(WPR/RC22/SR/2) SUMMARY RECORD OF THE SECOND MEETING WHO Conference Hall Tuesday, 21 September 1971 at 2.30 p.m. CHAIRMAN: Dr Tran-Minh-Tung (Viet-Nam) CONTENTS Report of the Regional Director (continued) 96
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Resolutions of regional interest adopted by the Twenty-fourth World Health Assembly ..........•.••..•.. 102 2.1 Occupational health programmes •••••••••••••••••••••.• 102 Community water supply: Report on the financial consequences of the programme for WllO ••••••.••••••••••••••••••••••••••••••••••••••• 106
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Second Meeting Tuesday, 21 September 1971 at 2.30 p.m. PRESENT I. Representatives of Member States AUSTRALIA CHINA JAPAN KHMER REPUBLIC LAOS MALAYSIA Dr H.M. Frank1ands Dr A. Tarutia Dr K.P. Chen Dr H. Kasuga Mr K. Watanabe Dr So Satta Dr Pruoch Vann Dr Phouy Phoutthasak Dr Tiao Jaisvasd Visouthiphongs Dato (Dr) Abdul Majid bin Ismail Dr Abdul Majid bin Tan Sri Abdul Aziz Dr Mechie1 Chan Kin Chung Mr Onn bin Kayat Dr C.N. Derek Taylor Dr C.S. Gatmaitan Dr M. Difuntorum Dr D.H. Silva Ferreira Mr Sae Hoon Ahn Dr V. Sundararajan Dr G.H. Choa Dr K.L. Thong Dr S.P. Ehrlich, Jr. Dr James King Mr F.S. Cruz Dr Dr Dr Mr Tran-Minh-TlJLng Truong-Minh-Cac Nguyen-Xuan-Trinh Chau-Van-Muoi (
NEW ZEALAND PHILIPPINES PORTUGAL REPUBLIC OF KOREA SINGAPORE UNITED KINGDOM UNITED STATES OF AMERICA
VIET-NAM
WESTERN SAMOA
Dr J.C. Thieme
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Representatives of the United Nations and Specialized Agencies INTERNATIONAL LABOUR ORGANIZATION Dr G. El Samra
III. Representatives of non-governmental organizations INTERNATIONAL UNION FOR HEALTH EDUCATION INTERNATIONAL DENTAL FEDERATION CHRISTIAN MEDICAL COMMISSION MEDICAL WOMEN'S INTERNATIONAL ASSOCIATION INTERNATIONAL COMMITTEE OF CATHOLIC NURSES LEAGUE OF RED CROSS SOCIETIES IV. WHO Secretariat REPRESENTATIVE OF THE DIRECTOR-GENERAL SECRETARY Dr H.T. Mahler Assistant Director-General Dr Francisco J. Dy Regional Director Mrs Luisa A. Alvarez Dr F.M. Herbosa Dr E. Villegas Dr I.Y. Zalamea Mrs M.R. Ordonez Mrs L. Batista Dr V. Galvez
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REPORT OF THE REGIONAL DIRECTOR: Item 10 of the Agenda (Document WPR/RC22/3 and Corr.l) (continued from the first meeting, section 8) !
Part I, section 6:
Family Health (pages 55-58)
Dr CHEN (China) congratulated WHO on having produced such an excellent report. He agreed that it was essential to strengthen health education and training programmes but considered that family planning was a personal matter for the married couple involved, and it was for them to decide whether they wished to accept it or not. He recommended that WHO should in future lay more stress on that aspect of family planning programmes and that particular attention should be given to research. Dr EHRLICH (United States of America) expressed pleasure at the increasing use being made of the United Nations Fund for Population Activities (UNFPA) since the Fund possessed considerable resources, which could benefit the Western Pacific Region as well as the other regions. It could also give valuable assistance in the long-term objective of integrating the programme with maternal and child health services. The REGIONAL DIRECTOR, replying to Dr Chen, said that WHO had embarked on research in the field of family health with a view to finding out whether there was any relationship between family size and family health. Dr Chen's observations would be given due consideration. Section 7: Health Protection and Promotion (pages 59-62) Section 7.1: Nutrition (pages 59-60) Dr EHRLICH (United States of America) wondered why no mention had been made of the World Food Programme (WFP), which had been referred to only in another context (Section 10.1, page 74), namely a programme concerned with schistosomiasis control in the Philippines. In view of its potentialities, he would advocate the fostering of closer relations with the World Food Programme in connexion with nutrition work. Dr BAILEY, WHO Regional Adviser on Nutrition, commented briefly on some existing projects concerning nutrition. WHO was assisting with a WFP project on environmental sanitation in China (Taiwan) aimed at providing better sanitation for people living in villages. This was a food for work programmes. WHO participated in its planning and evaluation and was continuing to watch over its development. WHO had also advised on the feeding of young children in day-care centres. The schistosomiasis control project in the Philippines, which had only just started,
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was another project receiving WFP assistance. but it was expected to have mUltiple benefits. Until now priority had been given to food for work programmes rather than those directly concerned with feeding. Programmes of the latter type were planned to be initiated next year in the British Solomon Islands Protectorate. Fiji. Singapore and Western Samoa. There was close co-ordination between WHO Headquarters. the Regional Office and the World Food Programme in Rome. All relevant WFP projects were referred to WHO for scrutiny of their health aspects. There was also co-ordination with the activities of the United States Agency for International Development in this field.
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Section 7.2:
Dental Health
(page 60)
Dr FRANKLANDS (Australia) called attention to the many dental health problems in developing countries. The Australian Dental Association was doing everything possible to promote good dental health within the Region, but it could not achieve much on its own without international assistance. Although the Report referred to the provision of dental advisers in 1972 and 1973, amounting to some twelve consultantmonths each year, no consideration appeared to have been given to the appointment of a Dental Health Adviser for the Region.
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The REGIONAL DIRECTOR recalled that this question had been raised informally in 1966 or 1967 at the Regional Committee meeting by the Representative of the International Dental Federation. He fully appreCiated the importance of dental health and the tremendous problem it presented in the Region, but no great enthusiasm had been shown by the various countries and territories towards the initiation of a dental health programme. With a view to stimulating interest within the Region, WHO had undertaken a phased dental health advisory services programme. This had consisted of surveys undertaken by consultants, courses in dental epidemiological methods, follow-up visits by consultants to the countries which had sent participants to the courses. fellowships. and, finally, two seminars, one held at the beginning of 1971 and the other planned for next year. The purpose of the programme had been to focus attention to the problem and stimulate action at country level. He had not recommended to the Director-General the appointment of a full-time dental health adviser because he did not feel he could utilize his services fully as, unlike a medical officer, he could not be assigned to work in other disciplines. He had to keep a close watch on costs, particularly in connexion with the Regional Office, but, if any government requested a dental health adviser on a long-term basis, would be happy to include the request in the programme and budget estimates. Dr FRANKLANDS (Australia) expressed 'satisfaction at the clear, concise explanation given by the Regional Director.
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Mental Health (page 61)
Dr FERREIRA (Portugal). after congratulating the Chairman and ViceChairman on their election, gave some information concerning mental health services in Macau. A large new psychiatric hospital had recently been inaugurated and the chronic mentally sick were accommodated in another modern institution. There were, however, difficulties in obtaining qualified staff, and three new fellowships in mental health training had been requested from WHO.
Section 8:
Education and Training (pages 62-70)
Dr CHEN (China) expressed appreciation at the educational assistance already provided to Taipei but drew attention to the fifth paragraph on page 63 concerning the provision of a consultant in behavioural science in the Philippines. This was an important social aspect ofl public health, and he wondered whether more interest could be aroused in it through the appointment of temporary consultants. The REGIONAL DIRECTOR concurred and said that he would do his best to provide consultants in that field of public health if governments made such a request.
Dr EHRLICH (United States of America), referring to page 62, first paragraph, considered that the trend for appointing short-term consultants should be encouraged and even extended since it gave greater flexibility and, when time was limited, governments tended to take full advantage of the assistance so provided. Section 8.1: Fellowships (pages 65-67)
Dr THIEME (Western Samoa) stressed the importance of fellowship programmes for small countries where training facilities were necessarily limited. While an increasing number of health workers were reqUired, training of medical staff at professional level had to be arranged overseas, since no such training was available locally. Undergraduate fellowships were as important as graduate ones for countries without adequate training facilities and requests for such should be fully supported.
Part II: Evaluation Summaries of Selected Projects (pages 85-94) Nursing Advisory Services. South Pacific (pages 90-94) Dr EHRLICH (United States of America) remarked that his delegation was most gratified at the inclusion of these evaluation summaries in the
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Report and suggested that this portion of the Report be expanded in the future.
The REGIONAL DIRECTOR pointed out that, although the Report might appear slimmer than in previous years. projects were on the increase as could be seen from the graph appearing on page 83. The reason for its lighter bulk was the use of a new offset printing machine similar to the one at WHO Headquarters, which printed on much thinner paper. Important savings in postage were thus effected. Dr SO SATTA (Khmer Republic) congratulated the Regional Director on his clear Report which reflected the good sense of WHO and the ability of the Region to adapt to realities. He also wished to make some comments on why the programme for his country had had to be modified. Before it had become the victim of a war of aggression, the Khmer Republic had had 500 hospital units, including hospitals and local health units, including malaria units, 367 physicians, 63 pharmacists, 395 midwives, 1670 nurses. 43 dentists and 59 laboratory technicians. Now, much of the accommodation had been destroyed; 184 hospital units had been completely damaged or destroyed, amounting to about 36 per cent. of the country's previous potential resources. Moreover, 3 physicians and 8 nurses were killed, and 3 physicians, 71 nurses, 11 midwives, 205 rural midwiVes and 25 sanitary agents were captured. He did not intend to make a political statement, but he must stress that a grave situation had arisen. The health of the people of the Khmer Republic should be of real concern to the other countries of the Region since their well-being was so closely linked with theirs.
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The CHAIRMAN, after noting that there were no further comments on the Report of the Regional Director, invited the Rapporteurs to prepare a draft resolution for consideration by the Committee at its next meeting. (For consideration of draft resolution, see minutes of the third meeting, section 4.)
Dr EHRLICH (United States of America) asked whether a brief meeting could be arranged with the Rapporteurs in order to discuss the drafting of a resolution concerning the malaria programme. (For consideration of draft resolution, see minutes of the fifth meeting, section 1.1.)
It was so agreed.
Dr EHRLICH (United States of America) said that it had come to his attention that a project system analysis approach was being developed in one or two countries in the Region. Since this was somewhat a departure from the previous attempts at programme planning and evaluation it might be interesting to hear more as to the nature of the system, its expected objectives and results.
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Dr MAHLER, Representative of the Director-General stated that the Project Systems Analysis concept had evolved considerably since it was introduced by the Director-General at the twenty-first session of the Regional Committee for the Western Pacific last year. At that time the process of developing a working methodology for use in the formulation of developmental projects had only just started. Thanks in great part to the willingness of Malaysia to provide a challenging environment and problem, the painful first gropings had been survived. Further practical evolution took place during a field trial in May and June of this year in the Americas where the PSA team assisted in evolving a project for the redevelopment of a country's maternal and child health programme, including family planning and nutrition. These theoretical concepts moulded by practical experience had been made available in the form of a health project formulation manual. The printing of this manual was not viewed as the end of the development of this methodology, but rather as one significant milestone in its evolution. In order to assess the viability of the product at its current state and to obtain guidelines for its future development and application, the Director-General had submitted the manual to a panel of nine experienced health and systems people, drawn from within and outside the Organization. Those inside the Organization had seen it in field use and could provide insight into these aspects; those outside, drawn from experts in academic and administrative positions, could review its logic and comprehensiveness. The individual replies had thus far been very encouraging and their criticisms highly constructive. A synthesis of these views into a single assessment report was now being made - and the one most consistent theme of their advice was clear: future progress was to be made through use. What could this analytical methodology do both at the national level and within the Organization? This entire effort had grown out of the awareness that the health sector must relate itself increasingly to the needs and demands of other sectors of society if it were to share fully in the push toward development. This awareness had brought to light the need for a systematic - analysis of the problem situation in as complete a way as was consistent with the expenditure of time and resources. The Project Systems Analysis approach was a beginning toward filling this need. If diligently and intelligently applied to national health problems and situations of sufficient size, scope and complexity he believed it had the potential to render them more susceptible to change. The investment required to make this analysis might initially cause it to be reserved for the largest and most important areas only, but as countries gained experience in the techniques employed they could no doubt use them to advantage for the analysis of any potential project.
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Such analysis would cover the over-all policies of the country, the health problems relevant to its development, the health resources (manpower and technology) available and the operational constraints under which existing services functioned. The project systems analysis approach led to carefully stated impact objectives that related to the country's over-all programme aims; a suitably designed service system to deliver carefully specified operational outputs projects, with a network of interrelated activities and a time schedule in consonance with the capability of the country's public health administration, designed to create the capability to achieve these stated objectives. Development was primarily a national task, but over the years many countries had come to appreciate the role that could be played by external assistance in providing at least some of the "critical mass" of resources and expertise necessary to overcome traditional inertia and create effective change in health systems. This potential of the project systems analysis method for clarifying programmes and projects at the country level would consequently have its ramifications within the Organization. As projects and programmes of major importance to the development of the health sector within a country were progressively identified, it would become more and more clear where WHO must be ready to provide its assistance. This was the challenge to which WHO must now rapidly gear itself if the Second Development Decade was to achieve its ambitious aims. At this point, another question was quite inevitable. Was this methodology competing with or replacing national health planning? The answer was a very clear "No" to both questions. The problem of conceiving an over-all strategy for the long-term development and administration of the total health sector, of establishing priorities relative to certain diseases or conditions. certain population groups and geographic areas, as well as the problem of allocating resources among the various needs and priorities, were still to be dealt with from a planning angle. The PSA methodology, on the other hand, had a more limited (at least in each formulation application) scope but it focused more sharply on the short-term practical decisions to be made. specifying what was to be done, by whom, when, where and how. The PSA methodology was not primarily aimed at sorting out the problems of priorities and allocation of resources, but at analyzing the technical and managerial requirements for making effective change in chosen priority problems, and assessing these in terms of the current status and resources available. The end-product of project systems analysis was a project proposal which health ministries should· be able to have funded nationally. Of course. as more projects evolved.out of this analytical process, more information would become available for selecting long-term priorities and for allocating resources.
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Consequently, the PSA methodology could be seen as an approach based on in-depth analysis of a specific situation and would appear to be a useful tool on the road to achieving the more broadly based integrated planning goals implied in the concepts of national health planning. In this way one could say project formulation was a complement of National Health Planning. Planning at all levels and in all sectors had been a keyword repeated and repeated during the past decade, unfortunately with more rhetoric than product. There had been talk about country programming at the national level; of planning cells within WHO. Neither would take on meaning unless the instruments necessary to do the planning job could be provided. The PSA methodology might provide some new elements in these directions. The PSA methodology had now passed its initial development phase and was ready to face the critical challenge of utilization. The methodology must be applied. criticized and continually revised if it were to become a working tool in the planning mechanism. The WHO Regional Office for the Western Pacific again through the initiative of Dr Dy, would begin this process of application very soon. The Philippine Government had offered to utilize this methodology in nearby Rizal Province. He was delighted with the challenge and looked forward to the opportunity to apply the methodology. In order to facilitate utilization at the country level the PSA development team had been assigned the task of transferring the methodology through the organization of workshops and the provision of full-time assistance at the country level during the course of the project formulation process. This was viewed as a transitional phase until a full capability was developed in the Region itself, depending, of course, upon the response and desires of the various countries represented at the meeting. The need for a practical project formulation methodology was widely recognized. There was no quick and easy method available to meet this need. but further tools for effecting change in the health sector could be developed through the initiative of WHO and the response of governments.
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RESOLUTIONS OF REGIONAL INTEREST ADOPTED BY THE TWENTY-FOURTH WORLD HEALTH ASSEMBLY: Item 11 of the Agenda (Document WPR/RC22/4 and Add.l) Occupational Health Programmes (resolution WHA24.30)
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The REGIONAL DIRECTOR said that a separate document (WPR/RC22/4 Add.l) had been prepared on this item. This touched on several technicaladministrative aspects of occupational health services, as well as on
SUMMARY RECORD OF THE SECOND MEETING their development and related problems. The attention of the Committee was drawn particularly to the requirements for the development of occupational health services. Proposals from Representatives with a view to defining areas in which WHO assistance could contribute to country efforts would assist the Director-General in preparing a report for the Twenty-fifth World Health Assembly.
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Dr GATMAITAN (Philippines) referred in particular to the recommendation regarding the possible expansion of health services in countries undergoing industrialization. The Philippines was one of the countries directly affected by this proposal, it being dominantly a country with small manufacturing, retailing, wholesaling and trading activities. In 1960, survey reports had shown that there were only 26 -607 non-agricultural establishments, with manufacturing components having 11 494 units and commerce 9912. No accurate survey had been undertaken since then so the present situation was unknown. With the decline in imports and consumer goods, locally produced activities had increased resulting in a rise in employment. The Department of Health, which was responsible in large measure for the surveillance of production hazards and harmful working conditions of labour in order to safeguard and maintain the health and welfare of the working masses, was being assisted by the Department of Labour. This confirmed the statement of the Regional Director that the problem regarding health services for industrial establishments demanded the co-.operation and collaboration of all agencies - the Department of Labour, Department of Health and the assistance of international organizations like WHO and ILO. The World Health Assembly had asked for suggestions as to how occupational health services could be expanded. He wished to propose that the survey of industrial, commercial and agricultural establishments, which had begun two years ago in the Philippines and involved eight regional offices, might be stimulated through seminars on industrial hygiene/ occupational health with the aim of disseminating information to industrial establishments. A study was in progress to find out if there existed a causative relation between the development of malignancy among workers and their occupations. Cancer patients, if still living, would be interviewed to find out the nature and duration of the work which they had done. Information would also be collected on the history of exposure to industrial substances, duration of exposure" and the clinical symptoms of each exposure. His delegation wished to suggest that the survey of X-ray installations throughout the country (both governmental and private) be expanded. He also emphasized the importance of the continued participation of representatives of the Department of Health, Department of Labour, Workmen's Compensation Commission, and the Institute of Public Health in all meetings of the Inter-Agency Committee, with particular reference to the ILO/WHO project on occupational health and safety. Although the Philippines was mainly an agricultural country, little attention had been paid to this group of workers. This was another area where assistance was required. His delegation wished to endorse the resolution and to confirm its support of any activity undertaken in this field.
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Dr EL SAMRA (ILO) congratulated the Regional Director on the preparation of an excellent and comprehensive paper. Training was a problem even in those countries where occupational health legislation existed and factory inspectors were abundant. The occupational health practitioner in the factory might not, however, have the required knowledge as the undergraduate medical curricula were usually weak in occupational health subjects. He supported, therefore, the suggestion for an inter-country training programme as a first step in creating training facilities in individual countries. The next two points meriting attention were the establishment of industrial hygiene laboratory facilities and the development of expertise to take care of the control and eradication of occupational health hazards. These services should be started as early as possible during an occupational health programme. Another useful activity would be the organization of seminars on ergonomics, a number of which had been sponsored by WHO in the past.
Dr TRUONG-MINH-CAC (Viet-Nam) said that the economy of Viet-Nam was predominantly agricultural and that the development of industrialization had been hindered by the war. In the present health situation, priority would have to be given to the development of the basic health services. This would require large investments and the assistance o[ all qualified staff who were in limited supply since many physicians and nurses had been drafted into the army. Therefore, the development of the basic health services could be accomplished only at the expense of the expansion of specialized services such as occupational health. It was hoped that in the near future Viet-Nam might be able to convert its economy and undertake rapid industrialization. Occupational health would then become important but its development would depend on the availability of qualified staff. Therefore, WHO assistance in the training of personnel now would be most useful. It should be mentioned however that control, security, and health in industry were the responsibility of the Labour Department. Close collaboration with this Department was therefore imperative. It was difficult to plan a programme of work since little statistical data were available, but in view of the present situation of small and medium-sized industries it seemed that the first task in the future would be the prevention of occupational accidents. Dr YEN (China) said that his country had very recently undergone rapid industrialization and had not been able to deal properly with the protection of the,health of occupational health workers. Apart from the lack of expertise to run such services, the mUltiple disciplinary fields of concern, which included labour, social welfare, industry and health, had to be strengthened. Committees were co-operating, investigating and giving advice but their activities were still limited. His delegation endorsed the resolution adopted by the World Health Assembly and supported the programme proposed by the Regional Director.
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Mr WATANABE (Japan) said that in Japan the Ministry of Health and Welfare had sole responsibility for the health of the entire country. Specific programmes, such as school health, health of the agricultural or factory workers were, however, carried out by different ministries. School health was the responsibility of the Ministry of Education. Occupational. health legislation, working conditions in factories, the health of the workers were the concern of the Ministry of Labour. There was, however, close co-operation with the Ministry of Health. Industrial health inspectors were being trained at the Industrial Specialist Training Centre of the Ministry of Labour, which had another research institute called the National Institute of Industrial Health. This was headed by the former Director of the Public Health Bureau of the Ministry of Health and Welfare. Dr FRANKLANDS (Australia) believed that in the developing countries more stress was possibly laid on curative rather than preventive medicine. This could be one of the reasons why so little attention was given to occupational medicine, coupled with the fact that this type of work was not lucrative. Australia itself realized the importance of occupational medicine, but although the School of Public Health gave short classes in occupational medicine, there were still very few medical practitioners with suitable training in industrial medicine. The.School of Public Health was now considering the establishment of a course of twelve months in occupational medicine and this might improve the situation. Some industries in Australia realized the importance of this form of medical practice and on their own accord had engaged medical practitioners to provide a service of this nature to the firms' employees. The Commonwealth Government had arranged for surveys of industrial areas and of industrial accidents in order to obtain some statistics as a basis for improving services in the areas concerned. Legislation was divided between labour organizations, or labour departments, and health departments. The State Departments were very interested in providing legislation and they had quite an active inspectorial system for the purpose of uncovering the problems in industry.
Dr TAYLOR (New Zealand) said that New Zealand was a small country with considerably limited resources and perhaps typified better many of the countries represented 'at the meeting. It had been found more satisfactory to have occupational health services within the Department of Health as it was important when medical resources manpower was limited not to have fragmented activities. By keeping medical resources in one place, there was the advantage, as stated earlier by the Regional Director when he spoke about having a dental officer, of using a medical officer in different ways if the situation permitted.
There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare an appropriate draft resolution. (For consideration of draft resolution, see minutes of the third meeting, section 4.3.)
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Community Water Supply: Report on the Financial Con*eguences of the Programme for WHO (resolution WHA24.55) ,
The REGIONAL DIRECTOR said that notwithstanding the many resolutions which had been passed by the World Health Assembly strongly supportinl?; this programme, country targets and national plans for water supply development had not materialized in all cases. In the Western Pacifi<: Region, some countries had already substantially met, or even exceeded, the targets proposed for the Second United Nations Development Decade but there was still a wide gap in others between the existing situation and the proposed target. It was hoped that these countries would take appropriate action to meet the wishes of the World Health Assembly. The Assembly had also endorsed targets for water supply development recommended by the Director-General. The individual capacity of countries t:o meet these targets depended on available financing resources and the priority given to this programme by the Government. The Regional Committee might wish to comment on whether these targets were generally realistic for countries in the Region in terms of concrete official government action and did not merely represent endorsement by health ministries on the ground of principle.
Dr SO SATTA (Khmer Republic) said that the provision of a potable water supply raised problems of financing. While certain projects had been implemented in the Khmer Republic, thanks to bilateral aid or long-term loans, the water supply in Phnom-Penh reached only 30 per cent. of the population and even within that population distribution was poor as very often the pressure of the water was not sufficient. Peddlers also sold water in the outskirts of the town. The problem was an acute one and the situation had deteriorated with the arrival of many displaced persons from areas where conditions were no longer secure. He thought this programme should be given definite priority but the problem of financing had to be solved.
Dr YEN (China) stated that one of the problems might be the fact the activities connected with water supplies were usually in the hands of another department. In Taiwan, the community water supply was taken care of under a single programme - the community development programme. Each year, about 300 to 400 villages were undergoing transformations, which included housing, water supply, drainage, etc. There were also problems which required study such as the fall in the water table in certain areas and the fact that the shallow water contained less toxic substances than the water in deep wells. On the western coast of Taiwan, some people had blackfoot disease due to the presence of toxic substances in the water. Dr Yen stressed the need for more comprehensive research in this field.
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Dr GATMAITAN (Philippines) stated that in the Philippines less than 20 000 000 (52%) of the 37 000 000 estimated population were
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served by a safe water supply, and of these only 10 600 000, or 25%, received water coming from waterworks systems. Approximately two-anda-half million, or 7%, obtained their drinking water from artesian wells. The Philippine delegation was happy to endorse the resolution, particularly paragraph 2(i) and (ii), regarding the adoption of a rational approach to the problems of both urban and rural water supplies and the continued efforts required to promote and stimulate the improvement of community water supply and sewerage programmes. Dr SUNDARARAJAN (Singapore) said that Singapore had worked out a plan to supply the entire island with a safe piped water supply. A water planning unit had also been established to explore further resources of water supplies. This was basically aimed to meet future requirements due to expansion of population. Steps had also been taken to prevent pollution of the water supplies. There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare an appropriate draft resolution. (For consideration of draft resolution, see minutes of the third meeting, section 4.4.) (For the continuation of the discussion on this item, see minutes of the third meeting, section 3.)
The meeting rose at 5.10 p.m.