W O R L D H E A L T H ORGANIZATION
ORGANISATION M O N D I A L E D E LA SANTÉ
E B 6 1 / 2 6
6 O c t o b e r 1 9 7 7 INDEXED E X E C U T I V E B O A R D
S i x t y - f i r s t S e s s i o n
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A P P R O P R I A T E T E C H N O L O G Y F O R H E A L T H R e p o r t b y the D i r e c t o r - G e n e r a l
In a c c o r d a n c e w i t h r e s o l u t i o n W H A 2 9 . 7 4 , ! a p r o g r a m m e o n a p p r o p r i a t e t e c h n o l o g y for h e a l t h h a s b e e n e s t a b l i s h e d b y the
D i r e c t o r - G e n e r a l . This p a p e r p r e s e n t s a n o v e r a l l v i e w of the p r e s e n t s i t u a t i o n w i t h r e g a r d t o r e l e v a n t t e c h n o l o g i e s , e s p e c i a l l y i n t h e c o n t e x t of p r i m a r y h e a l t h care in d e v e l o p i n g c o u n t r i e s . T h e a c t i v i - ties c a r r i e d o u t i n this p r o g r a m m e a r e a i n 1 9 7 7 , i n p r e p a r a t i o n f o r the d e v e l o p m e n t o f a g l o b a l p l a n of a c t i o n for t h e p e r i o d 1 9 7 8 to 1 9 8 3 , a r e d e s c r i b e d , A s u g g e s t e d r e s o l u t i o n i s a t t a c h e d .
I . I N T R O D U C T I O N
1 . F o l l o w i n g t h e p r e s e n t a t i o n of a r e p o r t 011 " H e a l t h t e c h n o l o g y r e l a t i n g to p r i m a r y h e a l t h care a n d r u r a l d e v e l o p m e n t " (document A 2 9 / 2 3 ) to the T w e n t y - n i n t h W o r l d H e a l t h A s s e m b l y i n M a y 1 9 7 6 , r e s o l u t i o n W H A 2 9 . 7 4 w a s a d o p t e d w h i c h r e q u e s t e d t h e D i r e c t o r - G e n e r a l to take a d e q u a t e m e a s u r e s to e s t a b l i s h a n d d e v e l o p a p r o g r a m m e of h e a l t h t e c h n o l o g y r e l a t i n g t o p r i m a r y h e a l t h c a r e a n d r u r a l d e v e l o p m e n t •
2 . This p r e s e n t d o c u m e n t shows t h e a i m s a n d p u r p o s e of t h e W H O progrannne of a p p r o p r i a t e t e c h n o l o g y for h e a l t h ( A T H ) , a n d b r i e f l y o u t l i n e s i t s a c t i v i t i e s s i n c e i t s e s t a b l i s h m e n t i n J a n u a r y 1977， i n a c c o r d a n c e w i t h t h e a b o v e - m e n t i o n e d r e s o l u t i o n .
3 . P r i m a r y h e a l t h c a r e n e e d s to b e e f f e c t e d w i t h i n the f r a m e w o r k of c o m m u n i t y d e v e l o p m e n t , p a r t i c u l a r l y in r u r a l a r e a s a n d u r b a n f r i n g e s , w i t h a c t i v e c o m m u n i t y p a r t i c i p a t i o n a n d w i t h p a r a l l e l d e v e l o p m e n t o f t e c h n o l o g i e s s u i t a b l e t o the r e a l n e e d s a n d s c a r c e r e s o u r c e s i n d e v e l o p i n g c o u n t r i e s . F i n a n c i a l r e s o u r c e s i n t h e s e c o u n t r i e s a r e n o t s u f f i c i e n t t o a l l o w total p o p u l a t i o n c o v e r a g e b y the c o n v e n t i o n a l h e a l t h t e c h n o l o g y w h i c h h a s b e e n d e v e l o p e d i n a d v a n c e d i n d u s t r i a l i z e d c o u n t r i e s . T h e a i m s of the W H O p r o g r a m m e a r e to p r o m o t e a n d d e v e l o p h e a l t h t e c h n o l o g i e s a p p r o p r i a t e to the n e e d s a n d r e s o u r c e s of a l l c o u n t r i e s , e s p e c i a l l y
d e v e l o p i n g o n e s , t o r e d u c e the d e p e n d e n c e of t h e s e c o u n t r i e s o n i m p o r t e d a n d / o r i n a p p r o p r i a t e t e c h n o l o g i e s , a n d to e n s u r e that t h e y b e c o m e s e l f - r e l i a n t a n d s e l f - s u f f i c i e n t in this d o m a i n . 4 . The p a p e r p r e s e n t e d to t h e W o r l d H e a l t h A s s e m b l y i n 1 9 7 6 d e f i n e d h e a l t h t e c h n o l o g y a n d d e s c r i b e d its q u a l i t i e s . T h e w o r d " a p p r o p r i a t e " w h i c h q u a l i f i e s h e a l t h t e c h n o l o g y i n t h e title of the p r o g r a m m e , w a s n o t s e l e c t e d h a p h a z a r d l y . It i n d i c a t e s t h a t o n l y t h e e s s e n t i a l q u a l i t i e s o f t e c h n o l o g i e s s h o u l d b e r e t a i n e d t h a t a r e s u i t e d in a l l r e s p e c t s to t h e l o c a l c o n d i t i o n s i n w h i c h t h e y w i l l b e u s e d . This a p p l i e s e q u a l l y to t h e i n d u s t r i a l i z e d a n d the d e v e l o p i n g c o u n t r i e s .
1 W H O O f f i c i a l R e c o r d s , N o . 2 3 3 , 1 9 7 6 , p . 4 9 .
E B 6 1 / 27 p a g e 2
I I . T H E P R E S E N T S I T U A T I O N
5 . I n the c o n t e x t of p r i m a r y h e a l t h c a r e , d e v e l o p i n g c o u n t r i e s s h o u l d b e d e e p l y c o n c e r n e d a b o u t the t e c h n i q u e s to b e u s e d , a s , i n t h e s e c o u n t r i e s , g r a v e i m b a l a n c e s e x i s t b e t w e e n the n e e d s o n the one h a n d , and the a v a i l a b i l i t y of r e s o u r c e s and the c a p a c i t y of s e r v i c e s to m e e t t h e m o n the o t h e r .
6 . D e v e l o p i n g c o u n t r i e s are c h a r a c t e r i z e d b y the f o l l o w i n g : (a) a l a r g e l y r u r a l p o p u l a t i o n；
(b) a h i g h p r e v a l e n c e of i l l n e s s and e a r l y d e a t h a n d a p a u c i t y of p r i m a r y care
o r g a n i z a t i o n a n d s e r v i c e s (in p a r t i c u l a r , a n i n f r a s t r u c t u r e to p r o v i d e c a r e a t v i l l a g e / c o m m u n i t y level)； and f i n a l l y
( c ) a s c a r c i t y of s k i l l e d m a n p o w e r a n d f i n a n c i a l r e s o u r c e s .
7 . I t is t y p i c a l for the l i m i t e d f i n a n c i a l r e s o u r c e s to b e used for the c i t y and the l a r g e t o w n , a n d w i t h i n u r b a n a r e a s for the m o s t c o m p l e x l e v e l of c a r e . H o s p i t a l s and m e d i c a l c e n t r e s , w h i c h tend to c a r e for the few w h o live c l o s e s t , are f i r s t in l i n e , w h i l e the p r i m a r y l e v e l f r o m the r e m o t e s t v i l l a g e to the l a r g e r h e a l t h c e n t r e s , is f i n a n c i a l l y d e p r i v e d ,
u n d e r d e v e l o p e d and n e g l e c t e d .
8 . This a l s o a p p l i e s to a c e r t a i n e x t e n t to some p a r t s of d e v e l o p e d c o u n t r i e s , such as u r b a n f r i n g e a r e a s and s l u m s a n d e x t r e m e l y r e m o t e p a r t s of the c o u n t r y .
9 . I n the d e v e l o p i n g w o r l d , t e c h n o l o g i e s u s e d in the d e v e l o p e d w o r l d h a v e u s u a l l y b e e n
" i m p o r t e d " w i t h o u t a d a p t a t i o n to p r e v a i l i n g c o n d i t i o n s . The f a c t that a m o n g the b e n e f i c i a r i e s a p r i v i l e g e d m i n o r i t y a r e in some w a y s l i v i n g in a s i m i l a r s i t u a t i o n to t h o s e in d e v e l o p e d c o u n t r i e s has r e i n f o r c e d this c o n d i t i o n .
1 0 . The t e c h n o l o g y p r o d u c e d a n d used in d e v e l o p e d c o u n t r i e s is b a s e d o n c a p i t a l - i n t e n s i v e t e c h n i q u e s a n d on the u s e of h i g h l y t r a i n e d and s p e c i a l i z e d h u m a n r e s o u r c e s . I t is t h e r e f o r e a n e x p e n s i v e c o m m o d i t y , a n d o f t e n i l l - a d a p t e d to the r e a l n e e d s a n d e c o n o m i c p o t e n t i a l of the c o m m u n i t y i t s e r v e s . T e c h n o l o g y in d e v e l o p i n g c o u n t r i e s , b y c o n t r a s t , s h o u l d b e b a s e d for the m o s t p a r t on l a b o u r - i n t e n s i v e t e c h n i q u e s so as to m a k e the m o s t e f f e c t i v e u s e of the m a n p o w e r a v a i l a b l e . O n l y s c a t t e r e d i n f o r m a t i o n on t e c h n o l o g i e s e x i s t s , the c o n t e n t and v a l u e
of w h i c h d e p e n d s u p o n the s o c i o e c o n o m i c , c u l t u r a l and p o l i t i c a l c o n d i t i o n s p r e v a i l i n g and the d e g r e e of e c o n o m i c g r o w t h a n d / o r d e v e l o p m e n t . It is i n ç o r t a n t that i n d i g e n o u s k n o w l e d g e and e x p e r i e n c e , n o t a l w a y s a c c e p t e d as s c i e n t i f i c b u t e x i s t i n g in n a t i o n a l and l o c a l c u l t u r e s , s h o u l d n o t b e d i s r e g a r d e d . The r e a l s o l u t i o n for d e v e l o p i n g c o u n t r i e s is for t e c h n o l o g i e s to b e f e a s i b l e , e f f e c t i v e a n d a p p r o p r i a t e to the c o n d i t i o n s in w h i c h t h e y w i l l b e a p p l i e d . This n o t o n l y e n t a i l s a p r o c e s s of a d a p t a t i o n a n d d e v e l o p m e n t b u t a l s o the p r o d u c t i o n o f t e c h n o l o g i e s w h i c h b l e n d i n d i g e n o u s k n o w l e d g e a n d e x p e r i e n c e w i t h the k n o w l e d g e a v a i l a b l e f r o m the m o r e d e v e l o p e d c o u n t r i e s .
1 1 . H e a l t h and m e d i c a l t e c h n o l o g y m u s t b e c o m e m o r e a c c e s s i b l e and u n d e r s t a n d a b l e to those o u t s i d e t h e t r a d i t i o n a l m e d i c a l e s t a b l i s h m e n t . E x i s t i n g h e a l t h t e c h n o l o g i e s n e e d to b e a d a p t e d , a n d m a d e m o r e e a s i l y a p p l i c a b l e to c o n d i t i o n s a p p r o p r i a t e to e a c h c o u n t r y , and their u s e s i m p l i f i e d . This p r o c e s s of a d a p t a t i o n w i l l offer o p p o r t u n i t i e s for a p p l i e d r e s e a r c h , a n d w i l l lead to a m o r e a d e q u a t e d i s t r i b u t i o n of a v a i l a b l e r e s o u r c e s .
1 2 . A m o r e b a l a n c e d use of a v a i l a b l e r e s o u r c e s to m e e t h e a l t h n e e d s at the p r i m a r y l e v e l of d e v e l o p i n g c o u n t r i e s r e q u i r e s that e a c h a c t i o n t a k e n r e a l i z e s its f u l l p o t e n t i a l for e f f e c t i v e - n e s s - t h a t it c a n b e a f f o r d e d , is u s a b l e u n d e r the c i r c u m s t a n c e s and a c c e p t a b l e to the
p e o p l e , a n d that the m e t h o d s , t e c h n i q u e s , i n s t r u m e n t s a n d s u p p l i e s a l s o m e e t these c o n d i t i o n s . C o v e r a g e c a n then b e e x t e n d e d to g r e a t e r n u m b e r s of p e o p l e . In a d d i t i o n , t h o s e w o r k i n g a t the v i l l a g e l e v e l , w h o h a v e o n l y h a d b a s i c t r a i n i n g and w h o a r e i n a d e q u a t e l y s u p e r v i s e d , w i l l b e a b l e to w o r k m o r e e a s i l y , e f f e c t i v e l y and s a f e l y .
EB61/27 page 3 I I I . OBJECTIVES OF THE PROGRAMME OF APPROPRIATE TECHNOLOGY FOR HEALTH
13. The ultimate goal of the development of appropriate technology is to promote national self-reliance in problem-solving in primary health care d e l i v e r y , to reduce the existing dependence on the industrialized countries for technological support, and to produce solutions that will be adaptable t o , and feasible i n , local country situations.
14. W H O1 s Sixth General Programme of Work considers the promotion of the development of appropriate technology for health one of its principal objectives； that i s , to promote the development of standard health technologies. This principal objective is broken down into m o r e detailed objectives:
(a) to promote and support the development of standardized health technologies； and (b) to collaborate w i t h countries in the development and adaptation of simple, low-cost and effective technologies in specific areas.
These objectives are expressed in a more specific w a y for the purpose of the ATH programme as follows :
(i) to promote and support the development of appropriate technologies for h e a l t h , which includes the collection and dissemination of information on existing and newly-developed technologies；
(ii) to collaborate w i t h countries and appropriate technology groups, institutions, and organizations in the development, a d a p t a t i o n , testing and application of simple, low-cost and effective technologies in specific health areas ；
(iii) to promote and develop the preparation of comprehensive lists of equipment and supplies for peripheral health services covering g e n e r a l , diagnostic, p r e v e n t i v e , therapeutic and rehabilitative activities. As soon as p r a c t i c a b l e , these activities will be extended to higher levels of health care delivery.
IV. PROGRESS REPORT ON ACTIVITIES CARRIED O U T IN 1976/l977
15. As a first step towards the implementation of the mandate given b y the resolution mentioned p r e v i o u s l y , the Director-General formed a working group to:
(a) prepare a draft programme statement ；
(b) o b t a i n , from colleagues throughout the Organization, a list of already identified needs for technologies to be developed and adapted ； and
(c) arrange a consultation in Geneva w i t h appropriate technology groups and interested agencies of the United Nations system.
16. The programme statement, used as a background paper for the consultation held in 1 ^ January 1977 and revised as a result of the discussions, describes the general concept and scope of appropriate technology for h e a l t h , attempts to define W H O1 s role in promoting i t , and outlines the future programme of w o r k . As stated, the s c o p e , priorities and boundaries of the programme were r e v i s e d , after which the consultation recommended various activities for 1977 ,2 the planning year. During this year a foundation was to be laid for a longer-term programme which was to be defined during a second consultation, with broader country representation, to be held in New Delhi in December 1977 (see paragraph 24 below).
1 АТн/77.1 (The World Health Organization's Role in Promoting Appropriate Technology for Health).
2 АТн/77.2 (Report of a Consultation on Appropriate Technology for H e a l t h , G e n e v a , 5-7 January 1977).
E B ó l / 2 7 p a g e 4
1 7 . T h e p r e l i m i n a r y l i s t of r e c o g n i z e d n e e d s , d r a w n up w i t h i n W H O , w a s s t u d i e d i n d e p t h b y t h e c o n s u l t a t i o n w h i c h r e c o m m e n d e d t h a t a c a r e f u l l y e d i t e d l i s t s t a t i n g p r i o r i t i e s s h o u l d b e p r e p a r e d d u r i n g 1 9 7 7 .
1 8。 A n u m b e r of s t e p s w e r e i m m e d i a t e l y t a k e n in l i n e w i t h t h e c o n s u l t a t i o n1 s r e c o m m e n d a t i o n s . T h e f i r s t s t e p w a s t o e n s u r e t h a t the c o n c e p t a n d b o u n d a r i e s of t h e p r o g r a m m e w e r e f u l l y u n d e r - s t o o d b o t h w i t h i n a n d o u t s i d e W H O . T h i s i n c l u d e d t h e d e f i n i t i o n o f t h e g l o b a l f u n c t i o n s o f t h e p r o g r a m m e , t o g e t h e r w i t h t h e r e s p e c t i v e r o l e s a n d r e s p o n s i b i l i t i e s o f a l l W H O e c h e l o n s . A t h e a d q u a r t e r s l e v e l a p r o g r a m m e a r e a f o r a p p r o p r i a t e t e c h n o l o g y f o r h e a l t h w a s e s t a b l i s h e d w i t h i n t h e D i v i s i o n of S t r e n g t h e n i n g o f H e a l t h S e r v i c e s , a n d a n I n t e r d i v i s i o n a l C o o r d i n a t i n g C o m m i t t e e , c o m p r i s i n g r e p r e s e n t a t i v e s f r o m a l l t h e i n t e r e s t e d p r o g r a m m e a r e a s , w a s s e t up b y t h e D i r e c t o r - G e n e r a l о A t t h e s a m e t i m e , the r e g i o n a l d i r e c t o r s d e s i g n a t e d f o c a l p o i n t s f o r t h i s p r o g r a m m e i n t h e i r r e g i o n s to a l l o w m u t u a l d i s c u s s i o n s t o t a k e p l a c e . A s u m m a r y o f t h e p r o g r a m m e s t a t e m e n t in t h e f o r m of a n i l l u s t r a t e d b r o c h u r e w a s p r e p a r e d a n d w i d e l y d i s s e m i n a t e d i n o r d e r t o c l a r i f y t h e p u r p o s e of t h e p r o g r a m m e t o t h e p u b l i c . S e v e r a l o t h e r s t e p s t o
p r o m o t e t h e p r o g r a m m e w e r e t a k e n l a t e r i n 1 9 7 7 , e . g . a r t i c l e s p r e p a r e d f o r t h e W H O C h r o n i c l e a n d W o r l d H e a l t h , a d i s p l a y p a c k a g e a s s e m b l e d f o r t h e r e g i o n s , a p h o t o g r a p h i c l i b r a r y b u i l t , a n d t e l e v i s i o n a n d r a d i o p r o g r a m m e s b r o a d c a s t o n t h e s u b j e c t .
1 9 . I t w a s o b v i o u s f r o m the o u t s e t t h a t t h e b u i l d i n g up of a n i n f o r m a t i o n s e r v i c e o n A T H w o u l d c o n s t i t u t e a n i m p o r t a n t p a r t of t h e p r o g r a m m e . I t w a s e s s e n t i a l t o o b t a i n d a t a o n a l r e a d y - e x i s t i n g t e c h n o l o g y s o t h a t i t s v a l u e c o u l d b e a s s e s s e d , a n d i t s e v e n t u a l t r a n s f e r t o o t h e r s i t u a t i o n s , a f t e r a d e q u a t e a d a p t a t i o n a n d p o s s i b l e i m p r o v e m e n t , s t u d i e d . S u c h a n
e n d e a v o u r h a d to i n v o l v e n o t o n l y a l l p a r t s of W H O , i n p a r t i c u l a r f i e l d s t a f f , b u t a l s o a l l the i n t e r e s t e d i n d i v i d u a l s , g r o u p s , i n s t i t u t i o n s a n d o t h e r a g e n c i e s o f the U n i t e d N a t i o n s s y s t e m。 A s p a r t of a c o n t r a c t u a l a g r e e m e n t c o n c l u d e d w i t h t h e A p p r o p r i a t e H e a l t h R e s o u r c e s a n d
T e c h n o l o g i e s A c t i o n G r o u p ( A H R T A G - U K ) i n L o n d o n , a c l e a r i n g h o u s e w a s e s t a b l i s h e d t o e x p l o r e t h e n e e d s for i n f o r m a t i o n s e r v i c e s , i d e n t i f y g r o u p s a n d i n s t i t u t i o n s c a p a b l e of t a k i n g t h e r e s p o n s i b i l i t y for m e e t i n g t h e s e n e e d s , a n d d e v e l o p a s y s t e m f o r i n f o r m a t i o n d i s s e m i n a t i o n。 A r e p o r t o n t h i s a c t i v i t y w i l l b e m a d e b y A H R T A G - U K a t the c o n s u l t a t i o n i n D e c e m b e r 1 9 7 7 a n d t h e i m p l e m e n t a t i o n o f a n i n f o r m a t i o n s y s t e m o n a p p r o p r i a t e t e c h n o l o g y f o r h e a l t h d i s c u s s e d . 2 0 . A l t h o u g h the p r o g r a m m e w a s m a i n l y f o c u s i n g o n p r i m a r y h e a l t h c a r e a n d d e v e l o p m e n t a t t h e c o m m u n i t y l e v e l , it w a s e v i d e n t t h a t p r i o r i t i e s f o r a c t i o n w e r e r e q u i r e d . I n c o m p l i a n c e w i t h t h e J a n u a r y c o n s u l t a t i o n1 s r e c o m m e n d a t i o n s a b o u t t h e l i s t o f n e e d s ( s e e p a r a g r a p h 1 7)，a n d a f t e r d i s c u s s i o n s w i t h t h e r e g i o n s , t h e l i s t w a s c i r c u l a t e d as a g u i d e l i n e to a l l t h e M e m b e r S t a t e s , t h r o u g h t h e W H O r e p r e s e n t a t i v e s , to a s s i s t t h e m in s p e c i f y i n g t h e i r o w n r e q u i r e m e n t s t o w h i c h t h e y w e r e a s k e d to s e t a n o r d e r o f p r i o r i t y . T h i s w i l l e n a b l e t h e d e v e l o p m e n t o f r e g i o n a l a n d g l o b a l p r i o r i t i e s , t h u s g i v i n g t h e p r o g r a m m e a d i r e c t i o n t o w a r d s r e l e v a n t a n d n e e d e d a c t i v i t i e s .
2 1 . T h e u l t i m a t e a i m of t h e p r o g r a m m e is t o a c h i e v e n a t i o n a l s e l f - s u f f i c i e n c y i n p r o b l e m - s o l v i n g i n t h e h e a l t h f i e l d。 T o r e a c h s u c h a g o a l , i t is of p a r a m o u n t i m p o r t a n c e , f i r s t , t o i d e n t i f y i n s t i t u t i o n s , g r o u p s a n d i n d i v i d u a l s , p a r t i c u l a r l y i n d e v e l o p i n g c o u n t r i e s , w i t h a n i n t e r e s t i n a p p r o p r i a t e t e c h n o l o g y a n d t h e c a p a c i t y to s u p p o r t t h e h e a l t h s e c t o r ； the s e c o n d s t e p i s t o e n c o u r a g e t h e m t o s h a r e or t a k e r e s p o n s i b i l i t y f o r e x p l o r i n g c e r t a i n n e e d s for t e c h n o l o g y , g i v i n g t h e m the m e a n s to d o s o b y b u i l d i n g up t h e i r m a n p o w e r a n d i n s t i t u t i o n a l f a c i l i t i e s。 T h e c o n t r a c t u a l a g r e e m e n t w i t h A H R T A G - U K p r o v i d e d t h e i n i t i a t i o n of r e s e a r c h i n t o c e r t a i n t e c h n o l o g i c a l n e e d s s u c h a s v i l l a g e o b s t e t r i c s , o r a l e l e c t r o l y t e s f o r r e h y d r a t i o n , v i t a m i n A d e f i c i e n c y a n d a n a e m i a s c r e e n i n g a t the p e r i p h e r y , a n d s o m e a s p e c t s o f i m m u n i z a t i o n t e c h n o l o g i e s , i n p a r t i c u l a r the c o l d c h a i n . T h i s a g r e e m e n t w a s m a d e s o t h a t a c t i v i t i e s c o u l d b e s t a r t e d i m m e d i a t e l y . H o w e v e r , t h e m a i n s t r e s s is p l a c e d o n p r o d u c t i o n w i t h i n t h e c o u n t r i e s u s i n g l o c a l e x p e r t i s e a n d m a t e r i a l . D u r i n g 1 9 7 7 , a g l o b a l e f f o r t , i n v o l v i n g n o t o n l y W H O b u t a l s o o t h e r a g e n c i e s o f t h e U n i t e d N a t i o n s s y s t e m a n d n o n g o v e r n m e n t a l g r o u p s , r e s u l t e d i n t h e e s t a b l i s h m e n t of a l i s t o f c e n t r e s a n d i n s t i t u t i o n s i n v o l v e d i n t h e d e v e l o p m e n t of h e a l t h a n d h e a l t h - r e l a t e d t e c h n o l o g i e s t o b e d i s c u s s e d d u r i n g t h e D e c e m b e r c o n s u l t a t i o n w i t h the a i m o f c r e a t i n g a w o r l d n e t w o r k o f c o l l a b o r a t i n g A T H c e n t r e s .
EB61/27 p a g e 5 2 2 . The s e c o n d h a l f of 1977 saw p r e l i m i n a r y n e g o t i a t i o n s for c o u n t r y a c t i v i t i e s . T h e s e i n c l u d e :
(i) p l a n n i n g for i n t e r c o u n t r y w o r k s h o p s i n 1978 ；
(ii) the s e t t i n g up of s t u d y a r e a s to e x p l o r e the p r o c e s s e s i n v o l v e d in p r o b l e m i d e n t i f i c a t i o n and the d e s i g n i n g a n d field t e s t i n g of t e c h n o l o g i e s ；
(iii) the s t u d y of p r o b l e m s r e l a t e d to the a c c e p t a n c e of t e c h n o l o g i e s a n d t h e i r p r o d u c t i o n , m a r k e t i n g and e v a l u a t i o n； and
(iv) the s e t t i n g up of r e s e a r c h a c t i v i t i e s in w e l l - d e f i n e d a r e a s .
2 30 In 1 9 7 5 , as p a r t of the a c t i v i t i e s of the D i v i s i o n of S t r e n g t h e n i n g of H e a l t h S e r v i c e s , a d o c u m e n t e n t i t l e d "WHO P r o v i s i o n a l R e f e r e n c e L i s t s of E q u i p m e n t a n d S u p p l i e s for P e r i p h e r a l H e a l t h S e r v i c e s " w a s p r o d u c e d Д A s a c o m p l e m e n t to this d o c u m e n t it w a s felt that a n i n d e x of t r e a t m e n t s for the m o s t c o m m o n d i s e a s e s in d e v e l o p i n g c o u n t r i e s w o u l d b e of u s e , a n d w o u l d c o n t r i b u t e to s u p p o r t i n g h e a l t h w o r k e r s a t d i f f e r e n t l e v e l s of c o m p e t e n c e in the d e l i v e r y of h e a l t h c a r ee W i t h the p a r t i c i p a t i o n of a l l the t e c h n i c a l p r o g r a m m e a r e a s , this w o r k w a s i n i t i a t e d i n 1 9 7 7 . I n a d d i t i o n , a n d a l s o as a c o m p l e m e n t to the a b o v e - m e n t i o n e d r e f e r e n c e l i s t s , it w a s t h o u g h t a d v i s a b l e to p r e p a r e a list of h e a l t h l a b o r a t o r y f a c i l i t i e s for p r i m a r y level h o s p i t a l s • This c a t e g o r y of h o s p i t a l is o r g a n i z e d f o r , or d e a l s w i t h , m a j o r h e a l t h p r o b l e m s a n d is used a s a r e f e r r a l c e n t r e for p e r i p h e r a l h e a l t h s e r v i c e s . This l i s t , c o m p i l e d
in c o l l a b o r a t i o n w i t h the H e a l t h L a b o r a t o r y T e c h n o l o g y u n i t a n d the r e g i o n s , w i l l s h o r t l y b e a v a i l a b l e for d i s t r i b u t i o n .
2 4# As r e c o m m e n d e d b y the c o n s u l t a t i o n held in J a n u a r y 1977， a f u r t h e r c o n s u l t a t i o n , w i t h r e p r e s e n t a t i o n from the r e g i o n s , has b e e n c o n v e n e d f r o m 5 - 8 D e c e m b e r 1977 in N e w D e l h i , I n d i a , w i t h the p u r p o s e of:
(a) r e v i e w i n g a c t i v i t i e s c a r r i e d o u t in 1977 s i n c e the p r e v i o u s c o n s u l t a t i o n o n a p p r o p r i a t e t e c h n o l o g y for h e a l t h held in J a n u a r y 1977；
(b) d i s c u s s i n g a n d r e v i e w i n g the c l e a r i n g h o u s e a n d i n f o r m a t i o n n e t w o r k a c t i v i t y b e i n g c a r r i e d out b y A H R T A G - U K ;
(c) e s t a b l i s h i n g p r i o r i t i e s for r e s e a r c h a c t i v i t i e s b a s e d on a n a l y s i s of c o u n t r y s t a t e m e n t s ；
(d) r e v i e w i n g the l i s t of i n s t i t u t i o n s i d e n t i f i e d , and d i s c u s s i n g the d e v e l o p m e n t of a n e t w o r k ；
(e) f o r m u l a t i n g a d r a f t g l o b a l p l a n of a c t i o n for a p p r o p r i a t e t e c h n o l o g y for h e a l t h . 2 5。 A u s e f u l c o n t r i b u t i o n to the D e c e m b e r c o n s u l t a t i o n w i l l c o m e f r o m a r e g i o n a l m e e t i n g in N o v e m b e r in A l e x a n d r i a , w h e r e the first s t e p s in the d e v e l o p m e n t of a r e g i o n a l p r o g r a m m e o n a p p r o p r i a t e t e c h n o l o g y w i l l b e u n d e r t a k e n。
2 6 . A v e r b a l r e p o r t on the D e c e m b e r c o n s u l t a t i o n w i l l be p r e s e n t e d to the E x e c u t i v e B o a r d . The focus w i l l b e e s p e c i a l l y on i t e m ( e ) , as the r e s u l t of this c o n s u l t a t i o n w i l l b e a p r e l i m i n a r y g l o b a l p l a n of a c t i o n for the p e r i o d 1978 to 1 9 8 3 .
S H S / 7 5 . 2 .
E B 6 1 / 27 p a g e 6 A N N E X
D R A F T R E S O L U T I O N
S i x t y - f i r s t S e s s i o n E B 6 l / 2 6 J a n u a r y 1978
A P P R O P R I A T E T E C H N O L O G Y F O R H E A L T H
The E x e c u t i v e B o a r d ,
H a v i n g c o n s i d e r e d the r e p o r t of the D i r e c t o r - G e n e r a l on a c t i v i t i e s in the new p r o g r a m m e of a p p r o p r i a t e t e c h n o l o g y for h e a l t h , p u r s u a n t to r e s o l u t i o n WHA29.74；
1 . N O T E S w i t h s a t i s f a c t i o n the steps taken b y the D i r e c t o r - G e n e r a l during 1977 to e s t a b l i s h the b a s i s for the d e v e l o p m e n t of a p r o g r a m m e of h e a l t h technology；
2 . R E C O G N I Z E S that the s u c c e s s of the p r o g r a m m e w i l l b e d e p e n d e n t o n the a c t i v e i n v o l v e m e n t of a l l M e m b e r States； a n d a c c o r d i n g l y
3 . R E Q U E S T S the D i r e c t o r - G e n e r a l :
(1) to t r a n s m i t his r e p o r t to the T h i r t y - f i r s t World H e a l t h A s s e m b l y t o g e t h e r w i t h the c o m m e n t s of the E x e c u t i v e B o a r d and a r e p o r t on d e v e l o p m e n t s s u b s e q u e n t to the C o n s u l t a t i o n on A p p r o p r i a t e T e c h n o l o g y for H e a l t h , held in N e w D e l h i f r o m 5 - 8 D e c e m b e r 1977 ； and
(2) to i n t e n s i f y h i s e f f o r t s to p r o m o t e the a c t i v e i n v o l v e m e n t of M e m b e r States in the f u r t h e r d e v e l o p m e n t and i m p l e m e n t a t i o n of the p r o g r a m m e。
