10–14 October 2016 Manila, Philippines
WPR/RC67/DJ/2 11 October 2016
Contents I. II. III. IV. Programme of work Report of meetings Other WHO meetings Director-General candidate meetings ……………………………... ……………………………... ……………………………... ……………………………... 2 2 7 7
Other information Venue Distribution of documents Conference Hall, Regional Office for the Western Pacific Representatives are kindly requested to collect daily their documents, messages and invitations at their designated mailboxes. The meeting will be held daily following the afternoon session at 17:15 in Room 403 (Emergency Operations Centre). The Regional Office has an Internet lounge along the corridor next to Room 212, adjacent to the Conference Hall on the second level. Publications related to the agenda of the Regional Committee are on display in the conference lounge and bookshop. A digital publications catalogue is contained on a USB digital flash drive provided to all representatives. Please ensure that your ID card is displayed at all times while on WHO premises. Kindly contact the WHO Conference and Administrative Services Officer, Ms Nguyen Thi Minh Ly, should you have any concerns at +63 2 528-9608 (landline) or +63 920-963-5457 (mobile). There is a no smoking policy on WHO premises. Likewise, smoking is prohibited in public areas in Metro Manila.
Rapporteurs meeting Internet access
WHO publications
Security
I. PROGRAMME OF WORK Agenda items 4 9 10 09:00–12:00 Address by the incoming Chairperson Proposed programme budget 2018–2019 Dengue WPR/RC67/4 WPR/RC67/5
Agenda items 12
14:00–17:00 Environmental health Panel discussion Plenary discussion WPR/RC67/7
11
Malaria
WPR/RC67/6
II. REPORT OF MEETINGS (MONDAY, 10 OCTOBER 2016)
First meeting Outgoing Chairperson: Mr James Gillan, Director, Department of Public Health and Social Services Guam, United States of America Incoming Chairperson: Honourable YB Datuk Seri Dr S. Subramaniam Minister of Health, Malaysia Item 1. Opening of the session The Chairperson declared open the sixty-seventh session of the Regional Committee for the Western Pacific. Item 2. Address by the outgoing Chairperson Addressing the Regional Committee, the outgoing Chairperson thanked the Regional Committee for the honour of having served as Chairperson. He thanked the DirectorGeneral for her leadership, courage and tenacity as she guided the Organization through significant challenges over the past 10 years. He acknowledged challenges the Region encountered over the past year, including dengue, malaria, chikungunya and Zika. He highlighted other issues that impact the Region, such as the escalating cost of medicines, limited access to health care, the burden of noncommunicable diseases (NCDs), emerging and tropical diseases, and the health-related effects of climate change. Given these challenges, the outgoing Chairperson urged Member States to continue to advance the agenda for promoting and protecting health. He expressed his gratitude to WHO for providing strong support to Member States.
Sixty-seventh session of the Regional Committee for the Western Pacific • 10–14 October 2016, Manila, Philippines Page 2
Finally, he mentioned the six candidates for WHO Director-General who indicated they will be attending the session. He outlined the guidance for their interaction with Member States. Item 3. Election of incoming officers: Chairperson, Vice-Chairperson and Rapporteurs The Regional Committee elected the following officers: Chairperson: Honourable YB Datuk Seri Dr S. Subramaniam Minister of Health, Malaysia Vice-Chairperson: Honourable Nandi Tuaine Glassie Minister of Health, Cook Islands Rapporteurs: In English: Ms Jacinta Holdway Director, Australian Government Department of Health In French: Mr Maziar Tahéri Deputy Chief, Office of International Health and Social Protection Ministry of Social Affairs, Health and Women’s Rights, France Item 5. Adoption of the agenda There being no objections, the provisional agenda was adopted by the Regional Committee accordingly (WPR/RC67/1 Rev. 2). New Caledonia In reference to a request from the Government of France as contained in Information Document 5 on New Caledonia, and in accordance and consistent with Article 47 of the WHO Constitution and past practice, the Regional Director welcomed New Caledonia to participate in the Regional Committee in its own name but without the right to vote. Item 6. Address by the Director-General The Director-General said this would be her last Regional Committee before retirement. She noted the Region’s vast diversity, its equally diverse health challenges and an exceptionally strong spirit of solidarity in meeting those challenges. She acknowledged the Region’s dengue problem, with declines in mortality offset by a dramatic increase in incidence, and praised the draft regional dengue plan. She noted that malaria deaths decreased by 87% between 2000 and 2015 in the Region and emphasized the need to interrupt transmission in the Greater Mekong Subregion. The Director-General said the Asia Pacific Strategy for Emerging Diseases and Health Emergencies was a model for building core capacities for the International Health Regulations, or IHR (2005), and praised the Region’s preparedness. She acknowledged concern over Zika, noting that scientists and public health authorities do not have all the answers. But she said the Region has the talent and research capacity to help the global fight against the virus. The Director-General said the draft strategy on health and the environment presented a practical menu of options for Member States to deal with this difficult, multisectoral problem, and cited the strategy as a comprehensive action agenda that can guide sustainable development. In closing, she congratulated Cambodia, Cook Islands, Niue and Vanuatu for their Sixty-seventh session of the Regional Committee for the Western Pacific • 10–14 October 2016, Manila, Philippines • Page 3
efforts in eliminating lymphatic filiariasis as a public health problem. Interventions were made by the representatives of the following Member States (in order): Japan, Malaysia, China, the Republic of Korea, Hong Kong SAR (China), Macao SAR (China), Singapore and Samoa. In response, the Director-General expressed her gratitude in serving the Organization for 10 years. She said that in her remaining time she would continue to do her utmost to help the Organization serve marginalized and vulnerable groups. She thanked again the countries that have collectively committed to achieving better health. Item 7. Address by and the report of the Regional Director The WHO Regional Director opened his address by noting that this would be the last Regional Committee for the Director-General. He praised her leadership and many accomplishments. He said her extensive and self-motivated reforms had made the Organization more effective and efficient, and much more responsive to Member States. Turning to the Region’s business, the Regional Director reminded representatives that they had received his formal report, Report of the Regional Director: The work of WHO in the Western Pacific Region — 1 July 2015 to 30 June 2016. He said WHO efforts have focused on supporting the priorities and needs of Member States, working diligently to support their health goals. The Regional Director highlighted achievements of the past year and commended Member States for their commitment and hard work. He said the new Sustainable Development Goals (SDGs), in which health plays a central role, have created new opportunities for better health and well-being. He pledged WHO support for Member States to achieve the SDGs. The Regional Director said the backbone of WHO’s success has been its strong relationship with Member States. He reaffirmed his commitment to ensure WHO continues to function seamlessly as one entity in supporting Member States in the Region. And he committed to making the final two years of his tenure the most productive. Interventions were made by the representatives of the following Member States (in order): Singapore, the Republic of Korea, Australia and Viet Nam. Second meeting Chairperson: Item 7. Honourable YB Datuk Seri Dr S. Subramaniam, Minister of Health, Malaysia Address by and Report of the Regional Director (continuation) In the continuation of the morning session on the report of the Regional Director, the Chairperson called on Member States for further interventions. Interventions were made by the representatives of the following Member States (in order): China, Japan, Samoa, Malaysia, New Zealand, Tonga, Papua New Guinea, Vanuatu, the Philippines, Fiji and Tuvalu. The Regional Director thanked Member States for their interventions and noted several subjects that were raised — including the Asia Pacific Strategy for Emerging Diseases, the SDGs, environmental health and Zika — would be discussed in separate sessions. He said diabetes was a special concern, and drew attention to efforts by the Regional Office to engage non-Member State stakeholders to address the issue. On gender balance, he said staff were recruited with transparency and Sixty-seventh session of the Regional Committee for the Western Pacific • 10–14 October 2016, Manila, Philippines • Page 4
fairness, pointing out that three of the Region's five technical directors are female. The Director-General also responded to Member State interventions, thanking them for their kind words and pledging that WHO will continue to provide technical support and leadership, particularly in relation to climate change. Item 8. Programme budget 2014–2015: budget performance (final report) The Director, Programme Management, presented document WPR/RC67/3 on the final report of budget performance for the 2014–2015 biennium. He mentioned that it is the first of three biennial budgets to be formulated under the 12th General Programme of Work 2014–2019, highlighting that the structure has changed from 13 strategic objectives to six categories with a results-based management structure. The Director, Programme Management, shared the details of the final budget working allocation. He said that total funds available from all sources amounted to US$ 266.6 million, representing 88.7% of the final working allocation of US$ 300.7 million. He compared this total with the previous biennium, indicating a decrease of nearly US$ 20.0 million, mainly due to a drop in voluntary contributions. He said total financial utilization of funds amounted to US$ 259.2 million, or 97.2% of available resources and 86.2% of the final working allocation. The Director, Programme Management, invited the Committee to review the report, which showed an increase in country utilization from 91.0% in 2012–2013 to 96.9% in 2014–2015. He said Table 4b provided a breakdown of available funds and the utilization of funds by country and area, and Table 5 showed that the largest expenditure continues to be staff costs (44.0%), followed by contractual services (22.0%), direct financial cooperation or DFC (13.0%) and travel (8.9%). The Director, Programme Management, noted that recommendations of all external audits conducted in the Regional Office and WHO country offices in China and Viet Nam were fully implemented, and the audit reports were officially closed. Recommendations of all internal audits conducted in the Regional Office and WHO country offices in Fiji, the Philippines and Solomon Islands were fully implemented and officially closed. Nearly all offices received satisfactory ratings, and any outstanding issues have been addressed in the few that received partially satisfactory ratings. In concluding, the Director, Programme Management, said staff diversity in terms of gender and geography remains a high priority with professional staff in the Region from 42 countries, making the Western Pacific the most diverse of all WHO regions. An end-of-biennium report on implementation of the Programme Budget 2014–2015 showed that 76 out of 81 outputs (94%) were fully achieved. Interventions were made by the representatives of the following Member States (in order): the United States of America, China, Japan and Kiribati. The Director, Programme Management, thanked Member States for their strong support and commitment, without which high implementation, no overdue direct financial cooperation (DFC) and timely donor reporting would not have been achieved. He said the five areas assessed as partially achieved were related to shortages of funding and staffing, as well as limited country capacities. He said the Programme Budget 2014–2015 was smaller than the preceding and succeeding programme budgets, due to a reduction in donor support in conjunction with some countries moving from low- to middle-income status. The Director, Programme Management, assured the Regional Committee that WHO will continue its efforts on two fronts: resource mobilization and the effective and Sixty-seventh session of the Regional Committee for the Western Pacific • 10–14 October 2016, Manila, Philippines • Page 5
efficient use of resources. He said WHO will continue to monitor implementation and to improve operational efficiency. The Chairperson noted that the Regional Committee has decided to accept the Regional Director's final report on Programme Budget 2014-2015. He asked the rapporteurs to draft the appropriate decision. Special briefing on Zika The Regional Emergency Director for the Western Pacific opened the briefing by noting that Zika virus is now widespread globally and regionally. She said 73 countries and areas globally have reported evidence of mosquito-borne Zika virus transmission since 2007, with 56 countries having reported Zika virus outbreaks since 2015. The Regional Emergency Director said that the Western Pacific Region is the most affected Region after the Americas. The Regional Emergency Director said Zika virus and associated congenital brain abnormalities and Guillain-Barré syndrome were declared a Public Health Emergency of International Concern in February and remains so. She said there is concern that the Region might experience further spread of Zika virus and possible complications associated with Zika in the future, which call for a concerted effort to put systems in place to promptly detect and monitor cases, outbreaks and complications. She said the Region needs to prepare to provide an appropriate response, reduce vector densities, especially in high-risk locations, and also develop a long-term strategy to mitigate the impact of Zika. The Philippines representative said the first locally diagnosed case was detected in 2012 and 15 additional cases were diagnosed in 2016. The representative said Zika also was diagnosed in six travellers returning to the Philippines. The representative said the overall response to Zika has focused on three strategic stages: preparedness, containment and mitigation. The representative said preparedness is built around a national plan focused on surveillance, laboratory capacity, risk communications and improved vector control. The Philippines representative said containment relies on early detection and rapid response. The representative said every case detected – whether from travellers or local transmission – is followed by investigation, contact tracing and intensified vector control. The representative said mitigation is intended to reduce the impact of Zika, and concluded by saying the Philippines is moving towards an integrated strategy for dengue, Zika and chikungunya. The Minister of State, Ministry of Health, Singapore, shared his country’s experience. He said that since Zika is not new, Singapore had been planning for some time. The initial approach was early detection to respond and contain the first cases and then move to the long-term management of Zika through mitigation. He said Singapore had detected an imported case in May 2016 in a patient who had travelled to South America. The first locally transmitted case was found in August 2016. The Minister said that local transmission to the wider community soon followed. The Minister said considering the fact that 80% of Zika-infected patients are asymptomatic and the increased population of Zika-infected mosquitoes, Singapore stopped isolating cases in hospitals. He said Zika management was moved to the community, with those testing positive hospitalized only if clinically necessary. He said vector control continues to be the cornerstone of Zika control. The main concern was about pregnant women, the Minister said, so a clinical advisory group was set up to provide guidance on pregnancy and Zika. He concluded by noting that transparency was key, and that a whole-of-society approach is needed that is practical and sustainable. He urged the Region to work Sixty-seventh session of the Regional Committee for the Western Pacific • 10–14 October 2016, Manila, Philippines • Page 6
together to strengthen surveillance and response. In response to the Member State interventions, the Director-General said there are many unanswered questions and scientific gaps concerning the virus. She said the health sector needs be prepared for the short- and long-term impacts. The health system impact can be huge, she said, especially in countries with a large number of babies with microcephaly due to Zika. The Director-General emphasized the need to strengthen surveillance, laboratory testing and mosquito control. She added that countries need to work together on research and development, including research on vaccines and new mosquito control methods. In closing, the Director, Programme Management, assured Member States that WHO will continue efforts to collect information and fill knowledge gaps on Zika. He said WHO staff will be available all week to answer questions Member States may have on Zika.
III. OTHER WHO MEETINGS Tuesday, 11 October 2016 12:45–13:45 Health-care financing for priority public health diseases (Conference Hall)
Wednesday, 12 October 2016 12:45–13:45 17:15 onwards Health security (Conference Hall) Private informal consultation with Member States (Conference Hall)
Thursday, 13 October 2016 12:45–13:45 WHO's work in countries (Conference Hall)
IV. DIRECTOR-GENERAL CANDIDATE MEETINGS
Tuesday, 11 October 2016 08:00–08:45 12:00–12:45 Presentation: Dr Tedros Adhanom Ghebreyesus (Room 210) Presentation: Professor Philippe Douste-Blazy (Room 210)
Wednesday, 12 October 2016 08:00–08:45 12:00–12:45 Presentation: Dr Sania Nishtar (Room 210) Presentation: Dr Miklos Szocska (Room 210)
Thursday, 13 October 2016 08:00–08:45 Presentation: Dr David Nabarro (Room 210)
Sixty-seventh session of the Regional Committee for the Western Pacific • 10–14 October 2016, Manila, Philippines • Page 7