ÜNICEP/WHO JOIMI COMMITTEE ON НЕШИ POLICY. Report of the Seventh Session

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1 UNITED NATIONS NATIONS UNHES WORLD HEALTH ORGANIZATION EXECUTIVE BOARD Fourteenth Session Supplementary agenda item ORGANISATION MONOIAIE DE LA SANTÉ SB04/16 21 May ORlGimLî ENGLISH ÜNICEP/WHO JOIMI COMMITTEE ON НЕШИ POLICY Report of the Seventh Session The Director-General has the honour to present to members of the Executive Board for their information the report of the seventh session of the UNICEF/WHO Joint Committee on Health Policy 1 held in Geneva 29 April - 1 May J * Document E/ÏCEF/263

2 E/ECEF/ May 1954 ORIGINAL: ENGLISH 4 UNITED MTIÇNS CHILDREN'S FUND Executive Board WORLD HEALTH OÎ^ANI^I.ON Executive Board UMCEF-WHO JOINT COMMITTEE ON HEALTH POLICÏ REPORT OF THE SEVENTH SESSION HELD AT THE HEADQUARTERS OF THE WORLD HEALTH ORGANIZATION, GENEVA 29 April - 1 May 1954 RAPPORTEURS: Prof. R. DEBRE and Dr. K.K. MACKENZIE Table of Contents Paragraphs Attendance 1 Election of Chairman 2 Approval of the îilnutes of the Sixth Session 3-4 Adoption of Agenda 5-6 Progress Report on BCG Campaigns 7-16 Progress Report on Trachoma Campaigns Progress Report on Treponematoses Control Cançaigns Aid for Nutrition Prograinmes Other Business 30-31

3 Attendance I The attendance at the session was as follows Representatives! UNICEF _i i шттётт^^ Prof. R. Debré Dr. M. M. Eliot Dr. A. R. Lindt Mr. R. Pleic Dr. B. Rajan WHO Prof. M.J. Ferreira (Chairman) Dr. Anwar Dr. S. Hayek Dr. M.M. Mackenzie Dr. H. van Zile Hyde Secretaries! Dr. B. Borcic Dr. Ip C. Yuan Dr. om. Bonne Dr. K. SinclaireLoutit Dr. F. Mortara Also present; Dr..R. Aykroyd, D JDM^G. Candau )FAO DrV.A. Sutter )DJ.S. Peterson rd)j. Holm rd Palmer )DrM.Giaquinto rdrt. Guthe rdr. Burgess re» Alexander Election of Chairman 2o Professor M.J. Ferreira was unanimously elected chairman. Professor Debré, the retiring chairman, thanked the Committee for its collaboration during the period of his office and welcomed Dr. Candau, the Director-General of WHO, expressing the assurance that working with the new Director-General will be as pleasurable as it had been with Dr«Chisholm. Formal approval of the minutes of the Sixth Session 3c The Chairman drew attention to the minutes of the Sixth Session of the UNICEF-WHO Joint Committee on Health Policy, which met in Geneva on 1 and 2 May, o The minutes of the Sixth Session of the UNICEF-WHO Joint Committee on Health Policy were forüially approvedo / Adoption «ее

4 Adoption of the Agenda «5. The question was raised whether the Committee was in a position to deal effectively with item 7 on the revised provisional agenda (Methodology of Long-Term Planning)» The Director-General of WHO stated that, after consultation with the Executive Director of UNICEF on this question, it had been agreed to suggest that this item should be withdrawn until there had been more discussion between the two Organizations and common points of view had been more clearly formed,, The Committee decided therefore that item 7 should be deleted from the agenda 0 ⑴ Election of Chairman Formal approval of the minutes of the Sixth Session. (JC6/UMCEF-WH6/Min. 1-4) Adoption of the Agenda Progress Report on BCG Campaigns (JC7/UNICEF-T(fflO/l) Progress Report on Trachoma Cançiaigns (JC7/UNICEFr4JH0/2) Progress Report on Treponematoses Control Programmes (JC7/UNICEF-WH0/3) 7) Aid for Nutrition Programmes (JC7/UNICEF" HO/5) 8) Other Business Progress Report on BCG Car^paigns^ ^ К щ i HI w I» " 1 «ЧИЧ и H ПИ--Г-1Г The Committee^ in considering the document entitled "Report on Tuberculosis to the Joint Committee on Health Policy" (Part I and Add. 1) and "Problems in Tuberculosis Control from the Public Health Point of View" (Part II), discussed the following 6. The Committee adopted the revised provisional agenda* as follows:- problemss- - r - : / 8. The first * JC7/UNICEF-WH0 ' 絲 JC7/UNïCE?-WH0/l

5 8 e The first considered was that of the work of the assessment teams. The Committee appreciated the importance of the work done by these teams with relation to allergic reaction These studies, however, might not give a full evaluation of the protective effect of the vaccine 0 The Coinmittee hoped that the investigations which are currently being carried out in certain countries and which are directed towards a comparative study of unvaccinated control groups and groups of those who have been vaccinated with BCG will coutinue and be expanded^ 9. The Committee further recommended, that ал investigation should be made regarding the possibility of supplementing the studies now under way studying the incidence of tuberculosis in vaccinated and unvaccinated individuals in suitably selected areas within the framework of the WHO UNICEF assisted BCG programes The Committee realized that such information might only provide indications but these would be of value e 10 The Committee, while noting the contents of the report before it, recommended that a further comparative study should be undertaken of the organizational methods and of the cost of the mass campaigns<> 11 Recent developments in new drugs appeared to leave little doubt that whatever the final curative effect might be, a lessening of the infectivity is obtained, at any rate temporarily e The appearance of resistance against these drugs may complicate their mass use 0 12 The Committee recommended that WHO and UNICEF should consider favourably a liniited number of requests for pilot projects designed to give protection to the ejiild population through the drug treatment of their iranediate infective contacts Such projects would necessarily have to be in carefully selected areas,limited in size and on strictly scientific lines /13 The Committed

6 13. The Committee reaffirmed that аду extension of BCG campaigns should continue to be based, on preliminary epidemiological studies as recommended at the last meeting of this Committeeо 14. Apart from BCG campaigns, the Committee considered the need for studies preliminary to large-scale tuberculosis control programmesо It was generally felt that requests for sttch studies should be considered for joint action by the two Organizations only when they farm a necessary part of a later definite programme, 15. The Committee took note of the need for the continued maintenance of an adequate stock of standardized PPD to serve the future needs of internationally-assisted mass campaigns» The Committee discussed the cpiestion of BCG projection laboratories. The Committee recognized that there was an obligation that laboratories manufacturing BCG to be used in UNICEF/WHO assisted vaccination cairpaigns should conform to the specifications concerning safety laid down by the third session of the WHO Expert Committee on Biological Standardization, as amended by its sixth session. 17. It noted that up to the present BCG vaccine used in UNICEF/WHO assisted campaigns had always been prepared by laboratories which had been approved for this purpose Ъу ТОЮ The Committee recommended that WHO be kept informed on the work and any changes in these "approved" laboratories by means of an annual report to be submitted by them, based on a WHO questionnaire. It is noted that such "approval" has only a restricted meaning, "Approval" of laboratories by WHO does not imply control of the vaccine. 18 太 he Committee expressed the vàsh to be kept informed of any serious conçlications rightly or wrongly attributed to BCG vaccination in various countries. /Progress report

7 Progress report on trachoma campaigns-x- 19 The Committee considered the document entitled "Report on Activities on Trachoma and Associated Ophthalinias to the UNICEF-WHO Joint Coinmittee on Health Policy" and noted with satisfaction the encouraging developments of the pilot projects hitherto undertaken with international assistance which were particularly 鲁 well received by the populations concerned. 20. The Committee recommended that the work be pursued on the lines alreadyestablished and that some widening of the anti-trachoma activities could be effected by:- (1) assisting new projects in areas having similar epidemiological conditions to those already dealt with through successful pilot projects; (2) assisting new pilot projects in countries having different epidemiological conditionsо 21 The Coinmittee expressed the wish to be informed on the progress of trachoma campaigns in various countries Progress report on treponematoses control campaigns^-x- 22o The Coranittee considered the two papers entitled "A Report on Treponematosis prepared for the Joint Committee on Health Policy, UNICEF-WHO, at its Seventh Session" (Part I) and "Problems in Treponematoses Control from the Public Health Point of View" (Part II). 23«The Committee expressed satisfaction with the presentation of the problems contained in these papers and approved the approach to their solution suggested. 於 JC7/UNICEF-WH0/2 絲 JC7/UNICEF^JH0/3 /24. The Coinmittee 1 s

8 24 T h e Committee's attention was particularly:given to the foxlc?wing four matters: (1) In tropical countries the treponematoses. control can best be achieved by a coordinated approach to the problems of the areas as a whole. The Committee therefore noted with approval the plans to hold an international yaws conference in Africa in 1955, which would not be limited to the problems of the continent,, The conference would provide for programme discussions in the over-all co-ordinated yaws control plan f lon S duration now under study in that region. The Committee noted that similar over-all planning was under way in the Western Pacific Region (2) The Committee noted the need for assessment of the work already achieved with international assistance. The 20 million examinations and. 4 million treatments which have been undertaken in mass campaigns to date offer a very rich source of data with which to guide future campaigns 0 It was noted with approval that such assessment could be accomplished by assessment teams concerned with technical as well as wi'h organizational and other aspects of the treponematoses control work. ⑶ The Committee recognized the need for a more detailed study of the way in which the initial gains of the penicillin mass carapaigns could be consolidated...it therefore recommended that consideration should be given to requests for projects designed to implement control of. the residue or re-appearance of treponematoses as part of the health services in rural or urban areas where a mass campaign had previously taken place» (4) The Committee discussed the variation in cost of the different mass campaigns. It observed with satisfaction the downward trend of mass control cost and also noted the epidemiological and other reasons for the miation in penicillin dosage actually employed in the different projects assisted by WHO and UNICEF 0 /Aid for

9 Aid for Nutrition Prograjoines-x-- 25«The Coinmittee considered the document entitled "Suggestions regarding Future Activities in the Prevention of Malnutrition in Infants and Young Children" 0 The chairman welcomed the observer from FAO) who presented a note prepared by FAO entitled "The Prevention of Malnutrition in Mothers^ Infants and Young Children" # 26 The Committee emphasized the interest of the Organizations in studies and pilot projects directed towards making available in a way suited to the economic and cultural life of protein-deficient countries supplies of proteins needed, for the health of infants, children and mothers 0 27 The Coïïimittee recommended that, in so far as internationally«assisted milk distribution schemes were concerned) the relation with the maternal and child health services should always be conditioned by the special circumstances of the area and the administrative policy of the government 28 The Committee noted with satisfaction the proposal to study the effectiveness of presen-o methods of milk distribution,, The Committee recommended that a careful study of the proposal to set up special milk distribution centres separate from maternal and child welfare centres should be included to determine the conditions under which such centres would make the greatest contribution to the long-range maternal and child health prcgranimes,, 29, The Committee noted FAO 1 s readiness 七 о assist in that portion of the review which falls within its scope * JC7/roiICE?^;fflO/5 /Other Business

10 Other Business 30o The Committee noted that, at the second meeting of the JCHP, a procedure was accepted by the Committee which established the responsibility for calling subsequent meetings in the following way: "It was agreed that the date and place of the next meeting should be left to the discretion of the Chairman,the Director-General of Ш0, and the Executive Director of UMCEFo" 31o The Committee decided to recommend that future meetings should be called on the ;joint decision of the Director-General of WHO and the Executive Director of UNICEF, in consultation with the Chairman of the JCHP 0