WORLD HEALTH ORGANIZATION ЕВ65/13 ORGANISATION MONDIALE DE LA SANTÉ 8 November 1979 EXECUTIVE BOARD INDEXED Sixty-fifth Session Provisional agenda item 11 1 5 NOV. 1379 REPORTS OF THE REGIONAL DIRECTORS ON REGIONAL COMMITTEE MATTERS REQUIRING THE PARTICULAR ATTENTION OF THE BOARD Thirtieth session of the Regional Committee for the Western Pacific The Director-General has the honour to present to the Executive Board a report by the Regional Director highlighting those matters emanating from the thirtieth session of the Regional Committee for the Western Pacific which may require the particular attention of the Board. Should members of the Board wish to see the full report of the Regional Committee, it is available in the Executive Board room.
EB65/14 Add.l page 2 ANNEX REPORT OF THE REGIONAL DIRECTOR ON THE WORK OF THE THIRTIETH SESSION OF THE REGIONAL COMMITTEE FOR THE WESTERN PACIFIC The thirtieth session of the Regional Committee for the Western Pacific was held in Singapore from 2 to 8 October 1979. Representatives of 16 of the 19 Member States of the Region attended. Representatives pf the United Nations, the United Nations Children's Fund, the United Nations Development Programme and the Office of the High Commissioner for Refugees, as well as of the International Committee of Military Medicine and Pharmacy and 20 nongovernmental organizations in official relations with WHO, were also present. The Director-General was present at the opening of the session. Dr Andrew G. K, Chew, Singapore, was elected Chairman; Dr Raja Ahmad Noordin, Malaysia, Vice-Chairman; Dr S. Foliaki, Tonga, Rapporteur for the English language and Mr Nguyen Van Trong, Viet Nam, Rapporteur for the French language. The Regional Committee decided to amend Rule 51 of its Rules of Procedure, relating to nomination of the Regional Director, to bring it into line with the corresponding rules of the other regional committees. The amendment provides for the election of one candidate from among the persons proposed for the post of Regional Director whose name will be submitted to the Executive Board, instead of the two or three candidates hitherto proposed to the Executive Board. The Committee reappointed the representative of the Philippines as a member of the Joint Coordinating Board of the Special Programme for Research and Training in Tropical Diseases for a further period of three years from 1 January 1980. The Committee reviewed and noted the significant changes in the approved programme budget for 1980-1981, due to developments at country level. 1. Report of the Regional Director In discussing the report of the Regional Director for the bietmium July 1977 to June 1979, the Coimnittee noted the following major achievements in the work of the Region: (1) establishment of the Western Pacific Regional Centre for the Promotion of Environmental Planning and Applied Studies (PEPAS); (2) establishment of a regional centre for research and training in tropical diseases at the Institute for Medical Research, Kuala Lumpur; (3) development of plans for a regional progranme of greatly intensified activities for diarrhoeal diseases control (the subject was also discussed as a separate item on the agenda, during which the importance of surveillance, especially for cholera, was emphasized as the only effective control measure, backed by such long-term measures as improved water supply and sanitation, with oral rehydration as an immediate short-term control measure); (4) progress in the development of the programme for the control of acute respiratory infections including the establishment of surveillance units for the collection of epidemiological data and for research on respiratory diseases (the Technical Presentation during the session was on the same subject); (5) progress towards the establishment of a South Pacific joint pharmaceutical service; (6) establishment of a regional coordinating group for the mental health programme; (7) increased activities for the control of drug dependence and, in particular, the development of a programme of research into the epidemiology of drug abuse; (8) development of a health services research programme; (9) intensified activities under the Expanded Programme on Immunization. 2. Subcommittees of the Regional Conmiittee In an attempt to rationalize membership of the two subcommittees of the Regional Committee and having established rotation of members, the Committee decided that the period of tenure should be for three years and that, if possible, a country should not be represented on both subcommittees at the same time. At the current session two members of the Subcommittee on
EB65/14 page 3 Annex Technical Cooperation among Developing Countries were replaced, so that its membership is: Australia, Papua New Guinea, Philippines and Republic of Korea; and three members of the Subcommittee on the General Programme of Work were replaced, so that its membership is: China, Japan, New Zealand, Samoa, Singapore, Tonga and Viet Nam. Members will henceforth be replaced whenever they have served for three years. 2.1 Subcommittee on Technical Cooperation among Developing Countries (TCDC) The report of the Subcommittee on Technical Cooperation among Developing Countries, composed at the time of its meeting (March 1979) of representatives of Japan, Papua New Guinea, Republic of Korea and Singapore, was presented to the Regional Committee and the recommendations contained in it were adopted. The Subcommittee had reviewed activities for TCDC in the fields of primary health care, drug policies and management and health manpower development. The next topic to be reviewed will be the primary health care aspects of communicable disease control. After its first attempt, at the twenty-seventh session, to define technical cooperation among developing countries,1 the Regional Committee was still much concerned to define the true meaning of the term and to establish exactly what, in the activities of WHO, the concept of TCDC embraced. It therefore requested the Subcommittee to discuss the meaning of the term in depth, together with mechanisms for its implementation and the role to be played by WHO. 2 2 Subcommittee on the General Programme of Work The Subcommittee on the General Programme of Work composed, in 1979, of representatives of Australia, Japan, Malaysia, New Zealand, Philippines, Tonga and Viet Nam had a heavy workload during the year. It met twice, in March and in August, and two groups of its members carried out country visits in April, to Papua New Guinea and the Solomon Islands and to the Philippines, the Republic of Korea and Viet Nam. Those activities were to fulfil the two main components of its terms of reference: review and analysis of the impact of WHO* s collaboration with countries, and the study of WHO'S structures in the light of its functions. The Subcommittee's involvement in the latter study was considered to be directly related to the support to be given to Member States in developing and implementing their national policies, strategies and plans of action for the attainment of an acceptable level of health for all by the year 2000. At its meeting in March 1979, therefore, it also undertook to recommend to the Regional Committee that the work in connexion with that formidable task should be added to its terms of reference. The Committee accepted the recommendation. The subjects for the review of the impact of WHO'S collaboration with countries in 1979 were: primary health care, including its health manpower development aspects, and drug policies and management as related to primary health care and certain aspects of disease control, such as tuberculosis. The Committee reviewed and endorsed the report of the Subcommittee which concluded that, in general, health administrations recognized priorities for training, health improvement and community participation and that WHO support should be directed towards educational, rather than operational, activities by developing mechanisms to help health staff at all levels to implement more effective health improvement services and achieve better communication with communities. The Committee also reviewed and endorsed the Subcommittee's conclusions with regard to WHO's structures in the light of its functions, for transmittal to the Director-General and inclusion in his global report to the Executive Board.2 It was noted that much emphasis was placed on the increasingly active involvement of the regional committees in the work of WHO and on their role as major policy-making organs and fora for promoting technical cooperation between Member States. It was considered lamentable that certain Member 1 Resolution WPR/RC27.R18, Handbook of Resolutions and Decisions of the WHO Regional Committee for the Western Pacific, Vol. I, 1978, p. 12. Document EB65/18.
EB65/14 page 4 Annex States of the Western Pacific Region had been unable to make a contribution to the deliberations of the Regional Committee because they had not been able to find sufficient funds to pay the cost of their representatives' attendance. It was also observed that the regional coxnmittees were the only WHO meetings for which travel and per diem expenses were riot paid, The Committee recommended to the Executive Board, and through it to the World Health Assembly, that action should be taken for WHO to consider financing the cost of travel, excluding per diem, of one representative from each Member State to attend the Regional Committee. 3 Formulation of strategies for health for all by the year 2000 As indicated above, the tasks involved in preparing for the Regional Committee 1 s first review were undertaken by the Subcommittee on the General Programme of Work. Reports received from Member States on progress in formulating or implementing national policies, strategies and plans of action to launch and sustain primary health care as part of a comprehensive national health system, in coordination with other sectors, had been reviewed by the Subcommittee and summarized in its report for the benefit of the Committee. Further reports were presented during the session. The Regional Director was authorized to transmit the report of the Subcoinmittee and a record, in an appropriate form, of reports and deliberations during the session to the Director-General for inclusion in his report to the Executive Board.1 To enable Member States to prepare their reports in time for the thirty-first session of the Regional Committee in 1980, the Regional Director was requested to develop and distribute an outline to be followed. He was also asked to develop suggested objectives, targets and indicators, so that a regional strategy can be formulated, and to establish support mechanisms for the formulation of both national and regional strategies. The Regional Coxnmittee reviewed and noted the draft material prepared for the assistance of the Programme Committee of the Executive Board in making proposals for the nature, objectives, structure and method of preparation of the Seventh General Programme of Work - one of the basic mechanisms to support strategies for the attainment of health for all by the year 2000. It also commented on the contribution that such strategies could make to the New International Economic Order. Health could form an important bridge between national and international economic development efforts. The contribution that WHO'S strategies for health for all could make towards economic development needed to be proved, not only at the technological, but also at the political level, so as to demonstrate to the world the benefits of investment in health: that it was not just a service provided to consumers but a major contributor to national productivity. The progress of country health programming in the Region was also considered. 4. Health manpower development Throughout the session representatives referred constantly to the importance of health manpower development, integrated with health services development, for achieving the goal of health for all by the year 2000. The Committee therefore welcomed the discussion on the WHO fellowships programme and the recommendations of the February 1979 Conference on Regional Cooperation in the WHO Fellowships Programme, aimed at improving selection procedures and the utilization of fellows on their return home by relating fellowships to specific national projects; improving the administration of fellowships by WHO; and action by receiving countries. The Regional Director was requested to continue evaluating the programme. 5 Development of biomedical and health services research The Committee noted the further consolidation of the programme, the impact being measurable in terms of the number of activities being implemented, the increased relevance of research to local needs and the fact that the six technical advisory bodies of the Western Pacific Regional 1 Document EB65/4.
EB65/12 page 5 Annex Advisory Committee oil Medical Research had ceased to be task forces and were now established as subcommittees of the Regional Advisory Committee. Resources, hitherto allocated to the research promotion and development programme, had been allocated to individual technical programmes - mainly communiсable disease control programmes - for the development of research components. It was felt that intensive effort should be made to provide career structures and employment opportunities for research workers. 6 Cancer situation in the Region Review of the available data consolidated by the Secretariat for presentation to the Regional Committee revealed lack of knowledge of the situation in the Region. What information there was, however, showed a remarkable range of site incidence. The Committee urged promotion of national cancer information systems, particularly the development of population-based and hospital-based cancer registries for assessment of the true nature and magnitude of the problem. 7 Immunization services and their evaluation The Committee agreed that the Expanded Programme on Immunization, delivered by means of the primary health care approach within the health services delivery system, represented one of the simplest and most effective activities WHO could encourage. The target of the Programme could be achieved only if information bases, both regional and national, adequate for the evaluation of the Programme were established, within the framework of national health management information systems. 8. Antimalaria programme Some national authorities were still failing to provide the necessary budgetary support to maintain the programme at the required level and the Committee emphasized that sustained government commitment remained a prerequisite for progress. Safeguarding their freedom from malaria was an important goal for countries that had reached the maintenance phase. There was also a need in the Region for applied research in field operations. 9 Radiation medicine in public health In discussing the development of radiation medicine services in the Western Pacific Region, the Committee looked forward to improved technical cooperation in that field in the future in order to strengthen national capabilities for planning and developing radiological services. It placed particular importance on the training of technicians in the maintenance and repair of radiological equipment. * * * The Committee noted that, after discussion between the Government of the Republic of the Philippines and WHO on the reinterpretation of the Host Agreement, Article VIII, section 22(g), agreement had been reached which made further negotiation inappropriate. After some discussion on whether or not sessions should extend over a week-end, the Committee decided that its thirty-first session should be held in Manila from 9 to 15 September 1980. It accepted with appreciation the invitation of the Government of the Republic of Korea to hold the thirty-second session in Seoul, noting that the representative of China had asked for the reservation expressed by his delegation to be placed on record. The theme of the Technical Presentation at the current session was "Acute respiratory infections". "Community involvement in the development of health services 11 was selected as the topic for the Technical Presentation in 1980. A proposal to discontinue the practice of arranging a technical presentation during sessions of the Regional Committee was not accepted.
WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ EB65/14 Add.l 5 December 1979 EXECUTIVE BOARD INDEXED Sixty-fifth Session Provisional agenda item 11 REPORTS OF THE REGIONAL DIRECTORS ON REGIONAL CCMMITTEE MATTERS REQUIRING THE PARTICULAR ATTENTION OF THE BOARD Reimbursement of travel costs of representatives to regional committees Report by the Director-General 1. The Regional Committee for the Western Pacific, at its thirtieth session in October 1979, adopted resolution WPR/RC30.R10 (see Annex) on the subject of cost of travel of representatives. As stated in operative paragraph 2 of this resolution, the Regional Committee recommends to the Executive Board and, through it, to the World Health Assembly that action should be taken for WHO to consider financing the cost of travel, excluding per diem, of a representative from each Member State to attend sessions of the Regional Committee. 2. The question of payment of travel expenses by WHO for representatives to regional committees was considered 011 a number of occasions by the Executive Board and the World Assembly during the period from 1948 to 1954. The action taken in this respect may be summarized as follows : Health (i) The Executive Board in 1948 authorized by resolution EB2.R53 the reimbursement for transportation expenses of one representative only of each Member State to the first meeting of each regional committee. (ii) In 1950 the Board, in resolution EB5.R61, confirmed its decision that reimbursement of transportation expenses of one representative of each Member State be authorized for the first meeting of each regional committee only, and that reimbursement for such expenditure should not be authorized for subsequent meetings of regional committees. (iii) In 1953 the Board, after reviewing a study of regionalization, recommended to the World Health Assembly in resolution EB11.R50 that it authorize the reimbursement of each Member State and each Associate Member for the actual travelling expenses of one representative to not more than one session a year of the regional committee. However, the Sixth World Health Assembly (1953) decided in resolution WHA6.44 to postpone its consideration of the matter and invited regional committees to study and comment 011 the Board's proposal. (iv) As requested by the Sixth World Health Assembly, the regional committees examined this matter at their sessions in 1953. The Regional Committees for Africa, Europe and the Western Pacific recommended that the travel expenses of representatives attending regional committee meetings should be borne by the Member States and Associate Members concerned. The Regional Committee for the Americas proposed that such expenses should be reimbursed. The Regional Committee for South-East Asia expressed the opinion that "such payment of travel expenses by WHO is desirable if it does not reflect adversely on the field programmes of the Organization") 1 WHO Official Records, No. 52, 19 54, Annex 5, for the Eastern Mediterranean did not meet in 1953, on by it. paragraph 2.1. this matter was As the Regional Committee not studied and commented
EB65/14 Add.l page 2 (v) In 1954 the Executive Board, having considered the comments of regional committees on the payment of travel expenses of representatives attending their sessions, withdrew its earlier recommendations 011 this subject, and in resolution EB13.R27 recommended to the World Health Assembly that these expenses should not be reimbursed by WHO. The Seventh World Health Assembly (1954), in resolution WHA7.27, accepted the Board's recommendation and decided that these expenses should not be reimbursed by WHO. 3. In view of the foregoing it is suggested that the views of the other regional committees on this matter be sought during 1980 so as to facilitate the Board's consideration of the proposal made by the Regional Committee for the Western Pacific. If the Board agrees to this approach it may wish to consider a draft resolution along the following lines: The Executive Board, Having noted the recommendation of the Regional Committee for the Western Pacific that action should be taken for WHO to consider financing the cost of travel, excluding per diem, of a representative from each Member State to attend sessions of the Regional Committee ; INVITES the other regional committees to consider this proposal at their sessions in 1980 and to submit their views and comments for consideration by the Executive Board at its sixty-seventh session in January 1981.
EB65/14 Add.l page 3 ANNEX RESOLUTION WPR/RC30.R10 OF THE REGIONAL FOR THE WESTERN PACIFIC COMMITTEE Cost of travel of representatives The Regional Committee, Referring to resolution WPR/RC4.R18, which recommended that the travelling expenses of Member and Associate Member States for attendance at sessions of Regional Committees be borne by the Member and Associate Member governments ; Noting that the cost of travel, excluding per diem, of a delegate from each Member to the World Health Assembly is borne by the Organization; State Recognizing the increasing involvement of the Regional Committee in the work of WHO and its role as a major policy-making organ and a forum for promoting technical cooperation between Member States of the WHO Western Pacific Region; Stressing the need for all Member States of the Region to be involved in the of the Regional Committee; deliberations 1. SYMPATHIZES with those Member States that, because of financial constraints, have either been unable to send representatives to sessions of the Regional Committee in recent years or have sent representatives despite the financial hardship involved; 2. RECOMMENDS to the Executive Board and, through it, to the World Health Assembly that action should be taken for WHO to consider financing the cost of travel, excluding per diem, of a representative from each Member State to attend sessions of the Regional Committee.