•

WORLD HEALTH ORGANIZATION

REGIONAL COMMITTEE FOR THE WESTERN PACIFIC

TWENTY - FIFTH SESSION

Kuala Lumpur. 2 - 9 September 1974

REPORT OF THE REGIONAL COMMITTEE

SUMMARY RECORDS OF THE PLENARY SESSIONS

MANILA

October 1974

II

WORLD HEALTH ORGANIZATrON

REGIONAL COMMITmE FOR THE WES'IERN PACIFIC

1WENTY'-FIFTH SESSION

Kuala Lumpur, 2-9 September 1974

REPORT OF THE REGIONAL COMMITmE SUMMARY RECORDS OF THE PIENARY SESSIONS

MANILA October 1974

NO'IE

The twenty-fifth session of the Regional Committee for the Western Pacific was held at the Dewan 'l\mku Abdul Rahman, Jalan Ampang. Kuala Lumpur. from 2 to 9 September 1974. under the Chairmanship of Tan Sri Dato (Dr) Abdul Majid bin Ismail (Malaysia). wi th Dr J. Dizon (Philippines) as Vioe-Chairman. Dr Peni Vuiyale (Fiji) and Dr J. Laigret (France) were the Rapporteurs.

The Regional Committee met on 2. 3. 4. 5 and 9 September. The report of the Committee will be found in Part I of this document on pages 1-58. the summary records of the plenary sessions in Part II on pages 65-161.

The Sub-Committee on Programme and Budget met on 4 and 7 September. The report of the Sub-Commi ttee will be found in Part I of this document on pages 4-17.

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I

II

III

I

CONTEN'lB

INTR.ODtJC'I!I ON" ••••••••••••••••••••••••••••••••••••••••••• 1

ANNUAL REPORT OF THE REGIONAL DIRECTOR COVERING THE PERIOD 1 JULy 1973 TO 30 JUNE 1974 ........ PROPOSED PROOlW<!<lE AND BUDGET FOR 1976 AND 1977 ........ 1 Intl'Oduotlon ••••.••••••.•.••.•.•••••••••••.•..••••

2 Review of budget performance 1973 -direct services to governments of the Region by subjeot heading, by country

2

4

4

and by proJeot •••.•••••••••••••••••••••••••••••••• 6

3

4

Modifioations to the 1974 and 1975 regular progranme and budget estimates

Review of the proposed programme and budget estimates for 1976 and 1977

5 Consideration of tentative projeotion

•••••••••••• 6

............ 7

tor 1978 8lld 1979 ......••........•........•.....•. 17

6 ResolutlOIl.B •••••••••••••••••••••••••••••••••••••••

O'rlER MA'rmM •••• ••••••••••••••••••••••••••••••••••••••

1 Resolutions of regional interest adopted by the Twenty-seventh World Health Assembly and the Executive Board at its fifty-third

17

18

s8ssiOIl ••.•••••••••••••••••••••••••••••••••••••••• 18

2

3

4

5

6

Disinsection of airoraft ••••••••••••••••••••••••••

QUali ty of water and food in international aviation ......................... Drug dependence •••••.•••••••••••••••••••••••••••••

Review of the Fifth General Prograrmne of Work Covering a Speoific Period (1973-1977 1nclus1 ve) •••.•.••••.••••.•••.••••••••.

ProJeot systems analysis ••••••••••••••••••••••••••

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21

22

23

24

25

IV

CON'lEN'lE

7 Cholera precautions - importation by pilgrims of holy water ••••••••••••••••••••••••• 25

8 Technical cooperation among developing oountries ••.•••••••••••.•••••••••••••••••••••••••• 25

9 Time and place of the twenty-sixth and twenty-seventh sessions of the Regional Committee ••••••••••••••••••••••••••••••••••••••••• 26

10 Technioal Discussions ••••••••.••••••••••••••••••••

11 Technioal Presentation •.•.••••••••••••••••••••••••

12 Reports received from governments on the progress of their health activities ••••••••••••••• 28

RESOI.U'1!IONS ADOP'lED BY THE REGIONAL COMMI'l"lEE .......... WPR/RC25.Rl

WPR/RC25.R2

WPR/RC25.R3

WPR/RC25.R4

WPR/RC25.R5

WPR/RC25.R6

WPR/RC25.R7

Annual Report of the Regional D1r-eotor •••••••••••••••••••••••••••••••

Quali ty of water and food in international aviation .............. Drug dependenoe ••.•••••••••••••••••••••

Review of the Fifth General Programme of Work Covering a Specific Period (1973-1977 inclus1 ve ) ...•.••.••.•••.•.•••••••

Project systems analysis ............... Disinsection of aircraft •••••••••••••••

Resolutions of regional interest adopted by the Twenty­seventh World Health Assembly and the E.xecuti ve Board at its fifty-third session ••••••••••••••••••••

DevelolXlleIlt of the ant1malaria progl'anune ••••••••••••••••••••••••••••••

-iv-

30

31

32

33

33

35

...

t

1

2

WPR/RC25.R9

WPR/RC25.RlO

WPR/RC2S.Rll

WPR/RC25.Rl4

WPRjRc25.Rl5

WPRjRc25.Rl6

WPR/RC25.Rl9

WPR/RC25.R20

COmENTS

Intensifioation of researoh on tropioal parasitio diseases

Infant nutrition and breast

......... feeding ..•...••..•.••••.•..•••.••••••.• 37

Teohnioal oooperation among developing oountries ............. Teohnioal Presentation •••••••••••••••••

Topio of Teohnioal Presentation in 1975 •.•....••••...••.••••.••••••..•.

Twenty-sixth and twenty-seventh sessions of the Regional Committee

Budget performanoe 197' - Direot

•••••

servioes to governments •••••••••••••••• 40

Modifioations made to the 1974 and 1975 programme and budget estimates •••••••••••••••••••••••••.•••• 40

Proposed programme and budget estimates for 1976 and 1977 ••••••••••••

Tentative proJeotions of the budget estimates for 1978 and 1979 ..... Adoption of the report •••••••••••••••••

Resolution of appreoiation •••••••••••••

ANNEXES

41

42

42

42

A.p1lda ••••••••••••••••••••••••••••••••••••••••••••••••• 45

47

55

List of representatives ••••••••••••••••••••••••••••••••

L1st of doouments ••.•••••••••••••••••••••••••••••••••••

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PART I

REPORT OF 'DE REOICfiAL C<M4IT'lEE

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(WPR/RC25/l5 )

INTRODUCTION

The twenty-fifth session of the Regional Committee for the Western Pacific was formally opened at the Dewan Tunku Abdul Rahman, Jalan Ampang, Kuala Lumpur by the Regional Director, Dr Francisco J. Dy in the absence of the retiring Chairman, Dr C.N. Derek Taylor, and the retiring Vioe­Chairman, Dr D. Singh. The Honourable Tun HaJi Abdul Razah bin Datuk HUssein, sm, Prime Minister of Malaysia, weloomed the representatives. The .Honourable Datuk HUssein bin Datuk Orm, SPMH, Deputy Prime Minister, was also present at the opening session and the Honourable Minister of Health Tan Sri Lee Siok Yew gave a short presentation. The session lasted from 2 to 9 September 1974.

The session was attended by Representatives of all Member States of the Region, of the Member States for territories in the Region, and of Papua New GUinea, an Associate Member. Representatives of the United Nations and United Nations Development Programme, UNICEF, the International Committee of Military Medicine and Pharmacy and 9 non-governmental organizations in official relations with WHO were also present.

The Committee elected the following officers:

Chairman

Vice-Chairman

Rapporteurs

in English

in Frenoh

: Tan Sri Dato (Dr) Abdul Majid bin Ismail (Malaysia)

Dr J. Dizon (Philippines)

Dr Peni Vuiyale (Fiji)

Dr J. Laigret (France)

Formal statements were made by Representatives of UNICEF, the International Dental Federation, the International Council of Nurses, the International Planned Parenthood Federation, the International Assooiation for Aooident and Traffic Medioine, the International Federation of Surgical Colleges, the International Federation of Pharmaceutioal Manufaoturers Associations, and the International Committee of Catholic Nurses.

The agenda appears in Annex 1 and the list of representatives in Annex 2.

At its first plenary session, the Committee established a Sub-Committee on Programme and Budget, oomposed of representatives of the following countries: Khmer Republic, Laos, Malaysia, the Philippines, Portugal, Singapore, the United States of America and Western Samoa. Further details are given in Part II of this report.

In the course of seven plenary sessions, the Committee adopted 20 resolutions whioh are set out in Part IV.

2 REGIONAL COMMI'I'lEE: 'NENTY-FIFTH SESSION

PART I. ANNUAL REPORT OF '!'HE REGIONAL DIRECTOR COVERING THE PERIOD 1 JULy 1973 TO

30 JUNE 1974

'!he Committee noted the new approach used in the Introduction whereby the aooompliahlllents, the probleJU and what still needed to be done had been listed under eaoh major field of WHO assistanoe to oountries and territories in the Resion. It agreed that the pioture ot prosres. presented in the report did not mean that the problema and oonstraints whioh still remained oould be ignored. New developments in the various fields of medioine tended to provoke enthuaiaem but health administrations must not lose sight of basio problellllJ. Operational research wu a meana ot test1n& alternative· approaches to the provision ot health oare and ensuring that even l1mi ted national resources were used to the best advantage.

One ot the areu where there oould be much oloser oooperation between various agenoies was that of family health; Maternal and ohild health, family planning, nutrition and health eduoation were all being integrated wi thin the framework of the basic health services. Health education had been partioularly effective in relation to family health programmes.

'llle Cornrn1ttee regretted that poor environmental oonditions, ignorance and poverty were stHl important factors in the spread ot ooamunicable diseues. It noted that many developing countries needed to strengthen their 1amunization programmes.

Governments needed to ensure that qualified national oounterparts were selected to work olosely with WHO staff collaborating in all proJeots, so that eventually the national staff could take over full responsibill ty for the progralllll... 'rhere was a need for more detailed. planning of fellowshipa at oountry level to ensure not only the oontinued eduoation and train1ng of health workers at all levels but also that, after training, fellows were properly utilized when they returned to their own oountries.

'!'he Coalli ttee noted that the report of the first .eeting of the Teohnioal Advisory Committee on Nursing was under oonsideration in the Regional Offioe.

In the ensuing disoussiana eleven representatives took part. Appreoiation was expressed of the work aooomplished. by the Direotor and staff of the Regional Offioe. 'l'he Regional Direotor was also oongratulated on the new way of presenting the Introduotion to the Annual Report.

One representative referred to the neoessity of utilizing the limited manpower resouroes available to sane oountries and terri tories to the best possible advantage in organiz1ng the delivery of health oare, whioh was a vital issue in the long term develop!lent of health servioe.. An attempt was being made in one oountry to use auxiliary medioal p81"111onnel to assist

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REPORT OF THE FlErn:ONAL COMMI'M'Z 3

the fully trained medical officers. One of the outcomes of a study whioh was being carried out with WHO assistance to identify and test alternative approaches to problems and constraints in the development of health .el'Y1o •• , had been the regionalization of the health care delivery syateJa. Another representative stressed the particular importanoe of health activities carried out in rural areas.

£. The C01lll11 ttee was informed that it was pO.8ible for WlI) to provide

'-

adVice to Member governments on the correct and most economioal u.. of sophisticated X-ray and other medical equipment.

The withdrawal of, or reduction in, bilateral "8istanoe to Lao. tar antimalaria activities, resulting in delays in implementation, was mentiaa.d. The same situation pertained in the Republic of Viet-Ha where reduoticma in bilateral assistanoe had resulted in shortages of insectioides.

The Committee was also informed that in Western SUloa illprovementll in environmental sanitation, espeoially excreta disposal, undertaken on ~ advice of WlI), had resulted in a considerable reduotion in the ooourreno. ot 'Q'phoid fever. The typhoid 1nIIIwlization progr8llllle was now int.srated completely into the general immunization soheme.

There was general agreement that more emphasis should be given to the programme for venereal diseases and treponematoses. '!be need for health education of the publio, particularly young people, was emphasised.

The emergence of non-oommunioable diseases in a number ot deYelopina oountries in patterns similar to those in developed countries, was mentioned.

The urgent need for researoh and tra1.n1ns programmes on the oon'GrOl of environmental pollution hazards in areas subjected to rapid industrialisation and urbanization, such as Malaysia, was brousht to the attention of the Commi ttee. Information was presented on a proposed proJeot in Laos tor the development of munioipal environmental health services.

The neceSSity for closer collaboration between WlI) and FAO to as.ist governments in formulating food and nutrition policies was mentioned.

Mention was made of the diffioulties encountered by governmenta in implementing UNFPA-assisted proJecta due to delays in reoeivins oonfirmation that assistance would be forthcoming.

The Committee was informed of the length of time normally necessary to prooess and despatch reports of WHO consultants to governments; regreta were expressed for unwarranted delays.

The Committee adopted a resolution not1ng with satisfaotion the manner in whioh the programme had been planned and carried out during the period under review and oommending the Regional Director and his staff on the work accomp11shed (see resolution WPR/RC25.R1) •

4

PART II. PROPOSED PROGRAMME AND BJIXIE'l1'Cll 1976 AND 1m

1 Introduotion

At its seventh sessiOll. the Regional COIIIIId.t", 1n resolution ~7 .Rr. deoided "that the establ1l1hment of a sub-oCllllll1 t... _ Jll'GptUlDe and budpt. oonsisting of six members plus the Oha1nun 01' t.be Rapcaal CODIIII1 ttee. should t.

become a routine aotivity 01' the Regional Oa.1t'Me"J IIDd reoOllllMlnded that "the membership of thia sub-oODllli ttee be rotaW .... the ~s.ntativ.s of various Members. subJeot to the provision that aJl7 Bieprellelltative d.siring to be a member of the Sub-Comm1ttee should be enti'Ued to ... • ..... ioipate". At its • twenty-first session. the membership of the Sub-C-'~';;" inore .. ed to '1 halfl the Members in the Region.

The Sub-comm1 ttee on Programme and. Budget _t OIl Wednesday afternoon, 4 September, and. oonsidered its draft report on Sa1Nl'dar mOrning, 7 September, under the ohairmanship of Tan Sri Dato (Dr) Abdul. MaJ14 bin Ismail. '!he attendanoe was as follows I

Members in acoordanoe with the principle of rotaUon I

Khmer Republio

Laos

Malaysia

Philippines

Portugal

Dr Nhonh Elm Ya;y Dr Emmanuel F.rnandes

Dr Phouy Phoutth •• a1I: Dr Ri tth1.ka7 Vll.a1ll-.,.

Datuk Paduka (Dr) Abdul. Wahab bin Mohd. Arift Dr Raja A1'lmad lfoord1n Mr Onn bin Kayat Dr Gumukh Singh Mr Cheong Wens H001 Dr Ta1 Yen Hoci Datuk (Dr) Abdul !h." 4 bin Sahan Dr G. V. Deni.

Dr J. Dizon Dr D. Rivera

Dr Ru1 Albuquerque Ribeiro cia Coata Pinhao Dr Longuinh08 Mcmteiro X&v1er

1 "Half the Membera" means that halt an odd maber woulcl be the next

higher tull number - e.g., one halt 01' 17 18 9.

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REPORT OF Tl!ii REGIONAL COMMITIEE

Singapore

Uni ted States of America

Western Samoa

Papua New Guinea

Dr A.G.K. Chew Dr Ng Kwok Choy

Dr J .C. King Mr F.S. Cruz Dr M. Kumangai

Dr J.C. 'lbieme

Dr A. Tarutia

other members of the Committee also in attendance were I

Australia

Fiji

France

Japan

New Zealand

Republio of Viet-Nam

Uni ted Kingdom

Dr R.W. Cumming

Dr Peni Vuiyale

Dr J. Laigret

Dr R. Okamoto

Dr R. Diokie

Dr Tran QUy Nhu Dr Pharo QUang Tuan Mr Nguyen-Viet-Danh

Dr J.A.B. Nioholson

The Regional Direotor was also present.

Dr Hesselvik, Direotor of Health Servioes, aotad as Seoretary. He was assisted by Mr Kakar, Budget and Finanoe Offioer.

The Sub-Commi ttee had before it the following doouments:

WPR/RC25/2 and Add.1

WPR/RC25/P&B/l

WPR/RC25/P&B/2

WPR/RC25/P&B/3

Proposed programme and budget estimates for 1976 and 1977

Suggested guidelines for the Sub-Cammittee on Programme and Budget

Budget performanoe 1973 - Direot servioes to governments of the Region by subJeot heading, by oountry and by proJeot

Proposed programme and budget estimates for 1976 and 1977

5

6

WPR/RC25/PlI:B/4

WPR/RC25/PlI:B/5

2

Tentative projections for 1978 and 1979

Proposed progrlUlllle and budget estimates. 1976 and 1977 (Extra budgetary ttmds)

Dr Hesselvik. Secretary. drew attention to .Annex 1 of document WPR/RC25/PlI:B/2 which showed by subjeot head1n& the original budget estimates. those revised in the subaequent year and. the obligations incurred. Although :\ the peroentages shown seemed. in some plaoes to indicate rather large deviations between the budptted sum and the BUIll oblisated. particularly for the 8DIaller allocations. large difterences were not apparent from the figures themselves. The overall implementation pioture was reasonably olose to the provisions originally made. That the total implementation figure was no higher than 88.7'1> was due to the faot that the original allooation inoluded an amount of over us$600 000. whioh the Direotor-a.neral did not in the end make available to the Region. The differenoes between the planned progrlUlllle and that delivered were due to unforeseeable faotors suoh as ohanges in government requests and priorities. and unexpeoted delays in recruitment.

3 t 25/plI:B/3)

'!be Seoretary drew the attention of the Sub-COJllll1 ttee to paragraph 4 of dooument WPR/RC25/PlI:B/3 and Annexes 1 and. 2 whioh oontained information on the differenoes bet .... en the original and. the revised est1maws for the two years. It had been neoessary to revise the estimates for both years beoause provisions·for the People's Republio of China were no lonser applioable and beoause five olasses of post adjustment had to be inoorporated in the salaries of professional staff as deoided by the Exeoutive Board.

The Representative of Australia reterred to Paragraphs 4.2 and 4.3 of document WPR/RC25/PiB/3 and pointed out that the progrlUlllle tor the People's Republio of China was shown in the Offioial Reoordal as $1 000 000 for 1975 and $900 000 for 1974.

Mr Kakar. Budget and Finanoe Offioer. stated that the oomparison made in dooument WPR/RC25/P!B/3 was based on the budget presented to the TWenty­fourth Regional Committee oontained in dooument WPR/RC24/2.

1 Off. Reo. Wld m. th Org.. 1973. 212. page 669.

REPORT OF THE REGIONAL COMMITIEE

4 6 1. 2

4.1 General observations

'!he Sub-Conmi ttee noted that the fOnD of presentation of the propo8ed progranme and budget estimates had been ohanged as a result ot a resolution of the Twenty-sixth World HBalth Assembly (WHA26.38) which had deoided that "every two years starting 1975 a proposed budget prepared by the Direotor­General oovering the suooeeding two years shall be plaoed betore the Exeoutive Board and the Assembly."

7

Dooument WPR/RC25/2 oontained information tor 1974. the revised budget for 1975, and the proposals for 1976 and 1977. '!he dooument was essentially programme-oriented.

The Representative of Western Samoa asked what were .-the legal implioa­tions of introduoing a biennial budget in antioipation of the approval of amendments to Artioles 34 and 55 of the Constitution.

Mr Kakar. Budget and Finanoe Offioer. explained that the position had been olarified by the Twenty-sixth World Health Assembly in resolution WHA 26.38.1 The legal position would be oovered by the World Health Assembly approving an appropriation resolution oonoerning only one finanoial year.

The Sub-Gormni ttee noted that information was provided on the present situation. the objeotives to be attained. and the means to be employed to realize the targets. The programme had been established in aooordanoe with the Fifth General Programme of Work for the Organization as a whole and the Fourth Regional ProgranJile of Work adopted by the Regional Cormni ttee at its twenty-first session (resolution WPR/HC21.R7). the reoommendations ot the Regional Committee at previous sessions, the deoisions of the Exeoutive Board and the World Health Assembly. and the results of evaluating some of the programmes.

The Organization was frequently plaoed in a diffioult situation in its efforts to meet requests from Member States as these oovered a generally wide range of health aotivities and it was not always possible to fit them into the limited resources available. The problem was how to strike the oorreot balanoe between the oontinuation of support to aotivi ties already in operation, in order to safeguard their ultimate suooess and the sometimes bolder oourse of embarking on new ventureS. The question oould be raised as to whether in taot it was justified to devote suoh a sizeable part ot the available funds to oontinuing projeots. In some oases. the answer was of

I Off. Reo. Wld lD.th Org •• 1973. 209, page 21.

8 REGIONAL COMMI'l'lEE t 'l\ENTY-FIFTH SESSION

oourse olear; for example, it was necessary to oontinue support to the malaria eradioation progrlUllllEls until viotory had been -obtained and thus to safeguard the investment already made. In ongoing projeots, important iImovations were frequently possible and oould in faot be made, sometimes radically ohang1ng the character of the projeot. Suoh projeots were severely scrutinized to see whether continuation in their present fom was justified.

The trend in favour of interoountry activities as opposed to ommtry projeots was oontinuing. It was believed oountries and territories in the Region were beooming more progressively able to make use of this type of assistanoe. The group eduoational aotivities proposed would benefit the whole Region or a oonsiderable part of it. The trend towards the use of short-term oonsultants rather than long-term field staff had also oontinued.

It was against this general background. that a budget had been prepared which amounted to $9.7 million in 1976 and to $10.3 million in 1977. The 1977 figure was slightlY' more than 5.~ above that tor 1976. The Table on page 3 provided information on the f'unds eJq)eoted to be available to the Region from souroes other than the regular budget. There appeared to be a oonsiderable deorease in this type of assistanoe but this did not neoessarily mean that the assistanoe would be as low as that shown. The different budgetary oyoles of the organizations involved meant that tirm approval might only oome later. It was stressed that it was the responsibility of Member oountries themselves to make requests for assistanoe to the United Nations Development Programme and the United Nations Fund for Population Aotivities.

The Representative of western Samoa asked it the acid1tional oost of $369 000 in 1975 mentioned in Paragraph 4.2 of dooument WPR/.RC25/P&:B/3 was to oover the use of averages and if so, would any savings in the operational year be available tor re-programrn1ng.

Mr Kakar, ame;et and Finanoe Offioer, stated that the amount of $36') 000 was required to meet the oost of inoorporating 5 olasses of post-adjustment into the salaries of the professional staff.

4.2

Referring to the statement that most of the projeots were oontinuing projeots, the Representative of the United States of Amerioa expressed the hope that oonsideration would be given to introduoing new projeots. He also remarked that the inorease in interoountry projeots was reallY' not so large as was mentioned in dooument WPR/.RC25/2.

The Representative of Western Samoa wanted to know the oriteria for assistanoe to oountries, partioularly to the least developed oountries.

The Regional Direotor stated that there was a mandate to give speoial oonsideration to the least developed oountries and that WPRO endeavoured to abide by it. The absorption oapaoity of the oountry and the assistanoe reoeived by it from other souroes were of oourse taken into oonsideration.

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REPORT OF THE REGIONAL COMMI'l'IEE

The Representative of New Zealand asked why there were no provisions in 1976 under oanoer. oardiovasoular diseases. and other ohronio non­oommunioable diseases sinoe there was provision in 1977.

Mr Kakar. Budget and Finanoe Offioer. replied that the assistanoe provided was in the form of oonsultantships. No requests had been reoeived for 1976 probably beoause follow-up aotion would not be required until 1977 on reports of oonsul tants who would oarry out aSSignments in 1975.

4.3 ro programme and pages 15-155)

In reviewing the regional programme and sub-programme statements the Sub-Comm1ttee noted the following:

Strengthening of Health Servioes (pages 22-31)

9

The goals of this programme were to make health oare aooessible to the largest possible segment of the population and to ensure that the servioes provided were effeotive and effioient. Emphasis had been plaoed on a more systematic approaoh than previously. and modem methods. such as operational researoh and catmtry health programming. were being promoted at different levels. In addition to the country projects. workshops on basio health services. as well as interoountry meetings on hospital management and rehabilitation - for whioh it was hoped to arrange UNDP funding - had been proposed. The summary on page 31 showed that for the regular budget, a oertain inorease for 1976 and 1977 as oompared with 1974 and 1975 was proposed.

The Representative of Australia oommented on the very small increase in the 1976 provision over that for 1975; in 1977 there was a deorease over 1976.

Mr Kaltar. Budget and Finance Officer. said that this was because Health Manpower Development had absorbed some of the training aotivities previously budgetted under Strengthening of Health Servioes.

Health Laboratory Servioes (page 32-35)

The intercountry programme consisted of assistanoe in the organization of servioes. teohnioal help for the production of vaooines and biologioals. and training. A seminar on blood transfusion servioes was proposed for 1976 and a oourse for laboratory methods in blood transfusion for 1977.

Family Health (pages 36-43)

This programme aimed at the development of family planning aotivities as an important and integrated part of the general health servioes, partioularly those directed at mothers and children. and the preparation of the health services to meet new needs resulting from the introduotion

10 REGIONAL COMf([TrEE: 'IWEN'l'Y-FIFTH SESSION

of family planning. The family health progr8llllle, therefore, included maternal and child health, family planning, nutrition and health education and aimed at an integrated approach with close collaboration between these areas and other components of the general health services. '1!le major part of the activities was funded by the United Nations Fund for Population Activities and it was hoped this support would continue.

Nutrition (pages 44-46)

The insidious nature of malnutrition often hindered appreoiation of the need for remedial aotion. In an effort to improve nutritional surveil­lance, to enoourage the formulation of national food and nutrition policies, and to promote staff training and the integration of nutrition into the general health services, it was proposed to create /'Ill interoountry nutrition advisory servioes project. This would consist of a medioal and a non-medical nutritionist whose services would be available to all countries of the Region at their request.

Health Education (pages 47-50)

Basically, each health worker should be encouraged to reoognize his personal responsibility as a health educator. For this he needed training and support and the regional programme, primarily geared towards integration of health education into other health activities, had that aim in view.

Health Manpower Developnent (pages 51-56)

This field had always been one of major WHO involvement. This remained so, although the ways in whioh Member countries wished to make use of the resouroes of the Organization were changing. !he recent promotion of a systematic methodology for the estimation of manpower needs in various fields was of particular interest. Another important trend was the development of national teacher training centres for which the WHO Regional Teaoher Training Centre in Sydney was serving as a model.

Communicable Diseases (pages 57-60)

Although morbidity and mortality patterns varied very widely within the Region, communicable diseases were still very important health problems, as evidenced by malaria, tuberculosis, cholera, parasitic infeotionS and dengue fever. The proposed regular budget provision had been inoreased from approximately US$1.7 million to US$1.8 million.

Epidemiological Surveillanoe (pages 61-63)

Because of lack of information on the incidenoe and prevalence of diseases, it was difficult in many countries to plan logically for their prevention and control. The intercountry team, composed of an epidemiologist and an entomologist, would therefore aontinue.

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Malaria and other Parasitic Diseases (pages 64-70)

The regional malaria progr_ aimed at (a> assisting eradioation prograDlll8S by providing them with teolmioal guidanoe and support, (b> assisting countries and territories where malaria had. been eradicated to maintain the malaria-tree status and (0) assisting govemments and

11

terri tones where malaria eradioation was not teasible at present to plan. implement and evaluate their malaria control operatiana as an interim measure towards ultimate eradication. 'l!le proposed prograJllllle tor malaria and other parasitic diseases tor 1976 and 1m foresaw activities on approximately the same level.

Bacterial Diseases (pages 71-74)

Attention would be paid to a variety of diseases such as plague. cholera and other gastrointestinal diseases. diphtheria, pertusSiS and tetanus. To a large extent, the solution of the problems connected with this group of diseases was one of environmental hygiene; in particular, the provision of adequate water supplies, proper waste disposal and proper tood sanitation. However, a radical decrease in the importance of diseases preventable by 1mrnun1zation, such as tetanus. should be possible using quite limited financial means. Assistance would be provided ma1nl,. by the intercolmtr;v epidemiological team.

Lepros,. . (pages 75-76)

Although leprosy was less prevalent today than previousl,. the number of: cases in certain cOlmtries in the Region was considerable. Assistance would be provided under the 1nd1 vidual oountr,. progr8111118s.

Tuberoulosis (pages 76-79)

TUberculosis presented a picture of contrasts. Some oOlmtries in the Region had the . lowest prevalenoe figures in the world. others, the highest. Although most cOlmtries in the Region had an organised tuberoulosis control service in one form or another, W1I> assistance was still required. It was thus proposed to maintain the regional tuberculosis oontrol team. to oontinue the regional tuberoulosis oourses and to assist the regional B::G vaooine laborator,. •

Vector BioloR and Control (pages 86-88)

The scope and variety of problems caused by disease vectors was oonsiderable but the technioal means tor dealing with them were developing quickly. Assistanoe would be given partly through the servioes of the interoolmtr;v epidemiologioal team, partl,. on a OOlmtr;v proJeot basis. A regional seminar on the sate use of pestioides was also proposed •

12 REGIONAL COMMI1'JEE I 'rIG:N'l't-mF'l'H BE9SION

Non-COJllllltUl1oable Dlseue Prevention and Centrol (pages 89-98)

There was no doubt that a number ot chronio disease. suoh as oanoer and oardiovasoular ailments were beoom1ns more 1mportant in the Region. It was logioal to increase the resource. devoted to the study and control of this group of diseases; US$~ 000 had been proposed tor lmcanpared with Just under US$200 000 allocated 1n 1974. The prograae on oancer would be malnly devoted to a tollow up in 1m on a national basls ot the working group on the organlzation ot comprehenslve oancer oentrol prosraaes which would be held in 1975. The progr_ in oardiovasoular d1seues tollowed a s1m11ar oourse. A seoond interooun1:r7 meetins was envlsaged tor 1975 and provlslon tor tollow up at a natlonal level proposed tor 1977.

Dental Health (pages 99-101)

'l'h1s was a long-term progr_ a1med at the strengthen1ng of national dental health .ervlces. eapecially in preventive dentis1:r7. through increased ooverage of vulnerable groups. Partioular 'attention would be given to utillzing dental theraplsts. It was proposed to maintain the lnteroountry dental health adviser. to arrange tor workshops in dental health eduoatlon and to conduot yet another oourse in publio health dentistry.

Mental Health (pages 102-103)

The programme in this tleld was still very modest and 1 t was clear that other problema had been given a higher priority in many Member cO\.mtries. Awareness ot the 1mportanoe at including a.ntal health tra1n1ng in the basic eduoation of health start was inoreasing. For this reuon. provlslon had been made tor oonsultant months and tellowah1pa.

Aloohollsm and Drug Dependence and. Abuse (pages 104-111)

'l'h1s was a tield whioh was pre-oooup71ns health authorities to an inoreasing degree. To respond to expressed needs and requests the regional programme was expanding rapldly. After the work1ns group on preventive measures envisaged tor 1974. a speoiallzed ott1oer. probably a psychiatrist wi th special experlenoe in drug problema. would be employed trom 1975 onwards. A working group on health eduoation progranmes tor young people as it ooncerned drug abuse to be held 1n 1975 would be tollowed in 1976 and 1977 by a work1ns group on early intervention progrUlll8S and a second' working group on health eduoation tor young people as it ooncemed drug abuse.

Promotlon ot Envlronmental Health (pages 112-127)

Population growth. the increased rate ot urbanization and industriali;" zation had brought torth new environmental health problema and had aaravated tradltional ones. Against Just over us$8oo 000 in earl1er ~ara the progranune now proposed tor 1976 and 1m was planned at a level US$200 000 higher. In addition. sizeable support was expeoted from UNDP.

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Biomedical and Environmental Health Aspects of Ionizing Radiation (pages 128-131)

In the field of the biomedical and environmental health aspects of ionizing radiation, the programme was expanding rapidly beoause of the inoreased use of X-ray or other radiation..emi tting equipment. It was proposed to oontinue the servioes of the interoountry technioian for training in maintenance and repair of X-ray and other equipment and the radiation health advisory servioes team would be strengthened by the addition of a radiologioal technician tutor.

Food Standards Programme (pages 135-136)

'lhis programme consisted of the servioes of a consultant to assist in problem identification and programme planning.

Health Statistics (pages 137-141)

13

The purpose here was to oontinue assistanoe towards developing the national structures and prooedures required for the aocurate and oomprehen­sive reoording and interpretation of data on national vital and health statistios. Inoreasing attention would be given to gathering relevant information for plarming, managing and evaluating the health servioes. It was proposed to retain the services of the intercountry health statistioian, to provide s9Jlle consultant months, and to convene a regional seminar on vital and health statistics with the sub-title "'!he Use of Computers for the Health Information System".

4.4 Regional Office (pages 162-166) Regional Advisers and WHO Representatives (pages 168-175)

A limited inorease in staffing was proposed, namely, one administrative assistant in the a.treau of Health Servioe. and two t;ypists in the steno­graphic pool. These addi tiona were deemed neoessary to handle the increased workload and were, together with the automatio coat inoreases, responsible tor the inorease in the total for the Regional ottioe t'rCllll about US$l.;(4 million in 1975 to 00$1.47 million in 1976 and US$l.60 million in 1977. No change was proposed in the number of Regional Advisers and the inorease in cost was entirely due to the higher general cost level. It was proposed to add one new post under WHO Representatives, namely that of a country progr8llllle manager. This, plus the automatic oost inoreases was resporusible for the total going up from about 00$470 000 to US$530 000 in 1976 and US$580 000 in 1977.

The Representative of Western Samoa requested details ot the new post of country programme manager.

The Seoretary stated that in view ot the greater emphasis on country programming and the deoentralization of aotivities at oountry level, it would beoome necessary to strengthen the WHO Representatives' offioes; this was the first post included in the budget.

14 REGIONAL COMMITlEE: 'n'IENTY-FIFTH SESSIOO'

4.5

'!he Sub-Conmi ttee noted that the title of Annex IV should refer to oountries and territories. These projeots had been established as the . result of direot oonsul tations between the governments oonoemed and the Regional Direotor and his staff.

The interoountry projeots had been endorsed by governments.

4.6

The Sub-committee noted that requests totalling US$2 204 580 for 1975 ' had had to be plaoed in the List of Additional Projeots. They oould not be aooommodated in the budget estimates beoause of limitation of funds, although they were teohnioally valid. The Regional Direotor would naturally, to the extent that savings beoame available. do his best to aooommodate these requests. If they were oonsidered to be urgent governments should review w.hether some other part of the WHO-assistanoe provided to them deserved lesser priority and OOuld be relinquished.

The following additional requests for assistance in 1975. 1976 and 1977 were presented during the meeting of the Sub-Commi ttee:

HMO 01 - Fiji Sohool of Medioine

Adviser for three years starting in 1975 in ootmexion with the oourse for medioal assistants.

Six 12-month fellowships in 1975 to take part in the course for medical assistants (first year) in Papua New Guinea.

Frenoh Polynesia

HMO 99 - Health manpower development fellowships

'Ibree-month fellowship in dental health in eaoh of the years 1975. 1976 and 1977.

One-month fellowship in dosage for residual pestioides in 1975.

CVD 01 - Cardiovascular diseases survey

Consultant for two months in 1975.

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KbDer Republio

Laos -

New projeot - Resuscitation services

One medical offioer for 1976 and 1977

Two nurses for 1976 and 1977

One oonsul tant for two months in 1976

24 fellowships (8 for nurses~ 8 for anaesthetists and 8 for handling instruments)

SUpplies and equipment

New project - Intensive care units

Two medioal officers (one for eaoh unit) tor 1976 and 1977

Two nurses (one for eaoh unit) for 1976 and 1977

One oonsul tant for two months in 1976

Supplies and equipment

New projeot - Public health servioes

Looal oosts in 1976 and 1977 to pay for ten publio health oftioers (one for each of the ten publio health oentres to be opened).

Note: The request for oonsultants in health planning. statistios. - health eduoation and malaria was noted and oould be met from interoountry projeots and/or from the Regional Offioe •

NUT 01 - Nutrition adviSOry servioes

US$3500 for supplies and equipment in 1975

1M> 01 - Health manpower development

l2-month fellowship in 1975

US$3500 tor supplies and equipment in 1975

ESD 01 - Disease prevention and oontrol

Four sets VHF type M1 ty Moe and one generator in 1975

16 REGIONAL COMMIT'IEE: 'lWENTY-FIFTH SESSICll

New projeot - Mental health

Consultant for three months in 1975

DES 01 - Vital and health statistios advisory servioes

One l2-month fellowship in. health statistios for 1975

US$3500 for supplies and equipment in 1975

Malaysia

sm 01 - DevelOpment of health servioes

One oonsul tant for four months in 1975 to oomplete the final draft of the Publio Health Aot.

One publio health administrator for 1976 and 1977

3x2 oonsultant months for the interoountry health planning oourse in 1976 and 1977

One l2-month fellowship in 1976 and 1977

One six-~onth fellowship in 1976 and 1977

VBJ 01 - Veotor oontrol

An adviser for the Veotor Control Unit in 1976 and 1977

One l2-month fellowship in 1976 and 1977

Philippines

HMO 01 - University of the Philippines

One l8-month fellowship in health eoonomios in 1975

MPD 01 - Malaria eradioation programme

~ post of adviser on training (entomologist) to oontinue in 1976 and 1977.

Republio of Viet-Nam

M8D 02 - Leprosy oontrol

A oonsul tant for three months in 1975

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SES 01 - Environmental health advisory services

The second post for a sanitary engineer to oontinue in 1975 and 1976.

Singapore

New project

A project manager for two years starting 1975 for the supervision of construction of a hospital of 1300 beds.

The Sub-Committee noted that the tentative projection had been prepared in response to the World Health Assembly resolution dealing .;;;;in~te~r !!!!. with biennial progr8llllling (resolution WHA22.53). For this purpose, the Director-General provided each Region with a tentative allocation for the two years succeeding the programme and budget years under review. The tentative allocation for the years 1978 and 1979 for this Region was US$10 840 000 and US$ll 436 000, respectively. Annex 1

17

of dooument WPR/RC25/P&:B/4 had been prepared on the basis of the priori ties established by governments for assistanoe in 1977.

6 Resolutions

The Committee adopted the following four resolutions in oonnexion with the programme and budget estimates:

(a) Budget performance 1973 - Direct services to governments (wpR/.RC25.Rl5)

(b) Modifications made to the 1974 and 1975 programme and budget estimates (WPR/.RC25.Rl6)

(c) Proposed programme and budget estimates for 1976 and 1977 (wpR/.RC25. Rl7)

(d) Tentative projections of the budget estimates for 1978 and 1979 (WPR/.RC25.Rl8).·

18 REGIONAL COMM[TIEE. 'lWEN'lY-FIF'1'H SESSION

PART III. OTHER MA'l'lEilB

1 Resolutions ot regLonal interest adopted by the Twenty-seventh World Health AasembG the Executive Board at ita fifty-third .. ssion (DOOUlll8Jlta 25/4 and WPiQk25/4 Add.l)

~ Committee considered the tollowing resolutionsz

Organizational study on the interrelationships between the oentral technioal servioes of WID and programmes of direot assistance to Member States (resolutions EB53.R44 and WHA27 .18)

Health eduoation (resolution WHA27. 27)

Health eduoation of ohildren and young people (resolution WHA27.28)

'!he role ot WHJ in bilateral or multilateral heal. th aid progrllllllles (resolution WHA27 .29)

Continuing education for phyaioians (resolution WHA27.3l)

Coordination with the United Nations System z the least developed among the developing countries (resolution WHA27.34)

Coordination with the United Nations Systems general matters (resolution WHA27.35)

Infant nutrition and breast feeding (resolution WHA27. 43)

Promotion of national health servioes (resolution WHA27. 44)

WJI)' s lnJman health and environment programme (resolution WHA27.49)

WJI)' s human health and environment programme I ooordination on progra/lllles and aotion in the tield ot the environment (resolution WHA27.50)

Developnent ot the antimalaria programme (resolution WHA27 .51)

Intenaitioation of research on tropioal parasitic diseases (resolution WHA27.52)

WHO expanded programme on immunization (resolution WHA27.57)

REPORT OF THE REGIONAL COMMITIEE

Coordination and strengthening of leprosy control (resolution WHA27.58)

Prevention or road traffio aocidents (resolution WHA27 .59)

WHO's role in the development and coordination of biomedioal researoh (resolution WHA27.6l)

Standardization of diagnostio materials (resolution WHA27.62)

Long-term planning of international oooperation in oanoer researoh (resolution WHA27.63)

(See resolution WPR/HC25.R7)

A summary of the comments made on specific resolutions is given below.

1.1 Health eduoation (resolution WHA27.27) Health education of ohildren and young people (resolution WHA27.28)

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The Representative of Japan spoke to this resolution. He oonsidered that with new technology for disease control and the emergenoe of new health hazards, health education would play an inoreasingly important role.

1.2 Infant nutrition and breast feeding (resolution WHA27.43)

The Committee noted the conoern of the Representative of Fiji over the encouragement of breast feeding. This was an important issue in developing oountries where ignoranoe and poor standards of hygiene prevailed. The Committee adopted a resolution whioh invited governments to intenSify efforts to promote eduoation and other measures in support of breast feeding of infants and the wider use of looally based weaning foods (see resolution WPR/HC25. RlO ) •

1.3 DevelOpment of the antimalaria programme (resolution WHA27.5l)

The Committee noted that malaria was again beooming a serious threat in a number of oountries throughout the world, while in others it had never been oontrolled effeotively. Happily, the Western Paoifio Region had been spared serious set-baoks, although, mainly beoause of financial and administrative diffioulties enoountered by governments, progress had been slow in some areas. Diffioul ties of a teohnioal nature had been experienced in the Region r the major malaria vectors remained susoeptible to DDT, despite its prolonged use, but in some areas the vector, because of its particular behaviour, did not oome suffioiently into contact with sprayed surfaoes to pick up a lethal dose; oertain strains of !. faloiparum were resistant to ohloroquine and other antimalarial drugs.

20 REGIONAL COMMI'l"lEE I 'lWENTY-FIFTH SESSION

nw COIIIIli ttee noted further that reviewe of aountry programmes had in general led to strategies aalaulated to give optimum re8Ul.ts although, in some instanaes, there was a need for aloser aoordination among different agenaies within and outside the health seotor, espeoially those operating in the rural aommuni ties.

Two members spoke to this resolution agreeing that inaweasing aosts and administrative diffioulties neaessitated a review of the possibilities for ahanges in strategy.

The Committee adopted a resolution urging governments (a> to establish the priority to be accorded ant1malaria programmes in relation to other large-saale programmes; (b) to aontinue to give full administrative and finanaial support to antimalaria aampaigns; (c) to promote a greater partiaipation and involvement of the general health services in the implementation and evaluation of antimalaria operations. It emphasized the need for oontinued vigilanae even when the incidenae of the disease had been reduaed to a low level and noted with appreciation the bilateral assistanoe given by some Member States to countries and territories within the Region in their antimalaria aotivities, hoping that Governments in the position to do so would aontinue to provide this type of assistanoe (see resolution WPR/RC25.R8) •

1.4 Intensification of research on tropiaal parasitia diseases (resolution WHA27.52).

'.the COIIIII1 ttee noted that, sinoe this resolution was aormeoted with the research aotivities of the Organization, ita implementation was primarily the responsibility of WlKl Headquarters. '.there "re, however, a number of parasi tia diseases whiah presented serious publia health problems in many parts of the Region. '.the Direator-CJeneral had been requested, in intensifying WHO's activities in the field of researah on the major tropical parasitic diseases, to aonsider the feasibility of aarrying them out in endemia areas and to bear in mind the primary needs of the developing aountries in defining priorities in researah.

Two representatives spoke to this resolution. The importanae of oarrying out researah work where a disease aotually existed was reaognized but these aativities should not be too aostly when faailities already existed in developed aountries for the same purpose. .

The Committee adopted a resolution giving priority to sah1stosomiasis and filariasis as the tropiaal parasitia diseases prevalent in the Western Paaifio Region on which intensified research should be undertaken. It alao invited the governments of those countries where the diseases were endemic to assist the Organization in carrying out researoh aativities (see resolution wpR/RC25.R9).

In addition to the parasitia diseases, the Committee Proposed the following as diseases prevalent in the Western Paaifia Region whioh it would like to see included in intensified researah programmes:

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REPORT OF THE REGIONAL COMMI'I'lEE

dengue haemorrhagic fever oholera typhoid fever Japanese enoephalitis rabies viral hepatitis

1.5 Coordination and strengthening of leprosy oontrol (resolution WHA27.58)

The Representative of Japan spoke to this resolution. He informed the COllDlli ttee that the Sasakawa Memorial Health Fotmdation had just been established in Japan. Its aims were to promote international oooperation in the field of leprosy partioularly in the Western Paoific and South-East Asia. It would be cooperating with WHO in the future.

1.6 Long-term planning of international cooperation in canoer research (resolution WHA27.63)

21

The Representative of New Zealand spoke to this resolution. He stressed the importanoe of .international cooperation in developing properly drawn up and effeotive protocols for oancer research.

2 Disinsection of aircraft (Document WPRjRC25/5)

The COllDllittee reviewed a report presented by the Regional Director whioh provided the information requested at its twenty-fourth session on disinseotion of aircraft (resolution WPR/RC24.R4). Twenty-three ootmtri.s and territories in the Region had confirmed that they would aooept the Diohlorvos Vapour System.

In accepting the System as valid the Representatives of Australia, Fiji and Franoe indicated that their governments reserved the right to disinseot aircraft on the ground as an additional measure if they considered it to be necessary. The Representative of Australia further indicated that his government was not satisfied with any method of disinsection in effeot at present and was oonducting its own researoh.

The Representative of China wished to be provided with documentation on the subject to enable further studies to be undertaken.

The Representatives of the Republic of Korea, the United Kingdom and the United States of Amerioa said that their governments supported any action the Committee might take in accepting the system as valid.

The Representative of Malaysia indicated that his government had accepted the "blocks away" method of disinseotion. None of the airlines using Kuala Lumpur airport were using the Diohlorvos Vapour System. The Representative of Papua New Guinea indicated that in his oountry all airoraft were disinsected on the ground upon arrival.

22 REGIONAL COMMITIEE: TtIEN'lY-FIFTH SESSION

The Committee adopted a resolution requesting the health authorities of Member governments to urge the authorities oonoerned to take the noessary steps to have the System installed in aooordanoe with the speoifioations laid down by ICAO; and to proposefollow-upatuti •• on the possible deleterious effeots of the System and the development of resistanoe in oertain inseots (see resolution WPR/RC25.R6).

.3 %al1ty of water and food in international aviation Dooument WPR/RC25/6)

The Committee reviewed a report presented by the Regional Direotor s1»runarizing the aotion taken in oonnexion with the resolutions adopted at its twenty-fourth session on quality of drinking water on international flights (WPR/RC24.R5) and on quality of food on international flights (WPR/RC24.R6). It noted that the two resolutions had been referred to the Direotor-General. Consideration of the subjeot by the fifty-third .ession of the Exeoutive Board, the eighteenth meeting ot the Committee on International Surveillanoe of Communioable Di.ea.es and the Twenty­seventh World Health Assembly had oulminated in a resolution adopted by the Assembly whioh reiterated the need for Member governments to olarify the ultimate responsibility in their own oountry or territory for the safety of food and water in international traffio by ensuring the olo.e and aotive oooperation of all servioes and agenoies oonoerned. The Organization oontinued to maintain olose oontaot with other international agenoies with a view to improving the safety of food and water and the handling of wastes.

The Committee noted that of the Member governments that had re.p0n4ed to the Regional Direotor's request for information on studie. being under­taken at present, only two had been, or were planning to, oarry out routine baoteriologioal examinations. It was hoped that more oountries would beoome interested in undertaking suoh studies.

During the disous.ion the Representatives of Fiji, Japan and Mala~la gave details of the proteotive measures taken in their oountrie., the sampling and tests oarried out and the results of these teste.

The Representative of Australia reported on the researoh that had been carried out during the past year on the quality of food and water on ::.nternational fl1ghts and on sporadio oases of gastroenterl t1a in pereons arriving on international flights. The results illustrated the neoe .. ity to refrigerate food before and after loading, espeoially at airports in tropical areas where there were high ambient temperatures.

The Committee adopted a resolution noting with satisfaotion that the . Direotor-General was vigorously pursuing aotion towards the improvement of existing practioes and the establishment of international miorobiolosioal standards for food (see resolution WPR/HC25.R2).

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4 Drug dependence (Document WPRjRC2517)

The Committee reviewed a report presented by the Regional Director summarizing the action taken in connexion with the resolution adopted at its twenty-fourth session on drug dependence (WPR/RC24.R8). It noted further that the visit of two consultants to the Philippines mentioned in the report as taking place in 1974 was in progress at the present time and that a working group on measures for the prevention and control of drug abuse would be held in Manila at the end of 1974.

The Committee noted that the first indications from the survey on drug dependence showed that alcoholism appeared to be the most widespread fom of dependence with the abuse of other drugs varying from area to area.

The Representative of the United states of America said that his Government regarded as reasonable the view expressed in the report of the two consultants who had visited Malaysia in 1973 that adequate manpower would have to be developed before rigorous epidemiological investigations oould be embarked upon. He oommended the establishment of a single fooal point in the Regional Office.

During the discussions the oomments of a number of Representatives indioated that alooholism was a muoh more serious problem in the Western Paoific Region than drug dependence stricto sensu. The excessive use of tobacoo, though it was not a psyohotropic drug, was also a serious form of abuse.

The Representative of Australia reported the measures taken in his oountry to prevent drug abuse. Emphasis was placed on two aspeotsJ (a) monitoring of legal traffic in drugs of dependence, and (b) health education, partioularly in sohools. A study was also being carried out on the use of drugs by housewives and women at home.

The Representative of Laos referred to the treatment given to drug dependents. He also said that poppy growing had been prohibited in Laos but no substitute orop had yet been selected.

The Representative of China expressed the hope that, while national sovereignty would be respected, international cooperation would oontinue in the oontrol of drug dependence and the exchange of experienoes.

The Representative of the United Kingdom referred to the Misuse of Drugs Act passed recently in the United Kingdom which made social provision for the problem.

The Committee adopted a resolution requesting the Regional Director to: (a) pursue the studies on the epidemiology of drug dependence and alcoholism; (b) support training programmes for national personnel in the

24 REGIONAL COMMITlEE: 'lWENTY-FIFTH SESSION

prevention and control of drug dependence and alcoholism and in rehabili­tation measures; (0) assist governments, upon request, in the study and development of action programmes against drug dependence and excessive use of alcohol and tobacco (see resolution WPRjRC25.R3).

5 Review Period inolusive

The Committee reviewed a report presented by the Regional Direotor on the deliberations and conclusions of a representative group of senior national health offioials from oountries and territories in the Region which met, together with members of the Secretariat of the Regional Offioe, in Manila in July 1974. The object had been to determine how the aotivities and the intentions of the programme of the Region were conforming to the Organization's Fifth General Programme of Work covering a Specific Period and, if they were not conforming, the reasons why. The oonclusions of the oonsultation group, together with the comments of the Regional Committee would be transmitted to the Direotor-General to assist him 1n preparing a global report to the Executive Board.

The Representative of Malaysia, Dr Noordin, who had been Chairman of the consultation group, explained the background to the Direotor-General's request for a review by Regional Offices. In preparing the Sixth Programme of Work closer involvement of Member countries in oonsultation with WHO, would be called for. It had been suggested that the duration of the Sixth Programme of Work should be six years.

The Committee adopted a resolution recommending that:

(a) the principles and oriteria of the Fifth General Programme of Work for the selection of WHO-assisted activities be sympathetically applied so that countries in most need could continue to receive assistance from the Organization;

(b) implementation of the objectives of the Fifth General Programme of Work be promoted not only through the increasing role played by the WHO Representatives in interpreting and fostering the cooperation of governments in the General Programme of Work but also by organizing group meetings between governments and WHO to improve further communication;

(0) the Organization secure the fullest participation of Member countries in future formulations of the General Programme of Work;

(d) oonsideration be given to preparing the Sixth General Programme of Work, as an updated continuation of the Fifth General Programme oovering a period of six years to harmonize with the new biennial programme of the Organization. (See resolution WPR/RC25.R4.)

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6 Project Systems Analysis (Document WP~25/9)

The Committee noted from a report presented by the Government of Malaysia, where pilot studies had been carried out, that the WHO Project Systems Analysis team established in 1970 had direoted its efforts towards improving country-oriented methodology in order to highlight health development projects within a oountry's sooio-economio development plan and to produce measurable objeotives •

The Committee noted the steps that were being taken by the Regional Director to develop, adapt and apply Projeot Systems Analysis methods. Experts on the subject were no longer oonoentrated at Headquarters but were gradually moving out to the Regions.

The Representative of Fiji asked for oopies of the Projeot Systems Analysis guidelines, whioh were in preparation, so that they oould be studied with a view to possibly testing the method in Fiji with WHO assistanoe.

The Committee adopted a resolution requesting the Regional Direotor to continue his present efforts with regard to these methods for the formulation and management of health programmes so that further assistanoe, guidance and expertise oould be provided to Member governments in the Region. (See resolution WPR!RC25.R5.)

7 il 1ms of hol water

The Committee noted from the report made available by the Government of Fiji that the Ministry of Health of Fiji had despatohed a oiroular to all its health offioials regarding the dangers of spreading oholera and the precautions to be taken in allowing pilgrimS to import holy water.

The Representatives of Australia, Japan and Malaysia spoke during the disoussions.

The Committee noted that Artioles 31.1 (b) and 47 of the International Health Regulations set forth adequate measures to prevent the spread of cholera from one country to another.

It was further felt that this was a subjeot that should be dealt with by individual governments rather than the Regional Committee.

8 Teohnioal cooperation among developing oountries (Dooument WPR/RC25/13)

The Comm1 ttee noted that the report of the UNDP Working Group, on which WHO had been represented, reoOlllllended ,that a special un1 t be established to deal with the question within the UNDP Seoretariat and that an information system be set up. Speoialized agenoies of the United Nations had been asked to establish focal points for the promotion of technical cooperation among developing oountries.

26 REGIONAL COMMlTmE t 'I'tlENTY-FIFTH SESSION

WHO had always given strong emphasis and support to the concept of cooperation in technical fields among developing countries. In the Western Pacific Region cooperation had been principally in the area of health manpower development and the prevention and control of oommunicable diseases. through the exohange of technical advisers and researoh workers. fellowships. conferenoes. seminars and training oourses.

The Representative of Western Samoa said that his Government was implementing this ooncept by providing assistance to the University of the South Paoific in Fiji.

The Committee adopted a resolution which referred to a proposal made at the nineteenth session of the Regional Committee (resolution WPR/RC19.R6) that Member States might wish to pursue joint studies of selected subjects of particular interest to groups of countries; agreed on the desirability of establishing a means whereby developing countries could share their technical oapabilities and experience with one another to bring about more effeotive regional oooperation. It commended the efforts being made by WHO to enoourage developing countries to devise specifio programmes on technioal cooperation among themselves and expressed the hope that governments of developing countries would cooperate with WHO in these efforts and assist the Director-General in supporting and implementing the recommendations of the UNDP Working Group as they applied to the field of health (see resolution wpR/RC25.Rll).

9 Time and plaoe of the twenty-sixth and twenty-seventh sessions of the Regional Committee

The Committee recalled that at its twenty-fourth session in 1973. it had decided that its twenty-sixth session would be held at regional headquarters in Manila.

At the same session the Committee had decided that it could meet in another country if an invitation was extended by a Member State. it being understood that this would not happen in two consecutive years and that all other sessions would be held at the regional headquarters (WPR/RC24.RlO).

In resolution WPR/RC22.Rl7 adopted at its twenty-second session, the Committee called "on each host government to provide the local facilities and to pay as much as possible of the additional expenses of meetings of the Regional Committee held on its territory. particularly that part whioh can be met in its national currency".

The Committee reaffirmed that the twenty-sixth session of the Regional Committee would be held in Manila from 1 to 6 September 1975. These early dates were necessary because the Chinese interpreters were seoonded from the United Nations and were due back in New York for the General Assembly.

The Representative of Japan extended a tentative invitation from his Government to hold the twenty-seventh session of the Regional Committee in Tokyo. The invitation was subjeot to oonfirmation before the end of 1975.

" ."

•

REPORT OF THE REGIONAL COMMITIEE

The Committee accepted this invitation with appreciation provided a satisfactory agreement could be ooncluded between the Government and WHO (see resolution WPR/RC25.Rl4).

10 Technical Discussions

10.1 DeSignation of Chairman

At its eleventh session, the Regional Committee adopted a resolution (WPR/RCll.Rll) recommending that the Chairman of the Technical Discussions should be appointed well in advance of the meeting. Following consultation between the Regional Director and the Chairman of the Regional Committee, Mr Cheong Weng-Hooi, Chief Entomologist, Institute of Medical Research, Kuala Lumpur, Malaysia, was selected for this office.

10.2 Organization

The theme of the Technical Discussions was "Control of Veotor Mosquitoes of Dengue Haemorrhagic Fever"

The first session consisted of introductory statements and an explanation of the procedures and techniques to be used in the Technioal Discussions. The participants were divided into three groups which met separately and conduoted a free discussion in accordance with the guidance and referenoes provided.

At the secondary plenary session, a summary report was considered and an evaluation made of the discussions. The report of the Technical Discussions was issued as document WPR/RC25/TDB.

11 Teohnioal Presentation

Reoalling resolution WPR/RC3.Rl4 adopted by the Regional Committee at its third session which resolved that they should be a part of the agenda in future sessions of the Regional Committee, the Committee reviewed the purposes and prooedures of the Technioal Disoussions.

It deoided that the Teohnical Disoussions should henoeforth be supplanted by a Teohnioal Presentation, which would have the following features:

(a) the topic for the presentation would deal with a special subjeot, or a health problem and/or approaches to a health problem and would be seleoted by the Regional Committee one year in advance;

(b) the topic would be presented by one or two reoognized experts who preferably should be familiar with the situation in the Western Pacific Region;

(0) a Technical Presentation would take place during each session of the Regional Committee.

28 REGIONAL COMMITlEE: 'lWENTY-FIFTH SESSION

The Representatives of most countries and territories of the Region took part in the disoussions whioh led to this decision.

The Committee adopted a resolution requesting the Regional Director to select the experts for the Teohnical Presentations, in oonsultation.with the Chairman of the Regional Committee, make the necessary budgetary provision if it was required and arrange the first Teohnioal Presentation at the twenty-sixth session of the Regional Committee (see resolution WPR/RC25.R12) •

11.1 Seleotion of to ic for the Teohnioal Presentation at the twent -sixth session of the Regional Committee WPR/RC25/U Add.l)

The Representative of Australia having withdrawn the topio suggested by his Goverrunent, the Committee selected "'lhe oontrol of tuberoulosis in the Western Paoifio Region" as the topio for the Teohnioal Presentation during the twenty-sixth session of the Regional Committee (see resolution WPR/RC25.R13) •

12 Reports reoeived from goverrunents on the progress of their health aotivities

The Chairman aoknowledged the following reports presented to the Committee:

(1) AUSTRALrA - Report on national health aotivities, 1973-1974;

(2) FRENCH POLYNESIA - Rapport suooinot sur les aotivit~s sanitaires dans le territoire de la Polynesie fran~aise, 1973;

(3) HONG KONG - Brief report on health activities, 1973;

(4) JAPAN - Progress report on the health administrations in Japan;

(5) KFmR REPUBLIC - Brief report on the health situation;

(6) LAOS - Rapport suocinot sur les activites sanitaires en 1973-1974;

(7) MACAO - Brief report on the progress of health activities, 1973;

(8) MALAYSIA - Brief report on the progress of health activities in Malaysia;

(9) NEW ZEALAND - Brief report on progress in health servioes;

> ,

•

-

REPORT OF THE REGIONAL COMMITlEE

(10) REPUBLIC OF KOREA - Report on the progress of health aotivities;

(11) REPUBLIC OF VIET-NAM - Rapport suooinot sur 1es aotivites sanitaires, 1973-1974;

(12) 'nMOR - Brief report on the progress of health aotivities in Portuguese Timor, 1973.

30 REGIONAL COMMITIEE: 'DlEN'lY-FIFTH SESSION

PART IV. RESOWTIOH3 ADOP'lED m'!'FE REGIONAL COMMITIEE

ANNUAL REPORT OF THE REGIONAL DIREC'roR

The Regional Comni ttee.

Having reviewed the Report of the Regional Direotor on the work ot the World Health Organization in the Western Paoifio Region during the period 1 July 1973 to 30 J\me 1974.1 and appreoiating particularly the new presentation of the Introduotion.

1. NO'lES with satisfaotion the marmer in whioh the programme was plarmed and oarried out; and

2. COMMENDS the Regional Direotor and his statf tor the work aooomplished.

Fourth meeting. 4 September 1974

WP~25.R2 QUAUTY OF WA'lER AND FOOD IN IN'lERNATIONAL AVIATION

The Regional Committee.

Having oonsidered

(a) the report of the Regional Direotor on the quality ot water and food in international aviation; 2 and

(b) the resolution adopted by the Twenty-seventh World Health Assembly on the safety of food and water and the handling of wastes in international traffio;3

1. RECOGNIZES that. although oonsiderable improvements have been achieved over reoent years. there is no room for oomplaoenoy. There is a need for further improvement and oonstant vigilanoe to ensure that high standards are reached and maintained;

2. NO'lES with satisfaction that the Direotor-General is vigorously pursuing aotion towards the improvement of ex:Lsting praotioes and the establishment ot international miorobiologioal standards for tood.

Fourth meeting. 4 September 1974

~ooument WP~25/3 and Corr.l.

~oument WPR/.EC25/6.

3Reso1ution WHA27.46.

REPORT OF 'mE REGIONAL COfttvlITlEE

WPR/RC25.R,3 DRUG DEPE:NIlElCE

'!he Regional Committee.

Having considered the progress report provided by the Regional Direotor in oonnexion with resolution WPR/RC24.RB on the above subJeot;l

Consoious that while drug dependence at present affeots relatively few in number of the Region's population. it could beoome a more widespread and grievous problem in the future;

31

Reoognizing also the problems oreated by excessive use of alooho1 and tobacoo, whioh are of great importanoe in this region.

1. NO'lES with satisfaotion that the regional progr8lllllE! on drug dependenoe is now under way and that proviSion has been made for its oontinuation and expansion;

2. URGES the expansion ot the regional programme to ino1ude the problem of alooholism so that effeotive aotion oan be taken to prevent its spread and to institute measures for its oontro1;

3. EXPRESSES the hope that experienoes from proJeots oonducted at national level. when combined with the results of research. will lead to effective methods of oontrolling drug dependenoe and alooho1ism;

4. REQUESTS the Regional Direotor to:

5.

(a) pursue the studies on the epidemiology of drug dependence and alcoholism;

(b) support training programes tor national personnel in the prevention. rehablli tation and control of drug dependence and alcoholism;

(0) assist governments. upon request. in the study and development of aotion programmes against drug dependenoe and excessive use ot alooho1 and tobaooo;

THANl(S the Regional Direotor tor his report.

Fourth meeting. 4 September 1974

~ooument WPR/RC2517.

32 REGIONAL COMMr'I'mE: 'NEN'lY-FIFTH SESSION

REVIEW OF THE FIFTH GENERAL PROGRAMME a! WORK COVERING A SPECIFIC PERIOD (1973-1977 IRmlSIVE)

'!he Regional Committee,

Having considered the Regional Director's report on the review made ot the Fifth General Programme of Work and the progress being made in implementing it,l

1. THANKS the individual members of the Consultation who assisted in the review and the Regional Direotor for his report;

2. CONSIDERS that the Fifth General Progr8lllDe ot Work ~ been sucoessfully adapted to the situation in the Western Pacitio Region;

3. N~ that the majority of regional aotivities are meking progress in aChieving the objectives of the Fifth General Prograllllle of Work;

4. R&:OMMENDS that:

(a) the principles and criteria of the Fifth General Programme of Work for the selection of WHO-assisted activities be sympathetically applied so that oountries in most need can oontinue to receive assistance tram the Organization;

(b) implementation of the objectives of the Fifth General Progr8llllle of Work be promoted not only through the inoreasing role played by the WHO Representatives in interpreting and fostering the cooperation of governments in the General Programme of Work but also by organizing group meetblgs between governments and WHO to improve further communioation;

(0) the Organization secures the f'ullest partic1pat1cm of Member oountries in future formulations of the General Progr_ of Work;

(d) consideration be given to preparing the Sixth General Progranme of Work, as an updated continuation of the Fifth General Programme. oovering a period ot six years to harmonize with the new biennial programme of the Organization;

5. REQUESTS the Regional Director to transmit the report and the summary records of the discussion of the Regional Comm1 ttee to the Director-General for oonsideration and inolusion in the dooument being prepared to assist the fifty-fifth session of the Exeoutive Board in reviewing the Fifth General Programme ot Work.

Fourth meeting, 4 September 1974

1 Dooument WPR/RC25/8.

-'

REPORT OF THE REGIONAL CtMt1I'l'lEE

PROJECT SYS'lEMS ANALYSIS

The Regional COmmittee,

Having oonsidered with interest the report presented by the Government of Malaysia and the aotion being taken by the Regional Direotor in the development, adaptation and applioation of Projeot Systems Analysis methods,

1. THANI<S the Government of Malaysia for making this information available;

2. Norms the aotivities being undertaken by WlI) to involve Member. oountries in studies aimed at adapting Projeot Systems AnalysiS methods to their individual needs;

3. RE~TS the Regional Director to continue his present efforts to develop and adapt ProJeot Systems AnalysiS methods for the fomulation and management of health progralllll8S so that further assistanoe, guidanoe and expertise can be provided to Member governments in the Region.

Fourth meeting, 4 September 1974

DISINSECTION OF AI~RAFT

The Regional Committee,

Having oonsidered the in1'ormation provided by the Regional Direotor in oonnexion with resolution wpR/R:::24.R4 in connexion with the above sUbJeot,l

1. Norms that the Twenty-seventh World Health Assembly has reoollDllended that Member States should accept as valid disinsecting of airoraft on international flights by the D1OhJ.orvos Vapour System, and that most of the oountries and territories in the Region have agreed to adopt this system, a few wishing to reserve the right to disinseot airoraft on the ground, as an add! tional measure it deemed neoessary;

2. REQUESTS the health authorities of Member governments to urge the authorities ooncerned to take the neoessary steps to have the system installed in aooordanoe with the speoifications laid down by

~oument wp~25/5.

33

34

ICAO; and to propose tollow-up studies on the possible deleterious etteota ot the system and the developgent of resistanoe in oertain inseota;

3. THANJ!S the Reglonal Direotor tor his report.

Fitth meetins, 5 S.ptember 1974

~OI1J'J![ONS OF REGIONAL Ilf.biJ1BSf ADOP.Jm) BY THE 'lWENTY­SEYEN'l'H WORID HEAIlrH ASSEMBLY AID 'lIE EXIUrl!LVE BOARD AT I'm lI'IP'l'!-'.l'H[JII) SESSICIf

TAKES Nom ot the tollowinS resolutions adopted b7 1Ihe 'l'Itenty­seventh World Health Assembly and the Executive Board at ita tifty­third session t

EB53.R44 -WHA27.J.8

Organizational study on the interrelationships between the oentral teo1m1oal aerYioes ot WH)

and progr8111D88 ot direot assistanoe to Member states

Health education

WHA27 • 28 - Health education ot oh1ldren and 70UIlI people

WHA27 • 29 - '!he role ot WH> in bilateral or multilateral health progr8111D88

WHA27 • 31 - Continu1ns education tor ph18ioiana

WHA27 • 34 - COOl'd1nation with the Un1 ted Nations sptem t the l .... t cleveloped UIOl'l8 the clevelop1ng oountries

WHA27 .35 - Coordination with the United Nations sptem: pneral lllattera

WHA27 • 44 - Promotion ot national health aerYioe8

WHA27 • Ji9 - WII)' s human health and envi1"ODlll8llt programme

WHA27 • 50 - WII)' s human health and envil'Olllllent progrlllllll8: ooordination on progr_s and aotion in the field ot the enviranment

.. '

" ~

WHA27 • 57 - WI!) expanded progr8111118 on 1Dmun1zation

WHA27 • 58 - Coordination and strengthen1ng ot leprosy control

WHA27 .59 - Prevention at road tratt!c accidents

WHA27.6J. - WlI)'s role in the development aDd coordination ot bic:aedical research

WHA27 • 62 - Standardization of diagnostic materials

WHA27 • 63 - Lang-term planning ot international cooperatiClll in cancer research

Firth meetingl 5 September 197.\

~25.R8

Having considered resolution WHA27.51 adopted by the TMenty­seventh. World Hltalth Assembly.

Viewing with ooncern the taot that malaria has remained a serious disease in scme parte ot the world because ot:

Ca> the t1nanoial and administrative difficulties encountered by governments ot conoernecl countries in implementing their antimalaria progr8111118Si and

Cb) teohnioal problema in relation to the behaviour ot oertain vectors aDd the resistanoe ot parasite strains to ant1maJaria drugs,

Noting with satisfaction. nevertheless, that in several areas ot the Western Pacific Region antimalaria operations have had a marked impact on the incidenae of the disease i

1. UllJES governments:

Ca> to establish the priority to be aocorded antimalaria progr8111118S in relation to other large-scale Progr8llllleSi

(b) to continue to give full administrative and tinancial SUpport to antimalaria oampaiPSi

35

36 REGIONAL COMMITIEE: 'lWENTY-FIFTH SESSION

(0) to promote a greater partioipation and involvement of the general health servioes in the implementation and eValuation of antimalaria operations;

2. EMPHASIZES the need for oontinued vigilanoe even when the inoidenoe of the disease has been reduoed to a low level;

3. NOTES with appreoiation the bilateral assistanoe given by some Member States to oountries and territories wi thin the Region in their antimalaria aotivities and hopes that governments in the position to do so will oontinue to provide this type of assistanoe;

4. REQUESTS the Regional Director to oontinue to give all possible assistanoe to governments enoountering problems in oonnexion with their oampaigns, including assistance in resolving some of the technical diffioulties conneoted with vector behaviour and the resistanoe to drugs of malaria parasites.

Fifth meeting, 5 September 1974

WPR/RC25.R9 INTENSIFICA'lION OF RESEAJ:CH ON mOPICAL PARASI'l'IC DISEASES

The Regional Committee,

Having oonsidered resolution WHA27.52 adopted by the Twenty­seventh World Health Assembly;

Noting that the implementation of this resolution is primarily incumbent upon WHO Headquarters;

1. REQUESTS the Direotor-General to give priority in WHO' s intensified researoh activities to schistosomiasis and f~lariasis which are prevalent in the Western Pacific Region;

2. INVITES the governments of those oountries where the diseases are endemic to assist the Organization in carrying out these activities.

Fifth meeting, 5 September 1974

REPORT OF THE REGIONAL COMMITlEE

~25.RlO INFANT NUTRITION AND BREAST FEEDIm

'!he Regional COIIII11ttee.

Having oonsidered resolution WHA27 .43 adopted by the Twenty- . seventh World Health Assembly.

Reoognizing that the implementation of the resolution depends to a large extent on the efforts of oountries to enoourage breast feeding and to develop weaning toods based on local produots.

1. INVI'lES governments to intensity their efforts to pranote eduoation and other measures in support of breast feeding of infants and the wider use of locally based weaning foods;

2. REQUESTS the Regional Direotor to extend teolmioal and other means of assistanoe available to the Organization in support of the efforts of governments to these ends.

Sixth meeting. 9 September 1974

WPR/lIC25.RU 'lECHNICAL COOPERATION AMWG DEVELOPING COUN'lmES

'!he Regional COIIII11 ttee.

Having oonsidered the statement provided by the Regional Direotor on the deliberations and reoanmendations of the Working Group on Technioal Cooperation among Developing Countries established by the Governing Counoil of the United Nations Development Programme. l

Reoalling resolution WPR/l!C19.R6 of the Committee which noted a proposal that Member States might wish to pursue joint studies ot seleoted subjeots that are of partioular interest to groups of countries,

1. WELCOMES the reoommendations of the working group and the implioations for the field of health;

2. AGREES on the desirability of establishing a means whereby developing oountries oan share their teohnioal oapabilities and eJlperienoe with one another and thus bring about more effeotive regional oooperation;

1nOOl.lll8ll.t WPR/lIC25/13.

37

REGI ONAL CCH1I1"lEE: '!WENTY' .. FIFTH SESSION

3. NOlES the extent to which this is already being d~ within the Western Pacific Region espeoially in the areas of health manpower develoJlllent and the prevention and oontrol of oOlllJlUl\1oable diseases;

4. COMMENDS the efforts being made by the World Health Organization to enoourage developing countries to devise speoifio programmes on technioal oooperation among themselves;

5. EXPRESSES the hope that governments of developing oountries will oooperate with WII> in these efforts and assist the Director-General in supporting and implementing the reoOlllll8Ildations of the UNDP Working Group as they apply to the field ot health.

Sixth meeting, 9 September 1974

WPR/f!C25.R12 'lECHNICAL PRESENTA1:ION

The Regional COIII1I1 ttee,

Having reviewed. the purpose ani prooedures of the Teohnical Disoussions ot the Regional Coam1ttee;

Reoalling resolution WPR/.RC3.Rl4 whioh resolved that Technioal Disoussions should be a part ot the agenda in fUture sessions of the Regional COIIIII1 ttee;

Believing that the Technical Discussions oan in f'uture be further oriented. towards the partioular interest of the Member oountries ot the Region.

1. DECIDES that the Teohnioal Disoussions will henoetorth be supplanted by Technical Presentations which will have the following features:

(a) the topio tor the presentation will deal with a speoial subjeot, or a health problem and/or approaches to a health problem. and will be seleoted by the Regional Comm1 ttee one year in advanoe;

(b) the topio will be presented. by one or two reoognized operts who preferably should be familiar with the situation existing in the Western Paoifio Region;

(0) a Teohnioal Presentation will be scheduled during each session of the Regional Coam1ttee;

REPORT OF THE REGIONAL COMMIT'lEE

2. REQUESTS the Regional Direotor:

(a) to seleot the experts in oonsultation with the Chairman of the Regional Cormnittee;

(b) to make the neoessary budgetary provision, if required;

(0) to arrange the first Teohnioal Presentation at the twenty-sixth session of the Regional Committee in 1975.

Sixth meeting, 9 September 1974

~25.Rl3 TOPIC OF 'lECHNICAL PRESENTA'nON IN 1975

The Regional Committee,

Having oonsidered the topios suggested by the Regional Direotor for the Teohnioal Presentation during the twenty-sixth session of the Committee,l

DECIDES that the subjeot for the Teohnioal Presentation in 1975 shall be "The oontrol of tuberoulosis in the Western Paoifio Region"~

Sixth meeting, 9 September 1974

WPR/RC25.Rl4 1WENTY-SIXTH AND 1WENTY-SEVENTH SESSIONS OF THE REGIONAL COMMIT'lEE

The Regional Committee,

Having oonsidered that a reasonable period of time neoessary for the oonduot of the Regional Committee meeting will be one week,

1. CONFIRMS that, in aooordanoe with resolution WPR/RC24.RlO, the twenty-sixth session of the Regional Committee will be held at regional headquarters in Manila, from 1 to 6 September 1975;

~ooument WPR/RC25/ll.

39

40 REGIONAL COMMITlEE: 'J.WENTY-FIFTH SESSION

2. ACCEP'IS with appreoiation the tentative invitation of the Government of Japan for the twenty-seventh session, provided a satisfaotory agreement is concluded between the Government and WHO;

3. REQUES'I5 the Government of Japan to confirm its invitation at the earliest possible date.

Sixth meeting, 9 September 1974

WPR/RC25.Rl5 ElJDGET PERFORMANCE 1973 - DIRECT SERVICES TO GOVERNMENTS

'!he Regional Committee,

1. NO'lES the report of the Regional Direotor on budget, performanoe for the finanoial year 1973;1 and '

2. REQUESTS the Regional Direotor to make reports of a similar nature to future sessions of the Regional Conmittee.

Sixth meeting, 9 September 1974

WPR/RC25.Rl6 MODIFICATIONS MADE TO '.1m 1974 AND 1975 pROQRAltM!: AND BUDGET ESTIMA'IES

'!he Regional COIIIlli ttee,

Having examined the report presented by the Regional Direotor on the modifioations made to the 1974 and 1975 regu1ar progro&mme and budget estimates,2

1. TAKES Nom of the ohanges made;

Having oonsidered the revised List of Add! tional ProJeots annexed to the regional programme and budget estimates for 1976 and 1977 contained in doouments WPR/RC25/2 and WPR/RC25/2 Add.1 and those brought forward during the meeting,

1 Dooument WPR/RC25/P&:B/2.

~ooument WPR/RC25/P&:B/3. •

•

REPORT OF THE REGIONAL COMMI:'I'lEE

2. REQUES'll3 the Regional Direotor to oonsider the List of Additional Projeots revised aoootdingly.

Sixth meeting, 9 September 1974

WPR/RC25.Rl7 PROPOSED PROGRAMME AND ElJDGET ES'I!l:MA'lES FOR 1976 and 1977

'!he Regional Committee,

Having examined the proposed progranme and budget estimates for 1976 and 1m to be finanoed from the regular budget and other souroes of :t\mds, and those inoluded. in the List of Additional Projeots,l and the report of the Sub-Commi ttee thereon, 2

1. NO'lES with satisfaotion the oontinued emphasis being given to interoountry projeots which serve to generate interest in speoifio fields as a first step to the organization of aotivities wi thin the oountries as well as promoting intercountry oooperation in the Region;

2. NO'lES with appreoiation the detailed information on oonsultant and fellowship provisions oontained in AnneDs VII and VIII of dooument WPR/RC25/2;

3. CONSIDERS the List of Additional Projeots as part of the regional programme;

4. REQUESTS the Regional Direotor:

(a) to assist governments in developing am implementing new projeots;

(b) to enoourage governments to assume financial respansiblli ty for ongoing projeots of proven feasibility;

(0) to transmit the proposals to the Direotor-General for oonsideration and inolusion in his proposed programme and budget estimates for 1976 and 1977.

Sixth meeting, 9 September 1974

luooument WPR/RC25/2 and WPR/RC25/2 Add.l.

~ooument WPR/RC25/14 •

41

42 REGIONAL CCM'tlIT'lEE: 'lWENTY-FrFTH SESSION

WPR/RC25.Rl8 'lENTATIVE PROJECTIONS OF THE BJDGET ESTIMA'lES, FOR 1978 AND 1979

~ Regional COmmittee,

Having examined the tentative projections of the budget estimates for 1978 and 1979, for the Western Pacific Region, presented by the Regional Director,l

REQtE3'lS the Regional Director to transmit these tentative projections to the Director-General

Sixth meeting, 9 September 1974

WPR/RC25.Rl9 ADOPTION OF THE REPORT

The Regional Committee,

Having oonsidered the draft report of the twenty-fifth session of the Regional Committee,2

ADOP'lS the report.

Seventh meeting, 9 September 1974

WPR/RC25.R20 RESOWTION OF APPRECIATION

The R~gional Committee

EXPRESSES its appreciation and thanks to:

(1) the Government and people of Malaysia for:

(a) having invited the Regional COIIIII1ttee to hold its twenty-fifth session in KUala Lumpurj

(b) the excellent arrangements and faclli ties provided, and

(0) the generous hospitality reoeivedj

~ocument WPR/RC25/P&B/4.

~cument WPR/RC25/15.

REPORT OF THE REGIONAL CCM4I'l'lEE 43/44

(2) the Honourable Prime Minister, Tun Abdul Razak bin HaJi lllsBein and the Honourabfe Minister of Health, Tan Sri Lee Siok Yew. for having addressed the formal opening of the twenty-fifth session of the Regional. Conm1ttee;

(3) the Director-General of Health Servioes. Tan Sri Dato (Dr) Abdul Majid bin Ismail, and his staff' for the excellent arrange­ments made for the meeting;

(4) the Chairman and other offioers of the Conm1 ttee;

(5) Mr Cheong Weng Hooi for having so ably served as Chairman of the Technioal Discussions, the plenary session rapporteurs, . the chairmen and rapporteurs of the three disoussion groups and the other experts who assisted with the Technical Discussions;

(6) the representatives of UNICEF and the non-governmental. organizations for their statements;

(7) the Regional. Director and ~ Secretariat for their work in corm.exion with the meeting.

Seventh meeting, 9 September 1974

REPORT OF THE RE!nONAL c9MMITOOi

ANNEX. 1

AGENDA

1 Qpen1ng of the session

2 Address by retiring Chaizwm

3 Eleotion of new of't'ioers: Chairman, Vioe-Chaizwm and Rapporteurs

4 Address by inooming Chairman

5 Adoption of the agenda

6 Technical Discussicns

Statement by the Chairman of the 'Teolm1cal Discussions

7 Proposed programme and budget estimates, 1976 and 1977

7.1 Establishment of the Sub-cOlllll1 ttee on Programme and 8.ldget

7.2 Consideration of the report presented by the Sub-comm1 ttee on' Progr8IIIIIIEI and Budget

8 Acknowledgement by the Chainnan of brief reports reoeived from governments on the progress of their health aotivities

9 Report of the Regional Direotor

10 Resolutions of regional interest adopted by the TWenty-seventh World Health Assembly and the EDoutive Board at its fifty-third session

11 Disinsection of aircraft (resolution WPR/HC24.R4)

12 QUail ty of water and food in international aviation (resolutions WPR/RC24.R5 and WI'R/RC24.R6)

13 Drug dependence (resolution WPR/HC24.R8)

14 Review of the Fifth General PrograD1118 of Work Covering a Speoifio Period (1973-1977 inclusive)

15 ProJeot systems analysis: Item proposed by the Government of Malaysia

46 REGIONAL COMMITlEE; '.lWENTX-FIFTH §'fMIPN

16 Cholera preoautions - importation by pilgrims of holy water: Item proposed by the Government of Fiji

17 statements of representatives of the United Nations, the Speoialized Agenoies, of intergovernmental and non-govemmental organizations in official relations with WID

18 Technioal oooperation among developing countries

19 Selection of topio for the Teohnical Discussions during the twenty-sixth session of the Regional Committee

20 Time and plaoe of the twenty-sixth and twenty-seventh sessions of the Regional Committee

21 Consideration of the report presented by the Chairman of the Teohnioal Disoussions

22 Adoption of the draft report of the Colmni ttee

23 Adjournment

AWmALIA AUSmALIE

CHl:NA CHl:NE

1

, ~

FIJI FIDJI

REPORT OF mE REGIONAL COMM[TIEE

LIST OF REPRESENTATIVES LIS'lE DES REPRESENTAN'lJ3

ANNEX 2 ANNEXE 2

47

I. REPRESENl'ATIVES OF MEMlER STA'JES REPRESENrAN'lB DES ETAT MEM8RES

Dr G. Howells (Chief Representat+ve) Direotor-General of Health (Chef de d~l~gation)

Dr R. W. CUmming (Al ternate/Suppl~ant) Assistant Direotor-General International Health Branch

Mr G. Atkin (Adviser/Conseiller) Second Seoretary Australia High Conmission Kuala ll.unpur

Dr Chen Ha.1-feng (Chief Representative) Direotor (Chef de d~l~gation) Department of Eduoation and Soientifio Researoh Ministry of Health

Dr Sung Karl (Adviser/Conseiller) Chinese Aoademy of Medioal Soienoes

Mr L1 Ching Hsiu (Seoretary/Seoretaire) Bureau of Foreign Affairs Ministry of Health

Dr Peni Vuiyale Direotor Preventive Medioal Services

Dr J. Laigret Direoteur de la San~ publique en Polynesie francraise

48 REGIONAL COMMITl'EE; lWENTY-FIFTH SFSSION

JAPAN JAPON

KmER REPUBUC REPUBLIQUE KHMERE

IAOO

MALAYSIA MALAISIE

Dr T. Takizawa Director-General Medical Affairs Bureau Ministry of Health and Welfare

Dr R. Okamoto Chief Medical Officer for International Health Minister's Secretariat Ministry of Health and Welfare

Mr M. Sasaki Second Seoretary Embassy of Japan in Malaysia

Dr Kim Vien Ministre de la Sante publique

Dr Nhonh Bun Yay Chef du Bureau des Relations exterieures

Dr Emmanuel Fernandez Medeoin Hopi tal Preah Ket Mealea

Dr Phouy Phoutthasak Direoteur general du Ministere de la Sante pubUque

Dr Ritthikay Vilaihongs Direoteur du Servioe national d'Hygiene et de Medeoin preventive

(Chief Representative) (Chef de delegation)

(Alternate/Suppleant)

(Adviser/Conseiller)

(Chief Representative) (Chef de delegation)

(Al ternate/Suppleant)

(Al ternate/Supp18ant)

(Chief Representative) (Chef de delegation)

(Al ternate/Suppleant)

Tan Sri Dato (Dr) Abdul Majid bin Ismail Direotor-General of Health (Chief Representative)

(Chef de delegation)

Datuk Paduka (Dr) Abdul Wahab bin Mohd. Ariff Direotor of Planning and Researoh

Dr Raja Ahmad Noordin Direotor of Health Servioes

REPORT OF THE REGIONAL cQMMl"'rIB 49.

MALAlBIA (OCllt1nued) Mr Onn bin Kayat MALAISD (11\11 te) Principal Assistant·Seoretary

(International Health) Ministry of Health

Dr Gurmukh Singh Deputy Direotor of Plarm1ng and Researoh

Mr Cheong Wens Hooi (Al temate/Supplc§ant) Chief' Entomologist Institute of Medioal Research

Dr Fang Ung Seng (Al temate/Supplc§ant) Director of' Medical Services

Dr Abdul Majid bin TUn Abdul Aziz (Al temate/Supplc§ant) Director ot Training and Manpower

Dr Tai Yen Hooi (Al temate/Supplc§ant) Direotor of' Dental Servioes

Datuk (Dr) Abdul Khalid bin Sahan (Al temate/SuppltSant) Director of' Medioal and Health Servioes Sabah

Dr G.V. Denis (Al temate/Suppleant) Direotor of' Medical and HBalth Services Selangor

., ZI£ALAlG) Dr R. Dickie lIJOVIf·nr..m.a1lB Direotor

Division of Hospitals

Pm:IDT~ Dr J. Dizon (Chief' Representative) , ~ Chief' (Chef' de delc§gation)

Disease Intelllgenoe Centre and concurrently Off'icer-in-oharge aa-eau of' Health Servioes and Disease Control

Dr D. Rivera (Al temate/Supplc§ant) Direotor Malaria Eradioation Servioe

50 REGIONAL COMMITI'§]: 'lWENTY-FIFTH SESSION

POR'lVGAL

REPUBUC OF KOREA REPUBUQUE DE COREE

Dr Rui Albuquerque Ribeiro cia Costa Pinhao Professor (Chief.R~prel!!entat~ve) Institute of HYgiene and Tropioal (Chef de delegation) Medicine, Lisbon

Dr Longuinhos xavier de Castro Monteiro Chief (Al ternate/Suppleant) Provincial Office of Health and Welfare Services Timor

Dr Seung Hahm Park Vioe-Minister . of Health and Social Affairs

(Chief Representative) (Chef de delegation)

Ministry of Health and Social Affairs

Mr Chong Seng Park Counoillor Korean Embassy in KUala Lumpur

Mr Byung Hoon Clnm Chief International Affairs Offioe

(Al ternate/Suppleant)

(Al ternate/Suppleant)

Ministry of Health and Social Affairs

Mr Han Il Ree Chief Division of Entomology National Institute of Health

(Alternate/Suppleant)

Mr Hang Sirb Song (Al ternate/Suppleant) Assistant Chief . / International Affairs Office Ministry of Health and Social Affairs

REPUBL1C OFVIET-NAM Dr Tran QUy Nhu (Chief RePl'esttptative) (Chef de delegation) REPUBUQ.UE Direoteur general de la Sante

DU VIET-NAM Dr Pham Quang TUan Directeur Direotion de la Sante publ1que

Mr Nguyen-Viet-Danh Second Secretary, Viet-Nam Embassy KUala Lumpur

(Al ternate/Suppleant)

<,

"

I.

REPORT OF THE REgIONAL comrTWfi 51

SImAPORE Dr A.G.K. Chew (Chief Representative) SnuAPOOR Deputy Direotor of (Chef de delegation)

Medioal Services

Dr Ng KWok Choy (Al ternate/Suppleant) Medioal Superintendent 'l'hOlll8on Road Oeneral Hospital

UNI'lED KI!QXIol Dr J .A.B. Nioho18on ROYAUfoE-UNI Medioal Adviser

Ministry of OVerseas Development Imldon

tJH['lED STA'lES Dr J .C. King (Chief Representative) fR AftEK[CA Deputy Direotor (Chef de delegation) ETA'lB-UNIS Offioe of International Haalth D'AMlmIQUE Department of Haalth

Eduoation and welfare. Waahington

Mr F.S. Cruz (Adviser/Conseiller) Direotor of Publio Health and Sooial Servioes Terri tory of Guam

Mr L.R. Jackson (Adviser/Conseiller) ElJlbaBsy of tQe UA1 ted. States of Amerioa in Kuala I1unpur

Dr M. Xumangai (Adviser/Conseiller) Direotor of Haal th Servioes TrUst Terri tory of the Paoifio Islands

WES'lERN SAMOA Dr J .C. Thieme SAMOA-OCCIDENTAL Direotor of Haalth

II. REPRESENrATIVE CF ASSOCIA'lE MEMBER REPRESENrANT DU MEMEIRE . ASSOCIE

PAPUA NEW GUINEA PAPUA-NOUVELIE-GUINEE

Dr A. Tarutia Senior Speoialist Medioal Offioer Environmental Health

52 REGIONAL cOOOTIW; . 'IWEN'IY'-FIFTH $F§sION

III. REPRESENTATIVES OF THE UNITED NATIONS AND RELATED ORGANIZATIONS REPRESENTAN'lB DES NATIONS UNIES ET DES ORGANISMFS QPI WI SONT RA'1'l'ACHES

UNITED NATIONS AND UNITED NATIONS DEVELOPMENT PROGRAMME NATIONS UNIES ET PROGRAMME DES NATIONS UNIES POUR IE DEVELOPPEMENT

UNITED NATIONS ClnIDREN'S FUND FONDS DES NA'1!WNS UNIES POUR L'ENFANCE

Mr A.F. Campbell Regional Representative of the United Nations Development Programme in Malaysia, Brunei and Singapore Kuala Lumpur

U TUn Aung Programme Offioer UNICEF East Asia and Pakistan Regional Offioe Bangkok

IV. REPRESENTATIVES OF THE OTHER IN'lER­GOVERNMENTAL ORGANIZATIONS REPRESENTANTS D'AUTRES ORGANISATIONS IN'IERGOUVERNEMEAIES

IN'IERNATIONAL COMMI'l"lEE OF MILITARY MEDICINE AND PHARMACY COMr'1E IN'lERNA'IIONAL DE MEDEClNE ET DE PHARMACIE MrLITAIRES

Colonel Dr S.A. Lopes, KMN Member of the ICMMP Direotor of Medioal Servioes Armed Foroes of Malaysia Ministry of Defense Kuala Lumpur

V. REPRESENTATIVES OF NON-GOVERNMENTAL ORGANIZATIONS REPRESENT ANTS DES ORGANISA'IIONS NON GOUVERNEMENTAIES

IN'IERNATIONAL ASSOCIATION FOR ACCIDENT AND '!RAFFIC MEDICINE ASSOCIATION IN'IERNA'IIONAIE DE MEDEClNE DES ACCIDE~ ET DU TRAFIC

Dr W.K. Ng Assooiate Professor University of Singapore 0/0 Department of Sooial Medioine and Public Health

1

j , t

IN'IERNA'I![ONAL DENTAL FEDERA'I![ON FEDERATION DENTAIRE IN'IERNATIONAIE

IN'IERNA'I![ONAL COMMITlEE OF CATHOLIC NURSES COMI'IE IN'IERNA'I![ONAL CATHOLIQUE DES INFIRMIERES ET ASSISTAN'IES MEDICO-SOCIAIES

IN'IERNA'I![ONAL CO~IL OF NURSES CONSEIL IN'IERNA'I![ONAL DES INFIRMIERES

IN'IERNA'I![ONAL PLANNED PARENTHOOD FEDERATION FEDERATION IN'IERNATIONAIE POUR IE PLANNING FAMILIAL

IN'IERNATIONAL FEDERATION OF PHARMACEUTICAL MANUFAC'lUREffi ASSOCIATIONS FEDERATION IN'IERNATIONAIE DE L'INDUS'.mIE DU MEDICAMENT

IEAGUE OF RED CRooS SOCIETIES LIGUE DES SOCIE'IES DE LA CROIX-ROUGE

IN'IERNA'I![ONAL FEDERATION OF SPORTS MEDICINE FEDERATI ON IN'IERNATIONAIE DE MEDECINE SPOR'I![VE

IN'IERNATIONAL FEDERATION OF SURGICAL COLIEGES FEDERATION IN'IERNATIONAIE DES COLIEGES DE CHrRURGIE

Dr Lim Chee Shin 0/0 Malaysian Dental Assooiation l

Selangor Selangor

Mrs M.A. Lai Nursing Sister University Hospital KUala Lumpur

Miss Chong Ah Foo President Malaysian Trained Nurses Assooiation I<Uala Lumpur

Dr W.K. Ng Assooiate Professor University of Singapore 0/0 Department of Sooial Medicine and Public Health

Mr Koh Choon HIli President Pharmaoeutioal Trade Assooiation Singapore

Y.B. Tan Sri Abdul Jamil Hais The Malaysian Red Cross Sooiety Kuala Lumpur

Dr M. Jegatheson Malaysian Assooiation of sports Medioine Institute of Medioal Researoh KUala Lumpur

Professor M. Balasegaram, FRCS.Ed Department of Surgery Kuala Lumpur

~ ~ -~ REPORT OF THE REGIONAL COMMITmfj

WPR/RC25/l Rev.2

WPR/RC25/l-a

WPR/RC25/2 and Add.l

WPRftID25/3 and Corr.l

WPR/RC25/4 and Add.l

WPR/RC25/5

WPRftID25/6

WPR/RC25/l

WPR/RC2518

WPR/Rc25/9

WPR/RC25/lo

WPR/RC25/ll and Add.l

WPR/RC25/l2 Rev.l

ANNEX 3

IJ:ST OF DOCUMEN'IS

Agenda

Annotated agenda

Proposed prograrmne and budget estimates. 1976-l9T7

Twenty-fourth Annual Report of the Regional Direotor

Resolutions of regional interest adopted by the TWenty-seventh World Health Assembly and the Executive Board at its fifty-thiz:d session

Disinsection of aircraft

Qual1 ty of water and food in international aviation

Drug dependence

Review of the Fifth General Progranme of Work Covering a Speo1tio Period (1973-1977 inclusive)

Project systems analysis: Item proposed by the Government of Malaysia

Cholera precautions - importation by pilgrims of holy water: Item proposed by the Govemment of Fiji

Seleotion of topio for the Technical Discussions during the twenty-sixth session of the Regional Committee

List of representatives

55

56 REGIONAL COMMIT'lEE: '1WENTY'-FIFTH SESSION

WP~25/l3 World,ng Group on Technioal Cooperation among Developing Countries

WP~25/l4 Report of the Sub-Commi ttee on Programme and Budget

WPR/RC25/15 Report of the twenty-fifth session of the Regional Cormni ttee for the western Paoifio

WP~25/p&:B/l Suggested guidelines for the Sub-Cormni ttee on Programme and Budget

WP~25/p&:B/2 Budget performanoe 1973

WPR/RC25/P&:B/3 Comparison of 1974 revised programme and budget estimates and operational budget Comparison of 1975 ori~al and revised estimates

WPR/HC25/p&a/4 Tentative proJeotions for 1978 and 1979

WPR/RC25/P&a/5 Proposed programme and budget estimates. 1976 and 1977 (extra-budgetary funds)

WPR/RC25/TDl Aedes aegypti surveillanoe and oontrol trials in the western Paoifio Region

WPR/RC25/TD2 Control of Aedes aegypti

WPR/RC25JTD3 The oontrol of Aedes aegypti during an outbreak of dengue haemorrhag10 fever in Peninsular Malaysia

WPR/RC25/TD4 Teohnioal Disoussions programme

• WPR/RC25JTD5 Prooedures and teohniques for the Teohnioal

Disoussions

WPR/RC25/TD6 GuideIlnes for the Technioal Disoussions

WPR/RC25JTD7 Disoussion group memberships

WPR/RC25/'ID8 Report of the Teohnioal Disoussions

WPR/RC25/TD9 Individual evaluation questionnaire

(unnumbered)

WPR/RC25/SR/l , j

WPR/RC25/sR/2

WPR/RC25/SR/3

WPR/RC25/sR/4

WPR/RC25/SR/5

WPR/RC25/SR/6

WPR;tic25/sR/7

REPORT OF THE REGIONAL COMMITlEE

Brief reports reoei ved from governments on the progress of their health aotivities

Summary reoord of the first meeting -2 September 1974

Summary reoord of the seo~ meeting -2 September 1974

Summary reoord of the third meeting -3 September 1974

Summary reoord of the fourth meeting -4 September 1974

Summary reoo~ of the fifth meeting -5 September 1974

Summary reoord of the sixth meeting -9 September 1974

Summary reoord of the seventh meeting -9 September 1974

I "'i

PART n

SUMMARY Rl!X:ORDS OF 'mE PImWiY SESSICNS

I !

..

CONTENTS

Agenda Item No.

1

2

3

4

5

6

Opening of the session ••••••••••••••••••••••••

Address by retiring Chairman ••••••••••••••••••

Election of new officers: Chairman, Vice­Chairman and Rapporteurs .•.•••••••••••••••••••

Address by incoming Chairman ••••••••••••••••••

Statement by the Representative of the

70

70

People's Republic of China •••••••••••••••••••• 70

Adoption of the agenda •••••••••••••••••••••••• 72

Technical Discussions ......................... 72

statement by the Chairman of the Technical Discussions •••••••••••••••••••• 42

7 Proposed programme and budget estimates,

8

9

1976 8Ild. 1977 ...................................................... n 7.1 Establishment of the Sub-Committee

on Programme and Budget •••••••••••••••••• 73

7.2 Consideration of the report presented by the Sub-Committee on Programme and Budget 153

Message of condolence on the death of Prime Minister Kirk of New Zealand •••••••••••• 73

Armouncements ........................................................ ..

Acknowledgement by the Chairman of brief reports received from governments on the progress of their health activities •••••••••••

Report of the Regional Director •••••••••••••••

-61-

73, 107, 148, 156

93, 141

95, 107, 127

CONTENTS

Agenda Item No.

10 Resolutions of regional interest adopted by the Twenty-seventh World Health Assembly and the Executive Board at its fifty-third session •••

Organizational study on the inter­relationships between the central tech­nioal services of WHO and programmes of direot assistance to Member states

108, 130, 141, 142, 152

(resolutions EB53.R44 and WHA27.18) •••••••• 108

Health education (resolution WHA27.27) ..... 108

Health education of children and young people (resolution WHA27.28) ••••••••••••••• 108

The role of WHO in bilateral or multilateral health aid programmes (resolution WHA27.29) 108

Continuing education for phYSicians (resolution WHA27.31) •••••••••••••••••••••• 108

Coordination with the United Nations system: the least developed among the developing countries (resolution WHA27.34).. 108

Coordination with the United Nations system: general matters (resolution wrIA27 .35) •• II II II • II II II II II II • II II 11'11 II II II • II II II II II II II II II II II II II 108

Infant nutrition and breast-feeding (resolution WHA27.43) •••••••••••••••••••••• 108, 152

Promotion of national health services (resolution WHA27.44) •••••••••••••••••••••• 108

WHO's human health and environment programme (resolution WHA27.49) •••••••••••• 108

WHO's human health and environment programme: Coordination on programmes and action in the field of the environment (resolution WHA27.50) •••••••••••••••••••••• 109

-62-

-.

•

, ;

Agenda Item No.

CONTENTS

Development of the antimalaria programme (resolution WHA27.51) .......................

Intensification of research on tropioal parasitic diseases (resolution WHA27.52) •••

109, 142

110, 142

WHO expanded programme on immunization (resolution WHA27.57) •••••••••••••••••••••• 110

Coordination and strengthening of leprosy control (resolution WHA27.SS) •••••••••••••• 110

Prevention of road traffic accidents (resolution WHA27.59) •••••••••••••••••••••• 110

WHO's role in the development and coordi­nation of biomedical research (resolution WlIA27 .. 61 ) .................................................................... III

Standardization of diagnostic materials (resolution WHA27.62) •••••••••••••••••••••• 111

Long-term planning of international cooperation in cancer research (resolution 'WfIA27 .63) .................................................................... 111

11 Disinsection of aircraft (resolution WPRjRC24.R4) •••••••..••••••.••.•••••.••••••••••• 111, 127, 141

12 Quali ty of water and food in international aviation (resolutions WPR/RC24.R5 and WPR,/RC24 .R6) ........................................................................ 113, 127

13 Drug dependence (resolution WPR/RC24.R8) •••••••• 114, 128

14 Review of the Fifth General Programme of Work Covering a Speoific Period (1973-1977 inclusive) 117, 129

15 ProJect systems analysis: Item proposed by the Government of Malaysia •••••••••••••••••••••••••• 118, 130

16 Cholera precautions - importation by pilgrims of holy water: Iteni proposed by the Government of Fiji ........................................................................................ 131

-63-

CONTENTS

Agenda Item No.

Statements of representatives of the United Nations, the Specialized Agencies, of intergovernmental and non-governmental organizations in official relations with WHO

United Nations Children's Fund

International Dental Federation

International Council of Nurses

International Planned Parenthood

.... 133, 142

133

133

Federation ,............................................................... 134

International Association for Accident and Traffic Medicine ••••••••••••••••••••••• 134

International Federation of Surgical Colleges ••••••.••.•••••••••••••.•.••••••••• 135

International Federation of Pharmaceutical Manufacturers Association •••••••••••••••••• 135

International Committee of Catholic Nurses.. 142

18 Technical cooperation among developing countries 142. 152

19 Selection of topic for the Technical Discussions during the twenty-sixth session of the>Regional Committee ••••••••••.••.•••••••.••••••.•••••••.•• 143, 152, 153

20 Time and place of the twenty-sixth and twenty-seventh sessions of the Regional Committee •••••• 147. 153

21 Consideration of the report presented by the Chairman of the Technical Discussions ••••••••••• 160

22 Adoption of the draft report of the Committee ••• 160

Resolution of appreciation •••••••••••••••••••••• 160

23 Adjournment ........................................................................ 161

-64-

.,':': (WPRjRC25/SR/l)

SUJIItfARY RECCIID OF '!HE FIRST ME:E'l'Im

Dewan TUnku Abdul Rahman, Kuala aunpur Mond.,. 2 September 1974 at 9." a.m.

CHAIRMAN: Tan Sri Dato (Dr) Abdul Majid bin Ismail (Malayaia)

1 Formal opening of the twenty-firth session of the Reaional Co~ ttee ••••••••••••••••••••••••••••• 69

2 Addre •• by retiring Chairman •••••••••••••••••••••••

3 Election of new offioers: Chairman, Vioe-Chairman and. Rapporteurs •••••••••••••••••••••••••••••••••••• 70

4 Addre •• b7 tnaaminl Chairman ••••••••••••••••••••••• 70

5 statement by the Representative of the People's Republio ot China. •••••••••••••••••••••••••••••••••• 70

6 Adoption ot the agenda ••••••••••••••••••••••••••••• 72

7 statement by the Chail'lll&ll of the Teohnioal Diaau •• iana •••••••••••••••••••••••••••••••••••••••• 72

8 Establishment of the Sub-Colllll1 ttee on Programme and B\:&c:Iget ••••••••••••••••••••••••••••••••••••••••••••• 73

9 Mess... of oondol.no. on the death of Prime Minister .!p.rk of New ~~ -.••••••••••••••••••••••• 73

10 Amlounoement ••••••••••••••••••••••••••••••••••••••• 73

-65-

66 REGIONAL COMMI'l"lEE: 'NENTY-FIFTH SESSION

First Meeting

Mondal' 2 September 1974 at 9.}O a.m.

I. Reeeentatives of' Member States

AUS'mAUA

CHnfA

JAPAN

LAOS

MALAYSIA

Dr G. Howells Dr R. W. Cumming

Dr Chen Hai-f'eng Dr Sung Kan Mr L1 Ching Hsiu

Dr Peni VUiyale

Dr J. Laigret

Dr T. Tak1zawa Dr R. Okamoto Mr M. Sasaki

Dr Nhonh Bun Yay Dr Emmanuel Fernandez

Dr Phouy PhoutthaSak Dr R1 tthikay Vilaihongs

Tan Sri Dato (Dr)· Abdul MaJid bin Ismail

Datuk Paduka (Dr) Abdul Wahab bin Mohd. Arif'f'

Dr Raja Ahmad Noordin Mr Onn bin Kayat Dr GurIIIukh Singh Dr Fang Ung Sang Dr Abdul MaJid bin TIm Abdul Aziz Dr Tai Yen Hooi Datuk (Dr) Abdul Khalid b1n Sahan Mr Cheong Weng Hooi Dr a.v. Denis

Dr R. Diolde

•

pmLIPPlNES

SUMMARY RECORD OF TlE FIRST MEE'lING

Dr J. Dizon Dr D. Rivera

67

POR'lUGAL Dr Rui Albuquerque Ribeiro da Costa Pinhao

REPUBLIC OF KOREA

REPUBLIC OF VIET-NAM

SINGAPORE

UNI'lED JaNGDOM

UNI'lED STA'lE'3 OF AMERICA

WES'lERN SAMOA

Dr Seung Hahm Park Mr Chong Sang Park Mr Byung Hoon Chun Mr Han Il Ree Mr Hang Sirb Song

Dr Pham Quang TI.wl

Dr A.G.K. Chew Dr Ng Kwok Choy

Dr J .A.B. Nicholson

Dr J.C. King Mr F.S. Cruz Mr L.R. Jaokson Dr M. Kumangai

Dr J .C. 'Ihieme

II. Representative of Assooiate Member

PAPUA NEW GUINEA Dr A. Tarutia

III. Representative of the United Nations and Related Organizations

UNI'lED NATIONS CHUDREN'S FUND U TIm Aung

IV. Representative of the Other Intergovernmental Organizations

IN'IERNA'lIONAL COIfi[TlEE OF MILITARY MEDICINE AND PHARMACY Colonel Dr D.A. Lopes. KMN

V. Representatives of Non-governmental Organizations

IN'lERNATIONAL ASSOCIATION FOR ACCIDENT AND 'mAFFIC MEDICINE Dr W.K. Ng

68 • ,<I

INTERNA'f[ONAL DENTAL FEDERA'l!ION Dr Lim Chee Shin

IN'lERNATICNAL COMMIT'lEE OF CATHOI.J:C NURSES Mrs M.A. La1

INTERNA'l!IONAL CCl.Jl'Ir.[L OF NURSES Miss Chong Ah Foo

IN'lERNA'l!IClfAL PLANNED P ARENT1I>OD FEDERA'l!ION Dr W.K. Ng

IN'lERNA'BONAL FEDERA'l!ION OF PHARMACEtJTICAL MANUFACmRERS Mr Koh ChoOll Hu.1 ASSOCIA'l!IONS

IEAGUE OF RED CROOS SOCIE'l'IES Y.B. Tan Sri AbdUl Jam11 Rais

IN'JEFlNA'BONAL FEDERA'BON OF SPOR'lB l€DICINE Dr M. JegathesOll

IN'lERNATIONAL FEDERA'l![ON OF SURGICAL COT.TF.QES Professor M. Balasegaram, FR::S.Ed.

VI. WHO Seoretariat

SECRETARY Dr Franoisoo J. D;y

, .

I .... , -:- SUMMARY RECORD OF Tf£ FIRST MEE'l![NQ

1 FORMAL OPENING OF 'l'f£ 'lWENTY-FIF'l'H SESSION OF THE REGIONAL COMMI'l"lEE: Item 1 of the Provisional Agenda

In the absence of Dr C.N. Derek Taylor. retiring Chairman. and Dr D. Singh. retiring Vioe-Chairman. the Regional Director formally opened the twenty-fifth session of the WHO Regional Committee for the Western Paoifio.

The Regional Direotor thanked the Government of Malaysia. on behalf of the World Health Organization. for the aITangements it had made in conneJd.on 1f1 th the susion and. oonveyed the greetings of the Direotor-Qeneral. He then referred to the excellent use Malaysia had made of the assistance reoeived from WHO in past years. The oountry was now able to deal with i till 011111 basio needs and this meant that in future WHO assistanoe oould be largely devoted to more highly specialized and speoifio fields. He oongratulated the Government on this achievement whiohwas the aim of all WHO-assisted programmes. He voioed the thanks of those oountries that had been able to send fellows to train in Malaysia.

The Regional Direotor also referred to the need to share teohnioal expertise. one of the first prinoiples of international health. which is beooming inoreasingly important now that rapid means of transport are faclli tating the spread of oommunioable diseases from one oountry to another.

The Honourable Minister of Health Tan Sri Lee Siok Yew addressed the meeting (see Annex 1 for oopy of his speech).

The Honourable TIm Jaji Abdul Razak bin Datuk Hussein. SMN. Prime Minister of Malaysia. then welcomed the COIIIII1ttee to KUala Lumpur (see Annex 2 for copy of his speeoh).

With the oompletion of the formal opening. the COIIIII1ttee adjourned and reconvened at 10.55 a.m.

2 ADDRESS BY RETIRING CHAIRMAN: Item 2 of the Provisional Agenda

In the absence of the retiring Chairman and the retiring Vioe­Chairman. the speeoh of the retiring Chairman was read by Dr Diokie.

Dr DICKIE (New Zealand) commenoed by saying that because of the illness of Dr Taylor he had been asked to deliver the address on his behalf. '1'h1s gave him great pleasure as it enabled him to return to an area of the world where he had served for twelve years. the last four as an officer of the Government of Malaysia. It also gave him the opportunity of attending another Regional Colllll1ttee. a.priv1lege he first had 24 years ago. He then read Dr Taylor's address (attaohed as Annex 3).

70

3 EUX:'frON OF NEW OPPICERS, CHAIRMAN, VICE-CHAIHMAH AND RAPPOR'IEURS: Item 3 ot the Provisional Agenda ,

3.1 Eleotion ot Chairman

Dr DIZON (philippines) nOlllinated Tan Sri Dato (Dr) ABDUL MAJID BtN ISMAIL (Malaysia); this was aeoonded b7 Dr CHEW (S1ngapore).

Deoision: Tan Sri Dato (Dr) ABDUL MAJID BtN ISMAIL was unanimously eleoted.

3.2 Eleotion ot Vioe-Chairman

Dr DICKIE (New Zeal.m1) nOlllinated Dr DIZON (Phil1ppines) as Vioe­Chairman; this was seocmded by Dr THIEME (Westem Samoa).

Deoision: Dr DIZON wu unan1IIIoualyeleoted.

3.3 Eleotion ot R!epOrteura

Dr PARK (Republio of Korea) nOlllinated Dr VUIYAIE (Fiji) as Rapporteur tor the EnsJ,1sh lmguqe; thia was seoonded b7 Dr THIEME (Westem Samoa).

Dr PHOU'l"l'HASAJC (Laos) nOlll1nated Dr LAIQRET (Franoe) as Rapporteur tor the Frenoh lansuage; this was seoonded by Dr '!'RAN (,J1Y NII1 (Republio ot Viet-Nam).

Deoisiona Dr VUIYAIE and. Dr LAIGRET were unanimously eleoted.

4 ADDRESS BY ~OMDO CHAIRMAN, Item 4 ot the Provisional Agenda

The CHAIRMAN addressed the meet1ng. His statement appears in Annex 4

5 STA'lEMENT BY TIE REPRESENTA'rIVE CP 'l'HE PEOPIE' S REPUBIlC OF CHrNA

Dr CIEN (China) stated that the Chinese delegation deemed it neoessal7 to point out that the tra1 toroua Lon Nol olique was a puppet regime o0D81atins ot a hIIndtUl ot natiCll&l. scum abandoned b7 the Cambodian people and oould b7 no meana represent the latter. The representative ot the treacherous Lon Nol olique was utterly unjustified in attending the sessions ot this Regional Coam1 ttee. Under the leader­ship of Samdek NorodOlll Sh1hanouk, the Ro7&l Government ot the National Union of Cambodia, which now oontroiled over ~ ot the Cambodian terri tory, was not onl7 warml7 supported b7 the Cambodian people but also had won the wide reoogni tion and admiration ot all p8aoe-lov1ng peoples and Jutioe-uphold1ns ocnm'tr1ea. '.DW R()J'al Government of the National tklion ot C8IIIbod1a, under the leaderah1p of Samciek NorodOlll S1hanouk, wu 'the 80le ;Lep]. SOV81'11De!1t repreaent1ng the Cambodian people.

...

..

..

SUMMARY RECORD OF THE FIRST MEETING

The Chinese delegation wished to point out further that the Paris Agreement on Viet-Mam had given de facto recognition to the existence of two administrations in South Viet-Mam, namely, the Provisional Revolutionary Government of the Republic of South Viet-Mam and the Saigon authorities. The Provisional Revolutionary Government of the Republic of South Viet-Mam was the genuine representative of the people of South Viet-Name Under the present circumstanoes. it was not appropriate for the representative of the Saigon authorities to unilaterally attend this session.

Dr Chen asked that his statement be recorded fully in the minutes of the meeting.

71

Dr THAN QPY NHJ (Republic of Viet-Nam) regretted he had to take up time to reply to the statement made by the delegation of the People's Republio of China. which once more had introduced politics into an international meeting dedicated to medioal questions. and interfered in the internal affairs of the Republio of Viet-Mam. He begged the Comm1 ttee to excuse the representatives of the People's Republic of China. who could not but carry out the instructions of their Government. The so-called Provisional Revolutionary Government had never been a government in South Viet-Name It had always rejeoted the proposal made repeatedly by the Government of the Republic of Viet-Mam. to organize elections under international supervision, had sought to prolong the Paris negotiations. and continued to intensify its military assaults. thus confirming its ill-will and its aggressive attitude. The delegation of the Republic of Viet-Mam strongly protested against the preposterous and unfounded allegations aimed at it. It wished to declare that there existed in South Viet-Nam only one authentic government, the Government of the Republic of Viet-Name

Dr NHONH am YAY (Khmer Republic) wished to express, on behalf of his delegation. his gratitude to the Government and people of Malaysia for their welcome and their hospitality.

In the name of the Khmer Republic he congratulated the Chaiman and the other officers of the Committee on their election.

Dr YAY said that the statement made by the representative of the People's Republio of China did not even deserve comment. Out of respeot for the host oountry and for the representatives attending the Colllll1ittee. his delegation would not stoop to answer in the same vein. It was an old refrain mechanically repeated by similar delegations at every international meeting. even scientific meetings. The delegation of the Khmer Republic would therefore refrain from replying to insult with insult. conSidering that the dignity of the Regional Colllll1i ttee should be safeguarded.

72 • REGIONAL CCMttITlEE: TWENTY-FIFTH SESSION

6 ADOP'l![~ OF THE AGENDA: Item 5 of the Provisional Agenda (Doouments WPRt1'Ic25/l Rev.l and. WPRt1'Ic25/l Rev.l Add.l)

The CHAIRMAN moved the adoption of the agenda.

Deoision: In the absenoe of ocmnents, the agenda was adopted.

7 STA'lEMENT BY 'l1fE CHAIRMAN OF THE 'lECHNICAL DISCUSSIONS: Item 6 of the Agenda

Mr CHEONG (Malaysia) stated he was greatly honoured by the invi tation to be Chairman of the Tealm10al Disoussions. '!he subjeot seleoted for the disoussions, "Control of Veotor Mosquitoes of Dengue Haemorrhagio Fever", wu very important as a number of outbreaks had been reported in several oO\Ultries and territories, inoluding Malaysia. These had been a cause of grave oonoern among the national health authorities oonoerned and had prompted them to give priority to the prevention and oontrol ot the disease.

The WHO Regional Offioes for South-East Asia and. the Western Paoifio, with the assistanoe of WHO Headquarters, had organized a Technioal Advisory COIIIIli ttee on Dengue Haemorrhagio Fever and the first meeting had been held in Maroh 1974 in Manila. '!he COIIIII1ttee had prepared tealm10al guides for the surveillanoe, diagnosis, oontrol and prevention of the disease. The South Paoifio Commission had launohed a speoial projeot designed to oontrol dengue fever.

The dooumentation of the Tealm10al Disouss.ions oons1sted of three working papers and organizational and prooedural papers. The teohnioal guides prepared by the Advisory Comm1ttee would also be available as referenoe material.

'!here would be two plenary sessions, both to be held in the Conferenoe Hall. The first would be on the morning of Friday, 6 September, when the prooedural arrangements would be disoussed further and the seoond on Monday mOrning, 9 September.

There would be three disoussion groups. Details would be given in dooument WPR/RC251ID7, which would be distributed shortly. Group A, whioh oanprised English-speaking members, and Group C. whioh oomprised English and Chinese speaking members, would meet in the Teohnioal Disoussion Rooms 1 and. 2 respeotively. and Group B. whioh oomprised English and Frenoh speaking members, would meet in the Conferenoe Hall. The Group Disoussions would start in the latter part of Friday morning and oontinue in the afternoon.

As the topio seleoted for this year's disoussion was a oonoise and olearly defined subjeot. it was hoped th8.t a praotioal and useful report would be produced whiah would be of assistanoe to oountries in the Region. (For oonsideration of the report of the Technioal Disoussions, see the seventh meeting, seotion 1.)

SUMMARY RECORD OF THE FIRST MEETING 73/74

8 ESTABLISIH:NT OF THE SUB-COMMIT'lEE ON PROGRAMME AND BUDGET: Item 7.1 of the Agenda

In aooordanoe with resolution WPR/RC21.Rl adopted by the Regional Committee at its twenty-first session, whioh deoided that the member­ship of the Sub-Committee on Programme and Budget should "consist of half the Members in the Region plus the Chairman of the Regional Camn1ttee and that it be rotated among the representat1ves of various Members, subJeot to the prOVision that any representative desiring to partioipate in the disoussion of the Sub-Commi ttee should be entitled to do so", it was agreed that the membership this year would be oomposed of representatives from the Khmer Republio, Laos, Malaysia, the Philippines, Portugal, Singapore, the United states of America and western Samoa.

It was further agreed that the Sub-Committee would meet at 2.30 on Wednesday afternoon, 4 September, and that a further meeting would take plaoe at 9.00 a.m. on Saturday morning, 7 September. (For oonsiderat1on of the report of the Sub-conmittee, see the sixth meeting, seotion 2.)

9 ~AGE OF CONDOlENCE ON THE DEATH OF PRIME MINIS'lER KIRK OF NEW ZEALAND

The CHAIRMAN proposed that the following oable be sent, on behalf of the Regional Committee, to the Minister of Health of New Zealand:

THE 'lWENTY-FIFTH REGIONAL COMMIT'lEE FOR THE \oIES'JERN PACIFIC OF THE WORLD HEALTH ORGANIZATION WHI:CH OPENED IN KUALA UlMPUR SECOND SEP'lEMEER REQUES'D3 YOU TO CONVEY I'IB DEEPEST SYMPATHY TO THE GOVERNMENT AND PEOPIES OF NEW ZEALAND AND MRS KIRK ON THE DEATH OF PRIME MI:NIS'lER KIRK

ABDUL MAJID mN ISMAIL, CHAIRMAN

It was agreed that the cable be despatohed.

Dr DICKIE (New Zealand), on behalf of the Government and people of New Zealand, thanked the Comm1 ttee for its kind thought in sending this message at a time when New Zealand had suffered a sudden and grievous loss whioh had shocked. all those present from New Zealand.

10 ANNotnaMENT

The CHAIRMAN suggested that the Committee should follow its usual prao'tioe and meet from 9.00 a.m. to 12.00 noon, with a short recess at about 10.30 a.m., and from 2.30 p.m. to 5.00 p.m., with a short reoess at about 3.30 p.m.

It was so agreed.

The meeting rose at 12 noon

,.

SUMMARY RECORD OF THE FIRST MEErING

ANNEX 1

SPEECH BY THE HONOURABIE MINIS'lER OF HEALTH, MALAYSIA

75

Saya berasa sukaoi ta mend.apat pe1uang 1n1 lmtuk beruoap kepacia wakil-waki1 negara yang dari Rantau Pasifik Barat, perwakilan yang dihormati daripada berbagai Pertubuhan Antarabangsa, Pengarah Serabtau bag1 Rantau Pasifik Barat dan kakitangan sekretariat beliau. Saya suka mengucapkan terima kasih kepada perwakilan rantau 1n1 dan Pengarah Serantau kerana telah menerima jemputan Kerajaan Malaysia . lmtuk mengadakan mesyuarat Jawatankuasa Serantau di Kuala Lumpur. I wish to extend a warm welcome to all the delegates. representatives of International Organizations. the Regional Director and his Secretariat staff. and hope that you will thorollghly enjoy your short but busy stay in Kuala Lumpur and partake our Malaysian hospi tali ty.

I wish also to convey my appreciation and thanks to the Direotor­General of Health. Malaysia and the members of his Conmittee. which is comprised of offioers of not only the Ministry of Health but of other Government agencies and departments. who have been responsible for months of preparation and arrangement for this Meeting. I hope that all the partioipants of this Meeting will find these arrangements adequate and satisfactory.

The health services in Malaysia have been expanding at a tremendous rate. lmprecedented in the history of' our COlmtry. We are proud to say that through this rapid expansion we have brought medical, health and dental care to the doorstep of almost all our population throughout the cOlmtry. We have not only expanded the physical infrastructure. but we have also implemented a number of public health programmes on a national basis in order to control or eradioate our most pressing health problems like tuberculosiS, malaria. leprosy, malnutrition, health education, environmental sanitation, fluoridation of water supplies, eto. These multi-p~onged attacks on our medical. health and dental problems have resulted in the aohievement of a comparatively high standard of health for all our people throughout Malaysia.

The crude death rate in this country has been reduced from 12.4 per thousand population in 1957 to 6.8 in 1971. a reduction of almost 50%. Similarly, the infant mortality rate has declined from 75.5 per thousand live-births in 1957 to 38.5 in 1971, again a reduction of almost 50%. The maternal death rate has been reduced by 63$ from 3.2 in 1957 to 1.24 in 1971. Life expectancy at birth has inoreased by more than 10% and now stands at 63 years for males and 66 years for

76 REGIONAL CCMt1ITlEE: '.NENTY-FIFTH SESSION

females. The decline in birth rate is around 3af> and now stands at 32.6 per thousand population. The Ministry is therefore implementing a family health programme in order to reduce further the population growth and improve the health of mothers.

The M:in1stry of Health has been able to sustain the rapid rate of eJCp8IlBion because the Health Budget is being substantially increased from year to year and maintained at around 6.5% of the National Budget. The Health Budget for 1974 is around M$352.5 million or an equivalent of US$147. 5 million. This means that the per capita health expenditure is approximately M$30 or US$12.5 wh10h in 1970 was only M$l7.5l or US$7 .32. In shortl during a five year span we are now spending almost twioe as much on the health of eaoh individual oitizen of this oountry.

In line with the objective of the New Eoonomio Polioy of eradioa­ting poverty among all raoes and of restructuring the Malaysian sooiety the Ministry of Health has been continually seeking ways ~d means of providing health serviaes and improving the health standards of all our people espeaially those living in the rural areas. There is more equitable distribution of wealth and the per capita inoome has inareased from M$1070 (us$448) in 1970 to M$1360 in 1973 (us$569). The foreoast for 1974 is that the per oapi ta income will further inorease to M$1500 (us$628).

The Ministry is continually striving to improve and expand the health service whether it be at hospital level or at public health progr8lllDe level in the field. In the peripheral areas we have establiahed a oomprehensive network of health oentres and midwife clinios now being up-graded and oonverted to Rural Community Health Clinics. The various publio health programmes in the country have been so successful beoause of the widespread basic health infrastruoture wh1ch we have built and established sinoe 1957. There are now no less than 261 health oentres and 1168 midwives-clinios allover Peninsular Malaysia and the same pattern of health infrastruoture is being bu1lt in the states of Sabah and Sarawak. The Rural Health Servioe offers an integrated ambulatory medical-oare personal and environmental health servioe and dental servioe within easy aoaess of the rural population.

The vast oapi tal investment we have put into the health servioes ineVitably oalls for a large amount of trained staff at professional and sub-profeSSional level to run the servioes. The M:in1stry has therefore embarked on a massive training programme. Whilst we have been able to araok this problem in so far as the sub-professional staff is oonoerned there is still an aaute shortage of professional staff like dootorsl dental surgeons I pharmaoists not to speak of the speoialists and oonsultants. Our looal training sohools and oentres

SUMMARY RECORD OF THE FIRST MEETING 77

are producing no les8 than a thousand five hundred paramedical, dental and health staff annually and this figure will soon reach two thousand in one or two years time. In so far as the professional staff is concerned we have two medical schools, a school in pharmaceutical soienoe and a dental faoulty. We need to inorease this further. Besides USing the faoilities available overseas we are also developing our own oapability in oonducting oourses and examinations at post­graduate level for professional staff as well as sub-professional staff. We need and oan absorb all the assistanoe whioh WHO and Member oountries oan provide in this field. We fully realize our staffing problem and are giving all the emphasis we oan to alleviate our staff­shortage.

We have reoognized that the economio and industrial programmes whioh are rapidly expanding in our oountry are oreating new and challenging health problems and the Ministry of Health has been geared to meet the new ohallenges. However, we shall need expertise and guidanoe in these new spheres of responsibilities and I hope the World Health OrganiZation will assist us whenever required.

I am deeply oonoerned with the outbreak of dengue haemorrhagio fever in Malaysia whioh has assumed epidemic proportions during the last two years. This publio health problem is not peouliar only to Malaysia but in all the oountries around us. Dengue haemorrhagio fever has been ooourring and spreading in the South-East Asia and Western Paoifio Regions of WHO during the last two deoades. In reoent years, however, the incidenoe of dengue haemorrhagio fever has been inoreasing in several oountries of the two Regions and the disease has moved from an endemic to an epidemio status. We in Malaysia are extremely oonoerned with this growing health problem and are working hard to oontain it. But the efforts of individual oountries will be nullified if oonoerted aotion i8 not taken to eradioate the disease on a regional and interregional basis. Henoe I would like WHO to ooordinate all the aotivities of individual oountries and where neoessary to provide the assistanoe and expertise in order to eradicate this menace from both the Western Paoific and South-East Asia Regions of WHO.

I would like to take this opportunity to thank WHO and the Regional Director for the Western Paoific Region for all their assistanoe and advioe in the past and look forward to their oontinued support for our publio health programmes now and in the future.

In oonolusion, I would like to thank the Ministry of Foreign Affairs, the Treasury, the Public Works Department, the Customs, the Immigration, the Polioe, the Department of Civil Aviation and all other departments and agenoies and all the staff of the Ministry of Health for their oooperative efforts whioh have made the holding of this

78 REGIONAL C<M7IT'lEE: 'NENTY-FIFTH SESSION

Conferenoe possible and last but not least to thank our be:\.oved Prime Minister tor hav1ng been so k1nd to spare some of llls busy, moments to be with us. I would like to wish all the partioipants ot this Meeting every suooess in their deliberations. I f'ully appreciate your very tight and busy programme ot work but I do hope that you will be able to spare some time to see some ot our develoJDent aclllevementsand sample our Malaysian hospi tali ty. May you all have a pleaaant and memorable stay in Malaysia and oome baok to us soon under less pressing ciroumstances.

'!hank you.

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SUMMARY RECORD OF THE FIRST MEE'I![NG

ANNEX 2

ADDRESS OF WEICOME BY THE HONOURABIE PRIME MJ:NIS'lER. 'ruN HAJI ABDUL RAZAK

79

I am indeed honoured to have this opportunity to address the distinguished representatives of WHO Member cowtries in the Western Paoifio Region, representatives of the various International Organiza­tions represented here today. the Regional Direotor for the Western Paoi:f'io Region. Dr Dy and his staff.

It 1s indeed a double honour for Malaysia to host this 25th sesdon of the Regional 001IIII1 ttee Meeting as 1 t coinoides with the Silver Anniversary of the Regional Office of the WHO and is immediately after our own National Day oelebrations.

I must thank all the delegates of this Region for having so graoiously aooepted our invitation during the 23rd session held in Guam in 1972 for this memorable session to be held in Kuala Lumpur. On behalf of the Government and people of Malaysia. I extend you a wann weloome -- Selamat Datang -- and wish you a pleasant stay here.

It is my belief (and I am sure all of you will agree with me) that the holding of the Regional Committee Meetings in various member oountries provides a better knowledge of the peoples of the region and the health situations of the various oountries. At the same time. it also helpa improve mutual relationship. understanding and respect between mem~r governments and strengthens our oonfidenoe in the World Health Organization.

We in Malaysia were fortunate to inherit a relatively sound health servioe structure from the oolonial administration at the time of our independenoe 1.8 years ago. However# the distribution and particularly the quality of the health services we 1nheri ted varied from State to State and also between areas wi thin a State. The servioes were mainly oonoentrated in the urban areas whereas the rural areas, where more than 7~ of our population lived. lacked adequate medical. health and dental faoilities. It was, therefore. a formidable task for our Ministry of Health to reotify this maldistribution between the urban and rural areas and at the same time to up-grade the quality of the servioes and harman1ze it quantity-wise between the various States. This is all the more important today in keeping with the prime objeotives of the New EoonOlll1o Polioy of my Government to eradicate poverty and inequalities no matter where they exist. Upon this firm foundation. we hope to build. strong. progressive. and united nation out of our multi-racial sooiety.

80 REGIONAL COMMITIEE: 'lWENTY-FIFTH SESSION

We are thankful for the staunch support and sound advice of the World Health Organization in our efforts in re-struoturing our health services, not only in overcoming our immediate and pressing health problems but also in satisfying the hopes and aspirations of our people. ! would like to express my appreciation to the Ministry of Health and its officials for their dedication, diligence and dynamism, whioh have, within the short span of less than two deoades, suooeeded in re-shaping the health services of this countI'll' to conform to the desired obJeotives. The imbalanoe in distribution has now been rectified and, today, there is hardly any area around the country without the basio medical, health and dental facilities.

In oorrecting the imbalance in the distribution of our health services, inadequate communication or inaccessible terrain and the like have not been an impediment to bringing essential health services to our remote and widely scattered isolated population. For instance, in Sarawak, where almost 85% of the population live in isolated long­houses in the far reaches whioh, in some cases, take up to three weeks to reach by normal means of transport, we have introduoed the Flying Dootor Service.

Today, these remote plaoes are visited regularly and the people there can enjoy necessary medioal and health servioes. Seriously ill cases are evacuated to hospitals wi thin a matter of hours. These and other innovations have ensured our isolated popula tion with proper medical and health oare whioh has brought about oonsiderable improvement to their standard of living.

Although we have made much progress in this field, we are not oomplaoent and will continue to improve and expand our services further. Having expanded the services so rapidly, we need now to consolidate our gains and fortify our efforts. As you all know, medicine i8 not a static science and ever',! day we hear of new di8coveries in speoialized areas. We must keep up with this so that our citizens oan be assured of the highest starx1ard of health and quality of life all the time.

Furthermore, health is a ohallenging field -- no sooner is a problem solved than another one emerges. The economic successes we have gained and the relative affluence brought in its wake new and even complicated health problems among our peOple. The changing patterns and mode of living further create problems in health. Industrialization, urbanization and land development invariably bring about problems such as pollution, occupational diseases and hazards, coronary diseases and industrial accidents. In short, as .soon as there is a change in the environment or ecology, we can eJGpect a health problem will emerge. 'lhis is in fact the beginning and not the end, and I am confident that the versatility and resilience with which our respective health authorities have been able to encounter these problems in the past, will enable them to face these challenges with confidence and courage in future.

SUMMARY RECORD OF THE FIRST MEE'nNG 81/82

Here in Malaysia. our most urgent task is to overcome the acute shortage of trained staff at all levels. While I am happy to note that the shortage of paramedical staff will soon be a thing of the past. there is still the shortage in the professional grades. We believe that the best way to overcome this is to establish our own post-graduate training institutions like the Colleges of Physicians and Surgeons. Only recently we established the Colleges of Surgeons. Physioians, and General Practitioners, with the oooperation and assistance of medioal oounterparts from overseas from where almost all our specialists have been trained. These Colleges will conduot courses and hold examinations leading to specialist qualifioations in the various disciplines.

It is my hope to see that Malaysia attains professional independence ultimately. In gaining professional independence our Colleges will be playing a very important role. It will also strive to maintain the closely established professional links with the sister colleges overseas. The aim is not only to bring people of the same profession from nations together but also to maintain a high standard of professional practice in Malaysia. We therefore appreciate very much all the assistance we can get from WHO and from member countries in this direction.

In his address Just now. the Minister of Health has expressed his growing concern regarding dengue haemorrhagic fever which has grown from endemic to epidemic proportions. This problem is not confined to Malaysia alone but to many countries in this Region. I am happy to know that one of the topics of your technical discussions during this session will be speoifically on dengue haemorrhagic fever. I would like to request WHO to collaborate and coordinate the various research programmes that are presently being carried out on dengue haemorrhagic fever by various institutions and organizations both within and outside this Region. with a view to advising member oountries on the latest methods and procedures in combating this growing menace. WID should also set up research studies or programmes on other aspeots of this disease which are not currently being covered. The Malaysian Institute for Medical Research has had a long and well-known success history in tropical diseases and I would like to offer the facilities and services of this Institute to assist in any study on research programmes in this field.

I am convinoed that the holding of this meeting in Kuala Illmpur will prove to be a souroe of inspiration to our Ministry of Health in their endeavours to improve the standard of health servioes in this country. The free exchange of views and knowledge will be of mutual benefit to all partiCipants of this meeting. However. I hope that in spite of your busy programme, you will find some time to acquaint yourselves with our people and the Malaysian way of life. so that your short stay in Malaysia will be a happy and memorable one. At the same time. I also hope that you will have interesting and fruitful deli bera tions •

"

SUMMARY RECORD OF THE FIRST MEETING

ANNEX 3

ADDRESS BY RETIRING CHAIRMAN1

When trying to reoall what retiring Chairmen have said at past sessions of the Regional Committee meetings the obvious step to take was to read the reports of past Committee meetings and find out.

While doing this, I realized that the first Regional Committee

83

I attended was the sixteenth session held in 1965. The retiring Chairman on that oooasion was Dr Jayesuria of Malaysia and inoidenta1ly his alternate in the Malaysian delegation. was Dr Robert Diokie, then of Sarawak but now the Direotor of the Division of Hospitals in the Health Department in New Zealand.

I have attended all but one of the ten Regional Committees involved from then until this, the twenty-fifth session. I mention this to illustrate the importance that my country attaohes to oontinuity of representation at these meetings and I know that other countries have a similar outlook.

Continuity of membership gives strength to the Regional Committee and enables us to give the WHO staff the leadership and support that they both need and deserve. We must always remember that the World Health Organization oonsists both of the staff and ourselves, the members.

Regional Committees play an important part in the work of the Organization and this was brought home to me at my first meeting when the Direotor-Genera1, then Dr Candau, reminded us that:

"The Regional Committee has the important task of helping the Organization formulate the po1ioies that govern the work in the Region, supervising the aotivities of the Regional Offioe, oooperating with the United Nations, the speoialized agenoies and other organizations interested in the field of health, advising WHO on international health matters whioh have wider than Regional significanoe, assisting in planning the programme of work and guiding the Director-General and the Regional Director in the execution of the work of the Organization."

~ead by Dr R. Dickie (New Zealand).

84 REGIONAL COftttUTlEE: 'IWENTY-FIFTH SESSION

This is no light task but one that we must, and in the main do, carry out conscientiously in that spirit of cooperation and understanding that comes from a genuine interest in one another's problems. At these Regional COl!llli ttee sessions the emphasis has always been on health problems and over the years representatives have shown commendable agility in their ability to avoid becoming involved in non-health issues. I have not noticed any diminution in this agility over the years and could give some good examples but this is not the time or the place to do so.

It is important that we keep the emphasis of these meetings on health problems, particularly at a time when we hear with dismay that the health services in some countries may be deteriorating. You will recall that the Executive Board in its recent organizational study reported that in many countries the health services are not keeping pace, either in quality or quantity, with the changing populations and may even be getting worse.

Last year Dr Candau's successor, Dr Mahler, referred to us as being all in the same global spaceship. I suggested at "!+he time that the global spaceship concept was satisfactory for WHO as a whole but at regional level, and particularly in this Western Pacific Region, it is perhaps more appropriate to think in terms of a canoe. I believe that, over the years, the Western Pacific Regional Committee has paddled its canoe strongly and well because we have all tried, and have usually managed, to paddle in unison and as I have said before, over the past ten years much of the credit must go to our navigator, the Regional Director.

Another highlight of my first meeting, and it was the main reason for the Director-General's presence, was that the then Regional Director was due to retire in a few months and one of the responsibilities of the Regional Committee was to make a recommendation to the Executive Board regarding his successor. I am proud to have been a member of the Regional Committee that recommended Dr Francisco Dy.

A thought that I would like to leave with you is that I believe it is necessary for us to be better organized on an informal basis to ensure that the Western Pacific Region maintains its proper re~sentation in the affairs of the Organization. Having had the opportunity to attend the Assembly for the past two years it is my impression that other Regions are doing this. For example, I think it should be agreed which country will be supported to nominate a representative on the Executive Board when the New Zealand nominee has to be replaoed next May and when China's turn comes two years later. Matters such as this should not be left to chance or to the last moment.

I could give other examples but. my point is that I. believe that we should be better organized in this regard so that where necessary representatives will have time to confer with their governments at home.

,-

SUMMARY RECORD OF THE FIRST MEETING 85/86

This means thinking ahead and planning ahead so that representatives come to meetings as fully briefed as possible. I do not believe that this sort of thing can often be done by holding an informal meeting. It lends itself more to the informal approach over coffee, in the corridor and so on, with which we are already familiar. The important thing is that somebody undertakes the job of seeing that representatives are sounded out informally and that they are kept informed of the opinions of other representatives and ultimately of the thinking of the majority. Representatives for their part, must come to Regional Committee sessions well briefed and be willing to be helpful when they are approached so that in the long run the good of the Region as a whole will be served.

Perhaps the role of stimulator and coordinator could be seen as the task of the Chairman who could call on his Vice-Chairman, the immediate past Chairman, and others, to assist him to discover what the wishes of the representatives are, and so to reach a consensus of opinion. For completeness, the Regional Director should be kept fully advised so that he is able to inform any representatives seeking information from him on these very important matters.

Now, may I thank the Goverrunent of Malaysia and its Ministry of Health for extending the invitation to hold the twenty-fifth session of the Regional Committee for the Western Pacific in their beautiful country, and for undertaking the vast amount of work involved. We have an interesting agenda which will give us ample opportunity to act as that international health conscience and coordinator that is our role as members of WHO.

And finally, may I thank the Regional Director and his staff, and all of you, for making my term as Chairman so straight forward and enjoyable.

I thank you all most sincerely.

'.

, .'

SUMMARY RECORD OF THE FIRST MEETING 87/88

ANNEX 4

ADDRESS BY INCOMING CHAIRMAN

On behalf of the Malaysian Delegation and myself, I would like to thank you for electing me as your Chairman for this meeting of the Regional Committee. You have done a great honour to our country. May I, on behalf of the Government of Malaysia, express our deep appreciation of this kindly gesture.

I am aware of the awesome duties and responsibilities of the Chairman in a meeting of such an august body and shall do my level best to fulfill these obligations.

I thank you for the confidence and trust you have put on me and I hope with your cooperation and assistance I shall come up to your expectations and conduct the meeting in the best manner and tradition of the Regional Committee.

This particular meeting of the Regional Committee has a great significance in that it is the Silver Anniversary Meeting for the Western Pacific Region. Malaysia is very proud indeed to be chosen as the venue for this auspicious session of the Committee.

At the Opening Ceremony you have heard the addresses from the Right Honourable Prime Minister and the Minister of Health who have stressed and elaborated the policy, development and achievements of the health services in Malaysia. I do not intend to elaborate any further but just to mention that should any of the delegates wish to visit some of our medical and health institutions or any health programme or activity, they are very welcome to do so. We shall only be too happy to make all the necessary arrangements.

Finally, for my part, I would like to say that it is a pleasure to me to see so many familiar faces once again. For the past so many years we have met and deliberated, dined and wined together and thereby established so much understanding and goodwill like one happy family. And this happy relationship has been brought about in no small measure by the able statesmanship and tactful diplomacy of our Regional Director Dr Francisco J. Dy. To him and members of his staff I would like to pay a great tribute.

I do hope that this spirit of cooperation, goodwill and understanding will prevail in the Regional Committee, and pray that their deliberations at this and future meetings of the Committee will bring forth more benefits and well-being to mankind in this region of the world.

Thank you.

SUMMARY RECORD OF THE SECOND MEETING

Dewan Tunku Abdul Rahman, Kuala Iwnpur Monday, 2 September 1974 at 2.30 p.m.

(wPR/Rc25/SR/2 )

CHAIRMAN: Tan sri Dato (Dr) Abdul Majid bin Ismail (Malaysia)

CONTENTS

1 Aoknow1edgement by the Chairman of brief reports reoeived from Governments on the progress of their health aotivities •••••••••••••••••••••••••• 93

2 Report of the Regional Direotor •••••••••••••••••• 95

-89-

Rl!llIONAL CCJiIiIiII'I"l'EE I 'lWEN'lY - FIlI'l'H SESSION

Second. Meeting

Monday, 2 September 1974 at 2.30 p.m.

I. Repre.entative. ot Member State.

AUBTRALtA

CHINA

PIJI

JAPAN

KHMER REPUBIJ:C

lAOS

MAlAYSIA

Dr G. Howells

Dr Chen Hai-teng Dr Sung Kan Mr L1. Ching Haiu

Dr Peni Vuiyale

Dr J. Laigret

Dr T. Taklzawa Dr R. Okamoto Mr M. Sasaki

Dr Kim Vlen Dr Nhonh Bun Yay Dr Emmanuel Fernandez

Dr Phouy Phoutthuak Dr Ri tth1kay Vllaihongs

Tan Sri Dato (Dr) Abdul Majid bin Ismail

Datuk Paduka (Dr) Abdul Wahab bln MohO.. ·Ar1f'f

Dr Raja Ahmad. Noordin Mr Onn bin Kayat Dr Gurmukh Singh Mr Cheong Weng Hool Dr Fang Ung Seng Dr Tai Yen Hool Datuk (Dr) Abdul Khal1d bin Sahan Dr G. V. Denis

SUMMARY RECORD OF THE SECOND MEETIOO 91

NEW ZEALAND

PHILIPPINES

PORTUGAL

REPUBLIC OF KOREA

REPUBLIC OF VIET-NAM

SINJAPORE

UNITED KINGDOM

UNITED STATES OF AMERICA

WESTERN SAMOA

Dr. R. Dickie

Dr J. Dizon Dr D. Rivera

Dr Rui Albuquerque Ribeiro da Costa Pinhao

Dr Seung Hahm Park Mr Chong Sang Park Mr Byung Hoon Chun Mr Han Il Ree Mr Hang Sirb Song

Dr Tran Quy Nhu Dr Pham Quang Tuan Mr Nguyen-Viet-Danh

Dr A.G.K. Chew Dr Ng Kwok Choy

Dr J.A.B. Nicholson

Dr J. C. King Mr F. S. Cruz Dr M. Kumangai

Dr J. C. Thieme

II. Representative of Associate Member

PAPUA NEW GUINEA Dr A. Tarutia

III. Representatives of the United Nations and Related Organizations

UNITED NATIONS CHIILREN 'S FVND U Tun Aung

92 REXlIONAL COMMITl'EE: TWEN'lY-FIFTH SESSION

IV. Representatives of the other Intergovernmental Organizations

INTERNATIONAL COJ't!tIT'lTEE OF MILITARY MEDICINE AND PHARMACY Colonel Dr D. A. Lopes. Kf.fl

v. Representatives of Non-governmental Organizations

INTERNATIONAL ASSOCIATION. FOR ACCIDENT AND 'mAFFIC MEDICINE

INTERNATIONAL DENTAL FEDERATION

INTERNATIONAL COMMI'lTEE OF CA'mOLIC NURSES

INTERNATIONAL COONCIL OF NURSES

INTERNATIONAL PLANNED PARENTHOOD FEDERATION

INTERNATIONAL FEDERATION OF PHARMACEUTICAL MANUFACTURERS ASSOCIATIONS

IEAGUE OF RED CROSS SOCIETIES

INTERNATIONAL FEDERATION OF SPORTS MEDICINE

INTERNATIONAL FEDERATION OF SURGICAL COLLEGES

VI~ WHO Secretariat

Dr W. K. Ng

Dr Lim Chee Shin

Mrs M. A. La1

Miss Chong Ah Foo

Dr W. K. Ng

Mr Koh Choon Hui

Y .B. Tan Sri Abdul Jamll Ra1s

Dr M. Jegatheson

Professor M. Balasegaram. FRCS.Ed

Dr Francisco J. Dy

,

SUMMARY RECORD OF THE SECOND MEETING 93

1. ACKNOWIElXl:EMENT BY THE CHAIRMAN OF BRIEF REPORTS RECEIVED FRm1 GOVERNMENTS ON THE PROORESS OF THEIR HEAL'llI ACTIVITIES: Item 8 of the Agenda

The CHAIRMAN acknowledged reports on the progress of health activities received from the following countries and territories: Australia, Hong Kong, Japan, Khmer Republic, Macau, Malaysia, New Zealand, Republic of Korea and the Republic of Viet-Name A report had been received from the Government of Laos but copies were not available for distribution; the report was with the WHO Secretariat and would be available to those interested.

Dr ABDUL WAHAB ARIFF (Malaysia) drew attention to the highlights of the report submitted by his Government and to the priority areas where technical assistance was required, to provide impetus to overall strategies for the dispersal of health services to lesser developed regions of Malaysia and to widen the scope of health activities to accommodate newly emerging health problems. The second Malaysian Development Plan of the Ministry of Health charted a new course in the development of health strategies to conform with overall national development and to support the Government's new economic policy. Satisfactory progress had been made so far but there were still many areas of health that needed strengthening. He mentioned specifically the continuing incidence of cholera and dengue haemorrhagic fever which pointed to the need further to fortify the health services. In other areas such as malaria and tuberoulosis progress had exceeded expeotations. The efforts needed to be sustained however.

There was a need to consolidate and expand training programmes for all categories of professional, paramedical, health and dental staff to cope with the present staff shortages and the continually expanding services. A post-graduate course for professional and paramedical staff was needed urgently. To keep in step with soientific and technological advancements the Government of Malaysia was changing from traditional and outmoded ideas and values in health planning to modern and more dynamic ones. His Government looked forward to continued collaboration with WHO in the development of new health planning teohniques.

WHO had provided invaluable assistanoe in the establishment of an epidemiological unit which now needed to be strengthened and expanded. Following a successful epidemiologioal survey of dental problems among schoolchildren a year ago, an epidemiological survey of dental problems in the adult population was now being started. For the first time, the development of the dental services would be on a soientific basis. The expansion of health services in Malaysia had contributed in no small manner towards the betterment of the standards of health of the nation and the quality of life of the people. The Government of Malaysia was

RIDIONAL COMMITl'EE: TWENTY-FIFl'H SESSION

determined not only to sustain these efforts but to accomplish even higher standards of health. This could not be achieved alone or in isolation. There was a need for continued assistanoe from and col­laboration with WHO, other international agencies such as UNICEF, UNDP. UNFPA, and Member governments of WHO.

Dr PARK (Republic of Korea) congratulated the Chairman and also the other officers on their eleotion. He expressed gratitude to the Government and peoples of Malaysia for inviting the Committee to hold its meeting in Kuala Lumpur.

After oonveying to the Regional Director his Government's appreoiation for the WHO assistance within the Region in 1973 and for the services of Dr C. H. Chong, a Malaysian, as v.H0 Representative to Korea, Dr PARK referred to the progress of health aotivities in his country. Everything had had to be bull t up from scratoh after the Korean war and emphasis had been placed on economic growth. More than half of a five-year long range plan had been accomplished with some success, and it was now possible to put more emphasis on health and medical care and social welfare.

As 1974 had been deolared World Population Year and the Republic of Korea, with a population of 33 million, ranked third as the most densely populated country in the world, priority Was being given to family planning. The national growth of the population had been reduced from ?I% annually in 1970 to 1.8% in 1973. It was hoped to bring this rate down further to 1.5% by 1976.

In thanking the Organization for its assistanoe to the Republic of Korea Dr PARK mentioned the tuberculosis control programme as being partioularly suocessful.

There had been an increase in the number of Korean health workers who had joined WHO. Although they represented a loss to the oountry, the Government considered it an honour and privilege to be able to help other oountries through WHO. Many health workers were emigrating to work in more developed countries. Some were being sent abroad by the Government; he mentioned the Korean medical team sent to the Republic of Viet-Nam. Others went on their own or through bilateral arrangements. About 2600 doctors, 500 nurses, 3400 nurse aides and 75 dentists were now working in the United States of America, Germany and other oountries.

On the advice of WHO the Government of Korea had set up a Health Planning Section in the Ministry of Health and Sooial Affairs. It was hoped that its next health plan would be integrated into the Fourth National Economic Plan for 1977-1981.

(For further reports acknowledged, see the fifth meeting, seotion 1.)

,

SUMMARY RECORD OF ':mE SECOND MEETING

2 REPORT OF THE REGIONAL DIRECTOR: Item 9 of the Agenda (Document WPR;RC25/3 and Corr.l)

In introducing the Annual Report, the REGIONAL DIRECTOR said

95

that, in preparing his Introduction to the Report he had used a new approach by listing under each major field of assistance to countries and territories within the Region, the accomplishments, the problems and what still needed to be done. Among the accomplishments were the operational research study in Rizal Province in the Philippines which had demonstrated how progress could be made in the delivery of health care services; the growing acceptance of the family health approach in promoting the health of mothers and ohildren; the fact that nearly every country and territory in the Region now had a central public health laboratory; and, an important step forward, the establishment of the Regional Teacher Training Centre in Sydney.

Tnis picture of progress did not mean that the problems and oonstraints whioh still remained oould be ignored. Although it was natural that new developments in the various fields of medicine should provoke enthusiasm, health administrations must not lose sight of basic problems such as the organization of health services sufficiently adequate to carry out the work assigned to them, and the need to build up health laboratory services to a point where they could provide the essential support required in medical oare, epidemiological investigations and surveillance. Operational research was a means of testing alternative approaches to the provision of health care and ensuring that even limited natural resources were used to the best advantage.

The Regional Director then referred to the family health programmes as being areas where there could be much closer co-operation between various agencies. Attention had to be given to nutrition from early infancy if the health of the child were to be promoted. Health education, which should play a part in all health programmes, had been particularly effective in those relating to family health. Maternal and child health, family planning, nutrition and health education were all gradually being integrated within the framework of the basic health services.

As far as the communicable diseases were concerned poor environ­mental oonditions, ignorance and poverty continued to be important factors. Efforts needed to be made in many of the developing countries to strengthen their immunization programmes.

The Regional Director emphasized the need for governments to select qualified national oounterparts to work closely with the WHO staff collaborating in all projects, so that eventually they could take over full responsibility for the programmes. He emphasized the need for more detailed planning of fellOWships at country level to ensure not only the continued education and training of health workers at all levels,

REGIONAL COMMI'I'IEE: 'lWENTY-FIFTH SESSION

but also that, after training, fellows would be properly utilized on returning to their own countries.

The REGIONAL DIRECTOR drew attention to those projects in the report selected for special summary.

The first meeting of the Technical Advisory Committee on Nursing which the Committee, at its twenty-second session, had agreed should be established (resolution WPR/RC22.R20), had been held in December 1973. Its report was now under consideration in the Regional Office.

In closing, the REGIONAL DIRECTOR expressed the hope that a detailed review of the report and a sharing of experiences at this meeting of the Regional Committee would go a long way towards assisting in solving some of the health problems faced throughout the Region.

The CHAIRMAN proposed that, as suggested by the Regional Director and with the approval of the Committee, the Report should be reviewed chapter by chapter. He then invited representatives to comment.

Dr KING (United States of America) complimented the Regional Director on the format used in the Introduction.

Dr THIEME (Western Samoa) congratulated the Chairman, the Vice­Chairman and the Rapporteurs on their election and expressed apprecia­tion of the work done by the Regional Director and his staff during the past year and of the report which was before the Committee. The presentation of the Report was improving year by year.

Referring to Section 1.2 of the Report, Dr THIEME stated that the organization and delivery of health care was a vital issue in the long-term development of health services, particularly in a country such as Western Samoa, where care had to be taken in utilizing the limited health manpower resources. Ways had to be found to improve the efficiency of the health care delivery system. The national health care services development project, which was actively assisted by WHO, UNICEF and UNDP, had produced very fruitful results in identifying and testing alternative approaches to problems and constraints in the development of health services. In addition to the achievements of this project in Western Samoa which were mentioned in the Report, research had been carried out which had led to a policy decision regarding a scheme for regionalization in the delivery of health care. The scheme would be accomplished in stages so that health staff would have time to prepare themselves to fit into the new system and to adjust the system to the general interests of the public.

Dr PHOUTI'HASAK (Laos) said that the third paragraph of page 8 should refer to 16 health centres and subcentres, and not to 16 zones. The course for sanitary agents mentioned in the same paragraph would not take place until the scholastic year 1975-1976.

,-

SUMMARY RECORD OF 'IRE SECOND MEETING 97 •

The RIDIONAL DIRECTOR said that the oomments of the Representative of Laos were appreciated and the Secretariat had taken note of the correotions suggested.

Dr CHEN (China) said that this was the second time the Chinese delegation had participated in the Regional Committee. It was pleased to have this opportunity to disouss problems with the other represent­atives. He thanked the host country for its preparations for the meeting and congratulated the Chairman, Vioe-Chairman and the Rapporteurs on their election. He also thanked the Secretariat for preparing the documentation for the meeting. During the study mission sent by the World Health Organization to China, which was mentioned in the Regional Director's Report, views had been exchanged on all aspects of his country's work. This had been a stimulating experience. The Government of the People's Republic of China attached particular importanoe to health activities carried out in rural areas.

Dr VUIYAIE (Fiji) thanked \1HO for the assistance recently given to Fiji in studying the pattern of health care deli very, especially in the rural areas. As a result of this study, he would have one or two requests to make during the discussion on the programme and budget estimates.

Dr NICHOLSON (United Kingdom) congratulated the Chairman, the Vioe­Chairman and the Rapporteurs on their election and thanked the Regional Director for his report. In connexion with assistance in strengthening the organization of health laboratory services and training laboratory technicians, he asked how much attention was given to the maintenance of laboratory equipment.

The RIDIONAL DIRECTOR stated that in the WHO intercountry programme provision had been made to assist countries in the Region and to teach national staff to repair and maintain equipment, particularly X-ray and other radiological equipment. WHO would be glad to receive requests from Member governments for assistance in the proper and most economical use of expensive and sometimes sophisticated equipment.

Dr THIEME (Western Samoa) referred to his previous remarks about his country's lack of health manpower, particularly medioal offioers. The Government of Western Samoa was thinking of using auxiliary medical personnel to assist fully trained medical officers in the delivery of health services. The problem was being approaohed with oaution, however, because of inexperience in utilizing this kind of health worker. Trained medical staff, especially medical officers were being wasted by being stationed in remote areas. He was therefore glad that Western Samoa had been invited to send a participant to the Seminar on Medioal Assistants. l

1 First Regional Seminar on Medical Assistants, Manila, 1-7 October 1974.

REXlIONAL COMMI'ITEE: TWEN'lY-FIF'lH SESSION

Dr VILAIHONGS (Laos) summed up the malaria oontrol ~tivitie8 conduoted in his oountry. A beginning had been made in the pilot provinoe of Vientiane by organizing geographical reoonnaissanoe and delineating the malarious areas. The shortage ofequiprnent, espeoially of transport. was oausing serious delays in the implementation of the programme, although the Armed Foroes had promised to help and from time to time had made helicopters available. Spraying of more than 7($ of the houses in the pilot province had been very effective as the latest paraaite survey among workmen of the Laos Power Authority showed.

Dr VIIAmONGS said, however. that the implementation of the three­year programme, largely finanoed by UNDP and WHO, was meeting with a number of difficulties. The initial provision of U3$349 000 had been reduoed to U3$249 000. mainly through the withdrawal of, or reduction in, bilateral assistance. It was hoped, however, that further bilateral assistanoe would be forthooming.

Dr THIEME (Western Samoa) said that typhoid fever had been prevalent in Western Samoa from 1966 to 1968 when there used to be 80 to 140 reported Gues for 100 000 population. Since 1968 the situation had been temporarily oheoked by mass immunization, using acetone dried. typhoid vaooine. In 1969-1970 there were still about 20 to 30 cases per 100 000 population. The typhoid incidenoe rate had dropped sinoe 1970 from 20.2 oases per 100 000 population to 9.8 oases per 100 000 in 1973. sinoe the adoption of WHO's reoOlllllendation, worked. out acoording to a mathematioal model based on the situation in Western Samoa, to plaoe the major emphasis on the improvement of environmental sanitation, particularly exoreta disposal. The immunization programme was used as a supplementary measure for the population at high risk. Up to the end of August 1974 only one typhoid oase had been reported in the whole oountry. This had allowed the typhoid immunization programme to be integrated oompletely into the general immunization scheme which was a routine acti vi ty of the general health services.

Dr THIEME expressed his Government's gratitude also to UNICEF which had oOlllni tted a substantial amount of money in 1975 and 1976 for the improvement of the water supply and excreta disposal programme.

Dr KING (United States of America) expressed disappointment to see that venereal diseases and treponematoses reoeived very little mention in the report and only a small allooation in the proposed programme and budget. He also oommented on the use of colour photographs in the Report and questioned. the extra expense involved.

The REGIONAL DIRECTOR agreed that more emphasis should. be given to venereal diseases by Member governments. As far as the use of oolour plates was oonoerned, the extra cost was between US$100 and U3$150. Considerable savings had in fact been made on produotion oosts for the Report beoause 'the printing had been done entirely in the Regional Offioe.

," SUMMARY RECORD OF THE SECOND MEETING 99

Dr VILAIHONGS (Laos) said that a oonsultant had carried out a survey in Laos to evaluate the situation 'in the field of venereal diseases and treponematoses. His report, which was not yet available, would set forth recommendations designed to reduoe the growing problem in the area. steps had been taken against these diseases with dis­appointing results. A considerable effort was being made in health education, but funds were unfortunately lacking.

Dr VUIYALE (Fiji) stated that gonorrhoea appeared to be under control in Fiji, but there was concern about the increase in the incidence of syphilis, especially among young people.

Dr TARUTIA (Papua New Guinea) reported an increasing incidenoe of venereal disease. Al though two WHO consultants had visited his country, the report had not yet been reoeived by his Government.

Dr THIEME (Western Samoa) said that the whole subject of venereal diseases needed to be investigated in Western Samoa. They knew how to treat syphilis but it was difficult to get the public to co-operate; the people, especially the young people, who were becoming more permissive, needed to be educated in the problem. The incidence of syphilis had not yet become serious; the yaws programme which ended 15 years ago may have provided protection.

Dr VUIYAIE (Fiji) said that in Fiji, diseases that could be prevented by immunization were under control, as were other communicable diseases. The non-communicable diseases were now coming to the fore in patterns similar to those of developed countries. He wondered about the experiences of other countries.

Dr NOORDIN (Malaysia) questioned, from an editorial point of view, the placing of dental health and mental health under the heading of "Non-communicable disease prevention and control".

The REGIONAL DIRECTOR replied that this was the classification required by WHO Headquarters.

Dr KIM VIEN (Khmer Republic) said that as a result of the development of the pharmaceutical industry whioh followed independence, and because the quality of a number of drugs had been open to criticism, the Khmer Republic had set up a network of control laboratories. A WHO consultant had visited all the pharmaceutical laboratories in the Republic. The authorities were looking forward to receiving his report, which should enable them to organize a more effective and practical control system.

Replying to the representatives of the Khmer Republic, Laos and Papua New Guinea on the subject of conSUltants' reports, the REGIONAL DIRECTOR apologized for any delays that might have occurred; the reasons would be investigated when the Secretariat returned to Manila

100 REXlIONAL COMMITrEE: TWENTY-FIFTH SESSION

and the reports would be issued as soon as possible. He added, however, that reports of this type took some time to process; they often had to be edited and those for French-speaking countries had to be trans­lated.

Dr ABOOL WAHAB ARIFF (Malaysia) congratulated the Chairman, Vice­Chairman and Rapporteurs on their election. He also congratulated the Regional Director on producing an excellent report. There was little mention in Section 6.3, however, of research and training programmes in relation to the control of environmental pollution hazards. This was an urgent problem in the Region, especially in Malaysia, because of rapid industrialisation and urbanisation and trained manpower was urgently needed. He asked the Regional Director whether he had any plans for research and the training of manpower in the Region.

The REJIONAL DIRECTOR agreed that environmental health hazards were important but said that it was diffioult for Regions to undertake research proJeots without the speoifio approval of WHO Headquarters. He said that fUrther requests for research projects should not be precluded sinoe there was a likelihood that such an approach might become possible in the fUture.

The REXlIONAL DIRECTOR also drew attention to the long-term plans for the promotion of environmental health which appeared in the form of a ohart on page 59 of his report.

Dr THIEME (Western Samoa) agreed with the statement made by the Regional Direotor in the Report that it was difficult to recruit staff for UNFPA projects 'because of the UNFPA policy of allocating funds on a yearly basis. In Western Samoa the WHO medioal officer assigned to the family planning project had ceased duty last June but no replace­ment had yet been recruited. He explained that the Government of Western Samoa had submitted a request for assistance to UNFPA in 1973 and it had been as late as August 1974 that approval was received; even then it was for the year 1974 only.

Mr KAKAR (Budget and Finance Officer) said that the problem encountered by Western Samoa in requesting UNFPA assistance was not common to all countries. Projects were usually approved for as long as they were to last and the funds allocated annually. The responsi­bility rested with governments to urge that approval should cover the entire duration of the project requested, otherwise there were bound to be delays in the allocation of funds and consequently in recruitment.

Dr THIEME (Western Samoa) said he did not wish to criticize, since the assistance of UNFPA was appreciated by the Government of Western Samoa. He merely wished to indicate the problems enoountered in the hope that a new policy might benefit both the agenoy providing assistance and the recipient country.

SUMMARY RECORD OF THE SECOND MEETING 101/102

The REGIONAL DIRECTOR said that there was a oontinuing dialogue between the UNFPA and WHO Headquarters and he hoped the situation would be ameliorated.

Dr VILAIHONGS (Laos) said that the environmental health seotion mentioned in the report (page 64, Seotion 6.6) had been in operation sinoe Maroh. WHO had sent three oonsul tants to Laos in three oonsecutive years to help reorganize the environmental health services. One of them had designed a remarkable projeot for munioipal environ­mental health in Vientiane whioh would be a new development in the country. Dr Vilaihongs requested WHO to oontinue its assistanoe by sup­plying equipment and providing fellowships.

The REGIONAL DIRECTOR said that if the Government of Laos wished addi tional assistance, a request might be made to the Sub-Committee on Programme and Budget.

Dr NOORDIN (Malaysia) asked if WHO was making any further efforts to achieve oo-ordination with FAO in formulating a joint policy on food and nutrition. At present it appeared that FAO was taking too much of a lead, resulting in an emphasis on food produotion to the detriment of nutrition and other aspeots. It would be necessary for the Government of Malaysia to request assistanoe from both WHO and FAO in the planning and implementation of a national food and nutrition policy. If oonsultants were provided they should have a common view.

The REGIONAL DIRECTOR said he shared the views expressed; there was considerable interest in this matter in the Region. FAO had been invited to develop a joint policy with WHO so that a balanoed programme oould be prepared for discussion with oountries wishing to establish food and nutrition policies.

The CHAIRMAN suggested that he adjourn the meeting and oontinue disoussion on the seoond part of the Annual Report at 9.00 a.m. on 3 September.

It was so agreed. (For continuation of discussion, see the third meeting, seotion 2.)

The meeting rose at 4.55 p.m.

...

(WPR/RC25/SR/3 )

SUMMARY RECORD OF 'mE THIRD MEETING

Dewan Tunku Abdul Rahman, Kuala Illmpur Tuesday, 3 September 1974 at 9.00 a.m.

CHAIRMAN: Tan Sri Dato (Dr) Abdul Majid bin Ismail (Malaysia)

1

2

3

4

CONTENTS

AImoUIlC emen t ..•••...•..•••....•......•.•••....••.•••..

Report of the Regional Direotor (oontinued) ........... Resolutions of regional interest adopted by the Twenty-seventh World Health Assembly and the Exeoutive Board at its fifty-third session ••••••••••••

Disinsection of airoraft ••.•••.••••.••••••••••••••••••

5 Quality of food and water in international

107

lO7

108

111

aviation .•....••....••.•....................•.•...•••. 113

6

7

Drug depeI1dence •••••••••••••••••••••••••••••••••••••••

Review of the.Fifth General Programme of Work Covering a Speoifio Period (1973 - 1977 inclusive) •••••••••••••

8 Project systems analysis: its development and the need to establish the capability of the Regional Office to provide assistance in this field: Item proposed by the

114

ll7

Government of Malaysia •••••••••••••..••.•••.••••••••.• 118

- 103-

104 REDIONAL COMMI'1'l'EE: 'l'WEN'lY-FIFrH SESSION

Thlrd Meetlng

Tuesday, 3 September 1974 at 9.00 a.m.

PRESENT

I. Representatl ves of Member States

AUS'ffiALIA

CHINA

FIJI

FRANCE

JAPAN

KHMER REPUBLIC

LAOS

MALAYSIA

Dr G. Howells Dr R. W. CUmming

Dr Chen Hai-feng Dr Sung Kan Mr L1 Chlng Hslu

Dr Pen1 Vuiyale

Dr J. Laigret

Dr T. Taklzawa Dr R. Okamoto Mr M. Sasaki

Dr Nhonh Bwl Yay Dr Emmanuel Fernandez

Dr Phouy Phoutthasak Dr Ritthlkay Vilaihongs

Tan Sri Dato (Dr) Abdul MaJld bln Ismail

Datuk Paduka (Dr) Abdul Wahab bin Mohd. Ariff

Dr Raja Ahmad Noordln Mr Onn bln Kayat Dr Gurmukh Slngh Mr Cheong Weng Hocl Dr Fang Ung Seng Dr Abdul Majid bln TUn Abdul Azlz Dr Tai Yen Hooi

SUMt-1ARY RECORD OF 'mE 'm:IRD MEETING 105

MALAYSIA (continued)

NEW ZEALAND

PHILIPPINES

PORTUGAL

REPUBLIC OF KOREA

REPUBLIC OF VIEI'-NAM

SINGAPORE

UNITED KINGDOM

UNITED STATES OF AMERICA

WESTERN SAMOA

Datuk (Dr) Abdul Khalid bin Sahan Dr G. V. Denis

Dr R. Dickie

Dr J. Dizon Dr D. Rivera

Dr Rui Albuquerque Ribeiro da Costa Pinhao

Dr Longuinhos Monteiro Xavier

Dr Seung Hahm Park Mr Chong Sang Park Mr Han II Ree Mr Hang Sirb Song

Dr Tran Quy Nhu Dr Pharo Quang Tuan Mr Nguyen-Viet-Danh

Dr A.G .K. Chew Dr Ng Kwok Choy

Dr J. A. B. Nicholson

Dr J. C. King Mr F. S. Cruz Dr M. Kumangai

Dr J. C. Thieme

II. Representative of Associate Member

PAPUA NEW GUINEA Dr A. Tarutia

III. Representatives of the United Nations and Related Organizations

UNITED NATIONS CHILDREN'S FUND U Tun Aung

106 RIDIONAL COMMI'lTEE: TWEN'lY-FIF'IH SESSION

IV. Representatives of the other Ipter-governmental Organizations

INTERNATIONAL COMVJI'lTEE OF MILITARY MEDICINE AND PHARMACY Colonel Dr D. A. Lopes, KltN

V. Representatives of Non-governmental Organizations

ImERNATIONAL ASSOCIATION FOR ACCIDENT AND TRAFFIC. MEDICINE

INTERNATIONAL DENTAL FEDERATION

INTERNATI ONAL COMMI'lTEE OF CATHOLIC NURSES

INTERNATIONAL COUNCIL OF NURSES

INTERNATIONAL PlANNED PAREN'lHOOD FEDERATION

INTERNATIONAL FEDERATION ·OF PHAmmCEUTICAL MANlJlI'AC'ruRERS ASSOCIATIONS

lEAGUE OF RED CROSS SOCIETIES

INTERNATIONAL FEDERATION OF SPORTS MEDICINE

INTERNATIONAL FEDERATION OF SURGICAL COLImES

VI • WHO Seoretariat

Dr W. K. Ni

Dr Lim Chee Shin

Mrs M. A. La1

Miss Chong Ah Foo

Dr W. K. Ng

Mr Koh Choon Hui

Y. B. Tan Sri Abdul Jamll Rais

Dr M. Jegatheson

Professor M. Balasegar8lll, FRCS.Ed

Dr Franoisoo J. Dy

SUMMARY REX:ORD OF '!HE nURD MEETIOO

1 ANNOUNCEMENT

Before the discussion on his Annual Report continued, the REGIONAL DIRECTOR said that the report of the First Meeting of the Technical Advisory Committee on Dengue Haemorrhagic Fever held in Manila in March 1974 had been distributed to the Committee and also provided to government and non-government agencies.

107

2 REPORT OF THE RIDIONAL DIREX:TOR: Item 11 of the Agenda (continued from the second meeting, section 2) (Document WPR,.11C25/3 and Corr.l)

Dr NOORDIN (Malaysia) questioned the absence on page 119 of any reference to project WPRO 4002 - Development of Health Services (Operational Research).

The REGIONAL DIRECTOR replied that it had been omitted because there was no particular activity to report.

Dr TAKIZAWA (Japan) congratulated the Chairman on his election. He praised the Regional Director's Report and the aChievements of the Secretariat, whose responsibilities were ever increasing as problems in the field of health became more complex. His delegation would strive to help in reduoing the differences in standards of health whioh existed at present between different oountries.

Dr YAY (Khmer Republio) wished to express his delegation's gratitude to WHO, and partioularly to the Regional Direotor and his co-workers both in Manila and in Phnom-Penh, for the assistance provided in the field of publio health and for the part the Organization had played in obtaining help for his country from other agencies within the United Nations system. The prevailing war conditions had often upset health projects and activities. It had nevertheless been possible to reevaluate and readjust them thanks to their built-in flexibility and the understanding of the Regional Direotor. It was hoped that peace, without which it was extremely difficult to undertake satisfactory planning, would shortly return to the Khmer Republio.

D~ DIZON (Philippines), Vioe-Chairman, expressed the appreciation of his Government for the assistance received from WHO.

There being no further oomments, the Chairman asked the Rapporteurs to prepare an appropriate resolution. (For consideration of the draft resolution, see the fourth meeting, seotion 1.1.)

108

3

REGIONAL C<JIfi'l"l'EE: ~-FIP.IH SESSION

RESOWTIONS OF REGIONAL INT.BREST AOOPrED BY THE 'lWENl'!-SEVENl'H WORlD HEAIlIH ASSDlBLY AND THE EXBXruTIVE BOARD AT ITS FIP'lY-'1'HIRD SESSION: l

Item 10 of the Agenda (Documents WPR;RC25/4 and WPR;RC25/4 Add.l)

Organizational study on the inter-relationship! between the oentral teohnioal services ot WHO and proarUlllletl ot direot UiIIiatanoe to Member States (reaolution. EB53.R44 and WHA27.l8)

The REGIONAL DIRECTOR drew attention to operative p~agraPh one of resolution WHA27.l8.

3 .2 Health eduoation (reaolution WHA27.27)

The REGIONAL D~ drew attention to operative parqraPh three.

3.3 Health eduoation ot ahlldren and Young people (re.olution WHA27.28)

3.4 The role ot WHO in bilateral Qr multilateral health aid progl'Ulllea (reaolution WHA27.29)

The RmIOOAL DIRECTOR drew attention to operative paragraPh one.

3.5 Continuing eduoation tor physioians (resolution WHA27.31)

The R1iDIONAL DIRECTOR drew attention to operative paragraph two.

3.6 Coordination with the United Nationll II stem: the Ie among the developing oountries (resolution WHA27.

3.7 Ooord1n&tion with the United. Nationa sptem: general matters (resolution WBA27.'S)

The RmIONAL DIREXnOB drew attention to operative par-srapha a1x and seven.

,.8 Infant nutrition and bre&llt-feeding (resolution WHA27.4,)

The RllDIONAL DIRECTOR drew attention to operative paragraphs one, two end three.

'.9 Promotion of national health servioes (resolution WHA27.44)

The R1iDIONAL DIRECTOR drew attention to operative paragraph 'one.

, 3.10 WHO's human health and environment progr8/lllle (rellolution WHA27 .49)

The RBDIONAL DIRECTOR drew attention to operative paragraph one.

lSee alao WPR~C25/SR/4, section 2.

SUMMARY RECORD OF 'mE THIRD MEETING 109

3.11 WHO's human health and envirorunent programme: Coordination on programmes and action in the field of the envirorunent (resolution (WHA27.50)

The REGIONAL DIRECTOR drew attention to operative paragraph one.

The Committee noted the above-mentioned resolutions without oomment.

3.12 Development of the antimalaria programme (resolution WHA27.51)

Dr DIZON (Philippines) said that the reduction, or even complete withdrawal, of international assistance and the effects of rising inflation necessitated a reassessment of the malaria programme to establish its priority and to provide a more practical approach and strategy.

The REGIONAL DIRECTOR referred to document WPR/RC25/4 Add.l) which gave some information on discussions on the antimalaria programme during the Twenty-seventh World Health Assembly. The disease was again becoming a serious threat in a number of countries while in others it had never been controlled effectively. Happily the Western Pacific Region had been spared serious setbacks although, mainly because of financial and administrative difficulties encountered by goverrunents, progress had been slow in some areas. Difficulties of a technical nature had been experienced in the Region: the major malaria vectors remained susceptible to DDT, despite its prolonged use, but in some areas the vector, because of its particular behaviour, did not come sufficiently into contact with sprayed surfaces to pick up a lethal dose; certain strains of R. falciparum were resistant to ohloroquine and other antimalaria drugs.

Reviews of country antimalaria programmes had in general led to strategies calculated to give optimum results although, in some instances, there was a need for closer coordination among other agencies within and outside the health sector especially those operating in the rural communities.

With the reduction in international and bilateral assistance goverrunents of malarious countries needed to reevaluate the situation, to establish the priority to be accorded antimalaria programmes and to secure the financial means for running them.

Dr NICHOLSON (United Kingdom) said that his Goverrunent supported the sentiments expressed at the World Health Assembly on the state of malaria eradioation. He endorsed the Regional Director's comment regarding increasing costs and decreasing administrative capability and believed that a reassessment was necessary to review the possibilities for changes in strategy.

110 RmIONAL COMMI'l"I'EE: TWENTY-FIF'lH SESSION

3.13 Intensification of research on tropical parasitic diseases (resolution WHA27.52)

The REGIONAL DIRECTOR mentioned that since this resolution was connected with the research activities of the Organization, implementing it was primarily the responsibility of WHO Headquarters. However, a number of parasitic diseases represented serious public health problems in many parts of the Western Pacific Region. '!he Director-General had been requested, in intensifying WHO's research activities in oonnexion with the major tropioal parasitio diseases, to oonsider the feasibility of oarrying them out in endemio areas and to bear in mind the -primary needs of the developing oountries in defining priorities in research.

Dr NICHOISON (United Kingdom) indicated that his Government welcomed this resolution. '!here had been little real breakthrough for many years in the area of tropical parasitic diseases, which represented one of man's greatest health hazards. '!he importance of carrying out research work where a disease actually existed was recognized but any researoh oentres developed should not be too elaborate or costly when funds· already existed in developed oountries for the same purpose.

3.14 WHO expanded programme on immuniZation (resolution WHA27.57)

'!he REGIONAL DIRECTOR drew attention to operative paragraph one.

'!he Committee noted this resolution without oomment.

3.15 Coordination and strengthening of leprosy control (resolution WHA27.58)

Attention was drawn to operative paragraphs two and three.

Dr OKAMOTO (Japan) told the Committee that the Sasakawa Memorial Health Foundation had been established in Japan. Its primary objective was to promote international cooperation among countries in South-East Asia in the field of leprosy by providing advisory servioes, encouraging eXChange of information on research, training personnel, organizing conferences, and providing research grants and equipment and supplies for the treatment of the disease. It was anticipated that the Foundation would collaborate with WHO in its future operations.

'!he REGIONAL DIRECTOR added that the Regional Offioe in Manila had recently reoeived a visit from Dr Saikawaof the Foundation to disouss its programme of assistanoe. More speoific information was to be provided which would be useful in drawing up programmes for countries with leprosy problems.

3.16 Prevention of road traffic accidents (resolution WHA27.59)

'!he REGIONAL DIRECTOR drew attention to operative paragraph one.

SUMMARY RECORD OF THE THIRD MEETING

3.17 WHO's role in the development and ooordination of biomedioal researoh (resolution WHA27.61)

3.18 standardization of diagnostic materials (resolution WHA27.62)

Attention was drawn to operative paragraphs one and three.

The Committee noted these resolutions without oomment.

111

3.19 10 -term planni of international oooperation in canoer research (resolution WHA27. 3)

Dr DICKIE (New Zealand) said his Government supported this resolution and endorsed the need for international cooperation in developing properly drawn up and effective protocols for oanoer researoh. The use in New Zealand recently of an undisclosed method of treatment by a doctor which led to a public enquiry conducteci by a distinguished Australian cancer expert had drawn attention to the pressing need for full inter­national cooperation in cancer research.

There being no further comments. the CHAIRI'.w.N asked the Rapporteurs to prepare appropriate resolutions. (For consideration of the draft resolutions, see the fifth meeting, sections 2.2, 2.3 and 2.4, and the sixth meeting, section 1.1.)

4 DISINSECTION OF AIRCRAFT (resolution WPR/RC24.R4): Item 11 of the Agenda (Document WPR/RC25/5)

The REGIONAL DIRECTOR stated that document iiPR/RC25/5 provided the information requested by the Regional Committee at its last session. Twenty-three countries and territories in the Region had confirmed that they would accept the Dichlorvos Vapour System for disinsecting airoraft. It was hoped that the health authorities of Member governments would encourage their aviation authorities to install the system in their aircraft.

Dr HOWELLS (Australia) stated that his country accepted the Oiohlorvos System of disinseotion in prinCiple with some reservations. It was not known whether the system would be effective in dealing with certain insects of primary quarantine importance to Australia; the Government of Australia reserved the right to continue disinsecting aircraft on the ground if necessary. It was not satisfied with any method of disinsection in effect at present and was conducting its own research and investigations.

Dr VUIYALE (Fiji) said that his country maintained a position similar to that of Australia and reserved the right to disinsect aircraft of international flights arriving in Fiji. The Dichlorvos Vapour Dis­insecting System was accepted in principle.

112 R&lIONAL COMMITl'EE: TWEN'l'Y-FIFl'H SESSION

Dr CHEN (China) stated that international aviation was developing so rapidly that the question of aircraft disinsection had become very important. He believed that, in principle, the Dichlorvos Vapour Disinsecting System was a good one but he wondered whether it was necessary to restrict disinsection to only one system. He hoped the Secretariat would provide his Government with more documentation on the subJeot to enable it to conduct further studies.

Dr LAIGRET (Franoe) endorsed for French Polynesia the reservations of the Government of Australia. '!he Government of Franoe reserved the right to disinseot on the ground if it proved to be neoessary.

Mr CRUZ (United States of America) said that his delegation welcomed the Regional Director's progress report on the subJeot and supported action which the Regional Committee might take in accepting the Dichlorvos Vapour Disinseoting System for aircraft as valid. Tests conducted in the United States to determine the effects of dichlorvos at high altitude had shown that it had no oumulative effect on human beings.

Dr NICHOLSON (United Kingdom) stated that his Government welcomed the world-wide interest in the Dichlorvos Vapour Disinsecting System which was considered to have been very well tested.

Dr DENIS (Malaysia) drew attention to the statement on the Government of Malaysia's position regarding disinsection which had just been dis­tributed (see Annex 1). '!he Government of Malaysia had accepted WHO's reoommendation on the blocks-away method of disinsecting aircraft on international flights.

Dr PARK (Republic of Korea) informed the Committee that his country accepted WHO's recommendation regarding the use of the Diohlorvos Vapour Disinsecting System. '!he Korean olimate was not favourable to the multi­plication of the dengue and the yellow fever mosquito, and therefore the use of the system had not been made compulsory for incoming and outgoing aircraft. Korean airlines were using the blocks-away method approved by the Twenty-sixth World Health Assembly.

Dr TARUTIA (Papua New Guinea) stated that currently in Papua New Guinea all aircraft were disinsected on the ground upon arrival.

There being no other comments, the CHAIRMAN asked the Rapporteurs to prepare an appropriate resolution. (For consideration of the draft resolutions, see the fifth meeting, section 2.1.)

SUMMARY ROCORD OF '!HE 'lHIRD MEETING ll3.

5 QUALITY OF WATER AND FOOD IN INTERNATIONAL AVIATION (resolutions WPR~C24.R5 and WPR~C24.R6): Item 12 of the Agenda (Dooument WP.R~C25/6)

The REDIONAL DIRECTOR informed the COlllDittee that dooument WPR~C25/6 summarized the action taken in oonnexion with resolutions WPR~C24.R5 and WP.R~C24.R6 adopted by the Regional Committee at its last session. The two resolutions had been referred to the Direotor­General. Consideration of the subjeot by the fifty-third session of the Exeoutive Board, the eighteenth meeting of the Committee on International Surveillanoe of Communioable Diseases and the Twenty-seventh World Health Assembly had culminated in a resolution adopted by the Assembly, whioh reiterated the need for Member governments to olarify the ultimate responsibility in their own oountry or territory for the safety of food and water in international traffio by ensuring the olose and active oooperation of all servioes and agenoies oonoerned.

The Organization oontinued to maintain olose oontact with other international agenoies with a view to improving the safety of food and water and the handling of wastes.

Of the Member governments that had responded to his request for information on studies being undertaken at present only two had been, or were planning to, oarry out routine baoteriologioal examinations. It was hoped that more oountries would become interested in undertaking suoh studies.

Dr OKAMOTO (Japan) said that during 1973, 76 water samples had been examined, of whioh 57.9% were unsatisfaotory oompared with 56.8% of those examined between 1967 and 1971. Bacteriologioal failures oomprised 38.2% and physioohemioal failures 31.5%. Between September 1973 and February 1974, 240 food samples had been taken from 40 aircraft. Pathogenio ooli, Staphylooooci and other ooliforms were found to be present although they might not have been present when the food was served one to seven hours before sampling.

Dr OKAMOTO understood that the WHO "Guide to Hygiene and Sanitation in Aviation (1960)" was being revised.

Dr VUIYAIE (Fiji) said that 157 water and 53 food samples were taken from aircraft in Fiji in 1973. Of these. 90 water and 4 food samples had been unsatisfaotory. In 1974·there was an improvement; of 90 water samples taken only eight, all from one airline. were unsatisfactory. Bacteriological and ohemioal tests on samples taken from airoraft were made at regular intervals and food handlers were examined.

Dr CUMMING (Australia) stated that sinoe the report of the Representative of Australia to the twenty-fourth session of the Regional

ll4 RliDIONAL COMMITTEE: ~-FIFI'H SESSION

Committee, further research had been carried out on the quality of food and water on international flights and on sporadic cases of gastro­enteritis in persons arriving on international flights. Two small episodes of infection with vibrio parahaemalyticus appeared to have been contracted at stops en route and one episode of gastroenteritis due to shigella~ had been caused by contaminated food on a flight from London via Europe and Asia.

Research was also continuing on the stability of foods under storage conditions. Precooked foods stored at 3°_6°c had an approx1m~ storage life of 3 days; at 20°C, 12 hours; and between 30 and 40°C, 5 hours. This illustrated the necessity to refrigerate food before and after loading, especially at airports in tropical areas where there were high ambient temperatures.

Dr PARK (Republic of Korea) said that Korea had adopted Artiel. 14 of the International Heuth Regulations. Kimo International Airport, one of three in Korea, provided meals for 1500 passengers a day on domestio and international flights. Equipment and food from the kitchen where the food wu prepared were checked three times a lIIonth; baoteriologieal examinations were oarried out two or three times a year: and the hands or all staff were checked before they went on duty. Water from the airport filtration plant was sampled quarterly and residual chlorine checked daily. The proposal to establish international standards for the selection, preparation, storage and quality control of foods on international flights, before and after loading, was supported.

Dr DENIS (Malaysia) said that bacteriological and chemical sampling of water and ice cubes destined for international flights was carried out regularly. Precooked foods for 1000 international and 2000 domestic passengers each day were supplied from two kitchens. The kitchen premises and personnel were visited regularly by health inspectors. Food samples examined in 1973 had been satisfactory. Sampling of water and food from arriving aircraft had not yet been undertaken.

There be1 ng no further comments, the CHAIRMAN asked the Rapporteurs to prepare an appropriate resolution. (For consideration of the draft resolution, see the fourth meeting, section 1.3.)

6 moo DEPENDENCE (resolution WPR/RC24.R8): Item 13 of the Agenda (Document WPR/Rc25/7)

The REXlIONAL DIRECTOR informed the Committee that document WPR/RC25/7 contained a progress report on the action taken in connexion with resolution WPR/RC24.R8 which had been adopted by the Regional Committee at its last session. The visit of the two consultants to the Philippines mentioned in the progress report as taking place in 1974 was in progress at the present time and a working group on measures for the prevention and control of drug abuse was to be held at the end of 1974.

I

~

SUMMARY RECORD OF THE THIRD MEETING 115

Representatives would note with interest that the first indications from the survey on drug dependence showed that alcoholism appeared to be the most widespread form of dependence with the abuse of other drugs varying from area to area.

Dr KING (United states of Amerioa) stated that this subject was one of considerable interest to his Government. The report of the con­sultants who visited Malaysia had been carefully studied and the view that adequate manpower would have to be developed before a rigorous epidemiologioal projeot oould be embarked upon was considered reasonable, espeoially as in many areas defining the nature of the problem depended upon adequate case-finding methods which might depend in part upon response to previous treatment of drug problems. A single technioal focal point in the Regional Office, whioh would be provided by the appoint­ment of a technioal officer to the intercountry project to deal with drug dependence and alcohol problems, would help individual countries and give substance to a regional approach whioh might evolve into a coordinated regional framework.

Cooperation and exchange of activities between the South-East Asia and Western Pacific Regional Offioes should be enoouraged and should prove to be of value. The results of the questionnaire developed by the Regional Office would also provide an important basis for a regional approach to the study of drug problems in the Western Paoifio.

The inclusion of questions on the use of alcohol and tobaoco was important. Sinoe in the health field the primary concern was with the effect on the individual and on sooiety rather than with the legal or illegal status of a drug, the full range of abuse should be oonsidered. Regional planning for prevention, training and treatment should inolude not only illioit drugs but alcohol and tobaooo. The proposed aotion to be taken from 1974 to 1977 was supported by the Government of the United States; it was satisfied with the emphasis plaoed on prevention and on health education.

Dr CUMMING (Australia) supported the remarks made by the representa­tive of the United states of America. In Australia, emphasis continued to be placed on two aspeots; (a) the monitoring of legal traffic in drugs of dependence, now oomputerized, through which it was possible to discover all d~ usage trends thus minimizing the risk of lawfully produced drugs being diverted to the illicit market; and (b) health education, on which major emphasis was placed. During the past twelve months, with funds supplied by the Federal Health Authorities, workshops, seminars and discussion sessions had been conducted for teachers, trainee­teachers, parents, civic youth groups, oommunity and business organiZations, housewives, trade unions and apprentices. Meetings had been held with officers of the Department of Eduoation throughout the Commonwealth of Australia in order to discuss a major review of existing school curricula

116 Rm IONAL COMMI'l'I'EE: TNEm'Y - FIFl'H SESSION

to emphasize the health education aspects in the struggle against drugs of dependence. A number of films had also been produced. A start had been made in assessing the results of these activities in several of the states and Territories within the Australian Federation. In the Australia Capital Territory the effectiveness of the experimental drug eduoation programme in schools was being investigated in an attempt to evaluate the different health education methods used. Similar stUdies were being carried out in other States including one in New South Wales and one in Tasmania on the use of drugs by housewives and women at home. Dr Cumming said that his Government would be glad to transmit the results of these studies to the Regional Director when they became available.

Dr PHOUTl'HASAK (Laos) stated that his Government had taken measures to treat persons dependent on drugs. Since its foundation in September 1972, the National Detoxication Centre, Vientiane, had treated 1090 cases, conSisting of 797 persons with opium dependence, 198 with heroin dependence, 87 with dependence on both drugs and 8 with morphine dependence. They included 26 cases of opium relapse and 10 of heroin relapse. It had not yet been possible to envisage rehabilitation measures for drug addicts. While poppy growing had been prohibited, the question of substitute crops had not yet been settled.

Dr CHEN (China) stated that drug dependence was not only a medical problem but, more important, it was also a social problem. From basic experience, this problem must be solved by analyzing it from its roots. solution depended primarily upon national efforts using effective methods. It was hoped that while respecting national sovereignty international cooperation in the control of drug dependence and exchanges of experience would be continued.

Dr VUIYALE (FiJi) said that the exact number of cases of dependence implicating other drugs in Fiji was not known but it was considered to be insignificant. The problem at present was the excessive use of alcohol. He was in agreement with the Representative of the United states of America that attention should also be directed to this aspect of abuse which appeared to be a pressing problem in some areas of the Region. He also wished to support the health education programme on drug dependence undertaken in Australia.

Dr NICHOLSON . (United Kingdom) asked whether the time had not come to .. ~ review the existing legislation, turning perhaps from the standard "Dangerous Drug Act" to legislation which also made social provision for the problems such as the recent "Misuse of Drugs Act" in the United Kingdom.

Dr LAIGRET (France) noted that the situation in the French PacifiC Territories was very similar to that outlined by the Representative of Fiji. Drug dependence was not a problem but alcoholism and even excessive use of tobacco were of serious concern. He supported the recommendations J that alooholism.and drug dependence should be linked together; the ~ alcohol problem could be associated with that of traffio accidents.

SUMMARY rux;ORD OF THE THIRD fl1EETING 117

In French Polynesia, a very high percentage of people involved in car accidents had excessive blood alcohol rates.

There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare an appropriate resolution. (For consideration of the draft resolution, see the fourth meeting, section 1.4.)

7 REVIEW OF THE FIFlli GENERAL PROORAMME OF WORK COVERING A SPECIFIC PERIOD (1973-1977 INCWSIVE): Item 14 of the Agenda (Document WPR/RC25/8 )

The REGIONAL DIRECTOR informed the Committee that a representative consultation group of senior national health officials from countries and territories in the Western Pacific Region and members of the Secre­tariat of the Regional Office had met in Manila in July. The object was to determine how the activities and the intentions of the Region's programme were conforming to the Organization's Fifth General Programme of Work oovering a speoific period and, if they were not conforming, the reasons why. '!he Fourth Regional Programme of Work and guidelines prepared by a consultant to WHO Headquarters, Professor Aujaleu, were used as a basis for the group's discussions.

The REGIONAL DIRECTOR asked the Committee to review the report of the group, particularly the conclusions, so that the Director-General could be provided with material that would assist him in preparing a global report to the Exeoutive Board.

Dr NOORDIN (Malaysia), a member of the consultation group, said that the Fifth General Programme of Work for 1973-1977, which had been prepared by the Executive Board and approved by the Twenty-fourth World Health Assembly was based on recommendations made by Member countries to \'iHO on long-term planning in the field of health. In making the review requested by the Director-General the Regional Office for the Western Pacific was, as far as he knew, the only Regional Office that had i:wolved representatives of Member countries in addition to the Secretariat. Representatives of five Member oountries had partioipated in the work of the consultation group.

The Group's review showed that generally the Fourth Regional Programme of Work conformed to the Fifth General Programme of Work, although the Regional Programme catered more for the special needs of the Region and it was felt that the criteria laid down in it were more practical and adapted to the needs of developing countries. Closer involvement of Member countries, in consultation with WHO, was called for in the preparation of the Sixth General Programme of Work, which should follow the Fifth General Programme of Work with some of the goals specified within the period of the programme. Here WHO Representatives could play a useful role. It had been suggested that the duration of the Sixth Programme of Work should be six years to harmonize with the biennial budgetting of the Organization.

118 REOIONAL COMMITI'EE: TWENTY-FIFTH SESSION

The REOIONAL DIRECTOR expressed his appreciation to Dr Noordin, for acting as Chairman, and to the other members of theCon$ultation Group for their invaluable assistanoe.

There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare a draft resolution. (For oonsideration of the draft reso­lution, see the fourth meeting, seotion 1.5.)

8 PROJECT SYSTEMS ANALYSIS: Its development and the need to establish the oapability of the Regional Office to provide assist­anoe in this field: Item 15 of the Agenda (Proposed by the Govern­ment of Malaysia) (Document WPR/RC25/9)

The CHAIRMAN drew attention to the fact that this item had been proposed by the Government of Malaysia and asked the Representative of Malaysia to introduoe it.

Dr GURMUKH SINOH (Malaysia) reported that the WHO Project Systems Analysis team established in 1970 had directed its efforts towards improving country-orientated methodology in order to highlight health development proJeots within a oountry's socia-economic development plan and to produoe measurable objeoti ves. Two visits were made to the Western Pacifio Region and Malaysia in 1970, the first to gain field experienoe and the seoond to formulate a developmental project proposal in a problem area selected by the Government of Malaysia. A manual of procedures for "Health Project FormUlation" and a "Workshop Syllabus" were subsequently produced. During the next three years, three countries of the Western Pacifio Region committed large resouroes in applying project systems analysis to their problem areas. The Region had there-fore been actively involved in project systems analysis as a health planning tool for four years. The resources made available to participating countries had mainly come from WHO Headquarters, which limited further development in the Western Pacific Region since other Regions were also seeking resources from Headquarters.

A Project Management Manual had now been developed.

Further modifio.ation of the method was required to sui t local country needs whioh would require development of project systems analysis capability at regional level.

It was felt that the Regional Office for the Weste~ Pacifio, as the pioneer Regional Offioe in this type of activity, should strengthen its project systems analysis nuoleus to assist Member oountries to apply the methodology and transfer it to national planners.

SUMMARY RECORD OF THE THIRD MEETING 119

Dr ANGARA (Assistant Director of Health Services), supplementing the remarks made by the Representative of ' Malaysia, said that WHO had undertaken to study a new method of project planning in 1969 because there had been difficulties in applying the methods suggested at the time for national health planning. Problems suoh as those listed below still needed to be solved:

(a) it had been noted during the 1974 workshop in Kuala ll.unpur that there was no method for establishing priority. A Government or Minister of Health could identify an area where project systems analYSis methodology could formulate a project. If problems arose, however, it became difficult to determine priorities;

(b) the prooedure was still too complicated for some oountries to undertake at present;

(c) no projeots formulated by projeot systems analysis methodology had yet been implemented and so the approach had not peen fully tested;

Cd) the management procedure involved in implementation was still being developed. A manual had been produoed but it needed further testing and would have to be refined from time to time.

The Regional Office was gradually preparing to take over from Headquarters a fuller role in project systems analysis activities. It was capable of doing so, having taken part in the initial activities mentioned by the Representative of Malaysia.

Steps had also been taken to make the project systems analysis method more widely applicable particularly in the areas of programme formulation and management. Courses were being given in national health planning which incorporated project systems analysis methods partioularly procedures for projeot design.

WHO Headquarters was at present developing and testing country health programming and here too project systems analysis methodology, particularly in project formulation would apply. It was planned further to employ project systems analysis methods in the regular review of projects requested by governments. An information,system still needed to be deve­loped; this was being done by Headquarters. Plans were already being made to extend further assistanoe to oountries after the methods for country programming and a health information system had been finalized and more requests had been received from Member governments. There were already staff who could provide this sort of advice available in the Regional Office. It was hoped that Member oountries would oollaborate if necessary in the further testing and refining of the methods.

120 RIDIONAL COr-KrTl'EE: 'lWENTY-FIFm SESSION

Dr VUIYAIE (Fiji) noted that methods· for determining priority were set out in a manual which had been developed in the Regional Office. His Government would be grateful if it could receive copies of the manual for information and guidanoe. It might, after the methodology had been studied, be possible to disouss it for further clarifioation and to test it in Fiji with the assistance of WHO.

Dr ANJARA (Assistant Direotor of Health Servioes) wished to make it olear that the manual was for national health planning whioh had inoorporated projeot design techniques into its procedures. It was at present under review but it should be available tor distribution in 1975.

The RmIONAL DIRlOC:TOR said that the time was not far distant when project systems analysis expertiee would be deoentralized to the Regions.

There being no further oomments, the CHAIRMAN asked the Rapporteurs to prepare a draft resolution. (For oonsideration of the draft resolution see the fourth meeting, section 1.6.)

The CHAIRMAN stated that as all the items on the programme of work had been disoussed, he proposed that the meeting should adjourn for the day.

It was so agreed.

The meeting rose at 12.05 p.m.

SUMMARY RECORD OF THE THIRD MEFl'ING

ANNEX 1

REPORT FROM MALAYSIA

DISINSECTION OF AIRCRAFT

1 PRESENT POSITION

1.1 In view of the growing danger of the dissemination of mosquito vectors by ever increl!Sing international air traffio, Malaysia hl!S accepted the WHO recommendation on the "bloCks away" method of disinsection of aircraft of international flights.

l2:}.

1.2 Under the above policy airlines are requested, as evidenoe of effeotive disinsection, to record the serial number of the aerosol dispenser in the health part of the Aircraft General Deolaration, and to store the empty cannister as evidence in the aircraft. It is gratifying to note that some international airlines have complied with the require­ments completely and some partly without giving adequate details as given in Armex VI of WHO International Health Regulation 1969, a copy of which has been ciroulated to all airlines by the Health Administration and brought to the attention of representatives of all airlines during Facilitation Committee Meetings. A summary of the airlines who carried out disinsection in June - July 1974 is given overleaf.

1.3 Practically all airlines passing through Kuala Lumpur International Airport are at present using aerosols of pyrlthrum and DDT by the "blocks away" method of disinseoting.

1.4 The latest WHO reoommendations contained in document WPR/RC25/5 Disinsection by the "Dichlorvos Vapour System" is not being adopted by any of the airlines that pass through Kuala Lumpur International Airport.

2 PROBIEM

As indicated above in paragraph 1.3 the number of aircraft that complied in the period June and July, 1974 is shown overleaf. There is a significant improvement in the percentage of airoraft carrying out the instruotions compared to July, August and September 1973 (57%), December 1973 (67%). The present survey shows an improvement to 76%.

3 RECOMMENDATIONS

It is intended to issue additional instruotions to Airlines and Local Agents as and when we find that the instructions in Armex VI of WHO International Health Regulations are not complied with.

NO.

1

1 2 3 4

5 6 7 8

9 10 11 12 13 14 15 16 17 18 19

-- ---

RESULT OF SUMMARY OF lll'TERNATIONAL AIRCRAFTS THAT ARE EXPECTED TO CARRY OUT DISINSECTION

FOR '!HE MONTH OF JUNE AND JULY 1974. INTERNATIONAL AIRPORT, K. WMPUR

NUMBER OF FLIGHTS NO GENERAL DISINSECTION PERCENTAGE

AS PER OVERFLYIOO ACTUAL DECLARATION AS SHOWN IN OF FLIGHTS

GIVEN GENERAL DEC- WHICH HAS AIRLINES SCHEDUIE AND FLIGHTS

LARA'.crON OONE DIS-CANCELlED

INSECTION FLIGHTS NOT

2 3 4 5 6 ~ ~ 9

AIR VIE'lNAM 9 0 9 0 9 0 100 SINGAPORE 25 0 25 0 25 0 100 CHINA AIR 15 0 15 0 15 0 100 JAPAN AIR 14 1 13 0 13 0 100 CA'IRAY PACIFIC 50 0 50 0 49 1 98 THAI INTERNATIONAL 49 4 45 0 44 1 98 S. K. (SCANDINAVIAN) 8 0 8 0 7 1 98 K. L. M. 25 0 25 0 24 1 97 M. A. S. 177 1 176 2 136 38 77 B. o. A. C. 46 2 44 6 34 4 77 PAKISTAN AIR 17 0 17 0 13 4 76 GARUDA 13 0 13 0 9 4 69 Q,ANTAS 76 1 75 1 48 26 64 SPECIAL FLIGHTS 15 0 15 5 6 4 40 AIR INDIA 15 0 15 2 4 9 27 CZECHOSLOVAK 6 0 6 0 1 5 17 S. U. (SOVIET) 8 0 8 0 2 6 25 SABENA 15 0 15 3 3 9 20 AIR CEYIllN 8· 0 8 0 1 7 12

TOTAL 591 9 582 19 443 120 76

- - -

..

REMARKS

10

-------------------

---

I-'

1\3

~ ~ ~ B •

I ~ ~ ~

(WPR/RC25/SR/4 )

1

SUMMARY RECORD OF THE FOURTH MEEl'IOO

Dewan Tunku Abdul Rahman. Kuala Lumpur Wednesday. 4 September 1974 at 9.00 a.m.

CHAIRMAN: Dr J. Dizon (Phili ppines)

CONTENTS

Consideration of draft resolutions ••••••••••••••••••

2 Reconsideration of resolutions of regional interest adopted by the Twenty-seventh World

127

Health Assembly..................................... 130

3 Cholera precautions - importation by pilgrims of holy water: Item proposed by the Government of Fiji •••••••••••••••••••••••••••••••••••••••••••••••• 131

4 Statements of representatives of the United Nations. the Specialized Agencies. of intergovernmental and non-governmental organizations in official relations wi til Wl10 •..•.....•....•.•.•••••.•••....••• 133

-123-

124 RIDIONAL COMMITTEE: TWENTY'-FIFTH SESSION

Fourth Meeting

Wednesday, 4 September 1974 at 9.00 a.m.

PRESENT

I • Representati ves of Member states

AUSTRALIA

CHINA

FIJI

FRANCE

JAPAN

KHMER REPUBLIC

LAOS

MALAYSIA

NEW ZEAIAND

PHILIPPINES

PORTUGAL

Dr G. Howells Dr R. W. Cumming

Dr Chen Ha1- feng Dr Sung Kan . Mr 11 Ching Hsiu

Dr Peni Vuiyale

Dr ,T. Laigret

Dr T. Takizawa Dr R. Okamoto Mr M. Sasaki

Dr Nhonh Bun Yay Dr Emmanuel Fernandez

Dr Phouy Phoutthasak Dr Ritthikay Vilaihongs

Datuk Paduka (Dr) Abdul Wahab bin Mohd.Ariff

Dr Raja Ahmad Noordin Mr Onn bin Kayat Dr Gurmukh Singh Dr Fang Ung Seng Dr Abdul Majid bin Tun Abdul Aziz Dr Ta1 Yen Hooi Datuk (Dr) Abdul Khal1d bin Sahan Dr G. V. Denis

Dr R. Dickie

Dr J. Dizon Dr D. Rivera

Dr Rui Albuquerque R1beriro da Costa Pinhao

Dr Longuinhos Monteiro Xavier

SUMMARY ~ORD OF THE FOURTH MEETING

REPUBLIC OF KOREA

REPUBLIC OF VIEl'-NAM

SINJAPORE

UNITED KINGDOM

UNITED STATES OF AMERICA

WESTERN SAMOA

Mr Chong Sang Park Mr Han Il Ree

Dr Tran Quy Nhu Dr Pharo Quang Tuan Mr Nguyen-Viet-Danh

Dr A. G. K. Chew Dr Ng Kwok Choy

Dr J. A. B. Nicholson

Dr J. C. King Mr F. S. Cruz Dr M. Kumangai

Dr J. C. Thieme

II. Representative of Associate Member

PAPUA NEW GUINEA Dr A. Tarutia

125

III. Representatives of the United Nations and Related Organizat1ons

UNITED NATIONS CHILDREN I S FUND U Tun Aung

IV. Representatives of the other Inter-governmental OrganiZations

V.

INTERNATIONAL COMMITTEE OF MILITARY MEDICINE AND PHARMACY Colonel Dr. D. A. Lopes, KMN

Representat1ves of Non-governmental Organ1zations

INTERNATIONAL ASSOCIATION FOR ACCIDENT AND TRAFFIC MEDICINE

INTERNATIONAL DENTAL FEDERATION

INTERNATIONAL COMMITTEE OF CATHOLIC NURSES

Dr W. K. Ng

Dr Um Chee Shin

Mrs M. A. La!

126 RIDIONAL COMMITl'EE: TWENTY-FIFl'H SESSION

INTERNATIONAL COUNCIL OF NURSES

INTERNATIONAL PLANNED PARENTHOOD FEDERATION

INTERNATIONAL FEDERATION OF PHARMACEUTICAL MANU­FACTURERS ASSOCIATIONS

IEAGUE OF RED CROSS SOCIETIES

INTERNATIONAL FEDERATION OF SPORTS MEDICINE

INTERNATIONAL FEDERATION OF SURGICAL COLI..lIDES

VI. WHO Secretariat

SECRETARY

Miss Chong Ah Foo

Dr W. K. Ng

Mr Koh Choon Hui

Y. B. Tan Sri Abdul Jamll Rais

Dr M. Jegatheson

Professor M. Balasegaram. FRCS.Ed.

Dr Francisco J. Dy

SUMMARY RECORD OF THE FOURTH MEETING 127

At this meeting Dr DIZON (Philippines), Vice-Chairman, took the Chair.

1 CONSIDERATION OF DRAFT RESOLUTIONS

The Committee considered the following resolutions:

1.1 Annual Report of the Regional Director (Document WPRjRC25/WP/l)

Dr PINHAO (Portugal) said that he fully endorsed the draft resolution and congratulated the Regional Director and his staff on their achievements. He pointed out that as the new regime in Portugal recognized the right to self determination of all people its colonies were being offered independence. Realizing its obligations to these people, Portugal would continue to cooperate fully with the Regional Director and Member countries in whatever assistance was requested by these newly independent countries.

Decision: The draft resolution was adopted (see resolution WPRjRC25.Rl).

1.2 Disinsection of aircraft (Document WPRjRC25/WP/2)

Dr NICHOISON (United Kingdom) suggested an amendment to the second paragraph of the draft resolution. The amendment was supported by the Representative of Australia. Further amendments were suggested by the Representative of France and supported by the Representative of the People's Republic of China. The Representatives of the United States of America and Western Samoa took part in the ensuing discussions.

It was agreed that a revised draft would be prepared for the consideration of the Committee. (For further consideration of the draft resolution, see the fifth meeting, section 2.1.)

1.3 Quality of water and food in international aviation (Document WPRjRC25/WP /31

Dr DICKIE (New Zealand) said that this resolution was not positive enough and suggested the following be inserted as the penultimate para­graph:

"RECOGNIZES that, although considerable improvements have been achieved over recent years, there is no room for complacency. There is a need for further improvement and constant vigilance to ensure that high standards are reached and maintained."

Dr NICHOLSON (United Kingdom) and Dr IAIGRET (France) supported the suggestion of the Representative of New Zealand.

128 RIDIONAL COMMI'ITEE: TWENTY-FIFTH SESSION

Decision: The draft resolution, as amended, was adopted (see resolution WPR!RC25.R2).

1.4 Drug dependence (Document WPR!RC25/wp/4)

Dr DICKIE (New Zealand) said that he had gathered from previous discussions that alcoholism was the major concern; he would like to see some recognition of this in the resolution. In the Western Pacific Region alcoholism and tobacco consumption were the main problems; this should be stressed.

Dr PINHAO (Portugal) agreed with the Representative of New Zealand but thought that alcohol and tobacco should not be classed together. The problem with tobacco was not that it was used exceSsively but rather that it was used at all.

Dr LAIGRET (France) supported the statement of the Representative of New Zealand.

Dr KING (United States of America) said that these facts were irrefutable. The resolution dealt with drug dependence however. When he had asked that alooho1 and tobacco should not be ignored, his intention had been to connect them with drug dependence to which they were related; they might more appropriately be considered under a different subject heading. He thought the draft resolution should be carefully considered before its primary purpose was changed.

The REGIONAL DIRECTOR suggested that the resolution be adopted with whatever amendments the Committee wished and a separate resolution on alcohol and tobacco proposed. The Representative of New Zealand might prepare a separate resolution in consultation with the Rapporteurs.

Dr LAIGRET (France) said that in the Western Pacific Region alcoholism was a much more serious problem than drug dependence stricto sensu.

Dr PINHAO (Portugal \ agreed with the Representative of France and said that tobacco should be kept with the other drugs, since people knew tobacco as a drug.

Dr ABDUL WAHAB MIFF (Malaysia) said that the resolution should make specific reference to drug dependence on which attention entirely focused and should not include alcohol and tobacco.

Dr DICKIE (New Zealand) said that problem than the so-called hard drugs. in the resolution.

alcohol presented a more serious He preferred to see it incorporated

SUMMARY RECORD OF THE FOUR'm MEEI'IOO 129

Dr NICHOLSON (United Kingdom) said that alcohol and the other drugs referred to in the draft resolution were psychotrophic; tobacco was not. Did tobacco really have a place in the original intention of the resolution.

Dr OKAMOTO (Japan) supported the statement of the Representative of the United Kingdom.

Dr LAIGRET (France) said he would prefer to keep 1;0 one resolution, since to link alcohol and tobacco to drug dependence would be a means of calling attention to the seriousness of these forms of abuse, which unfortunately tended to be regarded as hardly deleterious.

Dr KING (United states of America) recalled that when the resolution had originally been introduced at the Regional Committee in 1972, the intention had been to look at the problem of drug dependence in its narrowest and most clearly defined sense. The same title had been used ever since. He felt that the draft resolution, including the reference to alcoholism and the use of tobacco, was most appropriately worded and could be used by the Committee. The discussions on the subject would remain part of the permanent record and the Committee's concern about alcoholism might lead to further study of the subject; an item might even be included in the agenda of the twenty-sixth session.

Dr DICKIE (New Zealand) agreed with the Representative of the Uni ted states of America. He suggested that the phrase "which are of greater importance in this region" might be added to the third preambu­latory paragraph. This would provide the emphasis he would like to see in the resolution.

Dr KING (United states of America) supported the amendment suggested by the Representat1 ve of New Zealand but asked that the word "great" be used not "greater".

Dr HOWELIS (Austral1a) was not sure that either "great" or "greater" were appropr1ateto Australia; he would accept the word "great" but not "greater".

Dr DICKIE (New Zealand) and Dr KJNG (United states of America) agreed.

Decision: The draft resolution, as amended, was adopted (see resolution WPR/RC25.R3).

1.5 Review Period

Pro ramrne of Work Coveri a Specific Document WPRjRC25;'WP/5

Decision: The draft resolution was adopted (see resolution WPR/RC25.R4).

130 RIDIONAL COMMITl'EE: TWENTi-FIFlR SESSION

1.6 Project systems analysis (Document WPR/RC25/wp/6)

Decision: The draft resolution was adopted (see resolution WPR/RC25 .R5) •

2 RECONSro:rnATION OF RESOWTIONS OF RIDIONAL INTEREST ADOPTED :BY THE 'J."NENTY-SEVEN'lli WORID HEAL'lR ASSEMBLyl Item 10 of the Agenda (Documents WPR/RC25/4 and WPR/RC25/4 Add.l)

Dr WIYAIE (Fiji) felt that Item 10 of the Agenda had been considered rather quickly at the third meeting and sought permission to refer once more to two resolutions of the Twenty-seventh World Health Assembly: Infant Nutrition and Breast-feeding (resolution WHA27.43) and Intensification of Research on Tropical Parasitic Diseases (resolution WHA27.52)

The encouragement of breast-feeding was an important issue in most developing countries. where ignorance and poor standards of hygience prevailed. It should be considered more seriously. together with the problems of malnutrition and infection. leading to death. associated with it.

The weaning period was a very important stage in the life of a child. Dr VUIYALE proposed that positive steps be taken by WHO to investigate the preparation of weaning foods using the local products which were within the reach of people in the Western Pacific Region.

Intensification of research on parasitic diseases was also an important subject requiring further consideration in the Region.

Dr RIVERA (Philippines) asked why no draft resolution had been presented to the Committee after discussion on WHA27.5l. the development of the antimalaria programme.

The CHAIRMAN stated that presentation of the draft resolutions relating to Item 10 of the Agenda. had been deferred pending further discussions.

The Representative of Fiji had stressed the need for research in the Region on tropical parasitic diseases. He would like to propose that the following diseases be included in the research-programme of WHO:

1. schistosomiasis 2. filariasis 3. dengue haemorrhagic fever 4. cholera 5. typhoid fever 6. Japanese encephalitis 7. rabies

1 See also WPR/RC25/SRj). Section 3.

SUMMARY RECORD OF THE FOURTH MEEI'ING 131

Dr NICHOLSON (United Kingdom) proposed that viral hepatitis be included.

Dr DICKIE (New Zealand) supported the suggestion of the Representa­tive of the United Kingdom.

Referring to the Representative of the Philippines' intervention regarding the resolution on the antimalaria programme, Dr TUAN (Republic of Viet-Nam) said that some developing countries were facing shortages of insecticides. The Government of the Republic of Viet-Nam had intro­duced a malaria eradication programme in 1956-1958, but was now faced with difficulties because of reductions in bilateral assistance.

There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare the resolutions in connexion with Item 10 of the agenda still to be considered. (For consideration of the draft resolutions, see the fifth meeting, sections 2.2, 2.3 and 2.4 and the sixth meeting, section 1.1.)

3 CHOLERA PRECAUTIONS - IMPORTATION BY PILGRIMS OF HOLY WATER: Item proposed by the Government of Fiji: Item 16 of the Agenda (Document WPR/RC25/10)

In introducing the subject, Dr VUIYAIE (Fiji) stated that while cholera had not at any time been reported in his country or in the South Pacific Islands to which Fiji was considered the gateway, the danger of the disease spreading was present and his Government was fully aware of its responsibilities. Unlike Australia and New Zealand, where highly developed sanitary conditions and services had prevented the disease, recently brought in by air travellers, from spreading, there were areas in Fiji and the neighbouring islands with poor environmental sanitation where cholera could rapidly become established. Dr VUIYALE wished to make it clear that the Circular referred to holy water from all sources and not from one certain source. This item had been proposed for inclusion in the agenda so ~hat the Committee could be informed of the action being taken by the Government of Fiji and to stimulate comments on the subject.

Dr OKAMOTO (Japan) asked for what purpose the pilgrims brought back the holy water; what article in the International Health Regulations was being applied by the Fiji health authorities in detaining it; and what was the scientific basis for impounding it for 21 days at Nadi airport. Experience had shown that the bacteria of cholera, typhoid and paratyphoid could live much longer than 21 days, even for a year, under favourable conditions. He ended by thanking the Government of Malaysia for the documentation it had submitted in connexion with this item of the Agenda.

Dr HOWELLS (Australia) said that this was a delicate subject which should be dealt with by individual governments rather than the Committee.

132 REnIONAL COMMI'lTEE: '1WENT'i-FIFI'H SESSION

Australia tully acoepted the position paper submitted by the Government of Malaysia that there was no risk from the water oolleoted from the speoial well in Saudi Arabia. However, he agreed with the Representative of Fiji that an inoreasing problem did exist. In the last twenty years, people of many different nationalities and religious beliefs had migrated to Australia and during the past two years there had been a notioeable inorease in the importation of holy water in a variety of oontainers from many sources. He emphasized that the problem was not only one of oholera; there were many other baoterial and parasitio oontaminants. The quarantine regulations in Australia permitted holy water to be oonfisoated butthia was seldom done. Confisoation was not oarried out on a soientifio basis; olear speoimens oould also be highly oontaminated. The delegation of Australia had no immediate answer to the problem.

Dr ABDUL WAHAB ARIFF (Malaysia) said that the efforts being made by Fiji to oontrol the spread of oholera were appreoiated. He referred however to Artioles 31.1(b) and 47 of the International Health Regulations whioh set forth adequate measures to prevent oholera spreading from one oountry to the other. The WHO Committee on International Surveillanoe of Communioable Diseases also advised the Exeoutive Board and the Direotor­General regarding prevention measures thought to be desirable. As far as was known, the national health administrations of oountries with souroes of holy water exeroised measures to prevent the disease.

Dr ABWL WAHAB ARIFF referred to a statement he had made to the Twenty-fourth World Health Assemb1y.l In oono1uding his statement to the Assembly, he had appealed to all Member states to retrain from taking exoessive, ineffeotive and outmoded measures to the detriment of international traffio and to oontinue their fight against oholera in a spiri t of international cooperation and in the light of the most modern developments in the field of oholera control. He proposed that the Committee should ask the Representative of Fiji to refer the matter to the Direotor-General who was responsible for the International Health Regulations whioh governed procedures for cholera oontrol.

Dr WIYAIE (FiJi) thanked the Representatives of Australia, Japan and Malaysia for their observations whioh he would report to his Govern­ment. He did not feel he was oompetent to reply to the question raised by the Representative of Japan in the utilization of holy water. The decision to confiscate holy water had been taken as a way of compromising with those importing it. It was diffioult to Judge how long the oho1era vibrio might live in water sinoe this was inf1uenoed by different faotors.

Dr WIYAIE said that the oirou1ar had been brought to the attention of the Committee to stimulate general observations so that his Government, which was ooncerned-about the situation, could oonsider its position. Often there was no oertifioation from a oompetent authority and it was diffioult to determine the source of the holy water.

1 Off. Reo. Wld Hlth Org., 1971, No. 194. p.283.

, ..

SUMMARY RECORD OF THE FOURTH MEETING 133

The CHAIRMAN, supported Dr HOWELLS (Australia) felt that, in view of the discussions on the subject, the Committee need not adopt a resolution on this particular item.

4

It was so agreed.

STATEMENTS OF REPRESENTATIVES OF THE UNITED NATIONS, THE SPECIALIZED AGENCIES, OF INTERGOVERNMENTAL AND NON-GOVERNMENTAL ORGANIZATIONS IN OFFICIAL RELATIONS WI']}! WHO: Item 17 of the Agenda

On the invitation of the CHAIRMAN, the following representatives presented statements.

4.1 Representative of the United Nations Children's Fund

U TUN AUNG conveyed the greetings of the Executive Director and the Acting Regional Director for East Asia and Pakistan of UNICEF and referred to UNICEF's happy association with WHO. Health was still the main field in which UNICEF provided assistance, since the health system of a country had the highest significance for children. Although death rates had fallen and efforts to control communicable diseases were substantial, large gaps in health services still remained. Communicable disease and maternal and child health services required common support and WHO had now included the concept of community in the health system. Grave problems which remained were the effect on child nutrition of a static or declining rate of food production, end the increased costs of food in developing countries, where lower income groups spent about 80% of their income on food. It had been estimated that there were 10 million severely malnourished children in the world. Because of this UNICEF had adopted the Declaration of an Emergency for Children. WHO's continued assistance and cooperation would be relied on.

4.2 Representative of the International Dental Federation

Dr LIM oongratulated the Chairman, Vice-Chairman and Rapporteurs on their election and the Regional Committee on its aohievements. The International Dental Federation had long been associated with WHO.

It was pleasing to note that national dental surveys asSisted by WHO had recorded the type, severity and extent of dental problems in countries in the Region. At the Joint International Dental Federation and Australian Dental Congress which met in July 1973 and the Seventh Asian Pacific Dental Congress which met in June 1974, a day had been devoted to discussing the dental needs Of the Region. The assignment of a dental officer to the WHO RegJ.,onal Office pointed the way to the continued cooperation of the International Dental Federation with WHO in the Western Pacific Region.

134 REnIONAL CO!If.ITTl'EE: TWENTY-FIFTH SESSION

4.3 Representative of the International Council of Nurses

Miss CHONG brought greetings to the meeting from the Council's 79 member associations and referred to the close cooperation between WHO and ~he International Council of Nurses.

4.4 Representative of the International Planned Parenthood Federation

Dr NO stated that the International Planned Parenthood Federation of South East Asia and Oceania covered 17 countries with a total population of 308 million and faced major population problems.

Latcr this year the Western Pacific Region of the International Planned Parenthood Federation and South East Asia and Oceania would merge to form a new East Asia and Oceania Region.

The International Planned Parenthood Federation and the voluntary non-governmental Family Planning Associations which were members played an important role at government and at family level. Increasing govern­ment support was materialising and it would be supplemented by community support. Policies and decisions for programmes and activities were made by the Regional Council in Kuala Lumpur, which also conducted training programmes and gave advice on problems and how to manage them to produce effective results. Family Planning Associations were entitled to assistance from the International Planned Parenthood Federation and their ne.tional governments. Fund raising was being encouraged, to provide additional resources and. hopefully, financial independence.

Some countries had integrated family planning into the national health infrastructure and the Family Planning Associations had phased out the medical/clinic aspect or restructured the clinic facility towards the community-based distribution of contraceptives.

The International Planned Parenthood Federation and its Family Planning Associations had always cooperated fully with governments and agencies of the United Nations. It recognized the importance of family planning as a basiC hl~an right and the role it should play in maternal and child health care and socio-economic development.

4.5 Representative of International Association for Accident and Traffic r·1edicine

Dr NG then read a statement on behalf of the International Association for Accident and Traffic Medicine. He referred to a \~O recommendation to study the medical aspects of licensing drivers, road

f t Programmes and research into human and medical factors involved

sa e y 2 000 killed in traffic accidents. There are an estimated 50 persons id t ch Year and all available and 75 million injured in traffic acc en s ea

means should be sought to minimize the problem.

..

•

,.

.S

SUMMARY RECORD OF THE FOURTH MEETING 135/136

4.6 Representative of International Federatlon of Surgical Colleges

Professor BALASEDARAf'.l brought the Federation's greetings to the meeting and noted that topics for discussion were prevention of road accidents. d~~g dependence and malignant and metabolic diseases, together with manpower training. The Pederation was very concerned with these problems and he hoped that joint studies could be conducted with WHO in the near future. He hoped the cordial relationship which existed between the two organizations would continue to grow.

Representative of the International Federation of Pharmaceutical Manufacturers Associations

Mr HUI said that the International Federation of Pharmaceutical Manufacturers Associations had, in its research efforts, worked closely with WHO in the fight against disease and epidemics. It was hoped that this collaboration would continue.

The CHAIRMAN thanked the speakers. (For a further statement presented, see the fifth meeting. section 3.)

The meeting rose at 12.00 noon

, '-

(WPRjnC25/SR/5 )

SUMMARY RECORD OF THE FIFTH MEETING

Dewan Tunku Abdul Rahman, Kuala Lumpur Thursday, 5 September 1974 at 9.00 a.m.

CHAIRMAN: Tan Sri Dato (Dr) Abdul Majid bin Ismail (Malaysia)

1

2

CONTENTS

Acknowledgement by the Chairman of brief reports received from governments on the progress of their health activities (continued) ••••••••••••••••••••••

Consideration of draft resolutions •••••••••••••••••

3 Statements of representatives of the United Nations, the Specialized Agencies, of intergovernmental and non-governmental organizations in official relations

141

141

wi th WHO (continued) ,..,............................................ 142

4 Technical cooperation among developing countries

5 Selection of topic for the Technical Discussions during the twenty-sixth session of the Regional Committee and duration of the Regional Committee

... 142

Meeting .................................................................................... 143

6 Time and place of the twenty-sixth and twenty-seventh sessions of the Regional Committee ••••••••••••••••• 147

7 Announcement.. .. .. .. .. .. .. .. .. .. • .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. • • • • 148

-137-

138 REnIONAL COMMITl'EE: TWENTY-FIFl'H SESSION

Fifth Meeting

Thursday, 5 September 1974 at 9.00 a.m.

PRESENT

I. Representati veil of Member states

AUS'mALIA

CHINA

FIJI

FRANCE

JAPAN

KHMER REPUBLIC

LAOS

MALAYSIA

NEW ZEALAND

PHILIPPINES

PORTUGAL

Dr G. Howells Dr R. W. Cumming

Dr Chen Hai-feng Dr Sung Kan Mr L1 Ching HSiu

Dr Peni Vuiyale

Dr J. Laigret

Dr T. Tak1zawa Dr R. Okamoto Mr M. Seaaki

Dr Nhonh Bun Yay

Dr Phouy Phoutthasak Dr Ritthikay V11aihongS

Tan sri Dato (Dr) Abdul Majid bin Ismail

Datuk Paduka (Dr) Abdul Wahab bin ~1ohd. Ariff

Dr Raja Ahmad Noordin Mr Onn bin Kayat Dr Fang Ung Seng Dr Abdul Majid bin Tun Abdul Aziz Dr Tal Yen Hooi Datuk (Dr) Abdul Khalid bin Sahan Dr G. V. Denis

Dr R. Dickie

Dr .r. Dizon Dr D. Rivera

Dr Longuinhos Monteiro Xavier

, ,

SUMMARY RECORD OF THE FIFTH MEEI'ING

REPUBLIC OF KOREA Dr Seung Hahm Park Mr Chong Sang Park Mr Byung Hoon Chun Mr Han Il Ree Mr Hang Sirb Song

REPUBLIC OF VIET-NAM Dr Tran Quy Nhu Dr Pharo Quang Tuan

SINGAPORE Dr A. G. K. Chew Dr Ng Kwok Choy

UNITED KINJDOM Dr J. A. B. Nicholson

UNITED STATES OF AMERICA Dr J. C. King Dr M. Kumangai

WESTERN SAMOA Dr J. C. Thieme

II. Representative of Associate Member

PAPUA NEW GUINEA Dr A. Tarutia

III. Representative of the other Inter-governmental Organizations

INTERNATIONAL COMlITTl'EE OF MILITARY MEDICINE AND ffiARMACY Colonel Dr D. A. Lopes, KMN

IV. Representatives of Non-governmental Organizations

INTERNATIONAL ASSOCIATION FOR ACCIDENT AND TRAFFIC MEDICINE

INTERNATIONAL DENTAL FEDERATION

INTERNATIONAL COMMITl'EE OF CATHOLIC NURSES

INTERNATIONAL COUNCIL OF NURSES

INTERNATIONAL PLANNED PAREN'IHOOD FEDERATION

Dr W. K. Ng

Dr Lim Chee Shin

Mrs M. A. La1

Miss Chong Ah Foo

Dr W. K. Ng

139

140

INTERNATIONAL FEDERATION OF PHARMACEUTICAL MANU­FACTURERS ASSOCIATIONS

LEAGUE OF RED CROSS SOCIETIES

INTERNATIONAL FEDERATION OF SPORTS MEDICINE

INTERNATIONAL FErERATION OF SURGICAL COLLBOES

v. WHO Secretariat

SECRETARY

Mr Koh Choon Hui

Y. B. Tan Sri Abdul Jamll Rus

Dr M. Jegatheson

Professor M. Balasegar8ll\, FRCS. Ed.

Dr Franoisoo J. Dy

...

SUMMARY RECORD OF THE FIFTH MEETING 141

1 ACKNOWIEOOMENT BY THE CHAIRMAN OF BRIEF REPORTS RECEIVED FROM GOVERNMENTS ON '!HE PROORESS OF THEIR HEAL'IH ACTIVITIES: Item 8 of the Agenda (oontinued from the seoond meeting, seotion 1)

The CHAIRMAN acknowledged reports on the progress of health activities reoeived from Frenoh Polynesia and from Timor. Copies had been distributed.

2 CONSIlERATION OF IRAFT RESOWTIONS

The Committee considered the following resolutions:

2.1 Disinsection of aircraft (Dooument WPR,fflC25}NP/2 Rev.l) (oontinued from the fourth meeting, seotion 1.2.)

Dr DICKIE (New Zealand) suggested that the last line of paragraph one should be amended to read "if deemed neoessary" instead of "if and when necessary".

The CHAIRMAN said this would affect only the English version.

Dr ABOOL WAHAB MIFF (Malayl!lia) asked if national or international flights were referred to.

The REJIONAL DIRECTOR said it was presumed to concern international flights.

2.2

Decision: The draft resolution, as amended, was adopted (see resolution WPR,fflC25.R6).

at its tift -

Deoision: The draft resolution was adopted (see resolution WPR,fflC25.R7) •

Dr OKAMOTO (Japan) said he wished to comment on the two Twenty­seventh World Health Assembly resolutions on health eduoation: Health Eduoation (resolution WHA27.27) and. Health Education of Children and Young People (resolution WHA27 .28). Strengthening of the public health services was not an automatic oonsequence of economic growth. The health servioes beoame more complicated because of new technology for disease control and the emergence of new health hazards. Health eduoation would play a more important role as the key activity in many spheres and should be expanded to meet new needs.

142 RmIONAL COMMITl'EE: 'lw.EN'lY-FIFrH SESSION

2.3 Development of the antimalaria programme (Document WPR/RC25/WP/B)

Dr RIVERA (Philippines) suggested that the word "malarious" in paragraph (a) be replaced by "concerned".

Decision: The draft resolution, as amended, was adopted (see resolution WPR/RC25.R8).

2.4 Intensification of research on tropical parasitic diseases (Doownent WPR/RC25!WP /9)

Deoision: The draft resolution was adopted (see resolution WPR/RC25.R9) •

3 STATEMENTS OF REPRESENTATIVES OF '!HE UNITED NATIONS, '!HE SPECIALIZED AGENCIES, OF INTEffiOVERNMENTAL AND NON-GOVERNMENTAL CllGANIZATIONS IN OFFICIAL REIATIONS WITH WHO: Item 17 of the Agenda (continued from the fourth meeting, section 4)

3.1 Representative of the International Committee of Catholio NUrses

Mrs IAI said that the International Committee of Catholio Nurses was established in 1928 and came into official relationship with WHO in 1954. The lOth World Congress held in Rome in May 1974 had emphasized the need for nurses to work closely with other health professions for total health oare.

4 TECHNICAL COOPERATION AMONG DEVEIDPINJ COUNTRIES: Item 18 of the Agenda (Docwnent WPR/RC25/13)

The REGIONAL DIRECTOR said that docwnent WPRjRC25/13 briefly outlined the background to, and the outcome of, the deliberations of the UNDP Working Group on Technical Cooperation among Developing Countries.

The report of the Working Group, on which WHO had been represented, reoommended that a special unit be established to deal with the question wi thin the UNDP Secretariat and that an information system be set up. Specialized Agencies of the United Nations had been asked to establish focal points for the promotion of teohnioal oooperation among developing countries.

rHO hlid always given strong emphasiS and support to the concept of cooperation in technical fields among developing countries. In the Western Pacific Region cooperation had been principally in the area of heal th manpower planning and the prevention and control of communicable diseases through the exohange of technical advisers and research workers, fellowships, conferences, seminars and training courses.

_______ --:;.SU.MMARY RECORD OF THE FIFTH MEETING 143

Dr THIEME (Western Samoa) said his Government supported this concept and was already implementing it. He c1 ted the assistance being provided by the Government of Western Samoa to the University of the South Pacific in Fiji, another developing country.

There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare an appropriate resolution. (For consideration of the draft resolution, see the sixth meeting, section 1.2.)

5 SELECTION OF TOPIC FOR THE TECHNICAL DISCUSSIONS DURING THE TWENTY-SIXTH SESSION OF THE REGIONAL COMMITTEE: Item 19 of the Agenda (Documents WPR/RC25/11 and Add.l) AND DURATION OF THE REGIONAL COMMITTEE MEETING

Dr KING (United States of America) said that in their own countries, Representatives were persons of importance who had many responsibilities. They could not afford to be absent for long periods of time. He requested the Committee to re-examine the length of the Regional Committee meeting itself. Regarding the Technical Discussions per!!, the purpose of the Committee was to make decisions and not to discuss technical matters whiCh were primarily the purview of experts. If the ~echnical Discussions were to be eliminated, the length of the meeting could be shortened to one full week. The difficulty that this might entail to the Secretariat was recognized. However, with no Technical Discussions the deliberations of the present meeting could have been concluded in one week. He had raised this topic at the twenty-fourth session of the Regional Committee.

Dr HOWEL!.S (Australia) agreed that technical subjects should be discussed by experts. He felt that the meeting could have been concluded in a week with or without the Technical Discussions.

Dr DICKIE (New Zealand) supported the Representatives of Australia and the United States of America. During the early meetings of the Regional Committee the Technical Discussions were very valuable but this was not the case now.

Dr ABDUL WAHAB ARIFF (Malaysia) enquired whether there was reference to the Technical Discussions in the Rules of Procedure of the Regional Committee for the Western Pacific.

The REGIONAL DIRECTOR said there was nothing in the Rules of Procedure regarding holding technical discussions during Regional Committee meetings. This was covered by a resolution (WPR/RC3.Rl4) which had been adopted by the third session of the Regional Committee in September 1952. (The Regional Director read the resolution.) Provision had been made in each Regional Committee meeting to include Technical Discussions but Technical Discussions ~ ~ were not part of the Regional Committee.

144 RmIONAL COMMITl'EE: 'IWENTY-FIFlH SESSIOO

Dr ABDUL WAHAB ARIFF (Malaysia) sta1;ed that it h.:i been the traditional practioe to inolude Teohnioal Discussions dur1nc Regional Committee meetings. as in the World Health Assembly. Hi. delegation felt strongly that the practioe should be oontinued.

Dr TUAN (Republ1o of Viet-Nam) said that there was a dengue haemorrhagio fever problem in his oountry and his delegation h.:i oome to the meeting expeoting to have an exohange of i4eas and experienoe on the oontrol of the disease and its surveillanoe. He ... in favour of exchanging ideas and experienoe on relevant problems.

Dr HOWELIB (Australia) wished to olarify that he did not say there was no problem in dengue haemorrhagio fever •. He said that it should be disoussed by experts. not by the Colllll1ttee.

Dr LAIGRET (Franoe) suggested a oompromise: lnste.:i of Technioal Disoussions arrange tor a topio to be presented by one or two speoialists.

Dr PHOUTl'HASAK (Laos) oonsidered that, although they made the meeting longer, Teohnioal Disoussions were useful to representatives from developing oountries.

Dr THIEME (Western Samoa) stated that administratoR from small countries suoh as Western Samoa had to know how to deal with difterent problems; they oould not await the advice ,of experts who mi&}lt not be available in the area. '!he opportunity to gather more information while overseas was most weloome and the time spent for this purpose was oonsidered worthwhile. He supported the inolusion of the Technioal Disoussions in the Regional Committee meetings.

Dr NICHOISON (United Kingdom) felt that the business of the meeting could be oovered adequstely in one working week. He supported this. He oonsidered that there was something to be learned from the Technioal Disoussions and supported the suggestion of thaRepresentative of Franoe that they oould be oonduoted as a presentation. whioh would be open to questions, by one or two experts for the benefit of the adm1n!atrators.

Dr DIZON (Phil1ppines) conourred with the Representative of Franoe. In line with this. he suggested that "Control of tuberoulosis in the Western Paclfio Region" be the subjeot of the "briefing-orientation" at the next Regional COllllli ttee meeting. Tuberculosis oontinued to be a signifioant disease problem in the Region despite the tact that,there was already much information available about the epidemiologioal and other .. peots of the disease.

.1 ........ -

, ,

SUMMARY RECORD OF 'lEE FIF'lH MEETING 145

Dr DICKIE (New Zealand) said he would support teolmioal disoussions along the line suggested by the Represen1;ati ve of Franoe if at the same time the length of the meeting oould be kept to a week.

Dr LAIGRET (Franoe) envisaged a meeting oonsisting of the exposition of a subject by one or two experts, who would have previously oolleoted relevant data in the various oountries of the Region. Representatives could ask Questions or, should their experienoe warrant it, give their own views.

Dr KING (United states of Amerioa) said the Representative of France's proposal was an exoellent alternative whioh would permit Representatives to listen to a discussion that was of relevanoe on a teclmioal level to the Member countries and territories of the Region. He referred to the support by some Representatives of his proposal that the length of the Regional Committee meeting be kept to one week, commenc.ing on a Monday and ending on a Saturday. He enquired whether it would not be more appropriate to change the term "teohnioal dis­oussions" to "technical presentation".

Dr HOWELLS (Australia) reiterated that one week was adequate for the Regional Committee meeting. Although he was prepared to support the oompromise suggested by the Representative of Franoe, he had not ohanged his view that the teohnical discussions were a waste of time for senior health administrators such as himself.

The Representatives of Franoe, Malaysia and the Republio of Viet-Nam supported the proposal to limit the Regional Committee meeting to one week.

The REIHONAL DIRECTOR said there were two reasons for the two after­noons of free time during the present session. Firstly more disoussion had been antioipated on oertain items of the Agenda and seoondly time was needed for the Seoretariat to prepare the documentation reaul ting from discussions during the meeting. The burden fell partioularly heavily on the translators.

In 1975 it would be possible to complete the meeting in one week since now that the Organization had changed to biennial budgetting it would not be necessary to discuss the Programme and Budget in detail. In 1976, that is every other year, more discussion would be needed, but, if neoessary, evening sessions could be arranged.

It would be possible to arrange the type of teohnical presentation proposed by the Representative of France.

Dr THIEME (Western Samoa) reoalled that discussions during the plenary sessions used to take longer. The Committee might find itself in trouble if it shortened the session to one week.

146 RmIONAL COMMI'lTEE: 'NENTY-FIFTH SESSION

Dr LAIGRET (France) said that it wat(S striking to see how little discussion there had been on certain items. In his case, this was due to two factors: the documents had been late in reaching him; and laok of time and staff had made it impossible to read them as thoroughly as they deserved.

There being no further comments, the CHAIRMAN asked for suggestions on the topic for whatever type of technical disoussion would be held in 1975.

Dr HOWELL9 (Australia) stated that he would withdraw the suggestion of the Government of Australia (Dooument WPR/RC25/ll Add.l) in favour of the topic suggested by the Representative of the Philippines -"Control of Tuberoulosis in the Western Pacifio Region".

Dr VILAIHONGS (Laos) said he would like to maintain the topio initially suggested by Australia "The oommunity health oentre - a developing oonoept".

Dr LAIGRET (Franoe) said he would prefer "dental oare servioes" or "tuberoulosis". He oould make available experts on these subjeots with long experienoe in Frenoh Polynesia.

The CHAIRMAN oalled for a vote and then deolared that the topio for the technical presentation in 1975 would be "The oontrol of tuberoulosis in the Western Pacific Region".

The RmIONAL DIRECTOR asked who would be the expert for the technioal presentation. what its title would now be, how would the experts be seleoted and who would pay for those from outside the Region.

Dr DIZON (Philippines) suggested that an authority on the subJeot from within the Region be selected by the Regional Direetor.

Dr CHEN' (China) pointed out that teohnioal information should be accompanied by examples of how it was applied.

Dr DICKIE (New Zealand) suggested that oountdes with partioular problems in oonnexion with the topio seleoted should have them inoluded in the disoussion.

The REnIONAL DIRECTOR pointed out that technical orientation was a servioe provided to Member countries on request.

Dr LAIGltET (France) said that the experts should present a synthesis of the various aspeots of the question after having oolleoted information on the partioular problems in each country.

. ,

•

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SUMMARY REX:ORD OF THE FIFrH MEm'IID

Dr NOORDIN (Malaysia) said that "teohnical presentation" was preferable to the term "teohnioal orientation".

147

The REGIONAL DIREX:TOR said that if the Regional Comm1ttee approved of the expert who was to make the teohnical presentation visiting countries and territories in the Region, as suggested by the Representative of Franoe, authority would be needed to inolude in the Programme and Budget funds to meet the additional travel and salary expenses.

Dr DIZON (Philippines) suggested that there would be no need for the expert to visit countries in the Region if each oountry could brief him. In preference to an expert, he would like to have a panel dis­cussion. The members of the panel would be from countries where the topic to be considered either was, or had been, a problem.

The RmIONAL DIREX:TOR said that this suggested a seminar and questioned the desirability of conducting one at the Regional Committee meeting.

There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare appropriate resolutions. (For consideration of the draft resolutions, see the sixth meeting, sections 1.3 and 1.4.)

6 TIME AND PLACE OF '.mE TWENTY-SIXTH AND TWENTY-SEVEN'lH SESSIONS OF THE REGIONAL COMMI'lTEE: Item 20 of the Agenda

The REGIONAL DIRECTOR reminded the Cormnittee that at its twenty-fourth session in 1973, it had deoided that its twenty-sixth session would be held at regional headquarters in Manila (resolution WPRjRC24.R10). He suggested that the dates should be 1 to 6 September 1975. These early dates were neoessary because the Chinese interpreters were seconded from the United Nations and were due baok in New York for the General Assembly whioh oommenced around mid-September •

At its twenty-fourth session the Committee had also decided that it oould meet in another country if an invitation was extended by a Member State, it being understood that this would not happen in two oonseoutive years and that all other sessions would be held at the regional headquarters (WPRjRC24.R10).

He brought to the attention of the Committee resolution WPRjRC22.R17 which it adopted at its twenty-second session, in whioh it oalled "on each host government to provide the looal facilities and to pay'as much as possible of the additional expenses of meetings of the Regional Committee held on its territory, partioularly that part whioh oan be met in its national currency" •

148 RIDIONAL COMMITl'EE: 'lWENTY-FIFl'H SESSION

The RIDIONAL DIRECTCR stated that as yet no Government had extended an invitation for the twenty-seventh session of the Regional Committee. The Committee might wish to authorize him to aocept, on its behalf, any such invitation whioh might be extended, provided a satisfaotory agreement could be ooncluded between the Government and WHO. If he were to aocept such an invitation, he would inform All Member governments at the earliest possible date.

Dr OKAMOTO (Japan) said that the Government of Japan was considering inviting the Regional Committee to hold its twenty-seventh session in Tokyo in September 1976. Since for financial reasons he was unable to make a firm commitment, the invitation would be subject to confirmation before the end of 1975.

The CHAIRMAN, on behalf of the Committee, thanked the Representative of Japan tor his invitation. The twenty-sixth session would be held in Manila from 1 to 6 September 1975.

Dr PHOUTI'HASAK (Laos) recalled the flood that had occurred at the time of the Twenty-seoond session of the Regional Committee in Manila in 1971. He wondered whether it was appropriate to meet in September.

The REDIONAL DIRECTOR said that he oould not guarantee the weather, but since 1971 improvements to the- Regional Offioe building had been made to prevent further flooding. The weather in Manila during the past few days had been fine.

There being no further comments, the CHAIRMAN asked the Rapporteurs to prepare a sui table resolution. (For consideration of the draft resolution, see the sixth meeting, seotion.J,.5.)

7 ANNOUNCEMENT

The RIDIONAL DIRECTOR advised that the Sub-Committee on Progranme and Budget would meet on Saturday morning at 8.30 a.m. instead of 9.00 a.m.

The meeting rose at 11.25 a.m.

, .

•

1

SUMMARY RECORD OF THE SIXTH MEETING

Dewan Tunku Abdul Rahman, Kuala u.unpur Monday, 9 September 1974 at 10.45 a.m.

(WPR~C25/sa/6 )

CHAIRMAN: Tan sri Dato (Dr) Abdul Majid Bin Ismail (Malaysia)

CONTENTS

Consideration of draft resolutions ...... ,. .......... . 152

2 Consideration of the report presented by the Sub­Committee on Programme and Budget and the relevant resolutions •••••••••.••••...•.••••.••••••••••••••••• 15'

3 Armouncement. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 156

-149-

150 REnIONAL COMMITTEE: 'IWENTY-FIF'lR SESSION

Sixth Meeting'

Monday, 9 September 1974 at 10.45 a.m.

PRESENT

I. Representatives of Member states

AUSTRALIA

CHINA

FIJI

FRANCE

JAPAN

KHMER REPUBLIC

IAOS

MALAYSIA

PHILIPPINES

PORTUGAL

REPUBLIC OF KOREA

REPUBLIC OF VIET-NAM

SINGAPORE

Dr G. Howells Dr R. W. Cumming

Dr Chen Hai-feng Dr Sung Kan Mr L1 Ching Hsiu

Dr Peni Vuiyale

Dr J. Laigret

Dr R. Okamoto

Dr Nhonh Bun Yay pr Emmanuel Fernandez

Dr Phouy Phoutthasak Dr Ritthikay Vilaihongs

Tan Sri Dato (Dr) Abdul Majid bin Ismail Dr Raja Ahmad Noordin Mr Onn bin Kayat Dr Fang Ung Seng Dr Abdul Majid bin Tun Abdul Aziz Dr Tal Yen Hooi Dr G. V. Denis

Dr J. Dizon Dr D. Rivera

Dr Longuinhos Monteiro Xavier

Mr Hang Sirb Song

Dr Tran Quy Nhu Dr Pham Quang Tuan

Dr A. G. K. Chew Dr Ng Kwok Choy

l

SUMMARY RECORD OF THE SIXTH MEETING 151

UNITED KINGDOM Dr J. A. B. Nicholson

UNITED STATES OF AMERICA Dr J. C. King

WESTERN SAMOA Dr J. C. Thieme

II. Representative of Associate Member

PAPUA NEW GUINEA Dr A. Tarutia

III. Representatives of the other Inter-governmental Organizations

INTERNATIONAL COMMITI'EE OF MILITARY MEDICINE AND PHARMACY Colonel Dr D. A. Lopes, 100

IV. Representatives of Non-Governmental Organizations

INTERNATIONAL COMMITI'EE OF CA'lHOLIC NURSES Mrs M. A. La1

INTERNATIONAL COUNCIL OF NURSES

v. WHO Secretariat

SECRETARY

Miss Chong Ah Foo

Dr Francisco J. Dy

152 REDIONAL COMMI'l"l'EE: TWENTY-FIFlH SESSION

1 CONSIDERATION OF DRAFT RESOLUTIONS

The Committee oonsidered the following draft resolutions:

1.1 Infant nutrition and breast feediIl§ (Dooument WPRjRC25/1'1P /10)

Deoision: The draft resolution was adopted without oomment (see resolution WPRjRC25.R10).

1.2 Teohnioal oooperation apong developing oountries ( Dooument WPRjRC25/I'IP /11)

Dr CHEN (China) supported the adoption of the resolution. His delegation felt that the question of teohnioal oo-operation among developing oountries was a very important one. A number of oountries were still developing their national eoonomies and oonsolidating their national independenoe. Much oould be gained fran mutual exchanges of supplies and technioal information whioh would be benefioial in developing national health servioes.

Deoision: There being no further oomments. the draft resolution was adopted (see resolution WPR,tRC25.Rll).

1.3 Teohnioal presentation (Doouments WP.R,tRC25/I'IP/12 and WPRjRC25/I'IP/12 Rev.l)

Referring to paragraph l(a) of Dooument WP.R,tRC25/wp/12. whioh proposed that "The presentation should lead to practioal oonolusions easily applioable in the Region", the REDIONAL DIRECTOB said that one year it might be timely to choose a subjeot for the Teohnioal Presentation, for example the fUnotions of DNA or the metabolism of iodine, whioh might not lead to practioal oonclusions easily applioable to the Region. A revised draft resolution (Document WPR/RC25/I'IP/12 Rev.l) had therefore been prepared for the Committee's consideration Which Was less restrictive A

in the seleotion of subjects.

Referring to paragraph l(b) of Document WPR/RC25/I'IP/12, the REDIONAL DIRECTOR again pointed out that there might be a topio whioh would not require the expert who presented it to familiarize himself with the situation in the Region. Again a less restriotive text was presented in paragralil 1 (b) of Dooument WPR/RC25/WP /12 Rev.l. '!he appropriate instruotions oould be given to the Regional Direotor Mhen the subJeot for the Technioal Presentation was seleoted, one or two years in advanoe, and the experts ohosen through consultation between the Regional Direotor and the Chairman.

Dr NICHOUlON (United Kingdom) and Dr LAIGRET (Franoe) supported the text proposed in Dooument WPR/RC25/I'IP/12 Rev.l.

Deoisionl '!here being no further oOlllll8nta. the 1"evised draft resolution was adopted (see resolution WPR/RC25.R12).

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SUMMARY RECORD OF '!HE SIXTH MEETING l53

1.4 Topic of Technical Presentation in 1975 (Document WPR/RC25/wp/13)

Decision: The draft resolution was adopted without comment (see resolution WPR/RC25.Rl3).

1.5 Twenty-sixth and twenty-seventh sessions of the Regional Committee (Document WPR/RC25/wp/14)

Dr KING (United States of America) felt the limitation of the length of the Regional Committee meeting to one working week should be recorded. He proposed that a pre ambulatory sentence be added as follows:

"The Regional Committee,

"Having considered that a reasonable period of time necessary for the conduct of the Regional Committee meeting will be one week,".

Decision: The draft resolution WI!IS adopted I!IS amended (see resolution WPRjRC25.Rl4).

Dr OKAMOTO (Japan) said that every effort would be made to confirm the invitation to hold the twenty-seventh session in Japan.

2 CONSIDERATION OF 'mE REPORT PRESENTED BY THE SUB-COMMITl'EE ON PROORAMME AND BUOOET: Item 7.2 of the Agenda (Document WPR/Rc25/14)

The Committee considered and adopted this report without comment. It also considered the following draft resolutions submitted by the Sub-Committee on Programme and Budget:

2.1 Budget performance 1973 - Direct services to governments (Document WPR/RC25/wp/15)

Decision: The draft resolution WI!IS adopted without oomment (see resolution WPR/RC25.Rl5).

2.2 Modifications made to the 1974 and 1975 Programme and Budget Estimates (Dooument WPR/RC25/WP /16)

Decision: The draft resolution was adopted without comment (see resolution WPR/RC25.R16).

2.3 Proposed Programme and Budget Estimates for 1976 and 1977 (Document WPR/RC25/wp/17)

Dr KING (United States of America) drew attention to the faot that although many projeots throughout the world had been started with the

154 RBJIONAL COMMITl'EE: TWEN'lY-FIFm SESSION

initiative of WHO in the long run they were the responsibility of the host goverrunent. He suggested that operative paragra}il 4 be amended to rellld:

"REQUESTS the Regional Director:

(a) to assist goverrunents in developing and implementing new projects;

(b) to enoourage goverrunents to assume responsibility for ongoing projects whioh have passed the pilot stage;

(c) to transmit the proposals to the Director-General for consideration and inolusion in his proposed programme and budget estimates for 1976 and 1977."

Dr HOWELlS (Australia) supported the amendments suggested by the Representative of the United states of America.

The RBJIONAL DIRECTOR explained that the words "pilot stage" were not particularly applicable since there were no longer many WHO-assisted pilot projects. Perhaps the last two words of proposed paragraph 4(b) should be ohanged.

Dr NICHOISON (United Kingdom) proposed that the phrase be altered to "ongoing projects of proven feasib1lity".

Dr KING (United states of Amerioa) acoepted this proposal. He also agreed that the word "finanoial" be inserted between the words "assume" and "responsibil1 ty" in the same paragra}il.

Decision: 'lbe draft resolution was adopted as amended (see resolution WPRjRC25.R17).

Dr CHEN (China) stated that his delegation noted that the traitorous Lon Nol olique would be provided with servioes and assistance in the Programme and Budget Estimates for 1976 and 1977 of this Region. His delegation deemed it neoessary to point out that the trai toroue Lon Nol olique was but a handful of national scum which could by no means represent the Cambodian people and that its participation in the World Health Organization was utterly illegal. 'lbe provision of any assistance to Cambodia must be in consultation with the Royal Government of National Union of Cambodia, which was the sole legitimate government ot Cambodia. His delegation was resolutely opposed to providing any servioes and assistance to the traitorous Lon Nol clique.

At present, there existed two administrations in South Viet-Nam, namely, the Provisional Revolutionary Government of the Republic of South Viet-Nam and the Saigon authorities. The ProviSional Revolutionary

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Ir :..

SUMMARY RECORD OF THE SIXTH MEE.'l'ING 155

Government of the Republic of South Viet-Nam was the genuine representa­tive of the people of South Viet-Nam with regard to assistance to Viet-Nam through whatever means. Prior consultation must be held with and agreement must be sought from both the Government of the Democratic Republic of Viet-Nam and the two sides concerning South Viet-Nam. Under the present circumstances, his delegation held that it was not appropriate to provide any assistance unilaterally to the Saigon authorities.

Dr CHEN asked that his statement be fully recorded in the minutes of the meeting.

Dr YAY (Khmer Republic) said his statement at the first meeting remained valid. l Every man, whatever his politioal or religious conviotions, had a right to life and health. The Committee met precisely to help realize that objective. Anyone acting against it deserved only contempt and indifference.

Dr TRAN QUY NHU (Republic of Viet-Nam) referred to the tendentious remarks aimed at the Delegation of the Republic of Viet-Nam and wished to reply on its behalf. He was surpril!led that a certain Representative had attempted to demonstrate the authenticity of a so-called Provisional Revolutionary Government totally ignoring reality. It existed only as a ghost Government. It had no capital city, no territory and no people. It constituted the subversive element from the_~orth and, by spreading terror and death among the civilian population, had obstructed the application of the terms of the 1973 Peris Agreement. The only legitimate government was the Government of the Republic of Viet-Nam, with its population of 19 million. It was that Government and that people who, acting in self-defense, were fighting the subversive communist elements from the north without respite. Despite the 1973 Paris Agreement the aggression from the north was be80ming more and more flagrant. The Representatives of the Republic of Viet-Nam were convinoed that it could not endure. It would be overcome by the Vietnamese people and condemned by every nation in the world.

By its right of response the Delegation of the Republic of Viet-Nam wished to present the truth and to put an end to any confusion regarding the situation in the country due to insinuating propaganda.

2.4 Tentative projections for 1978 and 1979 (Document WPR/RC25/WP/18)

Decision: The draft resolution was adopted (see resolution WPR/ilic25 ~Bl8) •

1 . Document WPR/RC25/SR/l, page 71.

156 REnIONAL COMMITl'EE: 'IWEN'lY-FIFTH SESSION

3 ANNOUNCEMENT

The RIDIONAL DIRECTOR asked. if the COllln1ttee would be agreeable to reoonvening for 1ts f1nal plenary at 4.00 p.m. on 9 September to oons1der Items 21 and 22 of the Agenda.

It was so agreed..

The REnIONAL DIRECTOR went on to say that although the report of the Sub-Conm1ttee on Progranme and Budget had been attached as an annex to the. draft report of the Reg10nal Conm1ttee. to be oons1dered under Item 22 of the Agenda. the text would eventually be 1noorporated 1n the body of the COllln1 ttee 's f1nal report.

The meet1ng rose at 12.00 noon.

.'

(WPR/RC25/SR/7)

SUMMARY RECORD OF '!HE SEVEN'lH MEETING

Dewan Tunku Abdul Rahman, Kuala lumpur Monday, 9 September 1974 at 4.00 p.m.

CHAIRMAN: Tan Sri Dato (Dr) Abdul Majid bin Ismail (Malaysia)

CONTENTS

1 Consideration of the report presented by the Chairman of the Teohnical Discussions •••••••••••••••• 160

2 Adoption of the draft report of the Committee •••••••• 160

3 Resolution of appreciation •.•••..•••••••••.•••••••••• 160

4 AdJoUI'Illllent. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 161

-157-

158 REIJIONAL COMMITI'EE: TWENTY-FIFl'H SESSION

Seventh Meeting

Monday, 9 September 1974 at 4.00 p.m.

PRESENT

I. Representatives o~Member States

AUS'lRALIA

CHINA

FIJI

FRANCE

JAPAN

KHMER REPUBLIC

lAOS

MAlAYSIA

PHILIPPINES

PORTUGAL

REPUBLIC OF KOREA

Dr G. Howells Dr R. W. Cumming

Dr Chen Hai-feng Dr Sung Kan Mr Li Ching Hsiu

Dr Peni Vui;yale

Dr ,J. Laigret

Dr T. Takizawa Dr R. Okamoto

Dr Nhonh Bun Yay Dr Emmanuel Fernandez

Dr Phouy Phoutthasak Dr Ritthikay Vilaihongs

Tan Sri Dato (Dr) Abdul Majid bin Ismail Dr Raja Ahmad Noordin Mr Onn bin Kayat Dr Gurmukh Singh Mr Cheong Weng Hooi Dr Fang Ung Seng Dr Tal Yen Hooi Dr G. V. Denis

Dr J. Dizon Dr D. Rivera

Dr Longuinhos Monteiro Xavier

Mr Han Il Ree Mr Hang Sirb Song

~- .

, ,

, .(

SUMMARY RECORD OF THE SEVEN'rn MEETING

REPUBLIC OF VIET-NAM

SINGAPORE

UNITED KINGDOM

UNITED STATES OF AMERICA

WESTERN SAMOA

Dr Tran Q,uy Nhu Dr Pharo Quang Tuan Mr Nguyen-Viet-Danh

Dr A. G. K. Chew Dr Ng Kwok Choy

Dr J. A. B. Nicholson

Dr J. C. King Dr M. Kurnangai

Dr J. C. Thieme

II. Representative of Associate Member

PAPUA NEW GUINEA Dr A. Tarutia

159

III. Representatives of the other Inter-governmental Organizations

INTERNATIONAL COMMITTEE OF MILITARY MEDICINE AND PHARMACY Colonel Dr D. A. Lopes, KMN

IV. Representatives of Non-Governmental Organizations

INTERNATIONAL COMMITTEE OF CATHOLIC NURSES

INTERNATIONAL COUNCIL OF NURSES

V. WHO Secretariat

SECRETARY

Mrs M. A. La1

Miss Chong Ah Foo

Dr Francisco ,J. Dy

160 REGIONAL COMMITTEE: TWENTY-FIFTH SESSION

1 CONSIDERATION OF '!HE REPORT PRESENTED BY '!HE CHAIRMAN OF '!HE TECHNICAL DISCUSSIONS: Item 21 of the Agenda (Dooument WPR~C25/I'D8)

Mr CHEONG (Malaysia), Chairman of the Teohnioal DisoWlsiona, presented the report of the Technioal Disoussions on "Control of Veotor Mosquitoes of Dengue Haemorrhagio Fever" (Dooument WPR~C25jTD8). He took the opportunity to express his thanks to the partioipants, rapporteurs and ohairmen of the disoWlsion groups and to the rapporte\lI' and members of the Seoretariat for having made the disoussiona fruitfUl.

On behalf ot the Committee, the CHAIRMAN thanked the Chai:nnan of the Teohnioal Disoussions for his exoellent work and the partioipants, rapporteurs, ohairmen of disoussion groups and WHO Seoretariat for their part in produoing the report of the Teohnioal Disoussiona.

2 ADOPTION OF THE mAFT REPORT OF '!HE COMMIT'IEE: Item 22 of the Agenda (Document WPR~C25/l5)

The draft report of the twenty-fifth session of the Regional Committee for the Western Pacifio was presented to the Committee.

The RliDIONAL DIRECTOR drew attention to the fact that, in view of the modifioation made to the draft resolution on Teohnioal Presentation adopted during the sixth plenary session, Seotion 11 of the Committee's draft report would have to be revised. He hoped that the Committee would agree to leave the revision to the Seoretariat who would enaure that 1 t was in aooordance with the amendments approved.

There being no oomments, Dr HOWEI..!8 (Australia) moved. the adoption of the draft report, which was seconded by Dr RIVERA (Philippines).

Deoision: The draft report was adopted (see resolution WPR~C25.R19) •

3 RESOLUTION OF APPRECIATION

Dr 'mIEME (Western Samoa) presented a draft resolution of appreoiation.

Dr NICHOLSON (United Kingdom) and Dr PHOlJ'l'THASAK (IAos) supported the draft resolution.

Decision: The draft resolution WM unanimoualy adopted (see resolution WPR~C25.R20).

...

I _ .........

REDIONAL CtMtI'l'rEE: TWEN'l'Y-FIF'IH SESSION 161

4 ADJOURNMENT

In olosing, the CHAIRMAN expressed bis thanks to all those who had made the meeting a suooess; the Delegates, the Regional Director, the WHO Secretariat, espeoially the interpreters and translators, the looal Seoretariat involved, the Chairman of the Teclm1cal Discussions and bis team, as well as the Governmental agencies and departments that had oontributed in some way towarda the preparation and running of the meeting. He hoped that everyone had enjoyed their stay in Kuala Uuapur; aaaured them always of a warm welcome and wished them a sate journey home. He then deolared the twenty-fifth session of the Regional Committee olosed.

'!he meeting adjourned at 4.15 p.m.