ORGANISATION MONDIALE DE LA SANTÉ
22 M a y 1975 T W E N T Y - E I G H T H W O R L D H E A L T H A S SE M B L YD R A F T F I R S T REPORT OF CO MMITTEE A
Committee A h e l d n i n e m e et i n g s o n 15, 19, 20, 21 and 22 M a y 1975.
At its first meeting, the C o mmittee electëd Dr M a r c e l l a Davies (Sierra Leone) Vice- Ch a i r m an and Dr B. L e k i e (Zaire) Rapporteur, in accordance w i t h the suggestions of the Co mm it te e on Nominations.
During the course of these meetings, w h i le proceeding w i t h the detailed r e view of the prog r a mme budget for the financial years 1976 and 1977, C ommittee A decided to r ecommend to the Twen ty -e ig hth W o r l d H ea l t h As s e m bl y the ad option of the at tached resolutions o n the
fo llowing subjects; . . ..
W H O activities in regard to the development of met ho ds of c ont rolling the tropical parasitic diseases
Smallpox eradication programme Schistosomiasis
Preventi o n of bl M y c o t i c diseases
COMMITTEE A
Document A28/42.
W H O AC T I V I T I E S IN R EG A RD TO THE DEVEL O P M E N T OF METHO D S OF C O N TR O L L IN G THE TROPICAL PARASITIC
DISEASES
The T w e n t y-e i ght h W o r l d H ea l t h Assembly,
D r a w i n g the a t te n tio n of M e m b e r States once more to one of the m o s t u rgent public health p robl e ms in the d eveloping countries today - the tropical parasitic diseases, and p a rticularly onchocerciasis, filariasis, schistosomiasis and trypanosomiasis, w h i c h cause great damage to the people's he a l t h a nd r e t a r d social and economic progress in m o s t of the d eveloping
countries;
N o t i n g the steps taken b y the O rg a n i z a t i o n in accordance w i t h r es ol ut io n WHA27.52 to i n t e n s i f y r e s e a r c h programmes on tropical parasitic diseases, as desc rib e d in the Director- G e n e ral' s report on the w o r k of W H O in 1974;
C o n s id er in g it n e c es s ary to give pr i or i t y attention to the development of recommendations a n d meth ods for these programmes for the control of the m o s t important tropical parasitic d i seases a n d prima ri ly the programmes for the control of onchocerciasis, schistosomiasis, etc., w h i c h are b e i n g alre ad y carried out or are at the active plannin g stage, us ing to this end all the exper ie nc e a c c u m ula t ed by the M e m b e r States;
W e l c o m i n g the W H O b iom e di c a l r e s earch effort in this field,
1. URGES M e m b e r States, res e a rc h and practical establishments and m e d i c a l scientists work ing o n aspects of tropical patho l og y to inte n s i fy their efforts to develop effective, safe and p r a c t i c a b l e mea ns of contr o lli n g tropical parasitic diseases; and
2. REQUESTS the D i r e c tor - Gen e r al to u n d e rt a ke the measures nee d ed to improve the system of c oo r d i n a t i n g the various programmes for the control of the tropical parasitic diseases and also the m e th od s of ca r rying out these programmes and to pay special atte nt io n to these asp e cts in the report h e is to m a k e to the Twenty- ni nt h W o r l d He a l t h As se m b l y under the terms of r e sol u t i o n WHA27.52.
S M AL L PO X ERADI C A T I O N PROGRAMME
The T w e nt y-ei g hth W o r l d H ea l t h Assembly,
H a v i ng c onsi d ere d the Directo r -G e neral's report on the smallpox eradication programme;
N oting w i t h satisf a ct i on the considerable successes achieved in carrying out the programme, as wit n ess the sharp r eduction in the number of cases of smallpox in countries where it is endemic;
C o n s id er ing that the progress m a d e and the unfla gg in g efforts and care of W H O and its Me m b e r States in carrying out this programme inspire confidence that smallpox eradication will soon be a chieved throughout the world;
Bearing in m i n d that the successful complet io n of this programme w ill be the first example of the era d ica t io n of a disease by m a n as a result of bro ad international cooperation and the co ll ec ti v e efforts of WHO, its M e m b e r States and various international governmental and nong ov er nm enta l organizations;
R e c og ni zi ng that the success of the programme has b e en dependent on its profoundly scientific basis, on uncea s i n g research and practical investigations throughout the course of its implementation, on m a ki n g correct allowances for the special features of the causal agent of smallpox and the nature of immunity to it, on the considerable improvements achieve d in the last few years in the quality and effectiveness of the smallpox vaccine, on the development a n d w i d e practical introd u ct i on of new methods of mass v acc i n a t i o n and on constant impr o ve
ments in systems for case-f i nd i n g and for the recording of vaccinations;
N oting also that the entry of the smallpox eradication p rogramme into its final stage has been the result of lengthy and heroic efforts by numerous countries, international organizations, establishments, physicians and field workers, both in the period up till the 1950s w h e n na tional campaigns we r e developing and w h e n the p rerequisite conditions w e r e being created for sm allpox control on an international scale and after the procla ma ti on and deve lop men t of an i nternational smallpox er a dication campaign in accordance w i t h resolution W HA 1 1.5 4 in 1958 and the int e nsi fication of the programme from 1967 onwards in accorda nc e w i t h resolution WHA19.16, and
Expres sin g confidence that w i t h c ontinued effort the countries so near the end will achieve eradication,
1. CONGRATULATES the countries which, since the inception of the Global Programme, have mad e the o ut standing achievement of eradicating smallpox from wi t h i n their borders;
2. THANKS all governments, organizations and individuals w ho have con t rib u ted to the impleme nt at io n of the programme and asks them to continue to increase their efforts for smallpox e rad ication in this concluding stage of the programme;
3. EMPHASIZES the need to increase the vigilance and sense of re sp onsibility in all regions of the world, w i t h a v i e w to preventing possi bl e outbreaks of smallpox so as not to let slip the favourable si tuation for the successful concl us io n of the programme that now exists, by continuing active epidemiological surveillance and the corresponding v acc i n a t i o n programmes, partic ul ar ly for n ew- b o rn children;
4. DEEMS it necessary to summarize and describe in a m a j or publication the experience of smallpox e ra dication throughout the world, for w h ich purpose the help should be enlisted of scientific experts and practical workers who have taken part in carrying out the programme, h avi n g first a nal y sed w i th great care and thus pre se rv ed for m a n kin d the unique historical experience of the eradication of one of the most dangerous communicable diseases as a result of effective international cooperation, experience w h i c h will doubtless be used in programmes for the control of other communicable diseases;
5. REQ UE S T S the Di re c t or-General of the W o r l d H ealth Organization:
(a) to draw up re c ommendations regarding those further activities of the Organi z ati o n a nd its Me mb er States that will be ne e d ed to ma in t a i n smallpox eradi ca ti on throughout the world, including p o ssible changes in the International H ealth Regulations;
(b) to ensure the wider development of research on methods of d i f fe re nt ia ti ng viruses of the poxvirus group and determining the special features of their epidemiology, paying p a rti c u l a r attention to v a r i o l a- l ik e viruses (white strains) is olated from monkeys and to other mo n k e y viruses; and
(c) to submit a report on further developments in this sphere to the Exe cu ti ve Board at one of its sessions or to a W o r l d H e alth Assembly.
SCHISTOSOMIASIS The Twe n ty-eighth W o r l d H e a l t h Assembly,
Reca l lin g resolutions EB5.R5 and EB55.R22 on schistosomiasis;
Noting that the disease remains largely un co nt ro ll ed and that its p rev a len c e is increasing; and that w a ter development projects d es igned to improve n e e d e d agricultural produc ti on and to improve ne e d e d economic conditions u n d e r t a k e n with o ut co n s i d e r a t i o n given to preventive h ealth m e as u r e s m a y contribute to this increase;
Noting the i ncreasing evidence of the possible o cc ur r e n c e of serious comp l ica t ion s and sequelae as a result of schistosomiasis infection;
N o ting further that the W o r l d Food Conference emphasized the ne ed for greatly increased food p ro du ct io n and n o ted that m e e t i n g nutritional and other r equirements of the worl d' s expanding populat i on will require m o r e projects to impound w a t e r and irrigate fields;
Express in g the v i e w that proper engineering design of w a te r m a n a ge me nt projects can hav e considerable importance in limiting the spread of schistosomiasis among populations affe ct ed by such projects;
N oting the in clusion of schistosomiasis w i t h i n the c o o rd in at ed b iomedical research programme of the Organization;
Reco g niz i ng that effective planning for, and o p erati o n of, sch istosomiasis control
activities requires close c oo p eration and coordination among agencies wi t h i n the U n ited Nations system, the international financial community and m in is t r i e s w i t h i n na tional governments
under the leadership of the W o r l d H e a l t h Organization;
Expressing apprec i at i o n for the report of the Directo r- Ge ne ra l wh i c h ou t lines the complexity of the problems invol v e d to prove the feasibility of s c histosomiasis control;
Looking forward to the important international m e e t i n g on s chistosomiasis w hi c h is scheduled to be he l d in Cairo in October 1975 ; and
Recognizing the very high costs of i mp lementation of control programmes usin g present a vailable methods,
REQUESTS the Director-General:
(1) to prepare and keep guidelines current on the development of wa t e r m a n a g e m e n t projects including en g ineering specifications, to m i n i m i z e the p o s sib i lit y of the spread of schistosomiasis and other w a ter borne disease in w ater ma n a g e m e n t projects;
(2) to advise countries and donor organizations on the a ppl i c a t i o n of guidelines on w a t er development (including hydro-electric) projects planned, under construction, or c o mpleted ;
(3) to request mem b er s to m a k e available info rm at io n on s ch is to somiasis control programmes u n derway or carried out in their countries, incl ud in g details of research work, m an p o w e r development programmes, costs, etc.;
(4) to seek e x t r a -bu d get a ry support and assistance from various sources w i t h i n the U n i t e d N a t ion s system and in t er n ational and private agencies in order to provide a ssis ta nc e
(a) to governments in p l anning and ca rrying out studies of the epidemiology of the disease, the cost e ffectiveness of alter na ti ve m e t h o d s of control a n d its social and economic impact,
(b) to governments in the p r e p ar a tion and i mp le me nt at io n of control programmes, (5) to s timulate i n c rea s ed efforts in r es earch in drug development, chemotherapy, epidemiology, control i n c l ud i ng me t ho d o l o g i e s for self-help, and immunological aspects of s chistosomiasis;
(6) to d raw the a t te n tio n of M e m b e r States w h er e the disease is not endemic to the d e s i r ab il it y of o r g a n i z i n g e p i demiological surveillance w i t h i n h e a l t h services; and (7) to report on this m a t t e r to the Twenty-ninth W o r l d H ea l t h Assembly.
P REVENTION OF BLINDNESS The Twen ty -eig h th W o r l d H e a l t h Assembly,
R e c o g niz i ng the great h um a n suffering and the financial burden caused by blindness and the fact that a large part of such blindness could be prev en te d or cured;
T aking into account the resolutions on pr ev en ti on of blindness adopted by previous W o r l d H e a l t h Assemb l ies (WHA22.29 and WHA25.55) and the report of the Study Groupl co nvened b y W H O in 1972, as w e ll as the a d o ption of "Foresight prevents blindness" as the theme for W o r l d H e a l t h Day in 1976; and
Rec og ni zi ng the potential contri b ution of governmental and no n-governmental organizations, 1. EXPRESSES its apprec i a ti o n of the w or k alr ea dy undertaken in this connexion b y WHO, especia ll y w ith regard to some-major causes of blindness, such as onchocerciasis, trachoma and others;
2. REQUESTS the Director-General:
(a) to continue these efforts;
(b) to encourage me m b e r countries to develop national programmes for the prevention of blindness e specially aim ed at the control of trachoma, xerophthalmia, on c hocerciasis a nd other causes and to introduce adequate meas u r e s for the early detection and
treatment of other potentially blinding conditions such as cataract and glaucoma;
(c) to encourage national and international non-governmental organizations to m o b i l i z e financial and other resources for the i mp le mentation of this programme; and
(d) to report to the W o r l d Health Assem b l y on developments in the control of blindness in general and of onchocerciasis, trachoma and xerophthalmia in particular.
^ Technical Report Series No. 518 (1973).
The T w e n ty-eighth W o r l d H e a l t h Assembly,
H a v i n g examined the programme budget submitted by the D irector-General for the financial years 1976 and 1977;
No t i n g wi th satisfaction the important place given in this programme budget to the control of communicable diseases in general;
Co n s i d e r i n g that superficial and internal mycotic infections are e xtremely widespre a d bo th in industrial and developing countries, and that they amount to an important medico- social problem,
1. I N VIT E S the h e a l t h authorities of Me m b e r States to give m y c o tic infections the a t t e n t i o n w ar r a n t e d by their prevalence and m edico-social importance;
2. REQ UESTS the D irector-General to provide assistance w i t h i n the Organization's programme to epidem io lo gi ca l studies on superficial and internal m y c otic infections and to provide M e m b e r States with appro p ria t e technical advice o n their control; and
3. REQ UE S T S the Director-General to report to the Tw enty-ninth W o r l d He a l t h As s emb l y on the public h e alt h importance of m y c o t i c diseases in W H O Member States.
