WPRlRC60/SRJ2
SUMMARY RECORD OF THE SECOND MEETING (Grand Ballroom, Lower Level I, Kowloon Shangri-la Hotel) Tuesday, 22 September 2009, at 09:00
CHAIRPERSON: Dr P.Y. Lam (Hong Kong, (China))
CONTENTS page
1. 2. 3.
Address by the incoming Chairperson ...................................................................... . Address by and Report of the Regional Director (continued) .................................. . Programme budget 2008-2009: budget performance (interim report) ..................... . ANNEX 1 Address by the Incoming Chairperson ................................................... .
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I.
ADDRESS BY THE INCOMING CHAIRPERSON: Item 4 of the Agenda The CHAIRPERSON addressed the Committee (Annex I).
2.
ADDRESS BY AND REPORT OF THE REGIONAL DIRECTOR: Item 7 of the Agenda (document WPRlRC60/2)( continued) Dr MUGITANl (Japan) commended the Regional Director for having produced a very substantial
and high-quality report focused on important areas in the field of public health, amply illustrating the solid progress achieved during the past year. Concerning measures in response to communicable diseases, as a longstanding supporter of the Global Polio Eradication Initiative, Japan welcomed the continuing poliomyelitisfree status of the Region. Furthermore, having taken the lead with its introduction of initiatives in the areas of global parasite control and infectious diseases, it was keen to participate actively in measures for the prevention and control of tuberculosis (TB), in which regard the successes achieved thus far were threatened with reversal due to the spread of multidrug-resistant cases (MDR-TB). On that score, it looked forward to leadership from the WHO Regional Office for the Western Pacific. Concerning Pandemic (HI NI) 2009, he expressed the hope that WHO would facilitate deeper discussion on the information to be reported to it under the framework of the revised International Health Regulations (2005), which, together with the Asia Pacific Strategy for Eml:rging Diseases, had clearly proved its value in that context. As for HIVIAIDS, which was annually increasing throughout the Region, Japan would continue its efforts to reduce the number of newly infected people, including through the particularly vital activity of prevention and education targeted at the young. Japan also welcomed the adoption of resolutions on the subject of health systems strengthening through primary health care, an area in which its own efforts centred on assistance for the training of health workers, and would continue its active cooperation with WHO in its efforts to achieve the Millennium Development Goals. In conclusion, he noted with satisfaction the Regional Director's strong message concerning the need to strengthen management in the Western Pacific Regional Office and looked forward to his further action and achievements in that and other areas. Ms Amenta MATTHEW (Marshall Islands) said that the very comprehensive report of the Regional Director showed that, despite substantial progress, the Region continued to face challenges in the field of health. As one of the two countries in the Region where leprosy had not yet been eliminated, the Marshall Islands much appreciated the support and expertise received from WHO and other partner agencies towards the achievement of that goal. It also acknowledged the continued support of WHO and the United States Centers for Disease Control and Prevention for its fledgling efforts to face the challenges posed by MDRTB, which was set to rise. Such collaboration and support were vital to tackling the financial, health and environmental challenges of the current day and age. Lastly, she affirmed her Government's full support of the recommendations set forth in the report and its resolve to pursue the Healthy Islands programme and primary health care initiatives to fruition. Dr NGUYEN QUOC TRIEU (Viet Nam) said that the scale and speed of population growth in his country had created tremendous pressures on its health system. Notwithstanding its socioeconomic achievements, Viet Nam also faced difficulties and challenges posed by existing infectious diseases, which were exacerbated by the return of previously controlled epidemic diseases, the emergence of new diseases and the rapid growth of noncommunicable diseases. Its health indicators had nevertheless improved, as
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demonstrated by recent figures for malnutrition among children under five years of age, infant mortality rates, and deaths from malaria and TB. Viet Nam had also minimized the mortality rate from Pandemic (HINl) 2009, having successfully countered its spread. Consequently, only 0.13% of the 6880 reported cases had resulted in death. With active support from WHO and its strong regional leadership in the person of the Regional Director, Viet Nam looked forward to further health care improvements in the Region, not least in view of the newly proposed management reform plan, which it fully endorsed. Dr Neil SHARMA (Fiji) thanked WHO for the assistance provided to his country after recent severe flooding and noted that only combined support and action in the Region would counteract similar effects of climate change. His country was well on the way to achieving the health-related Millennium Development Goals; in that context, he welcomed the Regional Director's emphasis on health systems strengthening, primary health care and maintaining an adequate health workforce. He announced that Fiji was establishing a third university, in order to ensure that human resources were available for all sectors, including medical and nursing staff. With regard to governance and leadership, he welcomed WHO's support for the Meeting of the Pacific Ministers of Health, at which health issues common but specific to the subregion were discussed. Mr DUNOYER (France), having congratulated the Regional Director on the quality ofthe documentation provided, said that the interim report on performance for the Programme Budget 2008-2009 was essential for evaluating the activities of the Regional Office, the progress made and what remained to be done. Although much had been achieved in reducing child mortality in the Region, more progress was needed with regard to maternal mortality. He welcomed the strategy for combating vectorborne diseases, as dengue remained a problem in the French overseas territories. France shared the Regional Director's vision with regard to regional priorities, particularly country preparedness for pandemic and emerging diseases, health systems strengthening, and combating the effects of climate change. He agreed that the role of the Regional Office in improving public health should be strengthened. He welcomed the emphasis on result-based management and assured the Regional Director of France's continued support. Dr Stevenson KUARTEI (palau) welcomed the Regional Director's practical approach to health issues, as reflected in the four priorities outlined in the introduction to his report. He observed, however, that there was a persistent misconception that addressing the disparities that existed among Member States and between Member States and donors meant managing populations in despair. As long as disparity was measured in economic terms, those who "owned" economics internationally, regionally or nationally, "owned" the power
of real health choices. Reducing health disparities meant balancing intentions and expectations, so that individuals and communities could make their own health choices. He observed further that if, as the Regional Director had stated, health was a product of the whole of society, the recommended reforms should also be implemented in 'Other sectors. "Reaching out" should thus apply to all levels of society if a positive effect on health was to be achieved. The leap from vision to practical application necessarily involved change, which in turn required a willingness to move beyond the status quo. That was the challenge to the Member States, and his country would take up that challenge. Dr Vita SKILLING (Federated States of Micronesia) said that the Regional Director's emphasis on maximizing resources and involving all sectors for a holistic approach to the protection of health reflected her country's vision and had been applied in responding to Pandemic (HINI) 2009; management of multidrugresistant tuberculosis; prevention of cancer, diabetes and obesity at the community level; and disaster
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management. Her country had still, however, to improve the management of health resources and to upgrade health workers in order to achieve the Millennium Development Goal for maternal and child health and to attain the goal for elimination ofleprosy. The Regional Director's determination to "make a difference where it matters most" was encouraging, and her country would hold him to that resolve. His country supported his vision and would collaborate with other Member States to achieve a healthier life for all in the Region. Mr Clay Forau SOALAOI (Solomon Islands) thanked the Director-General for her leadership in health in the Region and globally and commended the Regional Director for the commitment he had already shown to supporting Member States. Citing the saying "Without a vision, people perish", he welcomed the Regional Director's priorities, which were appropriate and relevant for each Member State. In his country, malaria and an increase in lifestyle diseases were the main challenges, which were compounded by recent ethnic conflict and the global financial crisis. He thanked his country's partners for their continuous assistance. Solomon Islands was committed to revitalizing the Healthy Islands concept for development, and the country's next strategic plan would include the vision and the challenges described in the Regional Director's report. Mr SOAKAI (Nauru) said that his country supported the reforms proposed by the Regional Director for strengthening leadership and partnerships, sustaining and building human resources, ensuring the availability of trained staff and identifying ways of improving service delivery to Member States. He stressed the importance of involving Member States in the proposed reforms to ensure that the administrative and technical challenges faced at the country level were addressed and resolved. Mr OSMAN (Brunei Darussalam) commented that the Regional Director's first report had laid down a vision for the future and would assist Member States in understanding the current regional health situation and in responding accordingly. Brunei Darussalam paid tribute to the strong leadership shown by the DirectorGeneral in tackling Pandemic (HINI) 2009. WHO's guidance: had proved effective in ensuring that Member States were reacting in a coherent manner, and was supporting his country in handling the pandemic in the light of its human resource constraints. WHO was also playing a crucial role in ensuring health equity and accessibility during the current financial downturn, with the added burden of the pandemic. Coordination at the global, regional and national levels was crucial at such timc~s of crisis in order to ensure that the necessary responses were delivered effectively to targeted popUlations. Regional collaboration and partnership had greatly assisted Brunei Darussalam in developing its core capacities in a steady and focused manner, and the country looked forward to sharing its expertise, experiences and information, including best practices, in the collective efforts to achieve good health across the Region. Mr Iakoba Taeia ITALELI (Tuvalu) commended the Regional Director's commitment to focus on areas in which help was most needed, including primary health care and revitalization of the Healthy Islands concept. He re-emphasized the importance of addressing the effects of clim'ate change on health, which, for his country, was a matter of survival. The vision presented by the Director-General and the Regional Director must now be followed up with action in order to achieve healtll for all in the Region. Mrs GIDLOW (Samoa) acknowledged the Regional Director's call for continued assistance to Member States in the four priority areas. Samoa was working hard at national and regional levels in priority areas; yet there was a collective failure to achieve indicators and expected outcomes. She acknowledged her country's success in managing Pandemic (HINI) 2009 but expressed ,concern about continuing high maternal and
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infant mortality rates, the increasingly high prevalence of noncommunicable diseases, and complacency in controlling and managing emerging and re-emerging diseases. She thanked the Regional Director for his renewed efforts to strengthen Regional health systems through primary health care and health promotion, and urged him to build on existing work at country level. Her country continued to advocate a multisectoral approach at all levels; however, the practical translation of that approach would depend on national capacity. Country-specific health authorities were responsible for coordinating the health sector, improving health systems and devising regulatory standards to make those systems safe and effective. She looked to the Regional Office to provide guidance on climate change issues. She supported the four key areas for reform, as it was important to ensure that the poor and the vulnerable received support. Professor CHEN (China), referring to some of the priority areas, said that he appreciated the efforts of Member States and WHO, and in particular the Regional Office for the Western Pacific, in sharing information and technical knowledge with regard to Pandemic (HINI) 2009. The forthcoming winter and spring would be critical in dealing with the pandemic. China had already started to vaccinate priority populations, and stood ready to share information on the efficacy and safety of the vaccine. With regard to the Millennium Development Goals, China had already reached the targets set for infant mortality and under-5 mortality, but needed to make further efforts to achieve the targets for the reduction of maternal mortality, and for the prevention and control of HIV/AIDS, TB and malaria. A major problem faced by China concerned the disparities between regions, and between rural and urban areas. Also, accelerating urbanization was leading to an increase in the migrant population, putting added stress on the health system. China had therefore launched reforms to strengthen the health care system as a basis for coping with public health emergencies, dealing with noncommunicable diseases, and achieving the Millennium Development Goals. More efforts would also be needed to achieve the tobacco-free objective. He welcomed the approach proposed by the Regional Director, in which WHO's leadership would be supported by country-specific strategies. He hoped that it would be possible to build on success, and make ever greater improvements in the health of the people of the Western Pacific Region. Dr Enkhbat SHAGDARSUREN (Mongolia) said that his was one of very few countries that had not detected any cases of Pandemic (HINI) 2009. Mongolia had been fortunate so far because of the support and guidance provided by WHO since the onset of the pandemic, in particular through the International Health Regulations (2005) and the Asia Pacific Strategy for Emerging Diseases. He welcomed the focus on such areas as strengthening health infrastructure, developing intersectoral collaboration in order to achieve social development, and strong leadership at all levels of the health sector. The approach advocated by the Regional Director, of trying new ways and means to achieve the ultimate the years ahead. Mr KHAW (Singapore) said that the new Regional Director was facing a major health crisis very early in his term of office, but the challenge of the pandemic had had the positive effect of bringing people together, helping to build relationships and allowing leadership qualities to develop. There would be other challenges in the future, in particular the problems posed by ageing populations. It seemed that young people, especially in cities, did not want babies. The Regional Director might wish to look ahead to the end of his term, and think g~al
of providing the highest level of health
care to all, was particularly appealing. Mongolia was willing to continue collaborating closely with WHO in
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about his legacy. A noble vision would be for the Western Pacific Region to have the best health indicators in the world. He suggested looking at the health indicators for each of the WHO regions to see where the . Western Pacific Region was not at the highest level, then using the "best performance" as a benchmark in key areas, and working to close any gaps. Ms Leane PEARCE (Tokelau) said that it was timely to focus on the financial crisis, primary health care and Pandemic (HINI) 2009, because changes were needed. The four areas of health reform outlined by the Regional Director would be critical in assisting Member States to achieve their strategic objectives. Tokelau, with a population of 1500 and no airport, was only four metres above sea level and lay 500 kilometres north of Samoa-a 26-hour boat trip in increasingly rough seas. Tokelau had no GDP and was totally dependent on aid, so felt the effects of the financial crisis, as well as being affected by climate change. Primary health care support was below basic level. There was no equipment, no laboratory, no intensive care unit, and no emergency department. Medicines and vaccines were sent on the supply ship. The WHO Fiji Office had sent an expert to assist in epidemic surveillance, and 98% of the population had been vaccinated against seasonal influenza, a first for Tokelau. So far, there had been no case of Pandemic (HINl) 2009. Tokelau looked forward to WHO leadership in steering change through collaboration, coordination, consistency, cohesion and ownership at all levels, in the hope ofieaving a healthy legacy for future generations. At the invitation of the CHAIRPERSON, statements were made to the Committee by representatives of the Sasakawa Memorial Health Foundation, the Thalassaemia International Federation, the International Council for Control of Iodine Deficiency Disorders, Alzheimer's Disease International, the International Pharmaceutical Federation, the World Confederation for Physical Therapy, and the International Pediatric Association. In response to comments on his report, the REGIONAL DIRECTOR thanked the Member States and nongovernmental organizations for their commitment to public health. He took note of their concerns and would address each of them. Some, such as Pandemic (HINl) 2009, multidrug-resistant TB, tobacco, malaria and health systems strengthening, were to be discussed in the coming days. Strengthening support to Member States was critical and would be sustained over the next five years. Although he had been working for only seven months so far as Regional Director, he was glad to be recognized as a man of action. He took the comments of Member States very seriously, and believed that, if they could unite on a common agenda, great things could be achieved against formidable odds. He stressed once again the need to work more closely with each country. 3. PROGRAMME BUDGET 2008-2009: BUDGET PERFORMANCE (INTERIM REPORT): Item 8 of the Agenda (document WPRlRC60/3)
The SPECIAL ADVISER TO THE REGIONAL DIRECTOR, introducing the interim financial implementation report on budget performance for the 2008--2009 biennium explained that, in the Global Programme Budget 2008-2009, approved at the Sixtieth World Hea1thAssembly in May 2007, the assessed contribution amount for the Western Pacific Region had increased to US$ 80.2 million, a 4.8% increase from the 2006-2007 approved programme budget of US$ 76.5 million. However, the Director-General had established the initial working allocation at 980/0-<>r US$ 78.6 million-due to the projected delayed payment of assessed contributions. The resulting reduction for the Regional Office for the Western Pacific had been US$ 1.6 million. In June 2009, however, the Director-General had refunded US$ 801 500, representing
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half of the 2% contingency reserve, due to successful collection of assessed contributions. As a result, the net working allocation would increase to US$ 79.4 million. That would be reflected in the 2008-2009 final financial report. The programme budget had been implemented in accordance with the strategic objectives. As at 31 May 2009, US$ 48.5 million-or 62% of the assessed contributions-had been implemented, broken down into US$ 41.6 million in expenditures and US$ 6.9 million in encumbrances. That was a considerably lower rate of implementation when compared with the corresponding period in the previous biennium. However, it was largely due to the fact that salary costs had only been recorded up to the end of April 2009, whereas, in the previous interim report, staff commitments had been recorded until the end of the biennium. The introduction ofthe Global Management System (GSM) in the Regional Office for the Western Pacific in 2008 had also slowed implementation in 2008. Implementation of activities was being intensified to ensure that the remaining assessed contributions would be fully implemented by the end of2009. The introduction of the Global Management System on 1 July 2008 had been a challenge for the Organization. The Western Pacific Region had been chosen as the first region to roll out the system, along with Headquarters. Many issues had had to be faced, which was to be expected when a system of such magnitude was introduced. The staffhad risen to the challenge, however, and the system was now functioning much better and was facilitating the work of the Organization. He was pleased to report that the amount of voluntary contributions implemented had increased to US$ 92.1 million. That was an increase ofUS$ 22.2 million when compared with the corresponding period in the previous biennium. By the end of the biennium it was anticipated that there would be a substantial increase in both voluntary contributions and expenditures when compared with the previous biennium. Mr Mark ABDOO (United States of America) thanked the Regional Director for the report, which gave Member States a clear understanding of activities to date, especially with regard to strategic objectives 2 (to combat HlV/AIDS, tuberculosis and malaria), 8 (to promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health) and 9 (to improve nutrition, food safety and food security and in support of public health and sustainable development). He was, however, concerned at the lack of progress on regional expected result 04.002.WPOI. Given the importance of Millennium Development Goals 4 and 5, the development of national research capacity to improve maternal, newborn, child and adolescent health in Member States ofthe Region was crucial. That meant implementing research agendas and stepping up research capacity. Some descriptions lacked detail, an example being regional expected result 10.012.WP01, which reported but did not define good progress in national health accou~ts. Some activities seemed unduly limited in scope. Activities under Strategic Objective 3, on noncommunicable diseases, had to move from action plans to programme implementation. Mr Taniela Sunia SOAKAl (Nauru) voiced disappointment at the low level of budget implementation. He complained also at the absence of WHO from Nauru, continuing problems with the Global Management System, and poor communication between Nauru and the WHO Representative and the Western Pacific Regional Office. Nauru had raised the problem of the WHO presence the previous year. In the spirit of
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collaboration articulated by the Director-General, his country looked forward to participation in the reforms proposed by the Regional Director to improve implementation of the 20 I 0-20 11 budget. Dr JACOBS (New Zealand) asked, as in previous years, about under-spending, which appeared to be a risk once again. As of May 2009, 38.31 % of the budget was still to be spent, and there was not much explanation ofthat. He sought clarification on how the money would be spent until the end of2009, especially given that, as at 31 December 2008, a number of Expected Results areas were in trouble because of resource constraints. Turning to the effective and equitable use of resources, which was particularly important in the Western Pacific Region, he asked what percentage of the budget was being spent in the Pacific subregion. Dr GAO Weizhong(China) expressed appreciation of the report and asked how the programme budget would be implemented, given that, with three months of the biennium left, implementation at the end of May had been only 50% in such key areas as maternal and child health and social determinants of health. He asked the Secretariat to expedite implementation. The low implementation rate had been discussed at the previous meeting, when it had been explained that the Global Management System had delayed many procedures. He asked whether the current delays in implementation were still attributable to GSM. He asked, furthermore, how the results could be shared. In Appendix 3, there were descriptions of expected results but no detailed explanations that could enable delegates to see whether activities could be replicated. He asked for a summary report on the key priority areas at the end of the biennium. Ms HALTON (Australia) returned to some of the questions raised by colleagues. She thanked the Secretariat for the greater level of detail in the current report and acknowledged the difficulty of implementing programmes when 80% of funding was from voluntary sources. She asked whether delays had been caused by late receipt of voluntary contributions. As others had said, the programme budget was behind schedule in various areas. In respect of annex 4, in particular, there was a lot of description, but not enough tangible detail. The "on-track" judgment was not always borne out by the figures. When chairing the Programme Budget and Administration Committee of the Executive Board, she had been party to some sceptical comments on the roll-out ofGSM. She asked whether it was now achieving its objectives or still causing constraints, and what might be done if the latter were the case. If the Organization was to ensure that it achieved the Millennium Development Goals and met the Regional Director's aspirations, a little more transparency was needed, so that Member States could see clearly what needed to be done. Dr LEE Jong Koo(Republic of Korea) remarked that, despite the change to WHO's financial management system, most budgets for strategic goals had been more than 50% implemented; he expected the Secretariat to keep up the good work and to report 100% implementation at the next meeting of the Regional Committee. The format of the document was clear, but it would be even better if the strategic goals were to show the amount of assigned budget and the percentage Qf implementation. As he recalled, the 2008-2009 budget report at the fifty-eighth session of the Regional Committee had shown expected results by strategic objectives, with regional indicators and targets for 2009. He proposed that budgeting targets and implementation progress also be included in the 2008-2009 interim report. Sir Terepai MAOATE (Cook Islands) was pleased with the work completed and that the report clearly showed the extent of that progress; such an interim report would not be expected to include all activities within
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the overall strategic plan. He suggested that the report should subsequently include an overview of progress in relation to expected outcomes in the long term, and referred in particular to percentage achievement. That would also allow the Regional Co=ittee to ensure that all activities were receiving due attention. He expressed concern about the large amount of money unspent in the budget, particularly given the Healthy Islands initiatives, which required money to achieve their goals. Mrs GIDLOW (Samoa) noted that the utilization rate in the Programme Budget 2008-2009 reflected that of Samoa. She also acknowledged the progress made in the Global Management System since the previous session of the Regional Co=ittee. She asked if the cut-off date might be postponed until October 2009 so that all requests for full utilization of existing funds might be completed; that would compensate for the delay engendered by the change to the GSM. She also asked if unused fellowship costs might be used to fund other progra=e areas or local and overseas short-term training opportunities that were available in the current financial year. Without wishing to comment on the level of detail in the interim report, she noted that a great deal of work was being done and outcomes were being achieved. Mrs Debbie SORENSON (Tonga) expressed concern about the amount of the budget still unspent; implementation of activities depended on money and yet countries were told that no funding was available. One area in which Tonga, and many other countries, wished to make significant progress was maternal and child health, yet only 40% of the budget for that area had been spent. The regional expected result for strategic objective 4 called for more research and research capacity; however, the time for research was over and unspent funds should be targeted toward practical responses and progra=e implementation. She urged the unblocking of funding so that progress could be made on that issue. The challenges of implementing a new finance and management system in such a large and complex organization were great, but it was now time to move forward. Tonga looked forward to working with the Regional Office to improve performance. The SPECIAL ADVISER TO THE REGIONAL DIRECTOR, thanking representatives for their constructive co=ents, said that detailed information on implementation for the whole biennium, collection of which required considerable effort and resources, would be provided in the final report. The interim report before the Committee provided an overview of implementation of the 2008-2009 progra=e budget only to the end of May 2009. Furthermore, it included staff costs only to the end of April 2009. Had those costs been projected to the end of the financial period, the implementation rate would have been 79% (rather than the 62% reported), which was only a little lower than the 82% reported for the 2006-2007 biennium. As he had indicated in his introduction to the item, the launch of the GSM in the Region and at WHO Headquarters and the establishment of the Global Service Centre outside Kuala Lumpur, Malaysia, had been a major factor in the implementation of activities during 2008. There had been a period during which there had been a freeze on the recording of transactions and a number of problems had arisen, as was to be expected with such a large and comprehensive system. Solutions had been found and training had ensured that staff were now better able to use the system. Although some issues remained to be resolved, GSM was no longer affecting the rate of implementation. The implementation of some activities, such as the maternal and child health progra=e, was being affected by resource constraints. Such activities were largely funded by voluntary donations, which unfortunately continued to show uneven distribution across the Organization's strategic objectives. It was
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much easier to raise funds for activities to meet strategic objectives 1 and 2, which related to the control of co=unicable diseases, than for those to meet the other strategic objectives. The matter was a challenge for the whole Organization, and efforts were being made to redress the imbalance. In reply to the representative of Nauru, he said that provision of support to the large number of small island countries in the Region had always posed difficulties. WHO representation in the Pacific was greater than for any other United Nations organization: there were cUIrently six WHO country offices: Fiji, Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu; and there had been a WHO officer in the Federated States of Micronesia since 2008. However, permanent representation was expensive, and elsewhere support was provided through direct communication and country visits. The Regional Office would take steps to increase efforts in Nauru, which currently received two to three country visits per year, in order to improve the rate of implementation of the country programme budget. The Regional Director had expressed concern at the level of implementation and had issued instructions to promote the acceleration of quality activities. That action had already produced improvements, with the implementation rate for assessed contributions at the end of July 2009 standing at 72% compared with 62% in May. He was therefore confident that the programme budget would be fully implemented by the end of the biennium. The DIRECTOR, ADMINISTRATION AND FINANCE, replying to a question raised by the representative of New Zealand, said that roughly 10% of total resources were spent in the Pacific island countries and that implementation rates in the area were consistent with overall implementation rates in the Region. The REGIONAL DIRECTOR expressed confidence that the Programme Budget 2008-2009 would be fully implemented in accordance with all rules and procedures. The format of the final report was standardized across the Organization, but supplementary tables and explanations would be provided to ensure that the Region's Member States had a comprehensive picture of regional programme budget implementation. The scale of GSM was such that it was inevitable that it had had some teething troubles and, on taking office, he had had to spend a considerable proportion of his time resolving GSM-related problems. However, the system was being modified in the light of experience and was becoming more user-friendly. Moreover, staff were growing accustomed to working with it. He was sure that it would in due course bring great benefits in terms of transparency, coherence and integration of management at the global, regional and country levels, and of its ability to generate quantitative information. The meeting rose at 12:10.
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ANNEX 1
ADDRESS BY THE INCOMING CHAIRPERSON
First of all, I thank you all for the rare honour and the privilege to serve as Chairperson of the sixtieth session of the WHO Regional Committee for the Western Pacific. I have noted that this year, Hong Kong is hosting the Regional Committee meeting for the third time--the eighth session in 1957 and the forty-third session in 1992. This sixtieth session is a memorable one, it being the first Regional Committee meeting for Dr Shin Young-soo, our Regional Director. Furthermore, this sixtieth session is sort of a homecoming for our Director-General, Dr Margaret Chan. As was mentioned yesterday, the last time Hong Kong hosted the Regional Committee 17 years ago, it was Dr Margaret Chan, now our Director-General, who led its successful organization. I will try my best to live up to Hong Kong's reputation of hospitality and excellence and to steer this session to a fruitful conclusion in keeping with your trust and confidence Distinguished Representatives, yesterday we all welcomed our new Regional Director, Dr Shin Youngsoo. We listened to his vision for WHO in the Western Pacific Region. In his report yesterday, Dr Shin acknowledged the great strides made by his predecessor, Dr Omi, towards improving the health of all peoples in the Western Pacific Region. On the other hand, he challenged us not to rest on past achievements and to pay due and urgent attention to emerging issues that could have far reaching negative economic and social impacts on Member States. The world, including our Region, is again facing new and unprecedented challenges in health. From what we have heard yesterday, it is clear to me that Dr Shin has what it takes to carry out the mandate of WHO in the Region and beyond. His vision of bringing health especially to where it matters most, fully guided by the principles of equity and country specificity, and coupled with his determination to build an Organization that is better able to effectively serve countries in the context of an ever-changing global health environment, is, as the saying goes, a shot in the arm, considering the continuing and mounting challenges to health of people in our Region. Dr Shin has taken over a Region that has a well-established reputation of solidarity and performance. We are honoured, as Dr Shin mentioned yesterday, to have two of the pillars of the Western Pacific Region present here with us today. I refer to Dr Nakajima and Dr S.T. Han. I am sure you will agree with me that our Region has come this far, that we are better situated to face challenges that come our way, thanks to the achievements of those who came before him. But there is still a lot of work to be done. We all look forward to working very closely with you and your team, Dr Shin. Our agenda for the next four days includes a number of health issues which challenge us. Among others, they include the global financial crisis and the progress report on the Pandemic (HINI) 2009. The Region and the rest of the world have been buffeted by two raging storms--the financial crisis and the Pandemic (HINl) 2009. Now is the opportune time, as we have come together, to muster our collective wisdom and commit our resources to meet these challenges at these critical times head on. We are counting on your active participation in the discussions on the global financial crisis and its health impact in Asia and the Pacific.
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REGIONAL COMMITIEE: SIXTIETH SESSION
Annex I We shall have the opportunity to discuss and deepen our understanding of the evolving and unfolding . HINI phenomenon that continues to challenge the readiness and effectiveness of our health systems in responding to this threat, and ultimately affecting our people's health. Our past experiences with SARS and avian influenza have taught us valuable lessons and have led us to strengthen our surveillance and response capacities. But many things remain uncertain with the HINI and we need to learn from and work with each other in preparing ourselves to respond and manage effectively the influenza pandemic. We shall discuss a number of guiding documents, policy and programme frameworks that will help steer Member States' health efforts. These are the Health Financing Strategy for the Asia Pacific Region (20102015), the Tobacco Free Initiative Regional Action Plan (2010-2014), the Regional Action Plan for Malaria Control and Elimination in the Western Pacific (2010-20 IS) and the Asia Pacific Strategy for Strengthening Health Laboratory Services. You will appreciate that all these documents are intended to guide our collective efforts for a more strategic and effective action across the Re!,cion. I would encourage all Representatives to engage actively in our deliberations. It is important that we all understand what the expectations are and what we are committing to. At the end of the day, we all need to reflect on whether we have been able to act on those commitments that we made. Only then may we be able to say that we have stood up to the challenge, as individual Member States, and as a Region as a whole. We shall review our work in vaccine preventable diseases, HIV/AIDS including sexually transmitted infections, tuberculosis and noncommunicable diseases-all important issues of our time. They are not simply health issues. HIV/AIDS, for example is a global development and a human rights challenge. They are issues that go beyond the health sector and therefore it is imperative that we work effectively with other sectors, including the private sector. We know very well that the response capacity of our health systems needs to be strengthened more than ever, even to protect the gains that have been so far achieved in pursuing the Millennium Development Goals. However, in some countries of the Region, we need to do a whole lot more to achieve the MDGs by
2015. In light of WHO's mandate, it behoves this Committe(: to examine and discuss openly the proposed Programme Budget for 2010-2011. Of course, we recognize as well that health, including the broad range of its determinants, concerns the whole-of-government and the whole-of-society. This will call for a stronger and more sustained action in a comprehensive and inclusive approach. Towards the end of the week, the Committee will have to tackle two issues: the Procedure for Nomination of the Regional Director and the Policy Direction Concerning Establishment of Centres of the Regional Office in Countries. These are not exactly easy subjects; we may have different views on these, but I am sure that as we have observed in the past, ultimately, the overriding objective of doing what is right for the Region informs our decisions. It is critical that this session provide clear policy guidance and strategic directions, as well as facilitate
consensus and strengthen cooperation among the countries and areas of the Region. With your kind support and cooperation, and with the strong technical guidance ofthe WHO Secretariat, I am confident that we shall be able to achieve our objective and have a productive and successful meeting.
SUMMARY RECORD OF TIlE SECOND MEETING
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Annex 1 The health landscape before us is more complex and increasingly daunting. But the situation gives us the opportunity to bring out the best in ourselves, in our organizations, in our governments and in our entire societies. With our commitment and hard work, we can make this session the one giant step that will preserve our gains and bring us closer to our goal of health for all. Once again, I welcome all of you to Hong Kong. We will do our best to make every representative and guest feel at home. I hope you will find the time to experience and bring home memories of what has been described as "a dynamic metropolis steeped in unique blends of East and West". Even for a short but hopefully memorable time, do enjoy the best of both worlds.