. Graduates of ProLead (a leadership and management course for health promotion), representatives from health promotion foundations and boards, and other country
WPR/RC59/3 page 34 Annex 4 Regional expected results Achievement of expected results as measured by indicators representatives participated in the successful regional Workshop on Health Promotion Foundations: Sharing Lessons and Building Capacity, held in Manila in August 2007. Six countries (Fiji, the Republic of Korea, Malaysia, Mongolia, Singapore and Tonga) developed work plans to strengthen their health promotion infrastructure. Another five countries (Brunei Darussalam, Cambodia, China, the Philippines and Viet Nam) developed work plans to initiate health promotion financing and infrastructure development. An updated version of ProLead, called “ProLead Plus”, was initiated with participation of health promotion leaders from 13 countries (Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, Kiribati, the Lao People's Democratic Republic, Papua New Guinea, Samoa, Solomon Islands, Tonga, Vanuatu and Viet Nam). 5. Support provided to increase the capacity of ministries of health and education to plan, implement and evaluate school health programmes for reduction of risks associated with leading causes of death, disease and disability • • Training on the WHO Global School-Based Student Health Survey was provided to senior government officers responsible for health-promoting schools, health education, and NCD prevention and control in 15 Pacific island countries (Cook Islands, Fiji, Kiribati, the Marshall Islands, the Federated States of Micronesia, Nauru, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu and Vanuatu). Steps were taken to update the Regional Health Promoting Schools Guidelines. The regional health-promoting schools status reports were updated.
WPR/RC59/3 page 35 Annex 4 11. Violence, injuries and disabilities Regional expected results 1. Support provided to high-priority countries and areas for the implementation and evaluation of information systems for the major determinants, causes and outcomes of unintentional injuries, violence and disabilities. 2. Multisectoral interventions to prevent violence and unintentional injuries validated and effectively promoted in countries. 3. Guidance and effective support provided for strengthening of pre-hospital and hospital care for persons affected by injuries and violence. 4. Effective support provided for strengthening of country capacity for integrating rehabilitation services into primary health care, and for early detection and management of disabilities. 5. Improved capacity in selected countries and areas for framing policy on prevention of injury and violence or on managing disabilities. • • Five countries (Cambodia, China, Mongolia, the Philippines and Viet Nam) were supported to develop a national framework of action and national policies on injury and violence prevention. Twenty-four countries and areas (Brunei Darussalam, Cambodia, China, Cook Islands, Hong Kong [China], Fiji, French Polynesia, Guam, Kiribati, the Lao People's Democratic Republic, Malaysia, the Marshall Islands, the Federated States of Micronesia, Mongolia, New Zealand, • Two countries (Mongolia and the Philippines) were supported to participate in the Asia-Pacific Regional Meeting on Country-Based Rehabilitation in Bangkok, Thailand in November 2007. • • Thirteen countries and areas (Cambodia, China, Fiji, French Polynesia, Guam, the Lao People's Democratic Republic, the Federated States of Micronesia, Mongolia, Nauru, Palau, the Philippines, Vanuatu and Viet Nam) were supported to identify priority areas of intervention. Four countries (Cambodia, the Lao People's Democratic Republic, Mongolia and Viet Nam) were supported to develop pre-hospital and hospital care systems. Achievement of expected results as measured by indicators • Six countries (Cambodia, China, the Lao People's Democratic Republic, Mongolia, the Philippines and Viet Nam) were supported to strengthen their injury surveillance programmes.
WPR/RC59/3 page 36 Annex 4 Regional expected results Achievement of expected results as measured by indicators New Caledonia, Palau, Papua New Guinea, the Philippines, the Republic of Korea, Samoa, Solomon Islands, Vanuatu and Viet Nam) were supported to develop country profiles on injury and violence prevention. 6. Strengthened training capacity in priority countries and areas for prevention of injury and violence and for rehabilitation services. • Training modules for injury prevention (Training, Educating and Advancing Collaboration in Health on Violence and Injury Prevention [TEACH-VIP]) were provided to institutions in 11 countries and areas (Australia, China, Fiji, Hong Kong China, Japan, the Lao People's Democratic Republic, Malaysia, New Zealand, the Philippines, Singapore and Viet Nam) to strengthen training capacity. 7. Functional regional and national networks that strengthen collaboration between health and other sectors involving organizations of the United Nations system, Member States, regional and international development banks, and nongovernmental organizations, including those people with disabilities. • Two regional forums on injury and violence prevention were convened, one for Asian countries and another for Pacific countries, namely: (1) Meeting of National Focal Points on Injury and Violence Prevention, 15– 17 May 2006, Manila, Philippines; and (2) Meeting on Injury and Violence Prevention for the Pacific, 2–4 April 2007, Nadi, Fiji. As a result of these meetings, a regional framework of action and country profiles on injury and violence prevention were developed for 24 countries (Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, French Polynesia, Guam, Hong Kong [China], Kiribati, the Lao People's Democratic Republic, Malaysia, the Marshall Islands, the Federated States of Micronesia, Mongolia, New Zealand, New Caledonia, Palau, Papua New Guinea, the Philippines, the Republic of Korea, Samoa, Solomon Islands, Vanuatu and Viet Nam). • A regional Consultation on the World Report on Child and Adolescent Injury Prevention was held in Manila in June 2007.
WPR/RC59/3 page 37 Annex 4 12. Food safety Regional expected results Achievement of expected results as measured by indicators • The Asia Food Net was established to facilitate sharing of information on foodborne disease surveillance and food hazard monitoring among countries in the Region. Countries targeted in this biennium for strengthening foodborne disease surveillance – Cambodia, the Lao People's Democratic Republic and Viet Nam – conducted training on outbreak investigation and/or were involved in training by the Global Salmonella Surveillance Programme. • Professional staff from China, Papua New Guinea, the Philippines and Mongolia attended training courses and workshops on foodborne disease surveillance and/or total diet studies. Funds for food safety activities remain quite limited, however, with the majority of extrabudgetary funds being provided by the Ministry of Health, Labour and Welfare, Japan •
1.
Foodborne disease surveillance and food hazard monitoring and response programmes strengthened regionally and in targeted countries.
2.
Adequate support provided for building capacity in priority countries to apply risk profiling and risk assessment to food control.
International risk assessment is a WHO Headquarters-specific activity. However, technical support was provided for strengthening the application of risk profiling and risk assessment to food control in priority countries, including China, Malaysia and Papua New Guinea,
3.
Adequate support provided in priority countries to enable them to strengthen their food safety policies, legislation, standards work, analysis and enforcement.
•
While 84% of countries are members of Codex, the percentage of countries participating in international standard setting is difficult to determine. The Codex Trust Fund supported the attendance of many regulators at Codex meetings. However, their involvement in the standard setting process has not been objectively assessed. In addition, efforts to implement risk reduction strategies for foodborne illness and zoonoses through marketplace-focused action have been impacted by vertical programme attention to avian influenza without
WPR/RC59/3 page 38 Annex 4 Regional expected results Achievement of expected results as measured by indicators attention to food safety. Significant progress has been made in the review and revision of food safety in China and in establishing or amending policies, plans of action, legislation or enforcement strategies for food safety in Cook Islands, Fiji, Kiribati, the Marshall Islands, the Federated States of Micronesia and Nauru. •
4.
Adequate support provided in priority countries to enable them to strengthen their efforts in food safety education.
Efforts to enhance food safety education (based upon the five keys to safer food) have been made in Cambodia, China, Guam, the Lao People's Democratic Republic, the Marshall Islands, the Commonwealth of the Northern Mariana Islands and Viet Nam. Efforts have been focused on food safety education in schools and food safety education in rural and local communities.
13. Tobacco Regional expected results Achievement of expected results as measured by indicators • WHO Member States in the Western Pacific Region made remarkable progress in becoming parties to the WHO Framework Convention on Tobacco Control (FCTC). Early and active engagement in the FCTC process, as well as full participation in FCTC meetings, has been critical to this success. The United States of America has not yet ratified the WHO FCTC. Therefore, only the American territories that are in the Western Pacific Region are not bound by the WHO FCTC. This may be a challenge to fostering Western Pacific regional and subregional cooperation on tobacco control efforts and FCTC implementation.
1.
Support provided to increase entry into force of the WHO Framework Convention on Tobacco Control (FCTC).
WPR/RC59/3 page 39 Annex 4 Regional expected results Achievement of expected results as measured by indicators • Twenty-four countries and areas have adopted legislation or the equivalent in relation to at least one of the referenced settings and articles (American Samoa, Australia, Brunei Darussalam, China, Cook Islands, Fiji, French Polynesia, Guam, Japan, the Lao People's Democratic Republic, Malaysia, the Marshall Islands, the Federated States of Micronesia, Mongolia, New Caledonia, the Commonwealth of the Northern Mariana Islands, Palau, the Philippines, the Republic of Korea, Samoa, Tonga, Tuvalu, Vanuatu and Viet Nam). •
2.
Support provided to increase the number of Member States with established national tobacco control programmes from the 2004 baseline.
3.
Support provided to sustain tobacco control programmes operational in Member States, and integration of tobacco control approaches into public health and other programmes and events.
Most Member States are making good progress towards fully implementing the provisions of the WHO FCTC. Through its Regional and country office staff, and occasionally consultants, WHO provided specific country-level technical assistance to 15 Member States (Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, Kiribati, the Lao People's Democratic Republic, Malaysia, Papua New Guinea, the Philippines, Samoa, Tonga, Tuvalu, Vanuatu and Viet Nam). The assistance focused on legislation review and development of key tobacco control policies, including tobacco product packaging and labelling and bans on advertising and promotion as required by the WHO FCTC. Governments must maintain their political commitments under the FCTC. In general, country-level capacity must be strengthened in order to fully implement the FCTC. WHO will need to continue to give highest priority to identifying gaps and needs in tobacco control policy and legislation and providing high-quality country-level technical assistance.
WPR/RC59/3 page 40 Annex 4 Regional expected results Achievement of expected results as measured by indicators • The Regional Office actively promoted GLOBALink membership at all tobacco-related workshops and meetings.
4.
Support provided to increase and expand bilateral and multilateral partnerships established to address transnational tobacco control issues.
5.
Support provided to enhance surveillance, research, evaluation, information dissemination and advocacy.
•
WHO has undertaken an expansion of surveillance activities in the Region. By the end of 2007, 24 countries and areas had completed or were in the process of completing surveys under the Global Tobacco Surveillance System (American Samoa, Cambodia, China, Cook Islands, Fiji, Guam, the Lao People's Democratic Republic, Macao [China], Malaysia, Mongolia, the Marshall Islands, the Federated States of Micronesia, New Zealand, the Commonwealth of the Northern Mariana Islands, Palau, Papua New Guinea, the Philippines, the Republic of Korea, Samoa, Singapore, Solomon Islands, Tuvalu, Vanuatu and Viet Nam). In addition, WHO updated the online Global Information System for Tobacco Control data base, collected data for the Global Tobacco Control Report, and assisted parties with the required WHO FCTC progress report. In addition, a key study on betel nut and tobacco use was completed and will be disseminated by early 2008. The Western Pacific Regional Office provided technical and/or financial assistance for economic or intervention studies in Cambodia, China, the Lao People's Democratic Republic, Malaysia, Mongolia, the Philippines and Viet Nam. In 2008, work in this area will be significantly expanded with the support of the Bloomberg Global Initiative to Reduce Tobacco Use that will fund the new Global Adult Tobacco Survey in China, the Philippines and Viet Nam, as well as WHO staff to support surveillance efforts.
WPR/RC59/3 page 41 Annex 4 14. Nutrition Regional expected results Achievement of expected results as measured by indicators • Activities done in collaboration with other United Nations agencies such as the United Nations Children's Fund (UNICEF) have proven to be effective and support has been extended to more countries as funding has been co-shared by UNICEF and WHO. • A workshop on the introduction of the new WHO child growth standards for children under five was convened in collaboration with the UNICEF East Asia and Pacific Regional Office. The workshop was conducted with participants from nine countries from the Region: Cambodia, China, Fiji, the Lao People's Democratic Republic, Malaysia, Mongolia, Papua New Guinea, the Philippines and Viet Nam. • The adoption of the new WHO child growth standards was supported in seven countries (Cambodia, Fiji, the Lao People's Democratic Republic, Malaysia, Mongolia, the Philippines and Viet Nam). • Seven countries (Australia, Cambodia, the Lao People's Democratic Republic, Malaysia, Mongolia, the Philippines and Viet Nam) attended the training course on Child Growth Assessment in the Western Pacific Region from 11 to 20 September 2007, Shah Alam, Malaysia. The course included a training of trainers (11-14 September) and an end user's training (17-20 September), wherein 31 national participants from Malaysia attended. • As agreed with WHO Headquarters and UNICEF colleagues, the promotion of the new standards in the Region will be part of the child survival strategy.
1.
Technical support and guidance provided to countries and areas at the regional and subregional levels for strengthening nutrition programmes.
2.
New WHO growth standards introduced, and global, regional and national nutrition surveillance systems strengthened.
WPR/RC59/3 page 42 Annex 4
Regional expected results
Achievement of expected results as measured by indicators • Continuous collaboration between the South Pacific Commission (SPC) and WHO, along with the support of donor agencies such as the Japan International Cooperation Agency (JICA) and the Australian Agency for International Development (AusAID), has made significant contribution to the development of national plans of action on nutrition (NPANs) in the Pacific. Technical support has been made available through the Nutrition and Physical Activity Officer who is based in the WHO South Pacific Office. Some countries, however, still need technical assistance in the review and/or development of NPANs. • Two NPAN training courses were conducted in this biennium: one in the Federated States of Micronesia, 3–6 July 2006, and another in Suva, Fiji, 19–23 February 2007. The training course in 2006 was attended by four countries in the Pacific (Guam, the Marshall Islands, the Federated States of Micronesia and Solomon Islands); the training course in 2007 was attended by Fiji, the Commonwealth of the Northern Mariana Islands, Tokelau, Niue and Nauru. • The Marshall Islands and Solomon Islands have formulated a combined strategy for national plans of action on nutrition and noncommunicable diseases. Guam is reviewing its national plan of action on nutrition, and the Federated States of Micronesia has finalized its national plan. • In the Lao People's Democratic Republic, a review of the existing national plan of action on nutrition and nutrition programmes has been conducted. The review led to a draft National Food and Nutrition Policy, which will be followed by a new nutrition strategy and action plan.
3.
Integrated national food and nutrition policies and plans developed or revised and promoted.
WPR/RC59/3 page 43 Annex 4 Regional expected results Achievement of expected results as measured by indicators • The WHO/UNICEF Consultation on Breastfeeding Protection, Promotion and Support was held from 20 to 22 June 2007 in Manila, Philippines and was attended by 16 countries from the Western Pacific Region (Australia, Cambodia, China, Fiji, Japan, the Lao People's Democratic Republic, Malaysia, Mongolia, New Zealand, the Philippines, Papua New Guinea, Samoa, Singapore, Solomon Islands, Vanuatu and Viet Nam). The consultation strengthened the commitment of the countries to advocate breast-feeding and to develop their infant and young child feeding programmes. • The Philippines' implementation of the Code of Marketing of Breastmilk Substitutes has been an example for other countries wanting to strengthen their plans to promote, protect and support breast-feeding. • There was a shortage of resources to educate the public on the benefits of breast-feeding and to advocate actions to protect, promote and support breast-feeding. • Three countries have enacted and/or revised laws to support the International Code of Marketing Breastmilk Substitutes. Fiji endorsed the National Health Promotion Policy; the Lao People's Democratic Republic approved the revised version of the Regulation on Food Product for Infant and Young Child; and Viet Nam issued a government decree on marketing and usage of nutrition products for young children. •
4.
Technical and policy support provided for the implementation of integrated strategies to improve maternal and child health and nutrition.
5.
Technical and policy support provided to promote healthy diets, including the revision of food-based dietary guidelines, and to reduce obesity and other nutrition-related noncommunicable diseases.
Cambodia, the Lao People's Democratic Republic and Mongolia implemented nutrition programmes for the management of severe malnutrition.
WPR/RC59/3 page 44 Annex 4 Regional expected results Achievement of expected results as measured by indicators • The conclusions and recommendations from the Global Consultation on Weekly Iron and Folic Acid Supplementation were finalized; publication of the report in a scientific journal is in progress. Additional funds will be needed to promote fortification programmes in the Pacific. Commitments from all sectors and governments are essential in order to move forward. •
6.
Promotion of innovative ways of supplementation and optimal food-fortification programmes with micronutrients of public health significance.
7.
Technical and policy support provided to improve nutrition in crises and in special circumstances, including people living with HIV/AIDS.
Despite the shortage of funding, support was provided to priority countries such as Cambodia, China, the Lao People's Democratic Republic and Viet Nam. Unless funds from other extrabudgetary sources become available, planned activities cannot take place in the next biennium.
15. Reproductive health Regional expected results 1. Adequate guidance and support provided to improve family planning and reproductive health care in priority countries and areas through dissemination of evidence-based standards, and technical and managerial guidelines. Achievement of expected results as measured by indicators • The Global Reproductive Health Strategy to Accelerate Progress towards the Attainment of International Development Goals and Targets was disseminated throughout the Region. A workshop to review the implementation of the Global Reproductive Health Strategy in the Western Pacific Region was held from 12 to 14 November 2007, in Manila, Philippines. Thirty-three participants from 15 countries (Cambodia, China, Fiji, Kiribati, the Lao People's Democratic Republic, Malaysia, the Federated States of Micronesia, Mongolia, Papua New Guinea, the Philippines, Samoa, Solomon Islands, Tonga, Vanuatu and Viet Nam) attended the workshop, along with relevant WHO staff from Headquarters, Regional Office and country offices. Two partner agencies (UNICEF and UNFPA) were also represented.
WPR/RC59/3 page 45 Annex 4 Regional expected results 2. Policy and technical support effectively provided to countries and areas for the design and implementation of comprehensive plans for increased access to and availability of high-quality family planning and reproductive health services. 3. Ability of countries to identify regulatory obstacles to the provision of high-quality family planning and reproductive health services. • Many countries have been enhancing existing laws to facilitate high-quality family planning and reproductive health services. • Achievement of expected results as measured by indicators • Viet Nam and the Philippines have been doing research on integrating or linking services for sexually transmitted infection screening with cervical cancer screening. Cambodia has been carrying out research on malaria in pregnant women and on health services screening.
16. Making pregnancy safer Regional expected results 1. Technical and policy support provided to countries and areas for finalizing and implementing national plans of action for the reduction of maternal and newborn mortality. • Achievement of expected results as measured by indicators • The National Plan of Action, developed with technical support from WHO in 2005 was implemented by priority countries with varying degrees of success. Good implementation was achieved in China and Mongolia. Further technical and policy support (through advocacy) is needed in Cambodia, the Lao People's Democratic Republic, Papua New Guinea and the Philippines. 2. Adequate technical support provided for dissemination, adaptation and implementation of evidence-based standards and guidelines for effective maternal and newborn care. Guidelines and tools such as the Integrated Management of Pregnancy and Childbirth modules and the 4 cornerstones of family planning were provided by Headquarters and disseminated to countries; the WHO Regional Office in the Western Pacific (WPRO) provided technical support in translating, adapting and using them. Guidelines were also developed by WPRO to be used by countries. The four cornerstones of family planning are
WPR/RC59/3 page 46 Annex 4 Regional expected results Achievement of expected results as measured by indicators (1) the Medical Eligibility Criteria for Contraceptive Use, (2) Selective Recommendations for Contraceptive Use, (3) the Essentials of Contraceptive Technology and (4) the Decision-Making Tool for Family Planning Clients and providers. 3. Technical support provided for training of skilled attendants in basic and emergency obstetric care and newborn care. • Some priority countries (Mongolia and Viet Nam) were given support to attend skills training in emergency obstetric care in the Philippines. Support was provided to Cambodia and the Lao People's Democratic Republic to review the situation of skilled birth attendants in the country. Newborn care training was conducted in Mongolia, the Philippines and Viet Nam. 4. Technical support provided to priority countries and areas to make the continuum of care more effective. • There was minimal achievement in this Regional expected result due to shortage of funds and absence of a Regional Adviser. However, countries were made aware of the module that describes the process for continuum of care.
17. Gender equality, women and health Regional expected results 1. Knowledge and evidence on the link between gender-based issues and reproductive, maternal and women's health obtained. •
Achievement of expected results as measured by indicators •
Support was provided for the implementation of the Strategy for Integrating Gender into the Work of WHO, and for mainstreaming gender into reproductive, maternal and women’s health. Participation in “gender in health” workshops and meeting in Washington, DC.
2.
Policy and technical support effectively provided to integrate the gender perspective into health policy and strategy (i.e. women's health and maternal health) development and intervention.
•
As a follow-up to the Workshop on Gender and Rights in Reproductive and Maternal Health held in NovemberDecember 2005 in Malaysia, a training manual on gender and rights in reproductive and maternal health was developed. Gender and Rights in Reproductive and Maternal Health: Manual for a Learning Workshop was disseminated, promoted and translated into Chinese.
WPR/RC59/3 page 47 Annex 4 Regional expected results Achievement of expected results as measured by indicators •
A National Workshop on Gender and Rights in Reproductive and Maternal Health was held in Malacca, Malaysia from 7 to 13 July 2007, with support provided by the Regional Office and local facilitators. The workshop was organized with the Institute of Public Health, Ministry of Health. Thirty-four health care providers from the public sector and the Department of Health attended the workshop.
•
A National Workshop on Gender and Rights in Reproductive and Maternal Health was held in Beijing, China from 11 to 16 November 2007. The workshop was convened by the School of Public Health, University of Peking Health Science Centre, with support from WHO. Thirty-eight participants from 16 provinces in China participated.
•
WHO gave a Healthy Cities 2006 Good Practice Award to Kunshan, Jiangsu, China, for innovative approaches taken to address gender-based violence.
3.
Technical support provided to countries or nongovernmental organizations to empower women for self-confidence and seeking health service through family and community involvement.
•
Due to shortage of funds in the early part of the biennium and the very late arrival of funds in the last quarter of 2007, there was difficulty in achieving the expected result.
18. Child and adolescent health Regional expected results 1. Guidance and technical support provided for increased coverage and intensified action towards improving neonatal and child Achievement of expected results as measured by indicators •
Establishment of fixed-term posts in the Regional Office and priority countries ensures continued WHO presence and technical guidance in countries.
WPR/RC59/3 page 48 Annex 4 Regional expected results survival, growth and development. Achievement of expected results as measured by indicators •
Support was provided for the expansion of the Integrated Management of Childhood Illness (IMCI). Mongolia achieved nationwide coverage. Cambodia, Fiji and the Philippines expanded coverage to more than 50% of targeted districts, and 10 other countries and areas (China, Kiribati, the Lao People's Democratic Republic, Malaysia, the Federated States of Micronesia, Papua New Guinea, Solomon Islands, Tuvalu, Vanuatu and Viet Nam) are in various stages of geographical expansion.
•
Cambodia, Mongolia and Papua New Guinea have adapted neonatal care in national IMCI guidelines, while China and the Philippines are in the process of doing the same.
•
Eight countries (Cambodia, China, Fiji, the Lao People's Democratic Republic, Mongolia, Papua New Guinea, the Philippines and Viet Nam) have integrated Infant and Young Child Feeding (IYCF) with child health services. Support was extended for a technical consultation on breast-feeding promotion, protection and support.
2.
International and national strategies and efforts coordinated to attain globally agreed goals for improving child and adolescent health.
•
The successful launching of the WHO/UNICEF Regional Child Survival Strategy caused stakeholders to increase their attention to child survival. An increase in voluntary contributions mobilized by partners implies that child survival will continue to be given priority at regional and country levels.
•
Cambodia finalized and costed its national child survival plan for scaling up 12 scorecard interventions in priority provinces. The Philippines developed and launched its national strategic plan for child survival, which identified regions for priority action. Viet Nam drafted a national plan of action for child survival. China finalized the national assessment of maternal and child (MCH)
WPR/RC59/3 page 49 Annex 4 Regional expected results Achievement of expected results as measured by indicators survival strategies and defined an essential package of maternal and child care services; the Lao People's Democratic Republic is developing an integrated MCH strategy. Papua New Guinea drafted a national policy on IMCI and is in the process of completing its national plan; Solomon Islands worked on a national child survival strategic plan. •
Sustained partnership with UNICEF and other child survival programmes including the health systems development division should be nurtured for the efficient implementation of the Regional Strategy.
•
Tracking progress in child survival should become more systematic following agreements in a WHO/UNICEF intercountry consultation on Tracking Progress in Child Survival conducted in the last quarter of 2007.
•
Programme planning and monitoring is expected to become more organized in the coming biennium with the finalization of the integrated Programme Management Guidelines on Child Health.
3.
Technical support provided for improved strategies, norms and standards for protecting adolescents from disease and from behaviours and conditions that pose a risk to health.
•
Support to adolescent health (ADH) was enabled for six months through the recruitment of a regional short-term technical officer. At a regional child and adolescent health planning meeting, countries were oriented on the strategic priorities of ADH, including the tools and methods to support the "4S" strategy (strategic information, services and commodities, supportive evidence-informed policies, and strengthened sectoral collaboration). An interregional, interprogramme workshop was held in 2007 to develop a framework for linking services for prevention and management of STI/HIV with reproductive health, maternal and child health. An intercountry workshop on accelerating action
WPR/RC59/3 page 50 Annex 4 Regional expected results Achievement of expected results as measured by indicators for improving the sexual and reproductive health of young people took place in March 2007 •
Mongolia and Viet Nam participated in a global focus-country meeting in November 2007 to apply lessons learnt in programming to adolescent health.
•
Regional support in the area of adolescent and youth health will be strengthened when the ADH technical officer post is filled in early 2008
19. Essential medicines Regional expected results 1. Support provided to countries and areas to develop, revise, implement and monitor national medicines policies. Achievement of expected results as measured by indicators •
Six countries are formulating or revising national medicines policies based on a comprehensive assessment of pharmaceutical sectors using WHO tools and standardized indictors (Brunei Darussalam, Cook Islands, Fiji, Niue, Samoa and Solomon Islands).. These countries are also monitoring the impact of national medicines policies on accessibility, quality and appropriate use of medicines.
2.
Support provided to countries and areas to improve access to essential medicines using the Regional Strategy as a guide.
•
Using the Regional Strategy for Improving Access to Essential Medicines (2005–2010) as a guide, more countries undertook actions to improve access to essential medicines. Countries also became better informed on issues related to the TRIPS Agreement and access to essential medicines. Fiji, Samoa and Solomon Islands reviewed patent bills with a focus on the use of TRIPSrelated safeguards. Cook Islands, Fiji, Mongolia, Papua New Guinea and Samoa undertook a review of pharmaceutical financing and expenditures. More countries undertook price surveys and monitoring.
WPR/RC59/3 page 51 Annex 4 Regional expected results 3. Support provided to countries and areas to strengthen pharmaceutical regulation and quality assurance systems. Achievement of expected results as measured by indicators •
Awareness on counterfeit and substandard drugs is relatively high. Capacity to combat counterfeit medicines has been enhanced through the regional Rapid Alert System for combating counterfeit medicines and better collaboration with INTERPOL, law enforcement agencies, customs and consumers.
4.
Support provided to countries and areas to promote therapeutically effective, safe and cost-effective use of medicines by health care providers and consumers.
•
Cambodia, China, the Lao People's Democratic Republic, Mongolia and the Philippines promoted rational use of medicines through the introduction and implementation of the monitoring, training and planning (MTP) intervention in health facilities. Countries strengthened hospital drugs and therapeutics committees, and developed standard treatment guidelines as well as essential medicines lists.
5.
Support provided to countries and areas in development and implementation of a national policy on traditional medicine.
•
Increased interest in traditional medicines has been noted in many countries. Support was provided to four countries (China, Malaysia, the Republic of Korea and Singapore) for revising their national policy or legislation on traditional medicine, referring to the Regional Strategy for Traditional Medicine in the Western Pacific
•
Papua New Guinea developed a national policy on traditional medicine in March 2007.
6.
Support provided to countries and areas for improved regulations on herbal medicines.
•
The Western Pacific Regional Forum for the Harmonization of Herbal Medicine (FHH), in collaboration with the WHO Regional Office, continued its efforts to improve efficacy, quality and safety of herbal medicines in Australia, China, Hong Kong (China), Japan, the Republic of Korea, Singapore and Viet Nam.
7.
Support provided to countries and areas in implementing standards on traditional medicine.
•
The Regional Office continued its efforts to standardize traditional medicine.
WPR/RC59/3 page 52 Annex 4 Regional expected results Achievement of expected results as measured by indicators •
A Meeting on the Development of Standard Acupuncture Point Locations held in October 2006 in Tsukuba, Japan finalized the standardization of acupuncture point locations, intended to enhance the reliability of acupuncture research, practice and education.
•
WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region was published in July 2007.
•
An alpha version of the Regional Office’s International Classification of Traditional Medicine (ICTM) was accepted in principle as part of the WHO Family of International Classifications (FIC) Network in 2007.
•
A formula/template for developing evidence-base clinical practice guidelines on traditional medicine was prepared in December 2007.
20. Essential health technologies Regional expected results Achievement of expected results as measured by indicators •
1.
Support provided for the development of nationally coordinated blood transfusion services, with a quality system in all areas.
Support provided by WHO resulted in the successful implementation of several WHO initiatives such as the Blood Donor Recruitment Programme (BDP) and Quality Management Programme (QMP) for blood transfusion services. WHO supported the efforts of national governments to institutionalize what has been achieved to ensure sustainable development.
•
Strong government commitment and leadership facilitated progress in the areas of blood safety.
•
Some countries lack high-level commitment and responsibility despite the existence of policy. Inequity of development between the urban and rural areas also exists.
WPR/RC59/3 page 53 Annex 4 Regional expected results Achievement of expected results as measured by indicators •
2.
Support provided to improve the quality and safety of, and access to, appropriate diagnostic support and laboratory services.
WHO strengthened its coordination, collaboration and communication in the area of support to laboratory services and strengthened its role in coordinating other development partners that are interested in investing in this area.
3.
Support provided for injection safety and related infection control for the prevention of blood-borne infections in health care settings.
•
In five countries (Cambodia, China, Kiribati, Mongolia and the Philippines), the following outcomes were achieved: (1) baseline assessment on injection safety practices; (2) training of 130 trainers on international group discussions (IGDs) and of 222 on universal precautions; (3) production and distribution of six types of IEC materials; and (4) 52 IGDs that revealed perceptions and recommendations on injection practices. The results of monitoring and evaluation showed an improvement in injection safety practices in the selected health care facilities. The IGDs revealed misconceptions of the patients and of the doctors related to use of injectable drugs.
•
Injection safety, health care waste management, and infection control were integrated into the work of Infection Control Committees.
•
Training was supported at the provincial level on injection safety and health care waste management.
•
Monitoring systems were implemented through supervisory visits and checklists.
4.
Support provided in the use of training materials and tools to improve the technical skills of health personnel in safe use of essential emergency procedures and equipment in first-level referral health facilities.
•
One surgeon from Mongolia was successfully trained in Geneva on essential surgical care procedures. On return she conducted several training programmes for aimag-level health care workers.
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5.
Support provided to develop and implement guidelines, standards, and policies to strengthen medical equipment management and maintenance systems.
Guidelines and training materials for medical equipment maintenance were completed and medical engineers were trained.
21. Health system policies and service delivery Regional expected results Achievement of expected results as measured by indicators •
1.
Guidance prepared and technical support provided to improve national and local health-sector policy-making, regulation, strategic planning, implementation of reforms and inter-institutional coordination.
WHO contributed through technical and operational assistance in a diverse set of activities that were tailored to country needs and requests: work on public health law, harmonizing public health law with international health regulation requirements, assistance to sectorwide approaches and other donor coordination efforts, and preparation of policy briefs for the decision-making and policy-setting process.
2.
Capacity strengthened in Member States and WHO to better support health systems development.
•
The Western Pacific Regional Office does not have a specific programme for using Internet briefs for policy dialogue. Internet or e-mail communication with WHO country staff, which is then passed on to national colleagues, is a regular occurrence. Five WHO staff attended international meetings and 30 staff attended a workshop in an effort to operationalize the health systems strengthening strategy of the WHO Secretariat within the Western Pacific Regional Office. Four countries (Cambodia, China, the Lao People's Democratic Republic and Viet Nam) conducted training activities that are linked to this expected result.
3.
Guidance and technical support provided to countries and areas for strengthening the delivery of health services centred on quality, equity and efficiency.
•
Support was given to quality assurance or quality improvement initiatives in seven countries (China, the Lao People's Democratic Republic, Malaysia, the Federated States of Micronesia, Mongolia, Samoa and
WPR/RC59/3 page 55 Annex 4 Regional expected results Achievement of expected results as measured by indicators Viet Nam); pilots of management improvement in six countries (China, the Lao People's Democratic Republic, Mongolia, the Philippines, Samoa and Viet Nam); and also a comprehensive MCH review in Mongolia. The activities were designed to match country requests and included piloting integrated delivery methods, an emergency care pilot, and an MCH review.
22. Policy-making for health in development Regional expected results Achievement of expected results as measured by indicators •
1.
Member States have strengthened their awareness and capacity, during the biennium, to develop more equitable pro-poor, gender-responsive and ethical human rights-based health policies, programmes, and interventions.
Support was provided to raise awareness and capacity in Member States and among technical programmes to develop more pro-poor, equitable, gender-responsive and ethical human rights-based health policies, programmes and intervention, through a variety of activities, including policy analysis, meetings and workshops, participation in regional and global events, and the development of country profiles and other publications and tools. Also, support was provided to build country capacity and improve policy coherence on trade and health, through activities such as policy analysis, seminar and workshops, and study tours or fellowships. Efforts have been made to strengthen the evidence base on equity in health through analysis and publications, to strengthen capacity of countries and technical programmes to use such evidence to develop equity-focused health policies, and to better inform counterparts about the public health aspects of ongoing World Trade Organization negotiations.
WPR/RC59/3 page 56 Annex 4 23. Health financing and social protection Regional expected results Achievement of expected results as measured by indicators •
1.
Availability and use of policy options and strategies to improve health care financing and social protection mechanisms.
The Regional Strategy on Health Care Financing approved in September 2005 and the WHO interregional meeting on the implementation of the strategy held in August 2006 had very positive impacts on enhancing overall policy discussions on health care financing options and social protection polices. Participants from 11 countries of the Western Pacific Region (Cambodia, China, Fiji, the Lao People's Democratic Republic, Malaysia, the Federated States of Micronesia, Mongolia, the Philippines, Samoa, Tonga and Viet Nam) contributed to the achievement of this result. Country-specific actions led to the development of health financing policy options, improvement of social health protection, and reduction of out-of pocket payments in selected countries.
2.
Data, information, evidence and knowledge on health financing and social protection available and used.
•
National capacities were strengthened through various WHO interventions undertaken at regional and country levels. Efforts to use evidence and information for developing health financing and social health protection policy options and strategies were increased. More efforts and interventions are needed to build capacities in transitional economy countries and the Pacific.
3.
Increased access to regional training courses and seminars on health care financing and social health insurance.
•
WHO publications, policy briefs and other related references on key health financing issues have been well received in the Region. Member States recognize WHO's potential role in improving health financing and social health protection and have requested WHO to continue this important work at all levels.
4.
Informal network of national experts on health care financing and social protection established.
•
An international conference on the extension of social health insurance to the informal economy was convened in Manila and resulted in the establishment of an informal network of health economists in Asia and Africa. A
WPR/RC59/3 page 57 Annex 4 Regional expected results Achievement of expected results as measured by indicators WHO interregional meeting on the implementation of the Regional Strategy on Health Care Financing, held in Mongolia, contributed to broader communication among experts in the European, Eastern Mediterranean, SouthEast Asia and Western Pacific Regions of WHO.
24 Human resources for health Regional expected results Achievement of expected results as measured by indicators •
1.
Support provided to countries and areas in research, analyses and the development of guidelines and tools for effective health workforce planning, utilization and management.
Support was provided to countries and planned activities were implemented. The endorsed Regional Strategy on Human Resources for Health was used as a guide for the development of national strategies and plans in the Lao People's Democratic Republic and Vanuatu. Nursing and midwifery operational action plans were endorsed by nursing leaders during regional and subregional consultation. A simple health workforce projection tool is being piloted for use in the Region. The Pacific leaders endorsed the Pacific code of practice for recruitment of health workers in the Pacific island countries. There is a need to facilitate the implementation of the regional strategy, the code of practice and action plans as well as regular communication and information-sharing among multiple partners and stakeholders in this important area.
2.
Support provided for strengthened leadership, policymaking, and research capacities of nurses and other health professionals.
•
Significant progress was made during the biennium. Leadership training in health and in nursing were conducted in China, Mongolia, Pacific island countries and Viet Nam. In addition, high-level consultations with governments, stakeholders and partners were undertaken to foster collaborative and efficient human resources for health (HRH) planning, management and evaluation. These consultations led to the establishment of a high-level coordinating body in Mongolia and the Pacific
WPR/RC59/3 page 58 Annex 4 Regional expected results Achievement of expected results as measured by indicators Action Alliance on Human Resources for Health. Ongoing communications and planning with partners and stakeholders must be sustained. •
3.
Support provided to improve the quality of education and training of health professionals and to strengthen links between the key stakeholders involved.
The Pacific Open Learning Health Net (POLHN) continues to offer online and hybrid courses, course materials and health information to health professionals in Pacific island countries. Eighteen learning centres have been established in 12 Pacific island countries (Cook Islands, Fiji, Kiribati, the Marshall Islands, the Federated States of Micronesia, Nauru, Palau, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu) and are providing health courses to improve the quality and standards of practice of health professionals. However, in some of the learning centres, the lack of an effective POLHN coordinator has limited the use of the learning centre and has hindered the dissemination of information on upcoming courses. Support was provided to strengthen the quality of education and more than 1000 health workers and managers were trained through fellowships in the biennium.
4.
Technical advice and development support provided to regional, country and area programmes.
•
Technical support was provided to countries by WHO staff at regional and country level. WHO technical capacity at country level is being enhanced with efforts to recruit in-country HRH staff in Cambodia and in the Pacific.
25. Health information, evidence and research policy Regional expected results Achievement of expected results as measured by indicators •
1.
Support provided to countries and areas to strengthen health information system (HIS) that provide timely and quality data
Health information system (HIS) plans were developed and implemented in Cambodia, Fiji, the Lao People's Democratic Republic, Mongolia, Vanuatu and Viet Nam.
WPR/RC59/3 page 59 Annex 4 Regional expected results to improve the evidence base for health policy. Achievement of expected results as measured by indicators •
Eight countries in the Region (Cambodia, China, Fiji, the Lao People's Democratic Republic, Mongolia, the Philippines, Tonga and Viet Nam) received Health Metrics Network (HMN) assistance from both the first and second rounds.
•
Twenty-six countries and areas use ICD-10 for reporting morbidity and mortality statistics (American Samoa, Australia, Brunei Darussalam, China, Cook Islands, Fiji, French Polynesia, Guam, Hong Kong China, Japan, the Republic of Korea, the Lao People's Democratic Republic, Macao China, Malaysia, the Marshall Islands, Mongolia, New Caledonia, New Zealand, the Commonwealth of the Northern Mariana Islands, Papua New Guinea, the Philippines, Samoa, Singapore, Tonga, Vanuatu and Viet Nam).
•
Three countries (Cambodia, the Federated States of Micronesia and Solomon Islands) have included the use of ICD-10 in their plans for 2008–2010
2.
Better use of integrated information and evidence in health assessment, performance monitoring, evaluation and health plan formulation.
•
Curriculum, training modules and training materials were produced for country-level training on "Health Statistics for Decision Making". Trainers were trained from Cambodia, the Lao People's Democratic Republic and Viet Nam. Cambodia and the Lao People's Democratic Republic were assisted to conduct the training.
•
Brunei Darussalam, Malaysia and Viet Nam were supported to develop a core set of indicators and a minimum data set to monitor the health outcomes.
•
The WPRO Interactive Database, which stores Country Health Information Profiles (CHIPS) data from 2001, 2002, 2004, 2005 and 2006, and EPI data from 1974 to 2006, was released.
•
In 2007, service availability mapping (SAM) was carried out in Viet Nam. Significant evidence was generated to redirect health programmes to underserved areas.
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3.
Support provided for improved international cooperation on health research systems through established networks and partnerships strengthened in selected countries and areas, including the Western Pacific Advisory Committee on Health Research and WHO collaborating centres.
Fast improvements in national health research systems (NHRS) have been experienced in countries with good economic growth, including China and the Republic of Korea, and in developed countries, i.e. Australia, Japan and New Zealand. Health policy and systems research has developed mainly within research networks. WHO support has focused on low- and middle-income countries, many of which are making some (but slow) progress in improving their NHRS and research outputs.
4.
Support provided for improved mechanisms for using best evidence in decision-making for health policy and systems development.
•
The Regional Advisory Committee on Health Research (ACHR) is actively monitoring, promoting and advocating health research in the Region. National health research councils or similar bodies are functioning in most countries.
26. Emergency preparedness and response Regional expected results Achievement of expected results as measured by indicators •
1.
Strengthened national programmes in preparing and responding to health aspects of emergencies, disasters and crises and in formulating and implementing recovery, rehabilitation and mitigation policies.
Dedicated emergency and preparedness response (EHA) focal points were placed in priority countries to assist in strengthening office preparedness and to provide EHA support during emergencies. WHO was able to respond to emergencies even before the governments requested for international support.
2.
Support provided to countries and areas for capacity-building in health emergency preparedness and response.
•
Although WHO's response to recent emergencies was prompt, there is still a need to streamline administrative procedures to ensure prompt and effective action in emergencies and/or disasters.
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3.
Support provided for increasing access to knowledge on best public health practices through guidelines, standards, protocols, standard operating procedures, tools or reference materials.
Global standard operating procedures were developed so that WHO can respond and provide support to Member States more quickly.
•
Efforts have been made to develop regional guidelines and references for providing technically sound assistance in emergencies.
4.
Strengthened regional and national partnerships with relevant organizations.
•
WHO played an important coordinating role as the lead agency for the health cluster or health sector in recent major emergencies. WHO also organized national and regional networking meetings to strengthen coordination in preparedness and response.
27. Knowledge management and information technology Regional expected results 1. Information products generated at global, regional and country level and disseminated in the appropriate format and language. Achievement of expected results as measured by indicators •
The dissemination of information on the regional website has been improved through the use of a content management system, the adoption of web policies and procedures, and the hiring of a dedicated coordinator to work with the staff responsible for updating the Internet in each unit. These improvements have been reflected in the increase in visitors to the site.
2.
Regional Index Medici and list of journals made available through a platform and network of libraries.
•
The Western Pacific Region Index Medicus (WPRIM) has facilitated access to relevant health information emanating from member countries, i.e. articles published in local medical journals but not included in international indexing services.
3.
Support to country, regional and global information systems and their users, to improve performance in the Western Pacific Region.
•
Enhancing and moving the Regional Information System to a single platform, as a single instance, has eliminated the need for data exchange between the country offices and the Regional Office. The system provides staff with an up-to-date business view, with real-time data.
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Regional expected results 4. Health InterNetwork Access to Research Initiative (HINARI) resources effectively used by registered users.
Achievement of expected results as measured by indicators •
Health InterNetwork Access to Research Initiative (HINARI) training courses were conducted in Papua New Guinea in August 2006, in Mongolia in October 2006, and in Cambodia, the Lao People's Democratic Republic and Viet Nam in 2007. The participants considered the training very useful and shared what they had learnt with their colleagues.
5.
Ensure that regional and country office staff have reliable and adequate access to information technology systems and information content.
•
With the formulation of the country Information and Communications Technology (ICT) strategy and the subsequent implementation in all offices, the Region now has a uniformed infrastructure in place, from the desktop to the back end and user directory. This has improved staff mobility and support within the Region and has made the Regional Office ready for the Global Management System (GSM).
6.
Ongoing support and development of information and communications technology systems and applications to meet business requirements.
•
SharePoint technology has allowed staff to share and access documents more readily. Integrating regional information systems on the Intranet means that all information is now available via a single portal, using a single user name and password.
28. External relations Regional expected results 1. Support provided to strengthen collaboration, coordination and communication with United Nations agencies, other intergovernmental and governmental bodies, civil society organizations, Achievement of expected results as measured by indicators •
The Western Pacific Regional Office has collaborated actively with the United Nations, intergovernmental and governmental agencies and nongovernmental organizations (NGOs) in a number of important health programmes. Thirty-six memorandums of understanding and/or agreements were signed with 13 United Nations and intergovernmental agencies and 15 foundations and
WPR/RC59/3 page 63 Annex 4 Regional expected results nongovernmental organizations, the private sector and other partner agencies in support of more focused and coherent programmes at regional and country levels. •
Achievement of expected results as measured by indicators NGOs. Impediments included: (1) lack of clear guidelines from Headquarters for WHO Representatives and Country Liaison Officers to effectively work with United Nations team at country level; and (2) lack of long-term and concrete plan of action with required resources to implement agreed collaborative activities
2
Support provided to facilitate the voluntary contributions under the programme budget 2006– 2007.
•
The Region has made good progress in resource mobilization due to proactive efforts of staff, both at regional and country levels. The total amount of voluntary contributions (VC) for this biennium reached more than US$ 130 million, a 38% increase compared to the last biennium.
•
Impediments included: (1) most VC funds were mobilized on an ad hoc basis and were largely driven by donors; (2) inability to expand the donor base into the private sector because of WHO's policy on interaction with industry; (3) more than 75% of the total VC funds were allotted for communicable diseases programmes. More funds need to be mobilized for less attractive but important programmes through policy-level dialogue between WHO and major donor partners at global level.
3
Raised public awareness of important health issues, especially within the Region, through improved information dissemination.
•
As the Public Information Officer (PIO) has already established a good working relationship with media, the unit is now focused on maintaining this rapport to ensure fair and extensive coverage for WHO's programmes in the Region. Thus, PIO, in collaboration with the Communicable Diseases Surveillance and Response Unit and Headquarters staff, conducted workshops and other interactive activities where WHO and media practitioners are able to share their knowledge and experiences in the field of public health and media coverage. These workshops were extended to communications and information staff within the health ministries as they also
WPR/RC59/3 page 64 Annex 4 Regional expected results Achievement of expected results as measured by indicators play an important part in information dissemination.