W O R L D H E A L T H ORGANIZATION
ORGANISATION MONDIALE DE LA SANTÉ
EXECUTIVE BOARD EB))/5 , 20 November 1963 Thirty-third Session
ORIGINAL: ENGLISH Provisional agenda item 5-6.1
REGIONAL COMMITTEE FOR THE WESTERN PACIFIC Report on Fourteenth Session
The Director-General has the honour to present to the Executive Board the report of the Fourteenth Session of the Regional Committee for the Western Pacific.
1 Document W P / R C 1 4 / ” Rev.l
W O R L D H E A L T H ORGANIZATION
ORGANISATION MONDIALE DE LA SANTÉ
EB33/5 ANNEX
“、 ‘ ' - , . 、.•• - •
• REGIONAL OFFICE F O R T H E WESTERN PACIFIC BUREAU REGIONAL D U PACIFIQUE OCCIDENTAL
. . • • — —
R E G I O N A L CQIMITTEE . . W P / R C l V l ) H e v . l
‘ 27 S e p t e m b e r 1963 Fourteenth Session . . . .
. . ORIGINAL: ENGLISH Port M o r e s b y , 5 - Ю September 1963 . . .
• . ‘ • . •
‘ • • • • 響• •
• • • , - . . •. • • • • • • . ‘ • -
REPORT. OP T H E R E G I O N A L СОММГГТЕЕ
CONTENTS
Page
INTRODUCTION • 争 • 參 * . •華 1
PART I . ANNUAL REPORT OF T H E REGIONAL DIRECTOR 2 PART I I . PROPOSED PROGRAMME AND B U D G E T ESTIMATES F O R 1965 斗
PART I I I . OTHER MATTERS DISCDSSED 4 1 . Fluoridation of water supplies k
2 . K u r u in the Territory of Papua and N e w Guinea 4 Facilities for education and training of health
personnel in the Western Pacific Region 5
4 . Studies on cholera E l T o r 6 5 . Resolutions of regional interest adopted by the thirty-
first and thirty-second sessions of the Executive Board
and the Sixteenth World H e a l t h Assembly 6
6 . Population problems 7
PART I V . OTHER BUSINESS 7 1 . Progress reports from governments on health activities • 7
2 . T e c h n i c a l Discussions 8
W P / R C 1 4 / 1 3 R e v . l
page ii
Page
PART V . RESOLUTIONS ADOPTED B Y T H E COMMITTEE 9 WP/RC14.R1 Annual R e p o r t of the R e g i o n a l Director 9
WP/RC14.R2 K u r u 10 WP/RC14,R3 Proposed programme and b u d g e t estimates for 1965 . . . 10
WP/RC14.r4 Education and training 11
WP/RC14.R5 Cholera 12 WP/RC14 .R6 Genetic profiles 12
WP/RC14.R7 Technical Discussions . . . 1J>
WP/RC14.R8 Resolution of appreciation 1J WP/RC14 .R9 Adoption of the report 14
A N N E X 1 Agenda
ANNEX 2 List of representatives
A N N E X 3 Report of the Sub-Committee on Programme and B u d g e t A N N E X 4 T e c h n i c a l Discussions
A N N E X 5 L i s t of documents
W P / R C l V l 3 Rev.l page 1
REPORT OP THE REGIONAL COMMITTEE
INTRODUCTION
The fourteenth session of the Regional Committee for the Western Pacific was inaugurated at the Legislative Council Chambers by The Right Honourable Sir Robert Menzies, Prime Minister of the Commonwealth of Australia. Also present were His Honour the Administrator, Sir Donald Cleland, the Honourable Minister of State for Territories, Mr Paul Hasluck, and the Honourable Minister of State for Health, Senator Harrie W a d e . The session lasted from 5 to 10 September 1963,
The meeting was attended by representatives of nine Member States in the Region and of Prance, Portugal, the United Kingdom of Great Britain and Northern Ireland and the United States of America. Representatives of the South Pacific Commission and of five non-governmental organizations in official relations with WHO were also present.
The Committee elected the following officers：
Chairman : Dr R . F . R . Scragg (Australia) Vice-Chairman : Dr J . C . Thieme (Western Samoa) Rapporteurs
in English : in French :
Dr L . Uyguanco (Philippines) Dr A . Perron (Prance)
Formal statements were made by the representatives of the South Pacific Commission and of four non-governmental organizations in official relations with WHO.
The agenda is given in Annex 1 and the list of representatives in Annex 2.
At its first plenary session the Committee established a Sub-Committee on Programme and Budget, composed of representatives of the following countries：
Australia (Chairman), China (Taiwan), Japan, Malaya, New Zealand, the United Kingdom and Viet Nam. The Sub-Committee held two meetings, following which it submitted a report to the main Committee. Further details are given in Part II and Annex 3 of this report.
In accordance with the principle of rotation, the fifteenth session of the Committee will be held in Manila and the sixteenth session in Seoul, Korea.
In the course of five plenary sessions, the Committee adopted nine resolutions which are set out in Part V ,
W p/r C i V i?
Rev.l page 2PART I. ANNUAL REPORT OP THE R E G I O N A L DIRECTOR
The Regional D i r e c t o r , in introducing h i s A n n u a l R e p o r t , summarized the m a j o r developments during the period under r e v i e w .
The general expansion of public h e a l t h services had continued with particular attention being paid to local and rural h e a l t h services. In the field o f n u r s i n g , one of the remarkable features of the past year h a d been the replacement of the
emergency training of nurses by regular well-established courses. Interest in h e a l t h education h a d grown and an increasing number of countries and territories were
following WHO-recommended standards for h e a l t h e d u c a t i o n , leadership and o r g a n i z a t i o n . As a result of the intensive information programme launched during the year, there h a d b e e n rapid strides in the development of n u t r i t i o n programmes^ and plans were now w e l l in h a n d for a number of new projects. A greater degree of self-reliance and vigour w a s already manifest in many medical and nursing schools and public h e a l t h training institutions » The followship programme had continued to expand and no less than 50 per cent, of the fellowships awarded during the period under review h a d b e e n undertaken exclusively within the R e g i o n , Although there was as yet no country in the R e g i o n in w h i c h the m a l a r i a campaign h a d reached the stage of certification of e r a d i c a t i o n , further progress h a d been m a d e . Encouraging results regarding the interruption of transmission h a d been obtained from the two m a l a r i a eradication pilot p r o j e c t s . W i t h the completion of the m a s s treatment survey of the population in T o n g a all the known yaws-endemic areas in the southern part of the R e g i o n , except Portuguese T i m o r , h a d now been covered by mass treatment• No report of any recrudescence of the disease had been received from the other former yaws-endemic areas in the Pacific.
The attention of the Committee was then drawn to some of the areas of weakness in the regional programme •
In a number of cases a difficult question to decide was whether a country w a s in a position to absorb all the assistance it h a d requested. • T h i s question related specifically to the developing countries where the needs were all-embracing and it w a s , therefore., in these areas that planning became of fundamental importance. It w a s n o t possible to combat all problems at the same t i m e , one m u s t be selective in accordance with the situation in each country. The basic health needs and the problems h a d to be studied and investigated, priorities for action determined， and precise proposals formulated, aimed at the orderly development of a long-term h e a l t h plan. To be fully effective this plan should form an integral part of any social and economic programme • It w a s , therefore, essential to impress upon other
government departments that economic and social development depended on good h e a l t h . N e w programmes should only be undertaken when continuing ones were w e l l established»
It was essential n o t to disperse available resources but to use them in the m o s t efficient m a n n e r , to support the projects in operation to the u t m o s t limits, to sustain interest so that the combined efforts of the Organization and governments would grow constantly in scale and in. intensity.
WP/RCl4/l3 Rev.l page 3
Although maternal and child health programmes h a d expanded, there h a d been little diminution, if any, in the mortality and morbidity rates of the pre-school child.
There was a great need to establish services for this age-group which h a d , until n o w , been possibly the most neglected section of the community. Malnutrition and even under-nutrition continued to be widespread in the Region but programmes to remedy the situation were few. New approaches in nutrition education were， therefore, required* A further problem was the failure in most countries to realize what malnutrition meant in terms of economics.
There could be no question of allowing the slightest weakening in the efforts to control the communicable diseases. Cholera was still occurring in some countries, the tuberculosis problem was so tremendous that control programmes would be required for many years to come, health administrations must be aware of the significant persistent increase in the incidence of the venereal infections• The malaria eradication progr anime must n o t be allowed to diminish in strength because of the shortage of funds. W h e n one considered the direct bearing community water supplies and other sanitary facilities had on the prevention of disease, it was unfortunate that the initiative for improvements in the environment stemmed from non-public health agencies, Health administrations must exercise vigorous leadership and watchful guardianship in this important field.
The Regional Director then referred to what was possibly the most important field in the regional programme， that of education and training. If full use were to be made of regional training centres, standards for medical education must be established and maintained. It was also imperative to create a stable and progressive faculty. Improvements were required not only in the selection of candidates for fellowships b u t also for participation in inter-country group educational activities.
The attention of the Committee was drawn to the particular interest of WHO in radiation health and medicine and the importance of the establishment of radiation health programmes within the framework of the regular public health activities was stressed.
The Committee reviewed the annual report chapter by chapter. In the course of the discussion, attention w a s drawn to the difficulties encountered in the recruitment of experts of a high calibre• It was suggested that this problem might be overcome
if a review were made of basic salaries, allowances, post adjustments, etc.，which might require to be increased, in order to permit the recruitment of the most highly qualified persons. The importance of providing advisory services on the proper
planning of medical care facilities and on hospital administration was stressed. It was also suggested that the appointment of a regional adviser in this field would be beneficial to the governments of developing countries.
In discussing the part of the report relating to maternal and child health, the suggestion was made that this field provided an opportunity for bringing together a number o f related professional skills. Specific reference was made to the importance of the nutritional aspects of maternal and child health and it was felt that future attention should be focused on this aspect.
W p / R C l 4 / l 3 R e vл page 4
Further points raised covered the importance of health administrations giving leadership in the field of environmental h e a l t h , the investigation of genetics in isolated areas where the people were emerging from a primitive to a more modern way of living (see resolution WP/RC14.R6) and studies connected with population problems
(see Part I I I , section 6 ) . A number of representatives made statements on the progress of WHO-assisted activities in their own countries.
• i The Committee adopted resolution WP/RC14.R1.
PART 工工. PROPOSED PROGRAMME AND BUDGET FOR 1965
The Sub-Committee on Programme and Budget (established in accordance with
resolution WP/RC7-R7 adopted by the Committee at its seventh session) h e l d two meetings during which it made a detailed examination and analysis of the Regional DirectorT s proposed programme and budget estimates.
The Regional Committee examined the proposals for 1965 in the light of the findings and observations of the Sub-Committee•
The proposed regional programme a n d budget for 1965 was approved b y the Committee for transmission to the Director-General (see resolution WP/RCl4.R3) . The report of the Sub-Committee is contained in Annex
PART III. OTHER MATTERS DISCUSSED 1 . Fluoridation of water supplies (Document WP/RCl4/4 R e v . l )
The Committee discussed a paper presented as a sequel to the Technical Discussions h e l d in Wellington in 196l. This provided a digest of all available information on the safety，simplicity and economy of fluoridation of drinking water as the most efficacious single measure against dental decay• In the course of the discussion, information was presented by the representatives of Australia, New Zealand and the Philippines on the action taken in their countries in connexion with the fluoridation of community water supplies.
T h e representative of the International D e n t a l Federation presented a statement on the value of fluoridation, which he considered was the greatest single advance made in the field of preventive dentistry.
2 . K u r u in the Territory of Papua and New Guinea (Document Wp/RC14/5)
The Committee reviewed a report presented by the Director of Public Health of the T e r r i t o r y of Papua and New Guinea on k u r u , which occurs in a defined area in the Okapa Sub-District of the Eastern Highlands of the T e r r i t o r y . It also considered a paper by D r D , C . Gajdusek of the N a t i o n a l Institute of Neurological Diseases and B l i n d n e s s , N a t i o n a l Institutes of H e a l t h , B e t h e s d a , M a r y l a n d , United States of A m e r i c a , which gives a clear assessment of the past and present position»
Wp/RCl4/l5 R e v . l page 5
On the invitation of the C h a i r m a n , and w i t h the consent of the C o m m i t t e e , D r P . D . Schofield, Assistant Director of Medical R e s e a r c h , Papua and New G u i n e a , .
addressed the C o m m i t t e e . He stated that kuru occurred only in the Pore area of the Highlands and the epidemiology was peculiar because among children, boys and girls were equally affected, whereas among adults, women suffered m u c h more frequently than m e n . There was progressive degeneration of the central nervous system, leading to ataxia, involuntary m o v e m e n t s , muscular incoordination, paralysis and death usually in less than a year. The social effects were extremely serious, personal tragedies being frequent and adult m e n greatly outnumbering adult women because so m a n y of the latter died of kuru. There was no effective treatment and the disease was always, or almost always, fatal.
As regards etiology^ a genetic factor h a d been demonstrated by Professor Bennett of Adelaide University, b u t the disease closely resembled scrapie of sheep which is a virus disease. It also somewhat resembled amyotrophic.sclerosis from which a virus h a d been reportedly isolated in G u a m . Anthropologists believed that the disease h a d existed for less than 100 y e a r s , the primary focus h a d b e e n identified and the disease was still spreading and its incidence increasing. Genetics alone could not explain these facts and some environmental factor, at present unknown, m u s t also be involved.
D r Schofield described the intense scientific interest w h i c h this unique disease
h a d caused, since it was first described b y D r Zigas six years a g o , and the international research taking place in many countries to investigate all aspects of i t . It was
hoped that this work would throw light on other degenerative diseases of human beings at present incurable, such as amyotrophic lateral sclerosis, disseminated sclerosis, e t c . He also described the measures being taken by the Administration and the
missions to alleviate the situation pending the results of further research (see resolution Wp/rC14.R2),
3 . Facilities for education and training of h e a l t h personnel in the Western. Pacific Region (Document W P / R C 1 4 / 6 , Add,l and 2)
The Committee, at its thirteenth session, reviewed a report presented by the Regional Director on the facilities available for the education and training of health personnel within the R e g i o n , and adopted a resolution urging governments to submit full information on training prograjranes suitable for foreign students, so that it might be distributed to Member governments in the R e g i o n . A second report w a s , t h e r e f o r e , presented to the Committee summarizing the information received to d a t e . . It was noted that some replies were still awaited and that as soon as these had been received, full information on training programmes suitable for foreign students would be distributed to Member governments in the R e g i o n .
During the discussion, the view was expressed that more thought and attention must be given to the development of mechanisms whereby graduates could continue their
education effectively in the places where they w o r k e d . The Committee adopted a resolution recommending that efforts should be made b y governments to encourage the organization of refresher courses and in-service training programmes and to provide facilities for continuation studies for health workers (see resolution WP/RC14.R4).
Wp/rC 1 4 /i3 Rev.l page б
Studies on cholera E l Tor (Document WP/RCl4/7)
The Regional Director, in accordance with a request made by the Committee at its thirteenth session, submitted a paper incorporating the replies received from
governments in connexion with the cholera studies being carried out in the Region.
Additional information was also provided by China (Taiwan) on "The epidemic of E l Tor vibrio paracholera in Taiwan" and by Japan on the activities of its Research Committee on E l Tor cholera which, during the past ten months, had concentrated its efforts on the differentiation between the E l Tor cholera vibrio and classical cholera vibrio based on the following approach: (1) the antigenic structure, (2) the haemolysin test, (5) the phage sensitivity test and (斗）cultural methods. Studies had also been carried out on the differentiation of the E l Tor cholera vibrios into the Celebes and the other types.
The Committee was also informed that the Commonwealth Serum Laboratories, Australia had under preparation a vaccine against cholera E l Tor which had been inoculated into
animals and had shown very minor toxic or side-effects. Double blind trials of the vaccine had been arranged with the Department of Public Health as to its acceptability for immunizing human beings in the villages, and particularly in the Sepik District of the Territory. In view of WHO Ts recommendations during the Manila Conference that Asiatic cholera vaccines should always be given, it was proposed to give the new vaccine to one group and the new vaccine plus Asiatic cholera vaccine to the control group. If this trial were undertaken in the Territory, official guidance from WHO would be required•
During the discussion, attention was drawn to the importance of further studies on the problem of carriers. It was also proposed that any problem relating to the adequate vaccination of the personnel of fishing boats and similar ships moving casually from country to country should be referred to the Regional Director.
The opinion was expressed that the importance of considering the bio-social factors involved in a planned attack on cholera should be emphasized. It was, further,
suggested that the Directors of the WHO Regional Offices for the Western Pacific, South-East Asia and Eastern Mediterranean should consult together and explore ways and means of securing closer integration of anti-cholera work v/ith che ultimate aim of eradicating the disease from the entire area (see resolution Wp/RCl4.R5).
5 . Resolutions of regional interest adopted by the thirty-first and thirty-second sessions of the Executive Board and the Sixteenth World Health Assembly
(Document WP/RC14/8)
The attention of the Committee was drawn to seventeen resolutions of regional interest adopted by the Executive Board and the World Health Assembly. These covered the Expanded Programme of Technical Assistance (resolution EB31•h47)；
Decentralization of United Nations Activities (resolution JEB)1.R斗9); Malaria Eradication Special Account (resolutions E B 3 1 . R 2 6， WHA16.17 and EB32-R23)；
Development of the Malaria Eradication Programme (resolutions EB31.R31 and WHA16.23)；
W P / R C l 4 / l 3 Rev.l page 7
Developments in Activities assisted jointly with UNICEF (resolutions E B ) L R ) 2 and WHA16.24); Voluntary F u n d for Health Promotion: Medical Research (resolution
WHA16.26); Voluntary Fund for Health Promotion: Community W a t e r Supply (resolution WHA16.27); Continued Assistance to N e w l y Independent States (resolutions EB)1.R39 and WHA16.31)； Smallpox Eradication (resolution WHA16.37)； U n i t e d Nations
Development Decade (resolutions EB31.R50 and and Co-operation w i t h other Organizations: Programme Matters (resolution E B ) 2 . R 1 1 ) .
6 . Population problems
The possibility of WHO assisting in programmes connected with population problems was raised. The attention of the Committee was drawn to the fact that WHO Ts interest in this field was confined to the research aspects. The Government of the United States of America had made a voluntary contribution to WHO to support a u n i t which would carry out research work connected with human population studies. The Committee rioted that until such time as the World Health Assembly decided to formulate a prograinme
in this field, no action could be taken by the Secretariat. It was finally agreed, that it would be preferable to defer detailed consideration of this subject until governments had an opportunity of studying the matter further and deciding whether it should appear on the agenda of the next session of the Committee.
PART I V . OTHER BUSINESS 1. Progress reports from governments on health activities
The Chairman acknowledged the following reports which had been transmitted to the Regional Director:
(1) AUSTRALIA - Report of the Director-General of Health for the year ended 30 June 1962； Report of the National H e a l t h and Medical Research C o u n c i l , 1963；
a brief summary of the more important matters in the D i r e c t o r - G e n e r a l!s Report for 1962/63； June issue of the Health J o u r n a l published by the Department of Health;
(2) BRITISH SOLOMON ISLANDS PROTECTORATE - Report on the progress of health activities during 1962;
(3) BRUNEI - Report on the progress of health activities for the year 1962;
(4) CHINA (TAIWAN) - Report on the progress of health activities during the fiscal year 1963 (1 July 1962 - 30 June 1963)；
(5) FEDERATION OF MALAYA - Report on the progress of health activities during
1 9 6 1 - 1 9 6 2；
(6) JAPAN - R e p o r t on the progress of h e a l t h activities for the fiscal year 1962 (April 1962 - March 1963)； a brief report on public health administration in Japan for the period January 19б2 - July 1963；
W P / R C l 4 / l 3 R e v . l p a g e 8
The problem of leprosy in Viet-Nain from the public health point of view, Le-Cuu-Truong,
(2) A review of the present-day concepts of leprosy control with special reference to the role of the local health services, by Dr L. M. Bechelli.
(3) Case-finding, follow-up aad managenient of leprosy cases with particular reference to the integration of these a c t i v i t i e s into those of the established health services, by Dr R, A. Russell.
(4) The control of leprosy in F i j i within the public health programme, by Drs D- W, Beckett and A. J，Hîbell.
(7) KOREA - Report on the progress of health a c t i v i t i e s in 19o2;
(8) NEW ZEALAND - Report on the progress of health a c t i v i t i e s during 19Ô2;
(9) NORTH BORNEO - Report on the progress of health a c t i v i t i e s during 1962;
(10) PHILIPPINES - Report on the progress of health a c t i v i t i e s for the f i s c a l year 1962-1963；
(11) SARAWAK Medical and Health Department Annual Report, 1962;
(12) SINGAPORE - Report on the progress of health a c t i v i t i e s during the year 19б2;
(13) TERRITORY OF PAPUA AND NEW GUINEA - Annual Report of the Department of Public Health for 19б2-19бЗ； Report on the progress of health a c t i v i t i e s during 1962；
(14) VIET NAM - Report on the progress of health a c t i v i t i e s during 1962-196);
(15) WESTERN SAMOA - Report on the progress oí. health a c t i v i t i e s , I962-I963.
2. Technical Discussions 2 . 1 Designation of Chairman
At i t s eleventh sessiqn, the Regional Committee adopted a resolution (W P / R C 1 1 . R 1 1 ) recommending that the Chairman of the Technical Discussions should be appointed well in advance of the meeting. Following consultatiens between the Regional Director and the Chairman of the Regional Committee, Dr Le-Cuu-Truong, Director-General of Health and Hospitals in Viet Nam, was selected for t h i s o f f i c e •
2.2 Organization
The theme of the Technical Discussions was "The role of' the local health services in leprosy controln and four working papers were prepared covering the following
subjectsг
r D
s)/
1 у
(b
W p / r C 1 4 / i 3 R e v . l page 9
The f i r s t session consisted of an introductory statement by the Chairman, a panel presentation of the subject and an open discussion. In the second session, the participants were divided into groups which met separately and conducted a free discussion in accordance with guide-lines and references provided. The third session was again a plenary one at which the reports prepared by the discussion groups were presented, the views and opinions expressed were consolidated, and conclusions drawn. Full d e t a i l s are contained in the report of the Technical Discussions which appears in Annex 4.
2.3 Evaluation
Of the completed questionnaire received, a l l 22 assessed the choice of thé topic as timely; Ц) participants rated the Technical Discussions as very good axid eight as reasonably good; nine said they had gained many new ideas or concepts, and 12 had gained some.
2Л Selection of topic for the Technical Discussions in 1964
The Committee selected "The use of s t a t i s t i c s in public health administration"
as the subject for the discussions in 1964 (see resolution WP/RCl4.R7).
PART V. RESOLUTIONS ADOPTED BY THE COMMITTEE a
WP/RCI4.RI ANNUAL REPORT OF THE REGIONAL DIRECTOR The Regional Committee^
Having reviewed the Thirteenth Annual Report of the Regional Director covering the period from 1 July 1962 to 30 June 1963，1
1. NOTES with s a t i s f a c t i o n the progress made in the period under review;
2. EMPHASIZES that the f i e l d of maternal and child health provides an
opportunity for bringing together a number of related professional s k i l l s ; and Bearing in mind the f a c t that research has clearly indicated the importance of nutrition in the early years of l i f e ,
3. RECOMMENDS that attention should be concentrated on the nutritional aspects of maternal and child health;
1 U n p u b l i s h e d d o c u m e n t W P / R C l 4 / 2
W P / R C l 4 / l 3 R e v . l p a g e 10
4. REQUESTS the Regional Director：
(1) to draw the attention of the Dire с tor - General to the importance of reviewing the Organization's recruitment procedures, with particular attention to s a l a r i e s , allowances and post-adjustment, in order that governments may be provided with the most highly q u a l i f i e d experts;
(2) to study the p o s s i b i l i t y of appointing a regional adviser on medical care and hospital administration in order that governments may be provided with advisory services enabling them to plan, improve and expand t h e i r f a c i l i t i e s in these f i e l d s ;
5. CONGRATULATES the Regional Director on h:'.s comprehensive report•
WPR Handb.Res. 4th ed., 2 . 2 . 1 3 Fourth meeting, 9 September 19бЗ W P / R C 1 4 . R 2 K U R U
_ ‘ J ' , ••• •• - • • ‘ • . . ,
The Regional Committee,
Having considered.with interest the report presented on ”Kuru", a disease only found in the Territory of Papua and New Guinea,1
EXPRESSES i t s appreciation to the Department of Public Health in Papua and New Guinea for having made t h i s information available to the Committee.
WPR Handb.Res. 4th ed., 1.3.3(2) • Fourth meeting，9 September 1963
W P / R C I 4 . R 3 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 F O R 1 9 6 5 The Regional Committee，
I . Having examined the progranime and budget estimates proposed for the Western P a c i f i c Region in 19652 and the report of the Sub-Committee on Prograjnme and Budget,
1 . EOT)0RSES the proposed programme under the regular budget and those proposed to be financed from the Malaria Eradication Special Account and the Special Account for the Community Water Supply Programme;
2. NOTES the programme proposed to be financed under the Expanded Programme of Technical Assistance; and
1 Unpublished document Wp/rC14/5
2 Unpublished document WP/RC1斗/)
) U n p u b l i s h e d d o c u m e n t
Wp / rC 14/ h
R e v . lW P / R C 1 4 / 1 3 R e v . l p a g e 1 1
I I ,
3. AGREES that the following inter-country group educational a c t i v i t i e s are important and should be undertaken in 1965：
F i l a r i a s i s seminar
Seminar on helminthic diseases
• -Ш
Seminar on haemorrhagic f e v e r s
Seminar on health planning in urban development
Nursing conference on guides f o r s t a f f i n g of nursing s e r v i c e s and methods of study
Seminar on leprosy;
4. NOTES that the costing of the above a c t i v i t i e s i s based on t h e i r being held in Manila; a n d
5. DECIDES that i f a government wishes to serve as host to any i n t e r - country group educational a c t i v i t y , the additional expenses involved should be met by the government concerned;
Having studied the supplementary l i s t of p r o j e c t s , which were by governments, including those brought forward during the meeting, could not be accommodated within the regional a l l o c a t i o n f o r 1965, 1 , BELIEVES that these p r o j e c t s should be considered part of the programme;
requested , w h i c h
regional
2. REQUESTS the Regional Director to in the supplementary l i s t as p o s s i b l e , I I I . REQUESTS the
Director-General•
Regional Director to
implement as many of the p r o j e c t s as and when funds are a v a i l a b l e ; transmit the proposals to the
WPR Handb.Res. 4th ed.л
WP/RCI4.R4 EDUCATION The Regional
> • 1 . 1 ^ Fourth meeting， 9 September 1963
AND TRAINING Committee
1 . RECOfflíIZES the value of keeping health and medical workers abreast with progress in medical science;
2. EMPHASIZES the need f o r health and medical personnel to continue t h e i r education;
3. RECOMMENDS that e f f o r t s should be made by governments to encourage refresher courses, i n - s e r v i c e t r a i n i n g programmes and ensure f a c i l i t i e s f o r continuation studies f o r health workers.
WPR Handb.Res. 4th e d ” 1 . 7 . ^ Fourth meeting, 9 September 1963
W P / R C 1 4 / I 3 R e v . l p a g e 1 2
WP/RCI4.R5 CHOLERA
The Regional Committee,
Having reviewed the report presented by the Regional Director on the studies of cholera El Tor1 and the additional information furnished liy representatives,
1. NOTES:
(1) that the existing endemic f o c i serve as a threat to other countries; •
(2) the problems connected with cholera carriers;
2. CONSIDERS that further attention should be given to the t i o - s o c i a l factors involved in a planned attack on cholera, and
RECOMMENDS that：
(1) the problem of adequate vaccination of the personnel of fishing boats and similar ships moving casually from country to country should be referred to the Regional Director for appropriate action;
(2) the Organization should encourage and co-ordinate further studies on the problem of carriers;
� the Directors of the WHO Regional O f f i c e s for the Western P a c i f i c , South-East Asia and Eastern Mediterranean should consult together and explore ways and means of securing closer integration of anti-cholera work, with the ultimate aim of eradicating the disease from the entire area.
WPR Handb.Res. 4th e d•，1. 3 - 3 ( 1 ) Fourth meeting, 9 September 1963
WP/RCI4.R6 GENETIC PROFILES
� The Regional Committee
1. NOTES the advances made in recent years in understanding the genetic factors of a wide range of diseases;
2. EMPHASIZES the importance of studies aimed at determining the genetic p r o f i l e s of isolated groups l i v i n g in developing countries in the Western P a c i f i c Region, and the urgency of such studies while suitable groups s t i l l remain;
1 U n p u b l i s h e d d o c u m e n t W P / R C l 4 / 2
W P / R C l 4 / l 3 R e v . l page 1 3
RECOMMENDS that WHO should take the i n i t i a t i v e in exploring the p o s s i b i l i t i e s of such research and should bring t h i s to the attention of q u a l i f i e d research workers In d i f f e r e n t countries and of the governments 'of countries where suitable communities reside.
WPR Handb.Res. 4th éd., 1 . 5 . 3 F i f t h meeting, 10 September 196)
W P / R C L 4 . R 7 T E C H N I C A L D I S C U S S I O N S The Regional Cc^ftiittee
I . 1. NOTES the.report on the Technical Discussions;1
2. EXPRESSES i t s appreciation to Dr Le-Cuu-Truong for having so ably- served as Chairman^ and to the other experts who served as members of the Panel;
П . Having considered the topics proposed for the Technical Discussions in 1964,2
DECIDES that the subject shall be "The use of s t a t i s t i c s in public health adminictration",
WPR Handb.ReSo 4th e d•，5 - 5 . 2 ( 1 1 ) F i f t h meeting, 10 September 1 9 6�
WP/RC14.R8 RESOLUTION 0? APPRECIATION The Regional Committee
EXPRESSES i t s appreciation and thanks to：
(1) the Government and people of Australia and of the Territory of Papua and Nsw Guinea f o r :
(a) h a v i n g i n v i t e d the Regional Committee to hold i t s fourteenth session in ir-'ort IVforesby,
(b) the excellent arrangements and f a c i l i t i e s provided, (c) the generous h o s p i t a l i t y received, and
(d) the i n t e r e s t i n g t o u r s which have enabled representatives to see some of the achievements of the Territory;
(2) The Right Honourable the Prime Minister, Sir Robert Menzies, for having formally opened the fourteenth session of the Regional Committee;
1 Unpublished document WP/RCl4/l2 2 U n p u b l i s h e d d o c u m e n t W P / R C 1 V 9
WP/RCl4/l3 Rev.l page 1斗
(3) the Honourable Minister of State for Health, Senator Harrie Wade, His Honour the Administrator, Sir Donald Cleland, and the Honourable Minister of State f o r T e r r i t o r i e s , Mr Paul Hasluck, for having honoured the Committee with their presence at the opening ceremony;
(斗） the Director of Public Health, Dr R. P, R. Scragg, and h i s s t a f f f o r the e x c e l l e n t arrangements made f o r the meeting;
(5) the Chairman and other o f f i c e r s of the Committee;
(6) the Chairman of the Technical Discussions, Dr Le-Cuu-Truong, for h i s excellent planning and chairmanship, and the other experts who served as technical advisers and resource personnel;
(7) the representatives of the South P a c i f i c Commission and the non- governmental organizations who made statements;
(8) the Regional Director and the Secretariat f o r t h e i r work in connexion with the meeting.
F i f t h meeting, 10 September 19бЗ
WP/RC14.R9 ADOPTION OF THE REPORT The Regional Committee,
Having considered the d r a f t report on the fourteenth session of the Committee,
ADOPTS the report.
F i f t h meeting, 10 September 1963
WP/RCl4/l3 Rev.
ANNEX 1 page 1
AGENDA
1 . Opening of the session
2. Address by r e t i r i n g Chairman 3. Address by the Director-General
4. E l e c t i o n of new o f f i c e r s： Chairman, Vice-Chairman and Rapporteurs 5. Address by incoming Chairman
6. Adoption of the agenda 7 . Technical Discussions
7 . 1 Statement by the Chairman
7 . 2 Acceptance of the Programme f o r Technical Discussions 8. Proposed programme and budget estimates f o r the f i n a n c i a l year
1 January - 31 December 1965
8 . 1 Establishment of the Sub-Committee on Programme and Budget 8.2 Consideration of the report presented by the Sub-Committee
on Programme and Budget
9. Acknowledgement by the Chairman of b r i e f reports received from governments on the progress of t h e i r health a c t i v i t i e s
10. Report of the Regional Director 1 1 . Fluoridation of water supplies
12. Kuru in the Territory of Papua and New Guinea
13» F a c i l i t i e s f o r education and t r a i n i n g of health personnel in the Western P a c i f i c Region
14, Studies on cholera El Tor
15. Resolutions of regional i n t e r e s t adopted by the t h i r t y - f i r s t and thirty-second sessions of the Executive Board and the Sixteenth World Health Assembly
W P / R C 1 4 / I 3 Rev.L
Annex 1
page 2
16. Selection of topic for the Technical Discussions during the f i f t e e n t h session of the Regional Committee
17. Consideration of the report presented by the Technical Discussion Group 1 8 . Time, place and duration of the f i f t e e n t h and sixteenth sessions of the
Regional Committee 19* Other business
20. Adoption of the draft report of the Committee
21.
AdjournmentWP/RC1V13 Rev.l
ANNEX 2 page 1
LIST OP REPRESENTATIVES LISTE DES REPRESENTANTS
I . REPRESENTATIVES OP MEMBER STATES REPRESENTANTS DES ETAIS MEMBRES
AUSTRALIA AUSTRALIE
Dr R, F. R. Scragg
Director of Public Health Department of Public Health Territory of Papua and New Guinea Dr С. Hasz1er
Regional Kedical O f f i c e r Department of Public Health
Territory of Papua and New Guinea Dr K i l a Wari
Department of Public Health Territory of Papua and New Guinea Dr Himson Mulas
Department of Public Health
Territory of Papua and New Guinea Major-General VL D. Refshauge Diroctor-Genaral of Health Commonwealth of Australia Dr IL E« Dcwnes
Assistant Director-General of Health Commonwi)c.rui of Australia
Dr С. J . Ross-Smith General Secretary
Australian Medical Association
(Chief Representative) (Chef de délégation)
(Alternate/ Suppléant)
{Alternate/ Suppléant)
(Alternate/Suppléant)
(Alternate/ Suppléant)
(Alternate/ Suppléant)
(Alternate/ Suppléant)
CHINA CHINE
Dr С. К. Chang Director
Department of Health Administration Ministry of Interior
Taiwan, Republic of China Dr Т. С. Hsu
Commissioner of Health Department of Health
Taiwan Provincial Government Taiwan, Republic of China
(Chief Representative) (Chef de délégaticm)
(Alternate/ Suppléant)
WP/RC14/13 Rev.l
A n n e x 2
page 2
PRANCE Dr A. Perron
Médecin-Chef du
Sanatorium hansenien de Nouméa Nouvelle-Calédonle
JAPAN JAPON
Dr E. Wakamatsu Director
Public Health Bureau
Ministry of Health and Welfare Tokyo, Japan
Dr J , Ohmura Chief
National Sanatorium Section Medical A f f a i r s Bureau
Ministry of Health and Welfare Tokyo, Japan
Mr Y. Matsuda Third Secretary Embassy of Japan Manila
Dr К. Hamano Chairman
Board of Directors
Japanese Leprosy Foundation (Tofu-Kyokai )
Japan
(Chief Representative) (Chef de délégation)
(Alternate/ Suppléant)
(Alternate/ Suppléant)
(Adviser/ Conseiller)
KOREA COREE
Dr Suk Woo Yun Director
Bureau of Public Health Seoul, Korea
MAIAYA Dato Dr Mohajned Din bin Ahmad (Chief Representative) MALAISIE Director of Medical Services (Chef de délégation)
Federation of Malaya
Dr Haji Abbas bin Haji Alias (Alternate/Suppléant) Deputy Director of Medical Services
Federation of Malaya
WP/RClVl3 Annex' 2 page 3
Rev.l
NEW ZEALAND Dr D. P. Kennedy NOUVELLE-ZELANDE Director
Division of Public Health Department of Health New Zealand
PHILIPPINES Dr L. Uyguanco Director
Bureau of Disease Control Department of Health Manila
Dr F. T. Diy Director
Regional Health O f f i c e No, Department of Health
Cebu C i t y
Dr E. L. V i l l e g a s Medical Adviser Department of Health Manila
(Chief Representative) (Chef de délégation)
(Alternate/ Suppléant )
(Alternate/Suppléant )
PORTUGAL Dr Antonio Rosario Pinto Chief of the Health Services Timor
UNITED KINGDOM Dr С. H. Gurd (Chief Representative) ROYAUME-UNI Director of Medical Services (Chef de délégation)
F i j i
Dr R. Dickie (Alternate/Suppléánt) Deputy Director of Medical Services
Sarawak
Dr С- H. James (Alternate/Süppléant) Acting Deputy Director
of Medical Services North Borneo
W P / R C 1 4 / 13 R e v . l A n n e x 4 • — •、
p a g e 5
UNITED STATES OF AMERICA ETATS-UNIS D'AMERIQUE
Dr J . Watt Director
O f f i c e of International Health United States Public Health Service
Department of Health, Education and Welfare Washington
Dr R. К. С. Lee Director
Public Health and Medical A c t i v i t i e s University of Hawaii
Honolulu
Dr Saipele Matagi
Department of Medical Services American Samoa
(Chief Representative) (Chef de délégation)
(Alternate/ Suppléant)
(Adviser/ Conseiller)
VIET NAM Dr Le-Cuu-Truong
VIET-NAM Directeur général de l a Santé e t des Hôpitaux
Saigon, Viet-Nam
WESTERN SAMOA SAMOA OCCIDENTAL
Dr J . C. Thieme Director of Health Health Department Western Samoa
H . REPRESENTATIVES OF OTHER INTER-GOVERNMENTAL ORGANIZATIONS AND OF NCW-GOVERNMENTAL ORGANIZATIONS
REPRESENTANTS D'AUTRES ORGANISATIONS INTER-GOUVERNEMENTALES ET NON -GOUVERNEI^JTALES
INTERNATIONAL ASSOCIATION FOR THE PREVENTION OF BLINDNESS ASSOCIATION INTERNATIONAL DE PROPHYLAXIE DE LA CECITE
INTERNATIONAL COUNCIL OF NURSES
CœiSEIL INTERNATIONAL DES INFIRMIERES
Dr J . J . Loschdorfer
Medical S p e c i a l i s t (Ophthalmologist) General Hospital
Port Moresby ” Miss V. Bignold
Administrative S i s t e r
Department of Public Health Konedobu, Papua
INTERNATIOJAL DENTAL FEDERATION FEDERATION DENTAIRE INTERNATIONALE
Mr T. E. Hubble
с/о Director of Health Port Moresby
W P / R C l V l ) Rev.
Annex 2 page 5
LEAGUE OF RED CROSS SOCIETIES
LIGUE DES SOCIETES DE LA CROIX-ROUGE
Mr H. Buchanan Red Cross Society Melbourne
SOUTH PACIFIC COMMISSION COMMISSION DU PACIFIQUE SUD
Dr R. A. Chappel Medical O f f i c e r
South P a c i f i c Commission New Caledonia
WORLD MEDICAL ASSOCIATIΠASSOCIATIOi MEDICALE MONDIALE
Dr C. J . Ross-Smith General Secretary
Australian Medical Association
WP/RC14/13 R e v . l ANNEX 3
page 1
• . REPORT OP THE SUB-COMMITTEE ON PROGRAMME AND BUDGET
1 . INTRODUCTION
At i t s seventh session, thé Regional Committee, in r e s o l u t i o n WP/RC7*R7^ decided
" t h a t the establishment of a sub-committee on programme and budget, c o n s i s t i n g of s i x members plus the Chairman of the Regional Committee, should become a routine a c t i v i t y of the Regional Committee"； and recommended t h a t "the membership of t h i s sub-
committee be rotated among the representatives of various Members, s u b j e c t to the provision t h a t any representative d e s i r i n g t o be a member of the sub-committee should be e n t i t l e d t o p a r t i c i p a t e " •
The members of the Sub-Committee and t h e i r a l t e r n a t e s and advisers were as f o l l o w s :
A u s t r a l i a Dr R. F. . R . Scragg (Chairman)
China Dr C. K. .Chang
Japan Dr J . Ohmura
Mr Y. Matsuda ( a l t e r n a t e )
Malaya Dato Dr Mohamed Din bin Ahmad
Dr H a j i Abbas bin H a j i A l i a s 彳
New Zealand Dr D. P. .Kennedy
United Kingdom Dr C. H. .James
V i e t Nam Dr Le -Cuu-Truong
The meetings were a l s o attended by Dr С. Has z 1er ( A u s t r a l i a ) , Dr H. E. Downes ( A u s t r a l i a ) , Dr K i l a Wari ( A u s t r a l i a ) , Dr Suk Woo Yum (Korea), Dr E. L. V i l l e g a s ( P h i l i p p i n e s ) , Dr R. К. C, Lee (United S t a t e s of America) and Dr Saipele Matagi (United S t a t e s of America).
In- the course of i t s meetings on 6 and 9 September, the Sub-Committee, i n accor dance with the guide - l i n e s given on page 8, made a d e t a i l e d examination and a n a l y s i s of the ч proposed programme and budget estimates•
2 . GENERAL REVIEW OF THE PROPOSED PROGRAMME AWD BUDGET ESTIMATES FOR THE FINANCIAL YEAR 1 JANUARY 一 DECEI4BER 1965 (Document WP/RCH/?)
In introducing the proposed programme and budget in the Sub-Committee, the Regional Director stated t h a t the e f f e c t i v e working budget proposed f o r the Region under the regular programme i n 1965, excluding malaria a c t i v i t i e s ^ amounted t o
$ 2 477 000, an increase of $ 1^7 or 20 per cent, over the l e v e l f o r 1964. Of the proposed increase, $ 387 599 were a l l o c a t e d t o f i e l d a c t i v i t i e s and only $ 26 580 to the Regional O f f i c e . This was in l i n e with the p o l i c y t h a t the major proportion of any increase should be d i r e c t l y applied t o f i e l d a c t i v i t i e s ^
WP/RC14/13 Rev.l Annex 4 • — •、
page 5
The increases in the Regional O f f i c e , s i x - a n d - a - h a l f per c e n t . , the Regional Advisers, one per c e n t . , and the WHO Representatives, two-and-a-third per c e n t ” were a t t r i b u t a b l e t o s t a t u t o r y increases and uneven d i s t r i b u t i o n of home leave between the two y e a r s .
The Régional Director pointed out t h a t the proposed programme f o r 1965 was based on government requests, taking i n t o account continuing commitments, previously
e s t a b l i s h e d c r i t e r i a f o r regional programme p r i o r i t i e s , and the a l l o c a t i o n provided by the Director-General. Prom the summary of f i e l d a c t i v i t i e s , i t would be seen t h a t the 1965 f i e l d a c t i v i t i e s proposals t o t a l l e d $ 2 038 904, representing an increase of
$ 387 559, 23 per cent, over the corresponding estimate f o r 1964. One hundred and twenty-one p r o j e c t s were proposed under 19 d i f f e r e n t major s u b j e c t headings compared t o 92 i n 1964； 107 were country and 1 斗 inter-country p r o j e c t s ; 130 fellowships were included i n the proposals and 33， 25 per c e n t ” of these were f o r study within the Region.
The Regional Director referred t o document WP/RCl4/p&4/2 (see page 9) which showed the d i f f e r e n c e s between the proposed estimates f o r 1965 and the corresponding estimates f o r 1964 by amounts and percentages• I t would be noted t h a t in 1965 continuing p r o j e c t s accounted f o r approximately 7林 per c e n t , of the estimates.
Emphasis continued to be placed on p r o j e c t s r e l a t i n g t o the basic needs and problems of the Region, including public health administration, education and t r a i n i n g ,
strengthening of nursing and maternal and c h i l d h e a l t h s e r v i c e s , environmental health a c t i v i t i e s , and campaigns against communicable d i s e a s e s . The l a r g e s t i n d i v i d u a l percentage of funds continued t o be budgeted f o r public health administration> with 26.78 per c e n t , of the t o t a l , followed by education and t r a i n i n g , 12.93 per c e n t ” and nursing, IO.35 per cent.
In l i n e with the recommendations of previous meetings of the Regional Committee supporting p r o j e c t s b e n e f i t i n g more than one country, various region-wide a c t i v i t i e s were proposed. These included the continuation of the regional tuberculosis advisory and i n t e r - c o u n t r y treponematoses teams, seminars on f i l a r i a s i s and haemorrhagic f e v e r s and a conference on the public health aspects of protection against i o n i z i n g radiation•
In a d d i t i o n , provision was made f o r an i n t r a - r e g i o n a l survey of dental d i s e a s e s . The remaining inter-country p r o j e c t s covered consultant s e r v i c e s and f e l l o w s h i p s .
Despite the s i g n i f i c a n t increase i n the proposed programme f o r 1965, i t was s t i l l impossible to accommodate a l l the requests submitted by Member governments. I t had, t h e r e f o r e , been necessary t o r e l é g a t e c e r t a i n requests amounting t o $ 728 100 to the supplementary l i s t f o r possible implementation i f funds became a v a i l a b l e .
The Regional Director explairBd t h a t the 1965 Technical Assistance Programme
printed i n the document was, of course, t e n t a t i v e as government requests f o r the 1965/66 biennium had not y e t been submitted to the Technical Assistance Board. This included continuing commitments of long-term p r o j e c t s , which had already been approved beyond
1 9 6斗 by the Technical Assistance Board, and recommendations of the Regional O f f i c e
covering p r o j e c t extensions or modifications, and new a c t i v i t i e s f o r the 1965/66 biennium•
W P / R C 1 4 / 1 3 Rev.l A n n e x 4 • — •、
p a g e 5
He stressed the importance of health administrations' ensuring that the f i n a l
submission to the Technical Assistance Board should contain f u l l provision for both continuing projects and new requirements• In the current biennium there had been instances where the amounts requested and approved were not s u f f i c i e n t for the proposed programme• A great deal of d i f f i c u l t y had been encountered in attempting to cover d e f i c i t s by savings. The Regional O f f i c e supplied governments with cost estimates for t h e i r Technical Assistance projects based on WHO's costing averages.
Failure to use these costings would r e s u l t in incorrect amounts being approved by the Technical Assistance Board and would jeopardize the successful operation of the programme. The o v e r - a l l importance and relationship of health programmes to the economic and s o c i a l grovrth of developing countries was of the highest importance and t h i s should be made clear to national co-ordinating bodies when the Technical
Assistance Programme was being planned.
The Regional Director informed the Committee that commencing in 1964, a separate allocation had been provided within the Regular budget to cover a l l malaria a c t i v i t i e s except those carried under the Technical Assistance budget. The proposals f o r
malaria a c t i v i t i e s remained at approximately the same l e v e l as in 1964, A s l i g h t increase in the provision f o r Regional Advisers was mainly attributable to statutory increments and home leave costs. There were no changes in the s t a f f i n g pattern.
At present f i v e countries in the Region had f u l l malaria eradication projects in operation, namely, China, North Borneo, Philippines, Ryukyu Islands and Sarawak.
Assistance to China would be discontinued in 1965 as i t was expected that malaria would be eradicated by the end of 1964. I t was proposed to commence a pre-
eradication programme in Laos during 1965.
Proposals under the Special Account f o r Community Water Supply were tentative and subject to the contributions received. In addition to projects providing epcpert or consultant services to seven countries of the Region, a regional seminar on water u t i l i t y problems in urban developnent had been included in the proposal s .
In concluding, the Regional Director considered that the proposed budgetary increase f o r 1965 was reasonable, particularly i f one viewed the many reqüests which had had to be allocated to the supplementary l i s t because of limitations in funds.
DETAILED EXAMINATION AND ANALYSIS OP THE PROPOSED. PROGRAMME AND BIHDGET ESTIMATES
In the course of the Sub-Committee fs study, the following matters were discussed： Country projects
Cambodia 9 - Rural health training programme (pages 25-26)
I t was noted that the duration of assistance to t h i s project was estimated to be 10 years and information was requested on the number of personnel to be trained•
WP/RC14/13 Rev.l Annex 4 • — •、
page 5
The Regional Director stated that he could not provide a d e f i n i t e f i g u r e of the number involved but that students from the School of Nursing and the Royal School of Medicine used t h i s training centre f o r rural health experience. The training of sanitary agents was also being undertaken. The project had been faced with a number of d i f f i c u l t i e s , one of which was the recruitment of s u i t a b l e counterparts f o r WHO personnel. The s i t u a t i o n was, however, improving and a senior counterpart had recently been appointed. As he had pointed out in his annual report, unless govern- ments provided counterparts, WHO s t a f f would have t o remain i n the country longer than o r i g i n a l l y planned. I t would, thereforeл be necessary f o r assistance to t h i s project to continue f o r the next four years.
3 . I . 2 China 34 - Trachoma control (pages
Information was requested on t h i s project which i t was noted was an extensive one which had been going on f o r a number of years. I t was f e l t that the moment had possibly come to evaluate progress and determine whether the desired r e s u l t s were being achieved •
The Sub-Committee was informed that the programme had been o r i g i n a l l y designed to provide treatment f o r schoolchildren and a l s o , in certain areas, blanket treatment of family contacts. As the results had not been s a t i s f a c t o r y , epidemiological
studies had been carried out in 1 9 6 O - I 9 6 I by a WHO team, composed of a trachomatolo- g i s t and an e p i d e m i o l o g i s t / s t a t i s t i c i a n , and the national team. Therapeutic t r i a l s had been carried out at the same time to compare the e f f e c t i v e n e s s of continuous and intermittent treatment with a n t i b i o t i c ointment. I t had been found that trachoma was not confined t o the school-age groups and that the highest prevalence was consis- t e n t l y found in the 15-20 age-group, irrespective of o v e r - a l l prevalence r a t e , and the decline beyond t h i s peak was very gradual. The therapeutic t r i a l s had shown that intermittent treatment by achromycin ointment yielded r e s u l t s which were superior or a t l e a s t as good as those of continuous treatment.
The project had been redefined to provide f o r the treatment of a l l age-groups in the b e l i e f that the approach used would reduce the average prevalence. In under- taking the revised programme, the enormity of the task had impressed the Government and the team, and therefore very c a r e f u l and d e t a i l e d plans had been made. There had been t r i a l s of a l l proposed methods to t e s t t h e i r p r a c t i c a b i l i t y in the f i e l d before s t a r t i n g the mass campaign. The survey teams which were doing case-finding and treatment had covered to date over 90 per cent, of the population, and in most cases up to 99 per c e n t , , indicating the e f f e c t i v e n e s s with which the programme was being carried out. I t was realized that such a programme, to be e f f e c t i v e , depended upon a systematic approach and, i f possible, on a 100 per cent, coverage. I t was a tremendous challenge but i t was expected that the results would be s a t i s f a c t o r y . Provision had been made f o r an annual evaluation of the programme by a consultant and in the l a s t year there would be a consultant team which would do a complete evaluation.
WP/RC14/13 Rev.l Annex 4 • — •、
page 5
3 . 1 . 3 Korea 19 - Tuberculosis control (pages 55-56)
A t t e n t i o n was dra\m t o the f a c t t h a t , although t h i s p r o j e c t had s t a r t e d i n 19б>
or e a r l i e r and was expected t o f i n i s h in 1967， there was no evidence of any diminution i n WHO a s s i s t a n c e . I t was f e l t t h a t t h i s point covered a number of programmes and i t appeared t h a t in many c a s e s there was no tapering o f f of Ш0 assistance u n t i l t h e completion of the p r o j e c t . I t should be possible f o r competent counterparts t o replace the Ш0 s t a f f gradually so t h a t assistance was given on a diminishing s c a l e .
The Regional Director pointed out t h a t i n many cases the budget provision was to meet the cost of fellowships t o be awarded t o t r a i n l o c a l people. In 1965, f o r
example, there was provision f o r fellowships in the amount of $ 9800, which represented i n t e n s i f i e d t r a i n i n g of national s t a f f . The tuberculosis p r o j e c t in Korea had only j u s t s t a r t e d and one could not expect the government s t a f f t o take over within such a short period of time as four y e a r s . The aim was not merely t o demonstrate tuberulosis control but to work out. a n a t i o n a l plan. During the past months, the progress
achieved had been quite impressive.
3 . 1 . 4 Malaya 40 - Assistance to the University of Malaya (pages 77-78)
The Sub-Committee was informed t h a t the medical education programme in Malaya w a s b e i n g expanded and developed. The representative of Malaya asked, t h e r e f o r e , i f the fellowships appearing i n the proposed programme and budget could perhaps be advance -awarded. The e a r l y assignment of the consultants would a l s o be d e s i r a b l e . He jfu^ther requested t h a t the two-year f e l l o w s h i p f o r study of v i t a l s t a t i s t i c s i n the- United Kingdom should be changed to a two-year f e l l o w s h i p f o r study of epidemio- lo©r ,and s t a t i s t i c s i n the United S t a t e s of America, and t h a t the reference to London U n i v e r s i t y , followed by p r a c t i c a l t r a i n i n g i n A f r i c a and India, i n connexion wi*Ui the n u t r i t i o n f e l l o w s h i p , should be d e l e t e d .
3 , 1 - 5 New Zealand 200 - Public health administration (pages 79-80)
The Regional Director was requested t o amend the t e x t to read "To enable an o f f i c e inspector in the Depar-taisnt of Health to study public health administration and finance"•
5 . I. 6 Papua and New Guinea (pages 85-88)
The Sub-Committee was informed t h a t a majority of the fellowships awarded i n past years t o Papua and New Guinea had been taken by Europeans, as there had been no medically-trained l o c a l personnel. This would not be so in 1965, as a l l but one f e l l o w s h i p i n the surgery of leprosy were f o r national personnel and t h i s trend would be followed in future y e a r s .
