W O R L D H E A L T H O R G A N I Z A T I O N
O R G A N I S A T I O N M O N D I A L E D E L A S A N T É
EB43/4
3 J a n u a r y 1 9 6 9
INDEXED
E X E C U T I V E B O A R D
R E G I O N A L C O M M I T T E E F O R E U R O P E R e p o r t o n t h e E i g h t e e n t h S e s s i o n
T h e D i r e c t o r - G e n e r a l h a s t h e h o n o u r t o p r e s e n t t o t h e E x e c u t i v e B o a r d t h e r e p o r t o n t h e e i g h t e e n t h s e s s i o n o f t h e R e g i o n a l C o m m i t t e e f o r E u r o p e .1
1 D o c u m e n t E U R / R C 1 8 / 1 9 R e v . l
EB4j/4
WORLD HEALTH ORGANIZATION
В С Е М И Р Н А Я О Р Г А Н И З А Ц И Я З Д Р А В О О Х Р А Н Е Н И Я
R E G I O N A L C O M M I T T E E FOR E U R O P E C O M I T E R E G I O N A L DE L ' E U R O P E
Е В Р О П Е Й С К И Й Р Е Г И О Н А Л Ь Н Ы Й К О М И Т Е Т ANNEX
ORGANISATION MONDIALE DE LA SANTE
Eighteenth Session EÜR/RC18/19 Rev.l Varna. 24-28 September 1968 2 2 October 1 9 6 8
REPORT OF THE EIGHTEENTH SESSION OF THE REGIONAL COMMITTEE FOR EUROPE
Contents
EâBÊ.
INTRODUCTION ) PART 工
Report of the Regional Director 8 PART I I
Matters arising out of decisions of the World Health Assembly and
of the Executive Board 12 Matters arising out of decisions of the Regional Committee at its
seventeenth session 13 Accommodation for the Regional Office and place of Regional
Committee sessions 16 Technical máttérs
The public health uses of electronic computers 17 The prevalence of phenylketonuria in the European Region 17
Fatal home accidents in Europe l8
Technical discussions 18 Technical discussions at future sessions of the Regional Committee . . 19
Date and place of regular sessions of the Regional CcMnmittee in
1969 and 197O 19 Other business 19
E U R / R C 1 8 / 1 9 R e v . l page 2
Раде P A R T I I I
P r o p o s e d p r o g r a m m e a n d b u d g e t e s t i m a t e s for 197〇 19 P A R T I V - R e s o l u t i o n s
E U R / R C 1 8 / R 1 R e p o r t of the R e g i o n a l D i r e c t o r 2 1
E U R / R C 1 8 / R 2 N o i s e c o n t r o l 22 E U R / R C 1 8 / R 5 M a t t e r s a r i s i n g o u t of d e c i s i o n s of the W o r l d H e a l t h
A s s e m b l y a n d of the E x e c u t i v e B o a r d 22
EUR/SC18/R4 C a r d i o v a s c u l a r d i s e a s e s 2 J EUR/RC18/ÏÎ5 L o n g - t e r m p l a n n i n g a n d evaluation 2 3
E U R / R C l 8 / R o I n t e r - r e g i o n a l p r o j e c t s financed from the U n i t e d
N a t i o n s D e v e l o p m e n t P r o g r a m m e 25
E U R / R C 1 8 / R 7 B i e n n i a l p r o g r a m m i n g 25 E U R / R C 1 8 / R 8 P r o p o s e d p r o g r a m m e a n d b u d g e t e s t i m a t e s for 1970 26
E U R / R C 1 8 / R 9 T h e w o r k of the I n t e r n a t i o n a l A g e n c y for R e s e a r c h on C a n c e r in the E u r o p e a n R e g i o n a n d collaboration
. b e t w e e n the A g e n c y and the R e g i o n a l Office for E u r o p e . . 27
E U R / R C 1 8 / R 1 0 T h e p u b l i c h e a l t h u s e s of electronic computers 2了 E U R / R C 1 8 / R 1 1 T h e p r e v a l e n c e of p h e n y l k e t o n u r i a in the E u r o p e a n
R e g i o n 28 E U R / R C 1 8 / R 1 2 T e c h n i c a l d i s c u s s i o n s a t future sessions 28
E U R / R C 1 8 / R 1 5 Date a n d place of r e g u l a r sessions of the R e g i o n a l
C o m m i t t e e in 1 9 6 9 and 1 9 7 0 28 E U R / R C 1 8 / R 1 4 A c c o m m o d a t i o n f o r the R e g i o n a l Office - Site of
R e g i o a a l Committee m e e t i n g s 2 9 A N N E X E S
I A g e n d a
I I L i s t of r e p r e s e n t a t i v e s a n d other p a r t i c i p a n t s 32
I I I S u m m a r y r e p o r t of t e c h n i c a l d i s c u s s i o n s 40 I V A d d r e s s b y S i r M a x R o s e n h e i m in commemoration of the T w e n t i e t h
A n n i v e r s a r y of the W o r l d H e a l t h Organization 斗4
EUR / R C 1 8 / 1 9 R e v . l page 3
INTRODUCTION
The eighteenth session of the Regional Committee ( B u l g a r i a ) from 2 4 to 2 8 September 1 9 6 8 .
The following Member States were r e p r e s e n t e d :
for Europe was h e l d a t Varna
A l g e r i a A u s t r i a B e l g i u m B u l g a r i a
C z e c h o s l o v a k i a D e n m a r k
F e d e r a l R e p u b l i c of G e r m a n y F i n l a n d
F r a n c e
G r e e c e . H u n g a r y
I r e l a n d I t a l y L u x e m b o u r g M a l t a M o n a c o M o r o c c o N e t h e r l a n d s P o l a n d P o r t u g a l
R o m a n i a S p a i n S w e d e n S w i t z e r l a n d T u r k e y
U n i o n o f S o v i e t
S o c i a l i s t R e p u b l i c s
U n i t e d K i n g d o m o f G r e a t B r i t a i n a n d N o r t h e r n I r e l a n d
Y u g o s l a v i a
Representatives a l s o attended from the United Nations Development Programme, the Council of Europe, the I n t e r n a t i o n a l C h i l d r e n ' s Centre, the I n t e r n a t i o n a l Commit- tee of Catholic Nurses, the I n t e r n a t i o n a l Dental F e d e r a t i o n , the I n t e r n a t i onal Federa- t i o n of Gynaecology and O b s t e t r i c s , the I n t e r n a t i o n a l Union of A r c h i t e c t s , the League of Red Cross S o c i e t i e s and the Medical Women1s I n t e r n a t i o n a l A s s o c i a t i o n .
Opening the session as out-going Vice-Chairman, Professor R . Vannvigll pointed out that i t coincided w i t h the twentieth anniversary of WHO. The presence of Mr G9 T r a j k o v , Chairman of the Presidium of the B u l g a r i a n National Assembly, was evidence of the interest the Government of B u l g a r i a took i n the work of the World Health Organization and i t s Regional Committee for Europe. He thanked the Director- General, the Regional Director and the S e c r e t a r i a t as a whole for the v a l u a b l e work they had done during the past y e a r , and greeted h i s colleagues and the r e p r e s e n t a t i v e s of United N a t i o n s , intergovernmental and non-governmental o r g a n i z a t i o n s • He empha- s i z e d the instructive value of holding the Corranittee1s sessions i n various countries of the Region, and wished the Committee success i n i t s work.
Address by Mr G , Tra.lkov，Chairman of the Presidium of the Bulgarian N a t i o n a l Assembly
Mr Trajkov welcomed the Regional Committee to B u l g a r i a and r e f e r r e d to the bene- f i c i a l and valuable work done by the Organizaticm. He emphasized that i n t e r n a t i o n a l collaboration through WHO provided s p l e n d i d opportunities f o r the exchange of knowledge and experience i n the f i e l d of medicine and p u b l i c h e a l t h . R e f e r r i n g t o progress
E U R / R C 1 8 / 1 9 R e v . l p a g e 4
in B u l g a r i a in i m p r o v i n g the h e a l t h of the p e o p l e , M r T r a j k o v said that, t o g e t h e r w i t h t h e p r o g r e s s m a d e in o t h e r c o u n t r i e s of the E u r o p e a n Region, it offered a p o s i - t i v e e x a m p l e f o r t h e w o r l d a n d p a r t i c u l a r l y for d e v e l o p i n g countries. In conclusion h e w i s h e d t h e r e p r e s e n t a t i v e s on the R e g i o n a l Committee r e w a r d i n g w o r k a n d a pleasant s t a y a t V a r n a .
A d d r e s s by t h e D i r e c t o r - G e n e r a l
D r C a n d a u , n o t i n g t h e i m p o r t a n c e the w o r k o f t h e W o r l d H e a l t h O r g a n i z a t i o n a n d E u r o p e w i t h i t s h i g h l e v e l of d e v e l o p m e n t
hospitable h o s t G o v e r n m e n t a t t a c h e d t o the to i n t e r n a t i o n a l c o l l a b o r a t i o n , said t h a t h a d a very important role t o p l a y in the p r o g r e s s o f o t h e r regions• R a p i d a d v a n c e s h a d taken place in science a n d technology o v e r t h e p a s t 2 0 y e a r s , w h i c h c r e a t e d a n e e d f o r the constant a c q u i s i t i o n of new k n o w l e d g e t o p e n e t r a t e t h e s e c r e t s of n a t u r e t h r o u g h r e s e a r c h a n d to a p p l y the a c - q u i r e d k n o w l e d g e f o r t h e c o m m o n g o o d , A solution of h e a l t h p r o b l e m s called f o r a s p e c i a l e c o l o g i c a l a p p r o a c h in w h i c h man w a s v i e w e d a s p a r t of an " e c o - s y s t e m " , in- s e p a r a b l e f r o m h i s e n v i r o n m e n t . T h e p h y s i c i a n of t o d a y u n d e r s t o o d t h a t medicine w a s n o t o n l y a b i o l o g i c a l , b u t a l s o a s o c i a l science a n d that, in p r a c t i c e , s o c i a l reme- d i e s m i g h t be c h e a p e r a n d m o r e effective than b i o l o g i c a l remedies•
In t h e l i g h t of t h i s , m e d i c a l e d u c a t i o n w o u l d h a v e to change r a d i c a l l y , f i r s t in t h e d e v e l o p i n g countries• H o w e v e r , those c h a n g e s w o u l d certainly have f a r - r e a c h i n g r e p e r c u s s i o n s i n t h e m o r e d e v e l o p e d c o u n t r i e s . In conclusion, D r Candau e x p r e s s e d t h e h o p e t h a t in f u t u r e y e a r s c o - o p e r a t i o n b e t w e e n the countries w o u l d b r i n g a b o u t a p e r i o d in w h i c h t h e h o p e s t h e p e o p l e s h a d p l a c e d in the O r g a n i z a t i o n ' s destiny w o u l d be j u s t i f i e d .
A d d r e s s b y t h e R e g i o n a l D i r e c t o r
T h e R e g i o n a l D i r e c t o r e x p r e s s e d h i s a p p r e c i a t i o n of the h o n o u r a c c o r d e d to the R e g i o n a l C o m m i t t e e b y the p r e s e n c e of M r T r a j k o v , Chairman of the P r e s i d i u m of the B u l g a r i a n N a t i o n a l A s s e m b l y , a n d D r K i r i l Ignatov, M i n i s t e r of H e a l t h of B u l g a r i a . H e a l s o w e l c o m e d t h e p r e s e n c e of D r C a n d a u , the Director-General, w h o , b e s i d e s being a l e a d e r in w o r l d h e a l t h , w a s a r e n o w n e d e x p o n e n t of international peace a n d u n d e r - s t a n d i n g . H e t h e n g r e e t e d S i r M a x R o s e n h e i m , M r s B e g g and Dr v a n de Calseyde, w h o w e r e a t t e n d i n g a s g u e s t s in c o n n e x i o n w i t h the commemorative session to mark the t w e n t i e t h a n n i v e r s a r y of the W o r l d H e a l t h O r g a n i z a t i o n . S p e c i a l t h a n k s w e r e due to
EUR/ÍIC18/19 R e v . l page 5
the Government of B u l g a r i a , which had made great progress in the f i e l d of public health, for i t s invitation to hold the eighteenth session at Varna, and f o r i t s hospi- t a l i t y , In conclusion, he expressed the conviction that the Committee^ eighteenth session would contribute to the strengthening of peaceful international r e l a t i o n s i n Europe.
Election of officers
The Committee elected the following officers :
Professor J . Oszacki (Poland) was nominated Chairman of the technical d i s c u s s i o n s . In accordance with paragraph ；5, a r t i c l e 12 of the Committee's Rules of Procedure, the order in which the Vice-Chairmen should be consulted in case of need was determined by lot as： Dr Ammundsen, Dr Parádi•
The Chairman thanked the representatives for the honour accorded him by h i s elec- tion and expressed h i s appreciation of Dr Candau1s participation i n the eighteenth session of the Committee. He also welcomed Dr Lataillade on h i s f i r s t attendance at the Committee in h i s capacity as Director of Health Services, and thanked
Dr van de Calseyde and Mrs Begg for t h e i r attendance at the session.
Adoption of the agenda and programme of work
The agenda and i t s supplementary item (EUR/RCl8/l R e v . l ) and the programme of work were adopted•
Statement by the Director-General
The Director-General noted that the Regional Committee's agenda provided evidence of the level of s c i e n t i f i c development in the European Region, The pioneer role of Europe in the solution of health problems v/ould be of great value to other regions•
Emphasizing that many countries, even in Europe, were s t i l l facing major h e a l t h prob- lems, he pointed out that public health administrators were applying economics,
Dr V . Kalajd2iev (Bulgaria) Dr Esther Ammundsen (Denmark) Dr L . Parádi (Hungary)
Dr 0 . áSepin (USSR)
Dr J u r . J . de Coninck (Belgium)
Chairman Vice-Chairman Vice-Chairman Rapporteur Rapporteur
sociology and ecology to their solution as well as the latest findings of mathematical
E U R / R C 1 8 / 1 9 R e v . l
p a g e 1869
a n d o p e r a t i o n a l r e s e a r c h . Man w a s a n inseparable p a r t of an e c o l o g i c a l system a n d m a n y c u r r e n t p a t h o l o g i c a l s t a t e s w e r e due to h i s failure to u n d e r s t a n d a n d manage t h e o f t e n h o s t i l e f o r c e s in h i s e n v i r o n m e n t . 、
I m p r o v e m e n t s in h u m a n h e a l t h w e r e c o n t i n g e n t u p o n economic development, to w h i c h p r e v e n t i v e m e d i c i n e could make a s u b s t a n t i a l contribution. A m o n g other e x - t r e m e l y u r g e n t c u r r e n t p r o b l e m s , t h e D i r e c t o r - G e n e r a l r e f e r r e d to u r b a n i z a t i o n a n d t h e n e e d f o r r a d i c a l c h a n g e s in m e d i c a l e d u c a t i o n . The p h y s i c i a n should be t r a i n e d i n a n e n v i r o n m e n t a s s i m i l a r a s p o s s i b l e to t h a t in w h i c h he w o u l d eventually w o r k . U n d e r g r a d u a t e t r a i n i n g s h o u l d be c a r r i e d out in large specialized centres in the f i e l d . In p o s t g r a d u a t e t r a i n i n g , c o u n t r i e s w i t h w e l l - d e v e l o p e d m e d i c a l education f a c i l i t i e s w o u l d a l w a y s h a v e an i m p o r t a n t role to p l a y . In conclusion, h e stressed t h e i m p o r t a n c e of a t e a m a p p r o a c h t o h e a l t h p r o b l e m s .
S t a t e m e n t b y r e p r e s e n t a t i v e s of a g e n c i e s of the U n i t e d N a t i o n s f a m i l y a n d other i n t e r n a t i o n a l o r g a n i z a t i o n s
Ilr W . M i cuta., r e p r e s e n t i n g the U n i t e d N a t i o n s a n d UNDP in E u r o p e , said t h a t the U n i t e d N a t i o n s w a s w o r k i n g in close c o l l a b o r a t i o n w i t h the s p e c i a l i z e d a g e n c i e s w i t h a viev/ t o i m p r o v i n g the s o c i a l a n d economic situation in a l l c o u n t r i e s . U N D P funds v/ere f a c i l i t a t i n g t h a t . E a c h c o u n t r y c o u l d give a i d to others a n d a t the same time,
i f n e c e s s a r y , a l s o r e q u e s t h e l p i t s e l f . H e r e f e r r e d to U N D P1 s f r u i t f u l collabora- t i o n w i t h W H O a n d t h e B u l g a r i a n G o v e r n m e n t in d e v e l o p i n g the C e n t r a l Institute of P u b l i c H e a l t h a t S o f i a .
M r J , M . N e w t o n , r e p r e s e n t a t i v e of the I n t e r n a t i o n a l D e n t a l Federation^ said t h a t h i s o r g a n i z a t i o n w o u l d a l w a y s r e g a r d collaboration w i t h the W o r l d H e a l t h Organization a s a m o s t i m p o r t a n t a s p e c t of its w o r k .
M r II. P f e f f e r m a n n ^ r e p r e s e n t i n g the C o u n c i l of E u r o p e , p o i n t e d o u t t h a t relations b e t w e e n h i s o r g a n i z a t i o n a n d the W H O R e g i o n a l Office for E u r o p e h a d b e e n d e a l t w i t h i n t h e R e g i o n a l D i r e c t o r!s r e p o r t . A s e x a m p l e s , h e m e n t i o n e d v a r i o u s a s p e c t s of the w o r k of t h e b l o o d t r a n s f u s i o n service a n d of the use of b l o o d d e r i v a t i v e s u n d e r the a u s p i c e s of t h e C o u n c i l of E u r o p e . H e e m p h a s i z e d t h a t a l l countries in the E u r o p e a n R e g i o n c o u l d，b y a p p r o p r i a t e a g r e e m e n t , make use of those services. T o develop the
s e r v i c e f u r t h e r , c o u r s e s t o train s p e c i a l s t a f f were b e i n g o r g a n i z e d . The C o u n c i l w a s a l s o i n t e r e s t e d in the p r e v e n t i o n of r o a d accidents> n o i s e c o n t r o l a n d standards o f h y g i e n e in t h e c o n s e r v a t i o n of f o o d p r o d u c t s . In those matters^ f u r t h e r co- o r d i n a t i o n of e f f o r t w i t h t h e W H O R e g i o n a l Office for Europe w a s e s s e n t i a l .
E U R / R C 1 8 / 1 9 R e v . l page 7
0 . S t o i l o v , representative of the International Union of A r c h i t e c t s , was grateful for the opportunity to attend the Regional C o m m i t t e e e i g h t e e n t h s e s s i o n . The Organization1s efforts to improve environmental health were f u l l y supported by the International Union of A r c h i t e c t s . I n h i s view, mutual understanding between public health workers and architects was essential i f problems of disease prevention were to be solved. Similar understanding between architects and doctors was also of value in the construction of various s p e c i a l i z e d i n s t i t u t i o n s .
Miss L . Charles-Roques, representing the International Committee of Catholic Nurses, said that her organization was working extensively on the t r a i n i n g of nurses and was being assisted by the World Health Organization.
Dr E . Berthet, observer from the Io^ernation^l C h i l d r e n ' s Centre, referring, to the f r u i t f u l collaboration between the ICC and WHO in the t r a i n i n g of s t a f f f o r child care, said that the purpose of the Centre1 s training programme was not only the reduction of infant morbidity and mortality, but also the t r a i n i n g of children for l i f e . Commenting on the concern in the United Nations and among governments over the shortage of q u a l i f i e d s t a f f in a l l medical, educational and social special- t i e s , he s a i d that since the ICC had been set up much of i t s work had been devoted to the education and further education of professional workers concerned with the welfare of children and young people in d i f f e r e n t parts of the world. I t s prog- ramroes f o r training medico-social s t a f f were mainly directed towards the preventive, educational, social and economic aspects of child w e l f a r e . International t r a i n i n g always involved numerous d i f f i c u l t i e s , among which should b e m e n t i o n e d three of the most important : differences i n the level of t r a i n i n g , attainment and professional experience of the students； the need for the curriculum content to be balanced between the different medical, psychological and socio-economic aspects of the train- i n g ; and the need to adapt the training to students 1 requirements. I n conclusion, he said that the I C C ' s work could not be e f f e c t i v e without further co-operation with WHO, the Regional O f f i c e for Europe and governments.
Mr G . Gospodinov, representative of the League of Red Cross S o c i e t i e s , said that h i s organization1 s co-operation with WHO went back a long way and was equally useful for a l l the governments of the countries they served. The League had found participation of i t s representatives i n various symposia, conferences, working groups
EUR/ÍIC18/19 R e v . l p a g e 8
a n d o t h e r a c t i v i t i e s r u n b y W H O , e x c e p t i o n a l l y h e l p f u l . League v o l u n t e e r s p l a y e d a v e r y b i g p a r t in t h e p r o t e c t i o n of the h e a l t h of p e o p l e in a l l c o u n t r i e s , thus f a c i l i t a t i n g t h e w o r k of the W o r l d H e a l t h O r g a n i z a t i o n . .
T h e R e g i o n a l D i r e c t o r , t h a n k i n g the r e p r e s e n t a t i v e s of the v a r i o u s organizations, s t a t e d t h a t W H O H e a d q u a r t e r s w a s s p e c i a l l y s t u d y i n g the p o s s i b i l i t y of co-ordinating t h e w o r k of W H O a n d t h e n o n - g o v e r n m e n t a l o r g a n i z a t i o n s more e f f e c t i v e l y .
C o m m e m o r a t i o n of t h e t w e n t i e t h a n n i v e r s a r y of the W o r l d H e a l t h O r g a n i z a t i o n
A s p e c i a l c o m m e m o r a t i v e m e e t i n g to m a r k the t w e n t i e t h a n n i v e r s a r y of the W o r l d H e a l t h O r g a n i z a t i o n w a s h e l d on 2 4 S e p t e m b e r a t the Community C u l t u r a l C e n t r e , V a r n a . T h e m e e t i n g v/as o p e n e d b y t h e Chairman of the R e g i o n a l Committee^ D r K a l a j d 2 i e v , a n d a n a d d r e s s on H e a l t h in the W o r l d of T o m o r r o w v/as given by S i r M a x R o s e n h e i m , P r o f e s s o r of M e d i c i n e in U n i v e r s i t y College H o s p i t a l Medical-School> London• Also p r e s e n t a s g u e s t s of t h e R e g i o n a l C o m m i t t e e vrere Firs B e g g a n d Dr v a n de Calseyde> who l a t e r a d d r e s s e d t h e C o m m i t t e e on b o h a l f of M r s B e g g a n d himself.
P A R T 工
R e p o r t of the R e g i o n a l D i r e c t o r (EUR/RC18/2)
I n h i s r e p o r t , t h e R e g i o n a l D i r e c t o r r e f e r r e d to some, h i s t o r i c a l h i g h l i g h t s in t h e d e v e l o p m e n t of t h e R e g i o n a l O f f i c e for E u r o p e . The successes achieved, h a d been d u e t o f r u i t f u l c o l l a b o r a t i o n w i t h the g o v e r n m e n t s of M e m b e r States^ n o n - g o v e r n m e n t a l o r g a n i z a t i o n s a n d i n s t i t u t i o n s concerned to improve and maintain h e a l t h . He w a s c o n f i d e n t s u c h c o l l a b o r a t i o n w o u l d continue•
T h e O f f i c e h a d c o n t i n u e d to study p r o b l e m s of outstanding public h e a l t h importance in t h e R e g i o n , a n d h e h o p e d t h a t l o n g - t e r m planning coupled w i t h c o n t i n u o u s evaluation w o u l d l e a d t o t h e i r m o r e effective s o l u t i o n .
T u r n i n g t o m e d i c a l e d u c a t i o n , the R e g i o n a l D i r e c t o r stressed that, while tradi- t i o n a l f o r m s of t e a c h i n g largely p e r s i s t e d , m a n y countries h a d begun t o s e a r c h for
m o r e a d v a n c e d t r a i n i n g m e t h o d s w h i c h w o u l d m o r e fully satisfy g r o w i n g n e e d s . A t t e m p t s w e r e a l s o b e i n g m a d e to d e v e l o p the links' b e t w e e n m e d i c a l t e a c h i n g centres a n d m e d i c a l c a r e a n d w e l f a r e services• T h a t t r e n d w o u l d strengthen contact b e t w e e n c l i n i c a l s p e c i a l i s t s a n d p u b l i c h e a l t h w o r k e r s .
E U R / R C 1 8 / 1 9 R e v . l p a g e 9
T h e R e g i o n a l O f f i c e w o u l d be p l a y i n g a n i n c r e a s i n g l y large p a r t in t h e n e w d e v e l o p m e n t s i n the f i e l d of t r a i n i n g p u b l i c h e a l t h s t a f f a t b o t h u n d e r g r a d u a t e a n d graduate l e v e l s . In m e d i c a l training； a s y n t h e s i s of c l i n i c a l m e d i c i n e a n d p u b l i c h e a l t h w o u l d promote a t e a m w o r k a p p r o a c h t o the p r a c t i c a l w o r k of the d i f f e r e n t h e a l t h s e r v i c e s a n d this, in turn, w o u l d e n a b l e them to be i n t e g r a t e d .
The d e v e l o p i n g c o u n t r i e s w e r e n o w l o o k i n g increasingly to the E u r o p e a n R e g i o n f o r h e l p in t r a i n i n g t h e i r m e d i c a l staff• In t h a t connexion the f e l l o w s h i p s p r o g - ramrae i m p l e m e n t e d b y the O f f i c e for m e d i c a l w o r k e r s from Europe a n d a l l o v e r the w o r l d w a s p r o v i n g h i g h l y e f f e c t i v e .
D u r i n g the p e r i o d u n d e r review, n a t i o n a l p u b l i c h e a l t h p r o g r a m m e s a s s i s t e d b y the R e g i o n a l O f f i c e h a d h e l p e d to p e r f e c t a d m i n i s t r a t i v e apparatus, to s e t u p n e w public h e a l t h institutions, to study the p o s s i b i l i t y of a p p l y i n g n e w m e t h o d o l o g y t o improve s t a t i s t i c a l s e r v i c e s a n d organize m o r e e f f i c i e n t h e a l t h services•
In the field of s o c i a l h e a l t h a n d m e d i c a l care, the R e g i o n a l O f f i c e h a d s u c c e s s - fully collaborated w i t h g o v e r n m e n t s in s u c h fields a s m o d e r n m e t h o d s of r e s u s c i t a t i o n a n d e m e r g e n c y care f o r a c c i d e n t v i c t i m s , r e h a b i l i t a t i o n , g e r i a t r i c s , a n d c l i n i c a l a n d child p h y s i o t h e r a p y .
W o r k w a s c o n t i n u i n g in the f i e l d s of food h y g i e n e , p h a r m a c y a n d d r u g control, new m e t h o d s a n d t y p e s of h e a l t h e d u c a t i o n , a n d d e n t a l h y g i e n e . A R e g i o n a l O f f i c e r f o r D e n t a l H e a l t h h a d t a k e n u p h i s d u t i e s in the R e g i o n a l Office a t the b e g i n n i n g of 1968.
In the n u r s i n g field, the R e g i o n a l O f f i c e h a d c o n c e n t r a t e d a t t e n t i o n on m a n p o w e r n e e d s a n d the u t i l i z a t i o n of m a n p o w e r to m e e t the specific r e q u i r e m e n t s of countries•
In the f i e l d of m a t e r n a l a n d c h i l d h e a l t h , in a d d i t i o n to s t u d i e s a n d t r a i n i n g a c t i v i t i e s , specific q u e s t i o n s , such a s the supply of w e a n i n g - f o o d s , h a d b e e n d e a l t w i t h i n collaboration w i t h U N I C E F a n d the G o v e r n m e n t s of A l g e r i a , M o r o c c o a n d T u r k e y .
In order to a s s i s t those c o u n t r i e s of the R e g i o n w h i c h w e r e only b e g i n n i n g t o develop o c c u p a t i o n a l h e a l t h services, the R e g i o n a l O f f i c e h a d c o n c e n t r a t e d on the exchange of experience a n d the p r o v i s i o n of f e l l o w s h i p s a n d c o n s u l t a n t s e r v i c e s .
A s in the p r e v i o u s y e a r , in a c c o r d a n c e w i t h the R e g i o n a l C o m m i t t e efs r e c o m m e n d a - tion, priority h a d b e e n g i v e n t o the c o n t r o l of cardiovascular diseases• W o r k h a d
E U R / R C 1 8 / 1 9 R e v . l p a g e 1 0
c o n t i n u e d on e p i d e m i o l o g y in t h a t field, the t r a i n i n g of s t a f f in c o r o n a r y intensive c a r e , a n d t h e r e h a b i l i t a t i o n of cardiac p a t i e n t s . In view of the h i g h expenditure on a c t i v i t i e s in t h a t f i e l d , steps h a d b e e n t a k e n to evaluate the e f f e c t i v e n e s s of t h e p r o g r a m m e . T h e i n t e n t i o n w a s t o continue the w o r k n e x t y e a r •
M u c h w o r k h a d a l s o b e e n done on e p i d e m i o l o g y a n d h e a l t h s t a t i s t i c s w i t h a view to f u r t h e r i m p r o v i n g n a t i o n a l s t a t i s t i c a l services.
T h e R e g i o n a l O f f i c e w a s c o n t i n u i n g its i m p o r t a n t w o r k on communicable diseases, a s s i s t i n g the c o u n t r i e s c o n c e r n e d t o integrate p r o g r a m m e s of c o m m u n i c a b l e disease c o n t r o l w i t h the w o r k of the g e n e r a l h e a l t h s e r v i c e s arid to promote inter-country c o - o p e r a t i o n f o r c o m m u n i c a b l e - d i s e a s e s u r v e i l l a n c e . The m a i n e m p h a s i s of the g e n e r a l c o m m u n i c a b l e - d i s e a s e - c o n t r o l p r o g r a m m e in the p e r i o d u n d e r r e v i e w h a d b e e n on
t r a c h o m a , t u b e r c u l o s i s a n d m a l a r i a . The public h e a l t h a s p e c t s of r a b i e s h a d been d i s c u s s e d a t a c o n f e r e n c e .
T h e R e g i o n a l D i r e c t o r a l s o r e f e r r e d to the p r o g r e s s m a d e in further r e d u c i n g m a l a r i a m o r b i d i t y a n d o u t l i n e d the p r o g r a m m e in t h a t field f o r the n e x t few y e a r s .
T h e r e p o r t g a v e a n i m p o r t a n t p l a c e to m e a s u r e s carried out by the R e g i o n a l Office in t h e f i e l d of e n v i r o n m e n t a l health• T h o s e m e a s u r e s，o f e q u a l u r g e n c y for a l l
c o u n t r i e s in the R e g i o n , i n c l u d e d the O f f i c e fs various a c t i v i t i e s in co-ordination w i t h t h e S p e c i a l F u n d a n d w i t h i n t e r g o v e r n m e n t a l and other o r g a n i z a t i o n s . M u c h of t h e w o r k in t h a t f i e l d r e l a t e d to the c o n t r o l of air a n d w a t e r p o l l u t i o n , w a t e r s u p - p l y , w a s t e d i s p o s a l a n d t h e e x t e n s i o n of e n v i r o n m e n t a l h e a l t h services, noise con- t r o l a n d the t r a i n i n g of w o r k e r s in the e n v i r o n m e n t a l h e a l t h field,
A s e p a r a t e c h a p t e r of the r e p o r t w a s d e v o t e d to the r e s u l t s of co-operation b e t w e e n the R e g i o n a l O f f i c e a n d the U n i t e d N a t i o n s specialized agencies, i n t e r -
g o v e r n m e n t a l a n d o t h e r o r g a n i z a t i o n s . A s in p r e v i o u s years, t h i s collaboration had b e e n e x t r e m e l y f r u i t f u l a n d h a d led to the solution of v a r i o u s p r o b l e m s confronting t h e R e g i o n a l Office•
A d e t a i l e d a n a l y s i s h a d been m a d e of certain administrative a s p e c t s of the O f f i c e fs w o r k , the b u d g e t a n d f i n a n c i a l e x p e n d i t u r e .
A f t e r i n t r o d u c i n g h i s r e p o r t , the R e g i o n a l D i r e c t o r w a r m l y t h a n k e d the M e m b e r S t a t e s t a k i n g p a r t in t h e R e g i o n a l C o m m i t t e efs session a n d the r e p r e s e n t a t i v e s of the v a r i o u s o r g a n i z a t i o n s f o r t h e i r c o n t i n u e d c o l l a b o r a t i o n d u r i n g the p e r i o d u n d e r review
E U R / R C 1 8 / 1 9 R e v . l page 1 1
Many representatives expressed t h e i r s a t i s f a c t i o n at the work done by the
R e g i o n a l D i r e c t o r , D r K a p r i o , a n d h i s s t a f f in p r e p a r i n g a n e x c e l l e n t report• I t w a s a l s o e m p h a s i z e d t h a t the p r e s e n t s e s s i o n c o i n c i d e d w i t h the t w e n t i e t h a n n i v e r s a r y of the World Health Organization - marking the close of a period i n which much
v a l u a b l e w o r k h a d been d o n e .
T h e r e p r e s e n t a t i v e s e m p h a s i z e d t h a t in spite of the p r o g r e s s m a d e i n m a n y согдп- t r i e s of the Region, one of the main problems was the t r a i n i n g of various types of m e d i c a l p e r s o n n e l . T h e Regicxial D i r e c t o r h a d a c t e d r i g h t l y i n g i v i n g p r o m i n e n c e t o t h a t s u b j e c t in the r e p o r t . I t w a s p o i n t e d o u t t h a t a t p r e s e n t t h e d e v e l o p i n g c o u n - t r i e s n e e d e d h e l p i n g in order t o b u i l d u p t h e i r own m e d i c a l e d u c a t i o n a l f a c i l i t i e s , a s t h ^ t w a s the b e s t w a y t o m e e t l o c a l r e q u i r e m e n t s • The p r o g r e s s of one c o u n t r y i n a n y f i e l d of medicine or p u b l i c h e a l t h m i g h t n o t a l w a y s be a c c e p t a b l e in a n o t h e r w i t h - o u t suitable m o d i f i c a t i o n .
T h e ftirther i m p r o v e m e n t of h e a l t h in m a n y c o u n t r i e s of the R e g i o n d e p e n d e d on how far W H O c o u l d prcxnote a free e x c h a n g e of opinion w i t h i n Europe in the f i e l d of m e d i c i n e , p u b l i c h e a l t h a n d the l a t e s t r e s e a r c h .
One of the p r o b l e m s m e n t i o n e d as c a l l i n g for p a r t i c u l a r a t t e n t i o n w a s t h a t o f improving m e n t a l h e a l t h a^id preventing m e n t a l i l l n e s s .
A number of representatives pointed out the importance of improving environmental sanitation as a key factor i n the advancement of public h e a l t h .
A m o n g the p r o b l e m s r e f e r r e d t o a s outstanding in the R e g i o n w e r e h e a l t h p l a n n i n g a n d e c o n o m i c s , evaluation a n d i t s importance for the development of n a t i o n a l prog- r a m m e s a s w e l l as the p r e v e n t i o n of cardiovascular d i s è a s e s .
Some speakers stressed that the e f f e c t i v e n e s s of WHO's work depended on further strengthening links w i t h national h e a l t h prograranes. The u s e f u l work of the R e g i o n a l O f f i c e in r u n n i n g various conferences, symposia and working groups stimulated the development of c o r r ^ s p m d í n g n a t i o n a l p r o g r a m e s . They expressed the. hope that re- sources available i n national i n s t i t u t i o n s would be more f u l l y used for the b e n e f i t of WHO a c t i v i t i e s /
The hope was expressed that the Regional O f f i c e would, in f u t u r e , pay more atten- tion to the prevention of chronic pulmonary diseases and lung cancer. The need t o
E U R / R C 1 8 / 1 9 R e v . l p a g e 12
c o n d u c t s p e c i a l e p i d e m i o l o g i c a l s u r v e y s on the i l l e f f e c t s of s m o k i n g a n d to study m e t h o d s of r e d u c i n g m o r t a l i t y due t o s m o k i n g w a s p o i n t e d out.
S o m e r e p r e s e n t a t i v e s s a i d t h a t the w o r k done by W H O h a d been effective because a l l t h e c o u n t r i e s of the E u r o p e a n R e g i o n w e r e equally i n t e r e s t e d in it. H o w e v e r , t h e p r o g r e s s m a d e c o u l d be e v e n m o r e e f f e c t i v e if every country i n the E u r o p e a n R e g i o n w i t h o u t e x c e p t i o n w e r e to p a r t i c i p a t e in the O f f i c e fs w o r k . Co-ordination
o f W H O ' s e f f o r t s w i t h n a t i o n a l p r o g r a m m e s w a s e s s e n t i a l . I t w a s s t r e s s e d t h a t n e w a d m i n i s t r a t i v e p a t t e r n s h a d b e e n s u c c e s s f u l l y introduced in the w o r k of the Office.
I t w a s a l s o n o t e d t h a t the a v a i l a b l e k n o w l e d g e a n d experience for the i m p r o v e m e n t of p u b l i c h e a l t h w e r e n o w b e i n g m o r e e f f e c t i v e l y a p p l i e d .
I n r e p l y t o t h e d i s c u s s i o n the R e g i o n a l Director t h a n k e d the r e p r e s e n t a t i v e s f o r t h e i r c o n s t r u c t i v e c o m m e n t s a n d s u g g e s t i o n s and said t h a t he w o u l d take n o t e of t h e m a n y i n t e r e s t i n g p r o p o s a l s m a d e . A t the same time, he w i s h e d to draw the r e p r e s e n t a t i v e s1 a t t e n t i o n t o the f a c t t h a t the O f f i c efs f i n a n c i a l r e s o u r c e s w e r e l i m i t e d a n d t h a t a c e r t a i n c o n c e n t r a t i o n of e f f o r t w a s therefore n e c e s s a r y .
R e g a r d i n g n a t i o n a l h e a l t h p l a n n i n g a n d h e a l t h economics, a l t h o u g h some experience f r o m v a r i o u s c o u n t r i e s h a d a l r e a d y b e e n d i s s e m i n a t e d , t h e r e w a s s t i l l r o o m for
f u r t h e r w o r k in t h a t d i r e c t i o n . The R e g i o n a l Office woi^Id continue to r e g a r d c a r d i o v a s c u l a r d i s e a s e s a s one of the m o s t i m p o r t a n t p r o b l e m s of the d a y .
F o l l o w i n g t h i s e x c h a n g e o f v i e w s , r e s o l u t i o n E Ü R / R C 1 8 / R 1 on the r e p o r t of the R e g i o n a l D i r e c t o r w a s a d o p t e d u n a n i m o u s l y ,
of n o i s e a s a n i m p o r t a n t h e a l t h p r o b l e m , a n d c o n t r o l a t t a c h e d a s a n a n n e x to the R e g i o n a l a d o p t e d r e s o l u t i o n EUR/ftCl8/R2.
Further, r e c o g n i z i n g the significance in the l i g h t of the r e p o r t on n o i s e
D i r e c t o r1s r e p o r t , the R e g i o n a l Committee
P A R T I I
M a t t e r s a r i s i n g o u t of d e c i s i o n s of the W o r l d H e a l t h A s s e m b l y a n d of the E x e c u t i v e
B o a r d ( E U R / R C 1 8 / 9 ) — ——一― —
I n a c c o r d a n c e w i t h the w i s h e s of the R e g i o n a l C o m m i t t e e a t p r e v i o u s sessions, t h e a t t e n t i o n of t h e r e p r e s e n t a t i v e s o n the Committee w a s d r a w n to d o c u m e n t E U R / R C 1 8 / 9 o n m a t t e r s a r i s i n g o u t of t h e d e c i s i o n s of the W o r l d H e a l t h A s s e m b l y a n d the
EUR/ÍIC18/19 R e v . l p a g e 1 3
E x e c u t i v e B o a r d , l i s t i n g v a r i o u s r e s o l u t i o n s of p a r t i c u l a r i n t e r e s t t o M e m b e r S t a t e s of the R e g i o n , w i t h a n indication of f o l l o w - u p a c t i o n t a k e n or p r o p o s e d a t t h e
r e g i o n a l level• 、 The Committee a d o p t e d resolution EUR/ÏÎCI8/R3.
M a t t e r s a r i s i n g out of d e c i s i o n s of the R e g i o n a l Committee a t i t s s e v e n t e e n t h s e s s i o n F u r t h e r m e a s u r e s t o develop m e t h o d s of p r o g r a m m e e v a l u a t i o n in the E u r o p e a n R e g i o n ‘
(EÜR/RC18/5)
ïïie d o c u m e n t d e a l t w i t h the m a i n a s p e c t s of the R e g i o n a l O f f i c e Ts e f f o r t s t o improve evaluation• The O f f i c e h a d a l r e a d y c o l l e c t e d d e t a i l e d m a t e r i a l on f a c t s a n d m e t h o d s w h i c h could be of use in e v a l u a t i n g public h e a l t h m e a s u r e s . T h e m a i n e n d e a v o u r should hp d i r e c t e d to t e s t i n g the m e t h o d o l o g i c a l a p p r o a c h e s t o e v a l u a t i o n a t n a t i o n a l l e v e l a n d to studying f u r t h e r the p o s s i b i l i t y of m a k i n g a c o n c r e t e evaluation of v a r i o u s m e a s u r e s c a r r i e d o u t .
In i n t r o d u c i n g the d o c u m e n t the A s s i s t a n t Director of H e a l t h S e r v i c e s p o i n t e d to the e x i s t i n g close relationship b e t w e e n the evaluation a n d p l a n n i n g of d i f f e r e n t h e a l t h m e a s u r e s . H e also p o i n t e d o u t t h a t a n e v a l u a t i o n of child m e n t a l h e a l t h p r o g r a m m e s w a s to be undertaken the f o l l o w i n g year u n d e r b u d g e t a r y p r o v i s i o n m a d e for t h a t p u r p o s e . E v a l u a t i o n w o u l d a l s o b e d i s c u s s e d u n d e r the c a r d i o v a s c u l a r d i s - eases programme a n d long-term p l a n n i n g .
I n the discussion r e p r e s e n t a t i v e s e x p r e s s e d a p p r e c i a t i o n of the O f f i c e1s a t t e m p t to improve m e t h o d s of e v a l u a t i n g h e a l t h progranmies. A p r o p o s a l w a s m a d e t h a t r e p r e - sentatives s h o u l d indicate specific p r o g r a m m e s or q u e s t i o n s w h i c h , in t h e i r opinion, should be e v a l u a t e d a n d the r e s u l t s r e p o r t e d on a t future sessions o f t h e R e g i o n a l Committee. S u c h a n a p p r o a c h w o u l d i n t e n s i f y the e x i s t i n g b u i l t - i n system of e v a l u a - t i o n of the w o r k carried o u t b y the R e g i o n a l O f f i c e .
T h e n e e d f o r training p e r s o n n e l capable of e v a l u a t i n g the v a r i o u s h e a l t h p r o g - rarranes w a s stressed.
R e p o r t on the progress of the c a r d i o v a s c u l a r disease progranane (EUR/RC18/4)
The Committee considered the r e p o r t s u b m i t t e d by the R e g i o n a l D i r e c t o r on the f i r s t r e s u l t s of the w o r k in the f i e l d of c a r d i o v a s c u l a r d i s e a s e s a n d n o t e d w i t h pleasure t h a t the p r o g r a m m e r e f l e c t e d t h e r e q u i r e m e n t s of the m a j o r i t y of c o u n t r i e s
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i n t h e R e g i o n , T h e p r o g r e s s r e p o r t itself, g i v i n g in d e t a i l the v a r i o u s m e a s u r e s t o b e u n d e r t a k e n f o r t h e d e v e l o p m e n t of the i n d i v i d u a l p r o j e c t s , m e t w i t h g e n e r a l approval。 I t s s t r u c t u r e p o i n t e d the w a y t o the f u r t h e r d e v e l o p m e n t of a methodology o f e v a l u a t i o n f o r R e g i o n a l Office p r o g r a m m e s .
S p e a k e r s in t h e d i s c u s s i o n d e s c r i b e d the p r e s e n t cardiovascular d i s e a s e s situa- t i o n in t h e i r c o u n t r i e s a n d the m e a s u r e s the g o v e r n m e n t s w e r e t a k i n g to c o n t r o l t h e m . I t w a s q u e s t i o n e d w h e t h e r t h e p r e s e n t a p p r o a c h to h e a l t h e d u c a t i o n of the p u b l i c c o u l d d o m u c h t o p r e v e n t c a r d i o v a s c u l a r d i s e a s e . I t w a s s u g g e s t e d t h a t the W H O f e l l o w s h i p s p r o g r a m m e f o r t r a i n i n g s p e c i a l i s t s in cardiovascular d i s e a s e s should p r o v i d e o p p o r t u n i t i e s f o r short- a s w e l l a s long-term fellowships. T h e n e e d to s t u d y f u r t h e r t h e w h o l e complex of c a r d i o v a s c u l a r disease c o n t r o l p r o b l e m s w a s con- f i r m e d - p a r t i c u l a r l y e t i o l o g y , d i a g n o s i s , e m e r g e n c y care, the s p e c i a l t r a n s p o r t of c a r d i o v a s c u l a r p a t i e n t s t o h o s p i t a l a n d t h e i r rehabilitation, a n d the t r a i n i n g of s p e c i a l i s t s a s w e l l a s of p a r a m e d i c a l personnel•
I t w a s a g r e e d t h a t n o t e n o u g h a t t e n t i o n w a s a s y e t b e i n g p a i d to the prevention of c a r d i o v a s c u l a r d i s e a s e s . A p r o p o s a l w a s made t h a t preventive m e a s u r e s be p l a n n e d i n t h e l i g h t of n a t i o n a l e x p e r i e n c e . W h i l e a p p l y i n g the r e s u l t s of r e s e a r c h on c a r d i o v a s c u l a r d i s e a s e control^. w h e r e k n o w n m e t h o d s of diagnosis, t r e a t m e n t a n d p r e - v e n t i o n w e r e e m p l o y e d , b a s i c r e s e a r c h p r o b l e m s should n o t be neglected• In the l o n g r u n , c a r d i o v a s c u l a r disease p r o b l e m s w o u l d have to be solved on a t e a m w o r k b a s i s w i t h p a r t i c i p a t i o n of a l l the d i s c i p l i n e s concerned•
In r e p l y to the d i s c u s s i o n , the R e g i o n a l O f f i c e r for C h r o n i c D i s e a s e s n o t e d w i t h s a t i s f a c t i o n the s t r o n g s u p p o r t in the Committee for the c a r d i o v a s c u l a r diseases p r o g r a m m e . A s r e g a r d s the length of f e l l o w s h i p s , e a c h r e q u e s t w o u l d be examined i n t h e l i g h t o f i n d i v i d u a l circumstances^ t a k i n g into a c c o u n t the w i s h e s of the a p p l i c a n t s c o n c e r n e d . H e e m p h a s i z e d the s i g n i f i c a n t f a c t t h a t c a r d i o l o g i s t s a n d d o c t o r s c o n c e r n e d w i t h c a r d i o v a s c u l a r p a t h o l o g y were n o w increasingly u s i n g the s t a n d a r d t e r m i n o l o g y a n d m e t h o d s of d i a g n o s i s r e c o m m e n d e d by W H O e x p e r t committees.
H e e m p h a s i z e d t h a t the p r o b l e m of p r e v e n t i o n w a s a complex one, involving a n attempt t o c h a n g e the n a t u r e of m a n ' s b e h a v i o u r so a s to p r e v e n t the p o s s i b i l i t y of cardio- v a s c u l a r d i s e a s e a r i s i n g . The p r o j e c t on H e a l t h E d u c a t i o n of the Public in Cardio- v a s c u l a r D i s e a s e s w a s c o n c e r n e d w i t h i n c r e a s i n g our knowledge in t h a t r e s p e c t .
E U R / R C 1 8 / 1 9 R e v . l p a g e 15
It should be borne in m i n d t h a t the R e g i o n a l O f f i c e prograirane in the f i e l d of ischaemie h e a r t disease p r é v e n t i o n formed a n i n t e g r a l p a r t of a w o r l d - w i d e p r o g r a m m e of studies in w h i c h m a n y organizations w e r e c o l l a b o r a t i n g .
The R e g i o n a l O f f i c e w o u l d make every use of the experience g a i n e d f r o m r e s e a r c h b a s e d on d i f f e r e n t a p p r o a c h e s to c a r d i o v a s c u l a r d i s e a s e a n d , w h e r e a p p r o p r i a t e , a p p l y the findings in its own p r o g r a m m e . H e w e l c o m e d the a d m i n i s t r a t i v e a n d f i n a n c i a l s u p p o r t some r e p r e s e n t a t i v e s h a d a n n o u n c e d f o r the p i l o t p r o j e c t s in t h e i r c o u n t r i e s .
F o l l o w i n g the discussion, r e s o l u t i o n E U R / R C l 8 / R 4 w a s a d o p t e d b y the C o m m i t t e e . Long-term p l a n n i n g in the E u r o p e a n R e g i o n (EUR/RC18/8, E U R / R C l 8 / l 4 a n a E U R / R C 1 8 / 1 5 ) Introducing the subject, the R e g i o n a l D i r e c t o r p o i n t e d out t h a t the f i r s t e x p e - rience of long-term p l a n n i n g in a specific f i e l d in the E u r o p e a n R e g i o n g a v e g r o u n d s f o r h o p i n g t h a t i t w o u l d b e possible to d e v e l o p s y s t e m s of long-term p l a n n i n g f o r t h e more important p r o g r a m m e s of the R e g i o n .
In d i s c u s s í o ñ the s p e c i a l c o n d i t i o n s in E u r o p e w e r e s t r e s s e d a n d the n e e d f o r the R e g i o n a l Office for E u r o p e t o continue long-term p l a n n i n g i n specific a r e a s w a s e m p h a s i z e d . I t w a s r e c o m m e n d e d that, in a d d i t i o n t o the long-term c a r d i o v a s c u l a r disease programme, s i m i l a r p r o g r a m m e s should be d e v e l o p e d on the m e n t a l h e a l t h of y o u n g people, a n d the e f f e c t s on h e a l t h of e n v i r o n m e n t a l p o l l u t i o n .
In discussion, satisfaction w a s e x p r e s s e d a t the R e g i o n a l O f f i c e1s w o r k f o r t h e improvement of p l a n n i n g m e t h o d s . R e p r e s e n t a t i v e s s t r e s s e d t h a t the d o c u m e n t s u b - m i t t e d f o r discussion m i g h t prove a valuable a i d t o H e a d q u a r t e r s in c o - o r d i n a t i n g t h e progranroes of the d i f f e r e n t r e g i o n a l offices.
The r e p r e s e n t a t i v e s w e r e s a t i s f i e d w i t h the d o c u m e n t a t i o n r e l a t i n g t o w o r l d - w i d e p l a n n i n g a n d confirmed the n e e d u n d e r l i n e d in d o c u m e n t E U R/ R C 1 8 / 1 5 f o r the r e g i o n a l a n d g l o b a l p l a n s t o be closely linked w i t h n a t i o n a l p l a n n i n g .
Because of budgetary l i m i t a t i o n s5 it w a s f e l t t h a t in the r e g i o n a l p r o g r a m m e a certain flexibility in formulating long-term p l a n s should be r e t a i n e d so t h a t , by continuous review, the R e g i o n a l C o m m i t t e e s c o u l d r e d e s i g n them t o m e e t n e w n e e d s . Speaking In the d i s c u s s i o n , the D i r e c t o r - G e n e r a l said that long-term p l a n n i n g encountered difficulties a t a l l l e v e l s - n a t i o n a l , r e g i o n a l a n d g l o b a l . H e s t a t e d t h a t the Committee w o u l d n o d o u b t agree t h a t e v e n in the E u r o p e a n R e g i o n t h e d e g r e e
EUR/ÍIC18/19 R e v . l p a g e 16
of d e p e n d e n c e of t h e d i f f e r e n t couixtries on i n t e r n a t i o n a l c o n t a c t a n d a s s i s t a n c e in t h e f i e l d of h e a l t h v a r i e d g r e a t l y . I n d e e d , there w a s a w i d e range of d i f f e r e n t l e v e l s in t h e d e v e l o p m e n t of h e a l t h systems• Those w i t h more a d v a n c e d s y s t e m s c o u l d n o t n e g l e c t t h e n e e d s of other c o u n t r i e s .
I n l o n g - t e r m p l a n n i n g i t w a s e s s e n t i a l to know the r e s o u r c e s a n d r e q u i r e m e n t s of e a c h c o u n t r y a s w e l l a s the r e s o u r c e s of W H O . To m a k e effective use of those r e - s o u r c e s p l a n n i n g w a s essential• . S u c h long-term p l a n n i n g w o u l d b r i n g o u t the com- p l e x i t y o f the t a s k s a h e a d a n d p o i n t t o the p o s s i b i l i t i e s f o r t h e i r s o l u t i o n .
T h e R e g i o n a l D i r e c t o r , in c o n c l u s i o n , said t h a t t h e d i s c u s s i o n which had taken p l a c e w o u l d h e l p to f o r m u l a t e the basic p r i n c i p l e s of long-term p l a n n i n g a n d t h a t t h e w i s h e s of t h o s e w h o h a d s p o k e n of the n e e d for l o n g - t e r m p l a n n i n g in the f i e l d s
of t h e m e n t a l h e a l t h of young p e o p l e a n d the effects on h e a l t h of e n v i r o n m e n t a l p o l l u - t i o n t o g e t h e r w i t h o t h e r c o m m e n t s , w o u l d be examined b y the R e g i o n a l O f f i c e .
T h e w o r k of the I n t e r n a t i o n a l A g e n c y f o r R e s e a r c h on Cancer in the E u r o p e a n R e g i o n a n d c o l l a b o r a t i o n b e t w e e n t h e A g e n c y a n d the R e g i o n a l O f f i c e f o r E u r o p e (EUR/RCl8/lO)
T h e R e g i o n a l C o m m i t t e e c o n s i d e r e d the m a t e r i a l on the a i m s a n d constitution of t h e A g e n c y , i t s s t r u c t u r e a n d m e t h o d s of w o r k , its links w i t h the R e g i o n a l O f f i c e a n d t h e w o r k i t w a s d o i n g .
I t w a s p o i n t e d o u t t h a t the e s t a b l i s h m e n t of the A g e n c y h a d m e a n t the r e o r g a n i z a - t i o n of t h e O f f i c e 1 s c a n c e r e p i d e m i o l o g y a n d c o n t r o l programme• In order to a v o i d u n n e c e s s a r y d u p l i c a t i o n , it w a s m o s t i m p o r t a n t t h a t there should be close co-ordination
of t h e w o r k of the R e g i o n a l O f f i c e a n d the Agency•
A p r o p o s a l w a s m a d e t h a t the R e g i o n a l Committee should a l s o in future be informed of a l l m e a s u r e s b e i n g u n d e r t a k e n t o s t r e n g t h e n t h a t c o - o p e r a t i o n . The n e e d to
s t a n d a r d i z e t e r m i n o l o g y a n d the c l a s s i f i c a t i o n of m a l i g n a n t n e o p l a s m s w a s emphasized.
F o l l o w i n g t h e d i s c u s s i o n , the C o m m i t t e e a d o p t e d r e s o l u t i o n E U R / R C 1 8 / R 9 .
A c c o m m o d a t i o n f o r the R e g i o n a l O f f i c e (EUR/RC18/7) a n d place of R e g i o n a l Committee s e s s i o n s ( E U R / R C 1 8 / W P . 3 )
T h e R e g i o n a l C o m m i t t e e n o t e d the i n f o r m a t i o n given b y Chief, A d m i n i s t r a t i o n a n d F i n a n c e , on the w o r k in c o n n e x i o n w i t h the n e w building for the R e g i o n a l Office, w h i c h g a v e g r o u n d s f o r h o p i n g t h a t i t w o u l d be r e a d y b y 1971* T h e Committee a l s o n o t e d t h a t m a n y c o u n t r i e s of the R e g i o n h a d e x p r e s s e d their desire t o h e l p the R e g i o n a l O f f i c e e q u i p a n d f u r n i s h i t s f u t u r e p r e m i s e s .
EUR/ÍIC18/19 R e v . l p a g e 17
The R e g i o n a l Committee a l s o n o t e d the i n f o r m a t i o n in the d o c u m e n t b e f o r e it r e g a r d i n g the place of i t s s e s s i o n s h e l d a w a y from C o p e n h a g e n . R e p r e s e n t a t i v e s w h o spoke n o t e d t h a t i t w o u l d s t i l l be u s e f u l t o h o l d certain sessions of the R e g i o n a l Committee a w a y from the R e g i o n a l O f f i c e a n d t h a t the q u e s t i o n o f h o s t c o u n t r i e s
b e a r i n g a p a r t of the c o s t i n v o l v e d should be f u r t h e r studied. S o m e p o i n t e d out t h a t expenditure on s e s s i o n s of the Committee w a s a f f e c t e d b y the distance of the h o s t country from the R e g i o n a l O f f i c e . T h a t should n o t be p e r m i t t e d to increase the c o s t borne by the country w h e r e the s e s s i o n w a s h e l d .
F o l l o w i n g the discussion, the Committee a d o p t e d r e s o l u t i o n EUR/tîCl8/Rl4 r e q u e s t - ing the R e g i o n a l D i r e c t o r to s t u d y t h e m a t t e r further•
T e c h n i c a l m a t t e r s
The public h e a l t h u s e s of electronic computers (ЕШ/ЙС18/11 )
In the d o c u m e n t p r e s e n t e d t o the R e g i o n a l Committee f o r d i s c u s s i o n o n the a b o v e subject, m e n t i o n w a s m a d e of steps a l r e a d y t a k e n by the R e g i o n a l O f f i c e , W H O H e a d - quarters a n d other b o d i e s in connexion w i t h the use of electronic c o m p u t e r s in the f i e l d of medicine a n d public h e a l t h . F i e l d s in w h i c h e l e c t r o n i c d a t a p r o c e s s i n g c o u l d p r o b a b l y b e u s e d in a n early future w e r e the h o s p i t a l care "services a n d the long-terai p l a n n i n g of public h e a l t h s e r v i c e s .
In the discussion, the value of the m a t e r i a l s u b m i t t e d a n d the i m p o r t a n t w o r k done by the R e g i o n a l O f f i c e t o p r o m o t e the use of electronic d a t a p r o c e s s i n g in v a r i o u s f i e l d s of medicine a n d public h e a l t h w e r e e m p h a s i z e d . I t w a s p o i n t e d out t h a t in future the experience g a i n e d in the u s e of e l e c t r o n i c d a t a p r o c e s s i n g i n d i f f e r e n t countries s h o u l d continue t o be c o l l a t e d b y the Office a n d d i s s e m i n a t e d t o a l l countries of the Region• The exchange of e x p e r i e n c e in p l a n n i n g v a r i o u s m e a s - u r e s f o r the f u r t h e r p r o m o t i o n of e l e c t r o n i c data p r o c e s s i n g t h r o u g h the R e g i o n a l Office should also be considered.
F o l l o w i n g the discussion the Committee a d o p t e d r e s o l u t i o n E U R/ R C 1 8/ R I O . The prevalence of p h e n y l k e t o n u r i a in the E u r o p e a n R e g i o n (EUR/hCl8/l2 )
A t the p r e v i o u s session of the R e g i o n a l Committee the value of systematic c a s e - finding of phenylketonuria, in the n e w b o r n w a s s t r e s s e d . In view of t h a t the R e g i o n a l Office for E u r o p e h a d c o m p i l e d the d a t a a v a i l a b l e from 2 0 countries in the R e g i o n .
EUR/ÍIC18/19 R e v . l page 8
T h e d o c u m e n t b e f o r e t h e C o m m i t t e e w a s b a s e d on t h a t information. A l t h o u g h detection o f h y p e r p h e n y l a l a n i n a e m i a a n d p h e n y l k e t o n u r i a m i g h t make it possible to diagnose the d i s e a s e , w i d e m a s s s c r e e n i n g w o u l d be e x p e n s i v e a n d i t s a d v i s a b i l i t y w o u l d h a v e to b e c a r e f u l l y c o n s i d e r e d in e a c h i n s t a n c e .
I n t h e d i s c u s s i o n , r e p r e s e n t a t i v e s g a v e a n a c c o u n t of n a t i o n a l experience in s u r v e y i n g t h e p r e v a l e n c e o f p h e n y l k e t o n u r i a a m o n g children a n d of s u b s e q u e n t attempts t o u s e t h e e x p e r i e n c e g a i n e d for t r e a t i n g d e t e c t e d c a s e s . I t w a s , h o w e v e r , empha- s i z e d t h a t m e t h o d s f o r d i a g n o s i n g p h e n y l k e t o n u r i a r e q u i r e d to bs d e v e l o p e d f u r t h e r . A n u m b e r of r e p r e s e n t a t i v e s w i s h e d to s u p p l y the Office w i t h a d d i t i o n a l d a t a on the p r e v a l e n c e o f p h e n y l k e t o n u r i a available in t h e i r countries. I t w a s e m p h a s i z e d t h a t s t u d y of the p r e v a l e n c e o f the condition w a s only advisable w h e r e i t c o u l d be directed t o t h e e a r l i e s t p o s s i b l e d e t e c t i o n of e x i s t i n g cases, since only in t h a t w a y could t r e a t m e n t b e e f f e c t i v e . In conclusion, it w a s p o i n t e d out t h a t the S e c r e t a r i a t c o u l d p r e p a r e a n e w d o c u m e n t including the a d d i t i o n a l data r e c e i v e d d u r i n g the dis- c u s s i o n a n d l a t e r d i s s e m i n a t e it to a l l c o u n t r i e s interested in the m a t t e r .
F o l l o w i n g the d i s c u s s i o n , the C o m m i t t e e a d o p t e d r e s o l u t i o n E U R / ^ C l 8 / R l l . F a t a l h o m e a c c i d e n t s in E u r o p e (EÜR/RC18/6)
S u p p l e m e n t i n g e a r l i e r w o r k a n d the r e s u l t s of s p e c i a l surveys a l r e a d y r e p o r t e d b y t h e R e g i o n a l C o m m i t t e e in 1964, the above d o c u m e n t s u m m a r i z e d m a t e r i a l p r o v i d e d b y 1 0 c o u n t r i e s o f the R e g i o n on the e p i d e m i o l o g y of f a t a l h o m e a c c i d e n t s . The very d e t a i l e d i n f o r m a t i o n a n d s t a t i s t i c a l a n a l y s i s showed t h a t f a t a l h o m e a c c i d e n t s con- t i n u e d , i n m a n y c o u n t r i e s , t o be an i m p o r t a n t public h e a l t h p r o b l e m . Surveillance o f a c c i d e n t s w i t h a f a t a l outcome made i t possible to take a n u m b e r of preventive m e a s u r e s , e s p e c i a l l y i n h e a l t h e d u c a t i o n for p o p u l a t i o n g r o u p s p a r t i c u l a r l y a t risk.
T h e R e g i o n a l C o m m i t t e e rioted the d o c u m e n t w i t h satisfaction, a s the e n d r e s u l t o f a u s e f u l s t u d y c a r r i e d o u t by t h e R e g i o n a l O f f i c e •
T e c h n i c a l d i s c u s s i o n s (EUR/RCl8/Tech.Disc ./l, / 2 a n d / ) )
T h e t e c h n i c a l d i s c u s s i o n s on nC u r r e n t t r e n d s in u n d e r g r a d u a t e m e d i c a l education"
t o o k p l a c e u n d e r the c h a i r m a n s h i p of P r o f e s s o r J . O s z a c k i . A s h o r t r e p o r t on the t e c h n i c a l d i s c u s s i o n s (EUR/RCl8/Tech.Disc ./4) is a t t a c h e d . D i s c u s s i o n s w e r e also h e l d on d o c u m e n t s submitted, by the U n i t e d K i n g d o m on "Measures to combat h e r o i n depend- e n c e i n G r e a t B r i t a i n " a n d o n "Thromboembolic d e a t h s a n d o r a l contraceptives1' •
E U R / h C l 8 / l 9 R e v . l page 19
T e c h n i c a l d i s c u s s i o n s a t f u t u r e s e s s i o n s o f t h e R e g i o n a l C o m m i t t e e ( E U R / R C 1 8 / W P . 2 )
The C o m m i t t e e adopted resolution EUR/ÏIC18/R12 confirming that the subject for
technical d i s c u s s i o n s at i t s nineteenth session would be： 11 Roadvtraffic accidents as a public health p r o b l e m ", and also chose as the subject for the technical dis- c u s s i o n s at i t s t w e n t i e t h session： "The public health aspects of r e h a b i l i t a t i o n " . D a t e a n d P l a c e o f r e g u l a r s e s s i o n s o f t h e R e g i o n a l C o m m i t t e e i n 1 9 6 9 a n d 1 9 7 0
T h e C o m m i t t e e a d o p t e d r e s o l u t i o n E U R / R C l 8 / ^ 1 3 c o n f i r m i n g t h a t i t w o u l d h o l d i t s n i n e t e e n t h s e s s i o n f r o m 9 t o 1 3 S e p t e m b e r 1 9 6 9 a t B u d a p e s t • I t a l s o a c c e p t e d a n
i n v i t a t i o n b y t h e G o v e r n m e n t o f M a l t a t o h o l d i t s t w e n t i e t h s e s s i o n i n t h a t c o u n t r y .
O t h e r b u s i n e s s
The C o m m i t t e e c o m m e n d e d t h e R e g i o n a l D i r e c t o r o n h i s i n i t i a t i v e i n p r o v i d i n g a H a n d b o o k o f R e s o l u t i o n s a n d Decisions o f t h e Regional C o m m i t t e e f o r Europe, a n d -;
e x p r e s s e d i t s w i s h t h a t t h e d o c u m e n t b e m a d e a v a i l a b l e a l s o in F r e n c h a n d R u s s i a n f o r the next session of the Committee and that it be brought up to date at regular inter- v a l s . I t also welcomed the innovation of l i s t i n g reports on regional a c t i v i t i e s with an Indication of contents (EUR/1lCl8/l5-) and would appreciate such information b e i n g r e g u l a r l y b r o u g h t t o i t s a t t e n t i o n .
P A R T I I I
P r o p o s e d ГГТРГ^ПШР 严d b u d g e t e s t i m a t e s f o r 1 9 7 0 ( E U R / R C 1 8 / 5 , / 3 A d d . l , / 3 A d d . 2 , / 3 E0R/11C18/WP.1, EUR/ÏÎC18/14 and_EUR/ïlCl8/l6)
B e f o r e s t u d y i n g t h e p r o p o s e d p r o g r a m n e a n d b u d g e t e s t i m a t e s f o r t h e y e a r 1 9 7 ° i n d e t a i l , the Committee considered document E U R/ R C 1 8/ 5 Add.2 "Continuing inter- regional projects expected to be financed from the Technical Assistance component of the United Natiœis D e v e l o p m e n t Programme, 1970-1975". The Committee was informed t h a t u n d e r t h e n e w p r o c e d u r e s w h i c h c a l l f o r p r o j e c t b u d g e t i n g , t h e G o v e r n i n g C o u n c i l o f t h e Ifcxlted N a t i o n s D e v e l o p m e n t P r o g r a m m e e x p e c t e d a g e n c i e s t o s u b m i t a p p l i c a t i o n s f o r r e g i o n a l o r i n t e r - r e g i o n a l p r o j e c t s o n a p r o j e c t - b y - p r o j e c t b a s i s t o t h e
Administrator of the UNDP. The Governing Council required such applications to be supported by groups of governments. I t was therefore hoped that the Committee would d e e m i t a p p r o p r i a t e t o r e c o r d i t s a g r e e m e n t w i t h t h e R e g i o n a l p r o j e c t s e x p e c t e d t o b e i n o p e r a t i o n I n 1 9 7 0 a n d r e q u e s t t h e i r i m p l e m e n t a t i o n in t h a t a n d t h e f o l l o w i n g y e a r s .
E U R / R C 1 8 / 1 9 R e v . l p a g e 2 0
F o l l o w i n g d i s c u s s i o n t h e C o m m i t t e e a d o p t e d resolution EUR/^lCl8/R6.
T h e C o m m i t t e e w e n t o n t o examine d o c u m e n t EUR/RCl8/l4 "Biennial programming"•
T h e d o c u m e n t h a d b e e n s u b m i t t e d a s a r e s u l t of a discussion on the s u b j e c t a t the F o r t y - S e c o n d S e s s i o n o f the E x e c u t i v e B o a r d , a t w h i c h the B o a r d a c c e p t e d the
D i r e c t o r - G e n e r a l1 s s u g g e s t i o n t h a t the m a t t e r b e considered b y R e g i o n a l C o m m i t t e e s b e f o r e i t d e c i d e d o n w h a t a c t i o n to t a k e ,
w a s t h a t t h e p r o p o s e d p r o g r a m m e a n d b u d g e t i n c l u d e p l a n s f o r a f u r t h e r y e a r a h e a d a n d t h e c u r r e n t y e a r .
The suggestion o u t l i n e d in the document e s t i m a t e s f o r a n y given year should in future o m i t reference to p r o j e c t s for
T h e C o m m i t t e e d i s c u s s e d the p r o p o s a l in some d e t a i l and, after confirmation t h a t i t r e l a t e d e x c l u s i v e l y to b i e n n i a l p r o g r a m m i n g a n d n o t to b i e n n i a l b u d g e t i n g a n d w o u l d n o t t h e r e f o r e c o n f l i c t w i t h A r t i c l e 5 5 of the Constitution, adopted resolution
E U R / R C 1 8 / R 7 . . T h e C o m m i t t e e t h e n w e n t on t o s t u d y the p r o p o s e d p r o g r a m m e a n d b u d g e t e s t i m a t e s
a s a w h o l e .
N o t i n g t h a t t h e e s t i m a t e s f o r 197〇 r e p r e s e n t e d a n increase of a p p r o x i m a t e l y o v e r t h e p r o g r a m m e a n d b u d g e t a p p r o v e d f o r 1969, some r e p r e s e n t a t i v e s w e r e in favour of a s m a l l e r i n c r e a s e . O t h e r s s t a t e d that, in view of the m a n y u r g e n t n e e d s f o r W H O a s s i s t a n c e , e v e n a l a r g e r increase c o u l d be technically j u s t i f i e d .
F o l l o w i n g d e t a i l e d e x a m i n a t i o n of d o c u m e n t EUR/RC18/3 the country programmes w e r e a c c e p t e d w i t h o u t comment• D i s c u s s i o n centred on the i n t e r - c o u n t r y p r o g r a m m e s a s a r e s u l t of w h i c h the f o l l o w i n g d e c i s i o n s w e r e t a k e n :
(1) to t r a n s f e r to a d d i t i o n a l p r o j e c t s :
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E U R O 0 4 0 0 S t u d y on M e t h o d s of H o u s i n g A p p r a i s a l from
t h e P u b l i c H e a l t h S t a n d p o i n t ) 6 0 0 E U R O 0 4 2 7 S t u d y on T r e n d s a n d D e v e l o p m e n t s in Public
H e a l t h R a d i a t i o n P r o t e c t i o n 7 0 0 0
(2) t o t r a n s f e r from the. a d d i t i o n a l p r o j e c t s to the r e g u l a r p r o g r a m m e : E U R O 0 3 9 9 S e m i n a r on P r e v e n t i o n , T r e a t m e n t a n d
R e h a b i l i t a t i o n in C e r e b r o v a s c u l a r D i s e a s e s 10 600
