for the Eastern Mediterranean ORGANISATION MONDIALE DE LA SANTE

WORLD HEALTH ORGANIZATION Regional Office

for the Eastern Mediterranean ORGANISATION MONDIALE DE LA SANTE

Bureau rigional de la Miditerranee orientale

REGIONAL COMMITTEE FOR THE EASTERN MEDITERRANEAN Thirty-fourth Session Agenda item 22(a)

EM/RC34/l9 JUne 1987

ORIGINAL: ENGLISH

WHO SPECIAL PROGRAMME OF RESEARCH, DEVELOPMENT AND RESEARCH TRAINING IN HUMAN REPRODUCTION

(1) The WHO Special Programme of Research, Development and Research Training in Human Reproduction (HRP). whict is managed from WHO Headquarters. with the collaboratior of the Regional Offices. will be discussed as an agenda item by the Eighty-first Session of the Executive Board in 1988. The programme would like to benefit from the views and experiences of countries of the Region in preparation for its presentation to the Board. The Programme is also in the process of developing a long- term lS-year plan and would welcome inputs and guidance from the Regional Committee.

A summary background information paper describes the programme's objectives. activities and new directions.

(11) The Regional Committee will also have to elect one country under category (B) of the Policy and coordination 1\dvisory committee (PCAC) for a three-year term

(1 January 1988 to 31 December 1990), to replace Tunisia whose term of office finishes on 31 December 1987.

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TABLE OF CONTENTS

OBJECTIVES

INTERNAL ORGANIZATION ADVISORY BODIES

FINANCES

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1. OBJECTIVES

EM/RC34/19 page I

The WHO special Programme of Research. Development and Research Training in Human Reproduction was established in 1972 as the main instrument within WHO and the United Nations system:

to promote. coordinate and support internationally-based research in human reproduction and family planning of special relevance to developing countries by: improving the performance of current methods of fertility regulation. development of new and improved methods for fertility regulation. and improving the prevention and management of infertility; and

to promote and support national self-reliance in research on fertility regulation in developing countries through institutional development and research training.

2. INTERNAL ORGANIZATION

The Programme is organized in four distinct but closely integrated

"areas": Research and Development. Resources for Research. Statistics and Data processing. and programme Management (see Fig.l).

The Research and Development Area is organized into eight Task Forces covering three main topics: improving the performance of current methods (two Task Forces: safety and Efficacy of Fertility Regulating Methods. and Behavioural and social Determinants of Fertility Regulation). development of new and improved methods of fertility regulation (five Task Forces: Long- acting systemic Agents for Fertility Regulation. Post-OVUlatory Methods for Fertility Regulation. Vaccines for Fertility Regulation. Methods for the Regulation of Male Fertility and Natural Methods for Fertility Regulation).

and Prevention and Management of Infertility (one Task Force). Task Forces are subject to periodic evaluation. Task Forces may be phased out and new Task Forces may be established.

The Resources for Research Area (grants for institution strengthening.

training grants and maintenance of a network of collaborating institutions).

is organized into regional programmes (Africa. China. Asia except China. and Latin America). I t also includes the Programme for Standards and Quality Control of Laboratory Procedures.

The statistics and Analysis Area provides statistical and data processing support for research projects undertaken by the Task Forces.

Activities include the statistical design of projects. project organization.

project data collection and processing. data monitoring and management. data analysis. and dissemination of research results. It also provides support to the Resources for Research Area in strengthening biostatistical.

epidemiological and data processing capabilities in developing countries. The long-term goal is that. while global multicentre projects will continue to be managed statistically from Geneva. individual centres in developing countries should in time assume full statistical responsibility for their own single- centre stUdies. as well as coordinating their national multicentre projects.

Some centres will be strengthened to playa sub-regional role.

The Programme Management Area provides managerial and administrative support to the Programme.

EMlRC34/19 page 2

FIGURE 1. WHO SPBCIAL PROGRAMI'IB OF RBSEARCH. DBVBLOPMBNT AND RBSEARCH TRAINNING IN HUMAN REPRODUCTION

DIRECTOR

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safety and efficacy Africa

Behavioural and Asia except China

social determinants China

Long-acting systemic agents Latin America Post-ovulatory methods

Vaccines Male methods

Natural methods PROGRAME FOR

Infertility

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CONTROL OF LABORATORY PROCEDURES

IlMIRc34/l9 page 3

The Statistics and Data Processing Area and the Programme Management Area report directly to the Director of the programme. The Research and Development Area and the Resources for Research Area report through the respective Responsible officers.

3. ADVISORY BODIES

To develop and maintain the highest possible standard for its activities, th Special Programme has established a system of Advisory Bodies for the range of its activities (see Fig.2).

Advisory bodies related to individual Programme components report to the Director of the Programme, and include:

Research and Development: Steering Committees for the eight Task Forces Review Group and Toxicology Group

Resources for Research: Committee on Resources for Research, Steering Committee of the Programme for Standards and Quality Control of Laboratory procedures.

The Scientific and Technical Advisory Group advises on the whole Programme and reports to the Director-General of WHO and to the Policy and coordination Advisory Committee.

The Policy and Coordination Advisory Committee acts as an advisory body to the Director-General of WHO.

The Policy and Coordination Advisory Committee (PCAC) has its own

procedures for the election of members, who are representatives of governments and agencies.

For all other Committees of the Programme, members are selected on the basis of scientific ad technical competence, serve in their own personal capacity and are appointed for fixed terms, eligible for renewal only once.

Effort is made to include female scientists, to ensure an adequate participation of developing country scientists, and to achieve a fair geographical representation. For 1987, Committee membership is as fOllows:

Total number of scientists 152

Total number of female scientists 40 (26%) Total number of developing country scientists 85 (56\)

Number of developed countries 18

Number of developing countries 33 (65\)

Scientists from AFRO 13

Scientists from AMRO 35

Scientists from EMRO 7

Scientists from EURO 50

Scientists from SEARO 20

Scientists from WPRO 27

Steering committees

Steering committees exist for all the eight Task Forces in Research and Development, and for the Programme of Standards and Quality Control of Laboratory ProcedUres.

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Steering Committees. which meet at least once a year. develop. implement and monitor the strategic plan. Each Committee is composed of 6 to 12 scientists who are appointed for a term of up to three years. Membership can be extended to a maximum of six continuous years.

To encourage collaboration. scientists with the required expertise from other programmes active in the field are invited to a special category of membership; the category of Collaborating programme Scientist.

Review Group

The Review Group provides technical assessment of research project proposals approved by Steering committees. including ethical review for projects involving human subjects. The Review Group may recommend approval.

approval after amendment. approval with clarification. deferment or disapproval.

The Review Group. which meets twice a year. is composed of 12-15 independent scientists who are not members of other committees or principal investigators in studies supported by the Programme. Members are appointed for a term of three years. renewable only once.

Toxicology Group

The Toxicology Group reviews projects involving the use of new drugs and devices. recommends appropriate toxicological studies to be carried out before clinical trials. and monitors the various stages of clinical research in the context of toxicological requirements. The Group may recommend changes in the research protocol. may disapprove initiation of clinical studies. or may recommend discontinuation of human research for a given drug.

The Toxicological Group. which meets twice a year. is composed of 6-12 independent scientists who are not members of other Committees or principal investigators in studies supported by the Programme. Members are appointed for a term of three years. renewable only once.

committee on Resources for Research

The Committee on Resources for Research plans. monitors and evaluates strategies for the stregthening of capabilities for research in human reproduction in developing countries. These include institutional grants.

training grants. support to the network of centres. and the Programme for Standards and Quality Control of Laboratory Procedures.

The Committee. which meets at least once a year. is composed of 12-15 independent scientists appointed for a term of three years. renewable only once. together with representatives from WHO Regional Offices and Collaborating Programmes.

Scientific and Technical Advisory Group (STAG)

The STAG reviews the content. scope and dimensions of the programme.

recommends priorities within the programme. and provides the Director-General and PCAC with a continuous and independent evaluation of the scientific and technical aspects of all the activities of the Programme.

EM/RC34/19 page 6

The STAG. which meets at least once a year. is comprised of 15-18 members who serve in their personal capacities to represent the broad range of biomedical and other disciplines required for the Programme's activities.

They cannot be members of other committees. principal investigators in studies undertaken by the Programme. or recipient of Special Programme FUnds.

Members are appointed to serve for a period of three years. and will be eligible for immediate reappointment only once.

scientific and Technical Review Committees (STRCs) are ad hoc committees established by STAG to review in-depth individual components of the Programme. Each component is normally subject to such a review every four years. The STRC is composed of two or three selected members of STAG and up to three external consultants.

Policy and COOrdination Advisory Committee (PCAC)

The PCAC acts as an advisory body to the Director-General of WHO. making recomlnendations on matters related to the policies. strategies. financing.

overall organization. management and impact of the Programme.

The PCAC. which meets once a year. is composed of four categories of membership; the 12 largest financial contributors; 12 countries elected by WHO Regional Committees; up to 3 interested countries and non-governmental agencies elected by PCAC; and 3 permanent members (United Nations Fund for Population Activities. World Bank. and International Planned Parenthood Federation).

4. FINANCES

The Programme is supported by voluntary contributions. Twenty-four financial contributors. including six developing countries. have provided funds to the Programme since 1971. In addition. institutions working with the Programme make counterpart contributions in the form of manpower and institutional infrastructure. Although such contributions cannot be quantified with precision. they are most certainly substantial. In some cases. they have been roughly estimated to be at least equal to the input made by the Programme.

As can be seen from Figure 3. income to the Programme increased steadily until 1980. with a maximum of US$19 million. From 1981 there was a steady decrease until 1984 when the income amounted to US$l2.5 million. From 1985.

income has increased again. reaching an estimated level of some US$2l million for 1987 (as calculated at the beginning of April 1987).

EM/RC34/19 page 7

programme expenditure by country

Region/Country

GEOGRAPHICAL BREAKDOWN OF OBLIGATIONS CUMULATIVE BUDGI!TS FROM 1972 TO CURRENT YEAR

Call figures expressed in US$

ColI. Other Task Small Research centres centres forces supplies training

Total

Eastern Mediterranean

Egypt 585 030 5000 413 933 7 785 572 287 1 584 035 Islamic Republic of Iran 143 850 55463 199 313

Iraq 7 937 7 937

Lebanon 1 350 1 350

Pakistan 259 849 90 550 246 670 36 775 158 202 792 046

Sudan 23 780 31 715 55495

Tunisia 861 513 2 250 50 210 913 973

844 879 957 063 830 483 45910 875 814 3 554 149

Institutions collaborating with the Special programme of Research.

Development and Research Training in Human Reproduction. by country Alexandria University. Alexandria

Assiut university. Assiut

American university in cairo. Cairo Drug Research and Control Centre. Cairo The Bgyptian Fertility Care society. Cairo Institute of National Planning. Cairo

Institute of Research for Tropical Medicine. Cairo.

Islamic Republic of Iran

Pakistan

Sudan

Tunisia

shiraz university. Teheran

university of Teheran. Faculty of Medicine. Teheran QUaid-i-Azam university. Islamabad

National Research Institute of Fertility Control. Karachi university of Karachi. Karachi.

university of Khartoum. Khartoum Ministry of Health. Khartoum

Office national du Planning familial et de la population.

Tunis

EMlRC34/l9 page 8

Institutions collaborating in Task Force projects, by country Oral contraceptives

Institute of Research for Tropical Medicine, Cairo Drug Research and Control Centre, cairo

Alexandria university, Alexandria Intrauterine devices for fertility regulation

Alexandria University, Alexandria Long-acting systemic agents for fertility regulation

Alexandria university, Alexandria Assiut University, Assiut

Islamic Republic of Iran

university of Teheran, Faculty of Medicine, Teheran

Pakistan National Research Institute of Fertility Control, Karachi Methods for the Natural Regulation of Fertility

Alexandria university, Alexandria Female sterilization

Assiut university, Assiut Methods for the regulation of male fertility

Assiut University, Assiut Islamic Republic of Iran

University of Teheran, Faculty of Medicine, Teheran Pakistan Quaid-i-Azam University, Islamabad

Psychosocial Research in Family Planning

American University in cairo, Cairo Alexandria University, Alexandria Islamic Republic of Iran

Pakistan

Shiraz University, Shiraz

National Research Institute of Fertility Control, Karachi University of Karachi, Karachi

Behavioural and social determinants of fertility regulation Assiut University, Assiut

The Egyptian Fertility Care Society, Cairo Institute of National Planning, Cairo

Pakistan

I!M/RC34/l9 page 9

National Research Institute of Fertility Control, Karachi·

university of Khartoum, Khartoum safety and efficacy of fertility-regulating methods

Assiut university, Assiut Prevention and management of infertility

Pakistan National Research Institute of Fertility Control, Karachi Sudan Ministry of Health, Khartoum

Post-ovulatory methods of fertility regulation

Tunisia office national du Planning familial et de la Population, Tunis

Institutions receiving funds from resources for research Department of Obstetrics and Gynaecoloqy university of Alexandria

Alexandria

Pakistan Department of Biological Sciences Quaid-i-Azam University

Tunisia

Islamabad

National Research Institute of Fertility control Karachi

Aga Khan university Medical College Karachi

Centre for Research in Human Reproduction Tunis

Research Training Grants awarded in the I!astern Mediterranean Region

I!qypt 58

Islamic Republic of Iran 4

Iraq 1

Pakistan 12

Sudan 9

Tunisia ~

Total number of

grants for I!MR 92

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country Egypt

Kuwait Sudan Tunisia

EGYPT

EM/RC34119 page 10

SCIENTISTS FROM EMRO

PARTICIPATING IN THE PROGRAMME COMMITTEES

Name Sex Conmittee Start End

E l-Boro 11 osy , Dr A.W. M Toxicology group 1987 1989 Gadalla, Dr S. M Behavioural and social 1985 1987 Shaaban, Dr M. M Safety and efficacy 1987 1988

Toppozada, Dr M. M STAG 1986 1989

Hathout, Dr H. ^PI CRR 1987 1989

Rushwan, Or H. ^H lnferti 1 ity 1987 1989 Ladjimi, Dr A. M Infertil ity 1986 1988

EMRO PAST COMMITTEE MEMBERS

FATHALLA, Dr M. PI Review Group

Female sterilization STAG

HASSOUNA, Dr W. M Advisory Group TDPPDZADA, Dr M. M Long-acting agents

Prostaglandins

DMRAN, Dr A. M Service and psychosocial HAMIW1, Dr H. M Service research

RIZK HASSAN, Dr F. M Service research SHAASAN, Dr H. M Oral contraceptives ISLAMIC REPUBLIC OF IRAN NAHAPETIAN, Dr V. M Service research

MEHRYAR, Dr A. M Psychosocial

PAKISTAN QAZI, Dr M. M Advisory Group

Review Group CRR

KHAN, Dr T. F Long-acting agents ARSLAN, Dr M. M Male methods TUNISIA BOUKHRIS, Dr R. M long-acting agents

CHARFEDDINE, Dr M. ^PI Service research

GUEDRI, Dr H. M Standardization and quality BENZINA BEN CHEIK, Dr T. F Sequelae of abortion

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