REPORT OF THE REGIONAL COMMITTEE
39
ANNEX
3
REPORI' OF THE SUB-COMMITrEE ON PROGRAMME AND BUDGET 1. INTRODUCTION At its seventh seSSion, the Regional COmmittee, in resolution WP/RC7. R7, decided "that the establishment of a sub-committee on programme and budget, consisting of six members plus the Chairman of the Regional Committee, should become a routine activity of the Regional Committee"; and recommended that "the membership of this subcommittee be rotated among the Representatives of various Members, subject to the provision that any Representative desiring to be a member of the sub-committee should be entitled to participate". The members of the Sub-Committee and their alternates and advisers were as follows: France Korea Laos Malaysia Medecin Colonel M. Orsini Mr
Dr Sang Tae Han Kuan Seop Jin (alternate) Dr Phouy Phouttasak
Dr Dr Dr Dr
L. "\<1. Jayesuria (Chairman) D.M. Cameron (alternate) R. Dickie (alternate) V. Thevathasan (alternate)
Philippines
Dr A.H. Cruz Dr E.L. Villegas (alternate) Dr A. Acosta (alternate) Dr N.C. de Andrade Dr R.K.C. Lee Dr E.J. O'Rourke (adviser) Dr J. Ii. Sampson (adviser) Colonel E.J. Dehne (adviser) Dr J. C. Thieme
Portugal United States of America
Western Samoa
In the course of its meetings on 18 and 21 September, the SubCommittee examined the proposed budget in accordance with the guidelines given on page 48.
40
REGIONAL COMMITTEE: FIFTEENTH SESSICll
2
REVIEW OF THE PROPOSED PROGRAMME .AND BUDGE!' ESTIMATES FOR THE FINANCIAL YEAR 1 JANUARY - 31 DECEMBER 1966 (Document WP/RC15/ 2 ) Regular Budget - Proposed Budget Level for 1966 The Sub-Committee noted that the effective working budget proposed
2.1
for the Region under the regular programme in 1966, including malaria activities, amounted to $3 547 162 for 1966, indicating an increase of $245 022 over the 1965 provision. Of the proposed increase, $38 080,
representing approximately 16% of the overall increase, had been applied to the Regional Office, and the balance of :\>206 942, representing 84%, to field activities. The· representative of the United states of .America expressed
concern at the continued substantial gro'Wth in the budget.
The United
States delegation had at the beginning called attention to this point but for a while had supported the continued large increases. however, he felt that attentien shQuld be 2.2 Regional ortice The Sub-Committee was informed that in 1966 the regional office provision was $47l 279, approximately 8.79'f. higher than that in 1965. This increase was attributable to the normal statutory increments, the uneven distribution of home leave between the two years, and the costs connected with the salary and allowances for the new post of assistant director of health services. The proposal to establish this post arose dr~to
This time,
this.
fa~
from the need for greater co-ordination of activities in the various fields involved in the regional programme of aSSistance, and to ensure that work was not delayed when regional advisers were on duty travel or home leave.
REPORT OF THE REGIONAL COMMITTEE
41
2.3
Regional Advisers and WHO Representatives The Sub-Committee noted that an increase of ll.05i ,vas proposed
under Regional Advisers.
This was attributable to normal statutory
increments, the uneven distribution of home leave between the two years, and an increase in the duty travel for advisers. In reply to a question as to whether the Regional Director had taken any action in connection with the establishment of a post of regional adviser on medical care and hospital administration, recommended by tbe Committee at its last session, the Secretary stated that this suggestion had been given careful consideration by the Regional Director. It had been decided to make the second public health administration adviser responsible for this field. The candidate selected for the
post had considerable background in hospital administration and if more specialized advice were required short-term consultants would be employed. The Sub-Committee noted that it was proposed to establish two additional WHO representatives' posts in Laos and in the Philippines. It also noted the Regional Director's intention to transfer the WHO Representative stationed in the South Pacific area to Suva. As it was
not economical to assign WHO experts to territories with populations of only a few thousands, the WHO Representative's office would be used as an operational office and the central point from which technical advisory services could be rendered, as and when required. The maternal
and child health team being provided in 1965 would operate under the general supervision of the Fiji office, as would the sanitary engineer who had been working in Tonga. There }lad also been a suggestion that a
medical officer should be assigned to assist some of the territories in the planning and drat'ting of their public health programmes.
The Sub-Committee expressed its satisfaction at the proposed
transfer of the WHO Representative' s office from Sydney to Suva. In reply to a question as to why the WHO representatives were
included under field activities, the Secretary stated that, in addition to representing the Regional Director, they also served as public health advisers to the governments concerned and performed an important duty in the co-ordination of field activities. The representative of the United States of America considered that the inclusion of the posts of WHO representatives under field activities needed careful study. It had been stated that r
84%
of the
proposed increase was being spent on field activities.
However, the
inclusion of the WHO representatives under this heading meant that some of this increase was being used to cover the costs of additional administrative staff. This item should not be considered. part of the
field programme, as governments required assistance from specialists and the WHO representatives did not fall into this category. The Secretary pointed out that the presentation of the programme and budget in its present format had been decided by the Executive Board and was followed by all regional offices and Headquarters. 2.4 Field Activities The Secretary stated that the proposed field programme for
1966
was based on requests received from lo2mber governments, taking into account continuing projects, previously established criteria for regional programme priorities, and the allocation proposed by the DirectorGeneraL From the summary of field activities on pages 1 and 2 of
document WP/RC15/2, it would be seen that the proposals totaled
$3 CJT5 883, representing an increase of $206 942 (7.2l~) over the
REPORT OF THE REGIONAL COMMITTEE
43
corresponding estimates for 1965.
One hundred and forty-nine proJects
were proposed under twenty different major subject headings, compared to 130 in 1965; 137 represented country and 12 inter-country projects.
Also included in the 1966 regular programme were 237 fellowships, of which 102 were for study within the Region. In 1966, continuing projects
accounted for approximately 85.90% of the estimates and new projects for 14.10%. Special emphasis continued to be given to projects relating
to the basic needs and problems of the Region, including education and training, public health administration, strengthening of nursing and maternal and child health services, environmental health activities, and campaigns against communicable diseases. The analysis indicated that the
largest percentage of funds continued to be budgeted for public health administration, with 23.65% of the total, followed by malaria, 22.33%. (See analysis of field activities, pages 49-50.) The representative of France drew attention to the fact that 23.65$ of the funds under field activities seemed to be spent on public health administration. This was a rather large sum and more important It was
than that allocated to malaria, which received only 22%.
appreCiated that these forecasts were based on the real and actual needs of governments. It seemed somewhat strange, however, to see such a
large amount allocated to this field. The Secretary stated that the major heading of public health administration included public health laboratory services, veterinary public health, rabies, medical care, hospital administration, hospital architecture and such integrated fields as rural health and public health programmes.
44,
RIDIONAL COMMI'l'l'EE: FIFTEENTH SESSICI'l
The representative of the United states of America endorsed the
remarks of the representative of France and stated that the classification was not sufficiently clear. It was difficult to determine whether
the programme was properly balanced when so many different items were listed under this major heading. The Sub-Committee was informed that this was a standard classifi-
cation which the regional offices were expected to use in the preparation of the programme and budget. It was not, therefore, possible for
the Regional Office to adopt its own pattern. A suggestion was made that when the programme and budget was submitted to the Regional Committee for consideration, a list of the different subjects under the major headings should be included. This
would provide delegations with more detailed information and would help them determine whether the budget was balanced or not. The representative of the United States of America considered that the priorities given to the regional activities were not entirely acceptable, too much eDl.Phasis was being placed on administrative staffing and not enough technical advice was being given in specialized fields. 2.5 Malaria Activities The Secretary stated that the malaria activities had been included under the regular programme. According to the present forecast the there would be full malaria
situation in 1966 appeared as follows:
eradication programmes in four areas, namely, Brunei, the states of Sabah and Sarawak, and the Philippines. Pre-eradication programmes
would be in operation in the BriUsh Solomon Islands Protectorate, Cambodia, Korea, Laos, the state of Ma.1a.ya, Papua and New Guinea and Viet-Nam. A malaria eradication training centre had been in operation
REPORT OF THE REGIONAL COMMITl'EE ,
. in Manila since 1963 as a government project supported by the United states Agency for International Development and WHO. The
centre was
providing training in the theory and techniques of malaria eradication for malaria workers within and outside of the Region. this centre would continue. Assistance to
The total regional budget estimates for
malaria activities in 1966, including the cost of regional advisers, amounted to ~704 728. The Sub-Committee had no comments on this item. 2.6 Community Water Supply The
Sub-Committee noted that in addition to projects providing
technical or consultant services to six countries, it was also proposed to conduct a training course for well-drillers. It was pointed out that
all the proposals submitted were tentative and their implementation was subject to the availability of funds under the Special Account. In reply to a question raised by the representative of \iestern Samoa, the Secretary stated that although it was not possibl~
at this
stage to say whether money would be available for the sanitary engineer listed under Western Samoa, everything would be done to provide the Government with this assistance. The
sanitary engineer attached to the
office of the WHO Representative in Suva might be able to give the advisory services required. 2.7 Technical Assistance Funds The
Secretary stated that the 1966 proposed programme and budget
.
estimates to be financed from Technical Assistance funds reflected the actual requests made by M:!mber governments to the Executive Chairman of the Technical Assistance Board. Included in the programme were
"
continuing commitments of long-term projects and extensions and modifications suggested by the various governments.
Certain changes had been made to the assistance requested for the . British Solomon Islands Protectorate, Gilbert and Ellice Islands Colony and the New Hebrides.
These -were. as follows:
(1)
BSIP 7 - Rural health ser:rices
The project would now continue during 1966 and assistance would probably be required until 1968. The provision in 1966 would cover
the continuation of the services of the public health nurse, $11 144, and two fellowships - one for six months and the other for twelve months - at a cost of $6000. (2) GEIC 4 - Nursing education
In the document, assistance in 1966 was placed under Category II. Further assistance to this project had now been included under Category I. The 1966 programme and budget would, therefore, be adjusted to include the services of a nurse educator (continued) and a public health nurse, $23 190; a t-welve-month fellowship, ~3400; and medical literature, $50. Assistance would also probably be required until 1968. (3) New Hebrides 4 - Tuberculosis control
In the document, assistance in 1966 was placed under Category II. Further assistance to this project had now been included under category I. The 1966 programme and budget would, therefore, be adjusted to include
the services of a medical officer and a public health nurse (both continued), $25 400; a three-month fellowship, $2035; and su;p:plies and equipment, $200. Inter-country projects The Sub-Committee noted that the inter-country group educational activities listed under the Expanded Programme of ·Technical Assistance had been selected on the basis of expressions of interest on the part
of the governments themselves.
,
REPORT OF THE RIDIONAL COMMITrEE ",
The attention of the Sub-Committee was drawn to the fact that the
Executive Chairman of the Technical Assistance Board had requested governments to include in their programme requests statements regarding their support for and plans to participate in specific regional projects. A number of countries or territories in the Region had already done this. It would help to strengthen a request from WHO for funds to support these inter-country projects i f an endorsement to this effect were included in the resolution adopted by the Regional Committee. This was not a new
suggestion but merely a continuation of a pattern followed for a number of years.
3.
CYrHER POINTS RAISED Estimated Government Contributions The Sub-Committee noted that the Executive Board and the World
Health Assembly had requested the inclusion in the programme and budget of information relating to government contributions, in order to give an indication of the matching costs to be incurred in connection with projects assisted by the Organization. The difficulties M:!mber governments had in submitting this information
•
were noted.
It was, however, pointed out. that this .did not in any way The
mean a commitment and that the figures given need not be exact.
information would only be for the guidance of the Execut.ive Board and the World Health Assembly. In other words, the governing body of WHO
wished to have some idea how governments would collaborate.
4.
GENERAL CONCLUSIONS It was considered that the proposed programme and budget, which
was based on the requests from M:!mber governments, followed the general. programme of work.