E X E C U T I V E B O A R D 二 . •
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S e v e n t y - n i n t h S e s s i o n ！:•
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Agenda item 7.2 今 1 、 ？
DIARRHOEAL DISEASES CONTROL PROGRAMME
(Draft resolution proposed by the Director-General as amended by Dr К. Bart, Adviser to Dr F . E . Y o u n g )
The following proposed draft resolution is intended as a substitute for the text contained on pages 15-16 of document E B 7 9 / 1 1 .
T h e E x e c u t i v e B o a r d ,
Having examined the Director-General1 s report on the Diarrhoeal Diseases Control Programme;1
Recommends to the Fortieth World Health Assembly the adoption of the following resolution:
The Fortieth World Health A s s e m b l y ,
Recalling resolutions WHA31.44 and WHA35.22;
Having considered the Director-General1 s report on the Diarrhoeal Diseases Control Programme;
Having been informed (a) t h a t , by 1 9 8 5 , 104 countries (83% of the 125 target
countries) have national diarrhoeal diseases control programmes, (b) that access to oral rehydration salts has increased from 4% in 1982 to almost 33% in 1984, (c) that annual production of oral rehydration salts has risen from 60 million to 270 million one-litre equivalent packets, (d) that more than 40 countries have conducted an evaluation of their progress in diarrhoeal diseases control programmes and (e) that the use of oral rehydration therapy may have prevented up to 350 000 diarrhoea deaths in 1984, the last year for which data are available;
1 . EXPRESSES ITS SATISFACTION with the progress made in the implementation of national diarrhoeal diseases control programmes and in research to develop new approaches and tools for control;
1 : EXTENDS ITS APPRECIATION to the United Nations Children's F u n d , the United Nations Development Programme, the World Bank, and other international, bilateral and
nongovernmental agencies, for their continued collaboration in and support to the Programme;
3 . URGES Member States to intensify their diarrhoeal diseases control activities as a global priority for achieving health for all by the year 2000 and as an entry point for primary health c a r e , giving special attention to activities that can have an immediate impact on childhood m o r t a l i t y , while at the same time implementing interventions that can reduce diarrhoea morbidity;
1 Document EB79/11.
WORLD HEALTH ORGANIZATION
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
Ж � • 4、
EB79/Conf.Paper No.3 15 January 1987
ШШ
EB79/Conf.Paper No.3 page 2
4• AFFIRMS that the establishment of an effective diarrhoeal diseases control programme is the best means of ensuring the recognition and control of epidemics of cholera;
5 . URGES RECOGNITION that an effective diarrhoeal diseases control programme must include careful planning, adequate health manpower training, effective communication and social m a r k e t i n g , adequate production and distribution of oral rehydration s a l t s , and appropriate supervision, m o n i t o r i n g , evaluation and research;
6 . REAFFIRMS that oral rehydration therapy should consist of the administration of oral fluid, appropriate feeding during and after diarrhoea and referral when n e c e s s a r y , and that for the prevention of diarrhoeal diseases it is necessary for programmes also to stress improved n u t r i t i o n , the use of safe w a t e r , good personal and domestic h y g i e n e , and immunization, especially against measles;
7 . EMPHASIZES the need for continued adequate financial support to enable the Programme to carry out its planned activities and achieve its objectives； 8 . REQUESTS the Director-General:
(1) to increase collaboration with Member States in strengthening national control programmes, especially through activities in training and evaluation;
(2) to continue to support biomedical and health services research relevant to diarrhoeal diseases control;
(3) to maintain close collaboration with the United Nations Children's F u n d , the United Nations Development Programme, the World B a n k , bilateral and other agencies in carrying out Programme activities;
(4) to make efforts to attract the necessary extrabudgetary resources to meet the requirements of the Programme;
(5) to keep Member States, the Executive Board and the Health Assembly informed of the progress made in the implementation of the Diarrhoeal Diseases Control P r o g r a m m e .
) I
O R G A N I S A T I O N M O N D I A L E D E L A
W O R L D H E A L T H O R G A N I Z A T I O N E B 7 9 / C o n f . P a p e r No.3 Rev.l 20 J a n u a r y 1987
E X E C U T I V E B O A R D S e v e n t y - n i n t h S e s s i o n A g e n d a item 7 ê2
D I A R R H O E A L DISEASES C O N T R O L PROGRAMME
(Draft r e s o l u t i o n proposed by the D i r e c t o r - G e n e r a l and as a m e n d e d by Members of the E x e c u t i v e B o a r d )
The E x e c u t i v e B o a r d , Having
P r o g r a m m e ;
e x a m i n e d t h e D i r e c t o r — G e n e r a丄1s r e p o r t o n t h e D i a r r h o e a l D i s e a s e s C o u t r o丄
R e c o m m e n d s to the Fortieth W o r l d H e a l t h A s s e m b l y the a d o p t i o n of the following r e s o l u t i o n :
The Fortieth W o r l d H e a l t h A s s e m b l y ,
Recalling r e s o l u t i o n s ША31.44 and ША35.22;
H a v i n g considered the D i r e c t o r - G e n e r a l ' s report on the D i a r r h o e a l D i s e a s e s C o n t r o l P r o g r a m m e；
H a v i n g b e e n informed ( a ) t h a t , Dy 丄9 8 5 , 104 countries (83% of the 125 target
c o u n t r i e s ) have n a t i o n a l d i a r r h o e a l d i s e a s e s c o n t r o l p r o g r a m m e s , ( b ) that a c c e s s to oral r e h y d r a t i o n salts has increased from 4% in 1982 to almost 33% in 1 9 8 4 , (c) that a n n u a l p r o d u c t i o n of oral r e h y d r a t i o n salts has risen from 60 mi丄lion to 270 m i l l i o n one—丄itre e q u i v a l e n t p a c k e t s , (d) that m o r e than 4 0 c o u n t r i e s have c o n d u c t e d an e v a l u a t i o n of
their progress in d i a r r h o e a l d i s e a s e s control programmes and (e; that the u s e of o r a l r e h y d r a t i o n therapy m a y h a v e prevented up to 350 000 diarrhoea d e a t h s in 丄9 8 4 , the last year for w h i c h data are a v a i l a b l e ;
1 . EXPRESSES ITS SATISFACTION w i t h the progress m a d e in the i m p l e m e n t a t i o n of n a t i o n a l d i a r r h o e a l diseases c o n t r o l programmes and in research to d e v e l o p new a p p r o a c h e s and tools for c o n t r o l ;
2 . E X T E N D S ITS A P P R E C I A T I O N to the U n i t e d N a t i o n s Ctiildreu's F u n d , 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 , the W o r l d B a n k , and other i n t e r n a t i o n a l , b i l a t e r a l and
nongovernmenta丄 a g e n c i e s , for their c o n t i n u e d col丄aboration in and support to the P r o g r a m m e ;
3 . URGES Member States to intensify their d i a r r h o e a l diseases c o n t r o l a c t i v i t i e s a s a g l o b a l priority for a c h i e v i n g health for a l l by the year 2000 and as part of primary n e a l t h c a r e , giving special a t t e n t i o n to a c t i v i t i e s that can h a v e an immediate impact on childhood m o r t a l i t y , w h i l e at the same time implementing i n t e r v e n t i o n s , particularly i n t e r s e c t o r a l , that can reduce diarrhoea m o r b i d i t y ;
1 Document EB79/11.
EB79/Conf.Paper No.3 Rev. 1 page 2
4 . A F F I R M S that the e s t a b l i s h m e n t of an e f f e c t i v e d i a r r h o e a l d i s e a s e s c o n t r o l p r o g r a m m e is the best m e a n s of ensuring the r e c o g n i t i o n and c o n t r o l of e p i d e m i c s of c h o i e r a ;
5 . U R G E S R E C O G N I T I O N ttiac an e f f e c t i v e d i a r r h o e a l diseases c o n t r o l p r o g r a m m e must i n c l u d e c a r e f u l p l a n n i n g , a d e q u a t e health m a n p o w e r t r a i n i n g , e f f e c t i v e c o m m u n i c a t i o n and s o c i a l m a r k e t i n g , a d e q u a t e p r o d u c t i o n and d i s t r i b u t i o n of o r a l r e h y d r a t i o n s a l t s , and a p p r o p r i a t e s u p e r v i s i o n , m o n i t o r i n g , e v a l u a t i o n and r e s e a r c h ;
6 . R E A F F I R M S that for tiie p r e v e n t i o n of diarrhoea丄 d i s e a s e s it is n e c e s s a r y for p r o g r a m m e s also to stress improved n u t r i t i o n , ttie use of safe w a t e r , good p e r s o n a l and d o m e s t i c h y g i e n e , and i m m u n i z a t i o n , especia丄丄y a g a i n s t meas丄es, a n d that o r a l
r e h y d r a t i o n therapy should consist of the a d m i n i s t r a t i o n of oral f l u i d , together w i t h a d e q u a t e i n s t r u c t i o n to m o t h e r s in its u s e , a p p r o p r i a t e feeding during and after d i a r r h o e a and referral w h e n n e c e s s a r y ;
7 . E M P H A S I Z E S the need for c o n t i n u e d a d e q u a t e financia丄 support to e n a b l e tne P r o g r a m m e to carry out its planned a c t i v i t i e s and a c h i e v e its o b j e c t i v e s； 8 . REQUESTS the D i r e c t o r - G e n e r a l :
(丄j to increase c o l l a b o r a t i o n with M e m b e r States in s t r e n g t h e n i n g n a t i o n a l c o n t r o l p r o g r a m m e s , e s p e c i a l l y through a c t i v i t i e s in training and e v a l u a t i o n in order to achieve g l o b a l targets of at least 80% access to ora丄 r e h y d r a t i o n salts and at 丄e a s t 50% use of oral rehydration therapy by 1989;
、2) to continue to support b i o m e d i c a l and h e a l t h services research r e l e v a n t to diarrhoea丄 d i s e a s e s c o n t r o l；
(3; to m a i n t a i n с丄ose c o l l a b o r a t i o n w i t h the U n i t e d N a t i o n s Chi丄dren1s F u n d , the U n i t e d Nations D e v e l o p m e n t P r o g r a m m e , the World B a n k , b i l a t e r a l and other a g e n c i e s in carrying out P r o g r a m m e a c t i v i t i e s ;
(4) to m a k e efforts to attract the n e c e s s a r y e x t r a b u d g e t a r y r e s o u r c e s to m e e t the r e q u i r e m e n t s of the P r o g r a m m e ;
(5； to keep M e m b e r S t a t e s , the E x e c u t i v e Board and the H e a l t h A s s e m b l y informed o f t h e p r o g r e s s m a d e i n t h e i m p l e m e n t a t i o n of t h e D i a r r h o e a l D i s e a s e s C o n t r o l P r o g r a m m e .
E X E C U T I V E
WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA
B O A R D
Etí79/Conf.Paper N o . 3 R e v . 2 2丄 J a n u a r y 丄987
S e v e n t y — n i n t n S e s s i o n /I
、. . :、. . . . m A g e n d a i t e m 7.2 :: -
D I A R R H O E A L D I S E A S E S C O N T R O L P R O G R A M M E
( D r a f t r e s o l u t i o n p r o p o s e d b y ttie D i r e c t o r - G e n e r a l a n d a s a m e n d e d by M e m b e r s of tlie E x e c u t i v e B o a r d )
T h e E x e c u t i v e B o a r d ,
H a v i n g e x a m i n e d t h e D i r e c t o r — G e n e r a l *s r e p o r t on t h e D i a r r h o e a丄 D i s e a s e s C o n t r o l P r o g r a m m e ;
R e c o m m e n d s to t h e F o r t i e t h W o r l d Hea丄tn A s s e m b l y t n e a d o p t i o n of t h e f o l l o w i n g r e s o l u t i o n :
T h e F o r t i e t h W o r l d H e a l t h A s s e m b l y ,
R e c a l l i n g r e s o l u t i o n s WHA3丄.44 and W H A 3 5 . 2 2；
H a v i n g c o n s i d e r e d t h e D i r e c t o r - G e n e r a l1 s r e p o r t o n t h e D i a r r h o e a丄 D i s e a s e s C o n t r o l P r o g r a m m e；
H a v i n g b e e n i n f o r m e d ( a ) t n a t , b y 1 9 8 5 , 104 c o u n t r i e s (83% of the 125 t a r g e t
c o u n t r i e s ) h a v e n a t i o n a l d i a r r h o e a l d i s e a s e s c o n t r o l p r o g r a m m e s , ( b ) that a c c e s s to o r a l r e h y d r a t i o n salts has i n c r e a s e d from 4% in 1982 to a l m o s t 3 3 % in 1 9 8 4 , (c) t h a t a n n u a l p r o d u c t i o n of o r a l r e h y d r a t i o n s a l t s h a s r i s e n f r o m 60 m i l l i o n to 270 m i l l i o n o n e - l i t r e e q u i v a l e n t p a c k e t s , (d) t h a t m o r e than 4 0 c o u n t r i e s h a v e c o n d u c t e d an e v a l u a t i o n of their progress in d i a r r h o e a l d i s e a s e s c o n t r o l p r o g r a m m e s a n d (e) that the u s e of ora丄 r e h y d r a t i o n therapy m a y h a v e p r e v e n t e d u p to 3 5 0 000 d i a r r h o e a d e a t h s in 1 9 8 4 , the l a s t y e a r for w h i c h data a r e a v a i l a b l e ;
C o n s i d e r i n g that diarrhoea丄 d i s e a s e s c o n t r o l i n c l u d e s both p r o p e r c a s e m a n a g e m e n t and p r e v e n t i o n of d i a r r h o e a ;
1 . E X P R E S S E S ITS S A T I S F A C T I O N w i t h the p r o g r e s s m a d e in the i m p l e m e n t a t i o n of n a t i o n a l d i a r r h o e a l d i s e a s e s c o n t r o l p r o g r a m m e s and in r e s e a r c h to d e v e l o p n e w a p p r o a c h e s a n d too丄s for c o n t r o l ;
2 . E X T E N D S ITS A P P R E C I A T I O N to the U n i t e d N a t i o n s C h i l d r e n ' s F u n d , 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 , the W o r l d B a n k , and o t h e r i n t e r n a t i o n a l , b i l a t e r a l and
n o n g o v e r n m e n t a l a g e n c i e s , for their c o n t i n u e d c o l l a b o r a t i o n in and s u p p o r t to the P r o g r a m m e *,
3 . URGES Member States to i n t e n s i f y their d i a r r h o e a l d i s e a s e s contro丄 a c t i v i t i e s as a g l o b a l p r i o r i t y for a c h i e v i n g h e a l t h for a i l b y the year 2 0 0 0 and as part of p r i m a r y hea丄tn c a r e , g i v i n g s p e c i a l a t t e n t i o n to a c t i v i t i e s that can tiave an i m m e d i a t e impact on c h i l d h o o d m o r t a l i t y , w h i l e at the s a m e time i m p l e m e n t i n g i n t e r v e n t i o n s , i n c l u d i n g
i n t e r s e c t o r a l o n e s , that can r e d u c e d i a r r h o e a m o r b i d i t y ;
I
1 Document EB79/1丄.
EB79/Conf.Paper No.3 Rev.2 page 2
4 . AFFIRMS that the establishment of an effective diarrhoeal diseases control programme is the best means of ensuring the recognition and control of epidemics of cholera;
5 . URGES RECOGNITION by Member States that an effective diarrhoeal diseases control programme must include careful planning, adequate health manpower training, effective communication and social m a r k e t i n g , adequate production and distribution of oral rehydration s a l t s , and appropriate s u p e r v i s i o n , m o n i t o r i n g , evaluation and research;
6 . REAFFIRMS that for the prevention of diarrtioeal diseases it is necessary for programmes also to stress improved n u t r i t i o n , including breast feeding, the use of safe w a t e r , good persona丄 and domestic h y g i e n e , and immunization against measles; and that
treatment sliould consist of the administration of oral rehydration fluid, together with adequate instruction of mothers and other caretakers in its u s e , and appropriate feeding
during and after diarrhoea, with referral when n e c e s s a r y ,
7 . EMPHASIZES the need for continued adequate financial support to enable the Programme to carry out its planned activities and achieve its objectives;
8 . REQUESTS the Director-General:
(1) to increase collaboration with Member States in strengthening national control programmes, especially through activities in training, communications
(including social marketing) and evaluation in order to increase the acceptance of ora丄 rehydration therapy and effective case management of diarrhoea and achieve the global targets of 80% access to oral rehydration salts and 50% use of oral
rehydration therapy by 1989 ;
(2) to continue to support biomedical and health services research relevant to diarrhoea丄 diseases contro丄；
(3) to maintain close collaboration with the United Nations C h i l d r e nfs F u n d , the United Nations Development Programme, the World B a n k , bilateral and other agencies in carrying out Programme activities;
(4) to таке efforts to attract the necessary extrabudgetary resources to meet the requirements of the Programme；
(i>) to keep Member States, the Executive Board and the Health Assembly informed of the progress made in the implementation of the Diarrhoeal Diseases Control P r o g r a m m e .
