WO,RLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
REGIONAL OFFICE FOR
THE WESTERN PACIFIC
BUREAU R~GIONAL DU PACIFIQUE OCCID£NTAL
REGIONAL COMMITTEE Thirty-seventh session Manila 15-19 September 1986 Provisional agenda item 14.1
\\' PR/RC37 I 10 15 July 1986
ORIGINAL:
El\GLISH
CORRELATION OF THE WORK OF THE WORLD HEAL1H ASSEMBLY, THE EXECUTIVE BOARD AND THE REGIONAL COMMITTEE Consideration of r{·solutions of the Thirty-ninth World Health Assembly and the Executive Board at its seventy-seventh and seventy-eighth sessions Report by the Regional Director
Resolutions adopted by the Thirty-ninth World Health Assembly of interest for the work of WHO in the Western Pacific Region are hereby presented to the Regional Committee for comment, together with short analyses of their Implications for Member States of the Region and for WHO's programme of cooperation. Resolutions directly related to other items on the provisional agenda of the current session of the Regional Committee form part of the documentation for those individual agenda items. Resolutions of the seventy-seventh session of the Executive Board are reflected in the resolutions of the Health Assembly. The resolution adopted by the Executive Board at its seventy-eighth session in May 1986 is not of direct relevance to the work of the Regional Committee for the Western Pacific.
WPRJRC37/10 page 2
1.
Amendments to Articles 24 and 25 of the Constitution (resolution WHA39.6)
Pursuant to the recommendation contained in WPRfRC35.RlO and EB75.R4, the Thirty-ninth World Health Assembly has adopted, by resolution WHA39.6, amendments to Articles 24 and 25 of the Constitution providing for an increase in the membership of the Executive Board. This amendment provides for an increase in the membership of the Executive Board from 31 to 32. More specifically, the number of members from the Western Pacific Region wiU be increased from 3 to 4. However, in accordance with the provisions of Articles 73 and 79(b) of the Constitution, this amendment wilJ come into force only when two-thirds of the Members have deposited their formal instrument of acceptance with the Secretary-General of the United Nations. It should be noted that this process may require several years. The increased representation will give this Region a strengthened voice in conveying its views on regional and global issues. 2. Evaluation of the Strate for Health for AU b the Year 2000: Seventh re ort on the World Health Situation resolution WHA39.7 Attention is drawn to operative paragraphs 5 and 6. While the national evaluations of the health-for-all strategy have revealed the progress achieved in attaining national health goals, they have also highlighted the problems that still need to be overcome. Although the health-for-all movement has dearly increased awareness by national authorities of the need to adopt comprehensive policies which recognize health in the context of overall social and economic factors, there is still much to be done in terms of implementing strategies which are truly intersectoral in scope and which ensure the active participation of the community in the development and implementation of health programmes. The results of the evaluation provide direction on how to improve the organization of health systems based on primary health care, particularly in the areas of information support and the strengthening of management and supervisory skills at all levels of the organization. Most Member States have indicated a number of new approaches which are being attempted to achieve their health-for-all goals. However, a great deal of research and development is stiU needed in order to define appropriate technology and determine alternative methods of financing the health systems. The evaluation has shown that many Member States are facing similar problems. \\•HO, through national and international forums, will continue to coordinate the exchange of information on developm~nt issues and support technical cooperation among countries to further develop national health-for-all strategies. WHO will promote the continued use and further development of the health-for-all evaluation, particularly in the formulation of regional coJJaborative programmes and the allocation of WHO's financial resources.
WPR/RC37 flO page 3
3.
Tobacco or health (resolution WHA39.14) Attention is drawn to operative paragraph 4.
Tobacco or health programmes are being developed in several countries or areas such as Hong Kong and Singapore. It is essential that Member States which have not yet done so assess the nature and magnitude of tobacco-related health hazards through surveys of smoking trends and of mortality and morbidity due to tobacco-related diseases. They should also intensify their efforts to develop such programmes as an integral part of their national health services. For this purpose, ministries of health will need to establish responsible units or focal points. In the development of programmes, emphasis should be given to legislative action to restrict smoking in public places and places of work as well as to the education of the public, including schoolchildren. Viable economic alternatives to tobacco production, trade and taxation should also be explored and developed. WHO will endeavour to collaborate in establishing and developing national tobacco or health programmes, with special reference to legislative action, education and public information. It will also mobilize all possible sources of financial support for these activities. A few suitable countries or areas are being approached for possible collaboration in promoting programmes. A regional meeting is planned for 1987 to review progress and provide guidelines for the regional tobacco or health programme. 4. Global strategy for health for all by the year 2000: Repercussions of the world economic situation (resolution WHA39.15) Attention is drawn to operative paragraphs 1, 2 and 3. The regional evaluation of the health-for-all strategies revealed that the majority of countries or areas are concerned with how their health development strategies address such issues as improving the equity of care and providing services to underserved population groups. In the light of the current world economic situation, it is clear that the health systems of Member States not only face serious difficulties in preserving the significant gains of the recent past but must also seek innovative approaches to solving their current development objectives. It is important therefore that Member States: (1) further promote their health-for-all strategies as a national effort; (2) strengthen their managerial capabilities to prepare and use health sector financial plans; and (3) continue to explore alternative ways of financing the health care system, including the possible redeployment of existing resources. Very few countries in the Region have an accurate picture of how money spent on health is used or even where all the money comes from. The preparation of a comprehensive plan for the financing of health-for-all strategies can become a very useful political as well as management tool, especially during a time of economic difficulties. This type of planning can be used to stimulate and guide the national debates that are necessary to develop 'strategies which make the optimal use of all available resources to achieve the health development goals.
WPR/RC37/l 0 page 4
WHO, through national and international forums, will continue to promote the regional development strategies and coordinate multilateral and bilateral cooperation in health development. WHO has begun to provide technical support for the training of national staff in health care economics and financing. These efforts will be continued with additional support for the strengthening of managerial capabilities in health sector financial planning and management.
5.
Intersectora! coo eration in national strate ies for health resolution WHA39.22) Attention is drawn to operative paragraphs I and 4.
Intersectoral cooperation in achieving health goals has been accepted as one of the guiding principles of the health strategy adopted at the International Conference on Primary Health Care in A!ma-Ata in 1978. This principle holds that the improvement of health calls for more than just the provision of services by the health sector; the contribution of other sectors is explicitly recognized as necessary. The resolution calls on all Member States to promot~ intersectoral action for health and provides some important guidelines for them to follow. Evidently, the ministries of health will need to play a very strong advocacy role in this connection, which should be initiated within the ministry itseif and the health sector and be supported by a plan for the promotion of intersectoral cooperation. WHO must serve as a strong partner of the ministries of health in carrying out this advocacy role. Mechanisms for a more effective relationship between WHO and the health-related sectors need to be established. The intersectoral concept and approach to health development should be a major feature of all WHO collaborative activities with countries. 6. Prevention of mental, neurolo resolution WHA39.25) Attention is drawn to operative paragraphs 1 and 2. In many countries or areas in the Region, mental, neurological and psychosocial diseases tend to be regarded as unpreventable and incurable. Member States need to take into consideration the effectiveness of existing preventive measures and to incorporate programmes aimed at protecting the central nervous system as an important component of primary health care. The establishment of national coordinating mechanisms and groups on mental health programmes and the integration of mental health skills and knowledge are a prerequisite for the development of effective prevention programmes. Member States undergoing rapid sociocultural change will need to study the extent and causes of such health-damaging behaviour as alcohol and drug abuse, and may find it essential to introduce multidisciplinary and intersectoral measures for the prevention of these problems.
WPR/RC37f10 page 5
The resolution requests the Regional Committees to discuss ways in which the activities described in the Director-General's report on this subject, and directed towards the prevention of mental, neurological and psychosocial disorders, could best be implemented at regional and national levels. It will be recalled that in September 1985 the Regional Committee adopted resolution WPR/RC36.R 17 on mental health, which requested the Regional Director to strengthen cooperation with countries in the development of national mental health programmes in specific areas of public health importance. WHO will intensify its efforts. in the field of prevention, including the organization of training programmes to provide the necessary mental health skills and knowledge to all health and related workers and the fostering and coordination of research to develop further methods of prevention. 7. Abuse of narcotic and psychotropic substances (resolution WHA39.26) Attention is drawn to operative paragraphs 1 and 2. There has been increasing concern with the abuse of narcotic and psychotropic substances, particularly abuse by the younger age-groups· in the Region. Many countries or areas have intensified their efforts for the prevention and control of drug-related problems, mainly through Jaw enforcement and legislation. The resolution urges Member States to continue to develop and implement national policies to address the health problems related to the misuse of narcotic and psychotropic substances through prevention, treatment and rehabilitation. In particular they are required to strengthen their efforts to develop ways to assess and monitor trends, to promote social and educational measures and to encourage and support community action so as to reduce the inappropriate demand for narcotic and psychotropic substances. There is clearly a need for trained personnel in the Region to implement prevention, treatment and research programmes. I'Vlember States are therefore asked to give special consideration to _initiating or strengthening national training programmes for aJl personnel involved. WHO will continue to collaborate with !Vlember States in preventing the abuse of narcotic and psychotropic substances. At the regional level, particular emphasis will be given to promoting training for those involved in prevention, treatment/management and research at national and regional levels and to supporting a regional network of collaborative research groups. 8. The rational use of drugs (resolution WHA39.27) Attention is drawn to operative paragraphs 3, 4 and 5. Governments of i\.·lember States and all concerned parties, including the pharmaceutical industry, health personnel, teaching institutions, consumer groups and the mass media are urged to assume their responsibilities as listed in the Director-General's summing up of the Conference of Experts on the Rational Use of
WPR/RC37 /10 page 6
Drugs, held in Nairobi in November 1985. tviember States and various kinds of international organizations are also invited to support developing countries in fulfilling the responsibilities mentioned above. The. Director-General is requested to implement the WHO revised drug strategy as endorsed by the World Health Assembly, seeking extrabudgetary resources in addition to those in the regular budget. The regional drug programmes are already moving in this direction and inputs from the regular budget have increased considerably during the 1986-1987 biennium. Extrabudgetary resources, particularly those from UNDP, are likely to increase in 1987. 9. Infant and young child feeding (resolution WHA39.28) Attention is drawn to operative paragraph 2. In accordance with World Health Assembly resolutions WHA33.32 on infant and young child feeding and WHA3lf.22 and WHA35.26 on the International Code of Marketing of Breast-milk Substitutes, and following the endorsement in their entirety of the statement and recommendations made by the Joint WHO/UNICEF Meeting on Infant and Young Child Feeding, held in Geneva in October 1979, Member States in the Region are implementing comprehensive maternal and child nutrition activities which specifically emphasize breast-feeding and implementation of the International Code. However, those countries or areas which have not yet implemented the International Code will need to intensify their efforts to promote breast-feeding and provide appropriate supplementation to infants and young children in compliance with the International Code. Member States should furthermore ensure that the practices and procedures of their health care systems are consistent with the principles and aims of the International Code. WHO will continue to support Member States in their efforts to improve infant and young child nutrition as v..·ell as in measures that are consistent with the principles and spirit of the International Code. Furtherrnore, WHO will endeavour to provide all possible support to Member States as and when required, in particular in the preparation of national legislation or other measures. These activities may be drawn up in collaboration with other United !\lations agencies concerned with the area of maternal and child health and nutrition. 10. Expanded programme on immunization (resolution WHA39.30)
Attention is drawn to operative paragraph 3, which urges Member States to pursue vigorously the recommendations for action contained in the Director-General's report, and to operative paragraph 7. This resolution is intended to emphasize the need to accelerate immunization activities and to remind Member States of the five point action programme endorsed by the Thirty-fifth World Health Assembly in its resolution WHA35.31 in furtherance of the 1990 goal. In implementing the recommendations for action, Member States will need to allocate additional financial resources and manpower to improve the immunization
services provided to the disadvantaged, particularly ,in urban areas.
To accelerate
WPR/RC37fl0 page 7
immunization coverage, Member States will have to develop appropriate materials and mechanisms to ensure the provision of immunization at every contact point and to provide health education to the community with a view to reducing drop-out rates. In addition to continuing its cooperative efforts, WHO must respond to the increased need of countries to accelerate their immunization activities. WHO wilJ do so by: providing technical expertise through frequent country visits; . promoting and supporting disadvantaged urban areas; the development of immunization in
supporting training activities for middle and peripheral level personnel and cold chain repair and maintenance technicians;
h t~a1th
promoting and supporting the development of health education materials; effectively coordinating joint activities with UJ\ICEF and other agencies in the provision of cold chain equipment, vaccines ·and health education materials to Member States; requesting WHO Representatives to monitor the development implementation of the expanded programme on immunization. 11. Prevention and control of iodine deficiency disorders (resolution \lHA39.31) and
Attention is drawn to operative paragraph 1, which urges the governments of Member States to give high priority to the prevention and control of iodine deficiency disorders. Attention, however, should not be confined to endemic goitre alone; consideration also needs to be given to epidemiologically associated cretinism, deaf-mutism and mental retardation. The prevalence and severity of goitre, among women in particular, requires attention because of the danger of cretinism in infants. Member States are requested first to . identify accurately those areas where iodine deficiency disorders exist as a significant public health problem and where prevention and control measures have not yet been taken. An accurate assessment of the magnitude of the problem and the geographical distribution of such disorders is essential for identifying the most appropriate prevention and control measures. Legislation may also be necessary for the monitoring and evaluation of any prevention and control measures introduced. The prevention and control programme should be developed through appropriate nutritional programmes as part of primary health care. /\ strong political commitment is necessary to overcome the various geographical, economic and adrninistrative obstacles associated with iodine supplementation, and to improve the quality of life, productivity, and educability of children and adults suffering from iodine deficienc y disorders.
WPR/RC37 fl 0
page 8
WHO will endeavour to give all possible support to Member States in identifying appropriate approaches to the prevention and control of iodine deficiency disorders, in the light of national circumstances, needs and available resources. Technical support will also be provided for the conduct of surveys, the formulation, implementation, monitoring and evaluation of national prevention and control programmes, and assessment of the training needs of various categories of health workers. Such activities may be undertaken in cooperation with intergovernmental agencies, nongovernmental organizations and other United 1\iations agencies wherever possible. WHO will also intensify its efforts to mobilize all possible sources of financial support for these activities.
THIRTY-NINTH WORLD HEALTH ASSEMBLY ~nda
WHA39.6 12 May 1986
item 37
AMENDMENTS TO ARTICLES 24 AND 25 OF THE CONSTITUTION The Thirty-ninth World Health Assembly, Recalling resolution WHA38.14 concerning the number of members of the Executive Board; Considering that the membership of the Executive Board should be increased from 31 to 32, so that the number of Members of the Western Pacific Region entitled to designate a person to serve on the Executive Board be increased to four; 1. ADOPTS the following amendments ~o Articles 24 and 25 of the Constitution, the texts in the Arabic, Chinese, English, French, Russian and Spanish-languages being equally authentic: Article 24 The Board shall consist of thirty-two persons designated by as any Members. The Health Assembly, taking into account an equitable geographical distribution, shall elect the members entitled to designate a person to serve on the Board, provided that, of such Members, not less than three shall be elected from each of the regional organizations established pursuant to Article 44. Each of these Members should appoint to the Board a person technically qualified in the field of health, who may be accompanied by alternates and advisers. Article 25 These Members shall be elected for three years and may be re-elected, provided that of the members elected at the first session of the Health Assembly held after the coming into force of the amendent to this Constitution increasing the membership of the Board from thi.rty-one to thirty-two the term of office of the additional Member elected shall, insofar as may be necessary, be of such lesser duration as shall facilitate the election of at least one Member from each regional organization in each year." 2. DECIDES that two copies of this resolution shall be authenticated by the signatures of the President of the Thirty-ninth World Health Assembly and the Director-General of the World Health Organization, of which one copy shall be transmitted to the Secretary-General of the United Nations, depositary of the Constitution, and one copy ret ained in the archives of the World Health Organization; 3. DECIDES that the notification of acceptance of these amendments by Members in accordance with the provisions of Article 73 of the Constitution shall be effected by the deposit of a formal instrument with the Secretary-General of the United Nations, as required for acceptance of the Constitution by Article 79(b) of the Constitution.
Eleventh plenary meeting, 12 May 1986 A39/VR/11 = ...
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 20.1
WHA39.7 13 May 1986
EVALUATION OF THE STRATEGY FOR HEALTH FOR ALL BY THE YEAR 2000 SEVENTH REPORT ON THE WORLD HEALTH SITUATION The Thirty-ninth World Health Assembly, Reaffirming resolutions WHA30.43, WHA34.36, WHA35.23, WHA36.35 and WHA37.17 concerning the policy, strategy and plan of action for attaining the goal of health for all by the year ~ooo;
Recalling resolution WHA36.35 concerning the preparation of the Seventh Report on the World Health Situation on the basis of the first evaluation of the Strategy for Health for All by the Year 2000, at national, regional and global levels; Noting with appreciation that 86% of the Member States submitted reports on the evaluation of their national strategies; Mindful of the persistent deficiencies in the information support required to back the national managerial process for health development and of the consequent difficulties experienced by some Member States in generating relevant information and using it for the monitoring and evaluation of the Strategy; Stressing that the real value of the evaluation can only be realized if Member States use all available information to the fullest extent for accelerating the implementation of their strategies for health for all; Emphasizing that the achievement of the goal of health for all by the year 2000 requires continuing political commitment and is intimately linked to socioeconomic development, and to the preservation of peace; 1. 2. APPROVES the global report on the evaluation of the Strategy for Health for All by the Year 2000; NOTES with satisfaction the efforts made by Member States to evaluate the effectiveness of their strategies and transmit their reports to WHO and calls upon Member States which have not done so to undertake such action urgently; CONGRATULATES Member States which have made progress in the implementation of their strategies for health for all; DECIDES to modify the plan of action for implementing the Global Strategy for Health for All,l as recommended by the regional committees, by instituting reporting on aonitoring of the Strategy every three years instead of every two, to allow more time to strengthen the nationalmonitoring and evaluation process and the related information support;
3. 4.
1 Plan of action for implementing the Global Strategy for Health for All. World. Health Organization, 1982 ("Health for All" Series, No. 7).
Geneva,
WHA39.7 page 2 5. URGES Member States: (1) to make use of their evaluation reports to guide further their national health policies and health development processes towards the achievement of the goal of health for all, and to involve decision-makers, community leaders, health workers, nongovernmental organizations and people from all walks of life in the attainment of national health goals; (2) to maintain high-level political commitment to social equity and leadership for the further implementation of national strategies, including the reduction of socioeconomic and related health disparities among people, thus fulfilling a fundamental requisite for the achievement of health for all; (3) to pursue vigorously actions aimed at strengthening the manaiement of their health system based on primary health care, including the information support required for its monitoring and evaluation; (4) to accelerate efforts to obtain the collaboration of all health-related sectors and develop effective mechanisms for their coordinated support to achieve health goals; (5) to strengthen further the health system infrastructure based on primary health co r e in order to make full use of all available health resources; (6) to lay particular emphasis on district health systems based on primary health care defining targets for the integrated delivery of essential elements of primary health care until all districts and all elements are covered; (7) to promote relevant research and the use of appropriate health technology in their national health system;
(8) to investigate all feasible means of financing the implementation of their national strategies for health for all, including the rational and optimal use of national resources and external funding; 6. URGES the regional committees: (l) to give appropriate attention to the dissemination and use of findings of the evaluation report to support the implementation of national and regional strategies and to make the best use of WHO resources at regional and national . levels; (2) to promote mutual cooperation and exchange of experience among countries with regard to national health development based on primary health care; (3) (4) 7. to intensify further the mobilization of resources for the Strategy; to carry out the next monitoring of the regional strategies in 1988;
REQUESTS the Executive Board: (1) to continue to monitor and evaluate activ~ly the progress in the implementation of the Global Strategy, in order to identify critical issues and areas requiring action by M ember States and the Secretariat; (2) to explore other practical and effective economic approaches for financing the national health strategies, including the mobilization ;$.f.k;~~ uppor t from other sec tors; (3) to carry out the next review of the monitoring of th•· Global Strategy for Health for All in January 1989 and to report to the Forty-second World Health Assembly;
8,
DECIDES that the Forty-second World Health Assembly will review the report on the second mon.i taring of the Global Strategy for Health for All, in accordance with the revi'sed plan of action;
WHA39.7 page 3 9. REQUESTS the Director-General: (1) to publish the Seventh Report on the World Health Situation, prepared on the basis of the report on the evaluation of the Strategy, in accordance with resolution WHA36.35, in the six official languages; (2) to disseminate the report widely to governments, organizations and agencies of the United Nations system, and other intergovernmental, nongovernmental and voluntary organizations; (3) to use the national, regional and global reports to guide WHO's cooperation for health development and, in particular, as the basis for WHO's response to the needs of Member States in the Eighth General Programme of Work; (4) to intensify technical cooperation with Member States to strengthen the management · of health systems, including information support mechanisms; (5) to continue to support Member States in developing and implementing their strategies to reach the goal of health for all by the year 2000 and their alternative economic strategies for the attainment of that goal; (6) to support Member States in particular in establishing or strengthening district health systems based on primary health care; (7) to intensify support to the least developed countries, with particular emphasis on rationalizing the use of available resources and mobilizing additional financial resources for strengthening their health infrastructur& from national, international, bilateral and nongovernmental sources; (8) to support the monitoring and evaluation of the Strategy at national, regional and global levels. Twelfth plenary meeting, 13 May 1986 A39/VR/12
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 22 TOBACCO OR HEALTH The Thirty-ninth World Health. Assembly,
WHA39.H 15 May 1986
Recalling resolutions WHA31.56 and WHA33.35 on the health hazards of tobacco smoking and the WHO action programme on smoking and health; Deeply concerned by the current pandemic . of smoking and other forms of tobacco use, which results in the loss of the lives of at least one million human beings every year and in illness and suffering for many more; Believing that the battle between health and tobacco must and can be won for the sake of human health; Encouraged by the existence of total bans, restrictions or limitations on tobacco advertising in several countries; 1.
AFFIRMS: (1) that tobacco smoking and the use of tobacco in all its :forms is incompatible with the attainment of health for all by the year 2000; (2) that the presence of carcinogens and dther toxic substances in tobacco smoke and other tobacco products is a known fact; and that the causal link between tobacco and a range of fatal and disabling diseases has been scientifically proven; (3) that passive, enforced or involuntary smoking violates the right to health of non-smokers, .who. must be protected against this noxious form of environmental pollution;
2. 3.
CALLS for a global public health approach and action ..
~
to combat the tobacco pandemic;
DEPLORES. all direct and indirect practices the aim of which is to promote the use of tobacco, as this product is addictive and dangerous even when used as.promoted;
4. URGES those Member States which have not yet done so to implement smoking control strategies; these, as a minimum, should contain the following:
(1) measures to ensure that non-smokers receive effective protection~ to which they are entitled, from involuntary exposure to tobacco smoke, ih enclosed public places, restaurants, transport, and places of work and entertainment; (2) measures to promote abstention from the . use of tobacco so as to protect children and young . people from becoming addicted; (3) measures to ensure that a good example is set in all health-related premises and by all health personnel; (4) measures leading to the progressive elimination of those socioeconomic, behavioural, and other incentives which maintain and promote the use of tobacco;
WHA39. i4 page 2 (5) prominent health warnings, which might include the .s tatement ,that tobacco is addictive, on cigarette packets, and containers of all types of tobacco products; (6) the establishment of programmes of education and public information on tobacco and health issues~ including smoking cessation programmes, with active involvement of the health professions and the media; (7) monitoring of trends in smoking and other forms of tobacco use, tobacco-related diseases, and effectiveness of national smoking control action; (8) the promotion of viable economic alternatives to tobacco production, trade and taxation; (9) the establishment of a national focal point to stimulate, support, and coordinate all the above activities; 5. . APPEALS to other organizations of the United Nations system: (1) to support WHO in all ways possible within their fields of competence;
(2) to show solidarity with WHO's efforts to stem the spread of tobacco-induced diseases ·by protecting the health of non-smokers on their premises, as this action ~ou ld have a major exemplar role; · (3) t6 help Membe~ States in identifying and implementing economic alternatives to tobacco cultivation, production and trade; 6. REQUESTS the Director-General: (1) to strengthen the present programme on smoking and · health without waiting for its official introduction in the Eighth General Programme of Work, as a visible and resolute attitude on the part of WHO would provide Member States with encouragement and support, which are necessary prerequisites to abating the smoking pandemic before the year 2000; (2) to mobilize support for the present programme on smoking and health in terms of funds and manpower which would ensure adequate programme continuity on a long-term basis; (3) to coordinate activities in support of WHO's action on smoking and health with other organizations of the United Nations system at the highest executive level; (4) to continue and strengthen collaboration with nongovernmental organizations as appropriate; (5) to ensure that WHO plays an effective global advocacy role in tobacco and health issues and that, in common with other health institutions, it plays an exemplar role in non-smoking practices; (6) to provide support to national smoking control efforts;
(7) to report on progress to the Executive Board at its eighty-first session and to the Forty-first World Health Assembly.
Fourteenth plenary meeting, 15 May 1986
A39/VR/14
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 20.2 GLOBAL STRATEGY FOR HEALTH FOR ALL BY THE YEAR 2000: REPERCUSSIONS OF THE WORLD ECONOMIC SITUATION The Thirty~ninth
WHA39.15 15May 1986
World Health Assembly,
Bearing in mind resolution WHA38.20; .Recalling that the basic principle stated in the preamble of the Constitution of the World Health Organization that "Health is a state of complete physical, mental and social well-'being and n~t merely the absence of disease or infirmity"; Recalling further that in the light of the constitutional objective of WHO, the Declaration of Alma-Ata and resolutions WHA30.43, WHA32.30 and WHA33.24, the World Health Assembly approved the Global Strategy for Health for All by the Year 2000 in resolution WHA34.36 and adopted all relevant resolutions on TCDC/ECD~; Having considered the provisional report of the Director-General on the repercussions of the world economic situation;! Noting that the report, however provisional, recognizes that the widespread economic crisis has resulted in a fall in the living standards in many countries and provoked serious unemployment and formidable austerity policies which in some countries have resulted in a generalized increase of poverty and substantial cuts in health budgets; · AVate that the crisis facing the world economy adversely affecting the developing countries is aggravated by the persistent rise in the foreign debt and the deterioration of the balances of trade, among other factors, and endangers the possibility of reaching the goal of health for all by the year 2000; Recalling the importance of the New International Economic Order in overcoming the effects of the current economic crisis; Concerned at the present trends in both multilateral and bilateral external cooperation noted in the report of the Director-General, indicating that the health sector is not given the necessary importance; 1. URGES Member States: (1) to deploy all their efforts to avoid the reduction in the national budgets provided for health services and health-related activities with a view to achieving the objectives laid down in the Global Strategy for Health for All by the Year 2000; (2) to develop further their national strategies for health for all by the year 2000, inter alia, by producing whenever feasible casted plans in the most realistic way within the resources expected to be available, in particular focusing on primary health care; (3) to explore all possible sources of finance, including the redeployment of existing resources; 1
Document A39/4.
WHA39.15 page 2 .
2. CALLS UPON all developing countries to intf:msify their efforts for the further promotion of TCDC/ECDC with a view to overcoming the present . grave economic situation and thereby · contributing inter ana to the implementation of their .national strategies for health for all; 3. APPEALS to the developed countries to increase their cooperation with and assistance to developing countries through bilateral and multilateral channels, including WHO, in implementing their health plans;
4.
CALLS UPON organizations and agencies for international cooperation to increase their assistance to the national health strategies of developing countries;
DRAWS the attention of the international financial organizations to the need to take into account the specific conditions in each particular case as well as to apply criteria of social justice in formulating adjustment policies in order to avoid a deterioration in the health of the people. · 6.
S.
REQUESTS the. Director-General: (1) to continue to study the repercussions of the economic crisis on health in order to complete the present provisional report and make recommendations to the Fortieth World Health Assembly;
(2) to monitor trends in external cooperation for countries from all sources and, in this regard, to donors, nongovernmental organizations and agencies cooperation to increase their support for national plans for development of the developing countries;
the health sector of developing call upon countries and bilateral or organizations for multilateral health strategies w.i thin the general
(3) to continue to support countries in their financial planning for health through both technical cooperation and the promotion of training.
Fourteenth plenary meeting, 15 Hay 1986 A39/VR/14
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 20.1 INTERSECTORAL COOPERATION IN NATIONAL STRATEGIES FOR HEALTH The Thirty-ninth World Health Assembly,
WHA39. 2.2 16 May 1986
Recognizing that factors which influence health are found in all major sectors of development; Appreciating the active participation and support through cosponsorship of the Technical Discussions by the United Nations Office for Development and International Economic Cooperation, UNEP, HABITAT, FAO and UNESCO in the preparation and conduct of the Technical Discussions during the Thirty-ninth World Health Assembly, Recalling that existing inequal:l,ties in health between socioeconomic groups are - as stated in the Declaration of Alma-Ata on primary health care - politically, socially and economically unacceptable; Having con·sidered the report on the evaluation of the strategy for health for all Seventh Report ·on the World Health Situation,! which emphasizes the importance of intersectoral actions for health, and the background documents for the Technical Discussions on the role of intersectoral cooperation in national strategies for health for all, as well as the report of the Technical Discussions on this issue, · 1. CALLS ON ·Member States: (1) to identify and develop health objectives as an integral part of sectoral policies for agriculture, the environment, education, water, housing and other health-related sectors and to include health impact analyses in all feasibility studies of health-related programmes and projects; (2) to include in their health for all strategy specific equity-oriented targets expressed in terms of improved health among disadvantaged groups such as women, the rural poor, the inhabitants of urban slums, artd people engaged in hazardous occupations; (3) to use the health status within the population, and in particular its changes over time among disadvantaged groups, as an indicator for assessing the quality of development and its impact on the environment; (4) to ensure, in cooperation with international financing .institutions, that the health and nutritional status of the most disadvantaged social groups are protected when economic adjustment · policies are designed and implemented; (5) to encourage and support action-oriented multidisciplinary research focusing on socioeconomic and environmental determinants of health in order to identify cost-effective intersectoral actions for improving the health ~tatus of disadvantaged groups; 1
Document A39/3.
WHA39.22 page z· (6) to ~eview the training of economic .planners, agricultural extension workers, water engineers, teachers, environmental sp~riialists, and other professi6nal groups who are to work in health-relat.e d fields, in order to secure a:n adequate understanding of intersectoral relationships with health within their sphere of competence;
(7) to strengthen the capacity within the health sector at national and local levels to identify vulnerable groups, assess health hazards as experienced . by di.fferent groups, monitor health conditions within the population and assist other health-related sectors to formulate and evaluate intersectoral actions for health;
(8) to ensure .that the training of health professionals at all levels encompasses an adequate awareness of the relationships between environment, living conditions, life-styles and local health problems in order to enable them to establish a meaningful collaboration with professionals in other health-related sectors; (9) to develop appropriate mechanisms ~ithin the overall development process to promote intersectoral actions for health at national and local levels in order to facilitate an efficient use of e~isting resources for achieving mtiltisectoral health-for-all targets; 2. CALLS ON the relevant United Nations agencies and organizations to follow up their collaboration with WHO and Member States through concrete intersectoral activities, in particular at country level to ensure that socioeconomic development promotes the well-being of the people; 3. CALLS ON national and international nongovernmental organizations to promote and support intersectoral action for health, particular!~ at the community leyel, e.g •• as carried out by local self-help groups; 4. REQUESTS the regional committees to further develop specific regional health-for-all strategies fostering intersectoral actions in order to achieve equity-oriented health targets and to strengthen their .support to Member States in formulating, implementing and evaluating country-specific intersectoral health policies; 5. REQUESTS the Director-General: (1) to develop and strengthen the Organization's activities as regards: (a) support to Member States in their efforts to formulate, implement and evaluate intersectoral actions for health at national and local levels and to establish effective national intersectoral mechanisms that will ensure that development initiatives in any sector will not have adverse effects on health; (b) the promotion of equity-oriented health targets within the context of the Strategy for Health for All and the use of health indicators - in particular as related to disadvantaged groups - in assessments of socioeconomic development and quality of life; (c) the role of universities and nongovernmental organizations in promoting intersectoral actions for health in accordance with resolutions WHA37.31 and WHA38.31; (d) support to action-oriented rese~rch focusing on socioeconomic determinants of health and the coordination of such activities, for example, through the e s tablishment of a scientific working ~roup on intersectoral actions for health; (e) the further development of interage ncy cooperation at international, national and local levels, as envisaged in the Globa l Strategy ror Health for Ail, and in pursuit of the implementation of activities recommended by the Technical Discussions; to mobilize available resources and develop an appropriate organizational structure WHO in order to secure firm support to Member States as rega rds intersectoral ac tion for health; par.t if'cula rly as related to the improvement of health conditions among vulnerable groups ; withi~
(2)
WHA39.22 page 3 (3) to include in progress reports on the Health for All Strategy in-depth reviews of achievements within countries in formulating and implementing country-specific equity-oriented intersectoral health strategies and thus to reduce inequities in health between different socioecbnomic groups; (4) to report to the Forty-first World Health Assembly on the implementation of these activities. Fifteenth plenary meeting, 16 May 1986 A39/VR/15
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 2 3 .1
WHA39.25 16 May 1986
PREVENTION OF MENTAL, NEUROLOGICAL AND PSYCHOSOCIAL DISORDERS The Thirty-ninth World Health Assembly, Aware of the severity, magnitude and major public health importance of mental, neurological and psychosocial problems; Noting the existence of measures which can prevent the occurrence of a significant proportion of these problems, and thus reduce their negative social impact and human suffering; · Convinced that health for all can only be achieved if action to reduce such problems and promote mental health is given high priority and undertake~ urgently; Recalling resolutions WHA28.84 and EB6l.R28 on the promotion of mental health, resolution WHA29.21 on psychosocial factors and health, resolutions WHA32.40, WHA33.27 and EB69.R9 on drug- and alcohol-related problems, and resolution WHA30.38 on mental retardation; 1.
CALLS on Member States to apply the preventive measures identified in the report of the Director-General on the prevention of mental, neurological and psychosocial disorders,! and to include these activities in their strategies to achieve health for all by the year 2000;
2. REQUESTS Regional Committees to discuss ways in which the activities described in the Director-General's report on this subject, and directed towards the prevention of mental, neurological and psychosocial disorders, could best be implemented at regional and national levels;
3. REQUESTS the Director-General to take appropriate action to enhance the Organization's collaboration with Member States in the conduct of activities to prevent these disorders, including: (1) the development and dissemination of materials and technical guidance on the application of measures to prevent mental and neurological disorders and psychosocial problems; . ·
(2) the organization of training programmes that will help to ensure that available knowledge and experience reaches all those .concerned, both professional and non-professional health workers; (3) the stimulation, coordination and conduct of research to develop further methods of prevention and explore ways in which these can be most effectively used;
4. FURTHER REQUESTS the Director-General to report on the progress made to the Forty-second World Health Assembly. Fifteenth plenary meeting, 16 May 1986 A39/VR/15
1 Document A39/9.
TUIRTY~NINTH
WORLD HEALTH ASSEMBLY
WHA39.26 16 May 1986
Agenda item 23.2 ABUSE OF NARCOTIC AND PSYCHOTROPIC SUBSTANCES The Thirty-ninth World Health Assembly,
Recalling resolutions WHA37.23 and WHA33.27 on the abuse of narcotic and psychotropic substances, adopted by the Thirty-seventh and Thirty-third World Health Assemblies, and resolution EB73.Rll on the same subject; Having examined the Director-General's progress reportl on WHO activities in 1985 and 1986 on the abuse of narcotic and psychotr~pic substances, and the Director-General's report2 on the Conferenee of Ministers of Health on Narcotic and Psychotropic Drug Misuse, held in London, United Kingdom, from 18 to 20 March .l986; Noting with grave concern the dramatic increase of serious health and social problems related to misuse of narcotic and psychotropic substances; Affirming that health concerns in relation to the misuse of narcotic and psychotropic substances need to be given greater prominence and emphasis within the international drug control system; . .
Considering that there is an urgent need to intensify efforts and programme activities cc,>ncerned with the individual and community health aspects of problems related to the misuse of narcotic and psychotropic substances, including prevention, treatment, training and research; Noting with satisfaction the continued development of WHO's activities in this field, including its response to international treaty obligations; 1. URGES Member States to continue to: (1) develop and implement national policy to address the health problems related to the misuse of narcotic and psychotropic substances through prevention, treatment, and rehabilitation, and including training programmes and research, and to evolve mechanisms which will promote the coordination of the work of relevant government sectors and community organizations concerned with · tackling drug abuse; (2) develop ways to assess and monitor trends in the development of these problems and evaluate the effectiveness of programmes launched to combat them; (3) promote social and educational measures and encourage and support community action so as to reduce .the inappropriate demand for narcotic and psychotropic substances; (4) encourage the establishment and development of appropriate services to provide for the treatment of patients with drug-related problems, and their integration within _ existing health and mental health services, particularly at the primary health care level, and with social services and those provided by nongovernmental .organizations; 1 2
Document A39/10. Document A39/10 Add.l.
WHA39.26 page 2 (5) cooperate in activities under International Conventions on narcotic and psychotropic ·substances. and any other programmes directed towards the control of health problems related ta the misuse of such substances. 2. REQUESTS the Regional Committees to review the extent and nature of health problems related to the abuse of narcotic and psychotropic sub~tances in their respective regions and to decide on ways of ensuring cooperation among countries . in this area; 3. REQUESTS the Director-General to: (1) further develop the Organization's activities aiming to control health problems related to the misuse of narcotic and psychotropic substances, and to formulate a plan of action. (2) (3) facilitate cooperation in this field among different WHO regions; con$ider devoting a World Health Day to this topic;
(4) convey to the Secretary-General of the United Nations the need to increase the proportion of the financial s,u pport provided by the United Nations budget for the whole field of control of drug abuse given for activities and programmes dealing with health and related social problems caused by the misuse of narcotic and psychotropic substances. (5) . report to the United Nations Conference in 1987 on drug abuse and illicit traffic, WHO's activities and plans to combat heaith problems related to the abuse of narcotic and psychotropic substances. 4. REQUESTS the Executive Board to consider selecting the theme of Public Health Problems Related to the Abuse of Narcotic and Psychotropic Substances as a subject for Technical Discussion during a World Health Assembly at the earliest opportunity. Fifteenth plenary meeting, 16 May 1986 A39/VR/15
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 25
WHA39. 27 16 May 1986
THE RATIONAL USE OF DRUGS The Thirty-ninth World Health Assembly, Recalling resolution WHA37.33 on the rational use of drugs; Having considered the reports by the Director-General on the conference of experts on the rational use of drugs held in Nairobi in November 19851 and on WHO's revised drug strategy;2 Noting that the Director-General's summing up of the Conference3 forms the basis of this revised drug strategy; 1. THANKS the participants in the conference for their valuable suggestions;
2. DECIDES that WHO will assume its responsibilities as listed in the Director-General's summing up of the conference;3 3. URGES all concerned parties - governments, the pharmaceutical indus't ry, health personnel involved in prescription, dispensing, supply and distribution, universities and other teaching institutions, professional nongovernmental organizations, the public, patients' and consumer groups and the mass media - to assume their responsibilities as listed in the Director-General's summing up of the conference;3 4. URGES all Member States in a position to do so to support developing countries technically and financially in fulfilling responsibilities mentioned above, and thanks those .M.ember States already doing so; 5. INVITES United Nations agencies, programmes and funds concerned, development agencies and voluntary organizations to support developing countries to the same end, and thanks those already doing so; 6. 7. 8. ENDORSES the WHO revised drug strategy, annexed to this resolution; REQUESTS the Executive Board to monitor its implementation; REQUESTS the Director-General: (1) to publish the report on the Nairobi conference in all official languages and ensure its wide dissemination; (2) to implement the WHO revised drug strategy as endorsed by this Health Assembly by making optimal use of all available resources to this end, seeking extrabudgetary resources in addition to those in the regular budget; 1
Document A39/12. 2 Document A39/13. 3 Document A39/12 Part I. ·
WHA39~27
page 2 (3) to teport to the Executive Board and the Forty-first World Health Assembly on progress made and pro}:)lems encout1tered in implementingthe WHO revised drug strategy, including suggestions for modifying it if necessary in'the light of experience. Fifteenth plenary meeting, 16 May 1986 A39/VR/15
...
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 21
WHA39.28 1.6 May 1986
INFANT AND YOUNG CHILD FEEDING The Thirty-ninth World Health Assembly, Recalling resolutions WHA27.43, WHA31.47, WHA33.32, WHA34.22, WflA35.26 and WHA31.30 which dealt with infant and young child feeding; Havin~
considered the Progress and Evaluation Report on Infan,t and Young Child
Nutrition; Recognizing that the implementation of the International Code of Marketing of Breast-milk Substitutes is an important contribution to healthy . infant and young child feeding in all countries; Aware that today, five years after the adoption of the International Code, many Member States have made substantial efforts to implement it, but that: many· products un.s uitable for infant feeding are nonetheless being promoted and used for this purpose; and that sustained and concerted efforts will therefore. continue to be necessary to achieve full implementation of and compliance with the .International Code as well as the cessation of the marketing of unsuitable products and the improper promotion of breast-milk substitutes; · Noting with great satisfaction the Guidelines concerning the main health and socioeconomic circumstances in which infants have to be fed on breast-milk substitutes,2 in the context of Article 6, paragraph 6, of the International Code; Noting further the statement in the Guidelines, paragraph 47: "Since the large majority of infants born in .maternity wards and hospitals are full term, they require no nourishment o t her than colostrum during their first 24-48 hours of life - the amount of time often spent by a mother and her infant in such an institutional setting. Only small quantities of breast-milk substitutes are ordinarily required to meet the needs of a minority of infants in these facilities, and they should only be available in ways that do not interfere with the protection and promotion of breast-feeding for the majority."; 1. 2. ENDORSES the report of the Director-General; 1 URGES Member States: (1) to implement the Code if they have not yet done so;
(2) to ensure that the practices and procedures of their health care systems are consistent with the principles and aim of the International Code;
1 2
Document A39/8. Document A39/8 Add.l.
WHA39· ; 28
page 2 (3) ·to make the fullest use of all . c'once·rned parties - health professional bodies, nongovernmental organizations, consumer organizaUcms, manufacturers and distributors generally, in protecting and promoting breast ...feeding and, specifically, in implementing the Cod.e and monitoring its implementation and compliance with its provisions; (4) to seek the cooperation of manufacturers and distributors of products within the scope of Article 2 of the Code, in providing all information considered necessary for monitoring the implementation of the Code; (5) to provide the Director-General with complete and detailed information on the implementation of the Code; (6) to ensure that the small amounts of breast-milk substitutes needed for the minority of infants who require them in maternity wards and hospitals are made available through the normal procurement channels and not through free or subsidized supplies; 3.
REQUESTS the Director-General (1) to propose a simplified and standardized form for use by Member States to facilitate the monitoring and evaluation by them of their implementation of the Code and reporting thereon to WHO, as well as the preparation by WHO of a consolidated report by each of the articles of.the Code; (2) to specifically direct the attention of Member States and other interested parties to the facts that: (a) any food or drink given before complementary feeding is nutritionally required may interfere with the initiation or maintenance of breast-feeding and therefore should neither be promoted nor encouraged for use by infants during this period; (b) the practice being introduced in some countries of providing infants with ·specially formulated milks (so-called "follow-up" milks) is not necessary. Fifteenth plenary meeting, 16 May 1986 A39/VR/15
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 27
WHA39.30 16 May 1986
EXPANDED PROGRAMME ON IMMUNIZATION The Thirty-ninth World Health Assembly, Noting the report of the Director-General on the Expanded Programme on Immunizatior.. 1 and the Executive Board's discussion on the report; Noting further the general recommendations for action contained in the Director-General's report, which emphasize the need to accelerate progress, furthering the five-point action programme endorsed by the Thirty-fifth World Health Assembly by: promoting the achievement of the 1990 goal through collaboration among· ministries, organizations and individuals in both the public and private sector to create effective consumer demand and ensure that this demand is met; adopting a mix of complementary strategies for programme acceleration; and ensuring tnat rapid increases in coverage can be sustained through mechanisms which strengthen the delivery of other primary health care interventions; Noting also the recommendations for specific actions contained in the Director-General's report, which call for: providing immunization at every contact point, reducing drop-out rates between first and last immunizations, improving immunization services to the disadvantaged in urban areas and increasing the priority for the control of measles, poliomyelitis and neonatal tetanus; Recognizing that continued efforts are also required to strengthen disease surveillance and outbreak control, reinforce training and supervision, ensure the quality of vaccine production, management and administration, and pursue research and development;
1.
AFFIRMS that the Expanded Programme's goal of reducing morbidity and mortality by providing immunization for all children of the world by 1990 remains a global priority and represents a milestone toward achieving health for all by the year 2000;
2. WARNS that the goal will not be achieved without continuing acceleration of national programmes; 3. URGES Member States to pursue vigorously the recommendations for action contained in the Director-General's report and to commit themselves fully to achieving the 1990 immunization goal as part of their strategies for achieving health for all by the year 2000 through primary health care; 4. CALLS on organizations of the United Nations system to support the Expanded Programme on Immunization in the context of United Nations General Assembly resolution 34/58, which endorsed the Declaration of Alma-Ata, welcomed the efforts of WHO and UNICEF to attain health for all by the year 2000, and called upon the relevant bodies of the United Nations system to cooperate with WHO and support its efforts by appropriate actions within their respective spheres of competence; · 1
Document A39/15.
WHA39.30 page 2 5. NOTES with appreciation the increased international support for immunization programmes being provided particularly by the United Nations Children's Fund and by national development agencies,. private and voluntary organizations and individuals, whose collective efforts are helping to bring the immunization goal within reach; 6.
URGES that such international support should be further increased;
7. REMINDS Member States and collaborating organizations that the 1990 goal establishes a basis for immunization coverage, which must be sustained indefinitely; 8.
REQUESTS the Director-General: (1) to strengthen WHO's coordinating role to help to ensure that immunization programmes continue to be carried out in consonance with the relevant policies of the World Health Assembly, and in particular the policy of attaining health for all through primary health care;
(2) further to increase collaboration with Member States in order to meet the 1990 goal, with special emphasis on achieving reductions in the target diseases and on training, evaluation and the improvement of national, regional and global systems fo r monitoring progress; (3) to pursue basic and applied research relevant to the field of immunization and to make the results known in good time to Member States;
(4) to continue to keep the Health Assembly informed of the progress of the Expanded Programme and to propose the necessary means to achiev'e the 1990 goal. Fifteenth plenary meeting, 16 May 1986 A39/VR/15
THIRTY-NINTH WORLD HEALTH ASSEMBLY Agenda item 29
WHA39.31 16 May 1986
PREVENTION AND CONTROL OF IODINE DEFICIENCY DISORDERS The Thirty-ninth World Health Assembly, Noting the high prevalence of iodine deficiency disorders, affecting more than 400 million people in Asia alone as well as millions in Africa and South America; Concerned that iodine deficiency disorders include not only goitrous enlargement of the thyroid gland but also stillbirths, abortions and congenital anomalies; endemic cretinism characterized most commonly by mental deficiency, deaf mutism and spastic diplegia and lesser degrees of neurological defect related to fetal iodine deficiency; and impaired mental function in children and adults with reduced levels of circulating thyroxine; Aware that low cost effective technology, including use of iodized salt and iodized oil (by injection or mouth), is available for the prevention and control of iodine deficiency disorders; Considering that prevention and eradication of iodine deficiency disorders, which will result in improved quality of life, and productivity, and improved educability of children and adults suffering from iodine deficiency disorders, is feasible within the next 5-10 years; Aware that the United Nations Administrative Committee on Coordination's Sub-Committee on Nutrition had called for a global strategy by governments and United Nations agencies to prevent and control iodine deficiency disorders; and that this recommendation had been endorsed by the Administrative Committee on Coordination for immediate and high priority action; 1. URGES all Member States to give high priority to the prevention and control of iodine deficiency disorders, wherever these problems exist through appropriate nutritional programmes as part of primary health care; 2. REQUESTS the Director-General: (1) to give all possible support to Member States, as and when requested, in assessing the most appropriate approaches, in the light of national circumstances, needs and resources to preventing and controlling iodine deficiency disorders; (2) to collaborate with Member States in the monitoring of the incidence and prevalence of iodine deficiency disorders; (3) to prepare suitable materials for adaptation and use at national level for training health and development workers in the early identification and treatment of iodine deficiency disorders and the implementation of appropriate public health preventive programmes in iodine deficient areas; (4) to coordinate with other intergovernmental agencies and appropriate nongovernmental agencies, the launching and management of intensive and extensive international action to combat iodine deficiency disorders including the mobilization of financial and other resources required for su~h actions;
WHA39.31 page 2 (5) to report to the World Health Assembly on progress in this area, including the financial aspects. Fifteenth plenary meeting, 16 May 1986 A39/VR/15