HANDBOOK OF RESOLUTIONS OF THE GOVERNING BODIES OF THE PAN AMERICAN HEALTH ORGANIZATION. Volume III

Transcription

1 Document Official No. 212 HANDBOOK OF RESOLUTIONS OF THE GOVERNING BODIES OF THE PAN AMERICAN HEALTH ORGANIZATION Volume III XXII Pan American Sanitary Conference XXIX to XXXI Meeting of the Directing Council 90th to 97th Meeting of the Executive Committee PAN AMERICAN HEALTH ORGANIZATION Pan American Sanitary Bureau, Regional Office of the WORLD HEALTH ORGANIZATION 1987

2 Official Document No. 212 HANDBOOK OF RESOLUTIONS OF THE GOVERNING BODIES OF THE PAN AMERICAN HEALTH ORGANIZATION Volume III XXII Pan American Sanitary Conference XXIX to XXXI Meeting of the Directing Council 90th to 97th Meeting of the Executive Committee PAN AMERICAN HEALTH ORGANIZATION Pan American Sanitary Bureau, Regional Office of the WORLD HEALTH ORGANIZATION 525 Twenty-third Street, N.W. Washington, D.C , U.S.A. 1987

3 Published also in Spanish (1987) as: Manual de resoluciones de los Cuerpos Directivos de la Organización Panamericana de la Salud, Volumen III (Documento Oficial No. 212) Volume I, (1971) Volume II, (1983) ISBN Pan American Health Organization, 1987 Publications of the Pan American Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. For rights of reproduction or translation of PAHO publications, in part or in toto, application should be made to the Editorial Service, Pan American Health Organization, Washington, D.C. The Pan American Health Organization welcomes such applications. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the Pan American Health Organization concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

4 CONTENTS 1 Preface... Reference List: PAHO Governing Body Meetings... Page xi xii 1. PROGRAM General Directives Reorganization of the Pan American Sanitary Bureau Study on Fundamental Principles of Pan American Health Agreements with Member Governments Plan of Long-Range Health Programs and Other Program Criteria Miscellaneous Major Policy Decisions Charter of Punta del Este (August 1961) Task Force on Health at the Ministerial Level (April 1963) Declaration of the Presidents of America (April 1967) Special Meeting of Ministers of Health of the Americas (October 1968) III Special Meeting of Ministers of Health of the Americas - Ten-Year Health Plan (October 1972) IV Special Meeting of Ministers of Health of the Americas-- Extension of Coverage (September 1977) International Conference on Primary Health Care- Declaration of Alma-Ata (September 1978)... 2 Strategies for Health for All... 2 Plan of Action Special Initiatives... 4 Priority Health Needs in Central America and Panama... 4 Caribbean Cooperation in Health... 4 Andean Subregion, Joint Plan of Action Other General Programs of Work Covering a Specific Period... 6 Orientation and Program Priorities for Communicable Disease Prevention and Control Epidemiological Surveillance Special Surveillance Measures and Quarantine Border Health Agreements Parasitic Diseases Malaria Yellow Fever, Dengue, and Eradication of Aedes aegypti and Aedes albopictus Chagas' Disease Other Parasitic Diseases... 9 i This table of contents pertains only to Volume III. References to earlier material in Volumes I and II are given under the various headings in the text. The alphabetical index, which begins on page 95, covers the subjects dealt with in this volume and in Volumes I and I1. 111

5 1.2.3 Bacterial, Viral, and Mycotic Diseases Influenza Diarrheal Diseases Tuberculosis Meningitis Sexually Transmitted Diseases and Treponematoses Plague Cholera Leprosy Poliomyelitis Mycotic Diseases Typhus and Other Viral and Rickettsial Diseases Smallpox Hepatitis Foot-and-Mouth Disease and Other Zoonoses Expanded Program on Immunization Noncommunicable Disease Prevention and Control Chronic and Degenerative Diseases Cardiovascular Diseases Control of Cigarette Smoking Blindness Diagnostic, Therapeutic, and Rehabilitative Technology Laboratory Technology Blood and Blood Derivatives Essential Drugs, Vaccines, and Biologicals Promotion of Environmental Health Water Supply and Sanitation Sanitary Control of Housing Pollution Control (including Chemical Safety) Food Safety Development of River Basins Health Systems Development Health and Socioeconomic Development Health Planning and Administration National Health Plans Long-Term Planning and Evaluation Coordination Medical Care Primary Health Care and Community Participation Technical Cooperation among Developing Countries/Economic Cooperation among Developing Countries (TCDC/ECDC) Emergency Assistance iv

6 1.7 General Health Protection and Promotion Food and Nutrition Nursing Dental Health Mental Health Prevention of Accidents Health Education Protection and Promotion of the Health of Specific Population Groups Maternal and Child Health, Including Family Planning Health of Adults Workers' Health Health of the Disabled Women, Health and Development Training of Health Personnel Fellowships Textbook Program Research Promotion and Development Regional Centers Pan American Foot-and-Mouth Disease Center Pan American Zoonoses Center Institute of Nutrition of Central America and Panama Pan American Center for Health Planning Pan American Center for Sanitary Engineering and Environmental Sciences Caribbean Food and Nutrition Institute Pan American Center for Human Ecology and Health Latin American Center for Perinatology and Human Development Pan American Center for Research and Training in Leprosy and Tropical Diseases Caribbean Epidemiology Center Latin American and Caribbean Center for Health Sciences Information (before Regional Library of Medicine and the Health Sciences) Other Centers (including Latin American Center for Educational Technology in Health) Health Information Health Statistics PAHO Publications and Documentation Services v

7 Health Legislation Reports Reports of the Directing Council Annual and Quadrennial Reports of the Director Annual Reports of the Chairman of the Executive Committee Reports of the Governments WHO Expert Committee Reports Supplies and Equipment PROGRAM AND BUDGET Budget Policy Consideration and Approval of the Program and Budget For PAHO ( ) WHO Regional ( ) For PAHO ( ) WHO Regional ( ) For PAHO ( ) WHO Regional ( ) GOVERNING BODIES OF PAHO Pan American Sanitary Conference Time and Place Rules of Procedure Agenda Technical Discussions Directing Council Time and Place Rules of Procedure Agenda Technical Discussions Executive Committee Membership Time and Place Rules of Procedure Agenda Representation at the Conference and the Council vi

8 4. THE PAN AMERICAN HEALTH ORGANIZATION AND THE WORLD HEALTH ORGANIZATION Agreement between PAHO and WHO WHO Regional Committee for the Americas Study of WHO's Structures in Light of Its Functions WHO Resolutions of Interest to the Regional Committee PAHO Representatives on the Joint Coordinating Board of the WHO Special Program for Research and Training in Tropical Diseases PAHO Representatives on the Policy and Coordination Advisory Committee of the Special Program of Research, Development and Research Training in Human Reproduction WHO Meetings CONSTITUTIONAL AND LEGAL MATTERS Amendments to the Constitution Basic Documents Member Governments Admission of New Member Governments Associate Members Privileges and Immunities Observers Name and Official Insignia Name of the Organization Official Insignia Health Regulations Pan American Sanitary Code International Health Regulations International Transportation of Human Remains COOPERATION WITH OTHER ORGANIZATIONS Organization of American States Inter-American Development Bank Coordination with the United Nations and Other Organizations United Nations Children's Fund vii

9 6.3.2 International Labor Organization Nongovernmental Organizations Principles Governing Relationship Organizations in Official Relations with PAHO Other Entities Coordination of International Cooperation in the Health Field in the Americas FINANCIAL AND ADMINISTRATIVE MATTERS Financial Matters Financial Regulations and Rules Assessments and Contributions Scale of Assessment Collection of Contributions Working Capital Fund Holding Account Revolving and Special Funds Emergency Voluntary Fund Revolving Fund for the Expanded Program on Immunization Additional Income Sources and Programs Pan American Health and Education Foundation Other Accounts and External Audit Approval of Financial Report of the Director and Report of the External Auditor Appointment of External Auditor Travel Administrative and Staff Matters Staff Rules and Regulations Amendments to the Staff Rules and Regulations Recruitment and Service Recruitment of International Staff Study of Conditions of Employment Hiring under Local Conditions of Employment Salaries and Allowances Field Service Allowances Language Allowance Cost-of-Living Adjustment Study of Salaries and Other Compensations Salaries of Nonclassified Staff Members (Director, Deputy Director, Assistant Director) Tax Equalization viii

10 7.2.5 Pension Fund Director of PASB Other Officials PAHO Headquarters Buildings and Installations for Headquarters Buildings and Installations for Area and Field Offices Administrative Studies Administrative Rationalization PAHO/WHO COUNTRY OFFICES MISCELLANEOUS Awards Public Information and Special Events Congratulations, Expressions of Sympathy, etc Numerical Index Alphabetical Index ix

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12 PREFACE This edition, Volume III of the Handbook of Resolutions of the Governing Bodies of the Pan American Health Organization, includes the meetings of the Pan American Sanitary Conference, the Directing Council, and the Executive Committee held from 1983 to Volume I of the Handbook, published in 1971, covered the period from 1942 to 1970, and Volume II, published in 1983, dealt with the meetings held from 1971 to Since the present volume covers only a fouryear period, it is necessarily shorter than the previous ones, but the format is essentially the same. For each section, reference is made, when appropriate, to the corresponding pages in volumes I and II. Since many of the resolutions refer to more than one subject or to different aspects of a subject, some difficulties in classification arose. These difficulties have been overcome to some extent by means of cross-references and footnotes; in some cases, a resolution is included in more than one section. Further, the reader can readily find the main subject headings in the Contents at the beginning of the volume, and can also consult the alphabetical index at the end. Like the two previous volumes, the current one also contains an index of resolution numbers, which indicates the page or pages where the complete or abbreviated text of each resolution can be found. Purely procedural resolutions have been omitted, and in these cases, their numbers and dates are provided along with the paraphrased contents. The serial number preceding each resolution shows the meeting at which it was adopted. For example, CSP22.R1 indicates the first resolution approved by the XXII Pan American Sanitary Conference, CD30.R6 the sixth resolution approved by the XXX Meeting of the Directing Council, and CE97.R4 the fourth resolution approved by the 97th Meeting of the Executive Committee. Immediately below each resolution, on the right, the date of adoption is given, along with the number and page reference to the Official Document in which the text was first published. For example, OD 203, 24 refers to page 24 of PAHO Official Document 203. The minutes of the meetings of the Governing Bodies and the resolutions approved by them are published each year in a separate volume of the PAHO Official Document series. xi

13 REFERENCE LIST OF PAHO GOVERNING BODY MEETINGS (with the resolution symbol applicable to each meeting and the Official Document numbers in which they were originally published) Governing Body Held Resolution Symbol Official Document No. Executive Committee, 90 Directing Council, XXIX WHO Regional Committee, XXXV Executive Committee, 91 Executive Committee, 92 Executive Committee, 93 Directing Council, XXX WHO Regional Committee, XXXVI Executive Committee, 94' Executive Committee, 95 Directing Council, XXXI WHO Regional Committee, XXXVII Executive Committee, 96 Executive Committee, 97 Pan American Sanitary Conference, XXII WHO Regional Committee, XXXVIII Executive Committee, June September-3 October October June September September- 1 October October June September September June September September 1986 CE90.R- CD29.R- CE91.R- CE92. R- CE93.R- CD30.R- CE95.R- CD31.R- CE96. R- CE97.R- CSP22.R 'No resolutions were approved at these meetings. xii

14 1. PROGRAM 1.1 GENERAL DIRECTIVES 1. Reorganization of the Pan American Sanitary Bureau see Volume 1, page MAJOR POLICY DECISIONS 1. Charter of Punta del Este (August 1961)' see Volume 1, page Study on Fundamental Principles of Pan American Health see Volume 1, page Agreements with Member Governments see Volume I, page Plan of Long-Range Health Programs and Other Program Criteria see Volume 1, page Task Force on Health at the Ministerial Level (April 1963)2 see Volume 1, page Declaration of the Presidents of America (April 1967) 3 see Volume I, page Special Meeting of Ministers of Health of the Americas (October 1968) 4 see Volume I, page Miscellaneous see Volume I, page 5. 'OAS Official Records OEA/Ser.S/XIII. 1(Eng.), PAHO Official Document 51 (1964). 'OAS Official Records OEA/Ser.C/IX.1(Eng.), 'PAHO Official Document 89 (1969). I

15 2 1. PROGRAM 5. III Special Meeting of Ministers of Health of the Americas-Ten-Year Health Plan (October 1972) 1 see Volume II, page To note with appreciation the preliminary report submitted by the Director in Document CE90/4, Add. I. 2. To request the Director to transmit the report to the XXIX Meeting of the Directing Council. June 1983 OD 190, IV Special Meeting of Ministers of Health of the Americas-Extension of Coverage (September 1977)2 see Volume II, page International Conference on Primary Health Care-Declaration of Alma-Ata (September 1978) 3 CE90.RII see Volume II, page 4. STRATEGIES FOR HEALTH FOR ALL see Volume II, page 5. Having examined the preliminary report submitted by the Director on the situation in the Region of the Americas with regard to the strategies for health for all by the year 2000 (Document CE90/4, Add. I); Bearing in mind that the goals and objectives approved by the Member Governments in 1980 and ratified in 1981 underscore the need for a systematic evaluation and monitoring of the process for attaining the goal of health for all; Considering that, in agreement with the World Health Organization, four regional evaluations are to be made, the first in 1983 and the others in 1989, 1995, and 2001; and Recognizing that the initial evaluation must establish a baseline for monitoring, analyzing, and estimating the progress made toward attaining the goal of health for all by the year 2000, 'PAHO Official Document 118 (1973). 2 PAHO Official Document 155 (1978). 'Alma-Ata 1978: Primary Health Care. Geneva, WHO, "Health for All" Series, No. 1, CD29.R13 Considering that national evaluation and monitoring processes are of key importance in steering the efforts of the countries toward attainment of the goal of health for all by the year 2000, and must be made a part of every national administration and planning process, and be designed, organized, and implemented in keeping with the particular circumstances of each country; Cognizant of the need for systematic evaluation and monitoring, at the regional and global levels, of the national processes for attaining the goal of health for all by the year 2000 as an aid to the Organization and its Member Governments in guiding and adjusting their policies, priorities, strategies, and programs; and Noting that this evaluation and monitoring at the regional level must be based on the information of the national analyses, 1. To approve the preliminary report on the situation in the Region of the Americas in regard to the strategies for health for all by the year 2000 (Document CD29/24). 2. To urge the Governments to give highest priority to the continued adjustment of their national evaluation and monitoring processes as part of their planning and administration for the most effective and efficient attainment of the goal. 3. To request the Governments to provide in due time the information needed to consolidate the evaluation and monitoring processes at the regional and global levels. 4. To request the Director to intensify the Organization's support measures to Member Countries for national and regional planning and administration processes and, within these, for evaluation and monitoring procedures. CE92.R13 Sept. Oct OD 192, 58 Having considered Document CE92/16 and the report of the Subcommittee on Long-Term Planning and Programming and its appendices; Recognizing that the Common Framework and Format has been complemented with additional materials; Bearing in mind that the Common Framework and Format responds to resolutions of the Directing Council and the Executive Committee of PAHO as well as to resolutions of the World Health Assembly; and Considering that the report offers specific recommendations for action with the objective of improving the capacity of the Member Governments and the Organization to achieve the goal of health for all by the year 2000,

16 1.1 GENERAL DIRECTIVES GENERAL DIRECTI VES 3 1. To express appreciation for the information presented on the steps under way to implement within the Region of the Americas the process for evaluating the strategies for health for all and to urge the Director to implement the Subcommittee recommendations with regard to the adjustment of the evaluation instrument following field tests to ensure its most useful application within the Region of the Americas. 2. To urge Member Countries to cooperate in the field tests of the evaluation instrument and the application of the instrument as adjusted as a result of the field tests. 3. To urge Member Countries to use the evaluation instrument as an opportunity to review and make appropriate changes in their information and monitoring and evaluation processes in order to strengthen their efforts to achieve the goal of health for all by the year To urge the Director to provide support to Member Countries in the completion of the field tests, in the preparation of the regional contribution to the Seventh Report on the World Health Situation, and in improving information, monitoring, and evaluation capabilities. CD31.R27 June 1984 OD 195, 45 Having considered Document CD31/22 and Add. 1, constituting the chapter for the Region of the Americas for inclusion in the Evaluation of the Strategy for Health for All by the Year 2000: Seventh Report on the World Health Situation; ' Recognizing that the submission for the Region of the Americas is prepared in response to the resolutions of the World Health Assembly; and Bearing in mind that the submission from this Region will be published in the Seventh Report on the World Health Situation along with reports from other WHO Regions, 1. To revise the submission for the Region of the Americas based on the suggestions of Member Governments during the XXXI Meeting of the Directing Council. 2. To request the Director to submit the Regional Evaluation Report to WHO Headquarters following the specifications required by the WHO Secretariat. 3. To thank the Director for the preparation of the statement from this Region. September 1985 OD 203, 71 Evaluation of the Strategyfor Health or All by the Year 2000, Seventh Report on the World Health Situation. Volume 3, Region of the Americas. PAHO/WHO, Washington, D.C. (1986). PLAN OF ACTION' 'PAHO Official Document 179 (1982). CE92.R12 see Volume II, page 8. Bearing in mind Resolution XIII' approved by the 82nd Meeting of the Executive Committee (June 1979) establishing the Subcommittee on Long-Term Planning and Programming; Cognizant of the importance of more active participation of the Member Governments and the Organization to implement the collective decisions taken by the Governing Bodies; Considering that the health needs of the countries evolve through a dynamic process governed by economic, political, and social factors that necessitate an ongoing, intensive interinstitutional analysis; and Cognizant of the need to strengthen the other functions of the Subcommittee on Long-Term Planning and Programming with a view to improving analysis of problems and development of strategies that could be jointly adopted by the Organization and its Member Governments, 1. To express appreciation to the Subcommittee for its report. 2. To change the name of the Subcommittee to "Subcommittee on Planning and Programming." 3. To assign to the Subcommittee the following functions: a) Analysis of the process and methodology of planning, programming, and budgeting; b) Analysis of the information processes and systems for the conduct of technical cooperation with the countries, including evaluation and monitoring of the regional Plan of Action for health for all by the year 2000; c) Analysis of economic and social factors and their impact on health conditions and the health sector; d) Analysis of the policy and functioning of PAHO's administrative systems, including manpower planning and development; e) Analysis of special programs with special emphasis on their formulation and evaluation; f) Other functions to be determined by the Executive Committee. 4. To establish the membership of the Subcommittee at seven Members: four to be elected by the Executive Committee for terms of office running concurrently with those of their membership in the Executive Committee and three to be named prior to each meeting of the Subcommittee by the Director in consultation with the Chairman of the Executive Committee, in light of the specific topics for each meeting. 5. To establish the number of regular meetings at two per year, one occurring after the meeting of the Directing Council and before the Executive Board Meeting of WHO and another after the Executive Board Meeting of WHO and

17 4 1. PROGRAM 4 1. PROGRAM before the PAHO Executive Committee Meeting in June, plus such other special meetings as may be required. 'See Vol. II, p. 50. CD30.R17 8. Special Initiatives June 1984 OD 195, 44 PRIORITY HEALTH NEEDS IN CENTRAL AMERICA AND PANAMA Having been informed of the initiative of the Governments of Central America and Panama, endorsed in the plan known as "Priority Health Needs in Central America and Panama," which they have drawn up in concert and are jointly and severally committed to executing; Bearing in mind the Declaration of the Ministers of Health of Central America and Panama (San José, Costa Rica, 16 March 1984), in which they pledged to keep in place the arrangements for integrating and coordinating institutional resources for the benefit of the health and welfare of Central American families; Considering that the Foreign Ministers of the Contadora Group and of the Central American countries, meeting in Panama (30 April 1984), decided to support the plan without reservation; Aware that the Thirty-seventh World Health Assembly (9 May 1984) acknowledgedl that the iniciative has special importance for social development, for the solution of health problems, and as a bond to foster understanding, solidarity, and peace among the peoples of Central America and Panama at a particularly difficult juncture in their history; Noting that the Meeting of Ministers of Health and Directors of Social Security (Medellín, Colombia, 14 July 1984), which was attended by representatives from Argentina, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Panama, Peru, Spain, and Venezuela, declared it necessary to encourage mutual support among the Central American countries and other countries pledged to integrating efforts for backing the Central American initiative; and Considering that Belize likewise is geographically, culturally, socially, and ecologically a Central American country desirous of being associated with the plan known as "Priority Health Needs in Central America and Panama"; and In the conviction, reaffirmed by the Ministers of Health of Central America and Panama at their XXIX Meeting (Guatemala, 23 August 1984) and at this Council, that the successful execution of the plan known as "Priority Health Needs in Central America and Panama" is a prerequisite for the attainment of the goal of health for all by the year 2000 in the Central American Isthmus, 1. To express its full support for the plan known as "Priority Health Needs in Central America and Panama." 2. To recommend to PAHO and to the Member Governments that Belize be included in the plan known as "Priority Health Needs in Central America and Panama," and to request the Director to take the necessary steps to that end. 3. To recommend to the countries of the Region of the Americas that they jointly and severally support the efforts of the countries of Central America and Panama to satisfy their priority health needs in the context of the above-mentioned plan. 4. To recommend to the Director of the Pan American Sanitary Bureau that he continue to provide the plan with special support out of the resources available and take steps to obtain additional extrabudgetary funds. 5. To request the Director of the Pan American Sanitary Bureau to continue, in coordination with UNICEF and other interested international cooperation agencies, to support the efforts of the countries of Central America and Panama to prepare and execute specific projects under the plan. 6. To request the Director of the Pan American Sanitary Bureau to inform all the Member Countries of specific projects under the plan and to promote and administer any contributions that may be offered in support of the initiative of Central America and Panama. Sept.-Oct OD 197, 49 'Resolution WHA Document WHA37/1984/REC/1, 7. CE97.R8 CARIBBEAN COOPERATION IN HEALTH Having reviewed Document CE97/22, Caribbean Cooperation in Health; Considering the significance of this initiative to the development of the health sectors of the Member Countries in the Caribbean subregion; and Noting the endorsement of the Plan for Caribbean Cooperation in Health by the Ministers Responsible for Health in the Caribbean, 1. To request the Director to present the Plan for Caribbean Cooperation in Health to the XXII Pan American Sanitary Conference for its consideration. 2. To recommend to the XXII Pan American Sanitary Conference that it consider a resolution along the following lines:' June 1986 OD 211, 104 IFor text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference, see Resolution CSP22.RI1 below.

18 1.1 GENERALDIlRECTIVES GENERAL DIRECTI VES The XXII Pan American Sanitary Confer- CSP22.Rll ence, Having been informed of the initiative for health in the Caribbean known as "Caribbean Cooperation in Health," developed by PAHO and the Caribbean Community (CARI- COM) at the request of the Ninth Meeting of the Conference of Ministers Responsible for Health in the Caribbean, held at Roseau, Dominica, 1984; Considering that the Caribbean Ministers of Health attending the XXXI Meeting of the Directing Council of PAHO in Washington, D.C., September 1985, gave unanimous support to the plan presented by PAHO and CARI- COM,' and agreed to actively promote and develop the initiative within their countries; Noting that the Caribbean Ministers at the Tenth Meeting of the Conference of Ministers Responsible for Health in the Caribbean (CMH) held at Georgetown, Guyana, in 1986, formally endorsed the initiative and its objectives, priorities, and approaches; Appreciating that the English-speaking Caribbean countries share a common history, have had a long tradition of cooperation in matters of culture, education, health and economic development, noteworthy examples of which are subregional institutions such as the CARICOM itself, the University of the West Indies, and the Caribbean Development Bank; Aware that this initiative is an application of the subregional approach utilized by PAHO in its delivery of technical cooperation in the Caribbean, as exemplified by the Caribbean Program Coordinator's Office, the Caribbean Food and Nutrition Institute, and the Caribbean Epidemiology Center; Accepting that the six priority areas identified and agreed on for the development of the initiative are those reflected in the subregional policy statements, strategies, and plans of action previously endorsed by the Caribbean Ministers of Health; and Convinced that the successful execution of Caribbean Cooperation in Health will be an important contribution to the attainment of health for the peoples of the Caribbean subregion and to the global goal of health for all by the year 2000, 1. To endorse the initiative known as "Caribbean Cooperation in Health" and to request the Member Countries to provide their full support to CARICOM and the Ministries of Health in the implementation of this initiative. 2. To encourage the Member Countries of the Caribbean subregion to emphasize the Plan for Caribbean Cooperation in Health as the focus for the development of their proposals for technical cooperation. 3. To request the Director: a) to support the initiative within the regular programs of technical cooperation of the Organization; b) to cooperate fully with CARICOM and the Member Countries of the Caribbean subregion in the development of projects under the initiative; c) to inform all Member Countries of the specific projects under the initiative; d) to continue to promote the initiative in major international fora, with other international organizations and with interested multilateral and bilateral development agencies in order to obtain their support for these projects. 4. To inform the Director-General of the World Health Organization about the Caribbean Cooperation in Health initiative and to request his support for its continued development. 'See PAHO Official Document 204 (1986), 187. The XXII Pan American Sanitary Confer- CSP22.R22 ence, September 1986 OD 211, 137 ANDEAN SUBREGION, JOINT PLAN OF ACTION Having seen the document presented to the Conference on the Andean Subregion, Joint Plan of Action (Document CSI>22/14); Cognizant that health problems exist in the Andean area that are common to all the countries; Considering that the Governments of this area have established the Cartagena Agreement for the purpose of improving the standard of living of their inhabitants, and the Hipólito Unanue Agreement to help improve the level of health through coordinated subregional and intercountry measures; Mindful of the meetings of the Ministers of the Andean area in which the necessity of optimizing the use of resources in the solution of priority problems has been reiterated; Recognizing that initiatives have been going forward successfully in other subregions of the Region of the Americas, and that their experience could be useful in the Andean area; and Cognizant that a first draft of the Joint Plan of Action for this subregion was presented to the Executive Committee, which viewed it with favor, 1. To support the formulation and execution of a joint plan of action for the Andean area. 2. To request the governments of the subregion to support this initiative, especially as it contributes to the mobilization of resources for the selected priority areas. 3. To request the Director of the Pan American Sanitary Bureau to support, in conjunction with the Hipólito Unanue Agreement, the efforts of the Member Countries, and to promote with other appropriate agencies the external cooperation needed to support the Joint Plan of Action. 4. To request the Director to report on progress to the next meeting of the Directing Council in September 1986 OD 211, Other see Volume 1, page 9.

19 6 1. PROGRAM GENERAL PROGRAMS OF WORK COVERING A SPECIFIC PERIOD CD31.R27 see Volume 1, page 9 and Volume II, page 10. Having considered Document CD31/22 and Add. I, constituting the chapter for the Region of the Americas for inclusion in the Evaluation of the Strategy for Health for All by the Year 2000: Seventh Report on the World Health Situation;' Recognizing that the submission for the Region of the Americas is prepared in response to the resolutions of the World Health Assembly; and Bearing in mind that the submission from this Region will be published in the Seventh Report on the World Health Situation along with reports from other WHO Regions, 1. To revise the submission for the Region of the Americas based on the suggestions of Member Governments during the XXXI Meeting of the Directing Council. 2. To request the Director to submit the Regional Evaluation Report to WHO Headquarters following the specifications required by the WHO Secretariat. 3. To thank the Director for the preparation of the statement from this Region. September 1985 OD 203, 71 'Evaluation of the Strategyfor Healthfor All by the Year 2000, Seventh Report on the World Health Situation. Volume 3, Region of the Americas. PAHO/WHO, Washington, D.C. (1986). ORIENTATION AND PROGRAM PRIORITIES FOR CE97.R5 Having reviewed Document CE97/26 concerning the orientation and program priorities for PAHO during the quadrennium ; Bearing in mind the Constitution of the Pan American Health Organization, which establishes the Pan American Sanitary Cbnference as the supreme governing authority of the Organization and gives it the function of determining the general policies of the Organization; and Recognizing the benefits of establishing program priorities in order to enhance the mission of the Organization, to strengthen technical cooperation, and to guide the allocation of available resources within the context of the PAHO/WHO strategies for health for all by the year 2000, the Plan of Action for the implementation of the regional strategies, the managerial strategy for the optimum use of PAHO's resources, and the regional program budget policy, 1. To thank the Subcommittee on Planning and Programming and the Director for preparing a comprehensive document proposing program priorities for for consideration and action by the Governing Bodies. 2. To request the Director to revise Document CE97/26, "Orientation and Program Priorities for PAHO during the Quadrennium ," taking into consideration the comments expressed at the 97th Meeting of the Executive Committee, and to transmit the revised document to the XXII Pan American Sanitary Conference. 3. To suggest to the XXII Pan American Sanitary Conference that it adopt a resolution along the following lines:' June 1986 OD 211, 100 The XXII Pan American Sanitary Confer- CSP22.R15 ence, Having examined the material prepared for the contribution of the Region of the Americas to the draft Eighth General Program of Work of the World Health Organization ( inclusive) (Document CSP22/22); and Bearing in mind that the Director-General of WHO has requested this material from each Regional Committee to ensure that their views are properly taken into account by the Program Committee of the Executive Board in the preparation of the draft Eighth General Program of Work, 1. To take note of the summary of the material prepared as a regional contribution to the Eighth General Program of Work of WHO. 2. To request the Director to forward the draft document to the Director-General along with the comments of the Regional Committee to be used in the preparation of the draft Eighth General Program of Work. September 1986 OD 211, 143 'For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference after amending paragraphs 1 and 4 and adding paragraph 3 to the operative part, see Resolution CSP22.R21 below. The XXII Pan American Sanitary Confer- CSP22.R21 ence, Having considered Document CSP22/6, "Orientation and Program Priorities for PAHO during the Quadrennium ," and the comments' of the 97th Meeting of the Executive Committee; Bearing in mind the constitutional role of the Pan American Sanitary Conference to determine the general policies of the Organization; Recognizing the benefits of establishing program priorities in order to enhance the mission of the Organization, to

20 1.2 COMMUNICABLE DISEASE PREVENTION AND CONTROL 7 strengthen technical cooperation, and to guide the allocation of available resources within the context of the PAHO/WHO strategies for health for all by the year 2000, the Plan of Action for the implementation of the regional strategies, the managerial strategy for the optimum use of PAHO's resources, and the regional program budget policy; and Taking note of the publication Health Conditions in the Americas, , 2 and recognizing the current financial situation of the Organization, 1. To approve the document "Orientation and Program Priorities for PAHO during the Quadrennium ," presented by the Director to the XXII Pan American Sanitary Conference. 2. To request the Director: a) To transmit the document "Orientation and Program Priorities for PAHO during the Quadrennium " to the Member Countries; b) To apply the program priorities contained therein in the formulation of the biennial regular program budget proposals and in the approval of annual operating program budgets during the quadrennium Recognizing the importance of the health infrastructure in promoting the implementation of priority health programs, to request the Director and the Member Countries, in pursuing the minimum goals of the Plan of Action for health for all by the year 2000, to give special attention to: a) Strengthening of the health services infrastructures; b) Development of the health sector's financial analysis and resource management capabilities; c) Improvement of national health information systems; d) Definition of the roles of health workers, recognition of the importance of community participation, and integration of health manpower education and training. 4. To request the Member Countries to implement the Organization's program priorities for the quadrennium in the development of their country program proposals for technical cooperation during the years cited. 5. To request the Director to transmit the document to the Director-General of WHO for his consideration. 'See Resolution CE97.R5, p PAHO Scientific Publication 500 (1986). September 1986 OD 211, COMMUNICABLE DISEASE PREVENTION AND CONTROL EPIDEMIOLOGICAL SURVEILLANCE CD30.R16 see Volume II, page 12. Having seen the Final Report of the Seminar on Uses and Perspectives in Epidemiology, held in Buenos Aires, Argentina, 7-10 November 1983 (Document CD30/11) and considering that the document points to important prospects for the development of epidemiology as a strategic discipline for improving knowledge of the health problems of the population and guiding the search for ways and means of preventing and controlling them; and Recognizing that changes in health profiles and service demands require more appropriate use of the principles and methods of epidemiology in evaluating the health situation and its trends, redefining priorities, evaluating the effectiveness of technologies and the impact of health services, and improving knowledge of the occurrence, distribution, and causation of diseases and health problems, 1. To accept the recommendations of the Seminar on Uses and Perspectives in Epidemiology (Buenos Aires, Argentina, 7-10 November 1983). 2. To urge the Member Governments to: a) Reinforce, at all levels, the practice of epidemiology, expanding its scope application to all areas of the sector, including disease control, health planning, and evaluation; b) Mobilize and promote the coordination of epidemiological services, research, and teaching, in accordance with the needs of their countries. 3. To request the Director to develop, within the Organization's regular budget, a program of activities to assist the Member Countries in implementing the recommendations of the report. 4. To request the Director to seek extrabudgetary funds to enhance assistance in epidemiological activities in the Region. Sept.-Oct OD 197, 48

21 8 1. PROGRAM 8 1. PROGRAM 1. Special Surveillance Measures and Quarantine see Volume I, page 40 and Volume II, page 13. See also Section (Expanded Program on Immunization). 2. Border Health Agreements 2. To recommend to those Governments of countries and territories already free of Aedes aegypti that they maintain their surveillance efforts at a level necessary to detect and eliminate any reinfestation which may occur. 3. To request the Director: a) To encourage and support the mobilization of national, subregional, and regional resources; b) To promote intergovernmental and intersectoral mechanisms which may facilitate Aedes aegypti control and eradication activities. c) To stimulate the utilization of technological advances, the participation of an informed community, and the training of health personnel in new prevention, surveillance, and control approaches. see Volume I, page 81 and Volume II, page 13. September 1985 OD 203, PARASITIC DISEASES 1. Malaria see Volume 1, page 11 and Volume II, page Yellow Fever, Dengue, and Eradication of Aedes aegypti and Aedes albopictus CD31.R26 see Volume 1, pages 20 and 21 and Volume II, page 19. Having considered the Director's report on Aedes aegypti/ flavivirus control and eradication (Document CD31/19); Bearing in mind that extensive areas are still infested by Aedes aegypti in the Americas and there is a serious problem of reinfestation in many of the countries; and Recognizing the serious threat to health and economic development posed by the risk of appearance of urban yellow fever and the possible aggravation of the dengue situation in the Americas, The XXII Pan American Sanitary Confer- CSP22.R25 ence, Having considered the Director's report on the introduction and establishment of Aedes albopictus in two countries of the Region of the Americas (Document CSP22/INF/3); Bearing in mind the multiple biological attributes which would qualify A edes albopictus as an additional efficient vector of dengue, and possibly of yellow fever and some arboviral encephalitides in this Region; Recognizing the imminent risk and urgent necessity to prevent its further spread, and to control or eliminate already existing infestations; and Concerned by the deterioration of existing country programs for the control or eradication of A edes aegypti and the reinfestation of the Member Countries, 1. To request Member Countries to take note of the seriousness of the problem and to support activities initiated by PAHO towards its solution. 2. To recommend to Member Countries that they initiate or continue the necessary actions for effective surveillance of Aedes albopictus and measures to prevent its further dissemination or to eradicate it, if possible. 3. To urge the Director of the PASB to prepare a Plan of Action to combat Aedes albopictus in the Region of the Americas; to support the activities of Member Countries for early detection, surveillance and control of this vector; to promote research necessary to improve control measures; and to present this plan to the Executive Committee at its meeting in June September 1986 OD 211, To urge the Governments of the countries and territories still infested with Aedes aegypti to take appropriate actions to overcome barriers that may be hindering progress in their programs to control or eradicate this vector, giving necessary attention to the allocation of funds, personnel, and materials for these programs, and to implement measures for preventing exportation of the vector to other countries. 3. Chagas' Disease see Volume 1, page 38 and Volume II, page 24.

22 1.2 COMMUNICABLEDIlSEASE PREVENTION AND CONTROL COMMUNICABLE ANO CONTROL DISEASEPREVENTION 4. Other Parasitic Diseases see Volume II, page Cholera see Volume I, page 38 and Volume II, page BACTERIAL, VIRAL, AND MYCOTIC DISEASES 1. Influenza 2. Diarrheal Diseases see Volume 1, page 39. see Volume 1, page 38 and Volume II, page Leprosy 9. Poliomyelitis 10. Mycotic Diseases see Volume I, page 35 and Volume II, page 27. see Volume 1, page 39 and Volume II, page 28. see Volume I, page Tuberculosis see Volume I, page Typhus and Other Viral and Rickettsial Diseases see Volume 1, page Meningitis see Volume II, page Smallpox see Volume 1, page 27 and Volume II, page Hepatitis 5. Sexually Transmitted Diseases and Treponematoses 6. Plague see Volume I, page 35. see Volume 1, page 38. CD31.R25 Noting the magnitude and severity of the public health threat posed by all known forms of viral hepatitis, especially hepatitis B and delta hepatitis, as described in Document CD31/16; Realizing that new advances in technology have now made interventions for hepatitis control more practical and feasible, especially for hepatitis B; and Observing the development of the worldwide WHO program for hepatitis control and the need to develop regional approaches to the control of hepatitis,

23 10 1. PROGRAM PROGRAM 1. To thank the Director for preparing the report "Prospects for the Control of Hepatitis in the Americas" (Document CD31/16), and bringing it to the attention of the Council. 2. To endorse the regional approaches to hepatitis control outlined in the document. 3. To request the Director: a) To encourage Member Governments to develop the epidemiological information required to further define the magnitude of this problem and to define the seroepidemiology of hepatitis in their populations; b) To stimulate collaboration among the Member Countries, especially through the establishment of a network of laboratories for the production and distribution of reagents and vaccines for the diagnosis and control of viral hepatitis, and to encourage and support the production of hepatitis B vaccine in those countries where it is feasible and necessary. 4. To request the Member Countries to collaborate with the Director in the implementation of regional approaches to the control of hepatitis. 5. To request the Director to evaluate periodically the progress made by countries in the control of hepatitis, especially hepatitis B. September 1985 OD 203, FOOT-AND-MOUTH DISEASE AND OTHER ZOONOSES CE90.R15 see Volume 1, page 36 and Volume II, page 30. Having seen the report on the III Inter-American Meeting, at the Ministerial Level, on Animal Health' (Document CE90/16): Recognizing that the Pan American Foot-and-Mouth Disease and Zoonoses Centers perform a fundamental role in the programs of veterinary public health and animal health in the Hemisphere; Being aware that the technical cooperation of these two Centers is essential in supporting the consolidation of national programs for the prevention, control, and eradication of zoonoses and foot-and-mouth disease; Considering that the delegates of the countries participating in the III Inter-American Meeting, at the Ministerial Level, on Animal Health (RIMSA IIl) unanimously approved the proposed programs and budgets of the Pan American Foot-and-Mouth Disease and Zoonoses Centers for and recommended their approval to the Governing Bodies of PAHO; and Having taken note of the special contributions of the Governments of Argentina for the new facilities for the Pan American Zoonoses Center and Brazil for the improvement of the premises of the Pan American Foot-and-Mouth Disease Center, 1. To take note of the report of the III Inter-American Meeting, at the Ministerial Level, on Animal Health (Document CE90/16). 2. To express appreciation for the important contribution of the two Centers. 3. To commend the Ministers of Agriculture of the Region for the support given to the Centers and the financial cooperation provided for the execution of specific projects. 4. To thank the Governments of Argentina and Brazil for their valuable contributions to improve the facilities of the two Centers. 'See PAHO Scientific Publication 476 (1984). CD29.R26 Juine 1983 OD 190, 43 Having seen the report on the III Inter-American Meeting, at the Ministerial Level, on Animal Health (Document CD29/9);' Recognizing that the Pan American Foot-and-Mouth Disease and Zoonoses Centers perform a fundamental role in the programs of veterinary public health and animal health in the Hemisphere: Being aware that the technical cooperation of these two Centers is essential for support to the consolidation of national programs for the prevention, control, and eradication of zoonoses and foot-and-mouth disease; Considering that the Representatives of the countries participating in the III Inter-American Meeting, at the Ministerial Level, on Animal Health (RIMSA III) unanimously approved the proposed programs and budgets of the Pan American Foot-and-Mouth Disease and Zoonoses Centers for and recommended their approval to the Governing Bodies of PAHO; and Having taken note of the special contributions of the Governments of Argentina for the new facilities for the Pan American Zoonoses Center and Brazil for the improvement of the premises of the Pan American Foot-and-Mouth Disease Center, 1. To take note of the report of the III Inter-American Meeting, at the Ministerial Level, on Animal Health (Document CD29/9). 2. To express appreciation for the important contributions of the two Centers. 3. To commend the Ministers of Agriculture of the Region for the support given to the Centers and for the financial cooperation provided for the execution of specific projects. 4. To thank the Governments of Argentina and Brazil for their valuable contributions to improve the facilities of the two Centers. 5. To support the Director in opening negotiations toward an agreement for cooperation between PAHO and the Inter-American Institute for Cooperation on Agriculture

24 1.2 COMMUNICABLE DISEASE PREVENTION AND CONTROL 11 (IICA) on the basis of option D of the study on the possibility of a transfer of the Pan American Foot-and-Mouth Disease Center, and to request him to report on progress on this subject to the 92nd Meeting of the Executive Committee and the XXX Meeting of the Directing Council. 'See PAHO Scientific Publication 476 (1984). CE95.R16 Sept.-Oct OD 192, 74 Having examined the resolutions approved in the IV Inter- American Meeting, at the Ministerial Level, on Animal Health (RIMSA IV), held in Brazil from 1 to 3 May 1985 (Document CE95/23), 1. To thank the Government of Argentina for its support in the acquisition and outfitting of the new headquarters of the Pan American Zoonoses Center (CEPANZO). 2. To urge the Government of Argentina and the Director to complete the negotiations on that Government's subsidy to the CEPANZO budget for the years , so that it may be presented for consideration by the Directing Council in its XXXI Meeting. 3. To recommend to the XXXI Meeting of the Directing Council that it adopt a resolution along the following lines: l June 1985 OD 202, 51 'For text recommended by the Executive Committee and adopted by the Directing Council, after amending paragraph 6 of the operative part, see Resolution CD31.R17 below. areas of mutual interest, and that both sectors have infrastructures and human resources engaged in activities and programs that bear on the protection of foods and control of zoonoses, 1. To thank the Government of Argentina for its support in the acquisition and outfitting of CEPANZO's new headquarters. 2. To thank the Ministers of Agriculture for their financial support in strengthening the technical cooperation provided by CEPANZO to the agricultural sector. 3. To support the Director's initiative in the efforts in progress to facilitate and formalize the mobilization of contributions from the agricultural sector to CEPANZO. 4. To recommend to the Bureau that it draw up as soon as possible a regional plan of action for the protection of foods, based on the approaches that emerged from the Technical Discussions 1 of the XXVIII Meeting of the Directing Council of PAHO (1981), to support the organization, coordination, and improvement of national food protection services. 5. To request the Director to continue holding meetings, workshops, short courses, and seminars as an adjunct to the meetings of the Regional Coordinating Committee of the Codex Alimentarius for Latin America and the Caribbean. 6. To recommend to Member Governments that have not yet done so that they establish veterinary public health programs in their Ministries of Health, and to the Bureau that it collaborate with them in the organization and development of those programs in order to pool efforts and integrate the joint resources of the health and agricultural sectors. 7. To request the Director to devise, under the regional technical cooperation program, mechanisms and methodologies for implementing and strengthening the linkages between the health and agricultural sectors for the improvement of health, socioeconomic development, and human welfare. September 1985 OD 203, 60 CD31.R17 'See PAHO Scientific Publication 421 (1982). Having considered the resolutions approved in the IV Inter-American Meeting, at the Ministerial Level, on Animal Health (RIMSA IV), held in Brazil from 1 to 3 May 1985 (Document CD31/28); Aware that the technical cooperation of the Pan American Zoonoses (CEPANZO) and Foot-and-Mouth Disease (PANAFTOSA) Centers has been meeting the growing demands of the Ministers of Agriculture of the Region; Cognizant of the effort made by the Government of Argentina in contributing new installations to CEPANZO for the benefit of the Member Governments of PAHO, thereby expanding its physical capacity to provide technical cooperation in the different areas of veterinary public health and animal health; Cognizant of the benefit that the countries of the Region have derived from PAHO support to the holding of technical meetings prior to the meetings of the Regional Coordinating Committee of the Codex Alimentarius for Latin America and the Caribbean; and Aware of the need to integrate and coordinate the efforts of the health and agricultural sectors so as to pool efforts in EXPANDED PROGRAM ON IMMUNIZATION CE90.R13 see Volume II, page 36. See also Section (Revolvzng Fund for the Expanded Program on Immunization). Having examined the progress report presented by the Director on the Expanded Program on Immunization (EPI) in the Americas (Document CE90/15),

25 12 1. PROGRAM PROGRAM To recommend to the XXIX Meeting of the Directing Council that it adopt the following resolution:' June 1983 OD 190, 40 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R16 below. f) Report to the 94th Meeting of the Executive Committee in 1985 on the progress of the program and on application of the recommendations put forward herein. 'WHA35/1982/REC/1, 26. Sept.-Oct OD 192, 61 CE95.R14 CD29.R16 Having examined the Director's progress report on the Expanded Program on Immunization (EPI) in the Americas (Document CD29/23), and recognizing the limited funds allocated to the Program for the financial period ; Having taken note of the continuing efforts made to implement this program at country and regional levels; Recognizing that progress of the EPI is an essential element of the strategies to achieve health for all by the year 2000; and Recognizing that progress has been slow in most countries of the Region and if it is not accelerated the program goals will not be met by 1990, Having considered the Director's report on the Expanded Program on Immunization in the Americas (EPI) (Document CE95/15 and Add. I), To recommend to the XXXI Meeting of the Directing Council the adoption of a resolution along the following lines:' June 1985 OD 202, 49 'For text recommended by the Executive Committee and adopted by the Directing Council, after deleting paragraph 4c from the operative part, see Resolution CD31.R22 below. 1. To urge countries to: a) Set biennial targets for immunization coverage in children under one year of age and pregnant women and for the reduction of the morbidity and mortality of the diseases involved; b) Use immunization coverage in children under one year of age and pregnant women as an important indicator of the performance of maternal and child health services; c) Use morbidity and mortality data from measles, poliomyelitis, and neonatal tetanus as indicators of program development and impact; d) Use surveillance of vaccine-preventable diseases as another indicator of development of national epidemiological surveillance systems; e) Act on the Five-Point Action Program adopted by Resolution WHA of May 1982; f) Step up their evaluation of immunization programs and their implementation of recommendations emerging in the course of that process. 2. To request the Director to: a) Continue giving high priority to EPI at all levels of the Organization; b) Use the progress achieved by EPI as an indicator of the success of PAHO's technical cooperation in achieving the goal of health for all by the year 2000; c) Make a study of the vaccine production capacity of the Member Countries and of the quality and cost of the vaccines, with a view to their possible use in the EPI; d) Renew efforts to assure full capitalization of the EPI Revolving Fund; e) Promote evaluation of activities in the countries and assist in carrying them out in countries where he may deem this advisable; CD31.R22 Thle Directing Council, Having considered the Director's report on the Expanded Program on Immunization in the Americas (EPI) and the report of the 95th Meeting of the Executive Committee; Noting the overall improvement made at the national level in the implementation of this program and the impact already achieved in reducing morbidity by poliomyelitis; Believing that an attempt to eradicate poliomyelitis presents a challenge and a stimulus to the world to mobilize the resources to achieve the objective, and that the support required is available nationally and internationally; and Recognizing that the realization of this objective will enhance the overall success of the EPI, 1. To congratulate the Director on the report presented. 2. To reaffirm its full commitment to reach the overall goals of the EPI by To accept the Proposalfor Action for the eradication of indigenous transmission of wild poliovirus from the Americas by 1990 and declare the goals established in the Proposal for A ction as one of the major objectives of the Organization. 4. To urge Member Governments: a) To take the necessary steps to accelerate their EPI programs to assure the achievement of the overall objectives of the EPI and of the eradication of indigenous transmission of wild poliovirus from the Americas by 1990; b) To make the needed commitment and allocate the necessary resources for program implementation; c) To promote support towards these goals within those technical and financial multilateral agencies of which they are also members.

26 1.3 NONCOMMUNICABLE DISEASE PREVENTION AND CONTROL To draw the attention of the Member Governments to the necessity that: a) Immunization programs not be implemented at the expense of efforts to develop the infrastructure of health services and their overall promotion, prevention, and care activities; b) The strategy of campaigns and the tactic of national vaccination days be viewed as ad hoc measures, to be gradually replaced by regular immunization services performed routinely by health services. 6. To request the Director: a) To seek the additional political and material support needed for the realization of these goals from multilateral, bilateral, and nongovernmental agencies; b) To initiate immediate action as outlined in the Proposalfor Action to assure the necessary technical and financial support for the eradication of indigenous transmission of wild poliovirus from the Americas by 1990; c) To submit a progress report to the 97th Meeting of the Executive Committee and the XXII Pan American Sanitary Conference in The XXII Pan American Sanitary Confer- CSP22.R24 ence, September 1985 OD 203, 65 Having examined the Progress Report by the Director on the Expanded Program on Immunization (EPI) (Document CSP22/24 and Add. I) and its inspection by the 97th Meeting of the Executive Committee; Noting the progress made by the Member Countries and at the regional level following the decisions to accelerate EPI and to adopt the Plan of Action for the Eradication of Indigenous Transmission of Wild Poliovirus from the Americas by 1990; and Recognizing the efforts that have been made to secure the extrabudgetary funds necessary for the implementation of the program, as called for in the Plan of Action, 1. To reaffirm the strong commitment of the Pan American Health Organization to the achievement of the goals of the Expanded Program on Immunization by To express appreciation for the increased international support for EPI in the Americas, in particular the strong advocacy and financial support pledged by UNICEF, Rotary International, and most recently by the United States Agency for International Development to the Plan of Action for the Eradication of Indigenous Transmission of Wild Poliovirus. 3. To urge other multilateral, bilateral and nongovernmental organizations to offer their support to the Program as suggested in the Plan of Action. 4. To urge Member Countries to strengthen their efforts in relation to the EPI in each country and seek the allocation of the necessary national resources for the achievement of the established goals. 5. To request the Director to continue the efforts of the Pan American Sanitary Bureau to obtain full funding for accelerating the EPI and for implementing the Plan of Action for the Eradication of Indigenous Transmission of Wild Poliovirus and inform on the progress of the plan at the 1988 meeting of the Directing Council. 6. To congratulate the Director and all the agencies involved on the coordination achieved in support of the program. September 1986 OD 211, NONCOMMUNICABLE DISEASE PREVENTION AND CONTROL CHRONIC AND DEGENERATIVE DISEASES see Volume 1, page 79 and Volume II, page Control of Cigarette Smoking see Volume 1, page CARDIOVASCULAR DISEASES see Volume II, page BLINDNESS see Volume II, page 41.

27 14 1. PROGRAM PROGRAM 1.4 DIAGNOSTIC, THERAPEUTIC, AND REHABILITATIVE TECHNOLOGY LABORATORY TECHNOLOGY CE90.R18 see Volume II, page Blood and Blood Derivatives see Volume II, page 42. Having seen Resolution XXIX' of the XXI Pan American Sanitary Conference; Mindful of Resolution WHA of the Twenty-eighth World Health Assembly; and Informed of the report of the Consultative Meeting on strategies for strengthening blood transfusion services in Latin America and the Caribbean in 1990, held in Washington, D.C., from February 1983, 1. To thank the Director for the measures taken in accordance with Resolution XXIX of the XXI Pan American Sanitary Conference. 2. To take note of the recommendations made in the report of the aforementioned Consultative Meeting, with special attention to the ethical aspects of the matter. 3. To urge Member Governments that have not yet done so to frame policies for the preparation of a national blood transfusion program. 4. To recommend to the Directing Council that it approve the proposed regional program of work, drawn up in the Consultative Meeting, for strengthening blood transfusion services in Latin America and the Caribbean during the period , for implementation as available funding permits. 5. To request the Directing Council to recommend to the Director that he take the requisite action for the final formulation, financing, and implementation of the regional program. 6. To request the Director to present to the 92nd Meeting of the Executive Committee a report on the implementation of the program. achieving effective blood transfusion services in the Region, and mindful of Resolution WHA of the World Health Assembly; and Considering that Resolution XVIIIS of the 90th Meeting of the Executive Committee recommended the approval of the regional program of work suggested by the Consultative Meeting for strengthening blood transfusion services in Latin America and the Caribbean, 1. To approve the regional program of work summarized in Document CD29/12, in the context of the Plan of Action for the Implementation of Regional Strategies to achieve health for all by the year To urge Member Governments to take the requisite action for financing and implementing the recommendations of the Consultative Meeting, as appropriate in each country. 3. To urge Member Governments that have not yet done so to frame policies for the preparation of a national program of blood transfusion, with special attention directed to the ethical and health aspects of the services. 4. To reaffirm the need for national health authorities to follow closely the development of blood transfusion services with due regard for the actual situations in their countries, and to assume responsibility for the regulation and enforcement activities related to blood services, necessary to assure the safety of donors and recipients. 5. To recommend that Member Governments make adequate provision for funding and to facilitate the availability of essential materials. 6. To recommend that the Director take appropriate action for the development of this program and in particular facilitate technical cooperation as available funds permit and in accordance with the Plan of Action for the Implementation of Regional Strategies for health for all by the year To request that the Director present to the 92nd Meeting of the Executive Committee a progress report on the implementation of the program. 'See Vol. 11, pp WHO Official Records 226 (1975), 40. SSee Resolution CE90.R18 on this page. Sept.-Oct OD 192, 59 June 1983 OD 190, 45 'See Vol. II, p WHO Official Records 226 (1975), 110. CD29.R ESSENTIAL DRUGS, VACCINES, AND BIOLOGICALS Having examined the report of the Director (Document CD29/12) on blood transfusion services; Noting Resolution XXIX' of the XXI Pan American Sanitary Conference establishing the year 1990 as the goal for see Volume 1, page 74 and Volume II, page 43.

28 1.4 DIAGNOSTIC, THERAPEUTIC, AND REHABILITATIVE TECHNOLOGY 15 CD29.R30 Having examined the Report of the Technical Discussions (Document CD29/DT/4) held during the Council Meeting, which had before it Document CD29/DT/1;' Aware of the importance of ensuring the availability of essential drugs to all sectors of the population and of the need to identify appropriate administrative, technical, and financial mechanisms to achieve this goal; Recalling Resolutions WHA31.32 and WHA of the World Health Assembly and Resolution XXVII 3 of the XX Pan American Sanitary Conference, which recommended that Member Countries develop comprehensive national drug policies; and Noting the restrictions and costs associated with the research, development, and production of drugs and the transfer of appropriate technology to the developing world, 1. To urge Member Governments that have not done so to date to develop intersectoral drug policies linked to priority health needs. 2. To call upon Member Governments to evaluate present production, marketing, quality control, and supply practices with a view to introducing improvements that will permit a reasonable degree of self-sufficiency, control costs, improve distribution channels, and promote appropriate use of drugs. 3. To request the Director to provide, as budgetary resources permit, technical and financial assistance in establishing, in keeping with the recommendations formulated in the Report of the Technical Discussions, a cooperation program at the regional, subregional, and national levels, with a view to advising the Member Governments in all matters relating to the implementation of drug policies and programs. 4. To urge the Director to explore with bilateral and multilateral organizations, foundations, and other private institutions, including pharmaceutical companies and their associations, the possibility of providing the assistance required for the policies and programs referred to in paragraph To request the Director to present to the XXXI Meeting of the Directing Council a report on the progress of the implementation of the Organization's essential drug program. Sept.-Oct OD 192, 78 'See PAHO Scientific Publication 462 (1984). 2 WHO Official Records 247 (1978), 20, and Document WHA35/ 1982/REC/1, 21. SSee Vol. II, p. 38. CE95.R21 Having seen the report on the progress of the implementation of the Organization's essential drug program (Document CE95/4), Council that it adopt a resolution along the following lines: 1 June 1985 OD 202, 55 'For text recommended by the Executive Committee and adopted by the Directing Council, after amending paragraphs 1 b) and 2 a) of the operative part, see Resolution CD31.R20 below. CD31.R20 Having seen the report on the progress of the implementation of the Organization's essential drug program (Document CD31/8); and Considering that the Program is progressing in accordance with the recommendations I approved by the XXIX Meeting of the Directing Council of PAHO, 1. To recommend that the Member Governments: a) Formulate intersectoral policies and implement national programs on essential drugs, recognizing the importance of such drugs for the extension of coverage of health services and the need to rationalize expenditures for these drugs; b) Ensure that drugs marketed are of good quality and available at reasonable cost to all sectors of the population; c) Promote and monitor the rational and wise prescription and use of marketed drugs; d) Give emphasis to the analysis and formulation of pharmaceutical policies, to the strengthening of controls and quality assurance, to the development of systems for the supply of essential drugs, to the encouragement of domestic production where this is economically feasible and where countries are able to meet quality standards, and to manpower training, operations research, and evaluation mechanisms; e) Examine the possibilities held forth by technical and economic cooperation among developing countries (TCDC/ ECDC) for solution of the problems involved in making drugs accessible to populations in the Region. 2. To request the Director: a) To continue promoting cooperation by the Organization in the development and implementation of program activities relating to essential drugs, in collaboration with WHO's Action Program on Essential Drugs; b) To mobilize extrabudgetary resources for strengthening the Regional program and improving its capability for technical cooperation in support of national programs on essential drugs; c) To support TCDC/ECDC activities directed at finding ways to improve the supply of drugs of adequate quality at the lowest possible prices in the countries of the Region. September 1985 OD 203, 63 To recommend to the XXXI Meeting of the Directing 'See Resolution CD29.R30 on this page.

29 16 1. PROGRAM PROGRAM 1.5 PROMOTION OF ENVIRONMENTAL HEALTH see Volume 1, page 41 and Volume II, page WATER SUPPLY AND SANITATION CE97.R17 see Volume 1, page 43 and Volume II, page 43. Having examined Document CE97/20, Corrig., presented by the Director on the International Drinking Water Supply and Sanitation Decade- Regional Progress, To recommend to the XXII Pan American Sanitary Conference the adoption of the following resolution:' June 1986 OD 211, For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference, see Resolution CSP22.R16 below. The XXII Pan American Sanitary Confer- CSP22.R16 ence, Having seen the document presented by the Director on the International Drinking Water Supply and Sanitation Decade ( )- Regional Progress; Recalling Resolution XXII' of the XXVI Meeting of the Directing Council of PAHO (1979) as well as Resolutions WHA (1983) and WHA (1986) of the World Health Assembly, in which it is recognized that drinking water supply and sanitation are essential to the success of the global strategy for health for all by the year 2000 and that the Decade assigns priority to marginal urban and low-income rural populations; Noting the efforts made by the Governments, the degree of external support, and the progress made by the Decade program to date; Noting further the need to change the trends of coverage seen in the first half of the Decade, which indicate that several countries in the Region will be unable to reach the goals they have set for themselves, and that special efforts will be required if more progress is to be made in the final five years; and Taking into account the recommendations in the report of the Director in regard to the participation of health authorities in drinking water supply and sanitation programs through intersectoral collaboration, and for effective cooperation with external cooperation agencies, 1. To urge the Member Countries: a) To make a greater political commitment to attainment of the goals of the Decade, including incorporation of their national water supply and sanitation plans in their national economic and social development plans; b) To improve water quality, including fluoridation, and to extend the coverage of sewerage and excreta disposal services to levels comparable to those of water supply services; c) To promote and support the provision of drinking water and sanitation as essential components of primary health care; d) To ensure intersectoral collaboration and coordination among national entities, international organizations and bilateral agencies and other participants in the Decade in order to optimize efforts; e) To foster the administrative and technical development of the institutions responsible for water supply and sanitation services, including their human resources, so that they may carry out the functions of planning, execution and, in particular, operation, maintenance and rehabilitation of the services; f) To promote the control of losses and the efficient use of water in integration with institutional development so as to optimize the use of installed capacity and extend the drinking water supply systems to serve the largest possible proportion of the population; g) To ensure the participation of the community, and especially of women, in all stages-the planning, building, management, operation and maintenance-of the development of these services; h) To identify and mobilize on a large scale the national and local financial, human, technical and administrative resources by means of innovative strategies so as to reduce costs. 2. To urge the international cooperation and financing agencies: a) To continue giving high priority to drinking water supply and sanitation, and to increase the proportion of the funds they allocate for the financing of services, especially for the urban and rural poor; b) To increase the proportion of the funds they allocate to institutional and manpower development, to operation, maintenance and rehabilitation, to public information, to sanitary education, and to community participation; c) To continue their efforts to improve coordination and exchanges of information at the country and regional levels with national establishments and other interested external agencies. 3. To request the Director: a) To continue supporting the countries in the development of their programs on the Decade, with special emphasis on intersectoral coordination and action with other external agencies; b) To continue supporting the promotion of research in the health aspects of drinking water supply and sanitation

30 1.5 PROMOTION OF ENVIRONMENTAL HEALTH PROMOTION OF ENVIRONMENTAL HEALTH 17 programs and in the use of these services as well as in the development of low-cost technology; c) To continue supporting the development of drinking water supply and sanitation institutions, including their human resources, and in particular to promote and support efforts to make more efficient use of the installed capacity of drinking water supply systems; d) To continue supporting the development of Decade programs in the countries with a subregional approach that reinforces the national effort; e) To publicize the experiences of the countries in community participation, the mobilization of resources, appropriate technology, operation and maintenance, and other important aspects, and to encourage exchanges of information; f) To continue monitoring progress in drinking water supply and sanitation and give support in strengthening the management information systems of the countries. September 1986 OD 211, To take note of the report on the International Program on Chemical Safety (IPCS) presented by the Director and to refer it to the Directing Council with a recommendation that it approve the program proposed for the Americas. 2. To recommend to the Member Countries that they become more involved in the activities of IPCS and support the policies and strategies proposed in the report for determining the action to be taken in the Region. 3. To recommend to the Director that, subject to the availability of resources, he develop the measures suggested in the report, including the preparation of a status evaluation report on chemical safety in the Region and the development of a medium-term program ( ), and to request that he present a report on the results to thejune 1985 Meeting of the Executive Committee. 'Document EB73/1984/REC/1, 8. June 1984 OD 195, 38 'See Vol. II, p Document WHA36/1983/REC/I, 11. 'Document WHA39/1986/REC/1, SANITARY CONTROL OF HOUSING see Volume I, page 51 and Volume II, page POLLUTION CONTROL (INCLUDING CHEMICAL SAFETY) CE92.R5 see Volume I, page 50. Having reviewed the report on the International Program on Chemical Safety (IPCS) (Document CE92/19); Considering Resolution EB of the Executive Board of WHO urging countries to participate in IPCS, and the increasingly active involvement of all WHO Regional Offices in it; Aware of the growing importance of evaluating and dealing with health problems associated with human exposure to the extensive use of chemical substances and products, and of the need to avert the adverse effects of such products and preserve a wholesome environment; and Recognizing the importance of integrating I PCS into existing environmental and occupational health and safety programs so as to avoid costly duplication of services, CD30.R14 Having examined the report on the International Program on Chemical Safety (IPCS) (Annex II of Document CD30/ 17); Considering Resolution EB of the Executive Board of WHO urging the participation of the countries in the Program and the increasing participation therein of all Regional Offices of WHO; Considering Resolution V 2 of the 92nd Meeting of the Executive Committee recommending that the Directing Council approve the Program presented for the Americas; Aware of the growing importance of health problems associated with the exposure of human beings to the extensive use of chemicals and chemical products in the Region and of the need to prevent and control the adverse effects thereof and of preserving a wholesome environment; and Recognizing the importance of integrating the IPCS into existing environmental health programs, 1. To take note of the report on the International Program on Chemical Safety and to thank the Director for its preparation. 2. To urge the Member Governments to: a) Participate in activities under the IPCS and support the policies and strategies for the measures to be taken in the Region; b) Support the implementation of the evaluation of the status of chemical safety, mainly in regard to intersectoral action. 3. To request the Director to implement the measures suggested in the report, including the evaluation of the status of chemical safety in the Region and the framing of proposals for medium-term ( ) programs on the subject. 'Document EB73/1984/REC/1, 8. 2 See this page. Sept.-Oct OD 197,45

31 18 1. PROGRAM PROGRAM CE97.R16 Having seen the report on the International Program on Chemical Safety (Document CE97/16), To recommend to the XXII Pan American Sanitary Conference the adoption of the following resolution:' FOOD SAFETY see Volume 1, page 74. June 1986 OD 211, For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference, see Resolution CSP22.R13 below. CE97.R18 Having considered the Director's Report on the Program of Food Protection (Document CE97/13). To recommend to the XXII Pan American Sanitary Conference the approval of a resolution along the following lines: l June 1986 OD 211, 117 'For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference after adding subparagraph f) to operative paragraph 1 and amending subparagraph b) of operative paragraph 2, see Resolution CSP22.R17 below. The XXII Pan American Sanitary Confer- CSP22.R13 ence, Having seen the report on the International Program on Chemical Safety (Document CSP22/18); Considering the information available on the important health problems created in the countries of the Region by the extensive use of chemicals; Aware of the growing importance of preventing the adverse effects of those chemicals on health and the environment; and Cognizant of the need to initiate and strengthen concrete measures for reducing the existing problems, 1. To take note of the document presented, which contains an evaluative study of the chemical safety situation' in the Region, and a medium-term program in this regard. 2. To recommend to the Member Countries the establishment or strengthening of measures for coordination of national programs for the identification, evaluation, prevention and control of hazards to health and the environment associated with the use of chemicals. 3. To encourage the Member Countries that have already started programs to share with other countries, in collaboration with PAHO/WHO, information about their experience and progress. 4. To convey to the Director its satisfaction with the effort made in preparing this document, and to thank the Member Countries for their valuable contributions. 5. To request the Director to implement, to the extent that the Organization's resources allow, the specific activities of the medium-term program proposed in the document. September 1986 OD 211, 141 The XXII Pan American Sanitary Confer- CSP22.R17 ence, Having seen the report of the Director on the Program of Food Protection and the reportl of the 97th Meeting of the Executive Committee; Noting that this Program and its associated Plan of Action were designed and developed in compliance with Resolution XVII 2 of the XXXI Meeting of the Directing Council of PAHO, held in 1985; and Aware that well designed and executed food protection programs are imperative in the countries of the Region for the provision of foods that are safe and of good quality, thereby protecting the health of their populations, avoiding considerable food losses, and mitigating the severe economic consequences of the rejection of foods that are exported, all of which work greatly against the economic development and well-being of the countries, 1. To urge the Member Countries: a) To give higher priority to the establishment or strengthening of national food protection programs; b) To increase the intersectoral coordination of national food protection activities; c) To increase the resources allocated to the development of national food protection programs; d) To increase cooperation with other countries in the Region in aspects in which they are most advanced;

32 1.6 HEALTH SYSTEMS DEVELOPMENT HEALTH SYSTEMS DEVELOPMENT 19 e) To support the efforts that PAHO may undertake with international financing agencies, multilateral and bilateral cooperation agencies, and industrial firms, for the purpose of augmenting the resources available for technical cooperation in food protection activities with the countries in the Region; f) To strengthen the efforts targeted to establishing necessary laws and regulations to ensure adequate implementation of national food protection programs. 2. To request the Director: a) To continue supporting food protection and safety activities; b) To continue coordination with and seek financial support from the international financing agencies and the multilateral and bilateral agencies, and with the private sector, for increased technical cooperation with the countries in food protection. 'See Resolution CE97.R18, p See p. 11. September 1986 OD 211, DEVELOPMENT OF RIVER BASINS see Volume 1, page HEALTH SYSTEMS DEVELOPMENT HEALTH AND SOCIOECONOMIC DEVELOPMENT CE92.R14 see Volume 1, page 51 and Volume II, page 46. Having considered Document CE92/16 and the report of the Subcommittee on Long-Term Planning and Programming and its appendices; Noting that the document "The Economic Crisis in Latin America and the Caribbean and its Repercussions on the Health Sector" represents important new sources of information and analysis; Bearing in mind that this document responds to Resolution XX 1 of the XXVIII Meeting of the Directing Council of PAHO as well as to resolutions of the World Health Assembly; and Considering that the document offers specific recommendations for action with the objective of improving the information available to Member Governments and supporting their efforts to achieve the goal of health for all by the year 2000, To recommend to the XXX Meeting of the Directing Council adoption of the following resolution: 2 June 1984 OD 195, 46 'See Vol. II, p For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD30.R2 below. CD30.R2 Having considered the document on the economic crisis in Latin America and the Caribbean and its repercussions on the health sector (Document CD30/16), and the report of the 92nd Meeting of the Executive Committee, 1. To express appreciation to the Director for the study on the repercussions of the economic crisis on the health sector and to urge the Director to apply the document's recommendations. 2. To urge Member Countries to undertake the studies recommended in the report with the support of the Secretariat, including the impact of technology and human resources on health costs, the review of the financing of the health sector with the objective of moving toward the fulfillment of the principles of efficacy, efficiency, and equity, and the examination of the impact of the crisis on health sector resources, both public and private, and on their distribution and use. 3. To request the Director to continue to examine the international economic environment and the impact of changing developments on the health sector, to assist the Member Countries in their own analyses, and to report to the Governing Bodies on any major changes in the situation, as appropriate HEALTH PLANNING AND ADMINISTRATION Sept.-Oct OD 197, National Health Plans see Volume 1, page 53 and Volume II, page 46.

33 20 1. PROGRAM 2. Long-Term Planning and Evaluation see Volume 1, page 55 and Volume II, page 49. Council and before the Executive Board Meeting of WHO and another after the Executive Board Meeting of WHO and before the PAHO Executive Committee Meeting in June, plus such other special meetings as may be required. June 1984 OD 195, 44 See also Section (General Programs of Work Covering a Specific Period). 'See Vol. II, p. 50. CE92.R13 CE92.R12 Bearing in mind Resolution XIII' approved by the 82nd Meeting of the Executive Committee (June 1979) establishing the Subcommittee on Long-Term Planning and Programming; Cognizant of the importance of more active participation of the Member Governments and the Organization to implement the collective decisions taken by the Governing Bodies; Considering that the health needs of the countries evolve through a dynamic process governed by economic, political, and social factors that necessitate an ongoing, intensive interinstitutional analysis; and Cognizant of the need to strengthen the other functions of the Subcommittee on Long-Term Planning and Programming with a view to improving analysis of problems and development of strategies that could be jointly adopted by the Organization and its Member Governments, 1. To express appreciation to the Subcommittee for its report. 2. To change the name of the Subcommittee to "Subcommittee on Planning and Programming." 3. To assign to the Subcommittee the following functions: a) Analysis of the process and methodology of planning, programming, and budgeting; b) Analysis of the information processes and systems for the conduct of technical cooperation with the countries, including evaluation and monitoring of the regional Plan of Action for health for all by the year 2000; c) Analysis of economic and social factors and their impact on health conditions and the health sector; d) Analysis of the policy and functioning of PAHO's administrative systems, including manpower planning and development; e) Analysis of special programs with special emphasis on their formulation and evaluation; f) Other functions to be determined by the Executive Committee. 4. To establish the membership of the Subcommittee at seven Members: four to be elected by the Executive Committee for terms of office running concurrently with those of their membership in the Executive Committee and three to be named prior to each meeting of the Subcommittee by the Director in consultation with the Chairman of the Executive Committee, in light of the specific topics for each meeting. 5. To establish the number of regular meetings at two per year, one occurring after the meeting of the Directing Having considered Document CE92/16 and the report of the Subcommittee on Long-Term Planning and Programming and its appendices; Recognizing that the Common Framework and Format has been complemented with additional materials; Bearing in mind that the Common Framework and Format responds to resolutions of the Directing Council and the Executive Committee of PAHO as well as to resolutions of the World Health Assembly; and Considering that the report offers specific recommendations for action with the objective of improving the capacity of the Member Governments and the Organization to achieve the goal of health for all by the year 2000, 1. To express appreciation for the information presented on the steps under way to implement within the Region of the Americas the process for evaluating the strategies for health for all and to urge the Director to implement the Subcommittee recommendations with regard to the adjustment of the evaluation instrument following field tests to ensure its most useful application within the Region of the Americas. 2. To urge Member Countries to cooperate in the field tests of the evaluation instrument and the application of the instrument as adjusted as a result of the field tests. 3. To urge Member Countries to use the evaluation instrument as an opportunity to review and make appropriate changes in their information and monitoring and evaluation processes in order to strengthen their efforts to achieve the goal of health for all by the year To urge the Director to provide support to Member Countries in the completion of the field tests, in the preparation of the regional contribution to the Seventh Report on the World Health Situation, and in improving information, monitoring, and evaluation capabilities. CE92.R14 June 1984 OD 195, 45 Having considered Document CE92/16 and the report of the Subcommittee on Long-Term Planning and Programming and its appendices; Noting that the document "The Economic Crisis in Latin America and the Caribbean and its Repercussions on the Health Sector" represents important new sources of information and.analysis; Bearing in mind that this document responds to Resolution XX l of the XXVIII Meeting of the Directing Council of PAHO as well as to resolutions of the World Health Assembly; and

34 1.6 HEALTH SYSTEMS DEVELOPMENT 21 Considering that the document offers specific recommendations for action with the objective of improving the information available to Member Governments and supporting their efforts to achieve the goal of health for all by the year 2000, To recommend to the XXX Meeting of the Directing Council adoption of the following resolution: 2 June 1984 OD 195, 46 'See Vol. II, p For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD30.R2 below. CD30.R2 Having considered the document on the economic crisis in Latin America and the Caribbean and its repercussions on the health sector (Document CD30/16), and the report of the 92nd Meeting of the Executive Committee, 1. To express appreciation to the Director for the study on the repercussions of the economic crisis on the health sector and to urge the Director to apply the document's recommendations. 2. To urge Member Countries to undertake the studies recommended in the report with the support of the Secretariat, including the impact of technology and human resources on health costs, the review of the financing of the health sector with the objective of moving toward the fulfillment of the principles of efficacy, efficiency, and equity, and the examination of the impact of the crisis on health sector resources, both public and private, and on their distribution and use. 3. To request the Director to continue to examine the international economic environment and the impact of changing developments on the health sector, to assist the Member Countries in their own analyses, and to report to the Governing Bodies on any major changes in the situation, as appropriate. CE92.R15 Sept.-Oct OD 197, 35 Having reviewed the document "Managerial Strategy for the Optimum Use of PAHO/WHO Resources in Direct Support of Member Countries"; Having considered Document CE92/16, which describes the discussions and conclusions of the Subcommittee on Long-Term Planning and Programming of the Executive Committee of PAHO concerning the above-mentioned "Managerial Strategy"; and Considering that the "Managerial Strategy" seeks to encourage management changes that would strengthen the mandate of the Organization, make its programming more effective and efficient, and emphasize basic concepts of equity in the allocation of PAHO's resources, 1. To express appreciation to the Director for the preparation and dissemination of the "Managerial Strategy" and for involving the Governing Bodies in its examination and review. 2. To approve the recommendations of the Subcommittee on Long-Term Planning and Programming with regard to the "Managerial Strategy," and in particular the desirability that operational mechanisms be developed to promote the broad policy goals of the "Managerial Strategy." 3. To urge Member Governments to study carefully the elements of the "Managerial Strategy" and examine how available resources could be redeployed to promote the priorities adopted by the PAHO Governing Bodies. 4. To urge the Director to continue to examine the "Managerial Strategy" so that it can respond effectively to the changing dynamics affecting health conditions and the process of development within the Region. CD30.R15 3. Coordination June 1984 OD 195, 47 Having exanined the report on Coordination of Social Security and Public Health Institutions (Document CD30/18); Cognizant of the progress that the countries have made in this field and aware that, unless the ministries of health and social security institutions coordinate their activities, it will be virtually impossible for a large number of countries in the Region to achieve the objective of universal coverage; Bearing in mind the various suggestions and proposals made by the country delegations for strengthening and broadening coordination arrangements, which will improve the organization of national health resources in addressing the health care needs of the population; and Considering that the current critical situation of the Latin American economies directly affects the financing of health and social security programs, and that new financing approaches and strategies must be found for providing those programs with an adequate share of society's resources and opportunities, 1. To accept the report presented by the Director on coordination of social security and public health institutions. 2. To reiterate the recommendations included in Resolution XXXIVI of the XXVIII Meeting of the Directing Council (1981), especially those recommending that the Governments "establish or restructure the bodies for interinstitutional representation in the health field... to... give these institutions a role in decision-making" within the health sector and "include representatives of social security agencies and other health sector institutions in delegations to the Meetings of the Organization's Governing Bodies." 3. To recommend to the Member Governments that they formulate strategies for the progressive development of linkages in those areas in which the coordination of social security institutions and ministries of health would help ensure

35 22 1. PROGRAM PROGRAM better use of national resources for the extension of health care services to those population groups that still lack access to them. 4. To urge the Member Governments to: a) Carry out studies that will help define the sectoral framework and the interinstitutional relationships in which health care delivery actually takes place; b) Conduct health care coverage studies designed to determine the actual use made of the services and the possibilities of complementary sectoral institutions in providing health care for the population; c) Analyze the financial systems of social security institutions and the health sector as a whole, with a view to the adoption of policies and programs that will promote adequate interaction between ministries of health and social security institutions. 5. To recommend to the Member Governments that they include the health programs of the social security system in the preparation and implementation of technical cooperation plans and programs for the health sector, as well as specific activities for promoting and supporting the legal, institutional, and operational coordination of ministries of health and social security institutions. 6. To request the Director to take the steps necessary for the establishment and conduct of a well-defined program of technical cooperation with national and international social security agencies that will ensure the appropriate broadening and strengthening of activities for encouraging and supporting the above-mentioned actions. 7. To request the Director to report to the XXXII Meeting of the Directing Council on the current situation, the progress made, and activities undertaken in this field, and to include in his annual reports information on the continuing development of the matter TECHNICAL COOPERATION AMONG DEVELOPING COUNTRIES/ECONOMIC COOPERATION AMONG DEVELOPING COUNTRIES (TCDC/ECDC) CE92.R16 see Volume II, page 54. Having considered Document CE92/16, which describes the discussions and conclusions of the Meeting of the Subcommittee on Long-Term Planning and Programming of the Executive Committee of PAHO and which includes the documents examined by the Subcommittee, particularly the paper on "Guidelines for the Promotion of TCDC/ECDC in the Health Sector with the Collaboration of PAHO"; Recognizing that the mechanisms of TCDC/ECDC and the need to increase their application are supported by resolutions of the Directing Council of PAHO, the Governing Bodies of WHO and, in particular, the Plan of Action for health for all by the year 2000; and Bearing in mind that the document on guidelines for TCDC/ECDC represents an important source of information, analysis, and action guidelines for technical cooperation, To recommend to the XXX Meeting of the Directing Council adoption of the following resolution: l June 1984 OD 195, 48 'See Vol. 11, p Sept.-Oct OD 197, 46 'For text recommended by the Executive Committee and adopted by the Directing Council after amending paragraph 1 of the operative part, see Resolution CD30.R3 below MEDICAL CARE see Volume I, page 63 and Volume II, page 51. CD30.R3 Having considered the document containing guidelines for the promotion of TCDC/ECDC and the report of the 92nd Meeting of the Executive Committee (CD30/15 and Annexes); Sharing the conviction that TCDC/ECDC is a basic mechanism for the achievement of health for all by the year 2000; and Recognizing that TCDC/ECDC is a dynamic instrument for mobilizing scientific, technical, managerial, financial, and other resources necessary to generate and strengthen national and collective capabilities to improve the health of the people, PRIMARY HEALTH CARE AND COMMUNITY PARTICIPATION see Volume II, page 52. See also Sections and To express appreciation to the Director for the "Guidelines for the Promotion of TCDC/ECDC in the Health Sector with the Collaboration of PAHO" and to recommend their use as a basis for action in the field, together with the report of the Second Meeting of the PAHO/WHO Special Working Group on TCDC, created by the Organization for this purpose. 2. To urge the Member Countries to take the appropriate institutional, legal, administrative, and financial steps to

36 1.6 HEALTH SYSTEMS DEVELOPMENT HEALTH SYSTEMS DEVELOPMENT 23 promote, facilitate, and undertake collective and bilateral actions using the mechanisms of TCDC/ECDC relative to the Regional Strategies and the Plan of Action for health for all by the year To recommend that the Director take the necessary technical and administrative steps to collaborate with Member Countries in TCDC/ECDC in the priority areas of health noted in the guidelines and such other steps as may be necessary. 4. To request the Director to report to the XXXI Meeting of the Directing Council on Member Countries' progress in the use of TCDC/ECDC and on the support provided by PAHO/WHO. CE95.R20 Sept.-Oct OD 197, 36 Having seen the report presented by the Director on the progress made by the Member Governments in the use of technical and economic cooperation among developing countries (TCDC/ECDC) with the support of PAHO/WHO (Document CE95/19), To recommend to the XXXI Meeting of the Directing Council that it adopt a resolution along the following lines:' June 1985 OD 202, 54 'For text recommended by the Executive Committee and adopted by the Directing Council, after adding a third paragraph to the operative part, see Resolution CD31.R21 below. The XXII Pan American Sanitary Confer- CSP22.R23 ence, Having considered the report presented by the Director on the progress made by the Member Countries in the use of technical and economic cooperation among developing countries (TCDC/ECDC) with the support of PAHO/WHO (Document CSP22/11); Bearing in mind Resolution III' of the XXX Meeting of the Directing Council (1984) and Resolution XXI 2 of the XXXI Meeting of the Directing Council (1985) concerning the promotion of TCDC/ECDC in the health sector with collaboration of PAHO/WHO; and Aware that it has become increasingly evident that one of the long-term strategies to overcome the effects of the economic crisis in the Region of the Americas and to promote self-reliance is the undertaking of collective and bilateral actions, using the mechanism of TCDC/ECDC, 1. To urge Member Countries to take the necessary legal, financial, institutional and administrative steps to facilitate collective and bilateral actions, using the mechanism of TCDC/ECDC to address the current problems undermining their socioeconomic development, particularly in the health sector. 2. To request Member Countries and the Director to continue, on a permanent basis, studying, monitoring and assessing the effectiveness of this mechanism for stimulating individual country and collective self-reliance in the health sector. 3. To request the Director to report periodically to the Governing Bodies on the progress achieved by the Member Countries and by the Organization in this area. September 1986 OD 211, 153 CD31.R21 Having considered the report presented by the Director on the progress made by the Member Countries in the use of technical and economic cooperation among developing countries (TCDC/ECDC) with the support of PAHO/WHO (Document CD31/20), and bearing in mind Resolution III l of the XXX Meeting of the Directing Council (1984), 1. To urge the Member Governments and the Director to continue the appropriate steps alluded to in operative paragraphs 2 and 3 of Resolution III of the XXX Meeting of the Directing Council on the use of TCDC/ECDC. 2. To request the Director to report to the Governing Bodies of the Organization in 1986 on the progress made in the use of TCDC/ECDC by the Member Governments and the Organization. 3. To request the Director to favor the initiatives of the countries that serve to strengthen the activities of TCDC/ ECDC within the Region and among the interested countries. 'See Resolution CD30.R3, p. 22. September 1985 OD 203, 64 'See p. 22 'See this page EMERGENCY ASSISTANCE CD31.R2 see Volume 1, page 80 and Volume II, page 56. Having learned with deep sorrow of the catastrophe that has overtaken the United States of Mexico, where a major earthquake has caused tragic loss of life and heavy material damage, 1. To express to the Government and the people of Mexico its deep sorrow at the tragedy which has befallen the country. 2. To convey to the victims' families, to all the Mexican people, and to the authorities, a message expressing the sympathy and solidarity shared by all the Member Countries of the Pan American Health Organization. 3. To urge all Member Countries to participate in providing assistance to the United States of Mexico, not only to

37 24 1. PROGRAM PROGRAM the immediate consequences of the disaster but especially to the effort of reconstruction. 4. To urge international organizations, taking into account this tragedy, to give special understanding and support to the United States of Mexico, especially regarding its economic and financial obligations. 5. To request the Director to provide every assistance within the means of the Organization. CE95.R22 September 1985 OD 203, 45 Having seen the document presented by the Director on the progress of regional and national emergency preparedness programs (Document CE95/14), To recommend to the XXXI Meeting of the Directing Council the adoption of a resolution along the following lines: June 1985 OD 202, 56 'For text recommended by the Executive Committee and adopted by the Directing Council, after adding a paragraph to the operative part, see Resolution CD31.R23 below. CD3 1.R23 Having seen the document presented by the Director on the progress of regional and national emergency preparedness programs (Document CD31/18); Considering Resolutions X, XXXVI, and XL' of the XXIV, XXVI, and XXVII Directing Council meetings, respectively, on the Emergency Preparedness and Disaster Relief Coordination Program; Being aware of the increasing vulnerability of the Region of the Americas to negative health consequences of all types of disasters, and in particular those resulting from industrialization and urbanization processes; Concerned about the need to maintain the technical cooperation provided by the Organization independently from the support received by PAHO from funding agencies; Stressing that it is the national responsibility of each Member Government and especially of the Minister of Health as head of the sector to establish, as recommended by the Directing Council in its XXVI Meeting, an "ongoing program to update emergency plans, train health personnel, and promote research, and case studies to improve disaster management 2," and Noting the importance of maintaining close cooperation between the Organization and other regional or global programs of WHO, Office of the United Nations Disaster Relief Coordinator (UNDRO), Office of the United Nations High Commissioner for Refugees (UNHCR), and nongovernmental organizations, 1. To urge Member Governments who have not done so to establish within the Ministry of Health an emergency preparedness and disaster relief coordination program responsible for continuously updating emergency plans, training health personnel, developing national guidelines, and coordinating within and outside the sector. 2. To recommend to Member Governments that they cooperate with the Director in reinforcing the technical resources available to them for cooperation with other countries in preparing for disaster cases. 3. To request the Director to consider measures to maintain and increase the Organization's regular support to national programs. 4. To thank the Governments of Canada and the United States of America for their extrabudgetary support of the disaster preparedness program of the Organization. 5. To request the Director to strengthen, if possible, the Organization's technical cooperation and coordination in preparing the health sector to respond effectively to health problems caused by technological disasters, such as explosions and chemical accidents, as well as by displacements of large population groups caused by natural or man-made disasters. 6. To request the Director to explore the availability of additional funds from extrabudgetary sources and to continue the Organization's efforts to ensure that disaster prevention and preparedness be an integral part of the activities of the technical programs and professional staff of the Organization. 7. To encourage the Director to pursue his policy of joint activities and close cooperation with other regional offices of the World Health Organization, UNDRO, UNHCR, bilateral organizations, and governmental organizations, whenever appropriate. 8. To ask the Director to report on progress made towards compliance with this resolution at the Directing Council meeting in September 1985 OD 203, 67 'The resolutions mentioned here appear in Vol. II, pp , 59, and 60, respectively. YResolution XXXVI. Ibid, 59.

38 1.7 GENERAL HEALTH PROTECTION AND PROMOTION GENERAL HEALTH PROTECTION AND PROMOTION GENERAL HEALTH PROTECTION AND PROMOTION FOOD AND NUTRITION CE90.R21 see Volume 1, page 70 and Volume II, page 61. Having reviewed the report submitted by the Director (Document CE90/13) on action taken by Member Governments regarding infant and young child nutrition and the status of compliance with and implementation of the International Code of Marketing of Breast-milk Substitutes approved by Resolution WHA of the Thirty-fourth World Health Assembly; Noting that, while many Member Governments are taking useful measures related to improving infant and young child feeding, few Member Governments have adopted and adhere to the International Code as a "minimum requirement" and have implemented it "in its entirety," as called for in Resolution WHA34.22; and Recognizing the importance of sound infant and young child nutrition for the future health and development of the child and adult, 1. To thank the Director for the progress report on this important matter. 2. To inform the XXIX Meeting of the Directing Council on the results of the Organization's efforts in support of infant and young child nutrition in the Region. 3. To recommend to the XXIX Meeting of the Directing Council that it adopt the following resolution: 2 June 1983 OD 190, 48 'Document WHA34/1981/REC/1, For text recommended by the Executive Committee and adopted by the Directing Council, after adding subparagraph d) to paragraph 1 and subparagraph f) to paragraph 2 of the operative part, see Resolution CD29.R21 below. CD29.R21 Recognizing that there is a close interrelationship between infant and young child nutrition and socioeconomic development; Concerned that inappropriate feeding practices of infants and young children result in greater incidence of infant mortality, malnutrition, and disease, especially in conditions of poverty and poor hygiene; Conscious that breastfeeding is the ideal method of infant feeding during the first months of life and should be promoted and protected in all countries; Convinced that Member Governments have important responsibilities and a fundamental role to play in the promotion of good nutrition and in the protection of breastfeeding and sound weaning practices, as a means of improving infant and young child health; and Recalling Resolution WHA on Infant and Young Child Feeding and Resolution WHA adopting the International Code of Marketing of Breast-milk Substitutes, 1. To urge all Member Governments to: a) Give full support to their implementation of the recommendations made by the Joint WHO/UNICEF Meeting on Infant and Young Child Feeding (1979), and on the encouragement and support of breastfeeding; the promotion and support of appropriate weaning practices; the strengthening of education, training, and information; the promotion of the health and social status of women; and the appropriate marketing and distribution of breast-milk substitutes; b) Give renewed attention to the need for adopting national legislation, regulations, or other suitable measures to respond to the International Code of Marketing of Breastmilk Substitutes, and the monitoring of compliance with the Code; c) Involve all concerned social and economic sectors, nongovernmental agencies, academic institutions, professional associations, and the community as a whole in the implementation of concerted actions for the improvement of infant and young child nutrition, particularly in low-income groups of rural and periurban populations; d) Give the highest priority to establishing effective systems of ensuring adequate food supplies to infants and young children. 2. To request the Director to: a) Continue full support and cooperation with Member Governments in the design, implementation, and evaluation of national programs for the improvement of infant and young child feeding and maternal nutrition; b) Give all possible assistance to Member Governments, as and when requested, for the implementation of the International Code, particularly in the preparation of national legislation and regulations related to this matter; c) Intensify activities in the field of health and nutrition education and in training and information on infant and young child feeding, in particular through primary health care services; d) Support national studies regarding infant and young child feeding practices, particularly with regard to the prevalence and duration of breastfeeding; e) Strengthen coordination with other international and bilateral agencies for the mobilization of financial and technical resources in support of national food and nutrition programs; f) Encourage research within this Region among diverse communities to establish the nutritional requirements of infants at different stages of growth, especially to determine locally the optimum age for weaning and to identify re-

39 26 1. PROGRAM PROGRAM sources available to combat undernutrition before it becomes established. IDocument WHA33/1980/REC/1, Document WHA34/1981/REC/1, 23. Sept.-Oct OD 192, DENTAL HEALTH see Volume 1, page 74 and Volume II, page NURSING see Volume 1, page 65 and Volume II, page MENTAL HEALTH see Volume 1, page 73 and Volume II, page 64. CD29.R18 Having considered the document presented by the Government of Canada on the function of nursing personnel in primary health care; Cognizant of the very important role the nursing staff plays on the health team in pursuing the goal of health for all by the year 2000; and Mindful of Resolutions CE72.R21, CSP19.R28, CD23.R29, CD25.R24, and CD27.R19 1 adopted by the Governing Bodies over the last decade and urging the Member Governments to intensify their efforts to improve the organization of nursing services and to redirect education programs in order to strengthen the contribution of nursing to the enterprise of extending care services to the entire population, in accordance with the goal of health for all by the year 2000, 1. To thank the Government of Canada for its presentation of the aforementioned document and for its interest in the development of nursing in the Region. 2. To recommend to the Member Governments that they promote and recognize the participation of nursing in the taking of decisions involving their role in strengthening coverage extension programs with auxiliary, technical, and professional staff so as to enhance the quality of the care provided; give support to reorientation of the curricula of education programs; strengthen the preparation of teaching staff in aspects of community health; and give momentum to research and to the establishment of networks of scientific and technical information in the nursing field. 3. To request the Director to cooperate with the Member Governments in the effective implementation of the recommendations and to report periodically to the Governing Bodies on gains in this area. 'See Vol. II, pp Sept.-Oct OD 192, 63 CD29.R17 Having examined the Director's report on drug abuse prevention (Document CD29/22); Taking into account Resolution XLI of the XXVII Meeting of the Directing Council and Resolution XXV' of the XXI Pan American Sanitary Conference, which call upon the Member Governments and the Director to collaborate in strengthening national drug abuse control efforts; Bearing in mind that drug abuse appears to be one of the fastest growing public health problems in the Region; Aware that scientific evaluation should accompany any efforts to reduce drug abuse in order to assess their effectiveness; Recognizing that the social and health impact of the drug abuse problem in the Region has not been evaluated and is not being monitored; and Taking into consideration the importance of such studies in identifying the patterns of drug abuse and some of the principal causal factors as well as pointing out fruitful areas for prevention, 1. To urge the Member Governments to: a) Be mindful of the need to make ongoing epidemiological assessments of the drug abuse problem, as the basis for developing appropriate prevention strategies; b) Review or develop their national drug abuse plans and activities with an eye toward strengthening the health sector input; c) Explore new mechanisms for encouraging and supporting community participation in the prevention of drug abuse. 2. To urge the Director to ensure that the Organization: a) Give priority to drug abuse prevention within the program budget and seek additional extrabudgetary resources to undertake drug abuse prevention efforts; b) Strengthen the ability of the Secretariat to provide the Member Governments with additional technical support, particularly in the control of licit drugs, the development of effective national strategies, and the development of drug abuse data collection systems;

40 1.8 PROTECTION AND PROMOTION OF THE HEALTH OF SPECIFIC POPULATION GROUPS 27 c) Collaborate with Member Governments in designing and planning a regional strategy to monitor, prevent, and combat drug abuse on a continuing basis, including an analysis of the necessary resources; d) Collaborate with Member Governments in designing and evaluating community prevention programs. lsee Vol. II, pp. 65 and 66, respectively. Sept.-Oct OD 192, PREVENTION OF ACCIDENTS HEALTH EDUCATION see Volume II, page 66. see Volume 1, page 66 and Volume II, page PROTECTION AND PROMOTION OF THE HEALTH OF SPECIFIC POPULATION GROUPS MATERNAL AND CHILD HEALTH, INCLUDING FAMILY PLANNING CE92.R10 see Volume I, page 70 and Volume II, page 69. Having reviewed and discussed the Director's report titled "Basis for the Definition of the Organization's Action Policy with Respect to Population Matters" (CE92/12), To recommend to the XXX Meeting of the Directing Council the adoption of a resolution along the following lines: l June 1984 OD 195, 42 'For text recommended by the Executive Committee and adopted by the Directing Council, after amending subparagraph b) of operative paragraph 4, see Resolution CD30.R8 below. CD30.R8 Recognizing the close relationship of health, development, and population dynamics to the growth, distribution, and structure of the population, and noting wide differences in fertility and mortality rates between the countries of the Region and within population groups in the countries; Reaffirming the basic human right of parents to decide freely and in a well-informed and responsible way the number and spacing of their children, and recognizing that this is an important means of preserving the health of mothers and children as wéll as the social and economic well-being of the family; Observing that national health policies and programs do not always take account of population dynamics and its relevance to countries' economic and social development; and Affirming the proposals contained in Document CE92/12, "Basis for the Definition of the Organization's Action Policy with Respect to Population Matters," presented by the Director, as a basis for improving the health and quality of life of mothers, children, and family units, 1. To strengthen the maternal and child health programs, taking into account their close relationship to the problems of population dynamics, towards achievement of the goal of health for all by the year 2000 and the need to reinforce action among less-favored high-risk groups in order to narrow the gap between different socioeconomic groups in society. 2. To urge the Member Governments to: a) Promote the full participation of all sectors of society in the formulation and implementation of population policies appropriate to their own development plans; b) Promote the conduct of studies on mortality, fertility, and other demographic variables, and to take prompt action to alleviate the problems so identified, not only in the field of health, but also in relation to other areas of sectoral development; c) Conduct research, and develop and train the human resources needed to implement effective family planning programs;

41 28 1. PROGRAM d) Ensure that demographic data are used to identify health problems associated with population growth and migration; define the needs for services; identify high-risk and other priority groups; and structure required services on the basis of need; e) Actively involve the health sector in the task of upgrading the quality of demographic data and vital statistics and in their analysis and use as a planning tool; f) Ensure that human reproduction programs and activities are made an integral part of maternal and child health, and that such programs reach out to the entire population, in order that parents can exercise, on an informed basis, the right to decide on the number and spacing of their children, and thereby reduce health risks associated with the reproductive process, and ensure that population growth is consistent with the countries' social and economic policies and development; g) Actively promote the dissemination of information and advice on family planning so as to keep the community informed and able to participate in decisions and activities related to the human reproductive process; h) Pay particular concern to the problem of adolescent pregnancy and promote the teaching of family life education to the young. 3. To request the Director to: a) Promote and support the participation of the health sector in formulating population and development policies; b) Strengthen the Organization's coordination efforts, in conjunction with agencies of the United Nations System and governmental and nongovernmental bodies, so as to devote the maximum of resources available to support of maternal and child health and family planning programs; c) Report on the progress made in these areas to the XXXI Meeting of the Directing Council. countries have made in the implementation of Resolution VIII 1 of the XXX Meeting of the Directing Council, "Basis for the Definition of the Organization's Action Policy with Respect to Population Matters," 1. To request the Member Governments: a) To continue their efforts to implement as quickly as possible the mandates unanimously adopted in the resolution on the "Basis for the Definition of the Organization's Action Policy with Respect to Population Matters"; b) To direct their efforts at overcoming the limiting factors identified in the Director's report. 2. To request the Director: a) To continue supporting the activities needed to carry out the measures begun during the period covered by the report, with special attention to those for the mobilization of resources and coordination of efforts at the national and international levels; b) To present a progress report to the meeting of the Directing Council in 'See p HEALTH OF ADULTS September 1985 OD 203, 62 see Volume II, page 71. Sept.-Oct OD 197, 40 CE95.R17 Having seen the report of the Director on maternal and child health and family planning programs (Document CE95/16), To recommend to the XXXI Meeting of the Directing Council that it adopt a resolution along the following lines: I June 1985 OD 202, 52 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD31.R18 below. CE95.R12 Having studied the report of the Director on the Health of Adults Program (Document CE95/3), prepared in compliance with a decision of the 92nd Meeting of the Executive Committee, To recommend to the XXXI Meeting of the Directing Council that it adopt a resolution along the following lines: 2 June 1985 OD 202, 47 'See PAHO Official Document 195 (1984), For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD31.R16 below. CD31.R18 Having examined the report of the Director (Document CD31/24) on the progress that the Organization and the CD31.R16 Having considered the report of the Director on the Health of Adults Program (Document CD31/21); Recognizing that changes in their population structures and health profiles have prompted many countries in the Region to take note of the growing priority of the health of adults and the elderly;

42 1.8 PROTECTION AND PROMOTION OF THE HEALTH OF SPECIFIC POPULATION GROUPS 29 Noting that the program presented gives particular emphasis to the prevention of harm and promotion of health, and to the importance of the area of health services and the integration approach in the setting of primary health care; and Considering that some Governments have already launched programs with this comprehensive approach to the design of measures for the promotion of health and the control of risk and injury factors, 1. To urge the Member Governments, in their health programs, to incorporate activities for the health care of adults, geared to the primary health care approach, into their general health services at all levels of care. 2. To recommend to the Member Governments that they publicize the decision to emphasize primary prevention and early detection work in this field, particularly activities relating to lifestyles, harmful habits, and exposure to environmental pollutants. 3. To encourage Member Governments that have already launched programs to share their knowledge of and experience in successful efforts with other countries, with the collaboration of the Pan American Sanitary Bureau. 4. To convey to the Director its satisfaction with the strategies and basic approaches of technical cooperation under the Health of Adults Program in general, and its subprograms in particular. 5. To request the Director to give due attention to the epidemiological component and the strategy of prevention and health promotion under the Program, and particularly to its comprehensive intra- and intersectoral approach. 6. To request the Director to impart new dynamism to the Organization's programs and activities in this program area as budgetary limitations permit, and to continue the efforts needed to obtain extrabudgetary funds. September 1985 OD 203, 59 Aware of the growing importance of making rehabilitation services accessible to all population sectors in need of them, 1. To thank the Director for the information supplied on progress attained in the Region since 1981, the International Year of Disabled Persons, regarding programs to address the health of disabled persons. 2. To urge the Member Governments to: a) Continue adopting policies and programs for the comprehensive protection and care of disabled persons and for the prevention of causes of disability; b) Give special emphasis in programs for disabled persons to the development of family and community-based rehabilitation technologies in the context of the primary health care strategy. 3. To request the Director to continue cooperating with the Member Governments in the adoption of those policies and programs for disabled persons, and to strengthen the cooperation, surveillance, and evaluation activities under the Regional Program for the Development of Health Services for Disabled Persons. 'See Vol. 1, p WOMEN, HEALTH AND DEVELOPMENT Sept.-Oct OD 197, 39 see Volume II, page WORKERS' HEALTH HEALTH OF THE DISABLED CD30.R7 see Volume II, page 71. Having seen the report on health of disabled persons (Document CD30/14) and Resolution XLIII,' "International Year of Disabled Persons, 1981" of the XXVIII Meeting of the Directing Council; Cognizant that since 1981 many Member Governments have made important progress in the establishment of programs for disabled persons; and CE90.R7 Noting that the Special Subcommittee on Women in Health and Development, in compliance with Resolution XXVII 1 of the XXI Pan American Sanitary Conference, met to monitor the program and review achievements; and Having reviewed the report of the Special Subcommittee on Women in Health and Development (Document CE90/5, Add. 1). To recommend to the XXIX Meeting of the Directing Council that it approve the following resolution: 2 June 1983 OD 190, 35 'See Vol. II, p For text recommended by the Executive Committee and adopted by the Directing Council after adding subparagraph g) to paragraph 1 of the operative part, see Resolution CD29.R22 below.

43 30 1. PROGRAM CD29.R22 Recognizing the important roles played by women both in the home and in the work place; Considering that the Organization is capable of providing greater leadership and guidance in the design and implementation of activities related to women in health and development; Concerned with the slow rate of progress achieved in the implementation of the Five-Year Regional Plan of Action on Women in Health and Development; and Recognizing that success in attaining the goals of the Five- Year Plan of Action largely depends on the full participation of the Member Countries, CE92.R9 Aware that the Special Subcommittee on Women, Health and Development, in compliance with Resolution XXVII l of the XXI Pan American Sanitary Conference, has met to evaluate the program and review its achievements; and Having reviewed the report of the Special Subcommittee, To recommend to the XXX Meeting of the Directing Council adoption of the following resolution: 2 June 1984 OD 195, To urge the Member Governments to: a) Establish more effective mechanisms for the promotion and recognition of women's roles in health and development; b) Strengthen national policies and programs for the protection and improvement of women's health both in the regulated and unregulated sectors of the economy, and particularly with regard to the health and safety of women in the workplace; c) Strengthen programs for the prevention, early detection, and treatment of diseases such as breast and cervical cancer, peculiar to women in their reproductive role; d) Increase the participation of nongovernmental and charitable organizations, as well as community groups that are concerned with women's issues, in the formulation of national health care goals, priorities, and programs; e) Create more opportunities for women to acquire the skills necessary for professional development, career advancement, and accession to posts of authority, especially in the health and social sectors: f) Establish mechanisms to identify and nominate more women for professional posts in the Organization; g) Enact legislation designed to guarantee equal rights for women. 2. To request the Director to: a) Accord a higher priority to the program for women in health and development; b) Promote the measures required to make available the human and financial resources needed to effectively carry out activities to achieve the goals of the Five-Year Regional Plan of Action on Women in Health and Development; c) Intensify efforts to identify and recruit suitable women candidates for consideration in the selection process for senior and professional posts in the Organization; d) Ensure that Country Representatives commit themselves to carrying out their functions as focal points for women in health and development in the countries, and thus make persistent efforts to accomplish the purposes of the program; e) Provide policy guidelines to the Member Governments and the Organization to assist in the implementation of the Five-Year Plan of Action; f) Ensure closer coordination of PAHO's activities on women in health and development with those of other national and international agencies concerned with women's issues. Sept.-Oct Ob 192, 68 'See Vol. 11, p For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD30.R6 below. CD30.R6 Considering the importance of the United Nations Decade for Women in securing recognition for their role in society in the countries of the Region and in the agencies of the United Nations System and other regional agencies; Considering, however, that to guarantee the improvement of the health status of women, recognition must be translated into concrete action based on the goals of the Five-Year Regional Plan of Action on Women, Health and Development; and Cognizant that these actions must continue beyond the end of the five-year period as an integral part of the strategies for attainment of the goal of health for all by the year 2000, 1. To urge the Member Governments to: a) Intensify their efforts to provide more educational opportunities for women, such as will contribute to their occupational development and give due recognition and support to their important contributions as providers and users of health care at all levels; b) Strengthen country women, health and development focal points and give them a part to play at the decision-making level and the resources and time they need to bring about adequate intersectoral coordination among the different government institutions and women's nongovernmental organizations; c) Enforce their laws on the protection of women's rights and have all discriminatory legislation rescinded. 2. To request the Director to: a) Continue giving priority to support for country activities in implementation of the Five-Year Plan and to the women, health and development program, and to continue efforts to facilitate exchanges of information and experience in this field among the Member Countries, and to encourage PAHO Country Representatives to meet regularly with the heads of national offices established by countries to address special issues relative to women;

44 1.8 PROTECTION AND PROMOTION OF THE HEALTH OF SPECIFIC POPULATION GROUPS 31 b) Provide special training in key areas so as to enable Taking into consideration that the Region's poorest segwomen to compete on an equal basis for senior positions in ments of urban and rural society are overrepresented by the Organization, and to establish targets for staffing profes- women, particularly those who have sole responsibility for sional and senior positions with women; children or who are aged and infirm; c) Continue specific support to the Special Subcommit- Reaffirming the continuing importance of all PAHO resotee on Women, Health and Development in the performance lutions dealing with women, health and development of its functions, and to facilitate for the countries represented (CSP19.R37, CD23.R10, CD24.R25, CD27.R17, on it the receipt of current information on the subject; CD28.R15, CSP21.R27 1, CD29.R22 2, CD30.R6 3 ), as well as d) Ensure that the goals and actions of the Five-Year Re- the most recent World Health Assembly resolution on the gional Plan of Action on Women, Health and Development subject (WHA ); continue to be pursued beyond 1985 and are fully integrated Commending the Director on the achievements thus far in into the Plan of Action for the implementation of the Re- collaboration with the Member Governments, the intergional Strategies for the attainment of the goal of health for agency cooperation, as well as the beginning of collaboration all by the year with the nongovernmental sector, particularly in health edu- Sept.-Oct OD 197, 38 cation; Further commending the Director for the notable progress in the establishment and development of women, health and development Focal Points in Member Countries and in PAHO, for the help and encouragement of the Regional Focal Point through field visits, workshops and seminars, for the important paper on cervical cancer, and on the recent publication 5 on the health of women in the Americas; Realizing that at the end of the Decade significant efforts are required to improve the health status of women and to enhance their effective participation in health care in the Re- CE95.R8 g Furthermore, recognizing that the women, health and de- Aware that the Special Subcommittee on Women, Health velopment goals and activities remain an integral part of the and Development, in compliance with Resolution XXVII l of regional strategies to attain health for all by the year 2000 the XXI Pan American Sanitary Conference, has met to and, indeed, that its attainment is impossible without womevaluate the program and review its achievements; and en's active participation as agents and beneficiaries; and Having reviewed the report of the Special Subcommittee Acknowledging that the Forward-Looking Strategies reon Women, Health and Development, cently articulated by WHO and more generally stated at the 1985 World Conference on Women require regional inter- pretation and implementation, To recommend to the XXXI Meeting of the Directing Council that it adopt a resolution along the following lines: June 1985 OD 202, 44 tsee Vol. II, p For text recommended by the Executive Committee and adopted by the Directing Council, after amending subparagraph 2 a) ii) of the operative part, see Resolution CD31.R14 below. CD31.R14 Acknowledging that the International Decade for Women has revealed that women's health is an important determinant of national development and that a nation's health is also dependent upon women's development, particularly in the sectors of health, education and employment; Recognizing that women represent approximately 80% of all health care providers in the majority of countries of the Region, but are still underrepresented at policy, planning and decision-making levels; 1. To urge the Member Governments: a) To review, reaffirm and renew their commitment to the goals of women, health and development which address the physical and mental health needs of women in their productive and reproductive roles in the context of socioeconomic development and adopt effective action plans based on the Forward-Looking Strategies as well as the Regional Strategies to achieve health for all by the year 2000; b) To recognize the actual and potential contributions of women to the health sector and to overall socioeconomic development by working systematically to integrate women into all levels of health planning, organization and delivery of health care; c) To strengthen the capacities of women, health and development Focal Points to stimulate appropriate action and to monitor and report on progress attained. 2. To request that the Director: a) Reaffirm PAHO's commitment to carrying out the continuing mandates of the Organization related to women, health and development and the Forward-Looking Strategies by: i) Providing full support for the Regional Program on Women, Health and Development as an integral part of PAHO's overall responsibilities, and ensuring that PAHO's programs focus clearly on women's health needs and contributions;

45 32 1. PROGRAM PROGRAM ii) Stimulating education for women as users and providers of health and, in coordination with other international organizations, encouraging Member Governments to assist women to overcome obstacles to the fulfillment of their roles in the health sector; iii) Developing regional forward-looking strategies and guidelines for action to be integrated into short-term plans, medium-term plans, and long-term plans for women, health and development as part of the regional strategies to achieve health for all by the year 2000; b) Convene the Special Subcommittee on Women, Health and Development once a year to monitor progress, to propose solutions to problems identified and to promote concerted action on women, health and development. 3. To recommend to the Executive Committee that it expand the membership of its Special Subcommittee on Women, Health and Development from three to five members for the purpose of broadening representation from the subregions of the Region of the Americas. September 1985 OD 203, 57 Having reviewed the report of the Special Subcommittee on Women, Health and Development and the proposed Regional Forward-Looking Strategies on Women, Health and Development (Document CE97/12 and Add. 1), 1. To transmit the proposed Regional Forward-Looking Strategies on Women, Health and Development to the XXII Pan American Sanitary Conference. 2. To recommend to the XXII Pan American Sanitary Conference that it adopt a resolution along the following lines: 2 June 1986 OD 211, 96 'See p For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference, see Resolution CSP22.R12 below. 'The resolutions mentioned here appear in Vol. II, pp See p. 30. 'Ibid. 4 Document WHA38/1985/REC/1, See PAHO Scientific Publication 488 (1985). CE96.R1 Recognizing that the membership of the Special Subcommittee of the Executive Committee on Women, Health and Development should be more representative of all the subregions of the Region of the Americas; and Complying with a recommendation made in Resolution XIVI of the XXXI Meeting of the Directing Council, To increase from three to five the number of members of the Special Subcommittee of the Executive Committee on Women, Health and Development. 'See p. 31. CE97.R3 September 1985 OD 206, 8 Acknowledging that the Special Subcommittee on Women, Health and Development, in compliance with Resolution XIV' of the XXXI Meeting of the Directing Council, has met to monitor progress, propose solutions and promote concerted action on women, health and development; and The XXII Pan American Sanitary Confer- CSP22.R12 ence, Having reviewed the Regional Forward-Looking Strategies on Women, Health and Development prepared by the Special Subcommittee on Women, Health and Development and endorsed by the 97th Meeting of the Executive Committee; Reaffirming the commitment of the Member Countries and the UN specialized agencies to the "Forward-Looking Strategies for the Advancement of Women to the Year 2000" adopted by consensus at the World Conference on Women in Nairobi, in particular paragraphs 148 to 162; Noting and supporting Resolution WHA of the World Health Assembly which endorses the Forward-Looking Strategies, advocates cooperation with other UN organizations in the implementation of the Strategies, and requests a report to the Fortieth World Health Assembly on activities undertaken to implement the Strategies; Reaffirming the importance of all previous PAHO resolutions on Women, Health and Development, especially Resolution XIV 3 of the XXXI Meeting of the Directing Council, which requests the Director of PASB to elaborate Regional Forward-Looking Strategies to be integrated into plans of action on women, health and development as part of the health for all by the year 2000 strategies; Reiterating that women's active participation as agents and beneficiaries is crucial to the attainment of health for all by the year 2000 in this Region and that the Women, Health and Development Program is an integral component of these efforts; and Reaffirming the urgent need to improve the health of women in the Region and their access to quality health care, 1. To approve the Regional Forward-Looking Strategies on Women, Health and Development proposed by the 97th Meeting of the Executive Committee.

46 1.9 TRAINING OFHEALTH PERSONNEL TRAINING OF HEALTH PERSONNEL To urge the Member Countries: a) to develop specific plans of action on women, health and development for the next five years ( ) based on the proposed Forward-Looking Strategies; b) to strengthen national focal points on women, health and development by delegating authority to them and providing them with the resources needed to best carry out their functions; c) to ensure collaboration of interdisciplinary and intersectoral bodies in the implementation of national plans of action on women, health and development; d) to make maximum efforts to improve women's health conditions, giving special emphasis to: i) reducing the unacceptably high maternal mortality rates that still exist within many Member Countries; ii) strengthening efforts to reduce cancer mortality in women; iii) reducing the specific health risks of working women through workers' health programs; and iv) improving conditions affecting women's mental health; e) to ensure that health services meet women's needs and to improve their access to health care; f) to establish mechanisms for improved collaboration with nongovernmental organizations especially for women in developing activities on women, health and development. 3. To request the Director: a) to reaffirm PAHO's commitment to the Regional Program on Women, Health and Development, taking the actions necessary to implement the Regional Forward-Looking Strategies, paying special attention to the following actions: i) strengthening the Program's focal points in the PAHO Country Offices; ii) establishing mechanisms for exchanging experiences among national focal points; iii) strengthening existing support mechanisms in the Organization for implementation of the Women, Health and Development Program; iv) increasing mobilization of the resources required for the implementation of the proposed strategies; and v) stimulating collaboration with other agencies to coordinate activities and mobilize additional resources; b) to prepare a regional contribution to the progress report requested by the World Health Assembly in its Resolution WHA39.18, taking into consideration the strategies proposed by the Executive Committee and the most recent report submitted by the Special Subcommittee on Women, Health and Development; c) to establish a panel of experts in the Region to assist PAHO and the Member Governments in the implementation of the Regional Forward-Looking Strategies; d) to encourage a more equal participation of women on all PASB committees; e) to develop a plan to reach the target of 30% representation of women in professional and higher posts in PAHO. 'See Resolution CE97.R3, p Document WHA39/1986/REC/1, 18. JSee p. 31. September 1986 OD 211, TRAINING OF HEALTH PERSONNEL see Volume 1, page 81 and Volume II, page FELLOWSHIPS TEXTBOOK PROGRAM see Volume 1, page 84 and Volume II, page 79. see Volume 1, page 89 and Volume II, page 79.

47 34 1. PROGRAM PROGRAM 1.10 RESEARCH PROMOTION AND DEVELOPMENT see Volume I, page 96 and Volume II, page 82. CD29.R29 Having examined the report of the PAHO Advisory Committee on Medical Research 1 to the Director; and Having noted with interest the description of PAHO's research policy as presented by the Advisory Committee, 1. To commend the PAHO Advisory Committee on Medical Research for its report. 2. To take note of the concerns of the Committee in respect of the problems facing research and researchers in Latin America. 3. To ask the Director to implement the recommendations of the Committee to the extent possible within the resources of the Organization. 'Advisory Committee on Health Research. Sept.-Oct OD 192, REGIONAL CENTERS see Volume I, page 96 and Volume II, page 83. CE95.R23 Having seen the report of the Director on policy guidelines for the Pan American Centers (Document CE95/11), and having requested the PASB to revise Document CE95/11 prior to its presentation to the XXXI Meeting of the Directing Council to reflect the views and concerns expressed at the 95th Meeting of the Executive Committee, To recommend to the XXXI Meeting of the Directing Council adoption of a resolution along the following lines: l June 1985 OD 202, 57 'For text recommended by the Executive Committee and adopted by the Directing Council, after amending paragraph 1 of the operative part, see Resolution CD31.R24 below. CD31.R24 Noting that the XVIII 1 and XX 2 Pan American Sanitary Conferences drew up general guidelines for the establishment and operation of multinational centers; Recognizing that the Pan American Centers are integral components of the respective PAHO programs and constitute an effective mechanism for combining the functions of advisory services, teaching, research, and dissemination of information in accordance with the needs of the countries; Considering that the Pan American Centers are justified for fulfilling specific activities until such time as the countries and/or national institutions acquire the technical and institutional capacity for carrying out the corresponding functions whereby the Centers would no longer be needed; Considering the need to improve efficiency and obtain maximum use of resources; and Noting the contents of the Director's report and the progress made to date on these matters, especially in the Pan American Zoonoses Center (Document CD31/10), 1. To request the Director to continue to take appropriate actions to improve the cost effectiveness and efficiency of Centers in the use of available resources, including the establishment of new administrative and personnel systems at the Pan American Centers. 2. To confirm the Organization's long-term goal of working towards the transfer of the administration of the Centers to host countries, if and when national institutions are able to maintain the quality and quantity of services provided to Member Countries under existing administrative arrangements. 3. To ask the Director to report to the next meeting of the Directing Council on actions taken and progress made on this matter. 'Resolution XXXIII. Vol. 1, p Resolution XXXI. Vol. II, p. 84. September 1985 OD 203, 68

48 1.11 REGIONAL CENTERS PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER see Volume 1, page 98 and Volume II, page 86. See also Section PAN AMERICAN ZOONOSES CENTER see Volume 1, page 101 and Volume II, page 90. See also Section To approve PAHO's continued support to INCAP by temporarily assuming responsibility for the administration of the Institute and, subsequently, appointing its Director and Administrator. 3. To recommend the provision of this administrative support under the Basic Agreement of December 1953 and the new regulations approved by the INCAP Council, and in accordance with the administrative arrangements for the restructuring of the Institute in the spirit of Resolution XXIV of the XXI Pan American Sanitary Conference. 4. To direct that this support of PAHO be provided until such time as the INCAP Council of the Governing Bodies of PAHO. decide otherwise. 5. To request the Director to continue the support of PAHO to the operations of INCAP so that it will effectively accomplish its purposes and discharge its responsibilities to its Member Countries toward the provision of improved levels of food and nutrition for their population. 'Resolution CSP21.R24. See Vol. II, p. 94. Sept.-Oct OD 192, INSTITUTE OF NUTRITION OF CENTRAL AMERICA AND PANAMA see Volume I, page 102 and Volume II, page PAN AMERICAN CENTER FOR HEALTH PLANNING CD29.R27 Having examined Document CD29/17 and Add. I on the technical and administrative restructuring of the Institute of Nutrition of Central America and Panama (INCAP); Bearing in mind Resolutions III, VII, and VIII approved by the INCAP Council in its XXXIV Meeting, held in Panama City on 19 August 1983; Noting the progress made in restructuring the Institute in its scientific and technical aspects and in its administration; Bearing in mind that the INCAP Council has requested that the Institute continue to be administered by PAHO under the Basic Agreement signed in December 1953 and in accordance with the new administrative regulations and arrangements approved by the INCAP Council, which were noted by the XXI Pan American Sanitary Conferencel; and Considering that temporary support of the request by the INCAP Council is justified, while maintaining the Organization's policy of working toward a gradual assumption of the administration of Centers by their member countries in the near future, 1. To take note of Resolutions VII and VIII of the XXXIV Meeting of the INCAP Council concerning the restructuring of the Institute. see Volume 1, page 55 and Volume II, page PAN AMERICAN CENTER FOR SANITARY ENGINEERING AND ENVIRONMENTAL SCIENCES see Volume II, page CARIBBEAN FOOD AND NUTRITION INSTITUTE see Volume II1, page 97.

49 36 1. PROGRAM PROGRAM PAN AMERICAN CENTER FOR HUMAN ECOLOGY AND HEALTH see Volume II,' page LATIN AMERICAN CENTER FOR PERINATOLOGY AND HUMAN DEVELOPMENT see Volume II, page 99. CD29.R28 Having seen the report on the evaluation of the Pan American Center for Human Ecology and Health (ECO) (Document CD29/25); Considering the provisions of Resolution XXXII of the XX Pan American Sanitary Conference (1978); and Aware of the growing importance of evaluating and dealing with the health problems deriving from environmental pollution, particularly from industrial and agricultural sources, 1. To take note of the external evaluation report on the Pan American Center for Human Ecology and Health (ECO) and to thank the Member Governments that participated in the evaluation process. 2. To thank the Government of Mexico for the constant support it has given to ECO in generous aid and readiness to enable the Center to perform its functions, and to request that this support continue. 3. To commend and thank the Government of Mexico for its decision to provide the physical facilities needed to relocate ECO in the metropolitan area of Mexico City. 4. To request the Member Governments to identify and support the development of national institutions to form with ECO a network of collaborating centers in the Region for the promotion of training, exchange of information, and programs of applied research in the area of human ecology and health. 5. To thank the Director for communicating the report and recommendations of the Evaluation Group to the Directing Council. 6. To request that the Director implement, as the available resources allow, the first option recommended by the Evaluation Group, which is to consolidate ECO as a center capable of meeting the needs presented by the Organization's Member Countries, and that ECO's technical program be focused on the epidemiological and toxicological aspects of the effects on health of the principal chemical pollutants of industrial and agricultural origin. 7. To request the Director to intensify the Organization's efforts to coordinate and complement the work of this Center with that of the Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS) in order to avoid possible duplications of effort between them. 'See Vol. 11, p. 84. Sept.-Oct OD 192, PAN AMERICAN CENTER FOR RESEARCH AND TRAINING IN LEPROSY AND TROPICAL DISEASES see Volume 11, page CARIBBEAN EPIDEMIOLOGY CENTER see Volume 1, page 104 and Volume II, page LATIN AMERICAN AND CARIBBEAN CENTER FOR HEALTH SCIENCES INFORMATION (before REGIONAL LIBRARY OF MEDICINE AND THE HEALTH SCIENCES) see Volume 1, page 96 and Volume II, page OTHER CENTERS (including LATIN AMERICAN CENTER FOR EDUCATIONAL TECHNOLOGY IN HEALTH) see Volume I, page 104 and Volume II, page 102.

50 1.12 HEALTH INFORMATION HEALTH INFORMATION 37 CE90.R20 Having examined the report on the evaluation of the Latin American Center for Educational Technology in Health (CLATES) (Document CE90/18), To recommend to the XXIX Meeting of the Directing Council that it approve a resolution couched in the following terms: 1 June 1983 OD 190, 47 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R25 below. CD29.R25 Having examined the report presented by the Director on the evaluation of the Latin American Center for Educational Technology in Health (CLATES) (Document CD29/16); Noting with satisfaction the intense work done by the Center for Educational Technology in Health (NUTES) of Rio de Janeiro Federal University; and Considering further the spread of activities in this field throughout the Region, 1. To recognize the success of the Latin American Center for Educational Technology in Health and commend the Pan American Health Organization for its achievement. 2. To take note of and express appreciation for the support that the Government of Brazil has given to the Latin American Center for Educational Technology in Health. 3. To terminate CLATES on 31 December 1983 while continuing the support being provided to NUTES and to activities for educational technology at the regional and national levels. Sept.-Oct OD 192, HEALTH INFORMATION HEALTH STATISTICS REPORTS see Volume I, page 66. see Volume 1, page PAHO PUBLICATIONS AND DOCUMENTATION SERVICES see Volume 1, page Reports of the Directing Council see Volume 1, page HEALTH LEGISLATION see Volume I, page Annual and Quadrennial Reports of the Director see Volume 1, pages 105 and 106 and Volume II, pages 104 and 105.

51 38 1. PROGRAM CD29.R8 Having examined the Annual Report of the Director of the Pan American Sanitary Bureau for 1982 (Document CD29/ 4); and Bearing in mind the provisions of Article 9.C of the Constitution of the Pan American Health Organization, 1. To take note of the Annual Report of the Director of the Pan American Sanitary Bureau for To commend the Director of the Pan American Sanitary Bureau for the work accomplished by PAHO during the period covered by the Report. CD30.R4 Sept.-Oct OD 192, 54 Having examined the Annual Report of the Director of the Pan American Sanitary Bureau for 1983 (Official Document 196); and Bearing in mind the provisions of Article 9.C of the Constitution of the Pan American Health Organization, 1. To take note of the Annual Report of the Director of the Pan American Sanitary Bureau for To commend the Director of the Pan American Sanitary Bureau for the new format and organization of the Report, which facilitates better understanding of the work accomplished by PAHO during the period covered. 3. To thank the Director for his leadership and support to the Member Governments in the health programs and activities conducted during the past year. CD31.R4 Sept.-Oct OD 197, 37 Having seen the Annual Report of the Director of the Pan American Sanitary Bureau for 1984 (Official Document 201); Bearing in mind the provisions of Article 9.C of the Constitution of the Pan American Health Organization; and Noting with satisfaction the new changes and adjustments in the Report's structure and content, such as: in Part I, the analysis of the regional situation, the critical problems of the health sector and the approaches being followed to overcome them; in Part III, the description of those steps taken by Member Governments and by the Secretariat in 1984 to implement the resolutions approved by the Governing Bodies in 1983 as well as the responsibilities for both Member Governments and the Secretariat stemming from key resolutions approved in 1984; and in Part V, the identification of essential information regarding levels of health in each country, together with pertinent data on external resource mobilization, 1. To take note of the Annual Report of the Director of the Pan American Sanitary Bureau for To commend the Director for his continued efforts to transform his report into an instrument which can assist in the evaluation of the country/paho joint programming. 3. To thank the Director for his leadership and support to the Member Governments in the health programs and activities conducted by PAHO during CSP22.R7 September 1985 OD 203, 46 The XXII Pan American Sanitary Conference, Having seen the Annual Report, 1985, and Quadrennial Report, , of the Director of the Pan American Sanitary Bureau (Official Document 207) on the work of PAHO during the interval between the XXI and XXII Pan American Sanitary Conferences; Considering that the crisis of the countries in Latin America and the Caribbean profoundly affects the health status of their peoples, and the solutions proposed hitherto have been primarily economic in nature, and have given insufficient attention to the social sector; Recognizing that the countries face a considerable challenge in the need to upgrade their public administration systems, especially those in the health sector, so that they will function more effectively by using available resources more efficiently; Aware that the crisis affecting the international cooperation agencies is rooted in policy changes in the approach to external cooperation on the part of the leading contributing or donor countries, as well as in deficiencies of the internal management of the international agencies and in how their cooperation is provided to Member Countries; Considering that in the last four years the Secretariat has made important efforts to cope with the aforementioned problems under the guidance of the working principles laid down in its Regional Program Budget Policy and in the Managerial Strategy for the Optimum Use of PAHO/WHO Resources in Direct Support of Member Countries; and Recognizing that these efforts have been expressed in subregional initiatives on health priorities, in an increase of contacts among countries and institutions, in more effective and substantive mobilization of internal and external resources, and in adjustments within the Secretariat to enhance its efficiency, 1. To urge the Member Countries to redouble their efforts to define national policies and priorities for the serious problems of coverage in the health field, inefficient use of resources, and the inequity and high cost of medical care systems, so that the Organization may direct its resources toward measures of highest impact in the advancement of health toward the goal of health for all. 2. To thank the Director of the PASB for the important report on activities in the quadrennium , which attests to the great magnitude of the effort made by the Secretariat to overhaul the operations of PAHO and adjust them to the present situation, while seeking new forms of technical cooperation.

52 1.12 HEALTH INFORMATION HEALTH INFORMATION To recommend to the Director that he continue his efforts at the highest national and international policy levels to bring about real recognition of the importance of social development as an essential component of economic growth, and therefore of the need to integrate the social sector, and especially health, into overall development plans. 4. To recommend to the Director that the work be continued for development of the Secretariat as a necessary condition for increasing the efficient use of its resources, highlighting as fundamental purposes the strengthening of the planning, programming, monitoring and evaluation system; the deepening of relations with the governments and of their participation in the affairs of the Organization; the improvement of its administrative systems; and modernization of the policies and systems for use of the Organization's own manpower. 5. To request the Director to continue improving the structure and content of his Report so that it may become a fundamental element in evaluating the operations of the Bureau and the Organization. September 1986 OD 211, Annual Reports of the Chairman of the Executive Committeel see Volume I, page 106 and Volume II, page 105. Bearing in mind the provisions of Article 9. C of the Constitution of the Pan American Health Organization, 1. To take note of the Annual Report of the Chairman of the Executive Committee (Document CD30/3, Add. I, and Corrig.). 2. To congratulate the Chairman and the other members of the Committee on their excellent work. CD31.R3 Sept.-Oct OD 197, 44 Having seen the Annual Report of the Chairman of the Executive Committee (Document CD31/5 and Corrig.) on the work of the Committee from October 1984 to date, the period during which the 94th and 95th Meetings were held; and Bearing in mind the provisions of Article 9.C of the Constitution of the Pan American Health Organization, 1. To take note of the Annual Report of the Chairman of the Executive Committee (Document CD31/5 and Corrig.). 2. To congratulate the Chairman and the other members of the Committee on their excellent work. September 1985 OD 203, 45 CD29.R7 Having examined the Annual Report of the Chairman of the Executive Committee (Document CD29/5) on the work of the Committee from October 1982 to date, the period during which the 89th and 90th Meetings were held; and Bearing in mind the provisions of Article 9.C of the Constitution of the Pan American Health Organization, 1. To take note of the Annual Report of the Chairman of the Executive Committee (Document CD29/5). 2. To congratulate the Chairman and the other members and observers of the Committee on their excellent work. Sept.-Oct OD 192, 54 CSP22.R5 The XXII Pan American Sanitary Conference, Having seen the Annual Report of the Chairman of the Executive Committee (Document CSP22/5) on the work of the Committee from September 1985 to date, the period during which the 96th and 97th Meetings were held; and Bearing in mind the provisions of Article 9. C of the Constitution of the Pan American Health Organization, 1. To take note of the Annual Report of the Chairman of the Executive Committee (Document CSP22/5). 2. To congratulate the Chairman and the other members of the Committee on their excellent work. September 1986 OD 211, Reports of the Governments CD30.R12 Having examined the Annual Report of the Chairman of the Executive Committee (Document CD30/3, Add. I, and Corrig.) on the work of the Committee from October 1983 to date, the period during which the 91st, 92nd, and 93rd Meetings were held; and 'For list of Chairmen of the Executive Committee, see Section 3.3. CE90.R19 see Volume I, pages 107 and 108 and Volume II, page 106. Having seen the document presented by the Director on this subject (Document CE90/6),

53 40 1. PROGRAM To recommend to the XXIX Meeting of the Directing Council that it approve the following resolution:' June 1983 OD 190, 46 'For text recommended by the Executive Committee and adopted by the Directing Cou ncil. see Resolution CD29.R1 below. CD29.R1 Having examined the document on this subject presented by the Director (Document CD29/21); Mindful of the observations made on this matter during the XXI Pan American Sanitary Conference; Considering that the existing information on health conditions and progress in improving them in the countries of the Americas is steadily increasing and is more closely related to the goals and objectives of the Organization and its Member Governments; and Cognizant of the financial burden to the Governments of sending delegations to Pan American Sanitary Conferences, 1. To suggest to the XXII Pan American Sanitary Conference that it adopt the following guidelines on this matter: a) Request that the Member Governments present in writing their reports to the Pan American Sanitary Conference on health conditions and progress made in the intervals between the Conferences; b) Determine that those reports shall not exceed six double-spaced typewritten pages, for inclusion in extenso in the verbatim records of the Conference; c) Establish that the delegations will also have an opportunity, during the discussion of the Director's Quadrennial Report, to take the floor for no longer than 10 minutes, and that to do so they must register in advance with the Officers of the Meeting, the President of the Conference enforcing compliance with this rule; d) Urge the delegates that, in addition to complying with rules a), b), and c) above, they distribute their own printed matter on this subject to the other delegations, in the understanding that the shipment, reproduction, translation, and printing of those materials shall be the exclusive responsibility of the Member Governments. 2. To establish that Member Governments wishing to make general presentations on health conditions in their countries during the meetings of the Directing Council should adhere to the following rules: a) Presentations should be typed double-spaced on not more than six pages for inclusion in extenso in the summary records; b) Delegations wili also have an opportunity to take the floor for no longer than 10 minutes, and to do so they must register in advance with the Officers of the Meeting. 3. To request that the Director establish an automatic mechanism to enable the Officers of the Pan American Sanitary Conference and the Directing Council to monitor the time allowed each speaker. Sept.-Oct OD 192, WHO Expert Committee Reports see Volume I, page SUPPLIES AND EQUIPMENT see Volume 1, page 110 and Volume II, page 108.

54 2. PROGRAM AND BUDGET See also Section (Assessments and Contributions). 2.1 BUDGET POLICY see Volume I, page 113 and Volume II, page 110. CE90.R4 Considering Document CE90/17, which examined the question of the distribution of the financial resources of PAHO, the presentation by the Working Group which prepared that document, and the ensuing discussion; and Bearing in mind Resolutions XVI of the XXVIII Meeting of the Directing Council and XIV' of the XXI Pan American Sanitary Conference, which requested the Director to study the allocation of PAHO budget resources among Member Countries, 1. To recommend to Member Countries that they continue examining the study recommendations prior to the XXIX Meeting of the Directing Council. 2. To recommend to the XXIX Meeting of the Directing Council that it adopt the following resolution: 2 June 1983 OD 190, 32 'See Vol. II, pp. 131 and 132, respectively. 2 For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R3 below. CD29.R3 Having considered Document CD29/15 on the distribution of the financial resources of PAHO, and having heard the presentation by the Executive Committee; Bearing in mind Resolutions XVI of the XXVIII Meeting of the Directing Council and XIV' of the XXI Pan American Sanitary Conference, which request the Director to study the allocation of PAHO budget resources among Member Countries; and Noting the recommendations made by the 90th Meeting of the Executive Committee, 1. To note the report on the distribution of the financial resources of PAHO (Document CD29/15). 2. To thank the Director and the Working Group for the detailed and illuminating study and the Executive Committee for its careful review of this matter. 3. To urge the Director to take into account the recommendations contained in the study and the observations made during the discussions of the Executive Committee for establishing planning ceilings for the country program budget, including the importance of regional and national priorities as expressed in the Regional Strategies and the Plan of Action to attain the goal of health for all by the year 2000, governmental commitment, the absorptive capacity of the national administrations, and special situations, in addition to the appropriate quantitative indicators. 4. To urge the Director to continue to examine this question periodically, and particularly to review, with the participation of the Member Countries, the appropriate factors in light of the different and changing circumstances within the Region. 5. To ask the Director to include in the report on the program budget to the 94th Meeting of the Executive Committee an analysis of the impact of this study on the 41

55 42 2. PROGRAM AND BUDGFT PROGRAM AND BUDGET distribution of resources contained within that proposed budget. ISee Vol. 11, pp. 131 and 132, respectively. CE95.Rll Sept.-Oct OD 192, 51 Having examined Document CE95/24, Add. I on the regional program budget policy; Bearing in mind Resolution XV' of the 92nd Meeting of the Executive Committee, which supported the Managerial Strategy for the Optimum Use of PAHO/WHO Resources in Direct Support of Member Countries; Considering Resolution EB75.R7 2 of the 75th Meeting of the Executive Board of the World Health Organization, calling for the preparation of regional program budget policies, and Resolution WHA of the Thirty-eighth World Health Assembly, which strongly supported the preparation of such policies by the regional committees; and Taking into consideration the discussion of the Subcommittee on Planning and Programming and the comments and suggestions made by this Executive Committee, 1. To express its appreciation to the Director for the preparation of the regional program budget policy and for submitting it to the Governing Bodies for their examination and review. 2. To declare its overall support for the general approach and specific concepts contained within that policy statement, which will constitute an important step forward in the Organization's efforts to assure the optimum use of PAHO/WHO resources. 3. To recommend that the Director revise the document in response to comments of the Executive Committee and present the new text to the XXXI Meeting of the Directing Council for its consideration and approval. 'See p Document EB75/1985/REC/1, 6-7. YDocument WHA38/1985/REC/1, 8-9. June 1985 OD 202, 47 CD31.R10O Having seen Document CD31/29 on the regional program budget policy; Bearing in mind Resolution XV I of the 92nd Meeting of the Executive Committee which supported the Managerial Strategy for the Optimum Use of PAHO/WHO Resources in Direct Support of Member Countries; Considering Resolution EB75.R7 2 of the 75th Meeting of the Executive Board of the World Health Organization, calling for the preparation of regional program budget policies, and Resolution WHA of the Thirty-eighth World Health Assembly, which strongly supported the preparation of such policies by the Regional Committee; and Taking into consideration Resolution XI 4 of the 95th Meeting of the Executive Committee, 1. To express its appreciation to the Director for the preparation of the regional program budget policy and for submitting it to the Governing Bodies for their examination and review. 2. To approve the regional program budget policy (Document CD31/29) and to urge its immediate implementation. 3. To request Member Governments to study the regional program budget policy and to participate actively in its implementation. 4. To request the Director to submit the regional program budget policy to the Executive Board of the World Health Organization. 5. To request the Director to provide wide distribution of the regional program budget policy through the Organization and to discuss with Member Governments immediate actions for its implementation. 6. To request the Director to report to the Governing Bodies on its implementation in relation to the execution of the Program Budget and to the preparation of the Program Budget. 'See p Document EB75/1985/REC/I, 6-7. 'Document WHA38/1985/REC/1, See this page. September 1985 OD 203, CONSIDERATION AND APPROVAL OF THE PROGRAM AND BUDGET For Fiscal Years 1947 through 1971, see Volume 1, pages , and for 1972 through 1985, see Volume II, pages

56 2.2 CONSIDERATIION AND APPROVAL OF THE PROGRAM AND BUDGET CNSIDEATIONANO APRO VL OF HE PRGRAM ND BUGET FOR CD29.R23 The Directing Council CE90.R8 1. PAHO ( ) see Volume II, page 131. Bearing in mind Resolution IV of the 86th Meeting of the Executive Committee, Resolution XVI of the XXVIII Meeting of the Directing Council, Resolution XVII of the 88th Meeting of the Executive Committee, and Resolution XIV' of the XXI Pan American Sanitary Conference; Considering that the provisional draft of the program budget has been the subject of further study by the Governments and of consultations with them to determine their latest desires and requirements; Having carefully examined the proposed program budget of the Pan American Health Organization for the biennium (Official Document 187); Considering the recommendations and suggestions, contained in the records of this meeting, made by this Executive Committee concerning the format of Official Document 187 and the programs contained therein; Recognizing that the contribution by the Government of Argentina for support of the Pan American Zoonoses Center continues under negotiation; Taking into consideration the estimate made by the Director that $2 million may be available in Miscellaneous Income in addition to the $2,800,000 contained in the original proposal; and Bearing in mind Article 14.C of the Constitution of the Pan American Health Organization and Article III, paragraphs 3.5 and 3.6, of the PAHO Financial Regulations, 1. To express appreciation to the Director and his staff for the impressive presentation of the proposed program budget for and for the informative responses to questions of the Executive Committee. 2. To recommend to the XXIX Meeting of the Directing Council that it approve the proposed program budget of the Pan American Health Organization for the biennium , with an effective working budget of $104,320,000, by adopting the corresponding appropriation and assessment resolutions. 3. To recommend that the appropriation be financed by assessments to Member and Participating Governments as well as $4,800,000 in Miscellaneous Income. 4. To urge the Director to continue to refine the budget proposals, taking into account the recommendations and suggestions made by the Executive Committee in the revision of Official Document 187, for presentation to the XXIX Meeting of the Directing Council. ISee Vol. II, pp June 1983 OD 190, To appropriate for the financial period an amount of US$115,554,700 as follows: Part I: Direction, Coordination, and Management... $ 17,548,400 Part II: Health System Infrastructure... 35,937,500 Part III: Health Science and Technology-Health Promotion and Care... 18,359,600 Part IV: Health Science and Technology-Disease Prevention and Control... 16,154,700 Part V: Program Support... 15,958,800 Effective Working Budget (Parts I-V)... $103,959,000 Part VI: Staff Assessment (Transfer to Tax Equalization Fund)... 11,595,700 Total- All Parts... $115,554, That the appropriation shall be financed from: a) Assessments in respect to: Member Governments and Participating Governments assessed under the scales adopted by the Organization of American States in accordance with Article 60 of the Pan American Sanitary Code or in accordance with Directing Council and Pan American Sanitary Conference resolutions... $110,754 L,700 b) Miscellaneous Income... 4,80( )0,000 Total... $115,554,700 In establishing the contributions of Member Governments and Participating Governments, their assessments shall be reduced further by the amount standing to their credit in the Tax Equalization Fund, except that credits of those countries who levy taxes on the emoluments received from the Pan American Health Organization by their nationals and residents shall be reduced by the amounts of such tax reimbursements by PAHO. 3. That, in accordance with the Financial Regulations of PAHO, amounts not exceeding the appropriations noted under paragraph 1 shall be available for the payment of obligations incurred during the period 1 January 1984 to 31 December 1985, inclusive. Notwithstanding the provision of this paragraph, obligations during the financial period shall be limited to the effective working budget, i.e., Parts I-V. 4. That the Director shall be authorized to transfer credits between parts of the effective working budget, provided that such transfer of credits between parts as are made do not exceed 10% of the part from which the credit is transferred. Transfers of credits between parts of the budget in excess of 10% of the part from which the credit is transferred may be made with the concurrence of the Executive Committee. All transfers of budget credits shall be reported to the Directing Council or the Conference. Sept.-Oct OD 192, 70

57 44 2. PROGRAM AND BUDGET PROGRAM AND BUDGET FOR WHO Regional ( ) 1. PAHO ( ) see Volume II, page 132. Part 1: Part II: Part III: Part IV: Part V: Part VI: Direction, Coordination, and Management... Health System Infrastructure.. Health Science and Technology-Health Promotion and Care... Health Science and Technology-Disease Prevention and Control... Program Support... Effective Working Budget (Parts I-V)... Staff Assessment (Transfer to Tax Equalization Fund)... $ 15,996,300 40,439,000 20,950,500 15,643,900 19,454,300 $112,484,000 15,544,600 Total-All Parts... $128,028,600,k. CE95.R6 Having considered the report of the Subcommittee on Planning and Programming (Document CE95/9); Having examined the proposed program budget of the Pan American Health Organization for the biennium contained in Official Document 199; Considering the recommendations and suggestions, contained in the records of this meeting, made by this Executive Committee concerning the format of Official Document 199 and the programs contained therein; and Bearing in mind Article 14.C of the Constitution of the Pan American Health Organization and Article III, paragraphs 3.5 and 3.6, of the PAHO Financial Regulations, 1. To thank the Subcommittee on Planning and Programming for its preliminary review of and report on the proposed program budget. 2. To express appreciation to the Director and his staff for the informative presentation of the proposed program budget for To compliment the Director for his efforts in restraining overall budget increases while, at the same time, proposing overall program growth in the country programs through the combined PAHO and WHO regular program budgets. 4. To request the Director to continue to refine the program proposals, taking into account the recommendations and suggestions made by the Executive Committee, in the revision of Official Document 199 for presentation to the XXXI Meeting of the Directing Council. 5. To recommend to the XXXI Meeting of the Directing Council that it approve the proposed program budget of the Pan American Health Organization for the biennium , with an effective working budget of $112,484,000, by adopting the corresponding appropriation and assessment resolutions. CD31.R8 The Directing Council June 1985 OD 202, To appropriate for the financial period an amount of US$128,028,600, as follows: 2. That the appropriation shall be financed from: a) Assessments in respect to: Member and Participating Governments assessed under the scales adopted by the Organization of American States in accordance with Article 60 of the Pan American Sanitary Code or in accordance with Directing Council and Pan American Sanitary Conference resolutions... $123,228, 600 b) Miscellaneous Income... 4,800, 000 Total... $128,028,600 In establishing the contributions of Member and Participating Governments, their assessments shall be reduced further by the amount standing to their credit in the Tax Equalization Fund, except that credits of those countries which levy taxes on the emoluments received from the Pan American Health Organization by their nationals and residents shall be reduced by the amounts of such tax reimbursements by PAHO. 3. That, in accordance with the Financial Regulations of PAHO, amounts not exceeding the appropriations noted under paragraph 1 shall be available for the payment of obligations incurred during the period 1 January 1986 to 31 December 1987, inclusive. Notwithstanding the provision of this paragraph, obligations during the financial period shall be limited to the effective working budget, i.e., Parts I-V. 4. That the Director shall be authorized to transfer credits between parts of the effective working budget, provided that such transfers of credits between parts as are made do not exceed 10% of the part from which the credit is transferred. Transfers of credits between parts of the budget in excess of 10% of the part from which the credit is transferred may be made with the concurrence of the Executive Committee. All transfers of budget credits shall be reported to the Directing Council and/or the Conference. 5. That the Director increase progressively the relative allocation of resources to the country programs. September 1985 OD 203, 49

58 2.2 CONSIDERATION AND APPROVAL OF THE PROGRAM AND BUDGET 45 CE93.R1 2. WHO Regional ( ) Having considered Document CE93/2 pertaining to the tentative projection of $58,076,000 of the World Health Organization's funding for the Region of the Americas for the biennium ; Noting that, within the tentative projection, a subprogram has been established in the Regional Director's Development Program for Country Activities to give the Organization greater flexibility in responding to unexpected changes in the situations of Member Countries which affect the cost of the programs and to support those countries that are making genuine efforts to fulfill their obligations by carrying out the policies and strategies they have adopted collectively; and Noting that the proposed amount of $58,076,000 is $484,000 less than the original $58,560,000 regional allocation, To recommend to the XXX Meeting of the Directing Council, XXXVI Meeting of the Regional Committee of the World Health Organization for the Americas, that it adopt the following resolution:' 3. To request the Director-General, when formulating his budget, to take into account the views of Member Countries expressed in the Meeting of the Regional Committee for the Americas. 'See this page FOR Sept.-Oct OD 197, PAHO ( )1 'PAHO's budget for the financial period will be discussed during the meetings of the Governing Bodies in WHO Regional ( ) September 1984 OD 202, 5 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD30.R13 below. CD30.R13 Having considered Resolution I of the 93rd Meeting of the Executive Committeel and the tentative modified projection of $58,076,000 of the World Health Organization's funding for the Region of the Americas for the biennium ; and Noting that the proposed amount of $58,076,000 is $484,000 less than the original $58,560,000 regional allocation, 1. To recommend to the Director-General of the World Health Organization the modified proposed provisional distribution of the $58,076,000 program budget for the Region of the Americas. 2. To request the Director-General to consider the possibility of providing increased support to the program budget in the amount of $484,000 in order to support the Regional Director's Development Program for Country Activities, which is being established to give the Organization greater flexibility in responding to unexpected changes in the situations of Member Countries which affect the cost of the programs, and to support those countries that are making genuine efforts to fulfill their obligations by carrying out the policies and strategies they have adopted collectively. CE97.R7 Having considered Document CE97/25, Rev. 1, which contains a tentative request for US$62,970,900 from the World Health Organization for the Region of the Americas for the biennium ; and Bearing in mind the tentative regular program budget proposal for PAHO/WHO for the biennium contained in tables I-VI of Document CE97/25, Rev. 1, and the regional program budget policy which asserts that the fundamental priority of the Organization remains the countries' programs, whose overall allocation shall not be less than 35% of the total PAHO/WHO regular program budget, 1. To thank the Director for presenting to the 97th Meeting of the Executive Committee a tentative PAHO/WHO regular program budget proposal for the biennium which includes a 5 % real increase in the funds allocated to country programs (35.8% of the total), while at the same time proposing no overall real program growth. 2. To recommend to the XXII Pan American Sanitary Conference, XXXVIII Meeting of the Regional Committee of WHO for the Americas, that it approve the tentative regular program budget for the biennium by adopting a resolution along the following lines:' June 1986 OD 211, 103 lfor text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference, see Resolution CSP22.R6 below.

59 46 2. PROGRAM AND BUDGET CSP22.R6 The XXII Pan American Sanitary Conference, Having considered Document CSP22/20 and the tentative request for US$62,970,900 from the World Health Organization for the Region of the Americas for the biennium , that includes an estimated cost increase of 8.8%; and Noting the recommendation I made by the 97th Meeting of the Executive Committee, To request the Director to transmit to the Director-General of WHO the request for US$62,970,900 for the Region of the Americas for the biennium for consideration by the WHO Executive Board and the World Health Assembly. September 1986 OD 211, See Resolution CE97.R7, p

60 3. GOVERNING BODIES OF PAHO' see Volume 1, page PAN AMERICAN SANITARY CONFERENCE see Volume 1, page 155 and Volume II, page 134. The Pan American Sanitary Conference has served as Regional Committee of the World Health Organizationfor the Americas since 1July 1949, the date on which the Agreement between WHO and PAHO entered into effect. PRESIDENTS OF THE PAN AMERICAN SANITARY CONFERENCE TIME AND PLACE XI Conference (September 1942) XII Conference (January 1947) XIII Conference (October 1950) XIV Conference (October 1954) X V Conference (September-October 1958) XVI Conference (August-September 1962) XVII Conference (September-October 1966) XVIII Conference (September-October 1970) XIX Conference (September-October 1974) XX Conference (September-October 1978) XXI Conference (September 1982) XXII Conference (September 1986) DR. JOAO DE BARROS BARRETO Brazil DR. EDMUNDO FERNÁNDEZ Venezuela DR. MANUEL A. ROBIOU Dominican Republic DR. SERGIO ALTAMIRANO P. Chile DR. GUILLERMO ARBONA United States of America DR. JosÉ ALVAREZ AMÉZQUITA Mexico DR. ANTONIO ORDÓÑEZ PLAJA Colombia DR. JosÉ RENÁN ESQUlVEL Panama DR. ENRIQUE AGUILAR PAZ Honduras DR. HERBERT J. PREUDHOMME Grenada DR. GASPAR GARCÍA DE PAREDES Panama MR. JAKE EPP Canada 'See also complete reference list of meetings of the Governing Bodies of PAHO, Vol. I, p. xv, Vol. II, p. xii, and this volume p. xii. CE97.R1 see Volume 1, page 156 and Volume II, page 134. Considering that the Director has proposed the dates September 1986 for the XXII Pan American Sanitary Conference, XXXVIII Meeting of the Regional Committee of WHO for the Americas; and Bearing in mind Article 7.A of the Constitution of the Pan American Health Organization, To authorize the Director to convoke the XXII Pan American Sanitary Conference, XXXVIII Meeting of the Regional Committee of WHO for the Americas, to meet at the Headquarters building in Washington, D.C., from 22 to 30 September June 1986 OD 211, 95 47

61 48 3. GOVERNING BODIES OF PAHO 48 3.GVRIGBDE FPH RULES OF PROCEDURE l see Volume 1, page 159 and Volume II, page 135. only in even years is not approved, it adopt the following resolution:' June 1983 OD 190, 38 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R12 below AGENDA CE97.R2 see Volume 1, page 161 and Volume II, page 136. Having studied the provisional agenda (Document CSP22/1) of the XXII Pan American Sanitary Conference, XXXVIII Meeting of the Regional Committee of WHO for the Americas, drawn up by the Director and presented as annex to Document CE97/4; and In view of Article 7.F of the PAHO Constitution and Rule 6 of the Rules of Procedure of the Conference, To approve the provisional agenda (Document CSP22/1) of the XXII Pan American Sanitary Conference, XXXVIII Meeting of the Regional Committee of WHO for the Americas TECHNICAL DISCUSSIONS CE90.R10 June 1986 OD 211, 96 see Volume 1, page 162 and Volume II, page 137. Having seen the document presented by the Director on this topic (Document CE90/21); Mindful of the provisions of Rule 7 of the Rules for Technical Discussions; and In view of the proposal that Technical Discussions be held only in even years, in which there are no proposed biennial budgets to be approved, To recommend to the XXIX Meeting of the Directing Council that, if the proposal to hold Technical Discussions 'The text of the Rules of Procedure of the Conference appears in Basic Documents of the Pan A merican Health Organization, PAHO Official Document 188 (1983), CD29.R12 Mindful that the 90th Meeting of the Executive Committee recommended "Workers' Health" ' as the topic for the Technical Discussions in 1985; Having decided (Resolution VI) 2 that Technical Discussions are to be held only in even years; and Desirous that Technical Discussions be held on so important a subject, To declare "Workers' Health" selected as the topic for the Technical Discussions to be held in 1986 during the XXII Pan American Sanitary Conference. 'See Resolution CE90.R10 on this page. 2 See this page. CE90.R14 Sept.-Oct OD 192, 57 Having examined the study on the holding of Technical Discussions during meetings of the Directing Council and the Pan American Sanitary Conference (Document CE90/20) prepared in compliance with Resolution XXVII of the XXI Pan American Sanitary Conference; and Aware of the need to enable the Governing Bodies to give all necessary time to the study and approval of the proposed biennial program budgets of the Pan American Health Organization, without detriment to the interest and importance that must attach to the holding of Technical Discussions of the highest quality, To request the XXIX Meeting of the Directing Council to approve the following resolution: 2 June 1983 OD 190, 42 'See Vol. 11, p For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R6 below. CD29.R6 Having examined the study on the holding of Technical Discussions during meetings of the Directing Council and the Pan American Sanitary Conference, prepared in compliance with Resolution XXVI I of the XXI Pan American Sanitary Conference (Document CD29/8);

62 3.2 DIRECTING COUNCIL DIRECTING COUNCIL 49 Aware of the need to enable the Governing Bodies to give all necessary time to the study and approval of the proposed biennial program budgets of the Pan American Health Organization, without detriment to the interest and importance that must attach to the holding of Technical Discussions of the highest quality; and Bearing in mind Resolution XIV 2 of the 90th Meeting of the Executive Committee, 1. That no Technical Discussions are to be held during meetings of the Directing Council or Pan American Sanitary Conference in which the proposed program budget of the Pan American Health Organization is to be studied and approved. 2. That Technical Discussions are to open with a statement on the chosen topic, prepared by a group of experts of established standing in the subject. 3. That the duration of Technical Discussions is to be limited to the working hours of the Saturday of the first week of the meeting. 'See Vol. II, p lsee p. 48. Sept.-Oct OD 192, 53 CD31.R15 Having seen the Director's report on the holding of Technical Discussions during meetings of the Governing Bodies (Document CD31/12); Considering that the Technical Discussions are held during the meetings of the Governing Bodies in the years in which the Organization's biennial program budget is not discussed; Aware of a downtrend in the number of persons attending the Technical Discussions, even in 1984, when they were held on the Friday and Saturday of the first week of the meeting of the Directing Council; and Mindful that there are more efficient and less costly arrangements for exchanges of technical information on priority public health matters, 1. To suspend, starting in 1986, the holding of Technical Discussions during meetings of the Pan American Sanitary Conference and the Directing Council. 2. To request the Director to use other arrangements for exchanges of technical information in the most efficient way possible. September 1985 OD 203, DIRECTING COUNCIL see Volume 1, page 165 and Volume II, page 139. The Pan American Sanitary Conference, through the Directing Council, has served as the Regional Office of the World Health Organizationfor the Americas since 1July 1949, when the Agreement between PAHO and WHO came into effect. I Meeting (September 1947) II Meeting (October 1948) PRESIDENTS OF THE DIRECTING COUNCIL III Meeting (October 1949) I V Meeting (September 1950) V Meeting (September-October 1951) VI Meeting (September 1952) VII Meeting (October 1953) DR. ALBERTO ZWANCK Argentina DR. IGNACIO MORONES PRIETO Mexico DR. ANIBAL ALVAREZ LÓPEZ Peru DR. RICARDO CAPPELETTI Uruguay DR. NACIANCENO ROMERO Chile DR. CARLOS LUIS GONZÁLEZ Venezuela DR. HERNÁN URZÚA Chile VIII Meeting (September 1955) IX Meeting (September 1956) X Meeting (September 1957) XI Meeting (September 1959) XII Meeting (August 1960) XIII Meeting (October 1961) XI V Meeting (September 1963) XV Meeting (August-September 1964) DR. HÉCTOR A. COLL Argentina DR. CARLOS SOZA BARILLAS Guatemala DR. ALBERTO BISSOT, JR. Panama MR. HUMBERTO OLIVERO Guatemala DR. JOSÉ MACHADO VENTURA Cuba DR. LUTHER L. TERRY United States of America DR. JAVIER ARIAS ESTRELLA Peru DR. JOSé ALVAREZ AMÉZQUITA Mexico

63 50 3. GOVERNING BODIES OF PAHO GOVERNING BODIES OF PAHO XVI Meeting (September-October 1965) XVII Meeting (October 1967) XVIII Meeting (October 1968) XIX Meeting (September-October 1969) XX Meeting (September-October 1971) XXI Meeting (October 1972) XXII Meeting (October 1973) XXIII Meeting (September-October 1975) XXIV Meeting (September-October 1976) XX V Meeting (September-October 1977) XX VI Meeting (September-October 1979) XX VII Meeting (September-October 1980) XX VIII Meeting (September-October 1981) XXIX Meeting (September-October 1983) XXX Meeting (September-October 1984) XXXI Meeting (September-October 1985) DR. RAYMUNDO DE BRITTO Brazil DR. MAXWELL P. AWON Trinidad and Tobago DR. EZEQUIEL HOLMBERG Argentina DR. SYLVIA TALBOT Guyana DR. JESSE L. STEINFELD United States of America DR. JUAN CONCHA GUTIÉRREZ Chile DR. R. A. CHAPMAN Canada DR. ABRAHAM SAIED Panama DR. GINÉS NAVARRO DíAZ DE LEÓN Mexico MR. ADÁN CAJINA Ríos Nicaragua DR. HUMBERTO GARCIA BARRIOS Venezuela DR. ROQUELINO RECINO MÉNDEZ Guatemala DR. MIGUEL COELLO FERNÁNDEZ Ecuador DR. HORACIO RODRIGUEZ CASTELLS Argentina DR. JUAN FRANCO PONCE Peru DR. KENNETH BAUGH Jamaica Mindful of the wish expressed by the Representatives of the Member Governments to shorten the meetings of the Governing Bodies as much as possible without detriment to the important work done in them, 1. To authorize the Director to convoke the XXIX Meeting of the Directing Council of PAHO, XXXV Meeting of the Regional Committee of WHO for the Americas, to meet at the Headquarters building in Washington, D.C., from 26 September to 7 October To urge the XXIX Meeting of the Directing Council to seek suitable ways of shortening the meetings of the Governing Bodies without detriment to the work done in them. CE92.R6 June 1983 OD 190, 38 Considering that the Director has proposed the dates 24 September-2 October 1984 for the XXX Meeting of the Directing Council of PAHO, XXXVI Meeting of the Regional Committee of WHO for the Americas; and Bearing in mind Articles 12.A and 14.A of the Constitution of the Pan American Health Organization and Rule 1 of the Rules of Procedure of the Directing Council, To authorize the Director to convoke the XXX Meeting of the Directing Council of PAHO, XXXVI Meeting of the Regional Committee of WHO for the Americas, to meet at the Headquarters building in Washington, D.C., from 24 September to 2 October June 1984 OD 195, TIME AND PLACE CE90.R9 see Volume 1, page 165 and Volume II, page 140. Considering that the Director has proposed the dates 26 September-7 October 1983 for the XXIX Meeting of the Directing Council of PAHO, XXXV Meeting of the Regional Committee of WHO for the Americas; Bearing in mind Articles 12.A and 14.A of the Constitution of the Pan American Health Organization and Rule 1 of the Rules of Procedure of the Directing Council; and CE95.R9 Considering that the Director has proposed the dates 23 September-2 October 1985 for the XXXI Meeting of the Directing Council of PAHO, XXXVII Meeting of the Regional Committee of WHO for the Americas; and Bearing in mind Articles 12.A and 14.A of the Constitution of the Pan American Health Organization and Rule 1 of the Rules of Procedure of the Directing Council, To authorize the Director to convoke the XXXI Meeting of the Directing Council of PAHO, XXXVII Meeting of the Regional Committee of WHO for the Americas, to meet at the Headquarters building in Washington, D.C., from 23 September to 2 October June 1985 OD 202, 46

64 3.2 DIRECTING COUNCIL DIRECTING COUNCIL RULES OF PROCEDURE' see Volume 1, page 168 and Volume II, page 142. To approve the provisional agenda (Document CD31/1) prepared by the Director for the XXXI Meeting of the Directing Council of PAHO, XXXVII Meeting of the Regional Committee of WHO for the Americas, with the two additional items proposed by Brazil on hepatitis B and on the control and eradication of Aedes aegypti. June 1985 OD 202, AGENDA CE90.R6 see Volume 1, page 172 and Volume II, page 144. Having examined the provisional agenda (Document CD29/1) prepared by the Director for the XXIX Meeting of the Directing Council of PAHO, XXXV Meeting of the Regional Committee of WHO for the Americas, presented as Annex to Document CE90/8, Rev. 1; and Bearing in mind the provisions of Article 12.C of the Constitution of the Pan American Health Organization and Rule 7 of the Rules of Procedure of the Directing Council, To approve the provisional agenda (Document CD29/1) prepared by the Director for the XXIX Meeting of the Directing Council of PAHO, XXXV Meeting of the Regional Committee of WHO for the Americas, with the addition of a new item "The Role of Nursing Personnel in Primary Health Care." June 1983 OD 190, TECHNICAL DISCUSSIONS CE90.R10 see Volume 1, page 173 and Volume II, page 145. Having seen the document presented by the Director on this topic (Document CE90/21); Mindful of the provisions of Rule 7 of the Rules for Technical Discussions; and In view of the proposal that Technical Discussions be held only in even years, in which there are no proposed biennial budgets to be approved, To recommend to the XXIX Meeting of the Directing Council that, if the proposal to hold Technical Discussions only in even years is not approved, it adopt the following resolution: 1 June 1983 OD 190, 38 Note: The 92nd Meeting of the Executive Committee, in its sixth plenary session (held 27 June 1984), decided to approve the provisional agenda (Document CD31/1) prepared by the Director for the XXX Meeting of the Directing Council of PAHO, XXXVI Meeting of the Regional Committee of WHO for the Americas, after the introduction of several modifications proposed during the discussion of this matter, but did not approve a resolution in that regard. CE95.R10 Having examined the provisional agenda (Document CD31/1) prepared by the Director for the XXXI Meeting of the Directing Council of PAHO, XXXVII Meeting of the Regional Committee of WHO for the Americas, presented as Annex to Document CE95/7, Rev. 1; and Bearing in mind the provisions of Article 12.C of the Constitution of the Pan American Health Organization and Rule 7 of the Rules of Procedure of the Directing Council, 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R12 below. CD29.R12 Mindful that the 90th Meeting of the Executive Committee recommended "Workers' Health"' as the topic for the Technical Discussion in 1985; Having decided (Resolution VI) 2 that Technical Discussions are to be held only in even years; and Desirous that Technical Discussions be held on so important a subject, To declare "Workers' Health" selected as the topic for the Technical Discussions to be held in 1986 during the XXII Pan American Sanitary Conference. Sept.-Oct OD 192, 57 'The text of the Rules of Procedure of the Directing Council appears in Basic Documents of the Pan American Health Organization, PAHO Official Document 188 (1983), 'See Resolution CE90.R10 on this page. 2See p. 52.

65 52 3. GOVERNING BODIES OF PAHO GOVERNING BODIES OF PAHO CE90.R14 Having examined the study on the holding of Technical Discussions during meetings of the Directing Council and the Pan American Sanitary Conference (Document CE90/20) prepared in compliance with Resolution XXVI' of the XXI Pan American Sanitary Conference; and Aware of the need to enable the Governing Bodies to give all necessary time to the study and approval of the proposed biennial program budgets of the Pan American Health Organization, without detriment to the interest and importance that must attach to the holding of Technical Discussions of the highest quality, To request the XXIX Meeting of the Directing Council to approve the following resolution:' June 1983 OD 190, 42 'See Vol. II, p For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R6 below. CD29.R6 Having examined the study on the holding of Technical Discussions during meetings of the Directing Council and the Pan American Sanitary Conference, prepared in compliance with Resolution XXVI 1 of the XXI Pan American Sanitary Conference (Document CD29/8); Aware of the need to enable the Governing Bodies to give all necessary time to the study and approval of the proposed biennial program budgets of the Pan American Health Organization, without detriment to the interest and importance that must attach to the holding of Technical Discussions of the highest quality; and Bearing in mind Resolution XIV 2 of the 90th Meeting of the Executive Committee, 1. That no Technical Discussions are to be held during meetings of the Directing Council or Pan American Sanitary Conference in which the proposed program budget of the Pan American Health Organization is to be studied and approved. 2. That Technical Discussions are to open with a statement on the chosen topic, prepared by a group of experts of established standing in the subject. 3. That the duration of Technical Discussions is to be limited to the working hours of the Saturday of the first week of the meeting. 'See Vol. I1, p See this page. Sept.-Oct OD 192, 53 CD29.R30 Having examined the Report of the Technical Discussions (Document CD29/DT/4) held during the Council Meeting, which had before it Document CD29/DT/1; l Aware of the importance of ensuring the availability of essential drugs to all sectors of the population and of the need to identify appropriate administrative, technical, and financial mechanisms to achieve this goal; Recalling Resolutions WHA31.32 and WHA of the World Health Assembly and Resolution XXVII 3 of the XX Pan American Sanitary Conference, which recommended that Member Countries develop comprehensive national drug policies; and Noting the restrictions and costs associated with the research, development, and production of drugs and the transfer of appropriate technology to the developing world, 1. To urge Member Governments that have not done so to date to develop intersectoral drug policies linked to priority health needs. 2. To call upon Member Governments to evaluate present production, marketing, quality control, and supply practices with a view to introducing improvements that will permit a reasonable degree of self-sufficiency, control costs, improve distribution channels, and promote appropriate use of drugs. 3. To request the Director to provide, as budgetary resources permit, technical and financial assistance in establishing, in keeping with the recommendations formulated in the Report of the Technical Discussions, a cooperation program at the regional, subregional, and national levels, with a view to advising the Member Governments in all matters relating to the implementation of drug policies and programs. 4. To urge the Director to explore with bilateral and multilateral organizations, foundations, and other private institutions, including pharmaceutical companies and their associations, the possibility of providing the assistance required for the policies and programs referred to in paragraph To request the Director to present to the XXXI Meeting of the Directing Council a report on the progress of the implementation of the Organization's essential drug program. Sept.-Oct OD 192, 78 'See PAHO Scientific Publication 462 (1984). 'WHO Official Records 247 (1978), 20, and Document WHA35/ 1982/REC/1, 21. 'See Vol. II, p. 38. CD30.R18 Having examined the Report on the Technical Discussions on increasing the operational capacity of the health services for the attainment of the goal of health for all by the year 2000 (Document CD30/DT/2); 1 Cognizant that both the regional strategies for health for all by the year 2000, approved by the XXVII Meeting of the Directing Council, 2 and the Plan of Action for the implementation of regional strategies, approved by the XXVIII

66 3.3 EXECUTIVE COMMITTEE EXECUTIVE COMMITTEE 53 Meeting of the Directing Council, 3 attach critical importance to strengthening the operational capacity of health services; Aware of the restricted economic conditions and the growing challenges to the Member Governments to provide quality services equitably to all the population; and Concerned about the political implications of the widening gap between the growing needs and expectations of the population and the financial resources available for health care, 1. To take note of the Report on the Technical Discussions and to express its appreciation to the participants. 2. To recommend to the Member Governments that: a) In formulating health policy, they assign priority to aspects aimed at achieving equitable conditions for the population, especially the high-risk groups; b) They take steps to revise the financing structure of the services and to establish the actual composition of health expenditure and to increase the productivity of the sector; c) They promote research on the functions assigned to the various categories of health personnel, in order to revise and adjust the policies for the training and use of such personnel in health programs and institutions; d) They take steps to introduce managerial and technological innovations designed to make the health services more effective; e) They provide opportunities for the communities and the political structures that represent them to participate effectively in decisions relating to health. 3. To recommend to the Director that he: a) Take the necessary steps to promote and support the actions recommended above to the Member Governments; b) Foster and support an exchange of views and promote the development of operating arrangements for effective technical cooperation among the countries of the Region for increasing the operational capacity of health services. 'See PAHO Scientific Publication 482 (1985). 2 Resolution CD27.R20. See Vol. II, pp SResolution CD28.Rll. See Vol. II, p. 8. CD31.R15 Sept.-Oct OD 197, 50 Having seen the Director's report on the holding of Technical Discussions during meetings of the Governing Bodies (Document CD31/12); Considering that the Technical Discussions are held during the meetings of the Governing Bodies in the years in which the Organization's biennial program budget is not discussed; Aware of a downtrend in the number of persons attending the Technical Discussions, even in 1984, when they were held on the Friday and Saturday of the first week of the meeting of the Directing Council; and Mindful that there are more efficient and less costly arrangements for exchanges of technical information on priority public health matters, 1. To suspend, starting in 1986, the holding of Technical Discussions during meetings of the Pan American Sanitary Conference and the Directing Council. 2. To request the Director to use other arrangements for exchanges of technical information in the most efficient way possible. September 1985 OD 203, EXECUTIVE COMMITTEE see Volume I, page 179 and Volume II, page 152. CHAIRMEN OF THE EXECUTIVE COMMITTEE 1st Meeting (April-May 1947) 2nd Meeting (September 1947) 3rd Meeting (October 1947) 4th Meeting (May 1948) 5th Meeting (October 1948) DR. THOMAS H. PARRAN United States of America DR. THOMAS H. PARRAN United States of America DR. HÉCTOR PRAGUER FRÓES Brazil DR. HÉCTOR PRAGUER FRÓES Brazil DR. IGNACIO MORONES PRIETO Mexico 6th Meeting (October 1948) 7th Meeting (May 1949) 8th Meeting (October 1949) 9th Meeting (October 1949) loth Meeting (April 1950) DR. IGNACIO MORONES PRIETO Mexico DR. GUSTAVO ARGIL Mexico DR. ALBERTO ZWANCK Argentina DR. ALBERTO ZWANCK Argentina DR. ALBERTO ZWANCK Argentina

67 54 3. GOVERNING BODIES OFPAHO 54 3.GOVERING BDIES F PAH llth Meeting (September 1950) 12th Meeting (October 1950) 13th Meeting (April 1951) 14th Meeting (September 1951) 15th Meeting (October 1951) 16th Meeting (April 1952) 17th Meeting (September 1952) 18th Meeting (September 1952) 19th Meeting (April 1953) 20th Meeting (October 1953) 21st Meeting (October 1953) 22nd Meeting (April 1954) 23rd Meeting (October 1954) 24th Meeting (October 1954) 25th Meeting (April-May 1955) 26th Meeting (September 1955) 27th Meeting (September 1955) 28th Meeting (June 1956) 29th Meeting (September 1956) 30th Meeting (September 1956) 31st Meeting (June 1957) 32nd Meeting (September 1957) 33rd Meeting (September 1957) 34th Meeting (May 1958) 35th Meeting (September 1958) 36th Meeting (October 1958) 37th Meeting (May 1959) 38th Meeting (September 1959) 39th Meeting (September 1959) 40th Meeting (April 1960) 41st Meeting (August 1960) 42nd Meeting (August 1960) DR. JUAN ALLWOOD PAREDES El Salvador DR. JUAN ALLWOOD PAREDES El Salvador DR. Luis F. GALICH Guatemala DR. H. VAN ZILE HYDE United States of America DR. H. VAN ZILE HYDE United States of America DR. NACIANCENO ROMERO Chile DR. FELIPE GARCIA SÁNCHEZ Mexico DR. FELIPE GARCíA SÁNCHEZ Mexico DR. JUAN A. MONTALVÁN Ecuador DR. JosÉ ZOZAYA Mexico DR. ALMIR DE CASTRO Brazil DR. GERARDO SEGURA Argentina DR. JoSÉ ZOZAYA Mexico DR. ENRIQUE ZACARíAS ARZA Paraguay DR. ALBERTO BISSOT, JR. Panama DR. FREDERICK J. BRADY United States of America DR. JORGE JIMÉNEZ GANDICA Colombia DR. JORGE JIMÉNEZ GANDICA Colombia DR. JORGE JIMÉNEZ GANDICA Colombia DR. FÉLIX HURTADO Cuba DR. FÉLIX HURTADO Cuba DR. FÉLIX HURTADO Cuba ENG. HUMBERTO OLIVERO Guatemala ENG. HUMBERTO OLIVERO Guatemala ENG. HUMBERTO OLIVERO Guatemala DR. CARLOS DiAZ COLLER Mexico DR. MIGUEL E. Mexico DR. MIGUEL E. Mexico BUSTAMENTE BUSTAMENTE DR. BICHAT RODRIGUES Brazil DR. BICHAT RODRIGUES Brazil DR. Luls PATIÑO-CAMARGO Colombia DR. ELLIOT Ross JENNEY United States of America 43rd Meeting (May 1961) 44th Meeting (October 1961) 45th Meeting (October 1961) 46th Meeting (April 1962) 47th Meeting (September 1962) 48th Meeting (April 1963) 49th Meeting (September 1963) 50th Meeting (Aprii-May 1964) 51st Meeting (September 1964) 52nd Meeting (April 1965) 53rd Meeting (October 1965) 54th Meeting (April 1966) 55th Meeting (October 1966) 56th Meeting (April-May 1967) 57th Meeting (September 1967) 58th Meeting (October 1967) 59th Meeting (July 1968) 60th Meeting (October 1968) 61st Meeting (June-July 1969) 62nd Meeting (September 1969) 63rd Meeting (October 1969) 64th Meeting (June-July 1970) 65th Meeting (October 1970) 66th Meeting (July 1971) 67th Meeting (October 1971) 68th Meeting (July 1972) 69th Meeting (October 1972) 70th Meeting (July-August 1973) 71st Meeting (October 1973) 72nd Meeting (July 1974) 73rd Meeting (October 1974) DR. ELLIOT Ross JENNEY United States of America DR. JAMES WATT United States of America DR. JAMES WATT United States of America DR. VICTORIO V. OLGUíN Argentina DR. FRANCISCO URCUYO MALIANO Nicaragua DR. LEONARDO BRAVO Chile DR. CARLOS QUIRÓS SALINAS Peru DR. CARLOS QUIRÓS SALINAS Peru DR. CHARLES L. WILLIAMS, JR. United States of America DR. CHARLES L. WILLIAMS, JR. United States of America DR. MANOEL JOSÉ FERREIRA Brazil DR. MANOEL JosÉ FERREIRA Brazil DR. ALBERTO E. CALVO Panama DR. ALBERTO E. CALVO Panama DR. ALBERTO E. CALVO Panama DR. ROBERTO ACOSTA BORRERO Colombia DR. GUILLERMO MOLINA DEFRANC Ecuador DR. ORONTES AVILÉS Nicaragua DR. ORONTES AVILÉS Nicaragua DR. ORONTES AVILÉS Nicaragua DR. VICTORIO V. OLGUíN Argentina DR. VICTORIO V. OLGUíN Argentina DR. ROGELIO VALLADARES Venezuela DR. ROGELIO VALLADARES Venezuela DR. BALTAZAR CARAVEDO Peru DR. BALTAZAR CARAVEDO Peru DR. HUGO V. ALQUÉRES BAPTISTA Brazil DR. ALIX THÉARD Haiti DR. EDUARDO ENZO GALARETTO Argentina DR. EVERARDO GONZÁLEZ GÁLVEZ Panama DR. ROBERTO PEREDA CHÁVEZ Cuba

68 3.3 EXECUTIVE COMMITTEE EXECUTIVE COMMITTEE 55 74th Meeting (June-July 1975) 75th Meeting (October 1975) 76th Meeting (June 1976) 77th Meeting (October 1976) 78th Meeting (June 1977) 79th Meeting (October 1977) 80th Meeting (June-July 1978) 81st Meeting (October 1978) 82nd Meeting (june-july 1979) 83rd Meeting (October 1979) 84th Meeting (June 1980) 85th Meeting (October 1980) 86th Meeting (une 1981) 87th Meeting (October 1981) 88th Meeting (June 1982) 89th Meeting (September 1982) 90th Meeting (une 1983) 91st Meeting (October 1983) 92nd Meeting (June 1984) 93rd Meeting (September 1984) 94th Meeting (October 1984) 95th Meeting (une 1985) 96th Meeting (September 1985) 97th Meeting (June 1986) 98th Meeting (September 1986) DR. ROBERTO PEREDA CHÁVEZ Cuba DR. ORONTES AVILÉS Nicaragua DR. ORONTES AVILÉS Nicaragua DR. GUSTAVO MORA PATIÑO Colombia DR. GUSTAVO MORA PATIÑO Colombia DR. RUBÉN M. CÁCERES Paraguay DR. RUBÉN M. CÁCERES Paraguay MR. MICHEL CAREAU Canada MR. MICHEL CAREAU Canada MR. MICHEL CAREAU Canada MR. MICHEL CAREAU Canada DR. RAMÓN ALVAREZ GUTIÉRREZ Mexico DR. RAMÓN ALVAREZ GUTIÉRREZ Mexico DR. MANUEL BORGOÑO DOMíNGUEZ Chile DR. MANUEL BORGOÑO DOMíNGUEZ Chile Ms. LEA GUIDO Nicaragua Ms. LEA GUIDO Nicaragua DR. ARMANDO LÓPEZ SCAVINO Uruguay DR. ARMANDO LÓPEZ SCAVINO Uruguay DR. ABELARDO RAMíREZ Cuba DR. VIRGILIO MACíAS MURILLO Ecuador DR. VIRGILIO MACÍAS MURILLO Ecuador DR. NORMAN GAY Bahamas DR. NORMAN GAY Bahamas DR. NORMAN GAY Bahamas MEMBERSHIP see Volume I, page 181 and Volume II, page 155. [CD29.R19] The Directing Council elected Canada, Costa Rica, and Dominica to the Executive Committee upon termination of the periods of office of Argentina, Jamaica, and Nicaragua, and thanked the Governments of these countries for the seri'ces rendered to the Organization by their representatives on the Committee. Sept.-Oct OD 192, 64 [CD30.RII] The Directing Council elected Brazil, Colombia, and Honduras to the Executive Committee upon termination of the periods of office of the Dominican Republic, Panama, and Uruguay, and thanked the Governments of these countriesfor the services rendered to the Organization by their representatives on the Committee. Sept.-Oct OD 197, 43 [CD31.R7] The Directing Council elected Argentina, Bahamas, and Mexico to the Executive Committee upon termination of the periods of office of Cuba, Ecuador, and the United States of America, and thanked the Governments of these countriesfor the services rendered to the Organization by their representatives on the Committee. Sept OD 203, 48 [CSP22.R10] The XXII Pan American Sanitary Conference elected Ecuador, Saint Lucia, and the United States of America to the Executive Committee upon termination of the periods of office of Canada, Costa Rica, and Dominica, and thanked the Governments of these countriesfor the services rendered to the Organization by their representatives on the Committee. Sept OD 211, 137

69 56 3. GOVERNING BODIES OF PAHO COMPOSITION OF THE EXECUTIVE COMMITTEE FROM 193 TO 1987' TIME AND PLACE ANTIGUA AND BARBUDA ARGENTINA BAHAMAS BARBADOS BELIZE BOLIVIA BRAZIL CANADA CHILE COLOMBIA COSTA RICA CUBA DOMINICA TERMS COUNTRY FROM FROM FROM FROM OCT. U3 OCT. 14 OCT. ams OCT. IU TO TO TO TO OCT. 1U4 OCT 1US OCT. U OCT. ti7 DOMINICAN REPUBLIC ECUADOR //////// EL SALVADOR GRENADA GUATEMALA GUYANA HAITI HONDURAS _ JAMAICA MEXICO // /////// NICARAGUA PANAMA PARAGUAY PERU ST CHRISTOPHER AND NEVIS SAINT LUCIA ST. VINCENT AND THE GRENADINES SURINAME TRINIDAD AND TOBAGO UNITED STATES OF AMERICA URUGUAY////// VENEZUELA For the period 1947 lo 1970 see Vol. 1, p 181: for 1971 lo see Vol. II. p RULES OF PROCEDURE' see Volume 1, page 183. The time and place of the meetings of the Executive Committee are decided by the Director of PASB in consultation and agreement with the Chairman of the Executive Committee. see Volume 1, page 185 and Volume II, page 157. 'The text of the Rules of Procedure of the Executive Committee appears in Basic Documents of the Pan American Health Organization, PAHO Official Document 188 (1983), AGENDA see Volume 1, page REPRESENTATION AT THE CONFERENCE AND THE COUNCIL see Volume 1, page 187 and Volume II, page 158.

70 4. THE PAN AMERICAN HEALTH ORGANIZATION AND THE WORLD HEALTH ORGANIZATION 4.1 AGREEMENT BETWEEN PAHO AND WHO' see Volume 1, page 193. 'The text of the Agreement appears in Basic Documents of the Pan American Health Organization, PAHO Official Document 188 (1983), WHO REGIONAL COMMITTEE FOR THE AMERICAS see Volume I, page 195 and Volume II, page STUDY OF WHO's STRUCTURES IN LIGHT OF ITS FUNCTIONS see Volume II, page PAHO REPRESENTATIVES ON THE JOINT COORDINATING BOARD OF THE WHO SPECIAL PROGRAM FOR RESEARCH AND TRAINING IN TROPICAL DISEASES see Volume II, page WHO RESOLUTIONS OF INTEREST TO THE REGIONAL COMMITTEE' 'WHO Resolutions were considered, adopted. see Volume I, page 196 and Volume II, page 163. but no resolutions were CD29.R20 Bearing in mind that the composition of the Joint Coordinating Board of the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases includes 12 members selected by the WHO Regional Committee from among those countries directly affected by the diseases about which the Program is concerned, or from those countries providing technical or scientific support to the Program; and 57

71 58 4. THE PAN AMERICAN HEALTH ORGANIZATION AND THE WORLD HEALTH ORGANIZATION Considering that one of these 12 countries must be selected this year by the Regional Committee for the Americas, To select the Government of Venezuela to designate a representative to serve on thejoint Coordinating Board for a period of three years. CSP22.R8 Sept.-Oct OD 192, 65 The XXII Pan American Sanitary Conference, Bearing in mind that the composition of the Joint Coordinating Board of the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases is to include 12 members selected by the WHO Regional Committees from among those countries directly affected by the diseases dealt with by the Special Program, or from among those countries providing technical or scientific support to the Program, and that one of them must be selected by the Regional Committee for the Americas in 1986 for a threeyear term beginning 1 January 1987; and In view of the outcome of the vote taken to select that country, 1. To select the Government of Cuba to designate a representative to serve on thejoint Coordinating Board for three years. 2. To request the Director to inform WHO of this resolution. September 1986 OD 211, PAHO REPRESENTATIVES ON THE POLICY AND COORDINATION ADVISORY COMMITTEE OF THE SPECIAL PROGRAM OF RESEARCH, DEVELOPMENT AND RESEARCH TRAINING IN HUMAN REPRODUCTION CSP22.R9 The XXII Pan American Sanitary Conference, Bearing in mind that the composition of Category B members to the Policy and Coordination Advisory Committee of the Special Program of Research, Development and Research Training in Human Reproduction is to include 12 Member Countries selected by the WHO Regional Committees from among those countries that provide financial and/ or technical support to the program, as well as have interest in human reproduction, as demonstrated by national policies; Considering that two Member Countries must be selected with different tenure periods by the Regional Committee for the Americas; and In view of the outcome of the vote taken to select those countries, 1. To select the Government of Argentina for the period starting now and ending 31 December 1988, and the Government of the United States of America for the period starting now and ending 31 December 1989, to serve on the Policy and Coordination Advisory Committee of the Special Program of Research, Development and Research Training in Human Reproduction. 2. To request the Director to inform WHO of this resolution. September 1986 OD 211, 136 i. 4.3 WHO MEETINGS see Volume 1, page 199 and Volume II, page 167. CE95.R15 Considering that the political, social, and demographic developments of recent years may necessitate a revision of the distribution of seats on the Executive Board of the World Health Organization among the various regional groups, To recommend to the Directing Council that it adopt a resolution along the following lines:' The XXXI Meeting of the Directing Council, Considering that the political, social, and demographic developments of recent years may necessitate a revision of the distribution of seats on the Executive Board of the World Health Organization among the various regional groups, 1. To request the Director to convey to the Director-General of WHO the concern of the Member States in the Region

72 4.3 WHO MEETINGS 59 concerning the underrepresentation of the Americas on the Executive Board of WHO, and regarding the further change in proportional representation that would result from the increase in membership on the Board proposed by Resolution WHA To request the Director to suggest to the Director- General of WHO the advisability of undertaking a study of the composition of the Executive Board, including the global criteria that are to govern the representation of the different Regions on the Executive Board, and also including the effect on proportional representation that would result from the amendments proposed to the Constitution by WHA38.14, and to present the study to the Thirty-ninth World Health Assembly. 3. To express the wish that the Thirty-ninth World Health Assembly reconsider the intentions of Resolution WHA38.14 in light of the conclusions of the study referred to in the preceding paragraph. June 1985 OD 202, 50 'The Directing Council discussed this subject but did not adopt a resolution in this regard.

73 5. CONSTITUTIONAL AND LEGAL MATTERS see Volume 1, page AMENDMENTS TO THE CONSTITUTION see Volume I, page 200 and Volume II, page BASIC DOCUMENTSI see Volume 1, page 205 and Volume II, page MEMBER GOVERNMENTS see Volume 1, page ADMISSION OF NEW MEMBER GOVERNMENTS see Volume I, page 207 and Volume II, page 170. CE92.R7 The Executive Committee To recommend to the XXX Meeting of the Directing Council adoption of the following resolution:' June 1984 OD 195, 39 IThe text of the Basic Documents of the Pan American Health Organization appears in PAHO Official Document 188 (1983). 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD30.R1 below. 60

74 5.3 OBSERVERS OBSERVERS 61 CD30.RI Having examined the formal request for membership in the Pan American Health Organization made on behalf of the State of St. Christopher and Nevis by the Prime Minister, Minister of Foreign Affairs, in a communication dated 9 April 1984; and Considering that the Government of St. Christopher and Nevis has declared its readiness to accept all the obligations of the Constitution of the Pan American Health Organization, to comply with the provisions of the Pan American Sanitary Code, as amended by the Additional Protocol to the Pan American Sanitary Code (1952), and to contribute by means of a quota assessment to the financial support of the Organization, 1. To approve with satisfaction the request of the State of St. Christopher and Nevis for membership in the Pan American Health Organization. 2. To instruct the Director to transmit this decision to the Member Governments of the Organization ASSOCIATE MEMBERS Sept.-Oct OD 197, PRIVILEGES AND IMMUNITIES see Volume 1, page 208. see Volume I, page OBSERVERS see Volume 1, page 212 and Volume II, page 173. CE97.R14 Taking account of the interest expressed by the Government of Portugal in establishing arrangements for direct cooperation with the Pan American Health Organization and in obtaining observer status in the Organization; Bearing in mind Resolution XXVII' of the XXVIII Meeting of the Directing Council, which establishes the criteria for the granting of observer status in PAHO to non-american States having no territory in the Americas; Considering that these criteria are extremely limiting and restrictive in respect of requests such as that of the Portuguese Government; Cognizant of the very close historical and sociocultural ties that bind the Portuguese nation to the American Hemisphere; and Having seen the report presented by the Director (Document CE97/7) establishing new requirements and procedures to govern the granting to countries of observer status in PAHO, To recommend to the XXII Pan American Sanitary Conference the approval of a resolution along the following lines: 2 June 1986 OD 211, 110 JSee Vol. 11, p For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference, see Resolution CSP22.R3 below. CSP22.R3 The XXII Pan American Sanitary Conference, Taking account of the interest expressed by the Government of Portugal in establishing arrangements for direct cooperation with the Pan American Health Organization and in obtaining observer status in the Organization; Bearing in mind Resolution XXVII' of the XXVIII Meeting of the Directing Council, which establishes the criteria for the granting of observer status in PAHO to non-american States having no territory in the Americas; Considering that these criteria are extremely limiting and restrictive in respect of requests such as that of the Portuguese Government; Cognizant of the very close historical and sociocultural ties that bind the Portuguese nation to the American Hemisphere; and Having seen the report presented by the Director (Document CSP22/7) establishing new requirements and procedures to govern the granting to countries of observer status in PAHO, 1. To rescind Resolution XXVII of the XXVIII Meeting of the Directing Council. 2. To approve the following requirements, procedures and privileges for States requesting and obtaining observer status in PAHO: A. Prerequisites a) The requesting State must have historical and cultural ties to the Region of the Americas; b) The requesting State must show interest in participating in and contributing to inter-american institutions;

75 62 5. CONSTITUTIONAL AND LEGAL MATTERS c) The requesting State must make a technical or financial contribution to PAHO's technical cooperation programs. B. Processing Steps a) The requesting State must present its request at least 60 days in advance of the date set for the meeting of the Executive Committee to which it is to be presented, stating the reasons on which the request is based, as provided in paragraphs a), b) and c), above; b) The Executive Committee will consider the request in relation to the provisions of paragraphs a), b) and c), above, and make an appropriate recommendation to the Conference or Directing Council; c) The Conference or Directing Council, as appropriate, will decide whether the requesting State is to be granted observer status in PAHO. C. Privleges Countries granted observer status in PAHO shall enjoy the privileges of: a) Attending public sessions of the Governing Bodies and public sessions of the committees and working groups of those Governing Bodies, the costs of such attendance to be borne by the observer country; b) Participating, by leave of the Chairman, in the discussions of the Governing Bodies, but without the right to vote. They may not, however, make proposals of substance or procedural motions or requests, raise points of order, or impugn the decisions of the Chairman; c) Receiving documents prepared for the meetings of the Governing Bodies and other technical and scientific publications of interest to the observer country; d) Establishing technical and financial cooperation relations with the Organization through the Pan American Sanitary Bureau. 'See Vol. II, p CE97.R15 September 1986 OD 211, 130 Having in mind that injune 1985 the Government of Portugal presented a request for observer status in the Pan American Health Organization; Considering that Portugal fully meets the conditions precedent established in Resolution XIV' of the 97th Meeting of the Executive Committee; and Bearing in mind that the participation of Portugal in the Organization would make a very positive contribution to the common health effort of the peoples of the Americas, 1. To welcome with satisfaction the request of the Government of Portugal. 2. To recommend to the XXII Pan American Sanitary Conference the approval of a resolution along the following lines: 2 June 1986 OD 211, 112 ISee p For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference, see Resolution CSP22.R4 below. CSP22.R4 The XXII Pan American Sanitary Conference, Having in mind that in June 1985 the Government of Portugal presented a request for observer status in the Pan American Health Organization; Considering that Portugal fully meets the conditions precedent established by the XXII Pan American Sanitary Conference (Resolution III'); and Having seen Resolution XV 2 of the 97th Meeting of the Executive Committee, 1. As an exception in this case, to waive the requirements established in subparagraph a), paragraph 2.B of Resolution III of the XXII Pan American Sanitary Conference. 2. To welcome with satisfaction the request of the Government of Portugal, and to grant it observer status in the Pan American Health Organization. 3. To recommend to the Director that he promote technical cooperation between Portugal and the countries of the Americas. 4. To request the Director to transmit the present decision to the Government of Portugal and to the Member Governments of the Organization. 'See p See this page. September 1986 OD 211, NAME AND OFFICIAL INSIGNIA NAME OF THE ORGANIZATION OFFICIAL INSIGNIA see Volume I, page 213. see Volume 1, page 213.

76 5.5 HEALTH REGULATIONS HEALTH REGULATIONS PAN AMERICAN SANITARY CODE' see Volume I, page INTERNATIONAL HEALTH REGULATIONS see Volume 1, page INTERNATIONAL TRANSPORTATION OF HUMAN REMAINS 'The text of the Pan American Sanitary Code appears in the Basic Documents of the Pan Amenican Health Organization, PAHO Official Document 188 (1983), 1-5. see Volume I, page 215.

77 6. COOPERATION WITH OTHER ORGANIZATIONS r see Volume I, page ORGANIZATION OF AMERICAN STATES' see Volume I, page 218. 'The text of the Agreement between the OAS and PAHO appears in Basic Documents of the Pan American Health Organization, PAHO Official Document 188 (1983), INTER-AMERICAN DEVELOPMENT BANK see Volume 1, page COORDINATION WITH THE UNITED NATIONS AND OTHER ORGANIZATIONS see Volume I, page 223 and Volume II, page UNITED NATIONS CHILDREN'S FUND see Volume I, page 224 and Volume II, page INTERNATIONAL LABOR ORGANIZATION see Volume 1, page

78 6.4 NONGOVERNMENTAL ORGANIZATIONS NONGOVERNMENTAL ORGANIZATIONS NONGOVERNMENTAL ORGANIZATIONS see Volume 1, page PRINCIPLES GOVERNING RELATIONSHIP CE97.R20 see Volume I, page 225 and Volume II, page 178. Having seen Document CE97/8, "Relations with Nongovernmental Organizations at the Regional and National Levels," presented by the Director of the Pan American Sanitary Bureau; Mindful of Decision 81 of the 77th Session of the Executive Board of WHO, which requests the Regional Committees to examine Section 5 of the revised Working Principles governing admission of nongovernmental organizations into official relations with WHO, which bears on regional and national nongovernmental organizations; Considering that Resolution XX 2 of the XX Pan American Sanitary Conference, "Mechanisms for the Establishment of Official Relations between PAHO and Inter-American Nongovernmental Organizations," is compatible with the recommendations of Section 5 of the report on the Working Principles for establishing official relations between nongovernmental organizations and WHO; and Considering that several inter-american nongovernmental organizations, which are equivalent to regional nongovernmental organizations, have entered into official relations with PAHO and maintain working relations with it, 1. To transmit Document CE97/8 to the XXII Pan American Sanitary Conference for its consideration. 2. To recommend to the XXII Pan American Sanitary Conference the adoption of a resolution along the following lines: 3 June 1986 OD 211, 119 Considering Decision 81 of the 77th Session of the Executive Board of WHO, which requests the Regional Committees to examine Section 5 of the revised Working Principles governing admission of nongovernmental organizations into official relations with WHO, which bears on regional and national nongovernmental organizations; Considering that Resolution XX 2 of the XX Pan American Sanitary Conference, "Mechanisms for the Establishment of Official Relations between PAHO and Inter-American Nongovernmental Organizations," is compatible with Section 5 of the report on the Working Principles for establishing official relations between nongovernmental organizations and WHO; and Considering that several inter-american nongovernmental organizations, which are equivalent to regional nongovernmental organizations, have entered into official relations with PAHO and maintain working relations with it, 1. To express its agreement with the content of Section 5 of the WHO Working Principles governing relations with nongovernmental organizations contained in the report of the Standing Committee on Nongovernmental Organizations of the Executive Board of WHO. 2. To request the Director: a) To report to the 79th Session of the Executive Board of WHO on Resolution XX of the XX Pan American Sanitary Conference and on the inter-american nongovernmental organizations in official relations with PAHO; b) To continue encouraging regional and national nongovernmental organizations to participate in application of the strategies for health for all by the year 2000, and to make use as appropriate of the working relations between the Organization and those nongovernmental organizations; c) To transmit the present resolution to the 79th Session of the Executive Board of WHO. IDocument EB77/1986/REC/1, 23 2 See Vol. II, p September 1986 OD 211, 147 'Document EB77/1986/REC/1, See Vol. II, p For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference, see Resolution CSP22.R18 below. The XXII Pan American Sanitary Confer- CSP22.R18 ence, Having seen Document CSP22/12, "Relations with Nongovernmental Organizations at the Regional and National Levels," presented by the Director of the Pan American Sanitary Bureau; ORGANIZATIONS IN OFFICIAL RELATIONS WITH PAHO CE90.R12 see Volume 1, page 226 and Volume II, page 180. Having studied the report presented by the Standing Subcommittee of the Executive Committee charged with reviewing the list of nongovernmental organizations in relations with PAHO,

79 66 6. COOPERATION WITH OTHER ORGANIZATIONS 1. To confirm relations with the Latin American Association of Pharmaceutical Industries (ALIFAR), the Latin American Federation of Hospitals, the Latin American Federation of the Pharmaceutical Industry (FIFARMA), and the Pan American Federation of Associations of Medical Schools (FEPAFEM). 2. To continue relations with the Inter-American Council of Psychiatric Associations on a provisional basis in the understanding that, if no collaborative activities have materialized within the next 12 months, it will be recommended to the Executive Committee in its 92nd Meeting that those relations be suspended. 3. To suspend relations with the Pan American Medical Confederation. CE92.R11 June 1983 OD 190, 40 Having studied the report presented by the Standing Subcommittee charged with reviewing the situation of inter- American nongovernmental organizations in official relations with PAHO, in compliance with Resolution XII of the 90th Meeting of the Executive Committee, which calls for a reconsideration after one year of the relations with the Inter- American Council of Psychiatric Associations, To grant the Inter-American Council of Psychiatric Associations an extension of the term provided in Resolution XII of the 90th Meeting of the Executive Committee to June 1985, in order to give it a last opportunity to collaborate with the Organization. Failing such action, official relations with the Inter-American Council of Psychiatric Associations will be terminated. CE95.R18 June 1984 OD 195, 44 Having studied the report presented by the Subcommittee of the Executive Committee charged with reviewing the working relations of the Pan American Health Organization with nongovernmental organizations, and with the Inter- American Council of Psychiatric Associations (CIAP) in particular; and Taking account of the decision contained in Resolution XI of the 92nd Meeting of the Executive Committee of PAHO, 1. To authorize continued working relations between the Inter-American Council of Psychiatric Associations and the Pan American Health Organization, but only until the 97th Meeting of the Executive Committee, in June 1986, reviews the progress made in activating the relationship. 2. To request the Director to urge the CIAP to continue the efforts needed to enter into real collaboration with the Organization in the mental health field and in the framework of the strategies for health for all by the year June 1985 OD 202, 53 CE95.R19 Having seen the report on the application of the Latin American and Caribbean Association of Public Health Education (ALAESP), presented by the Standing Subcommittee of the Executive Committee charged with reviewing applications presented by inter-american nongovernmental organizations interested in establishing official working relations with the Pan American Health Organization; and Taking account of the provisions of Resolution XX 1 of the XX Pan American Sanitary Conference, 1. To authorize the establishment of official working relations between the Latin American and Caribbean Association of Public Health Education and the Pan American Health Organization. 2. To request the Director to convey this decision to the Latin American and Caribbean Association of Public Health Education and to inform it of the rights and obligations associated with this situation. 3. To request the Chairman of the Executive Committee to advise the XXXI Meeting of the Directing Council of this decision. 'See Vol. II, p CE97.Rll June 1985 OD 202, 54 Having studied the report presented by the Standing Subcommittee of the Executive Committee charged with reviewing the list of nongovernmental organizations in official relations with PAHO; and Mindful of the provisions of Article 1.9 of Resolution XX' of the XX Pan American Sanitary Conference, 1. To confirm relations with the Latin American Association of Pharmaceutical Industries (ALIFAR), the Latin American Federation of Hospitals, the Latin American Federation of the Pharmaceutical Industry (FIFARMA), the Pan American Federation of Faculties (Schools) of Medicine (FEPAFEM), and the Latin American and Caribbean Association of Public Health Education (ALAESP). 2. To suspend for three years the relations of PAHO with the Inter-American Council of Psychiatric Associations (IACPA). 3. To request the Director to convey this resolution to the organizations named in the foregoing paragraphs. 'See Vol. II, p CE97.R12 June 1986 OD 211, 108 Having seen the report presented by the Standing Subcommittee of the Executive Committee charged with reviewing the working relations of inter-american nongovernmental organizations with the Pan American Health Organization, and particularly the application presented by the Latin

80 6.5 OTHER ENTITIES OTHER ENTITIES 67~~~~~~~~~~~~~~ American Union against Sexually Transmitted Diseases (ULACETS); and Mindful of the provisions of Resolution XX l of the XX Pan American Sanitary Conference, 1. To authorize the establishment of official working relations between PAHO and the Latin American Union against Sexually Transmitted Diseases (ULACETS). 2. To request the Director to convey this decision to the Latin American Union against Sexually Transmitted Diseases (ULACETS) and to inform it of the rights and obligations attached to these relations. 3. To request the Chairman of the Executive Committee to inform the XXII Pan American Sanitary Conference of this decision. ISee Vol. 11, p June 1986 OD 211, OTHER ENTITIES see Volume II, page COORDINATION OF INTERNATIONAL COOPERATION IN THE HEALTH FIELD IN THE AMERICAS see Volume II, page 183. CE92.R12 Bearing in mind Resolution XIII' approved by the 82nd Meeting of the Executive Committee (June 1979) establishing the Subcommittee on Long-Term Planning and Programming; Cognizant of the importance of more active participation of the Member Governments and the Organization to implement the collective decisions taken by the Governing Bodies; Considering that the health needs of the countries evolve through a dynamic process governed by economic, political, and social factors that necessitate an ongoing, intensive interinstitutional analysis; and Cognizant of the need to strengthen the other functions of the Subcommittee on Long-Term Planning and Programming with a view to improving analysis of problems and development of strategies that could be jointly adopted by the Organization and its Member Governments, 1. To express appreciation to the Subcommittee for its report. 2. To change the name of the Subcommittee to "Subcommittee on Planning and Programming." 3. To assign to the Subcommittee the following functions: a) Analysis of the process and methodology of planning, programming, and budgeting; b) Analysis of the information processes and systems for the conduct of technical cooperation with the countries, including evaluation and monitoring of the regional Plan of Action for health for all by the year 2000; c) Analysis of economic and social factors and their impact on health conditions and the health sector; d) Analysis of the policy and functioning of PAHO's administrative systems, including manpower planning and development; e) Analysis of special programs with special emphasis on their formulation and evaluation; f) Other functions to be determined by the Executive Committee. 4. To establish the membership of the Subcommittee at seven Members: four to be elected by the Executive Committee for terms of office running concurrently with those of their membership in the Executive Committee and three to be named prior to each meeting of the Subcommittee by the Director in consultation with the Chairman of the Executive Committee, in light of the specific topics for each meeting. 5. To establish the number of regular meetings at two per year, one occurring after the meeting of the Directing Council and before the Executive Board Meeting of WHO and another after the Executive Board Meeting of WHO and before the PAHO Executive Committee Meeting in June, plus such other special meetings as may be required. 'See Vol. II, p. 50. CE92.R13 June 1984 OD 195, 44 Having considered Document CE92/16 and the report of the Subcommittee on Long-Term Planning and Programming and its appendices; Recognizing that the Common Framework and Format has been complemented with additional materials; Bearing in mind that the Common Framework and Format responds to resolutions of the Directing Council and the Executive Committee of PAHO as well as to resolutions of the World Health Assembly; and Considering that the report offers specific recommendations for action with the objective of improving the capacity

81 68 6. COOPERATION WITH OTHER ORGANIZATIONS COOPERATION WITH QIHER ORGANIZATIONS of the Member Governments and the Organization to achieve the goal of health for all by the year 2000, 1. To express appreciation for the information presented on the steps under way to implement within the Region of the Americas the process for evaluating the strategies for health for all and to urge the Director to implement the Subcommittee recommendations with regard to the adjustment of the evaluation instrument following field tests to ensure its most useful application within the Region of the Americas. 2. To urge Member Countries to cooperate in the field tests of the evaluation instrument and the application of the instrument as adjusted as a result of the field tests. 3. To urge Member Countries to use the evaluation instrument as an opportunity to review and make appropriate changes in their information and monitoring and evaluation processes in order to strengthen their efforts to achieve the goal of health for all by the year To urge the Director to provide support to Member Countries in the completion of the field tests, in the preparation of the regional contribution to the Seventh Report on the World Health Situation, and in improving information, monitoring, and evaluation capabilities. the health sector (Document CD30/16), and the report of the 92nd Meeting of the Executive Committee, 1. To express appreciation to the Director for the study on the repercussions of the economic crisis on the health sector and to urge the Director to apply the document's recommendations. 2. To urge Member Countries to undertake the studies recommended in the report with the support of the Secretariat, including the impact of technology and human resources on health costs, the review of the financing of the health sector with the objective of moving toward the fulfillment of the principles of efficacy, efficiency, and equity, and the examination of the impact of the crisis on health sector resources, both public and private, and on their distribution and use. 3. To request the Director to continue to examine the international economic environment and the impact of changing developments on the health sector, to assist the Member Countries in their own analyses, and to report to the Governing Bodies on any major changes in the situation, as appropriate. Sept.-Oct OD 197, 35 June 1984 OD 195, 45 CE92.R14 Having considered Document CE92/16 and the report of the Subcommittee on Long-Term Planning and Programming and its appendices; Noting that the document "The Economic Crisis in Latin America and the Caribbean and its Repercussions on the Health Sector" represents important new sources of information and analysis; Bearing in mind that this document responds to Resolution XX l of the XXVIII Meeting of the Directing Council of PAHO as well as to resolutions of the World Health Assembly; and Considering that the document offers specific recommendations for action with the objective of improving the information available to Member Governments and supporting their efforts to achieve the goal of health for all by the year 2000, To recommend to the XXX Meeting of the Directing Council adoption of the following resolution: 2 June 1984 OD 195, 46 'See Vol. II, p For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD30.R2 below. CD30.R2 Having considered the document on the economic crisis in Latin America and the Caribbean and its repercussions on CE92.R15 Having reviewed the document "Managerial Strategy for the Optimum Use of PAHO/WHO Resources in Direct Support of Member Countries"; Having considered Document CE92/16, which describes the discussions and conclusions of the Subcommittee on Long-Term Planning and Programming of the Executive Committee of PAHO concerning the above-mentioned "Managerial Strategy"; and Considering that the "Managerial Strategy" seeks to encourage management changes that would strengthen the mandate of the Organization, make its programming more effective and efficient, and emphasize basic concepts of equity in the allocation of PAHO's resources, 1. To express appreciation to the Director for the preparation and dissemination of the "Managerial Strategy" and for involving the Governing Bodies in its examination and review. 2. To approve the recommendations of the Subcommittee on Long-Term Planning and Programming with regard to the "Managerial Strategy," and in particular the desirability that operational mechanisms be developed to promote the broad policy goals of the "Managerial Strategy." 3. To urge Member Governments to study carefully the elements of the "Managerial Strategy" and examine how available resources could be redeployed to promote the priorities adopted by the PAHO Governing Bodies. 4. To urge the Director to continue to examine the "Managerial Strategy" so that it can respond effectively to the changing dynamics affecting health conditions and the process of development within the Region. June 1984 OD 195, 47

82 7. FINANCIAL AND ADMINISTRATIVE MATTERS 7.1 FINANCIAL MATTERS see Volume 1, page 228 and Volume II, page 185. _ FINANCIAL REGULATIONS AND RULES' see Volume 1, page 228 and Volume II, page 185. 'The text of the Financial Regulations and Rules of the Pan American Health Organization appears in Basic Documents of the Pan American Health Organization, PAHO Official Document 188 (1983), CD29.R5 Having considered the recommendation of the 90th Meeting of the Executive Committee and the proposed changes in the Financial Regulations proposed in Document CD29/31; and Taking into consideration that the changes in the Regulations will provide conformity between the Financial Regulations of WHO and PAHO with respect to the availability of appropriations, To approve the changes in the Financial Regulations of the Pan American Health Organization as they appear in Document CD29/31. Sept.-Oct OD 192, 52 CE90.R17 Having considered the Director's presentation on the availability of appropriations to finance outstanding legal obligations from prior financial periods (Document CE90/25, Rev. 1), 1. To approve the changes in the Financial Rules of the Pan American Health Organization as they appear in Document CE90/25, Rev To recommend to the XXIX Meeting of the Directing Council that it give favorable consideration to the request of the Director and to the amendments to the Financial Regulations of the Pan American Health Organization included in Document CE90/25, Rev. 1, by adopting the following resolution: ASSESSMENTS AND CONTRIBUTIONS 1. Scale of Assessment see Volume 1, page 233 and Volume II, page 187. see Volume 1, page 234 and Volume II, page 189. June 1983 OD 190, 44 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R5 below. CD29.R24 Whereas Member Governments appearing in the scale adopted by the Organization of American States are assessed 69

83 70 7. FINANCIAL AND ADMINISTRATIVE MATTERS according to the percentages shown in that scale in compliance with Article 60 of the Pan American Sanitary Code; and Whereas other Member Governments and Participating Governments are assessed on the basis of percentages which would be assigned to such countries if they were subject to the OAS scale, To establish the assessments of the Member Governments and Participating Governments of the Pan American Health Organization for the financial period in accordance with the scale of quotas shown below and in the corresponding amounts. (1) (2) (s) (4) (5) (6) (7) Adjusmment for taxes Actual per- imposed centage ad- by Member OAS justed to Cnrit Gcmments Scale Member from Tax on enolfor Gov.enmens GCma Equalization uments of Net 1983 of PAHO asesnent Fund PAHO Staff amsseent Counmy % % (USS) (uss) (uss) (US$) Antigua and Barbuda , ,832 Argentina , ,742-6,881,634 Bahamas ,957-59,496 Barbados ,528 8,117 69,411 Bolivia ,283 19, ,570 Brazil ,624,584 1,007,666-8,616,918 Chile , ,609 Colombia , , ,763 Costa Rica , ,570 Cuba ,207, ,393-1,080,833 Dominica ,151 2,319-19,832 Dominican Republic ,283 19, ,570 Ecuador ,283 19, ,570 El Salvador , ,570 Grenada ,226 3,479-29,747 Guatemala ,283 19, ,570 Haiti , ,570 Honduras ,283 19, ,570 Jamaica ,283 19, ,570 Mexico ,221, ,040 6,465,166 Nicaragua ,283 19, ,570 Panama ,283 19, ,570 Paraguay ,283 19, ,570 Peru , ,796 Saint Lucia ,226 3,479-29,747 St. Vincent and the Grenadines ,151 2,319-19,832 Suriname í Trinidad and Tobago ,283 19, ,570 United State of America ,881, ,004 5,400,000 66,174,552 Uruguay ,566 39, ,141 Venezuela ,699, ,296 26,000 3,337,911 Subtotal ,979,720 10,781,683 5,433,500 97,631,537 Other Member Governments Equivalent percentage Belize ,302 4,638-39,664 Canada ,232, ,199 2,300 6,477,383 Guyana , ,570 Participating Governments France , ,570 Kingdom of the Netherlands ,453 6,957 59,496 United Kingdom ,377 5,797-49,580 Subtotal 7,56 7,02 7,774, , ,263 Total Assessmens- All Countries , ,595,700 5.,435, ,594,800 (2) This column shows the current OAS scale and equivalent percentages applicable to other Member Governments and Participating Governments which are not included in the OAS scale. (3) This column shows actual percentages in respect to asessments of Member Governments and Participating Governments of the Pan American Health Organization for (6) This column include estimated amounts to be received by the respective Member Governments in in rpecrt of tases levied by them on staff members' emoluments received from PAHO, adjusted for any difference between the estimated and actual for prior years. CD31.R9 Sept.-Oct OD 192, 71 Whereas Member Governments appearing in the scale adopted by the Organization of American States (OAS) are assessed according to the percentages shown in that scale in compliance with Article 60 of the Pan American Sanitary Code; and Whereas other Member and Participating Governments are assessed on the basis of percentages which would be assigned to such countries if they were subject to the OAS scale, To establish the assessments of the Member and Participating Governments of the Pan American Health Organization for the financial period in accordance with the scale of quotas shown below and in the corresponding amounts. (1) (2) (5) (4) (5) (6) (7) Adjustment for taxes imposed Actual by Member percentage Governments OAS adjusted Credit from on Scale to Member Tax emoluments for Governments Gross Equaliation of PASB Net 1985 of PAHO assessment Fund Staff assessment Country % % (USS) (USS) (USS) (USS) Antigua and Barbuda ,646 3,109-21,537 Argentina ,552, ,795-7,473.,269 Bahamas ,937 9, Barbados ,260 10,881-75,379 Bolivia ,489 26, ,063 Braril ,708,564 1,350,826-9,357,738 Chile , ,398 Colombia ,010 3, ,693 Costa Rica ,489 26, ,063 Cuba , ,436-1,173,756 Dominica ,646 3,109-21,537 Dominican Republic ,489 26, ,063 Ecuador ,489 26, ,063 El Salvador , ,063 Grenada ,968 4,663-52,305 Guatemala ,489 26, ,063 Haiti , ,063 Honduras ,489 26, ,063 Jamaica ,489 26, Mexico , ,508-7,020,996 Nicaragua ,489 26, ,063 Panama ,489 26, ,063 Paraguay ,489 26, ,063 Peru , ,420 St. Christopher and Nevis , ,769 Saint Lucia ,968 4,663-32,305 St. Vincent and the Grenadines , ,537 1

84 Suriname Trinidad and Tobago United States of America Uruguay Venezuela Subtotal Other Member Equivalent Governments percentage Belize Canada Guyana Participating Governments France Kingdom of the Netherlands United Kingdom Submotal Total Assess mens- All countries , ,489 26, ,526,808 9,527,284 3, , ,977 52, ,115, , ,590,275 14,454,924 3,.722,000 1( , , , , ,489 26, ,937 9, , , ,089, , ,722, , FINANCIAL MATTERS FINANCIAL MATTERS , , To take note of the report of the Director on the collection of quota contributions (Document CE90/24 and Add. I). 3,615, To thank the Governments that have already made 3,857.,351 payments in 1983, and to urge other Governments to pay their current quotas as early as possible in the year they are due so that the work of the Organization can continue and the financial burden of its program can be spread fairly 43,073 among all Members. 7,031, To thank the Director for completing the study on 183,063 quota payments requested at the 88th Meeting of the Executive Committee and to accept the recommendations contained therein To request the Director to continue to inform the Governments of any balances due, and to report to the 64,610 XXIX Meeting of the Directing Council on the status of the collection of quota contributions ,548,649 June 1983 OD 190, 31 (2) This column shows the current OAS scale and equivalent percentages applicable to other Member and Participating Governments which are not included in the OAS scale. (3) This column shows actual percentages in respect to assessments of Member and Par. ticipating Governments of the Pan American Health Organization for (6) This column includes estimated amounts to be received by the respective Member Governments in in respectof taxes levied by them on staff members' emoluments received from PAHO, adjusted for any difference betw-en the estimated and actual for prior years. CE90.R2 September 1985 OD 203, Collection of Contributions see Volume 1, page 235 and Volume II, page 194. Having considered the report of the Director on the collection of quota contributions (Document CE90/24 and Add. I); Noting that, of the three Member Governments with approved payment plans for liquidating their arrears, only one country had made a partial payment as of the date of issuance of Addendum I to Document CE90/24; Bearing in mind the provisions of Article 6.B of the Constitution of PAHO relating to the suspension of voting privileges of Governments failing to meet their financial obligations; Considering the importance of prompt and full payment of quota contributions to assure the financing of the authorized program and budget and to maintain the Organization in a sound financial position; and Taking into consideration the findings and recommendations of the Director's study on the constitutional and regulatory provisions governing the payment of quota contributions in WHO and PAHO, CD29.R9 Having considered the report of the Director on the collection of quota contributions (Document CD29/27 and Add. I and II); Considering the importance of prompt and full payment of quota contributions in ensuring the financing of the authorized program and budget and maintaining the Organization in a sound financial position; and Noting the report of the working party on the application of Article 6.B of the PAHO Constitution, relating to the suspension of voting privileges of Member Governments that fail to meet their financial obligations, 1. To take note of the report of the Director on the collection of quota contributions (Document CD29/27 and Add. I and II). 2. To thank the Member Governments that have already made payments in 1983 and to urge the other Governments to pay their current quotas as early as possible in the year in which they are due, so that the work of the Organization can continue and the financial burden of its program can be spread fairly among all Members. 3. To request the Director to continue to inform the Governments of any balance due. CD29.R11 Sept.-Oct OD 192, 55 Having examined the report of the working party established to study the application of Article 6. B of the Constitution of PAHO relating to the suspension of voting privileges of Governments that fail to meet their financial obligations; and In view of the proposals of the above-mentioned working party for granting the three countries more than two years in arrears a further opportunity to pay their outstanding quotas through deferred payment plans,

85 72 7. FINANCIAL AND ADMINISTRATIVE MATTERS 1. To permit the representatives of the countries referred to in the report of the working party to exercise the privilege of the vote at the current Meeting of the Directing Council. 2. To instruct the Director to officially inform the Governments concerned of the quota payment conditions recommended by the working party studying the application of Article 6.B and approved by this Meeting of the Directing Council. 3. To instruct the 92nd Meeting of the Executive Committee to conduct a review of the situation of the countries in arrears in an amount exceeding the sum of their quotas for two full years, and to report on their findings and recommendations to the XXX Meeting of the Directing Council. CE92.R3 Sept.-Oct OD 192, 56 Having considered the report of the Director on the collection of quota contributions (Document CE92/14 and Add. I); Noting that there are significant arrears in the payment of the contributions to an extent that some countries could be subject to the application of Article 6.B of the Constitution of the Pan American Health Organization; and Considering the importance of prompt and full payment of quota contributions to assure the financing of the authorized program and budget and to maintain the Organization in a sound financial position, 1. To take note of the report of the Director on the collection of quota contributions (Document CE92/14 and Add. I). 2. To thank the Governments that have already made payments for 1984, and to urge the other Governments to pay their outstanding quota contributions as early as possible, so that the work of the Organization can continue and the financial burden of its program can be spread fairly among all Members. 3. To request the Director to continue to inform the Governments of any balances due and to report to the XXX Meeting of the Directing Council on the status of the collection of quota contributions. CE92.R4 June 1984 OD 195, 36 Having considered the special report of the Director on Member Countries in arrears in the payment of their contributions to the extent that they are subject to the application of Article 6.B of the Constitution of the Pan American Health Organization; Noting the report of the Working Party appointed by the XXIX Meeting of the Directing Council to review the application of Article 6.B of the PAHO Constitution, relating to the suspension of voting privileges of Member Governments that fail to meet their financial obligations; Noting that Resolution XI' of the XXIX Meeting of the Directing Council instructed the 92nd Meeting of the Executive Committee to conduct a review of the situation of the countries in arrears in an amount exceeding the sum of their quota contributions for two full years, and to report their findings and recommendations to the XXX Meeting of the Directing Council; Taking into consideration the concern voiced by the members of the Executive Committee at its 92nd Meeting; and Noting that implementation of deferred payment plans approved by the Governing Bodies for the payment of arrears in quota contributions has only been partially effective in securing payment, 1. To request the Director: a) To explore alternative means for securing the payment by Member Countries whose arrears of quota contributions prior to 31 December 1983 could make them subject to the application of Article 6.B; b) To present to the XXX Meeting of the Directing Council a plan of action discussed with those Member Countries in arrears. 2. To request the Member Countries in arrears to cooperate with the Director in developing plans of action to resolve their problems of arrears and to avoid the invocation of Article 6.B of the Constitution. 3. To recommend to the XXX Meeting of the Directing Council: a) That, as a matter of policy, the mechanism of deferred payment plans not normally be utilized as the means to recover outstanding quota contributions in the future; b) That, if progress has not been made by the Director to secure the active cooperation of Member Countries over two years in arrears by the time of the XXX Meeting of the Directing Council, Article 6.B of the Constitution be invoked. 'See p. 71. CD30.R10 June 1984 OD 195, 37 Having considered the report of the Director on the collection of quota contributions (Document CD30/21 and Add. I); Noting the report of the Working Party on the application of Article 6.B of the PAHO Constitution relating to the suspension of voting privileges of Member Governments that fail to meet their financial obligations to the Organization; Expressing concern that five Member Countries are in arrears in the payment of their quota contributions to the extent that they are subject to the application of Article 6.B of the Constitution; Taking into consideration that the Pan American Sanitary Code precludes the payment of quota contributions in local currencies; and Noting with satisfaction that most countries in arrears have entered into agreements with the Director for the liquidation by 1988 of arrears, 1. To take note of the report of the Director on the collection of quota contributions (Document CD30/21 and Add. I). 2. To thank the Governments that have already made payments in 1984, and to urge the Governments to fulfill r

86 7.1 FINANCIAL MATTERS FINANCIAL MATTERS 73 their financial obligations to the Organization in a prompt and responsible manner. 3. To permit the representatives of the Member Countries to which Article 6.B applies to exercise the privilege of the vote at the current Meeting of the Directing Council. 4. To request the Director to monitor carefully the agreements made by Member Countries in arrears in the payment of their quota contributions; to advise the Executive Committee of countries' compliance with their commitments for the liquidation of their arrears; and to report to the XXXI Meeting of the Directing Council on the status of the collection of quota contributions for CE95.R1 Sept.-Oct OD 197, 42 Having considered the report of the Director on the collection of quota contributions (Document CE95/21 and Add. I) and the special report provided on Member Governments in arrears in the payment of their quota contributions to the extent that they are subject to the application of Article 6.B of the Constitution of the Pan American Health Organization; Noting the report of the Working Party appointed by the XXX Meeting of the Directing Council to review the application of Article 6.B of the PAHO Constitution, relating to the suspension of voting privileges of Member Governments that fail to meet their financial obligations; and Noting with concern that four of the five Member Governments subject to the application of Article 6.B have not met their commitments for the liquidation of their arrears, and taking into account the concern voiced in the 95th Meeting of the Executive Committee, 1. To take note of the report of the Director on the collection of quota contributions (Document CE95/21 and Add. I). 2. To thank the Member Governments that have already made payments for 1985 and to urge the other Member Governments to pay their outstanding quota contributions as early as possible, so that the work of the Organization can continue and the financial burden of its program can be shared fairly among all Members. 3. To recommend to the XXXI Meeting of the Directing Council that the voting restrictions contained in Article 6.B of the PAHO Constitution be strictly applied to those Member Governments who by the opening of that Meeting have not discussed again with the Secretariat their possibilities for meeting their payment commitments and the manner of doing so. 4. To request the Director to.continue to inform the Member Governments of any balances due and to report to the XXXI Meeting of the Directing Council on the status of the collection of quota contributions. CD31.R6 June 1985 OD 202, 40 Having seen the report of the Director on the collection of quota contributions (Document CD31/27 and Add. l); Noting the report of the Working Party on the application of Article 6.B of the PAHO Constitution relating to the suspension of voting privileges of Member Governments that fail to meet their financial obligations to the Organization (Document CD31/27, Add. II); and Recognizing that, in the case of the three Member Governments subject to Article 6.B, the Government of Haiti has generally complied with its approved payment plan and the Governments of the Dominican Republic and Paraguay have, at this session of the Directing Council, presented plans of payment which are both acceptable to the Organization and to this Council, 1. To take note of the report of the Director on the collection of quota contributions (Document CD31/27 and Add. 1). 2. To thank the Member Governments that have already made payments in 1985, and to continue to urge the Member Governments in arrears to fulfill their financial obligations to the Organization in a prompt and responsible manner. 3. To permit the Government of Haiti to vote at this Meeting of the Directing Council, in view of its compliance with the payment plan established with the Organization. 4. To permit the Governments of Paraguay and the Dominican Republic to vote at this meeting of the Directing Council in view of the payment commitments provided by their Representatives at this session; and to recommend that if adequate payments under these commitments are not made by the opening dates of the XXII Pan American Sanitary Conference or future meetings of the Directing Council the voting restrictions contained in Article 6.B be rigorously applied. 5. To request the Director: a) To monitor carefully the implementation of the agreements made by Member Governments in arrears for the payment of their quota contributions; b) To advise the Executive Committee of countries' compliance with their commitments for the liquidation of their arrearages; c) To report to the XXII Pan American Sanitary Conference on the status of the collection of quota contributions for 1986 and prior years. CE97.R4 September 1985 OD 203, 47 Having considered the report of the Director on the collection of quota contributions (Document CE97/10 and Add. I) and the special report provided on Member Countries in arrears in the payment of their quota contributions to the extent that they are subject to the application of Article 6.B of the Constitution of the Pan American Health Organization; Noting the provisions of Resolution VI' of the XXXI Meeting of the Directing Council with respect to the application of Article 6. B of the PAHO Constitution, relating to the suspension of voting privileges of Member Countries that fail to meet their financial obligations; and Noting with concern that the Member Countries subject to the application of Article 6.B in 1985 have not to date met their commitments for the liquidation of their arrears,

87 74 7. FINANCIAL AND ADMINISTRATIVE MATTERS FINANCIAL AND ADMINISTRATIVE MATrERS 1. To take note of the report of the Director on the collection of quota contributions (Document CE97/10 and Add. 1). 2. To thank the Member Countries that have already made payments for 1986 and to urge the other Member Countries to pay their outstanding quota contributions as early as possible, so that the work of the Organization can continue and the financial burden of its program can be shared fairly among all Members. 3. To request the Director: a) To continue to inform the Member Countries of any balances due; b) To inform the Member Countries subject to the application of Article 6.B of the amount of their arrearages, and to urge them to make the payment necessary to avoid the application of the voting restrictions contained in Article 6.B; c) To report to the XXII Pan American Sanitary Conference on the status of the collection of quota contributions. 4. To recommend to the XXII Pan American Sanitary Conference that the voting restrictions contained in Article 6.B of the PAHO Constitution be strictly applied to those Member Countries who by the opening of the Conference have not made additional and substantial payments towards their assessed quotas or to their deferred payment commitments. 'See p. 73. June 1986 OD 211, To take note of the report of the Director on the collection of quota contributions (Document CSP22/16 and Add. 1). 2. To express appreciation to Member Governments that have already made payments in 1986, and to urge all Member Governments in arrears to fulfill their financial obligations to the Organization in a prompt manner. 3. To permit the Government of Haiti to vote at this Pan American Sanitary Conference, in view of its efforts to comply with its payment commitments. 4. To permit the Government of Paraguay to vote at this Pan American Sanitary Conference, and to endorse the acceptance of the Government's revised deferred payment plan. 5. To instruct the Article 6.B Working Party to reconvene and provide its recommendation to the Conference in the event that an accredited Delegation from the Dominican Republic is present at this Conference. 6. To request the Director: a) To continue to monitor the implementation of special payment agreements made by Member Governments in arrears for the payment of prior years' quota assessments, with particular attention to the case of the Dominican Republic; b) To advise the Executive Committee of Member Countries' compliance with their quota payment commitments; c) To report to the XXXII Meeting of the Directing Council on the status of the collection of quota contributions for 1987 and prior years. September 1986 OD 211, 'See Resolution CE97.R4, p J CSP22.R1 The XXII Pan American Sanitary Conference, Having seen the report of the Director on the collection of quota contributions (Document CSP22/16 and Add. I) and taking into consideration the concerns expressed by the 97th Meeting of the Executive Committee' with respect to Member Countries subject to Article 6.B who have not met their commitments for liquidation of their quota arrearages; Noting the report of the Working Party on the application of Article 6.B of the PAHO Constitution relating to the suspension of voting privileges of Member Governments that fail to meet their financial obligations to the Organization in a timely manner (Document CSP22/16, Add. II); Recognizing that, in the case of the three Member Governments subject to Article 6.B, the Government of Haiti has continued to make payments towards its prior years' assessments, but that it has been unable to fully meet all of its payment commitments, and that the Government of Paraguay has presented a revised deferred payment plan which is acceptable to the Secretariat and the Article 6.B Working Party, as well as having made payments under its original payment plan; and Noting specifically that the Article 6.B Working Party was in consensus that Article 6.B should be applied to the Dominican Republic, but also noting the Working Party's determination that the provisions of Article 6.A of the Constitution and the absence of an officially accredited Delegation from the Dominican Republic constitutionally precluded the application of Article 6.B at this time, WORKING CAPITAL FUND 1. Holding Account see Volume 1, page 241 and Volume II, page 203. see Volume II, page REVOLVING AND SPECIAL FUNDS see Volume 1, page 245 and Volume II, page

88 7.1 FINANCIAL MATTERS Emergency Voluntary Fund see Volume II, page Revolving Fund for the Expanded Program on Immunization CE90.R13 see Volume II, page 206. See also Section (Expanded Program on Immunization) Having examined the progress report presented by the Director on the Expanded Program on Immunization (EPI) in the Americas (Document CE90/15), To recommend to the XXIX Meeting of the Directing Council that it adopt the following resolution:' b) Use immunization coverage in children under one year of age and pregnant women as an important indicator of the performance of maternal and child health services; c) Use morbidity and mortality data from measles, poliomyelitis, and neonatal tetanus as indicators of program development and impact; d) Use surveillance of vaccine-preventable diseases as another indicator of development of national epidemiological surveillance systems; e) Act on the Five-Point Action Program adopted by Resolution WHA of May 1982; f) Step up their evaluation of immunization programs and their implementation of recommendations emerging in the course of that process. 2. To request the Director to: a) Continue giving high priority to EPI at all levels of the Organization; b) Use the progress achieved by EPI as an indicator of the success of PAHO's technical cooperation in achieving the goal of health for all by the year 2000; c) Make a study of the vaccine production capacity of the Member Countries and of the quality and cost of the vaccines, with a view to their possible use in the EPI; d) Renew efforts to assure full capitalization of the EPI Revolving Fund; e) Promote evaluation of activities in the countries and assist in carrying them out in countries where he may deem this advisable; f) Report to the 94th Meeting of the Executive Committee in 1985 on the progress of the program and on application of the recommendations put forward herein. Sept.-Oct OD 192, 61 June 1983 OD 190, 40 'WHA35/1982/REC/1, 26. 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD29.R16 below ADDITIONAL INCOME SOURCES AND PROGRAMS CD29.R16 Having examined the Director's progress report on the Expanded Program on Immunization (EPI) in the Americas (Document CD29/23), and recognizing the limited funds allocated to the Program for the financial period ; Having taken note of the continuing efforts made to implement this program at country and regional levels; Recognizing that progress of the EPI is an essential element of the strategies to achieve health for all by the year 2000; and Recognizing that progress has been slow in most countries of the Region and if it is not accelerated the program goals will not be met by 1990, 1. To urge countries to: a) Set biennial targets for immunization coverage in children under one year of age and pregnant women and for the reduction of the morbidity and mortality of the diseases involved; 1. Pan American Health and Education Foundation 2. Other see Volume 1, page 259 and Volume II, page 208. see Volume II, page 209.

89 76 7. FINANCIAL AND ADMINISTRATIIVE MATTERS FINANCIAL AND ADMINISTRATIVE MATTERS ACCOUNTS AND EXTERNAL AUDIT 1. Approval of Annual Financial Report of the Director and Report of the External Auditor CE90.R3 see Volume 1, page 259 and Volume II, page 212. Having examined the Interim Financial Report of the Director for the year 1982 (Officzial Document 189); and Recognizing that the Organization continues to be in a sound financial condition, 1. To take note of the Interim Financial Report of the Director for the year 1982 (Official Document 189). 2. To transmit the Interim Financial Report of the Director for the year 1982 to the XXIX Meeting of the Directing Council. June 1983 OD 190, 32 while recognizing that the Organization has continued to maintain a sound financial position, 1. To take note of the Financial Report of the Director and Report of the External Auditor for the biennium (Official Document 194 and Add. 1). 2. To transmit the Financial Report of the Director and Report of the External Auditor for the Biennium to the XXX Meeting of the Directing Council. 3. To express concern over: a) The impact on the financial status of the Organization of the slow payment of assessments; b) The financial situation of the Institute of Nutrition of Central America and Panama (INCAP) and the Caribbean Epidemiology Center (CAREC), which has been exacerbated by recent economic problems beyond the control of the Organization; 4. To request the Director to carefully review the financial situation of the above-mentioned Centers so as to ensure their ability to conduct their programs with greater effectiveness and efficiency. 5. To congratulate the Director on having maintained a sound financial position and to thank the External Auditor for the report presented. June 1984 OD 195, 35.4 CD29.R10 Having examined the Interim Financial Report of the Director for the year 1982 (Official Document 189); and Recognizing that the Organization continues to be in a sound financial situation, 1. To take note of the Interim Financial Report of the Director for the year 1982 ( Official Document 189). 2. To congratulate the Director for having maintained a sound financial condition. CE92.R2 Sept.-Oct OD 192, 56 Having examined the Financial Report of the Director and Report of the External Auditor for the biennium ( Official Document 194 and Add. I); Noting with satisfaction the progress that has been made in implementing the financial management system and the effective manner in which the Internal Audit Office is carrying out its function; but Concerned over the increase of outstanding quota contributions and managerial problems identified by the auditors, CD30.R5 Having examined the Financial Report of the Director and the Report of the External Auditor for the period (Official Document 194 and Add. I); Noting the report (Document CD30/3, Add. 1, and Corrig.) of the 92nd Meeting of the Executive Committee on its review of the financial statements and relevant schedules of the Organization as contained in Official Document 194 and Add. 1, especially its concerns regarding the status of quota contributions; and Recognizing that the Organization continues to be in a sound financial situation, 1. To take note of the Financial Report of the Director and the Report of the External Auditor for the period (Official Document 194 and Add. 1). 2. To endorse fully the comments and concerns expressed by the 92nd Meeting of the Executive Committee in its report on the financial condition of the Organization as of 31 December 1983 (Document CD30/3, Add. 1). 3. To commend the Director for having maintained a sound financial situation. CE95.R2 Sept.-Oct OD 197, 37 Having examined the Interim Financial Report of the Director for the year 1984 ( Official Document 200 and Add. I); and *4

90 7.1 FINANCIAL MATTERS FINANCIAL MATTERS 77 Noting with concern the significant increase in outstanding quota contributions for 1984 and prior years, while recognizing that the Organization has continued to maintain a sound financial condition, 1. To take note of the Interim Financial Report of the Director for the year 1984 ( Official Document 200 and Add. 1). 2. To transmit the Interim Financial Report of the Director for the year 1984 to the XXXI Meeting of the Directing Council. 3. To express concern over the impact on the financial status of the Organization of the delayed payment of quota assessments for the year 1984 and prior financial periods. 4. To congratulate the Director on having maintained the Organization in a sound financial position. CD31 :R5 June 1985 OD 202, 41 Having examined the Interim Financial Report of the Director for the year 1984 ( Official Document 200 and Add. I); Noting the report of the 95th Meeting of the Executive Committee on its review of the financial statements and relevant schedules of the Organization as contained in Official Document 200 and Add. 1, particularly its concerns regarding the status of quota contributions: and Recognizing that the Organization continues to be in a sound financial situation, 1. To take note of the Interim Financial Report of the Director for the year 1984 ( Official Document 200 and Add. I). 2. To fully endorse the comments and concerns expressed by the 95th Meeting of the Executive Committee in its report on the financial condition of the Organization as of 31 December To commend the Director for having maintained the Organization in a sound financial condition. CE97.R6 September 1985 OD 203, 47 Having examined the Financial Report of the Director and the Report of the External Auditor for the period (Official Document 205 and Add. I); Noting the concerns expressed by the External Auditor with respect to the control of Organization manpower, to the general management, control, and security of computer systems, and to the existence of certain continuing problems in the financial management system; and Expressing concern over the slow rate of quota payments during , while recognizing that, in spite of this, the Organization has continued to maintain a satisfactory financial condition, 1. To take note of the Financial Report of the Director and Report of the External Auditor for the period (Official Document 205 and Add. 1). 2. To transmit the Financial Report of the Director and Report of the External Auditor to the XXII Pan American Sanitary Conference. 3. To express concern over: a) The slow rate of quota payments and its impact on the financial status of the Organization should this rate be maintained; b) The slow progress in elimination of problems in PAHO's computerized systems; c) The need for careful attention to vacancy rates for professional staff; d) The financial situation of the Caribbean Epidemiology Center and the Caribbean Food and Nutrition Institute, which have been seriously affected by delayed payment of quota contributions by Member Countries. 4. To request the Director to monitor carefully the financial situation of the above-mentioned Centers and to continue to encourage Member Countries to meet their quota commitments in a timely manner. 5. To congratulate the Director for his efforts to maintain a satisfactory financial condition and to thank the External Auditor for the report presented. The XXII Pan American Sanitary Confer- CSP22.R14 ence, June 1986 OD 211, 102 Having examined the Financial Report of the Director and Report of the External Auditor for the biennium ( Official Document 205 and Add. I and II); Noting the report' of the 97th Meeting of the Executive Committee on its review of the financial statements and schedules of the Organization as contained in Official Document 205, particularly its concerns relating to the status of quota payments, the continuation of problems in the Organization's computerized systems, professional vacancy rates, and the financial situations of the Caribbean Epidemiology Center and the Caribbean Food and Nutrition Institute; Taking into consideration the recommendation 2 of the 97th Meeting of the Executive Committee to approve the allocation of $22,210 in surplus income from the financial period to the PAHO Building Fund; and Expressing concern over the slow rate of quota payments during , while recognizing that, in spite of this, the Organization has continued to maintain a satisfactory financial situation, 1. To take note of the Financial Report of the Director and Report of the External Auditor for the biennium (Official Document 205 and Add. I and II). 2. To endorse the comments and concerns expressed by the 97th Meeting of the Executive Committee in its report on the financial condition of the Organization as of 31 December 1985.

91 78 7. FINANCIAL AND ADMINISTRATIVE MATTERS 3, To approve the allocation of surplus income in the amount of $22,210 to the PAHO Building Fund, established to defray the costs of major maintenance and repairs to PAHO facilities. 4. To commend the Director for having maintained the Organization in a satisfactory financial condition in spite of the slow rate of quota payments. 'See Resolution CE97.R6, p. 77. SSee Resolution CE97.R19, p. 84. September 1986 OD 211, Appointment of External Auditor see Volume 1, page 261 and Volume II, page 216. holder of the office of Comptroller and Auditor General of the United Kingdom of Great Britain and Northern Ireland, who has been appointed External Auditor of the World Health Organization for the financial periods and , has expressed a willingness to serve as External Auditor of the Pan American Health Organization, To appoint the holder of the office of Comptroller and Auditor General of the United Kingdom of Great Britain and Northern Ireland External Auditor of the accounts of the Pan American Health Organization for the financial periods and , and to request him to conduct his audits in accordance with the principles set forth in Article XII of the PAHO Financial Regulations, with the provision that, should the need arise, he may designate a representative to act for him in his absence. Sept.-Oct OD 192, TRAVEL CD29.R4 Bearing in mind that it has been the practice of the World Health Organization and the Pan American Health Organization to have the same External Auditor, and that the see Volume I, page 262 and Volume II, page ADMINISTRATIVE AND STAFF MATTERS STAFF RULES AND REGULATIONS see Volume 1, page 263 and Volume II, page 218. Recognizing the need for uniformity of conditions of employment of PASB and WHO staff; Bearing in mind the provision of Staff Rule 020; Mindful of the Director's recommendation to introduce the end of service grant with effect from 1 July 1983; and Bearing in mind that the Area Offices will probably be eliminated by the XXIX Meeting of the Directing Council with effect from 1 January 1984, as proposed in Resolution I' of this meeting of the Executive Committee, 1. Amendments to the Staff Rules and Regulations CE90.R5 see Volume I, page 266 and Volume II, page 218. Having considered the amendments to the Staff Rules of the Pan American Sanitary Bureau submitted by the Director in the Annex to Document CE90/3; 1. To confirm the amendments to the Staff Rules of the Pan American Sanitary Bureau submitted by the Director in the Annex to Document CE90/3, with effect from 1 January To confirm the introduction into the Staff Rules of the Pan American Sanitary Bureau of the following Rule 375, with effect from 1 July 1983: 375. END-OF-SERVICE GRANT A staff member holding a fixed-term appointment whose appointment is not renewed after he has completed ten years of continuous qualifying service shall be entitled to a grant based on his years of service unless he

92 7.2 ADMINISTRATIVE AND STAFF MATTERS ADMINISTRATIVE AND STAFF MATTERS 79 has either received and declined an offer of renewal of his appointment or has reached 60 years of age. The amount of the grant shall be fixed according to the schedule in Rule for termination of temporary fixed-term appointments. 3. To confirm the amendments to Staff Rules , , and to include a reference to the end-of-service grant. 4. To authorize the Director to make the necessary changes in Staff Rule , with effect from 1 January 1984, in the event that the Area Offices are eliminated, without prejudice to the subsequent presentation of these amendments to the 92nd Meeting of the Executive Committee. 'See p. 85. June 1983 OD 190, 33 consolidation of 20 points of post adjustment into net base salary. CE97.R9 June 1985 OD 202, 41 Having reviewed the Director's report on the local hiring of personnel (Document CE97/23, Rev. 1), To recommend to the XXII Pan American Sanitary Conference the adoption of a resolution in the following terms:' June 1986 OD 211, 106 CE92.R1 Having considered the amendments to the Staff Rules of the Pan American Sanitary Bureau submitted by the Director in the Annex to Document CE92/3; Recognizing the need for uniformity of conditions of employment of PASB and WHO staff; Recalling Resolution VI of the Executive Committee at its 90th Meeting; and Bearing in mind the provisions of Staff Rule 020, To confirm the amendments to the Staff Rules of the Pan American Sanitary Bureau submitted by the Director in the Annex to Document CE92/3, with effect from 1 January 1983, concerning the conditions governing restoration of prior contributory service in the United Nations Joint Staff Pension Fund and the timing of contributions to the Pension Fund during leave without pay, and, with effect from 1 January 1984, concerning the Board of Appeal, the education and special education grants, and minor corrections to two other Staff Rules. ISee p. 78. CE95.R3 June 1984 OD 195, 35 Having considered the amendments to the Staff Rules of the Pan American Sanitary Bureau submitted by the Director in the Annex to Document CE95/10; Recognizing the need for uniformity of conditions of employment of PASB and WHO staff; and Bearing in mind the provisions of Staff Rule 020, To confirm the amendments to the Staff Rules of the Pan American Sanitary Bureau submitted by the Director in the Annex to Document CE95/10, with effect from 1 July 1984, concerning the increase in the basic level of financial incentive, and with effect from 1 January 1985 concerning the introduction of a second level of the financial incentive and the 'For text recommended by the Executive Committee and adopted by the Pan American Sanitary Conference after amending paragraphs 1 and 2 and adding paragraphs 3, 4, and 5 to the operative part, see Resolution CSP22.R19 below. The XXII Pan American Sanitary Confer- CSP22.R19 ence, Having reviewed the Director's report (Document CSP22/ 28) on the local hiring of personnel; Considering that the Organization possesses, in its own right, the legal capacity needed to issue its own legally binding rules on the appointment, qualifications, rights and obligations of its employees, and further possesses within the territory of each of its Member Countries the status of juridical person, endowing it with the capacity to take legal actions and enter into agreements of any nature; and Mindful that these two capacities make it legally possible and fitting to establish two categories of personnel in the Organization, the first comprised of international staff members, whether internationally or locally recruited, who will continue to be governed, as hitherto, by the Staff Regulations and Staff Rules of PASB, and the second, created by means of this resolution, consisting of national staff members appointed to such posts as the Director shall determine, who shall be governed in all their relations with the Organization by the labor laws and practices of the country in which they serve. This new category of personnel shall replace that of the present contractors and consultants in cases in which there actually exists an employer/employee relationship, and personnel in this category shall be referred to as national staff members because their conditions of employment shall be governed, in fact and in law, by the labor legislation and practices of the countries in which they serve, 1. That effective immediately until 30 September 1989 (unless a differing recommendation be made by the Executive Committee in the interim), the Staff Regulations of PASB shall be amended as follows:

93 80 7. FINANCIAL AND ADMINISTRATIVE MATTERS "1.12 The Bureau may hire under local conditions of employment national staff members (nationals of the country and aliens, whether residents or not, who legally qualify for employment there), to whom the Staff Regulations and Rules shall not apply save in regard to the present Article 1 on Duties, Obligations and Privileges as national employees and not as international functionaries. Respecting privileges, such employees shall be governed by the Basic Agreement on Privileges and Immunities between the Organization and the country in which they are employed The contracts of such national employees shall be governed in every aspect, including those of work-related accidents, social security and pensions, by the labor laws and practices of the country concerned The Director shall determine the posts to be subject to these rules and shall establish scales of salaries and allowances, in conformity with competitive conditions of employment of the locality in the type of work performed or related to the functions of the office National employees shall have access to arbitration or labor tribunals of the countries in which they are employed for the settlement of disputes, in accordance with their respective contracts, and shall therefore have no access to the Administrative Tribunal of the International Labor Organization, whose competence is not recognized in respect of national employees." 2. To request the Director to issue such rules as he may deem appropriate to regulate contracts of this type for national personnel, subject to confirmation by the Executive Committee pursuant to Staff Rule 015.2, and to incorporate them into the Staff Rules. 3. To request the Director to provide the Executive Committee with annual interim reports on the implementation of these amendments to the Staff Regulations, and with a full report, prior to 31 May 1989, to include such matters as identification of the positions involved, the cost implications, administrative adjustments, and general operations of the system of hiring under local conditions of employment, together with his recommendations regarding this new system. 4. To request the Director, pending completion of the review by the Executive Committee in 1989, to implement these amendments on a limited basis and to exclude from the application thereof any currently established posts under the Staff Rules and Regulations which are not or do not become vacant, unless the Executive Committee decides otherwise in advance. 5. To delegate to the Executive Committee the authority to determine if these amendments to the Staff Regulations shall remain in effect after 30 September To confirm the amendment to the Staff Rules of the Pan American Sanitary Bureau submitted by the Director in the Annex to Document CE97/9, with effect from 1 January 1985, concerning the effective gross base salary to be used in computing terminal remuneration RECRUITMENT AND SERVICE June 1986 OD 211, Recruitment of International Staff see Volume I, page Study of Conditions of Employment see Volume I, page Hiring Under Local Conditions of Employment SALARIES AND ALLOWANCES 1. Field Service Allowances See Section see Volume I, page 273. see Volume I, page 273. September 1986 OD 211, Language Allowance see Volume 1, page 274. CE97.R10 Having considered the amendment to the Staff Rules of the Pan American Sanitary Bureau submitted by the Director in the Annex to Document CE97/9; Recognizing the need for uniformity of conditions of employment of PASB and WHO staff; and Bearing in mind the provisions of Staff Rule 020, 3. Cost-of-Living Adjustment see Volume I, page 275.

94 7.2 ADMINISTRATIVE AND STAFF MATTERS Study of Salaries and Other Compensations CE91.R1 see Volume I, page 275 and Volume II, page 223. Having examined the report of the Director on the currency of salary payments (Document CE91/2); Aware of the foreign exchange difficulties confronting some of the Organization's Member Governments; and Convinced of the advisability of following the practice established by the United Nations for the payment of salaries and allowances and observed by the World Health Organization as well, 1. To request the Director to take the necessary steps for the introduction in PAHO as soon as possible of rules similar to those followed in WHO and the United Nations governing the currency of payment of salaries and allowances. 2. That in all the countries, exceptions to the enforcement of the new system may be granted if special circumstances at a given duty station so warrant. October 1983 OD 195, Salaries of Nonclassified Staff Members (Director, Deputy Director, Assistant Director) see Volume 1, page 276 and Volume II, page To note that, consequent upon the revision of salaries for these officials, appropriate reduction will be made in the post adjustment rates. 3. To recommend to the Directing Council at its XXXI Meeting that it establish the net salary of the Director at $65,320 (dependency rate) or $58,918 (single rate) per annum, effective 1 January 1985, and that, consequent upon the adjustment of salary, appropriate reduction be made of the post adjustment rate. 'Document EB75/1985/REC/1, Annex 3. 2 See Vol. II, p CD31.R19 June 1985 OD 202, 42 Considering the revision made to the schedule of salaries of the professional and higher categories of staff in graded posts, effective 1 January 1985; Taking into account the decision by the Executive Committee at its 95th Meeting to adjust the salaries of the Deputy Director and the Assistant Director (Resolution CE95.R4 1 ); Having noted the recommendation of the Executive Committee concerning the salary of the Director of the Pan American Sanitary Bureau (Resolution CE95.R4); and Bearing in mind the provisions of Staff Rule 330.3, 1. To establish the net salary of the Director of the Pan American Sanitary Bureau at $65,320 (dependency rate) or $58,918 (single rate) per annum, effective 1 January To note that, consequent upon the salary adjustment for the Director, appropriate reduction will be made in the post adjustment rate. 'See this page. September 1985 OD 203, 62 CE95.R TAX EQUALIZATION Considering the revision made to the schedule of salaries of the professional and higher categories of staff in graded posts, effective 1 January 1985; Taking into account the recommendation' of the 75th Session of the WHO Executive Board of the Thirty-eighth World Health Assembly related to the salaries of the Regional Directors, the Deputy Director-General, and the Director-General; and Bearing in mind Staff Rule 3.1 of the Pan American Sanitary Bureau and Resolution XX 2 of the XX Meeting of the Directing Council, 1. To approve the proposal of the Director, effective 1 January 1985, to: a) Establish the net salary of the Deputy Director at $59,203 (dependency rate) or $53,866 (single rate) per annum; b) Establish the net salary of the Assistant Director at $58,203 (dependency rate) or $52,866 (single rate) per annum PENSION FUND DIRECTOR OF PASB see Volume I, page 279. see Volume 1, page 279. see Volume 1, page 282 and Volume II, page 226.

95 82 7. FINANCIAL AND ADMINISTRATIVE MATTERS FINANCIAL AND ADMINISTRATIVE MATTERS CSP22.R2 The XXII Pan American Sanitary Conference, Bearing in mind Articles 4.E and 21.A of the Constitution of the Pan American Health Organization, which provide that the Pan American Sanitary Bureau shall have a Director elected at the Conference by the vote of a majority of the Governments of the Organization; Bearing in mind Article 4 of the Agreement between the World Health Organization and the Pan American Health Organization and Articles 49 and 52 of the Constitution of the World Health Organization, which establish the procedure for the appointment of Regional Directors of the World Health Organization; and Satisfied that the election of the Director of the Bureau has been held in accordance with the established procedure, 1. To declare Dr. Carlyle Guerra de Macedo elected Director of the Pan American Sanitary Bureau for a period of four years to begin 1 February To submit to the Executive Board of the World Health Organization the name of Dr. Carlyle Guerra de Macedo for appointment as Regional Director for the Americas OTHER OFFICIALS September 1986 OD 211, 129 see Volume I, page PAHO HEADQUARTERS see Volume I, page BUILDINGS AND INSTALLATIONS FOR HEADQUARTERS CE91.R2 see Volume I, page 285 and Volume II, page 227. Having considered the report of the Subcommittee of the Directing Council of the Pan American Health Organization on the Governor Shepherd site, established by Resolution XXIX' of the XXVIII Meeting of the Directing Council; Recognizing the inadequacies of the Governor Shepherd building in which approximately 110 PAHO staff are currently located, as well as the limited possibilities for modernization of that structure; Bearing in mind the need for PAHO to provide adequate and reasonable office space for its Headquarters staff at the most economical rate with a minimum financial impact or risk to PAHO; Recalling the recommendation of the Subcommittee to the 90th Meeting of the Executive Committee regarding selection of a preferred developer; and Satisfied that the proposed terms of the intended project meet the best interests of PAHO, 1. To authorize the Director to sign the proposed Letter of Intent for development of the Governor Shepherd site, as reviewed by the Subcommittee of the Directing Council on the Governor Shepherd site, and to negotiate and execute a Development Agreement, an Office Lease, a Ground Lease, and all other instruments and documents necessary or contemplated by the Letter of Intent. 2. To request the Subcommittee to report regularly to the Executive Committee and the Directing Council on the status of the project and on any action taken in accordance with Resolution XXIX of the XXVIII Meeting of the Directing Council and Resolutions II and XIX 2 of the 87th and 88th Meetings of the Executive Committee, respectively. 3. To thank the Director-General of INTELSAT for his cooperation with PAHO in the negotiation of this project. 'See.Vol. II, p bid., p CE95.R24 October 1983 OD 195, 21 Having seen Document CE95/22, Rev. 1 relating to the PAHO Building Fund and the recommendations of the Director contained therein, To recommend to the XXXI Meeting of the Directing Council the adoption of a resolution along the following lines: 1 June 1985 OD 202, 58 'For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD31.RI1 below.

96 7.3 PAHO HEADQUARTERS PAH HEDQURTES 8 CD31.RI1 Considering that there is a one-time need to capitalize the PAHO Building Fund to meet office space requirements for PASB staff in the new building to be constructed on the Governor Shepherd building site; Bearing in mind Resolution XVI' of the XXVI Meeting of the Directing Council which authorized the transfer of funds into the Building Fund to purchase a building for the Area II Office and that there is currently $128,220 in the Building Fund reserved for that purpose; and Noting the availability of land rent from the Governor Shepherd site and the need to pay operational/rental costs for temporary office space awaiting completion of the new building and for the PAHO office space in the new building, 1. To approve the capitalization of the PAHO Building Fund to meet requirements, not to exceed $915,000, relating to PAHO office space in the new building to be constructed on the Governor Shepherd building site. 2. To approve the Director's recommendations for the utilization of the following funds for capitalization of the Building Fund for the requirements indicated in operative paragraph 1 above: a) $200,000 in land rent to be paid to PAHO in 1986 by the developer of the new building on the Governor Shepherd building site; b) $128,220 currently reserved from the PAHO Building Fund for purchase of an Area II office building; c) $197,000 in other estimated available balances in the PAHO Building Fund; d) Up to $390,000 in potential savings in the PAHO Regular Budget. 3. To report to the Executive Committee in June 1986 on the implementation of operative paragraphs 1 and 2 above. 'See Vol. II, p CE95.R25 September 1985 OD 203, 53 Having seen Document CE95/22, Rev. 1 relating to the PAHO Building Fund and the recommendations of the Director contained therein, To recommend to the XXXI Meeting of the Directing Council the adoption of a resolution along the following lines:' June 1985 OD 202, 59 1For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD31.R12 below. CD31.R12 Considering that the PAHO Headquarters building is 20 years old and has started to require major maintenance and repairs; Recognizing that so long as PAHO owns office buildings in Buenos Aires, Guatemala, Brasília, Lima, and Caracas, PAHO is responsible for major maintenance and repair of these five buildings; Noting that there is a need for further capitalization of the PAHO Building Fund to meet future requirements for major maintenance and repair of PAHO-owned buildings; Noting that during the negotiations between PAHO and WHO to develop a cost-sharing formula for financing real estate operations in the Region of the Americas, PAHO proposed a reimbursement percentage in the range of 29-34%; Bearing in mind that the WHO Director-General has decided that PAHO will receive a 25% reimbursement for all PAHO/WHO major construction and repair projects (over $20,000) which are deemed qualified for cost-sharing by the WHO Building Program Committee; and Noting that PAHO will be returning to the WHO Real Estate Fund the allocation of $250,000 which was authorized by the World Health Assembly towards the construction of a building for the joint WHO/PAHO Publications and Documentation Service (SEPU) and the office of the PAHO Representative in Mexico, 1. To approve the recommendations of the Director for further capitalization of the PAHO Building Fund to meet future requirements for major maintenance and repair of PAHO-owned buildings. 2. To authorize the Director to utilize the following funds for capitalization of the Building Fund as indicated in operative paragraph 1 above: a) Up to $100,000 per year of excess miscellaneous income earned over the amount of miscellaneous income appropriated by the PAHO Governing Bodies; b) Up to $150,000 per year of revenues received from land and space rentals, other sales and services and program support costs. 3. To establish a policy that the money for the PAHO Building Fund as indicated in operative paragraph 2 above be used to finance major maintenance and repair projects of $20,000 and over. 4. To urge the Director to continue to negotiate with the Director-General of WHO a mutually satisfactory level of percentage participation by WHO in the Region of the Americas' program budget for all PAHO/WHO major construction and repair projects (over $20,000) which are deemed qualified for cost-sharing by the WHO Building Program Committee and to report on the progress of these negotiations to the meeting of the Executive Committee in June To establish a ceiling of $500,000 in the PAHO Building Fund for the maintenance and repair of PAHO-owned buildings. 6. To request the Director to present annually to the Executive Committee for approval a proposed maintenance and repair program for the succeeding year, and to report yearly to the Executive Committee for its approval all expenditures charged to the PAHO Building Fund during the preceding year. September 1985 OD 203, 54

97 84 7. FINANCIAL AND ADMINISTRATIVE MATTERS CE97.R19 Having reviewed Document CE97/15, which reports on actions taken by the Secretariat in relation to the PAHO Building Fund; Bearing in mind Resolutions XI and XII' of the XXXI Meeting of the Directing Council; Noting the measures taken to capitalize the PAHO Building Fund for expenses related to PAHO office space in the new building being constructed at 2121 Virginia Avenue, N.W., Washington, D.C., and for expenses related to major maintenance and repair projects of PAHO-owned buildings; and Taking into account the Director-General's decision and WHO Resolutions EB77.R9 2 and WHA39.5, 3 which confirm the participation of the WHO Real Estate Fund in amounts of 25% of the cost of major maintenance and repair projects in the Region of the Americas, Shepherd Building as provided under the agreement with the developer. 3. To recommend to the XXII Pan American Sanitary Conference that the surplus of income over expenditures of $22,210 be approved for allocation to the PAHO Building Fund. 'See p. 83. 'Document EB77/1986/REC/1, 10. SDocument WHA39/1986/REC/1, 3. June 1986 OD 211, BUILDINGS AND INSTALLATIONS FOR AREA' AND FIELD OFFICES 1. To approve the major maintenance and repair program for 1986 (1 June May 1987) and for 1987 (1 June May 1988) proposed in Document CE97/15 and to note the anticipated projects for To approve the transfer of $120,000 from the regular budget to the PAHO Building Fund to meet PAHO's share of tenant removal costs from the old Governor 'Up to 1976 called Zone Offices. see Volume 1, page 294 and Volume II, page ADMINISTRATIVE STUDIES see Volume 1, page ADMINISTRATIVE RATIONALIZATION see Volume 1, page 297.

98 8. PAHO/WHO COUNTRY OFFICES see Volume I, page 299 and Volume II, page 234. CE90.RI Having examined the report presented by the Director on the study of the functions of the Area Offices' of the Pan American Sanitary Bureau (Document CE90/11); Bearing in mind Resolution XII of the XXVIII Meeting of the Directing Council and Resolution XVI 2 of the XXI Pan American Sanitary Conference on this subject; and Mindful of the provisions of the regional Plan of Action outlining the need to increase the operating capacity of the Pan American Sanitary Bureau to support national and regional processes, 1. To commend the Director for the study contained in Document CE90/ To transmit the study of the functions of the Area Offices of the Pan American Sanitary Bureau (Document CE90/11) to the XXIX Meeting of the Directing Council. 3. To recommend to the XXIX Meeting of the Directing Council that it adopt the following resolution: 3 June 1983 OD 190, 30 'Up to 1976 called Zone Offices. 2 See Vol. II, p SFor text recommended by the Executive Committee and adopted by the Directing Council after adding paragraph 4 to the operative part, see Resolution CD29.R2 below. Mindful of the provision of the regional Plan of Action to increase the operating capacity of the Pan American Sanitary Bureau to support national and regional processes, 1. To thank the Director for the study of the functions of the Area Offices of the Pan American Sanitary Bureau (Document CD29/18). 2. To approve the Director's recommendation in this study that the Area Offices be eliminated with effect from 1 January 1984, as well as the measures proposed for accomplishing this end, including the administrative actions and their implementation schedule, as set forth in Document CD29/ To recommend to the Director that he initiate negotiations with the countries in which Area Offices are located to review and conclude new Basic Agreements for the establishment of Country Representative Offices, similar to the agreements in effect with other Member Governments of the Organization. 4. To request the Director to evaluate the extent and effectiveness of the proposed implementing measures and to report on the advances made in this direction to the Meeting of the Directing Council in Sept.-Oct OD 192, 50 CD29.R2 CE95.R13 Having examined the report presented by the Director on the study of the functions of the Area Offices of the Pan American Sanitary Bureau (Document CD29/18); Recalling Resolution XII of the XXVIII Meeting of the Directing Council and Resolution XVI of the XXI Pan American Sanitary Conference; and Having seen the report presented by the Director on the actions taken in regard to the elimination and functions of the Area Offices of the Pan American Sanitary Bureau (Document CE95/12); Mindful of the discussion that has taken place on the topic in the Executive Committee; and 85

99 86 S. PAHO/WHO COUNTRY OFFICFS PAHO/WHO COUNTRY OFFICES Considering Resolution II of the XXIX Meeting of the Directing Council, To recommend to the XXXI Meeting of the Directing Council the adoption of a resolution along the following lines: 2 June 1985 OD 202, 48 1 See p For text recommended by the Executive Committee and adopted by the Directing Council, see Resolution CD31.R13 below. CD31.R13 Having seen the report presented by the Director on the actions taken in regard to the elimination and functions of the Area Offices of the Pan American Sanitary Bureau (Document CD31/11); Considering Resolution II of the XXIX Meeting of the Directing Council; and Bearing in mind the report of the Executive Committee on this topic, 1. To request the Director: a) To continue negotiations with the Governments of Argentina, Guatemala, Peru, and Venezuela to finalize new Basic Agreements for the establishment of Country Representatives' Offices, similar to the agreements in effect with other Member Governments of the Organization; b) To continue negotiations with the Member Governments for contributions towards the operating costs of Country Offices, in accordance with the provisions of the Basic Agreements between PAHO/WHO and the Governments; c) To continue negotiations with the Governments of Argentina, Guatemala, Peru, and Venezuela regarding the future status of the PAHO-owned buildings currently occupied by the Country Representatives' Offices in those countries; d) To continue efforts to ensure that the Organization's Country Representatives play their important part in the development of the Organization's strategies and cooperation programs; e) To continue the evaluation of the need for and use of the Organization's multicountry resources in the field and take such steps as may be necessary to ensure that those resources are put to the best possible use; f) To report to the Executive Committee in 1986 on the progress of the above-mentioned negotiations.' 2. To urge the Governments to cooperate with the Director in the implementation of these measures. September 1985 OD 203, 56 'See PAHO Official Document 208 (1986), p. 165.

100 9. MISCELLANEOUS 9.1 AWARDS see Volume I, page 300 and Volume II, page 235. CE90.R16 Having examined the report of the Award Committee of the PAHO Award for Administration (Document CE90/12, Add. I); Bearing in mind the provisions of the Procedure and Guidelines for conferring the PAHO Award for Administration; and Considering the importance of encouraging a higher level of competence in the administration of health services, 1. To note the decision of the Award Committee to confer the PAHO Award for Administration, 1983, on Dr. Arnaldo Tejeiro Fernández of Cuba, for the contribution to and social impact of his work in his country's National Health Service. 2. To transmit the report of the Award Committee of the PAHO Award for Administration (Document CE90/12, Add. I) to the XXIX Meeting of the Directing Council. CE92.R8 Having examined the report of the Award Committee of the PAHO Award for Administration (Document CE92/9, Add. I); Bearing in mind the provisions of the Procedure and Guidelines for conferring the PAHO Award for Administration; and Considering the importance of encouraging a higher level of competence in the administration of health services, 1. To note the decision of the Award Committee to confer the PAHO Award for Administration, 1984, on Dr. Manuel Barquín, of Mexico. 2. To transmit the report of the Award Committee of the PAHO Award for Administration (Document CE92/9, Add. I) to the XXX Meeting of the Directing Council. June 1984 OD 195, 40 June 1983 OD 190, 44 CD29.R14 Having reviewed the report of the Award Committee of the PAHO Award for Administration and Resolution XVI' of the 90th Meeting of the Executive Committee (Document CD29/19 and Annexes); and Bearing in mind the regulations set forth in the Procedure and Guidelines governing the PAHO Award for Administration, To declare Dr. Arnaldo Tejeiro Fernández of Cuba winner of the PAHO Award for Administration, Sept.-Oct OD 192, 59 CD30.R9 Having reviewed the report of the Award Committee of the PAHO Award for Administration, 1984 and Resolution VIII' of the 92nd Meeting of the Executive Committee (Document CD30/7 and Annexes); and Bearing in mind the regulations set forth in the Procedure and Guidelines governing the PAHO Award for Administration, To declare Dr. Manuel Barquín, of Mexico, winner of the PAHO Award for Administration, Sept.-Oct OD 197, 41 'See this page. 'See this page. 87

101 88 9. MISCELLANEOUS MISCELLANEOUS CE95.R5 Having examined the report of the Award Committee of the PAHO Award for Administration (Document CE95/18, Add. I); Bearing in mind the provisions of the Procedure and Guidelines for conferring the PAHO Award for Administration; and Considering the importance of encouraging a higher level of administrative and managerial competence throughout the health sector in the Region of the Americas, 1. To note the decision of the Award Committee to confer the PAHO Award for Administration, 1985, on Dr. Elizabeth Quamina of Trinidad and Tobago. 2. To transmit the report of the Award Committee of the PAHO Award for Administration (Document CE95/18, Add. I) to the XXXI Meeting of the Directing Council.' June 1985 OD 202, 42 1 At the XXXI Meeting of the Directing Council, the PAHO Award for Administration, 1985, was presented to Dr. Elizabeth Quamina of Trinidad and Tobago. CE97.R13 Having examined the report of the Award Committee of the PAHO Award for Administration, 1986 (Document CE97/11, Add. I); and Bearing in mind the provisions of the Procedure and Guidelines for conferring the PAHO Award for Administration as approved by the XVIII Pan American Sanitary Conferencel (1970) and as amended by the XX Conference 2 (1978) and the XXVII Meeting of the Directing Council s (1980), 1. To take note of the decision of the Award Committee to declare void the PAHO Award for Administration, To transmit the report of the Award Committee of the PAHO Award for Administration (Document CE97/11, Add. I) to the XXII Pan American Sanitary Conference. 4 June 1986 OD 211, Resolution XVIII. See Vol. I1, p Resolution XVII. See Vol. II, p Resolution V. See Vol. II, p The XXII Pan American Sanitary Conference took note of the decision of the Award Committee to declare void the PAHO Award for Administration, PUBLIC INFORMATION AND SPECIAL EVENTS see Volume 1, page 301 and Volume II, page 239. CE90.R22 Considering that the 24th of July of this year marks the bicentennial of the birth of that great luminary in the history of the Americas, Simón Bolívar; Considering that for his contribution to the independence of the American republics he is rightly called "the Liberator"; Considering the Pan American character of the intellectual legacy of Simón Bolívar; and Considering that it was thanks to Simón Bolívar that the Amphictyonic Congress of Panama, the first attempt to develop solidarity and cooperation among the Governments in the Hemisphere, was convened, 1. To approve a special vote in tribute to the memory of Simón Bolívar on the bicentennial of his birth. 2. To request the Director to transmit this decision to the Member Governments of the Organization. 3. To convey this resolution formally to the authorities of the Government of Venezuela in charge of the commemoration of the Simón Bolívar bicentennial. June 1983 OD 190, 50 CD31.R1 Having noted that the Inter-American Development Bank (IDB) is celebrating the XXV Anniversary of its fruitful existence; In recognition of the valuable contribution made by the IDB to the countries of the Americas in the mobilization of finance in support of their development and particularly for the satisfaction of the basic health needs of their population; In recognition also of the valuable encouragement and unflagging support that the President of the Bank, Mr. Antonio Ortiz Mena, has given to PAHO in its efforts to improve the health conditions of the peoples of the Americas; and Desirous of commemorating this anniversary of the IDB in a proper and significant way, 1. To hold during its XXXI Meeting a special session in commemoration of the XXV Anniversary of the IDB. 2. To memorialize the XXV Anniversary of the IDB on a commemorative plaque. 3. To confer on the President of the Bank, Mr. Antonio Ortiz Mena, a special diploma conveying the appreciation of the Directing Council of PAHO.

102 9.3 CONGRATULATIONS. EXPRESSIONS OF SYMPATHY. ETC To request the President of the XXXI Meeting of the Directing Council to present the aforementioned commemorative plaque and diploma to the President of the IDB in the special session on behalf of the Council. September 1985 OD 203, 44 CSP22.R20 The XXII Pan American Sanitary Conference, Having seen the information received from the Director on the excellent work done by the National Library of Medicine of the United States of America, which is completing its 150th year of service to the world scientific community; Cognizant of its contribution to the development and operation of the Latin American and Caribbean Center for Health Sciences Information (BIREME) and of PAHO's access to the MEDLARS system; and Wishing to commemorate this important anniversary by paying well-earned tribute to the National Library of Medicine, 1. To take cognizance of the support that the National Library of Medicine of the United States of America has unfailingly given to PAHO and its Member Countries. 2. To transmit to the Director of the National Library of Medicine and its staff its warmest congratulations and wishes for success in its invaluable efforts on behalf of the health sciences. September 1986 OD 211, CONGRATULATIONS, EXPRESSIONS OF SYMPATHY, ETC. see Volume 1, page 302 and Volume II, page 241. CE90.23 Having seen the work done by the Secretariat to present the topics submitted for its consideration; Having taken account of the changes that the Director is making to maximize the work of the Organization for the most successful accomplishment of its purposes; and Cognizant of the extraordinary gifts that adorn the person of Ms. Lea Guido, Representative of Nicaragua, and the sensitivity, affability, and firmness with which she conducted the discussions of the Meeting, 1. To thank the Secretariat for the manner in which it presented the topics to the Meeting. 2. To thank the Director for the manner in which he presented his reports, describing a process of change requested through the Governing Bodies. 3. To voice its support for the work that the Director is doing, and its wish that he continue to seek new ways of operating which help to satisfy the needs and wants of the peoples of the Americas. 4. To put on record its appreciation to Ms. Lea Guido, of Nicaragua, for the skill and affability with which she presided over the proceedings of the Meeting. June 1983 OD 190, 51 CE95.R7 Having heard, with regret, that Dr. Stuart Portner is gravely ill; and Bearing in mind the meritorious work in the health field in the Americas carried out by Dr. Portner as Chief of Administration of PASB and, subsequently, as Assistant Secretary General for Management of the OAS, and that he generously donated the funds to establish the PAHO Award for Administration; To request the Director that he convey to Dr. Stuart Portner the gratitude of the Executive Committee and its wishes for his recovery. CD31.R2 June 1985 OD 202, 44 Having learned with deep sorrow of the catastrophe that has overtaken the United States of Mexico, where a major earthquake has caused tragic loss of life and heavy material damage,

103 90 9. MISCELLANEOUS 1. To express to the Government and the people of Mexico its deep sorrow at the tragedy which has befallen the country. 2. To convey to the victims' families, to all the Mexican people, and to the authorities, a message expressing the sympathy and solidarity shared by all the Member Countries of the Pan American Health Organization. 3. To urge all Member Countries to participate in providing assistance to the United States of Mexico, not only to the immediate consequences of the disaster but especially to the effort of reconstruction. 4. To urge international organizations, taking into account this tragedy, to give special understanding and support to the United States of Mexico, especially regarding its economic and financial obligations. 5. To request the Director to provide every assistance within the means of the Organization. September 1985 OD 203, 45

104 INDEXES

105

106 NUMERICAL INDEX RESOLUTIONS OF THE PAN AMERICAN SANITARY CONFERENCE Page Resolution CSP22.R9 CSP22.R10 CSP22.Rll CSP22.R12 CSP22.R13 CSP22.R14 CSP22.R15 CSP22.R16 Page Resolution CSP22.R17 CSP22.R18 CSP22.R19 CSP22.R20 CSP22.R21 CSP22.R22 CSP22.R23 CSP22.R24 CSP22.R25 RESOLUTIONS OF THE DIRECTING COUNCIL Page , , , Resolution CD29.R27 CD29.R28 CD29.R29 CD29.R30 CD30.R1 CD30.R2 CD30.R3 CD30.R4 CD30.R5 CD30.R6 CD30.R7 CD30.R8 CD30.R9 CD30.R10 CD30.R11 CD30O.R12 CD30.R13 CD30.R14 CD30.R15 CD30.R16 CD30.R17 CD30.R18 CD31.R1 CD31.R2 Page , ,21,68 / ,89 Resolution CD31.R3 CD31.R4 CD31.R5 CD31.R6 CD31.R7 CD31.R8 CD31.R9 CD31.R10 CD31.Rll CD31.R12 CD31.R13 CD31.R14 CD31.R15 CD31.R16 CD31.R17 CD31.R18 CD31.R19 CD31.R20 CD31.R21 CD31.R22 CD31.R23 CD31.R24 CD31.R25 CD31.R26 CD31.R27 93 Resolution CSP22.R1 CSP22.R2 CSP22.R3 CSP22.R4 CSP22.R5 CSP22.R6 CSP22.R7 CSP22.R8 Page Resolution CD29.R1 CD29.R2 CD29. R3 CD29.R4 CD29.R5 CD29.R6 CD29.R7 CD29.R8 CD29.R9 CD29.R10 CD29.Rll CD29.R12 CD29.R13 CD29.R14 CD29.R15 CD29.R16 CD29.R17 CD29.R18 CD29.R19 CD29.R20 CD29.R21 CD29.R22 CD29.R23 CD29.R24 CD29.R25 CD29.R26 Page , ,6

107 94 NUMERICAL INDEX RESOLUTIONS OF THE EXECUTIVE COMMITTEE Resolution Page Resolution Page Resolution Page CE90.R1 85 CE92.R5 17 CE95.R18 66 CE90.R2 71 CE92.R6 50 CE95.R19 66 CE90.R3 76 CE92.R7 60 CE95.R20 23 CE90.R4 41 CE92.R8 87 CE95.R21 15 CE90.R5 78 CE92.R9 30 CE95.R22 24 CE90.R6 51 CE92.R10 27 CE95.R23 34 CE90.R7 29 CE92.R11 66 CE95.R24 82 CE90.R8 43 CE92.R12 3,20,67 CE95.R25 83 CE90.R9 50 CE92.R13 2,20,67 CE90.R10 48,51 CE92.R14 19,20,68 CE96.R1 32 CE90.R11 2 CE92.R15 21,68 CE90.R12 65 CE92.R16 22 CE97.RI 47 CE97.R2 48 CE90.R13 11,75 CE90.R14 48,52 CE93.R1 45 CE97.R3 32 CE90.R15 10 CE95.R1 73 CE97.R4 73 CE90.R16 87 CE95.R2 76 CE97.R5 6 CE90.R17 69 CE95.R3 79 CE97.R6 77 CE90.R18 14 CE95.R4 81 CE97.R7 45 CE90.R19 39 CE95.R5 88 CE97.R8 4 CE90.R20 37 CE95.R6 44 CE97.R9 79 CE90.R21 25 CE95.R7 89 CE97.R10 80 CE90.R22 88 CE95.R8 31 CE97.R11 66 CE90.R23 89 CE95.R9 50 CE97.R12 66 CE95.R10 51 CE97.R13 88 CE91.R1 81 CE95.R11 42 CE97.R14 61 CE91.R2 82 CE95.R12 28 CE97.R15 62 CE95.R13 85 CE97.R16 18 CE92.R1 79 CE95.R14 12 CE97.R17 16 CE92.R2 76 CE95.R15 58 CE97.R18 18 CE92.R3 72 CE95.R16 11 CE97.R19 84 CE92.R4 72 CE95.R17 28 CE97.R20 65

108 ALPHABETICAL INDEX Accidents, prevention of, see Volume I Accounts and external audit, Administrative and staff matters, Administrative studies, see Volume I administrative rationalization, see Volume I see also PAHO/WHO Country Offices Admission of new Member Governments, St. Christopher and Nevis, 61 see also Volumes I and II Aedes aegypti, 8 see also Volumes I and II Aedes albopictus, 8 Agency for International Development (USA), 13 Agenda Directing Council, 50 Executive Committee, see Volume I Pan American Sanitary Conference, 48 Agreement between OAS and PAHO, see Volume I Agreement between WHO and PAHO, see Volume I Agreements border health, see Volumes I and II with Member Governments, see Volume I with other entities, see Volume II ALAESP, see Latin American and Caribbean Association of Public Health Education Alcoholism, see Mental health ALIFAR, see Latin American Association of Pharmaceutical Industries Allowances, salaries and, Andean Subregion, Joint Plan of Action, 5 Animal health, Area and Field Offices, see PAHO/WHO Country Offices see also Volumes I and II Assessments and contributions, collection of contributions, scales of, see also Budget policy; and Volumes I and II Assistant Director of PASB, salary of, 81 Associate Members, see Volume I Awards, Bacterial, viral, and mycotic diseases, 9-10 see also Volumes I and II Barquín, Manuel, 87 Basic Agreement on INCAP, 35 Basic Documents, see Volumes I and II Biomedical communications, see Latin American and Caribbean Center for Health Sciences Information Blindness, see Volume II Blood and blood derivatives, 14 see also Volume II Border health agreements, see Volumes I and II Budget, see Program and budget Budget policy, see also Program and budget Building (Reserve) Fund, see Volume I Buildings and installations for Area and Field Offices, 83 for Headquarters, see also Volumes I and II Cancer, see Noncommunicable disease prevention and control Cardiovascular diseases, see Noncommunicable disease prevention and control CAREC, see Caribbean Epidemiology Center Caribbean Community, 5 Caribbean Cooperation in Health, 4-5 Caribbean Development Bank, 5 Caribbean Epidemiology Center, 5 see also Volumes I and II Caribbean Food and Nutrition Institute, 5 see also Volume II CARICOM, see Caribbean Community Cartagena Agreement, 5 CEPANZO, see Pan American Zoonoses Center CEPIS, see Pan American Center for Sanitary Engineering and Environmental Sciences Chagas' disease, see Volumes I and II Charter of Punta del Este, see Volume I Chemical substances, control of, Cholera, see Volumes I and II Chronic and degenerative diseases, see Volumes I and II Cigarette smoking, control of, see Volume I CLAP, see Latin American Center for Perinatology and Human Development Collection of contributions, Communicable diseases, prevention and control, 7-13 Community participation and primary health care, see Volume II Community Water Supply Fund, see Volume I Conference of Ministers Responsible for Health in the Caribbean, 4, 5 Congratulations, expressions of sympathy, etc., Constitutional and legal matters, amendments to the Constitution, see Volumes I and II Basic Documents, see Volumes I and II Contadora Group, 4 95

109 96 ALPHABETICAL INDEX 96 ALPHABETICAL INDEX~~~~~~~~- Cooperation with other organizations, Coordinating Committee of the Codex Alimentarius, 11 Coordination of international cooperation, Coordination between institutions, 21 Coordination with the United Nations and other agencies, see Volumes I and II Cost-of-living adjustment, see Volume I Declaration of Alma-Ata, see Volume II Declaration of the Presidents of America, see Volume I Dengue, 8 see also Volumes I and II Dental health, see Volumes I and II Deputy Director of PASB, salary, 81 Diagnosis, technology of, Diagnostic, therapeutic, and rehabilitative technology, Diarrheal diseases, see Volumes I and II Directing Council, agenda, 50 officers, Rules of Procedure, 51 Technical Discussions, time and place of meetings, 50 see also Volumes I and II Director of PASB election of, reports annual and quadrennial, financial, salary, 81 see also Volumes I and II Disasters, see Emergency assistance Drugs abuse of, essential, production policy and marketing, time and place of meetings, 56 see also Volumes I and II Expanded Program on Immunization, Revolving Fund, 12, 75, see also Volume II Extension of coverage, see Volume II External auditor appointment, 78 report of, see also Volumes I and II Extrabudgetary funds and resources, Fellowships, see Volumes I and II Field service allowances, see Volume I FIFARMA, see Latin American Federation of the Pharmaceutical Industry Financial and administrative matters, Financial regulations and rules of PAHO, 69 see also Volumes I and II Financial Report of the Director and Report of the External Auditor, Five-Year Regional Plan of Action on Women in Health and Development, 30 see also Volume II Fluoridation, of salt and water, see Volumes I and II Food and Agriculture Organization of the United Nations (FAO), see Volume II Food and nutrition, policies, national, 25 see also Volumes I and II Food, sanitary control of, see also Volume II Foot-and-mouth disease and other zoonoses, see also Volumes I and II Fundamental principles of Pan American health, studies on, see Volume I Funds and resources, extrabudgetary, ECDC, see Economic cooperation among developing countries Economic cooperation among developing countries, Elderly, health care of, see Health of adults Emergency assistance, see also Volumes I and II Emergency Preparedness and Disaster Relief Coordination Program of PAHO, 24 Emergency Revolving Fund, see Volume 1 Emergency Voluntary Fund, see Volume II Employment conditions, study of, see Volume I Environmental health, promotion and development of, see also Volumes I and II EPI, see Expanded Program on Immunization Epidemiological surveillance, 7-8, 12 see also Volume II Epidemiology, 7 Equipment, see Supplies and equipment Evaluation and long-term planning, of the Pan American Centers, see also Volumes I and II Executive Committee, annual reports, 39 membership, 55 officers, representation at the Conference and the Council, 56 General directives for PAHO program, 1-7 General programs of work covering a specific period, 6-7 see also Volumes I and II Governing Bodies of PAHO, list of meetings, xii Guido, Lea, 89 Headquarters, PAHO, buildings, see also Volume I Health of adults, Health for all by the year 2000, strategies, 2-3 see also Technical cooperation among developing countries Health of the disabled, 29 Health education, see Volumes I and II Health of the elderly, see Volume II Health information, Health legislation, national, see Volume I Health personnel migration of, see Migration of health personnel training of, see Volumes I and II Health planning and administration, Health and population dynamics, see Volume I Health promotion, see Health protection and promotion Health protection and promotion general, specific population groups, 27-33

110 ALPHABETICAL INDEX 97 ALPHABETICAL INDEX 97 Health regulations, see Volume I Health services and systems, development of, 19-24, see also Volumes I and II Health and socioeconomic development, 19 see also Volumes I and II Health statistics, see Volume I Health and youth, Hepatitis, 9-10 Hipólito Unanue Agreement, 5 Holding Account, see Volume II Hospitals, maintenance and engineering, see Volume II Housing, sanitary control of, see Volumes I and II Human resources, development of, 33 Hypertension, see Noncommunicable disease prevention and control IDB, see Inter-American Development Bank IICA, see Inter-American Institute for Cooperation on Agriculture ILO, see International Labor Organization Immunization, see Expanded Program on Immunization INCAP, see Institute of Nutrition of Central America and Panama Income sources and programs, additional, other, see Volumes I and II Influenza, see Volume I Insignia, official, PAHO, see Volume I Institute of Nutrition of Central America and Panama, 35, 76 see also Volumes 1 and II Inter-American Commission of Women, see Volume II Inter-American Council of Psychiatric Associations, 66, 67 Inter-American Development Bank, see also Volumes I and II Inter-American Institute for Cooperation on Agriculture, 10 Inter-American Meeting, at the Ministerial Level, on Animal Health I and II, see Volume II III, IV, 11 see also Zoonoses; Veterinary public health Inter-American Meetings, at the Ministerial Level, on Footand-Mouth Disease and Zoonoses Control, see Volumes 1 and II see also Zoonoses; Veterinary public health International Conference on Primary Health Care-Declaration of Alma-Ata (September 1978), see Volume II International Drinking Water Supply and Sanitation Decade, 16 International health regulations, see Volume I International Labor Organization, see Volume I International Program on Chemical Safety, International transportation of human remains, see Volume 1 International Yéar of Disabled Persons, 29 see also Volume II Joint Coordinating Board of the WHO Special Program for Research and Training in Tropical Diseases, PAHO representation on, see also Volume II Joint Plan of Action, Andean Subregion, 5 Joint WHO/UNICEF Meeting on Infant and Young Child Feeding, 25 Laboratory, technology, Language allowance, staff, see Volume I Latin American and Caribbean Association of Public Health Education, 66 Latin American and Caribbean Center for Health Sciences Information, see Volumes I and II Latin American Association of Pharmaceutical Industries, 66 Latin American Center for Educational Technology in Health, see also Volumes I and II Latin American Center for Perinatology and Human Development, see Volume II Latin American Federation of Hospitals, 66 Latin American Federation of the Pharmaceutical Industry, 66 Latin American Union against Sexually Transmitted Diseases (ULACETS), 67 Leprosy, see Volumes I and II Long-range health programs, plans of, and other program criteria, see Volume I Long-term planning and evaluation, see also Volumes I and II Long-Term Planning and Programming Subcommittee, see Planning and Programming Subcommittee Macedo, Carlyle Guerra de, Malaria, see Volumes I and II Maternal and child health, including family planning, see also Volumes I and II Measles, 12 Medical care administration, see Volumes I and II coordination with social security services and other institutions, 21, see also Volume I hospital planning and administration, Meetings Directing Council, Executive Committee, Pan American Sanitary Conference, 56 Member Governments admission to membership, reports of, see also Volumes I and II Member States of PAHO, see Member Governments Meningitis, see Volumes I and II Mental health, Migration of health personnel, see Volume I Ministers of Health, special meetings, see Volumes I and II Mycoses, see Volume I Name, official, PAHO, see Volume I National health committees, see Volume I National health plans, see Volumes I and II National Library of Medicine (USA), 89 Noncommunicable diseases, prevention and control, see Volumes I and II Nongovernmental organizations, see Volume I organizations in official relations with PAHO, principles governing relationship, 65 see also Volumes I and II Nursing, 26 Nutrition, (see also Caribbean Food and Nutrition Institute; Institute of Nutrition of Central America and Panama)