WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
EXECUTIVE BOARD E B 3 9/ H
1 December 1966 Thirty-ninth Session
_ _ ORIGINAL: ENGLISH
Provisional agenda item
REGIONAL COMMITTEE FOR THE EASTERN MEDITERRANEAN Report on the Sixteenth Session
The Director-General has the honour to present to the Executive Board the report on the sixteenth session of the Regional Committee for the
Eastern Mediterranean1 which has been established in pursuance of resolution WHA7.55, paragraph 2 (8) in order to harmonize the decisions of _ 2
Sub-Committees "A" and "B" held, respectively, in Karachi, Pakistan, from 19 to 23 September 1966, and in Geneva on 30 and 31 August 1966.
E _ C 1 6 / 1 0 Document
2 Handbook of Resolutions and Decisions. 8th e d ” pp. 259-260
W O R L D H E A L T H o r g a n i z a t i o n
REGIONAL OFFICE FOR THE EASTERN MEDITERRANEAN
^
E B 3 9 / 1 1
ANNEX
o r g a n i s a t i o n m o n d i a l e de l a s a n t é BUREAU REGIONAL DE LA MEDITERRANEE ORIENTALE
REGIONAL COMMUTEE FOR THE EM/RCI6/IO EASTERN MEDITERRANEAN October 1 9 6 6
Sixteenth Session ORIGINAL: ENGLISH
REPORT
ON THE SIXTEENTH SESSION OF THE
REGIONAL COMMUTEE FOR THE EASTERN MEDITERRANEAN
EM/ftCl6/10 page i
Election of the Regional Director 10 Resolutions of General Interest Adopted by the Nineteenth 11
World Health Assembly and by the Executive Board at its Thirty- seventh and Thirty-eighth Sessions
Representatives of Sub-Committee A and В (Rules of Procedure) 11 Places of Seventeenth, Eighteenth and Nineteenth Sessions of
the Regional Committee
Adoption of Reports of Sub-Committees A and В 11 Closure of the Session of Sub-Committee A 11 1. General
2. Election of Officers 5. Adoption of the Agenda 4. Voting
PART II REPORTS AND STATEMENTS
ANNEX I ANNEX II
ANNEX III
ANNEX IV
Agenda
List of Representatives, Alternates, Advisers to Sub-Committee A of the Regional Committee,
and Observers Sixteenth Session List of Representatives, Alternates, Advisers and Observers to Sub-Committee В of the Regional Committee, Sixteenth Session Summary of Discussions in Sub-Committees A and В on the Proposed Programme and Budget Estimates for 1968 for the Eastern
Mediterranean Region and Technical Matters
1. Annual Report of the Regional Director to the Sixteenth Session 2 of the Regional Committee
2. Co-operation with other Organizations and Agencies 4 PART III SUB-DIVTSION ON РИСХШАММЕ
1. Appointment of Sub-Division 5
2. Report on the Discussions 5
PART IV TECHNICAL DISCUSSIONS
1. Health Aspects of Industrialization with Special Reference to 8 Air Pollution
2. Subject for Technical Discussions at Future Sessions 10 PART V OTHER MATTERS
TABLE OF CONTENTS
Page PART I INTRODUCTION
2
34
5 6
1 2 2
OJ
ANNEX V Summary Technical Report - Technical Discussions on Health Aspects of Industrialization with Special Reference to Air Pollution - Sixteenth Session - 1966
тШ1в/ю pifege il
INDEX OP RESOLUTIONS
REGIONAL COMMITTEE FOR THE EASTERN MEDITERRANEAN SIXTEENTH SESSION
Аш»ш1：Report of the Regional Director EZ^tion of the Regional Director
ffladAb-Aspects: of Industrialization with Special R^f«rence tor Air Pollution
Htopital Records and their Importance for Health AtoiMstration：
Proposed Programme and Budget Estimates for 1968 flterthe Eastern tediterranegin Region
SmedLl|>ox Eradication
Technical Problems met in Malaria Programmes of the Region - Methodology of their Studies and some Soope for their Solution
Resolution No.
EM/ftCl6/R.l EM/hCl6/ft.7 EM/ftCl6/R.6
EM/ftCl6/tl,5 EM/lRCl6/h.2 m/RCl6/RA EM/RC16/R.3
Co-operation with other Organizations and Agencies
Sub-Committee A
EH/HC16A/5
EM/hCl6/10 page 1 PART I
INTRODUCTION 1. GENERAL
Sub-Committee A of the Regional Committee for the Eastern Mediterranean at its Sixteenth Session met in Karachi (Pakistan) from 19 to 2J September 1966. Sub-Committee В met in Geneva on 30 and 31 August 1966.
The resolutions adopted by the Sub-Committees on subjects common to the two agendas were either identical or the same in substance.
The present report gives the co-ordinated decisions of the two Sub- committees and has been prepared for submission to the Executive Board of the World Health Organization in accordance with Resolution WHA7.33 and Rule 47 of the Rules of Procedure.
Sub-Commit te A held four plenary meetings and the Sub-Division on
Programme took place on Wednesday 21 September and Thursday 22 September 1966.
Sub-Committee В held three plenary meetings• Both Sub—Committees discussed the election of the Regional Director^- in closed session. "Health Aspects of Industrialiaation with Special Reference to Air Pollution" was the subject of the Technical Discussions at both Sub-Committees.
The following states were represented:
Sub-Committee A
Cyprus Pakistan Ethiopia Saudi Arabia
Prance Somalia Iran Sudan Iraq Syrian Arab Republic
Jordan Tunisia Kuwait United Arab Republic
Lebanon United Kingdom of Great Britain Libya and Northern Ireland
Yemen Sub-Committee В
Ethiopia — …•……
Prance Israel
United Kingdom of Great Britain and Northern Ireland.
At Sub-Committee A, the United Nations, the United Nations Development Programme, the United Nations Childrenf s Fund and the United Nations. Relief and Works Agency for Palestine Refugees were represented.
Representatives or observers from nine international non-governmental, intergovernmental and national organ!zations^ were present•
^•Agenda item 7
^See: Annex II - List of Representatives, Alternates, Advisers and Observers to Sub-Committee A .
eivRCIÓAO page 2
At Sub-Committee В, the United Nations and the United Nations Develop- ment Programme were represented, and representatives from eight non-govern- mental organizations^- were present. The International Children's Centre was represented by an observer.
2. EIECTION OF OFFICERS (Agenda item 2) . Sub-Committee A elected its Officers as follows:
Chairman: Brigadier M.S. Haque (Pakistan) Vice-Chairmen: H.E. Haji Bascir Ismail (Somalia)
— — — — — W A b d u l r n aji d Abdulhadi (Libya)
Dr. Mahgoub Hamza (Sudan) was elected Chairman of the Sub-Division on Prograimne，and Dr. Awni Ari'f (Iraq) was elected Chairman of the Technical Discussions.
Sub-Committee В elected its Officers as follows:
Chairman: Mr. M . Lennuyeux-Comnène (Prance) Vice-Chairman: D r . P. Dill-Russell (United Kingdom) Dr. P. Dill-Russell also presided over the Technical Discussions at Sub-Committee B .
3 . ADOPTION OP THE AGENDA
Both Sub-Committees adopted the provisional agenda as presented^.
k. VOTING
The Governments represented in both Sub-Committees exercised their right of vote in Sub-Committee A. Other Governments exercised their right of vote in the Sub-Committee at which they were represented.
PART II
REPORTS AND STATEMENTS
1. АШЦАЬ REPORT OF THE REGIONAL DIRECTOR TO THE SIXTEEOTH SESSION OF THE REGIONAL COMMITTEE (Agenda item 5> Document ЕМ/ЙС16/2) 一 The following vyere some of the main points that ^emerged from the dis- cussions on the. Annual Report of the Regional Director:
a. Education and training activities in the field of health continued to be of paramount importance for every country in the Region. The training of nurses, dentists and dental auxiliaries particularly required consideration.
^-See： Annex III - List of Representatives, Alternates, Advisers and Observers to Sub-Corranittee B .
^See: Annex I
E1V^C16A0
page 3b . The creation of medical schools was a great step forward. Three factors, however, had to be borne in mind when establishing them, namely：
medical faculties were the most expensive of all university faculties；
students should be of a suitable educational standard； teaching staff should exist in sufficient number and calibre.
c. The teaching of medical sciences could be considered on a regional basis. Publishers should be contacted with a view to obtaining usually ex- pensive textbooks at a lower cost.
d . The fellowships programme was very valuable for both undergraduate and post-graduate training. The selection of candidates and their effective utilization when returning home after training abroad were important.
e . Nutrition and especially the training of hospital dieticians were receiving increasing attention throughout the Region. Hospital diet and kitchen services should not only benefit the patient but should also be used as laboratory for student nutritionists, nurses and doctors.
f. The outbreaks of cholera El Tor in the summers of 1965 and 1966 in new areas of this and other Regions caused great concern to the Governments.
The situation of the recent outbreak in Iraq was made the subject of a detailed statement by the Representative of Iraqi. While preventive measures in excess of the International Sanitary Regulations were considered detrimental to the economy of the countries affected by the disease, the need for reviewing the International Sanitary Regulations as they stood at present was also stressed, and it was felt that this view should be conveyed to the Director-General•
g. Malaria and smallpox were other communicable diseases of importance.
Smallpox eradication programmes were of interest not only to countries where endemic foci still existed but also to those already freed from the disease, so as to prevent its reintroduction. Resolution WHA19.16 approving a ten- year global smallpox eradication programme was appreciated.
h . Mass campaigns, and indeed аду particular health activity, should be under continuous evaluation especially with a view to their future inte- gration into the basic health services.
Health hazards consequent to industrialization, mental health, urbanization, growth of population, family planning, health problems of old age and medical research were amongst the new problems which were facing the countries of the Region and which deserved special attention.
J. The quality control of pharmaceutical preparations was receiving greater attention. It was hoped to establish a regional reference laboratory for the quality control of locally manufactured or imported pharmaceutical preparations• î
к. The trend towards diminution in some countries of the health share of the Technical Assistance portion of their United Nations Development Pro- gramme was of concern both to the Member States and- the Regional Office • The co-ordination body of the respective governments should include a responsible representative of their health authorities when formulating their overall country requests.
1See： Document EM/RC1'oA/^, Annex III,
EM/hci6Ao
page 4Following is the Resolution on the Annual Report of the Regional Director:
EM4lCl6/h,l
The Regional Committee,
Having reviewed the Annual Report of the Regional Director for the period 1 July 1965 to 30 June 1966;
Being fully aware of the growing need for health services to cope with the health problems associated with the rapid social and economic development taking place in the Region;
Noting the constantly increasing need for more medical, paramedical and auxiliary health personnel required for developing health services；
Considering the necessity for control and eradication of endemic and epidemic diseases which still represent a major health problem in the Region;
Acknowledging the fact that within a total public health programme the provision of an adequate safe water supply and the safe disposal of human and industrial waste should receive a high priority,
1. REQUESTS the Regional Director to continue to provide advisory assistance to Member States in the development of all aspects of their health programmes, including preparation of realistic long-term national health plans；
2. ENDORSES the emphasis being given to the training of technical and auxiliary personnel and trusts that the Governments of the Region will make effective use of the recently established WHO Revolving Fund for the supply of teaching and laboratory equipment for medical education and training；
3. URGES the Governments to explore possibilities of obtaining financial assistance from the UNDP Special Fund, the Regional Development Banks or the International Development Association (IDA) of the World Bank, particularly for projects in the field of community water supplies, and to request assistance from WHO for the formulation of such requests；
4. THANKS the World Health Organization and ihealth authorities of the region for the effective action taken with regard to the outbreak of cholera El Tor last year and endorses the preventive measures against future outbreaks；
5. NOTES with appreciation the efforts to assist the countries towards the eradication of smallpox from the Region;
6. COMMENDS the Regional Director for his clear and substantial report•
2. CO-OPERATION WITH OTHER ORGANIZATIONS AND AGENCIES (Agenda item 6) Statements were made by eight Representatives or Observers in Sub- committee A1, and two in Sub-Committee B2,
^ e e ; Document EM/RCI6A/5
^See: Document EM/RC16B/5
EM/hci6Ao, page 5 Following is the Resolution adopted by Sub-Committee � in connexion with this Agenda item:
Sub-Committee A,
Having heard with interest the statements and reports of Representatives and Observers of Organizations and Agencies；
Having studied the report of the Department of Health of the United Nations Relief and Works Agency for Palestine Refugees (Document EM/ftCl6/9)；
Noting with satisfaction their valuable work in fields related to health, 1. THANKS UNRWA for continuing to provide essential services for the Palestine refugees；
2. EXPRESSES its gratitude for the continuing close co-operation between International Organizations.
PART III
SUB-DIVISION ON PROGRAMME 1. APPOIOTMENT OF SUBDIVISION (Agenda item 斗)
Sub-Committee A， in conformity with Rule 14 of the Rules of Procedure, established a Sub-Division on Programme comprising the Sub-Committee as a whole under the Chairmanship of Dr. Mahgoub Hamza (Sudan).
The Proposed Programme and Budget Estimates for 1968 for the Eastern Mediterranean Region (Agenda item 9) an^ Technical Matters (Agenda item 10) were referred to the Sub-Division.
Sub-Committee В discussed these agenda items in plenary session under its Chairman, Mr. M . Lennuyeux-Comnène (Prance).
2. REPORT QN THE DISCUSSIONS (Agenda item 11) A sximmary of the discussions on Agenda items Following are the resolutions:
9 and 10 appears in Annex IV.
PROPOSED PROGRAME АШ BUDGET ESTIMATES FOR 1968 FOR THE EASTERN MEDITERRA№:AN REGION (Document EM/RC16/3)~ — - 一 一 - — —— — ——一一 — „ —
The Regional Committee,
Having examined the Proposed Programme and the Regional Director for the year 1968 for the Viewing with concern the continued general for health under the United Nations Development
Budget Estimates submitted by- Eastern Mediterranean Region;
trend of decrease of funds Programme,
Resolution Е_С1бА/ИЛ
EM/ftCl6/lO page 6
1. FINDS that the programme as presented ensures a suitable balance between the major subject headings；
2. NOTES with satisfaction that the smallpox eradication programme, formerly financed from the Voluntary Fund for Health Promotion, has now been incorporated in the Regular programme in accordance with Resolution WHAI9.I6 of the Nineteenth World Health Assembly ； *
J. APPRECIATES that continued prominence is given to Education and Training, Public Health Administration and Environmental Health as well as continued support to the control of Communicable Diseases；
REITERATES the importance of inter-country programmes, and supports the requests submitted to the Governing Council of the United Nations Develop- ment Programme for activities included under this heading in the biennium 19б7А9б8 as well as the inter-country activities included in the Regular programme；
5. URGES Member States to accord a reasonably high priority to health projects- within their overall submission to the Governing Council of the United Nations Development Programme；
6. ENDORSES the Proposed Programme and Budget for 1968 to be implemented from the Regular budget of the World Health Organization and the activities proposed to be financed from Special Accounts under the Voluntary Fund for Health Promotion ;
7. THANKS UNICEF for its constant co-operation and continued valuable support•
TECHNICAL MATTERS
a. Technical Problems met in Malaria Eradication Programmes of the Region - Methodology of their Studios and some Scope for their Solution (Document ]bt/hCl6/4 ) — "
The Regional Committee,
Having studied the document on the above subject submitted by the Regional Director;....“
Having also taken note of the information on malaria eradication provided in the Regional Director's Annual Report (Document EM/RC16/2)；
Noting with satisfaction the progress made in malaria eradication and pre-eradication programme of the Region, and particularly the steps taken by additional Member States to launch malaria eradication programmes；
"Noting also the difficulties encountered in some of the malaria eradication programmes as evidenced by the establishment of transmission in areas originally considered free or already freed from the disease.11
Noting with appreciation the valuable research activities being carried out in the Region in the field of Malaria Eradication;
ЕМ/кС1бД0 page 7
Having witnessed that successful results were obtained in interrupting the transmission of malaria in southern Iraq, where the local vector had developed resistance to hydrocarbon insecticides, by resuming DDT spraying in combination with other measures as necessary,
1. EXPRESSES appreciation for the contributions of the Member States, particularly of the new subscribers to malaria eradication, towards the Region's efforts to eradicate malaria；
2. URGES the Governments to continue to provide the required adminls—.
trative, technical and financial support to malaria eradication until the final goal is reached and to make every effort in ensuring Accurate operations in order to prevent the possible reintroduction of the disease into originally free or already freed areas；
RECOMMENDS that the possibility of DDÜL^praying in combination with other measures be considered as an effective attack measure in areas having vector resistance problems similar to those in southern Iraq;
REQUESTS the Regional Director to provide assistance for special studies in problem areas whenever required.
b. Smallpox Eradication (Document EM/RC16/5) EM/RCl6/RA
The Regional Committee,
Having studied with interest the document on smallpox eradication pre- sented by the Regional Director；
Recognizing the importance of smallpox eradication programmes in the Region as part of the global eradication programme；
Being aware of the Resolution of the Nineteenth World Health Assembly on the Smallpox Eradication Programme1
；
Recalling the need for adequate basic health services for the maintenance phase ；
Having noted with interest the smallpox eradication programme included in the Proposed Programme and Budget Estimates for 1968 for the Eastern Medi- terranean Region (EM/RC16/3),
1 . COMMENDS the Organization on its efforts to eradicate smallpox on a global basis ；
2, URGES countries which plan to strengthen or initiate smallpox eradi- cation programmes to take the necessary steps to begin the work as soon as possible ；
5. REQUESTS Member States to provide adequate material and technical support for the realization of the programme；
xSee: Resolution WHAI9.I6
EM/ftCl6/10 page 8
4. EXPRESSES its satisfaction with the work carried out by the Organization concerning smallpox eradication;
5 . REQUESTS the Regional.Director, with the co-operation of all Member States, to co-ordinate the smallpox eradication programme within the Region.
c. Hospital Records and their Importance for Health Administration (Document EM/ftCl6/6)
The Regional Committee,
Having studied the document on Hospital Records and their Importance for Health Administrationi
Considering that careful analysis of hospital utilization is important in effective planning and functioning of health services；
Recognizing that this evaluation of hospitals1 performance requires a system of detailed and continuous recording, and periodic statistical analysis and reporting;
Being aware of the need in the countries of the Region for improving hospital record keeping and for establishing records rooms within hospitals, supervised by specially trained personnel,
1, RECOMMENDS that Member States take steps to establish adequate systems of hospital recording and filing of information, in order to serve as a basis for hospital morbidity statistics and for evaluation of hospital services；
2. REQUESTS the Regional Director to continue to provide assistance to Member States for promoting hospital recording and to provide fellowships and training in medical records librarianship.
PART IV
TECHNICAL DISCUSSIONS
1. HEALTH ASPECTS OF INDUSTRIALIZATION WITH SPECIAL REFERENCE TO AIR POLLUTION (Agenda item 12，Documents EM/hCl6/Techn.Disc >/1-2)
Both Sub-C ornmi tt ее s held Technical Discussions on Health Aspects of Industrialization with Special Reference to Air Pollution^-, Sub-Committee A with Dr. Awni Arif (Iraq) as Chairman, and Sub-Committee В under the Chair- manship of its Vice-Chairman, Dr. P. Dill-Russell (United Kingdom). A document prepared by the Regional Office formed the background to the dis- cussions.
Following is the resolution adopted in connexion vzith this Agenda item:
^•See: Annex V for Summary Technical Report
ЕМ/ЙС1б/10 page 9
EM/hCl6/h>6
The Regional Committee,
Having considered the document on Health Aspects of Industrialization with Special Reference to Air Pollution;
Realizing that human beings are the most important single development resource and the central factor in development；
Recognizing that modern public health now has the tools required to achieve marked improvement in the health of the people during the transition from an agrarian to an industrial economy；
Believing that any country wishing to achieve rapid industrialization without paying an excessive price in human .values should accord a very high priority to measures for the protection and promotion of the health of the gainfully-employed segment of the population and their families,
RECOMMENDS that
a. the health of the nation be considered an essential element in all social and economic development programmes；
b. a close working relationship be established between the health authorities and other authorities responsible for the economic and social development to ensure the participation of health authorities in the planning and implementati on of the industrial- ization programme at all levels；
c, in planning new industrial projects, due consideration be given to the integration of these projects in the community's general development programme to ensure a healthy environment through the provision of both preventive and curative health services, healthy housing, safe community water supply, sanitary methods for the disposal of sewage, refuse and industrial waste；
d , where industries are well established and environmental and public health problems exist, detailed studies pertaining to these problems be undertaken and corrective measures initiated without delay；
e. adequate consideration be given to the training of the medical, paramedical and auxiliary personnel needed for the full range of health services；
f. countries of the Region accord a reasonably high priority to the provision of occupational health services, since the maintenance of health of the workers is an essential requirement for improving productivity;
g. effective measures for the prevention and control of environmental pollution (atmospheric, riverine and marine) be initiated and maintained;
ЕМ/^С16Д0 page 10
h . adequate legal provision be made by Governments in the Region at an early stage to safeguard the health of the people and ensure the control of the working environment；
i. a health education prograimne be designed to encourage the general public to adapt themselves to the new way of life imposed by in- dus tri aliz ati on and to ensure the proper use of health services and other measures provided to promote health,
2 . SUBJECT FOR TECHNICAL DISCUSSIONS AT FUTURE SESSIONS (Agenda item 1 31)
"Review of the Education and Training of Nurses to meet the Needs of the Region" had previously been chosen by Sub-Committee Л for Technical Discussions in 1967 and was also selected by Sub-Committee В in the course of the Sixteenth Session, Sub-Committee A decided to discuss "Integration of Mass Campaigns in the National Basic Health Services" in 1968.
РЛНТ V OTHER MATTERS
1. ELECTION OF THE REGIONAL DIRECTOR (Agenda item 7 , Document EM/RCl6/f) This matter was considered in closed session by both Sub-Committees A and B . D r . А.Н» Par ah, Representative of Tunisia, and H.E. Yohannes Tseghe, Representative of Ethiopia, were appointed tellers for Sub-Committees A and В respectively•
The following resolution was adopted：
EM/RCl6/h>7
The Regional Committee,
Considering the provisions of Resolution ШЛ7.53 relating to elections,
2
1. REQUESTS the Director-General to transmit to the Executive Board the name of the candidate nominated by the Regional Committee for the post of Regional Director in accordance with Rule 28 of the Rules of Procedure?;2. RECOMMENDS that the appointment be made for a period of five years from 1 September 1967.
^Subsequently, on 20 September, the Deputy Director-General announced that he had sent a cable to the Director-General informing him that D r . A.H.
Taba had'been elected by the Regional Committee for the Eastern Mediterranean for nomination to the Executive Board as Regional Director by procedure of postal vote, and that this would be notified immediately by the Director-General to all Member States in the Region. This announcement was received with
acclamation^
iSee： Documents EM/RCI6A/5, Resolution EM/ftCl6A/ft• 6 , page 11, and ЕМ/ЙС16В/5, Resolution EM/RC16B/R.9, page 12.
！Handbook of Resolutions and Decisions, 8th ed. pages 259-260
^EMRO Handbook of Resolutions and Decisions, Annexes II and III, page vi
EM/hCl6/10 page 11 2. RESOLUTIONS OF GENERAL INTEREST ADOPTED BY THE NINETEENTH WORID HEALTH
ASSEMBLY AND BY THE EXECUTIVE BOARD AT ITS THIRTY-SEVENTH AND THIRTY-
EIGHTH SESSIONS (Agenda item 8，Document EM/ftCl6/8) — — — Both Sub-Committees A and В reviewed the resolutions included in the document and took note of their contents^-.
3. REPRESENTATIVES OF SUB-COMMITTEES A AND В (RULES OF PROCEDURE) (Agenda item 15)
In pursuance of Resolution WHA7.33, paragraph 2 (8) and of Rule 林7 of the Rules of Procedure of the two Sub-Committees of the Regional Committee for the Eastern Mediterranean, S u b - C o m m i t t e e� � designated Dr. M,K. Afridi
(Pakistan) as its representative to meet with the Regional Director in order to harmonize the decisions taken by both Sub-Committees during the 1966 Sesssion.
Sub-Committee В requested the Regional Director to act on its behalf in the same connexion.
4. PLACES OF SEVENTEENTH，EIGHTEENTH AND NINETEENTH SESSIONS QF THE REGIONAL COMMITTEE (Agenda item 13)
Sub-Committee A) noted its previous decision to hold the Seventeenth Session in Iran in 1967 and accepted the invitation of the Government of Somalia to hold its subsequent Session in Somalia in 1968. Sub-Committee A further accepted the invitation of the Government of Cyprus for 1969»
5. ADOPTION OP REPORTS21 OF SUB-COMMITTEES A AND В (Agenda item 14) Both Sub-Committees adopted the report submitted on their respective sessions, Sub-Committee A as amended and Sub-Committee В as presented.
6. CLOSURE OF THE SESSION OF SUB-COMMIITEE A (Agenda item 13) 5
Sub-Committee A夕 adopted a vote of thanks to the Government of Pakistan for the generous hospitality extended towards all the participants of the Sixteenth Session.
^See: Document EM/RCI6A/5, Resolution EM/RCI6A/R.5 page 11, and Document . EM/ÎIC16B/3, Resolution EM/^Cl6B/h,3, page 9 .
2See: Document EM/ftCl6A/3, Resolution EM/ftCl6A/tL7, page 11 3See: Document EM/tiCl6/5, Resolution EM/ïlCl6A/k.8, page 12
斗See: Document EM/RCI6A/3, Resolution ЕМ/ЙС1бА/Й• 15, page l6 and Document EM/RCI6B/3, Resolution EM/RC16B/R. 11, page 13
5SEE: Document EM/TLCLÓA/j, Resolution EM/RC16A/R.14, page 1б
EM/hCl6/lC Annex I
6.
7.
8.
9-
ANNEX I
A G E N D A
REGIONAL COMMITTEE FOR THE EASTERN MEDITERRANEAN SIXTEENTH SESSION
Opening of the Session Election of Officers Adoption of the Agenda
Appointment of the Sub-Division on Programme
(m/RClb/1 Rev.l)
Annual Report of the Regional Director to the Sixteenth Session of the Regional Committee ； Statements and reports by Representatives of Member States
Co-operation with other Organizations and Agencies
Statements and reports by Representatives and Observers of Organizations and Agencies Election of the Regional Director
Resolutions of Regional Interest Adopted by the Nineteenth World Health Assembly and by the Executive Board at its Thirty-seventh and Thirty-eighth Sessions
Proposed Programme and Budget Estimates for 1968 for the Eastern Mediterranean Region 10• Technical Matters 2
a. Technical Problems met in Malaria Eradication Programmes of the Region - methodology of their studies and some scope for their solution
b. Smallpox Eradication
c. Hospital Records and their Importance for Health Admini strati on
11. Approval of the Report of the Sub-Division on Programme
12. Technical Discussions: "Health Aspects of Industrialization with Special Reference to Air Pollution"
( E _ C l 6 / 2 )
(EM/RC16/9)
(EM/SCI6A)
(EM/SC16/8)
( E _ C l 6 / 5 )
(EM/ftCl6/4) (EM/hCl6/5)
(Е_С1б/6)
(EM/ftCl6/Tech.Disc ./1-2) 13. Other business
14. Adoption of the Report
ЕМ/^С1бД0 Annex II page i
ANNEX II
LIST OF REPRESENTATIVES, ALTERNATES, ADVISERS AND OBSERVERS TO SUB-COMMITTEE A OF THE REGIONAL COMMITTEE
SIXTEENTH SESSION
REPRESENTATIVES OF MEMBER STATES QP THE WHO EASTERN MEDITERRANEAN REGION
CYPRUS Representative - Dr, V. Vassilopoulos
Director-General of Health Ministry of Health
Nicosia
ETHIOPIA Representative - E.E. Yohannes Tseghe
Minister of State for Health Ministry of Public Health Addis Ababa
PRANCE
Representative - Médecin-Colonel Carrere
Service of Technical Co-operation Ministry of Social Affairs
Paris
IRAN Re pre sentat ive - Dr. H. Morshed
Under-Secretary of State Ministry of Public Health Teheran
Adviser - Dr. C. Mofidi
Director Public Health Research Institute Teheran ‘
IRAQ Representative Dr. Awii Arif
Director-General of Preventive Medicine Ministry of Health
Baghdad
JORDAN Representative - Dr, T. Karadchi
Senior Medical Officer Airman District Ministry of Health
Amman
Щ/йС1б/з:0
Annex II page iiJORDAN (continued) Alternate - Dr. Isam Hidjazi
Assistant Under-Secretary of State Ministry of Health
Amman
KUWAIT Repre sentative - Dr. A.R. Al Adwani
Medical Specialist
Ministry of Public Health Kuwait
Adviser - Mr. Jassim Mohamed Behmáh
Council and Administrative Affairs Officer Embassy of Kuwait
Karachi
LEBANON Re pre sentat ive - Mr. R . Heyder
Chargé d'Affaires Lebanese Embassy- Karachi
LIBYA
Representative - Dr. Abdulmajid Abdulhadi Under-Secretary of State Ministry of Health Tripoli
PAKISTAN Representative Brigadier M.S. Haque
Director-General of Health and Joint Secretary to the Government of Pakistan (ex officio)
Ministry of Health, Labour and Social Welfare
Islamabad
Alternates -
Colonel M.K. AfridiHonorary Consultant Malariologist Peshawar
Colonel Ziauddin Khan
Deputy Director-General of Health and Deputy Secretary to the Government of Pakistan Ministry of Health, Labour and
Social Welfare Islamabad
ElVRClô/ïO/
Annex II page iii
PAKISTAN (continued) Lt. Col, S.A. Mallick
Director of Health Services (East Pakistan)
Dacca
Dr. Nazir Ahmed
Dean, Institute of Hygiene Tropical Medicine
Lahore
Dr. Ali Nawab Khan
Deputy Director-General of and Deputy Secretary Ministry of Health, Labour
Social Welfare Dr. Z. Rahman
Assistant Director-General Ministry of Health, Labour
Social Welfare Islamabad
Dr. S. Mahfuz Ali
Assistant Director-General Ministry of Health, Labour
Social Welfare Islamabad
Dr. (Mrs) S.B. Agha
Deputy Assistant Director-General of Health
Ministry of Health, Labour and Social Welfare
Islamabad
Dr. Akram Pervez
Deputy Assistant Director-General of Health
Ministry of Health, Labour and Social Welfare
Islamabad
Lt. Col. S.M.H. Bokhari Project Director
National Health Laboratories Islamabad
Major Д.Н.К. Niazi Director
Central Health Establishment and Stores Karachi
and
Health and
of Health and
of Health and
ETV^Cl6/ïO
Annex II page ivPAKISTAN (continued) Advisers
(contfd)
Lt. Col. K.A. Rashid Director
Jinnah Post-graduate Medical Centre Karachi
Dr. M . Hasan Director
Tuberculosis Control Karachi
Dr. Habibur Rahman Clinical Leader
Directorate of Nutrition Survey and Research
Karachi
Dr. Zahid Husain Khan Acting Director
Bureau of Laboratories Islamabad
Dr« Mohd Ibrahim Professor of Medicine
Jinnah Post-graduate Medical Centre Karachi
Dr. Hamid Ali Khan Professor of Paediatrics
Jinnah Post-graduate Medical Centre Karachi
Dr. Syed A.K.M, Hafizur Rahman Deputy Director of Health Services
of East Pakistan Dacca
Major A.Q.B, Rahman' Provincial Chief (Malaria) :East Pakistan
SAUDI ARABIA Representative - Dr, A.S. El Tabbafa
Director-General of International Health Ministry of Public Health
Riyad
SOMALIA
Representative - H.E. Haji Bascir Ismail Minister of Health and Labour Ministry of Health and Labour Mogadishu
SOMALIA (continued) Adviser - Mr. Adan Far ah Abrar
Chief, Health Department Ministry of Health and Labour Mogadishu
SUDAN Representative - Dr. Mahgoub Hamza
Assistant Under-Secretary of State for International Health Affairs
Ministry of Health Khartoum
SYRIAN ARAB REPUBLIC Repre sentative - Dr. D,E.
Director Ministry Damascus
Chatty
of International Health Affairs of Health and Public Assistance
TUNISIA Representative - Dr. A.R. Farah
Divisional Medical Inspector Ministry of Public Health Tunis
Alternate - Dr, M.T. Hachicha
Regional Medical Inspector Ministry of Public Health Tunis
UNITED ARAB REPUBLIC Representative - Dr. Mohamed Abdel Wahab Shukri
Under-Secretary of State Ministry of Public Health
Cairo “
Alternate - Dr. Hashem M . El Kadi Under-Secretary of State Ministry of Public Health Cairo
UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
EI^Cl6 До
Annex II page VRepresentative Dr. C.R. Jones
Director of Medical Services Aden
EVRCIÔ/XO
Annex II page viYEMEN Representative - Mr. A.H. El Shukani
Direetor-General
Ministry of Public Health Sana!a
REPRESENTATIVES OF UN工TED NATIONS ORGANIZATIONS UNITED NATIONS Mr. Daniel K. Hopkinson
Resident Representative of the United Nations Development
Programme in Pakistan Karachi
UNITED NATIONS
IHVELOPMENT PRO®AMME
Mr. Daniel K . Hopkinson Resident Representative of United Nations Development
Programme in Pakistan Karachi
the
Mr. K, Kitatani Programme Officer
United Nations Development Programme in Pakistan Karachi
UNITED NATIONS CHILDREN^ FUND
Mr. Gurdial S. Dillon Resident Director
UNICEF Eastern Mediterranean Region Beirut
Mr. Perry 0 . Hanson
UNICEF Representative in Pakistan Karachi
UNITED NATIONS RELIEF Dr. M . Sharif
AND WORKS AGENCY FOR Director of Health and PALESTINE REFUGEES WHO Representative
UNRWA Beirut
REPRESENTATIVES AND OBSERVERS OF INTERNATIONAL NON-GOVERNMENTAL AND INTER-GOVERNMENTAL ORGANIZATIONS
INTERNATIONAL ASSOCIATION Prof. Mahmud Ali Shah Representative FOR PREVENTION OP BLINDNESS
INTERNATIONAL DENTAL Dr. H.R. Shah Representative
ЕЕШБАТЮЫ
INTERNATIONAL FEDERATION OP Dr. A.S. Choudhuri Representative GYNAECOLOGY AND OBSTETRICS
E M / R C 1 6 / 2 Q Annex II page vii
WORLD MEDICAL ASSOCIATION INTERNATIONAL COMMITTEE OF MILITARY MEDICINE AND
PHARMACY
INTERNATIONAL COUNCIL OF NURSES
LEAGUE OP RED CROSS SOCIETIES
INTERNATIONAL STATISTICAL EDUCATION CENTRE
Dr. H.R. Khan
Major-Gen. S.A. Mian Lt. Col. Bashir Hussein Miss F. Munshi
Major-Gen. S.A. Mian Lt. Col. Bashir Hussein Mr. Faiz El Khuri
Representative Representative Representative Representative Representative Representative Observer
UNITED STATES NAVAL
MEDICAL RESEARCH UNIT NO 3
Dr. Lloyd P, Miller Observer
ЕМ/^С16Д0 Annex III page i
ANNEX III
LIST OF REPRESENTATIVES, ALTERNATES , ADVISERS
AND OBSERVERS TO SUB-COMMITTEE В OP THE REGIONAL COMMITTEE SIXTEENTH SESSION
REPRESENTATIVES OF M E M E R STATES OP THE WHO EASTERN MEDITERRANEAN REGION
ETHIOPIA Representative - Mr. Seyoum Alemayehou
Senior Statistician
Imperial Ethiopian Government Central Statistics Office Addis Ababa
FRANCE
Representative - Mr, M . Lennuyeux-Comnène Premier Secrétaire d'Ambassade
Mission permanente de la France auprès de 1'Office des Nations Unies et des institutions spécialisées ayant leur siège à Genève
Chambésy, Geneva ISRAEL Representative - Dr. R . Gjebin
Director-General Ministry of Health Government of Israel Jerusalem
Adviser - Mr. J . Alon Second Secretary
Permanent Mission of Israel to UN Office in Geneva Geneva
UNITED KINGDOM OP GREAT BRITAIN AND NORTHERN IRELAND Representative - Dr. P. Dill-Russell
Deputy Medical Adviser
Ministry of Overseas Development London
REPRESENTATIVES OF UNITED NATIONS ORGANIZATIONS UNITED NATIONS
UNITED NATIONS DEVELOPMENT PROGRAMME
Mr. W . Kooy
Representative of the United Nations Development Programme in Europe, a.i Palais des Nations
Geneva
EM/hCl6/iO Annex irl page ii
REPRESENTATIVES AND OBSERVERS OF INTERNATIONAL NON-GOVERNMENTAL AND INTER-GOVERNMENTAL ORGANIZATIONS INTERNATIONAL CHILDKEN'S CENTRE Dr.
INTERNATIONAL ASSOCIATION FOR Dr.
PREVENTION OP BLINDNESS
INTERNATIONAL DËNTAb FEDERATION Dr •
INTERNATIONAL PLANNED PARENTHOOD Dr.
FEDERATION
INTERNATIONAL SOCIETY OP CRIMINOLOGY Mr.
LEAGUE OP RED CROSS SOCIETIES Dr.
MEDICAL WOMEN'S INTERNATIONAL Dr.
ASSOCIATION
WORIX) FEDERATION FOR MENTAL HEALTH Dr.
WORLD MEDICAL ASSOCIATION Dr.
E . Berthet A . Ricci C.L. Bouvier Isam Nazer
Jean-Jacques Simon H . Zielinski A . Audéoud-Naville À . Audéoud-Naville Jean Maystre
Observer Representative Representative Representative
Representative Representative Representative
Representative Representative
EM/RC16/10 Annex IV page i
/ШЕХ IV
SUMMARY OP DISCUSSIONS IN SUB-COMMITTEES A AND В ON THE
PROPOSED PROGRAMS AND BUDGET ESTIMATES POR 1968 FOR
THE EASTERN MEDITERRANEAN REGION (Agenda item Q) AND TECHNICAL MATTEPS (Agenda item 10, a-b-c)1
1. PROPOSED PROGRAMME AMD BUDGET, ESTIMATES FOR
1968FOR THE EASTERN
imDITERRAÑEAN^REGION (Document ЕМ/ЙС16/5, Resolution EM/ftCl6/ft,2)The Regional Director introduced the document and referred briefly to
its various chapters, including its seven annexes, and stated that every attempt had been made in the form of presentation to follow as closely as possible the pattern of Official Records No, 146.The column headed "Technical Assistance" consisted of two separate but
complementary types of projects. The major part reflected the health share of the consolidated requests from Member Governments to the United NationsDevelopment Programme for the next biennium 1967A968. The remainder was,
however, of quite some magnitude, more than $ 720 000 in 1967 and of $ 610 000, so far, in 1968, and represented projects under "Funds-in-Trust" arrangements to be implemented in the normal manner by the Organization, except that their total costs were refundable to the Organization by the Governments concerned.The programme proposals for 1968 under the Regular Budget were based on
a tentative allocation of $ 53^ 000, or 10.38 per cent higher than the costs of the approved regular programme for 19^1• Slightly above per cent of the estimated increase had been devoted to the strengthening of the field programme. While there was some increase in all country programmes so that the additional funds represented a reasonable distribution between countries, no attempt had been made to strengthen all country programmes with the same percentage• The approach had been to meet the individual governments1 needs on the basis of requests received and consultations held, and taking into con- sideration the urgency and priority attached to the activity by the government as interpreted by the Regional Office.The attention of the Representatives was particularly drawn to the Inter-
Country proposals on pages 228 to 2б0, approximating some $ 472 000 in 1968 under Regular funds and augmented by an anticipated amount of about $ 102 000 under Technical Assistance in the same year. In the past, the Regional Committee had expressed its appreciation of and support for such activities and had found it of great value to approach some health problems on an inter- country basis in the form of conferences, seminars, training courses or through the assistance of experts made available to them in certain specific fields•In the course of the discussion which followed the document was analyzed chapter by chapter.
iThese Agenda items were discussed by the Sub-Division on Programme of Sub-Committee A , under the Chairmanship of Dr. Mahgoub Hamza (Sudan) and by Sub-Committee В in plenary session under the Chairmanship of Mr. M . Lennuyeux-Сomnène (Franco)
2Sees page 5 in the body of this report
E L V H C L Ô A O
Annex IV page ii
Summary by Main Subjects
Some Representatives expressed the opinion that parasitic and other communicable diseases were still of major concern to the Region and that time might not be ripe to reduce the provisions for such activities to the benefit of newer fields, as appeared to have been the case over the three- year period 1966Д968. To this it was explained that variations in the total amount provided for the same major subject heading between the three years did not mean that the emphasis was changing significantly• These variations might be due to the fact that an intor-country activity such as a conference or a seminar held in a given year was not usually repeated in the subsequent ones. Por example, the Bilharziasis Training Course in 1966 and the Seminar in the same field in 1967 made it unnecessary to consider similar activities in 1968. Another element was the priority assigned by the governments them- selves to the fields for which they requested assistance • Moreover, some governments were now in a position to carry on activities previously assisted by the Organization. This particularly applied to the field of communicable diseases, the costs of such activities being now gradually taken over by the national services.
Regional Office
It was noted that only one post for a conference officer was added to the existing staff, the need for which being the great expansion of the inter- covmtry programme which included an increasing number of conferences, seminars and similar activities.
WHO Representatives
It was pointed out that WHO representatives were essentially technical officers whose role was to represent the Regional Director in the countries of assignment and act as senior public health advisers to the governments concerned. The selection of the countries of assignment was influenced by- two factors: first the volume of work or other considerations warranting the opening of such an office, and second the opinion of the countries considered.
Inter-Country Programme ，
During the review of this chapter, two activities were suggested: a seminar on vital and health statistics, to follow up the work undertaken during the period I965-I965, and a travelling study group for experts in public health laboratories. These suggestions would be taken into considera- tion in future programme planning-
The Regional Committee found that the programme, a suitable balance between the major subject headings posed programme and budget estimates for 1968.
as presented, ensured and endorsed the pro-
EM/ftCl6/lO Annex IV page iii
2. TECHNICAL MATTERS (Agenda item 10，a-b-c)
a. Technical Problems met in Malaria Eradication Programmes of the Region; Methodology of their studies and some scope for their Solution (Docui^ent EM/hCl6/4, Resolution EM/RClë/l^))1
In the introduction of this item it was stated that failure to achieve targets as planned in malaria operations might be due to techni- cal, operational or administrative failure, or a combination of these factors• The document before the Committee discussed technical problems met in several malaria eradication programmes of the Region and described some of the studies undertaken and how these affected, in particular, the activities of the programme in Iraq. It was further mentioned that problem areas as defined by the Tenth Expert Committee on Malaria should not be confused with residual foci, as the former were characterized by failure to interrupt transmission despite total, complete, regular and sufficient coverage by the spraying operations, i.e. during the attack phase, while the latter were traceable to operational inadequacy in a limited area, discovered during the consolidation phase, which usually readily responded to a concentrated focal action.
One of the technical problems referred to and studied was the resistance to dieldrin and DDT in Anopheles stephensi in southern Iraq.
These studies had revealed that, though resistance to dieldrin was complete, the resistance to DDT in A>stephensi in southern Iraq was developing only to a certain level, not reaching 100 per cent.
The reinstatement of residual spraying with DDT in this area, in combination with other measures, had shown that interruption of trans- mission was achieved provided that the spraying operations were carried out correctly.
Among the special studies conducted in this Region, reference v/as made to themalathion pilot project in Bandar Abbas in Iran, an area where A.stephensi was also the predominant vector in the littoral plains, and A,fluviatilis in th-з foot-hill region. Also mentioned was the medi- cated salt pilot project in the Kazeroun area covering a stable and moving population of approximately 20 000, which had so far obtained good results. Further, the study comparing the application of BHC, ШГ and malathion in an area where A.pharoensis had developed high tolerance to DDT in the United Arab Republic was also referred to.
In the discussion following the introduction, the Representative of Iran provided valuable additional information on the progress made by the various research activities during the past year, including the evaluation of DDVP and 0MS-33- He further stated that the 1957 epidemic of malaria broke out in Khuzistan, Iran， when the area was already under spraying with DDT and that the epidemic years could be forecast, the next expected one being about 19б7Д9б8. He therefore warned that coun- tries in which the prevailing conditions were similar to those in southern Iran should be ready to take additional counter-measures and not rely solely on DDT spraying. The Representative of Iraq gave, in a short ISees page б in the body of this report.
Щ/ЙС1б/10 Annex IV page iv
statement, additional information regarding the larviciding programme in the south, carried out in relation to other attack measures. The Representative of Pakistan gave information on research programmes carried óut in both East and West Pakistan, which included the DDVP trial which was being carried out, despite discouraging results obtained with this insecticide in other parts of the world, because of favourable conditions in a tribal belt area where it was expected that this insecti- cide might be of use. Particular mention was also made of the trials in both East and West Pakistan related to integration of the surveillance activities with other preventive measures. He also fully supported the views of the Representative of Iran on the subject of forecasting epi- demics and the need for taking additional measures if found necessary.
The Representative of the United Arab Republic mentioned that the government had included provision for a malaria eradication programme in the second five-year development plan and that the preparatory phase was planned to last until 1967/1968. It was hoped that UNICEF
assistance could be obtained to assist in the procurement of supplies and equipment. Also mentioned were the larviciding operations being carried out in the Assuan Governorate with a view to preventing the entry of A.Gambia into the United Arab Republic, which campaign was being carried out in co-operation with the Government of Sudan.
The Representative of Cyprus mentioned that no indigenous cases had been reported since 1950, while the last imported case was reported in 1956. The request to send a team to Cyprus in order to register it among the countries where malaria had been eradicated before 1955 was reiterated.
The Representative of Israel indicated that, as a result of the overall application of appropriate measures, Israel was at the point of finally eradicating malaria. The main problem was that of the malnte- палсе of achieved eradication, which was made more difficult because of immigration, expanding irrigation v/ork, movement of population and the
considerable influx of visitors from other malaria areas.
The Representative of UNICEF reminded Sub-Committee A of the policy decision on aid to Malaria Eradication taken at the UNICEF Executive Board meeting held in Bangkok in 1964, which had been communicated to the Governments in the Region interested in receiving UNICEF assistance for their planned Malaria Eradication projects. He also made specific replies to the points raised by' the Representatives of Pakistan, Sudan and the United Arab Republic.
b. Smallpox Eradication (Document EM/RC15/5, Resolution EM/hCló/R^)1
Introducing this item, Dr. A.H. Taba, Regional Director, stated that according to present knowledge, the eradication of smallpox was scientifically and technically feasible and that this was the reason why the Nineteenth World Health Assembly, on the recommendation of the Ш0 Executive Board at its Thirty-seventh Session, passed a resolution in May 1966 approving a ten-year global programme and made an appropri- ation for 1967, of 2.4 million for WHO assistance to countries in their Isee: page 7 in the body of this report.
EM/hCl6/lO Annex IV page v
smallpox eradication programme. The reasons in support of feasibility of world-wide smallpox eradication were the following: the diagnosis of the disease was relatively easy; there were no carriers； the only known reservoir was man; the period during which the patient communicated the disease was only of a few weeks； the major endemic foci still existing were well-known； and a potent vaccine uas available•
Notwithstanding these factors, endemic foci still existed in the Region and in fact in the world. The major difficulties were the following: the unavailability of sufficiently reliable information on the prevalence and incidence of the disease； the lack of proper plan- ning, administration and organization of the programme； the lack of necessary funds and supplies； the shortage of trained personnel； the use of vaccine of doubtful potency； an incomplete coverage of the population and the lack of concurrent evaluatipn.
It was realized that the smallpox eradication programme on a national scale was a long-terra and costly activity, which was to be undertaken as an integral part of well-established health services wherever they existed, or in their absence, as a separate individual campaign. Also to be noted was the fact that smallpox eradication programmes were important and of interest, not only for the countries where the disease was endemic, but also for preventing its re-intro- duction into those which were already freed.
It was, therefore, hoped that the countries of this Region would give full attention to this important problem and that all of them would take necessary steps to carry out the smallpox eradication programme.
In this connexion, WHO was prepared to assist with the planning and launching of the programme, the production of vaccine and the evaluation of the campaign.
c. Hospital Records and their Importance for Health Administration (Document EM/RC16/6, Resolution EM/SCI6/R.5)丄 � � In the introductory remarks it was pointed out that hospitals were everywhere assuming a large and increasing proportion of the costs of health services• Analysis of the use of and services rendered in hospi- tals were, therefore, becoming of increasing necessity for health ad- miaistration, and properly organized hospital recording was an indis- pensable tool for such analysis.
Careful recording of diagnostic findings, of all services of a medical nature and of results of hospitalization would benefit the individual patient and would serve as the basis for medical research, for evaluation of the performance of hospitals, for hospital morbidity statistics and for health planning.
Hospital recording was to some extent performed in all hospitals.
A few hospitals in the Region had established excellent recording pro- cedures. What was mainly lacking was a uniform minimum amount of accurate hospital records and their periodic processing and analysis.
lgee: page 8 in the body of this report.
EM/ftCl6/10 Annex IV page vi
The basic requirements for an adequate hospital records system were outlined. Large and most medium sized hospitals would usually find it necessary to organize a special medical records department under the supervision of specially trained medical records officers.
The need for training programmes for hospital records personnel was recognized. The collaboration of hospital medical and adminis- trative staff would also be needed in establishing a hospital records system or in improving an existing system. New emphasis should also be placed on proper medical recording procedures to be included in the training of physicians and other health workers.
Being aware of the need for hospital statistics and hospital recording and being of the opinion that conditions in countries of the Region allowed the development of hospital statistics, the Committee
felt that much attention should be given to the establishment of hospi- tal recording• The importance of the education of hospital staff in this field was also emphasized. During the discussion It was pointed out that many hospitals in countries of the Region already possessed hospital records covering a number of years and that mechanical process- ing of such records might greatly contribute to describe morbidity patterns in the countries. For easy interpretation of data, graphical present- ations might be found of practical use.
Great interest was expressed for endeavouring to standardize hospi-
tal record forms, not only within a country but, if possible, on a
regional basis. The use of modern data processing facilities for
analysis of records was regarded as desirable for economy in processing
costs and for speedily obtaining results.
ЕМ/ЙС1бД0 Annex V page i
ANNEX V
SUMMARY TECHNICAL REPORT
TECHNICAL DISCUSSIONS ON HEALTH ASPECTS OF INDUSTRIALIZATION WITH SPECIAL REFERENCE TO AIR POLLUTION
SIXTEENTH SESSION - 1966 1. INTRODUCTION
Both Sub-Committees A and В had chosen "Health Aspects of Industri allz a- tion with Special Reference to Air Pollution" as the subject for Technical Discussions at the Sixteenth Session of the Regional Committee •
Dr. Awni Arif (Iraq) was elected Chairman of the Discussions at Sub- Committe A; and Dr, P. Dill-Russell (United Kingdom), Vice-Chairman of Sub-Committee B, chaired the Discussions of that Sub-Committee•
As a basis for discussion, the Representatives had before them a document which had been prepared by the secretariat of the Regional Office-^-.
2. SUMMARY OP BACKGROUND INFORMATION
Reference was made to the fact that in the past ten years industriali- zation had been given priority in many countries in the Region, with the aim
of raising the per capita income and the living standards of the people.
Industrialization had brought with it many health problems, affecting not only the industrial worker himself but also the community at large. It was there- fore essential that the health authorities should be aware of those problems and help deal with them from the planning stage onwards. As a result of the
increasing industrialization, migration from the rural areas to the towns hadincreased enormously, bringing overcrowding
3inadequate housing, water and
sewage disposal problems, disruption of traditional family patterns, and socialand behavioural disorders. The occupational hazards were great, especially among the unskil?ed labour from the rural areas. One of the great problems was that in many countries there were insufficient medical and health services,
so that a decision had to be reached on whether to divert scarce medical services to cope with the many problems. One thing that was certain was that the participation of the health authorities in all plans for industrialization and in their implementation was necessary.
However, the process of industri alization exerted a variety of influences on the physical, mental and social health of the people and those influences could be good or bad as they favoured or inhibited improvements in health.
Among the favourable influences were factors such as economic growth and expansion of public services and facilities, i.e., health sanitation, housing, education, transport and the like. The harmful influences, on the other hand, included such factors as urbanization with a marked increase in population density, accentuated environmental health problems favouring the spread of certain communicable diseases, the creation of new occupational health problems, aggravated nutritional problems and adverse effects on mental health.
^Por Agenda, see page iv of this Annex.
EM/RC16/L0 Annex V page ii
If the harmful effects of urbanization and industrialization were stressed, that was because they led to conditions that called for action and because their effect did not become evident until after industriali- zation had advanced and in consequence their significance was not realized at a sufficiently early stage• They should be viewed together with their favourable counterparts, and it should be borne in mind that both varied greatly from one country to another as they were governed by factors such as population characteristics, the human and material resources with which the countries were endowed and, last but not least, the available technology.
In order to make it possible to mitigate the harm that might be caused by industrialization it was important to identify as many of the factors as possible. Once they had been identified, it was essential to evaluate their relative importance, to determine priorities, and then to devise methods by which to promote those factors that were favourable and to counteract those that were unfavourable to health• That could only be done by mobilizing all available national forces eo that adequate legal, social, and technical measures could be taken from the start.
In the course of visits to factories and mines, it had been observed that all too often the health conditions v;er© not what they should be.
Safety regulations were not paid proper attention; health education pro- grammes were either inexistant or poor; trained first-aid workers were scarce； medical services left much to be desired; occupational diseases and accidents were badly reported； labour legislation was elaborated without consideration to local conditions； and above all there was a great shortage of trained personnel.
耆 Given such a situation, it was essential" that occupational health pro-
blems in developing countries should deal not only with health problems of work and the working environment but also with the total health of the gainfully- employed segment of the population.Other problems of urbanization and industrialization included road accidents, noise arising from industrial activities and transport, and
especially the disruption of traditional family life. The entry of women ‘ and adolescents into -industry as wage earners seemed to be associated with an increase in divorce, alcoholism, gambling, prostitution and Juvenile delinquency.
Air pollution, although not yet a widespread problem in the Region, would obviously become more important in future. As well as medical effect, air pollution had tangible economic consequences (adverse effects on vegeta- tion, soiling and damage to all kinds of property). The main source of man-made air pollution was products of combustion, and industry, although not the only source, was frequently a major one.
With regard to the role of the health authorities, it was necessary to remember that the means were now available to improve greatly the health of the people during the transition from an agrarian economy to a combined agrarian/industrial or even predominantly industrial economy, and that a
country could be no stronger than the health,of its people permitted. 、,’
