(WPR/RC28/SR/5)
SUMMARY RECORD OF 'THE FIFTH MEETING Nippon Press Center Hall, Tokyo Friday, 9 September 1977 at 9.25 a.m. CHAIRMAN: Dr J. Sumpaico (Philippines) CONTENTS 1. Selection of topic for the Technical Presentation during the twenty-ninth session of the Regional C01lUllittee • . . • . . . . • • • • • . • • • . • • . . • . . • . • . . . . . . . . . . . . • . . . . . . . .
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Time and place of the twenty-ninth and thirtieth sessions of the Regional Committee ........•............... 143 Statements of representatives of the United Nations, the Specialized Agencies, intergovernmental and non-governmental organizations in official relations with WHO •.•.....•...•.•....•..••.......................... 145
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For the List of Representatives at the twenty-eighth session, see separately issued document WPR/RC28/14 Rev.l.
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1.
SELECTION OF TOPIC FOR THE TECHNICAL PRESENTATION DURING THE TWENTY-NINTH SESSION OF THE REGIONAL COMMITTEE: Item 21 of the Agenda (Document WPR/RC28/l2)
Dr SENILAGAKALI (Fiji) requested the Regional Director to inform the Representatives of the various topics of the Technical Presentation over the last few years to assist in the choice for 1978. The REGIONAL DIRECTOR replied that the following had been the topics, first of the Technical Discussions and, from 1975, of the Technical Presentation: 1969 - The Planning and Organization of a National Epidemiological ervice; 1971 - Health Manpower in the Developing Countries: Problems and Needs; 1972 - Environmental Pollution Problems and Approach to their Control in the Western Pacific Region; 1973 - The Role of the Hospital in the Community and the Financing of Hospital Based Medical Care; 1974 - Control of Vector Mosquitos of Dengue Haemorrhagic Fever; 1975 - The Control of Tuberculosis in the Western Pacific Region; 1976 - Primary Health Care; 1977 - National Drug Policies and Management. Dr NICHOLSON (United Kingdom) proposed "Diarrhoeal diseases, including cholera" as the topic for the 1978 Presentation. This was supported by Dr CHRISTMAS (New Zealand) and Dr FA'AI'UASO (Samoa). Dr Christmas added that it seemed appropriate that emphasis should be given to diarrhoeal disease control, as cholera and other enteric diseases were recurring in some countries in the Middle East. Dr TAPA (Tonga) also endorsed "Diarrhoeal diseases, including cholera" but wondered whether the other entel['ic diseases, such as typhoid fever and paratyphoid fever, could also be included. The REGIONAL DIRECTOR agreed and suggested that the topic be reworded as follows: "Diarrhoeal diseases, including cholera, typhoid and paratyphoid fever". Dr KING (United States of America) said that now the Regional Committee had indicated its interest in having diarrhoeal diseases including cholera as the topic of the Technical Presentation, it might be appropriate if the resolution on Item 19 of the Agenda, which was the same subject, could be written in such a way that the Regional Director was requested to survey the problem in Member States of the Region, obtain data on the incidence of these diseases and identify programmes directed towards control and research. The information thus obtained would be invaluable and would add considerably to the Technical Presentation. Mr SAFITOA (Papua New Guinea) supported the proposal to have "Diarrhoeal diseases, including cholera" as the topic of the 1978 Technical Presentation. Dr NGUYEN VAN DAN (Socialist Republic of Viet Nam) expressed the interest of his country in the question of malaria; it was therefore in favour of "The status of the antimalaria programme in the Western Pacific Region" as the topic for the Presentation.
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Dr KEO PHIMPHACHANH (Lao People's Democratic Republic) suggested the addition of two topics: "Leprosy control at the village level" and "Drugs essential to primary health care, with due consideration to their cost and effectiveness". Mr REGALA (Philippines) expressed the support of the Delegation of the Philippines for "Diarrhoeal diseases, including cholera". Dr EVANS (Australia) drew attention to the close relationship between the topic of the 1977 Technical Presentation and that of the Technical Discussions to be held during the Thirty-first World Health Assembly in 1978, "National policies and practices in regard to medicinal products; and related international problems". The topic of the Technical Discussions during the Thirty-second World Health Assembly, "Technical cooperation among developing countries in the field of health" had been discussed by the current Regional Committee. Although it was ideal for the technical discussions during the Regional Committee and the World Health Assembly to be related, it was not often feasible. Any topic selected should be one which the Representatives, as health administrators, could appreciate and understand. Although it had no objection to "Diarrhoeal diseases, including cholera", the Delegation of Australia preferred "The status of the antima1aria programme in the Western Pacific Region". Dr REMEDIOS (Portugal) expressed preference for "Diarrhoeal diseases, including cholera". Dr SENILAGAKALI (Fij i) proposed "Control of sexually transmitted diseases lt • These diseases were on the increase allover the world and could be attributed to breakdown in the social structure. A very important aspect of the problem was the growing resistance of organisms to modern methods of treatment. Dr DEBRAY (France) supported the suggestion made by the Representative of the United Kingdom, since diarrhoeal diseases, particularly among children, was a preoccupation of public health authorities in New Caledonia. In view of the statements made by some Representatives, the REGIONAL DIRECTOR suggested that the status of the antimalaria programme in the Western Pacific be included as an item on the agenda of the twenty-ninth session of the Regional Committee, and a working paper prepared on the subject. Dr NICHOLSON (United Kingdom) supported the Regional Director's proposal. Dr NGUYEN VAN DAN (Socialist Republic of Viet Nam) expressed his delegation's satisfaction at the suggestion made by the Regional Director. Dr EVANS (Australia) appreciated the Regional Director's suggestion to place the subject of malaria on the agenda of the twenty-ninth session. The Government of Australia was anxious to promote the control of malaria
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in the Region because the vector was present in the northern part of the country and the disease was prevalent in some neighbouring countries. The consensus being that "Diarrhoeal diseases, including cholera, typhoid and paratyphoid" be chosen as the topic of the Technical Presentation during the twenty-ninth session of the Regional Committee, the CHAIRMAN said he would ask the Rapporteurs to prepare an appropriate draft resolution. (For consideration of the draft resolution, see the sixth meeting, section 6.7.) . 2. TIME AND PLACE OF THE TWENTY-NINTH AND THIRTIETH SESSIONS OF THE REGIONAL COMMITTEE: Item 22 of the Agenda
The REGIONAL DIRECTOR said that in 1976 the Committee had decided that its twenty-ninth session would be held in Manila. It had also accepted the tentative offer of the Government of the Philippines to act as host during the session. No doubt the Representatives of the Philippines would wish to indicate later whether or not their Government was able to confirm its invitation. The Regional Director suggested that the dates of the session be from 22 to 28 August 1978. That was earlier than usual because of the necessity to avoid conflict with the International Conference on Primary Health Care, to be held in the USSR in the early part of September, and also because the Chinese interpreters had to return to New York for the United Nations General Assembly immediately after the Conference, and would not therefore be available for the Regional Committee session. Since the twenty-ninth session was to take place in Manila, the thirtieth could, in accordance with the decision made at its twentyfourth session be held in another country in 1979. In that connexion the Regional Director was pleased to announce that on 6 September 1977 a cable had been received from the Ministry of Health of Singapore tentatively inviting the Committee to hold its thirtieth session in that country. He presumed that confirmation or otherwise of the invitation would be given at the twenty-ninth session. Mr REGALA (Philippines) was pleased to confirm his Government's offer to host the twenty-ninth session of the Committee in Manila. While he welcomed the invitation extended by the Government of Singapore, Dr EVANS (Australia) recalled that Australian representatives at various meetings in the past had expressed the preference that all sessions of the Regional Committee be held in Manila because of the availability there of all the staff and facilities of the Regional Office, and the probable saving in travel costs. With regard to the timing of the twenty-ninth session, he wondered whether it would not be more convenient for Representatives to schedule the proceedings from Monday, 21 to Friday, 25 August 1978. Such a schedule, enabling Representatives to travel the weekends and be absent from their work for one week only, have proved very satisfactory the previous year.
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The REGIONAL DIRECTOR replied that the inclusion of a weekend had been proposed because it was expected that the Host Government would wish to show Representatives something of the country and because a Monday-to-Friday session would involve an arduous schedule for members of the Secretariat and also for the Committee. However, the timing was entirely a matter for the Committee to decide. Dr CHANG (Republic of Korea) thanked the Government of the Philippines for its invitation and wished to announce that his Government would be pleased to act as host to a session of the Committee in Seoul in the near future. Dr KING (United States of America) said that in the past he had been much impressed by the efficiency of the Secretariat in Manila and appreciated the need for rest as well as the wish that Representatives enjoy the countryside. Nevertheless, in view of the level of responsibility exercised by the Representatives, he supported Dr Evans in favouring a Monday-to-Friday session. Dr SENILAGAKALI (Fiji) supported the views expressed by the Representatives of Australia and the United States of America, especially as in Fiji it was difficult to maintain continuity at senior level in the Ministry of Health. Dr TAPA (Tonga), while agreeing that the representatives had important responsibilities, pointed out that in cases where, in addition to the Regional Office, a host government was involved in the organization of a session, some consideration was due to that government. Thus he felt that the dates originally proposed should be retained for the next session. If a Monday-to-Friday session were decided upon, he also wondered how the two subcommittees would function; they might have to meet on the previous Saturday or Sunday. Dr NOORDIN (Malaysia) felt that the Regional Committee sessions should be as short as possible. It was apparent from the deliberations during the past week that the work could be expedited. Consideration could also be given to discussing the programme budget without a subcommittee, thus making the proceedings even shorter. Mr REGALA (Philippines) said that he had noted with interest the different views expressed and wished to assure the Committee that his Government was agreeable to any arrangement that might be decided upon. Dr TAPA (Tonga) said that in view of the comments of the Representative of the Philippines, his Delegation now supported the proposal for a Monday-to-Friday session. Dr REMEDIOS (Portugal) said that his Delegation was also in favour of the proposal.
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Dr FA'AI'UASO (Samoa) thanked the Government of the Philippines for its offer. He concurred with the earlier remarks of the representative of Tonga concerning the need to give consideration to host governments and to the secretariat which provided indispensable support during the sessions. Mr TAN (Singapore) supported the proposal for a Monday-to-Friday schedule at the next session. Dr CHRISTMAS (New Zealand) noted that an important advantage of the Regional Committee sessions for representatives of the smaller countries, was the opportunity they provided for discussions, especially informal, with colleagues on mutual problems. For instance, in planning budgets and programmes a wide understanding of the situation of other countries was essential. As Rapporteur he had not had sufficient opportunity for such contacts. It was important, too, that the Committee should not be in the position of having to accept mechanically, information presented to it. Thus he had some misgivings about compressing the sessions still further. However, he was agreeable to a Monday-to-Friday schedule for the next session as it was being held at the regional headquarters with the full secretariat available and the Committee had already met in Manila on numerous occasions. But he felt that the subcommittees should be convened separately to expedite their work. The REGIONAL DIRECTOR said he would be pleased to comply with the Committee's wishes. However, with regard to Dr Evan's point concerning the advantages of holding sessions at the regional headquarters, he hoped that a Monday-to-Friday session would allow representatives sufficient time for meetings with the WHO staff. There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare an appropriate resolution. (For consideration of the draft resolution, see the sixth meeting, section 6.8.) 3. STATEMENTS OF REPRESENTATIVES OF THE UNITED NATIONS, THE SPECIALIZED AGENCIES, INTERGOVERNMENTAL AND NON-GOVERNMENTAL ORGANIZATIONS IN OFFICIAL RELATIONS WITH WHO: Item 20 of the Agenda
At the invitation of the CHAIRMAN statements were presented as follows: 3.1 Representative of the United Nations Children's Fund (UNICEF)
Mr McBAIN spoke of the complementarity of interests and the increasing collaboration of WHO and UNICEF. In particular his organization strongly supported, in its policies and programmes, the promotion of primary or "low cost" health care using the intersectoral basic services approach approved by the United Nations. That approach emphasized the importance of bringing to the underserved areas of developing countries, within the context
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of overall socioeconomic development, primary health care, formal and non-formal education, improved nutrition and food supply, clean water and sanitation, responsible parenthood, and improvement in the lives of women and girls. Local leadership and community participation were key factors in accomplishing the objectives. The approach was seen as a practical way to reach the greatest possible number of children and families with essential services at costs that countries and communities could afford, with significant but by no means unrealistic increases in external assistance. During the year, UNICEF had discussed the basic services strategy with key officials in developing countries and with staff of the United Nations, bilateral aid and international finance agencies. Efforts had been made to encourage research institutions to explore the strategy and orientation of UNICEF staff on its programme implications had started. In that connexion it was realized that since a successful basic services system often necessitated a change in traditional administrative structures, as well as a full political commitment to the change, orientation and training of national staff at policymaking and local levels were also essential. Finally, it was felt that developing countries could learn much from the experience of the socialist countries in strengthening their basic services, since the latter had faced similar difficulties. Mr McBain then recalled that the United Nations General Assembly had declared 1979 the International Year of the Child (IYC). Each Member State had been asked to renew its concern for children - their present and their future - both within its own borders and worldwide. UNICEF had been designated the lead agency within the United Nations system to coordinate the activities of the Year. There would be no expensive global conference on the Year; its aim was rather to spur governmental and non-governmental action on behalf of children in each country, developing and developed. The countries were urged to establish broadly representative national commissions for IYC which, in turn, would convene appropriate meetings in 1977 and 1978 and determine priority needs for national action programmes beginning in 1979. UNICEF had set aside $3 million for support of the undertaking. An advisory group had been organized to provide information on the progress made and guidance on the activities. 3.2 Non-governmental organizations
Representatives of the following non-governmental organizations made statements on the work of their organizations in collaboration with WHO, aimed at promoting and enhancing the health of the people: International Council on Alcohol and Addictions World Council for the Welfare of the Blind International Dental Federation International Federation for Medical and Biological Engineering
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World Federation for Mental Health International Federation of Ophthalmological Societies World Association of Societies of (Anatomic and Clinical) Pathology League of Red Cross Societies International Sociological Association
The meeting rose at 12.45 p.m.