• Aucun résultat trouvé

W O R LD H E A LT H ORGANIZATION

N/A
N/A
Protected

Academic year: 2022

Partager "W O R LD H E A LT H ORGANIZATION"

Copied!
41
0
0

Texte intégral

(1)

W O R L D H E A L T H ORGANIZATION

EXECUTIVE BOARD . Twenty-ninth Session

Provisional agenda item 6.J>

ORGANISATION MONDIALE DE LA SANTE

EB29/7

1 December l96l ORIGINAL: ENGLISH

W “ 。〕 \

àj : ^ У

I

S •

REGIONAL COMMITTEE FOR SOUTH-EAST ASIA Report on Fourteenth Session

The Director-General has the honour to present to the Executive B o a r d the report of the Fourteenth Session of the Regional Committee for South-East A s i a . ^

1 Document SEA/RC14/26 Rev.l

(2)

EB29/7 ANNEX

REGIONAL OFFICE FOR SOUTH-EAST ASIA

REGIONAL COMMITTEE Fourteenth Session

Ootacamund, India, 19-25 September 19б1

S E A / R C 1 4 / 2 6 Rev.l 13 October

I96I

REPORT ON THE FOURTEENTH SESSION OF THE WHO REGIONAL COMMITTEE FOR SOUTH-EAST ASIA

CONTENTS

Page

工N T R O D U C T I O M 3

PART I . RESOLUTIONS 5 S E A / R C I V R I Recruitment of Technical Staff 5

S E A / R C I V R2 Eradication of Smallpox 5

SEA/RCl4/R3 Thirteenth Annual Report of the Regional Director . . . 6 SEA/RC14/R4 Expanded Programme of Technical Assistance :

long-term projects 6 SEA/RCl^/FS External Cross-Checking of Blood Films 7

S E A / R C l VR6 Accommodation for the Regional Office for

South-East Asia 7 SEA/RC14/R7 Malaria Eradication Postage Stamps 7

SEA/RC14/R8 Approval of the Proposed Programme and Budget

Estimates for 1963 8 S E A / R C 1 V R 9 Priorities in Programme . . 8

SEA/RC14/R10 Selection of Subject for Technical Diseussions in 1962 9

S E A / R C l V R l l Time and Place of the Fifteenth and Sixteenth

Sessions 9

P A R T I I . DISCUSSION ON THE THIRTEENTH ANNUAL REPORT OF THE REGIONAL DIRECTOR • 10

(3)

SEA/RC14/26 Fley.l page 2

Page PART 工 工 工• E X A M Ï _ I O N OF THE PROPOSED PROGRAMME AND BUDGET

E S T I M A T E S P O R 19бЗ 1 2

PART ГУ. DISCUSSION ON OTHER MATTERS 1 斗 1 . Resolutions of Regional Interest Adopted by the Fourteenth

W o r l d Health Assembly and the Executive Board

2 . Pilariasis 15 5 . Enteric Group of Diseases 15

4 . Freeze-Dried BCG Vaccine . . . •…,.• 1б

5 . Epidemiological Units . .、. ;" . V . . • . . . / : - , .、• . 16 6 . Technical Discussions on "The Role of Public Health

Departments in the improvement of Nutrition" 17 7 . Domiciliary Treatment of Tuberculosis 。 . . . 17

8 . Evaluation of Internationally-Assisted‘Projects l8

9 . Time and Place of the Fifteenth and Sixteenth Sessions of the Regional Committee 18 A M S E X E S 1 .

2 .

3 .

P i n a l List of Participants ( S E A / R C l V2l R e v . 2 ) ь

Agenda ( S E A / R C l V l Rev.l)

Report of the Sub-Committee on Programme and Budget

‘(SEA/RC1V22)-)

Conclusions and Recommendations Arising out of the Technical Discussions on "The Role of Public Health Departments in the Improvement of Nutrition"

( S E A / R C 1 V 2 5 ) *

(4)

INTRODUCTION

The fourteenth session of the Regional Committee for South-East Asia w a s held in the Arranmore Palace, Ootacamund (South India), from 19 to 25 September 1 9 6 l . Representatives of eight countries were present; those of France and Portugal were a b s e n t . For list of participants^ see Annex 1 (document SEA/RC14/21 R e v . 1 ) .

The session was declared open b y the R e g i o n a l D i r e c t o r , in the absence of the retiring C h a i r m a n , Dr Saiful Anwar (Indonesia)^ a n d retiring Vice-Chairman,.

D r Kamdhorn Suvarnakich (Thailand)• Just b e f o r e the s e s s i o n , n e w s h a d been received of the tragic death of the Secretary-General of the United N a t i o n s , Mr D a g H a m m a r s k j o e l d • In tribute t o the memory of the Secretary-General^ immediately after the session h a d b e e n inaugurated b y the Governor of M a d r a s , Shri Bisnuram Mehdij and statements h a d b e e n

made b y the Secretary of the Union Ministry of H e a l t h , M r . B . R . Tandan^ a n d the representative of U N I C E F , Mr Poul L a r s e n

t h e meeting w a s a d j o u r n e d . The Regional Committee asked the Regional Director to c o n v e y , through the D i r e c t o r - G e n e r a l5 to the appropriate authorities^ their deepest sympathies concerning the u n t i m e l y d e a t h

of Mr Hammarskjoeld.

On the n e x t d a y , a message from H。E. the M i n i s t e r of Health of the Government of India^ Shri D . P . Karmarkar^ w a s read out b y the chief delegate from I n d i a , Dr V . Srinivasan, A message on behalf of the D i r e c t o r - G e n e r a l of W H O w a s also delivered b y the WHO Assistant Director-General^ Dr F . Grundy^ and statements of good wishes for the success of the session were made b y representatives of UNICEF^

FAOj the International Association for the Prevention of B l i n d n e s s , the World Medical Association^ the World Federation of Occupational T h e r a p i s t s , the Medical W o m e n ' s

International Association and the International Committee of Catholic N u r s e s . A statement was circulated b y the representative of the World Federation of M e n t a l H e a l t h .

A Sub-Committee on Credentials w a s appointed^ consisting of representatives from Afghanistan, Indonesia and T h a i l a n d , and its report (document S E A / R C l V2^ ) w a s later approved.

(5)

SEA/RC14/26 R e v . l

page 4

The R e g i o n a l Committee unanimously elected the following officersi Chairman : Dr V . Srinivasan (India)

Vice-Chairman 2 Dr A . R . Hakimi (Afghanistan)

The agenda was adopted and i s given as Annex 2 (document S E A / R C l V1 R e v . l ) •

The Committee established a Sub-Committee on Programme and Budget^ consisting of d e l e g a t e s from B u r m a , Ceylon,India and the United Kingdom, The terms of reference f o r t h i s Sub-Committee w e r e revised in accordance with the directives given by the R e g i o n a l Committee at its thirteenth session. The Sub-Committee held three meetings a n d submitted a detailed report^ which was endorsed by the Regional Committee

( s e e Part 工 工 工 and Annex 3 ) (document S E A / R C l V2^ ) •

On 20j 21 and 2J September technical discussions were held on the subject

"The Role of Public Health Departments in the Improvement of Nutrition", under the chairmanship of Dr D . B . Gunasekara (Ceylon). The conclusions and recommendations arising from these discussions appear in Annex. 4 (document SEA/RC14/25).

In the course of six plenary meetings the Committee considered a variety of subjects and adopted eleven resolutions, which are set out in Part 工 of this report.

Parts 工 工 , 工 工 工 and XV are devoted to summaries of important points brought out in the d i s c u s s i o n .

(6)

РАНТ I.

The following eleven resolutions were adopted during the course of the

RESOLUTIONS

(circulated in a special resolutions series) session. For further comments on the subjects of some of these resolutions, see Parts 工 工 , 工 工 工 and IV.

S E A / R C l 4 /R 1 Recruitment of Technical S t a f f

The Regional Committee,

Having noted the difficulties which are being experienced by the Regional Director in recruiting an adequate number of appropriately trained professional staff for the South-East Asia Region,

Realizing the indispensabi 1 ity of having adequate staffs both in the Regional Office and in the fields for the successful carrying out of the programme^

REQUESTS the Regional Director:

(1) to draw the attention of the Director-General to the concern felt by the Regional Committee over these recruitment difficulties^ and (2)

Handbook 8.5 (7) page 85

to ask the Director-General to invite Member governments to do all

in their powerj either b y means of secondment or otherwise, to facilitate the recruitment of professional staff for work in the South-East Asia Region, a n d , further^ to bring this matter to the notice of the

Fifteenth World Health Assembly.

Third Meeting, 22 September 196l S E A / H C l V M i n . 3

S E A / R C l V ^2 Eradication of Smallpox

The Regional Committee,

Recalling the resolutions of the Eleventh and Fourteenth World Health

Assemblies concerning the eradication of smallpox (WHA11.54 and WHAl4.40) and the two resolutions on this subject adopted by the Regional Committee at its eleventh and twelfth sessions (SEA/RC11/R6 and SEA/RC12/R6)^

Considering that control programmes have been adopted by the national governments in almost all the countries of the Region, and

Recognizing the practicability of bringing about the eradication of smallpox by the intensive efforts of national governments with the assistance of international and bilateral agencies.

(7)

p a g e 6

1 . U R G E S t h e g o v e r n m e n t s in the South-East Asia R e g i o n to take every possible a c t i o n to c a r r y out p r o g r a m m e s of smallpox eradication, preferably w i t h i n a s p e c i f i c p e r i o d of f i v e y e a r s , and

2 . R E Q U E S T S the R e g i o n a l Director to give governments all possible assistance i n e v o l v i n g a n d i m p l e m e n t i n g the requisite p r o g r a m m e s , and to report b a c k on the p r o g r e s s b e i n g m a d e t o the fifteenth session of the Regional C o m m i t t e e .

H a n d b o o k 2 . 1. 4 Third M e e t i n g , 22 September 1961

p a g e 15 SEA/RCl4/Min.3

S E A / R C 1 4 / R 3 T h i r t e e n t h Annual Report of the Regional Director T h e R e g i o n a l C o m m i t t e e ,

H a v i n g r e v i e w e d the thirteenth A n n u a l Report of the Regional Director ( S E A / R C l 4 / 2 b

1 . B E L I E V E S t h a t t h e r e p o r t b r i n g s to the attention of Member States certain f i e l d s of p u b l i c h e a l t h i n w h i c h further sustained effort is n e e d e d ;

2 . E X P R E S S E S i t s a p p r e c i a t i o n of the work of the Regional O f f i c e , and 3 . C O N G R A T U L A T E S the R e g i o n a l Director on h i s r e p o r t .

H a n d b o o k 5 . 1 (13) Third M e e t i n g , 22 September I96l

page 5 1 S E A/ R C l 4/ M i n O

S E A / R C1 4 / r 4 E x p a n d e d P r o g r a m m e of T e c h n i c a l Assistance; long-term projects

T h e R e g i o n a l C o m m i t t e e ,

H a v i n g n o t e d the implications on long-term projects of the n e w country p r o g r a m m i n g p r o c e d u r e s of t h e E x p a n d e d Programme of Technical A s s i s t a n c e ,

1 . C O N S I D E R S t h a t m a n y projects in the field of h e a l t h m u s t n e c e s s a r i l y continue f o r m a n y y e a r s in o r d e r t o achieve their objectives;

2 . U R G E S t h a t some d e g r e e of W H O assistance should be available for as long as n e c e s s a r y t o ensure t h a t the objectives are reached;

3- APPROVES the general principles adopted by the Regional Director as outlined i n d o c u m e n t S E A / R C 1 7 , subject to individual agreements w i t h each governmentj

. C O N F I R M S its f u l l support of the principles that h e a l t h projects should be p l a n n e d f o r p r e s e n t a t i o n to the United N a t i o n s Technical Assistance B o a r d for the f u l l d u r a t i o n of the assistance requested from W H O , and

5- .RECOMMENDS t h a t t h e R e g i o n a l Director and the Director-General bring these v i e w s to the n o t i c e of the Technical Assistance B o a r d .

H a n d b o o k 4 . 3

p a g e 6 0 Third M e e t i n g , 22 September 196l

S E A / R C l V M i n . 3

(8)

S E A / R C l 4 /R5 External Cross-checking of Blood. Films

The Regional Committee^

Noting the rapid progress being made in the national malaria eradication programmes in the South-East Asia R e g i o n ,

Recognizing the importance of adequate laboratory examination of b l o o d films in ensuring the success of these p r o g r a m m e s ,

R E Q U E S T S the Regional Director t o provide appropriate facilities to

governments of the Region for an external cross-checking of a certain percentage of the b l o o d films taken in their n a t i o n a l m a l a r i a p r o g r a m m e .

Handbook 2.1,1 (2) Third Meetings 22 September 1961

page 9 S E A / R C l V M i n . 3

SEA/RC14/R6 Accommodation for the R e g i o n a l Office for South-East Asia The Regional Committee

1 . N O T E S w i t h appreciation that construction of the new b u i l d i n g , the p e r m a n e n t accommodation of the Regional O f f i c e , is proceeding according to schedule;

2 . APPRECIATES the plans of most of the Member States of the Region to provide cultural contributions

U R G E S all governments that have n o t y e t agreed to do so to contribute

generously at an early d a t e , in order to make the building widely representative of the a r t , skills and culture of the countries of the Region, and

E X P R E S S E S its deep appreciation to the Government of India f o r its generosity in providing the b u i l d i n g , certain equipment and artistic c o n t r i b u t i o n s ,

Handbook (3) Fourth M e e t i n g , 22 September 1 9 6 l

page 90 SEA/RCl4/Min.4

SEA/RC14/R7 Malaria Eradication Postage Stamps The Regional Committee,

Recognizing that a programme for issuing malaria eradication p o s t a g e stamps should give world-wide publicity to the malaria eradication programme^

(9)

SEA/RCL4/2 6 REV.L p a g e 8

1 . H O P E S t h a t a l l g o v e r n m e n t s , if t h e y d o n o t issue special stamps on 7 A p r i l 1962j w i l l a t l e a s t o v e r p r i n t e x i s t i n g stamps or authorize a special p o s t m a r k c a n c e l l a t i o n , a n d

2 . U R G E S t h o s e g o v e r n m e n t s w h o h a v e n o t y e t agreed to d o so to n o t i f y the R e g i o n a l D i r e c t o r of t h e i r i n t e n t i o n s a s e a r l y as p o s s i b l e .

H a n d b o o k 2 . 1 . 1 (2) F o u r t h M e e t i n g , 22 S e p t e m b e r 1 9 6 1

p a g e 9 S E A / R C l V M i n - 4

S E A / R C l 4 / R 8 A p p r o v a l of t h e P r o p o s e d P r o g r a m m e and B u d g e t E s t i m a t e s f o r 19бЗ T h e R e g i o n a l C o m m i t t e e ,

H a v i n g e x a m i n e d the P r o p o s e d P r o g r a m m e and B u d g e t E s t i m a t e s f o r 1963,

a s s h o w n in d o c u m e n t S E A / R C l 4 / 3 ^

1 . E X P R E S S E S i t s s a t i s f a c t i o n a t the r e p o r t of the Sub-Committee on Programme a n d B u d g e t ( d o c u m e n t S E A / R C 1 ) У

2 . A P P R O V E S t h e R e g u l a r Programme a n d B u d g e t , i n c l u d i n g p r o j e c t s f i n a n c e d f r o m t h e M a l a r i a E r a d i c a t i o n S p e c i a l A c c o u n t , as shorn in A n n e x 2

s u b j e c t to t h e m i n o r a m e n d m e n t s i n d i c a t e d in its f i n a l report j

3 . E X P R E S S E S i t s e l f s a t i s f i e d w i t h the p r o p o s e d p r o g r a m m e u n d e r the E x p a n d e d P r o g r a m m e of T e c h n i c a l A s s i s t a n c e (document SEA/RCl4/3^ A n n e x

1),and

4 . R E C O M M E N D S ^ s p e c i f i c a l l y , t h e i m p l e m e n t a t i o n of the i n t e r - c o u n t r y p r o j e c t s i n c l u d e d u n d e r t h e R e g u l a r B u d g e t , the E x p a n d e d P r o g r a m m e of T e c h n i c a l Assistance a n d the M a l a r i a E r a d i c a t i o n A c c o u n t .

H a n d b o o k 4 . 1 ( 1 ^ ) F i f t h M e e t i n g

2 5 September I96l

p a g e 5 9 S E A / R C l 4 / M i n . 5

3 E A / R C 1 V R 9 P r i o r i t i e s in P r o g r a m m e T h e R e g i o n a l C o m m i t t e e ,

N o t i n g r e s o l u t i o n W H A 1 4 . 5 9 of the F o u r t e e n t h W o r l d H e a l t h Assembly^ w h i c h h a d b e e n r e f e r r e d to the C o m m i t t e e b y the D i r e c t o r - G e n e r a l ^

C o n s i d e r i n g d o c u m e n t s S E A / R C l V ” and A d d . l on t h i s s u b j e c t , and

H a v i n g n o t e d t h e c o n c l u s i o n s of i t s S u b - C o m m i t t e e on Programme a n d B u d g e t r e s u l t i n g f r o m a n e x a m i n a t i o n of p r o g r a m m e p r i o r i t i e s ^ a s r e p o r t e d in S e c t i o n б of i t s report (document S E A / R C l V2 ¿0

(10)

1 . OBSERVES that programme priorities have been kept under frequent review by successive Regional Committees and that guidance on programme has been given to the Regional Director;

2 . NOTES the substantial proportion of the total costs which have been devoted to the major objectives of communicable-disease control and training of health personnel - both problems of the highest importance to the Region;

3 . CONSIDERS that the programme in South-East Asia has developed in accordance with the public health needs and resources of the countries of the R e g i o n , and Ц-. REQUESTS the Regional Director to convey these views to the Director—General, with the appropriate documentation.

Handbook 1.4 Fifth Meeting, 2J September 1961

page 2 S E A / R C l V M i n . 5

S E A / H C l VR 10 Selection of Subject for Technical Discussions in 1962 The Regional Committee

1 . DECIDES to hold the technical discussions at its fifteenth session in 1962 on the subject of Community Water Supplies;

2 . REQUESTS the Regional Director to take appropriate steps to arrange for discussions on this subject and to place it on the agenda of the fifteenth session, and

URGES governments of the Region to include in their delegations adequate technical representation.

Handbook 5-5.1 (8) Fifth Meeting, September 196i

page 68 SEA/RCl4/Min.5

SEA/RC14/R11 Time and Place of the Fifteenth and Sixteenth Sessions The Regional Committee^

Bearing in mind the principle of holding alternate sessions of the Regional Committee at the Regional Headquarters^

CONFIRMS its previous decision (resolution SEA/RC13/R6) to hold its fifteenth session at the seat of the Regional Office in New Delhi in September 1962, and 2 . ACCEPTS with gratitude the offer of the Government of Thailand to hold its sixteenth session, in 1963, in Thailand.

Handbook 5-1 (13)

page 64 Fifth Meeting, 2J September I96l

S E A / R C l V M i n . 5

(11)

SEA/RCl4/26 R e v . l p a g e 10

PART I L DISCUSSION ON THE THIRTEENTH ANNUAL REPORT OF THE REGIONAL; DIRECTOR

The R e g i o n a l Committee ^ in its examination of the Thirteenth Annual Report of the Regional Director (SEA/RC14/2 and Corr.l and 2), emphasized the following points s

The Committee appreciated that the report placed due weight upon the major problems of communicable disease c o n t r o l , training of personnel and environmental sanitation.

The reappearance of plague in certain parts of India and Indonesia was a cause for c o n c e r n , and the possibility of a considerable recrudescence of this disease following the w i t h d r a w a l of residual spraying in malaria eradication campaigns called for attentic;

C h o l e r a continued to b e a m a j o r threat in the Region• It was realized that the

fundamental solution w a s an improvement in environmental sanitation and social conditions The cost of such- measures w a s very h e a v y . -•• In this context, it was hoped that greater use m i g h t be made of funds which might become available from international sources for the development of water supplies and drainage.

W i t h the progress of malaria eradication programmes in the Region,the importance of assessment of resuits w a s becoming increasingly pronounced. Parasite pictures and infection rates w e r e changing• It w a s suggested that it might be desirable to establish a reference centre to w h i c h a certain percentage of blood films from all countries

could be sent for cross-checking. The Regional Director was requested to provide appropriate facilities for such external cross-checking (see resolution SEA/RC14/R5 ) •

While confirming its agreement w i t h a policy of smallpox eradication throughout the Region^ the Committee stressed the administrative difficulties w i t h which such a programme was still confronted. It. was felt that progress towards the eradication of smallpox in the Region w o u l d inevitably be slow but that it might be useful to attempt to set a target period within which it should be achieved。 The Committee passed a

resolution u r g i n g a l l countries to proceed with smallpox eradication programmes with a l l possible s p e e d , preferably within a period of five y e a r s , and to seek, where

n e c e s s a r y , i n t e r n a t i o n a l a s s i s t a n c e i n s u c h p r o g r a m m e s ( S E A / R C l V ^2) •

(12)

Enteric and helminthic infections were less spectacular than some of the conditions previously mentioned but were responsible for a greater load of morbidity. Little had yet been achieved in solving this problem. It was realized that the control of these infections was closely bound u p with improvements in environmental sanitation and that such improvements must be a very costly undertaking for these countries

and would inevitably take a very long time。 However, the importance of health education of the public as a means of securing some improvement in environmental

conditions, and the large role played by lack of food hygiene in the Region must always be kept in mind.

Other items concerned with communicable diseases which came under discussion included filariasis, BCG vaccine and epidemiological services. These subjects are dealt with at greater length in Part I V .

Several countries in the Region were engaged in the development of integrated health services, in association with community development programme s. It w a s generally regarded that a community approach to the development of health services was appropriate to the needs and resources of developing countries^ but stress w a s laid on the overwhelming load which the demand for curative care placed upon the limited personnel and other facilities, to the detriment of preventive w o r k . It was suggested that increased use should be made of supervised auxiliaries to relieve the curative burden on doctors in rural areas.

Other conclusions in the report which aroused particular discussion included maternal and child h e a l t h , and especially the needs of the pre-school c h i l d , for which very little had yet been done. The importance of health education programmes relevant to local problems was stressed^ and the emphasis on health education was linked up w i t h the participation of health departments in nutrition programmes. It was realized that the field of simple preventive dental health care in the Region was as yet hardly

touched u p o n . It was felt that wider training and use of dental auxiliaries might be undertaken for this purpose•

The Regional Committee expressed some concern at the number of unfilled technical posts in the Regional Office and felt that national administrations should be made aware

o f t h e problem and should be requested to release or second experts more freely- It

appeared that conditions of service and salary levels were not high enough to attract suitable candidates. A resolution was passed to record the Committee's concern with this problem (resolution SEA/RCl^/Rl).

(13)

SEA/RCL4/26 R e v . l p a g e 12

PART 工 工 工• EXAMINATION OP THE PROPOSED P R O G R A M E AND BUDGET ESTIMATES FOR 19幻

In accordance w i t h the terms of reference laid down b y the Regional Committee

in plenary session, the Sub-Committee on Programme and Budget met on 20 and 21 September and submitted a comprehensive report (see Annex ),document S E A / R C l V2^ ) •

After receiving the Sub-Committee ' s report., the Regional Committee in plenary

session reviewed in detail the Programme and Budget Estimates for 19бЗ (document SEA/RCl^/p T h e Regional Committee rioted that besides the percentage of expenditure which was represented as being allocated to education and training, many other projects included substantial training element s ^ and that the Sub-Committee had expressed the view that 45 per c e n t , of the field expenditure was a satisfactory figure for the funds proposed for t r a i n i n g . Similarly^ noting that the planned expenditure on environmental

sanitation w a s a relatively small proportion of the total budget for field activities but that there v;ere elements of sanitation included in many other projects^ the

R e g i o n a l Committee requested t h a t , in future years^ information should be separately g i v e n w h i c h w o u l d facilitate making a closer estimate of the total expenditure for s a n i t a t i o n .

The following amendments to the Programme and Budget document v^ere recommended:

1• C o u n t r y Projects (1 ) India

The two p r o j e c t s . Public Health Nursing Education, Kerala (India 179), and Environmental Sanitation (Community Water Supply)^ Punjab (India 11)), were to be eliminated^ and the project^ 1 TPublic Health Programme^ Madras" ^ which appeared u n d e r the Additional Projects^ should be introduced into the Category 工 programme•

⑵ Maldive Islands

The fellowship in undergraduate medical training planned for 1963 should be b r o u g h t forward to 1962 if the candidate was ready to start earlier. Also, under the Public Health Administration Project (Maldive Islands

5 ) ,if

the receptive capacity and local resources were adequate^ the nurse-midwife-tutor at present

appearing u n d e r Additional Projects should be provided under the Category 工 programme.

(14)

⑶ Nepal

Efforts would be made to transfer the project on Assistance to Central Health Directorate (Nepal 4 ) from the Expanded Programme to the Regular B u d g e t . The Government had already requested the elimination of the post of a sanitarian in the project on Training of Health Assistants (Nepal J ) and now planned to discontinue this project at the end of 196^. The Government had also requested that the number of nurse-tutors provided under the project Training of Nurses

(Nepal 2 ) should be reduced from three to t w o .

These amendments were approved by the Committee. There were no alterations to be made in the other country programmes.

2 . Inter-country Projects

It was agreed to cancel the two projects SE ARO 6 8 , Seminar on Filariasis Problems and SEARO 69, Training Course on Bilharziasis. The Regional Committee agreed to introduce a new inter-country project for studies on filariasis. Ail other inter- country projects were approved.

3 . Annexes

In considering the various annexes, the Regional Committee endorsed the TA-II programme given in Annex 1 .

The Regional Committee noted that the Sub-Committee had reviewed the staffing aspects and technical principles of several projects and had expressed themselves satisfied with the explanations given by the Regional Director.

Both the Programme and Budget Estimates and the Report of the Sub-Committee on Programme and Budget were approved (see resolution 3EA/RC14/R8)^ and the Regional Committee expressed its appreciation of the detailed scrutiny which had been m a d e .

(15)

SEA/RCL4/26 Rev.l

page 4

PART I V . DISCUSSION ON OTHER MATTERS

T h e Regional C o m m i t t e e , in its discussions, gave particular emphasis to the following i t e m s , in addition to those mentioned in Parts 工工 and III of this report

(the relevant resolutions are given in Part I):

1 . Resolutions of Regional Interest Adopted by the Fourteenth World Health Assembly and the Executive Board

A n u m b e r of resolutions of regional interest had been adopted by the Fourteenth W o r l d H e a l t h Assembly and the Executive B o a r d , as outlined in document S E A / R C 1 4 Д2. R e s o l u t i o n s on priorities in programme

( VJHA14.59) î

accommodation for the Regional Office for South-East Asia (EB27.R17 and VJHA14.25), the malaria eradication programme

(EB26.R52, E B 2 8 . R 2 6 , E B 2 8 . R 2 7 , ША14.2, ША14.27 and WHA14.38), adoption of the WHO flag (WHA14.24), continued assistance to newly independent states (ША14.37^ VJHA14.58 and E B 2 8 . R 2 2 ) , the smallpox eradication programme (ША14Л0), WHO/UNICEP jointly assisted activities (WHA14.42 and EB28.R14), radiation health (VJHA14.56), decisions affecting W H O activities in administrative and technical training (EB27-R21) and the programme procedures for the Expanded Programme of Technical Assistance (EB28.R15) w e r e n o t e d . The subject of smallpox eradication had already been considered by the Committee w h e n examining the Annual Report of the Regional Director (see Part 工工).

The following matters came up for special discussion:

1.1 Priorities in Programme

The Health Assembly's resolution on this subject (VJHA14.39) and other relevant p a p e r s before the Committee (SEA/RC1斗/15 and Add.l) had been referred to the 3ub- C o m m i t t e e on Programme and B u d g e t . The Regional Committee concurred with the views

expressed by the Sub—Committee in i t s report (see Annex ),document S E A / R C l V2^ ) and f e l t

t h a t it was n o t practicable to attempt to lay down any strict order of priorities.

Adequate guidance was being given by the Committee to the Regional Director from time to t i m e , in accordance with the basic needs of the whole Region as well as of individual c o u n t r i e s , such as those for the control of communicable diseases and. the training of h e a l t h p e r s o n n e l . Priorities vary from country to country according to needs^ and the Committee w a s of the opinion that their programme was suited to the special public health n e e d s of the Region and fell within the World Health Assembly's Third General Programme of W o r k for a specific period (1962—1965). It approved a resolution to this effect

(16)

1.2 Permanent Accommodation for the Regional Office for South-East Asia

After consideration of a report on the progress being made in the construction of the new b u i l d i n g , as presented b y the Regional Director (document SEA/RCl4/l8 the Regional Committee expressed its appreciation to the Government of India for its generosity and also to the countries in the Region for the plans they were m a k i n g for cultural contributions to the new building (see SEA/RC14/R6)•

Malaria Eradication Postage Stamps

The Regional Director brought to the attention of the Committee the public

information value of this programme (document SEA/RCüA/1^), and the R e g i o n a l Committee agreed that all countries of the Region should make every effort to p a r t i c i p a t e , by- issuing a stamp, or at least b y over-printing or issuing a special cancellation

(see resolution S E A / R C 1 V R 7 ) • 2 . Filariasis

In view of the special interest in this subject taken at the thirteenth session of the Regional Committee, a paper (SEA/RC14/10) h a d been placed before the Committee outlining the latest information available regarding possibilities for organizing successful control measures. In the discussion it w a s indicated that a short-term consultant had recently studied related problems in Ceylon and B u r m a . As a result it was envisaged that further studies would be made there shortly w i t h the object of designing a pilot project. The keynote of future activities should be caution in approach, as it w a s still n o t clear what measures were likely to prove effective in controlling the disease. In India some good results were being obtained f r o m anti-

larval measures., b u t other measures h a d n o t proved encouraging. It w a s generally a g r e e d that the large-scale malaria eradication v/огк under w a y in countries of the Region c o u l d not be expected to provide any effective assistance to the control of f i l a r i a s i s .

3 . Enteric Group of Diseases

During the discussion on document S E A / R C 1 4 / H on this subject, the view w a s

expressed that national reference centres through which the causative organism of these diseases could be investigated were needed in the R e g i o n . In the case of Indi a ^ it was mentioned that two specific investigation centres h a d now been established and t h a t

(17)

SEA/RCL4/26 R e v . l p a g e 6

a third was likely to be set u p shortly. The widespread prevalence of- a number of infections in the group was acknowledged, although their extent could not b e precisely s t a t e d , since m o s t of them were not notifiable and therefore did not always come to the attention of the h e a l t h authorities. The new trend towards establishing

epidemiological units at b o t h central and state or provincial levels would facilitate the obtaining of information in the matter in future.

Freeze-Dried BCG Vaccine

The Regional Committee at its thirteenth session had requested information on WHO'S position in regard to the use of this vaccine. The document presented on this subject (SEA/RC14/6) was welcomed as a m o s t helpful and informative statement. It was recognized that n o standards or minimum requirements in respect of the vaccine could at present b e laid down b y WHO for universal acceptance. It was hoped that in the n e a r future experienced laboratories would have sufficiently mastered the techniques required for the manufacture of this vaccine to enable consideration to be given to the question of standardization. Meanwhile., a satisfactory dry vaccine could be used w h e r e v e r climatic conditions indicated.

5- Epidemiological Units

The delegate from Ceylon presented a paper on "The Epidemiological Unit in a N a t i o n a l Health Scheme" ( S E A / R C l V ^ ) ^ v;hich described the functions and activities carried out b y the u n i t established in his country^ in order that other countries of the Region m i g h t have the benefit of Ceylonf s experience. He emphasized the value to b e derived from establishing such u n i t s . Endorsing the values mentioned^ the

Indian delegate stated that h i s country had already established a central epidemiological u n i t and was n o w developing similar units at state level. In the ensuing discussion^

it w a s emphasized that epidemiological units would need to be supported by public health laboratories if their full potentialities were to be realized; such laboratory services w e r e still p o o r l y d e v e l o p e d .

(18)

6 . Technical Discussions on "The Role of Public Health Departments in the Improvement of Nutrition 1

Recommendations arising out of the technical discussions held during the session were considered and are given in Annex 4 (document SEA/RC14/25 ) • Tbey were based

on three working papers (SEA/RC14/7 and A d d山 8 and 9 ) . An important conclusion reached was that malnutrition^ notably protein malnutrition and vitamin/mineral

deficiency diseases, constituted a major health problem in South-East A s i a . Following discussions on the causes involved, it was concluded that there was urgent n e e d for

the production of more foodstuffs^ particularly protective f o o d s , to meet the needs of the whole population. These must b e available at prices within the reach of the lowest income groups• Recognition w a s given also to the part played b y b a d dietary habits, lack of knovrledge of nutrition., extensive intestinal parasitism resulting from poor sanitary conditions, and aggravation caused by changed living conditions arising from increasing industrialization and urbanization. Recommendations put forward advocated the establishment of specific Nutrition Division in health services^ along with the creation of both an over-all advisory committee representative of technical opinion on nutrition and a National Food and Nutrition Co-ordinative Body entrusted with defining national nutrition policy.

7* Domiciliary Treatment of Tuberculosis

Keen interest having been expressed on the extent to which the patterns of

domiciliary treatment, evolved with such success at the Tuberculosis Chemotherapy Centre^

Madras^ could be applied elsewhere^ it was explained that in India a domiciliary service was now regarded as a necessary adjunct cf all established tuberculosis clinics. In the meantime^ further extensive research on various organizational aspects of the application of domiciliary treatment was being conducted under the auspices of India's National

Tuberculosis Institute at Bangalore. From these studies it was hoped to get information on whether patients generally could be expected to take the drug at h o m e , provided

arrangements were made to follow up individual defaulters. Attention was called to the valuable contribution which the Madras Tuberculosis Chemotherapy Centre w a s making to world-wide knowledge cf the treatment of tuberculosis and the great need to continue this w o r k .

(19)

SEA/RCL4/26 R e v . l page 8

8 , Evaluation of Internationally-Assisted Projects

At the thirteenth session of the Regional Committee, it had been agreed that it w o u l d b e valuable if governments w o u l d carry out evaluation studies of selected

internationally-assisted projects^ having in mind the necessity for continuously improvj.r.:

the planning of such p r o j e c t s , and the Regional Director h a d been requested to recommend to governments that they make these evaluations. In answer to the consequent request of the Regional Director,, some detailed evaluations h a d been received from almost all the countries in the R e g i o n . They had been summarized in documents SEA/ÏIC14/5 and Add.l^ 2 and which w e r e submitted to the Regional Committee. It was agreed that this type of evaluation b y governments was most useful and should be encouraged.

The R e g i o n a l Director offered WHO'S assistance in any independent assessment of such projects w h i c h governments m i g h t desire to have made in future•

9 . Time and Place of the Fifteenth and Sixteenth Sessions of the Regional Committee The Committee confirmed that its 1962 session would be held at the seat of the R e g i o n a l Office in New Delhi in September of that year. The delegate for Thailand conveyed h i s GovernmentT s invitation to hold the sixteenth session^ which would take place in September 1965,in Thailand. This invitation was accepted with appreciation^

a n d a resolution to this effect adopted ( 3 E A / R C l 4 /R 1l ) •

(20)

page 1

AFGHANISTAN Representative

BURMA

Representative

CEYLON

Representative Alternate

INDIA

Representative

Alternates

Advisers

FINAL LIST OF PARTICIPANTS1

1 . Representative s ^ Alternates and Advisers

Dr A . R , Hakimi, Director-General of Public Health Services., Kabul

D r A . M . Mobsby, Assistant Director of Health Servicesj Rangoon

Dr W . A . K a m m a r a t n e , Director of Health Services, Colombo Dr D。B . Gunasekara, Acting Deputy Director of Health

(Laboratory Services)^ and Director^ Medical Research Institute• Colombo

L t . Col. V . Srinivasan, Director-General of Health Services, New Delhi

Dr M . S . Chadha, Deputy Director-General of Health Service s , New Delhi

Shri C . Nanjappa^ Member of Parliamentд Coimbatore Dr A . P . R a y , Director, National Malaria Eradication

Programme, Delhi

Dr V , PU Thayumanaswamy, Director of Medical Services, IVIaaras State

Dr N . Par tha s ara t h y , Director of Public H e a l t h , Madras State Dr С, Gopalan^ Director, Nutrition Research Laboratories,,

Hyderabad

1 Issued as document SEA/RC14/21 Rev .2, on 28 September 196l

(21)

S E A/ R C1 4 /2 6 R e v . l A n n e x 斗 •—

p a g e 277

I N D I A ( c o n t i n u e d ) A d v i s e r s

I N D O N E S I A R e p r e s e n t a t i v e A l t e r n a t e

N E P A L

R e p r e s e n t a t i v e

D r N . V e e r a r a g h a v a n , Director^ Pasteur Institute, Coonoor D r D . Choudhury, Assistant Director-General of Health

Services (International H e a l t h ) , N e w D e l h i

Shri Basheshar N a t h , Under-Secretary, Ministry of Health,

N e w Delhi

D r Soemiatno, D i r e c t o r , Pasteur Institute, Bandung D r Dradjat D . Prawiranegara, Director^ Institute of

Nutri t i o n , D j a k a r t a

D r Dineshananda B a i d y a , Director of Health Services) Kathmandu

T H A I L A N D

R e p r e s e n t a t i v e

A l t e r n a t e

U N I T E D K I N G D O M R e p r e s e n t a t i v e

A l t e r n a t e

U N I T E D N A T I O N S a n d

U N T A B U N I C E F

P A O

D r B o o n Suvarnasara^ Deputy Director-General, Department of Healthy B a n g k o k

D r Prachoom Indrambarya^ D i r e c t o r , Nutrition D i v i s i o n , Department of Health- Bangkok

D r L . H . M u r r a y , Principal Medical Officer, Ministry of Health, London

M r О. В.. B l a i r , F i r s t Secretary, Deputy High Commission f o r the United K i n g d o m , Calcutta

2 . Representatives of the United Nations a n d Specialized Agencies

M r Arsene S h a h b a z , D e p u t y Resident Representative of the United Nations Technical Assistance B o a r d , N e w Delhi

1У1г Poul F . Larsen^ Acting UNICEF Area Repre sentative f o r I n d i a , Afghanistan and C e y l o n , New D e l h i

M r K . A . B e n n e t t , Deputy Regional Repre sentative for Asia a n d the F a r E a s t , Western Z o n e , New D e l h i

(22)

J• Representatives of Inter-Governmental Organizations International Committee

of Military Medicine and Pharmacy

Colonel N . D , P . Karani, Deputy Director (Health and Pathology)- Army Headquartersд Ministry of Defence^

New Delhi

4 . Representatives of Non-Governmental Organizations International Association

for the Prevention of Blindness

Dr A . D . Sagayam^ Ophthalmic Surgeon, Ootacamund

International Committee of Catholic Nurses

Mrs Mary D a l b y , Chief N u r s e , Bowring Hospital^ Bangalore Mile Carmen Lanthier, Leprosy Centre^ Polambakkam P . O .

Madurantakam T a l u k . Madras State International Council

of Nurses

Miss S . Kunjummen, Directorate of Medical Services, Madras

League of Red Cross Societies

Medical Womenf s

International Association

Dr (№s) M . B . Kagalj, Director^ Maternity and Child Welfare Bureau- Indian Red C r o s s , New Delhi

Dr (Mrs) Sharyu B h a t i a , President, Association of Medical Women of India, Bangalore

World Federation of Mental Health

Dr 0 . D . Amarasinha, Psychiatrist^ Nugegoda, Ceylon

World Federation of Occupational Therapists

Mrs К. V . Nimbkar^ Honorary Adviser on Occupational Therapy and Rehabilitation to the State Government of Maharashtra Bombay

World Medical Association Dr Y . P . Vasudevan, D e a n , Kuppusv/amy Memorial Hospital for Women and Children, Coimbatore

(23)

SEA/RC14/26 Rev.l ANNEX 2

page 1

1 . 2.

3 . 4 .

5 .

6.

7-

8.

9 .

1 0 .

l l .

12.

13.

Opening Address by Appointment of Sub .Approval of

Election of of Adoption Agenda Appointment and Budget

A G E N D A1

Chairman

-Committee on Credentials Report .

Chairman and Vice-Chairman Provisional and Supplementary

of Sub-Committee on Programme

Adoption of Agenda and Procedures for the Technical Discussions, and Appointment of Chairman

Thirteenth Annual Report of the Regional Director

Technical Discussions; "The Role of the Public Health Department in the Improve- ment of Nutrition “

Resolutions of Regional Interest Adopted by the Fourteenth World Health Assembly and the Executive Board

Filariasis

Enteric Group of Diseases Freeze-Dried BCG Vaccine Food Hygiene and Adulteration

SEA/RC14/2J

SEA/RC14/1 and Add.l

SEA/RC14/22

SEA/RCÍ V l 斗:

SEA/RC14/2 and C o r r . 1 and .2

SEA/RC14/7 and A d d . l , SEA/RC 一 V 8

SEA/RC14/9 .

S E A / R C 1 V 1 2

S E A / R C l V l ? and Add.l S E A / R C l V i S

SEA/RC14/19 S E A / R C i V l O SEA/RC14/11 SEA/RC14/6 SEA/RC14/20

1 Issued as document SEA/RC14/1 R e v . l , on 2 0 September I96l, and including references to documents issued since that date

(24)

1Ц-. T h e E p i d e m i o l o g i c a l U n i t in a N a t i o n a l H e a l t h S c h e m e ^ w i t h p a r t i c u l a r r e f e r e n c e t o C e y l o n (item p r o p o s e d b y t h e Govern- m e n t of C e y l o n )

1 5 . E v a l u a t i o n of I n t e r n a t i o n a l l y - A s s i s t e d P r o j e c t s

1 6 . P r o p o s e d R e g i o n a l 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 3

I 6 . I C o n s i d e r a t i o n of the R e p o r t of the Sub- C o m m i t t e e on P r o g r a m m e a n d B u d g e t 1 7 • C o n s i d e r a t i o n of the R e c o m m e n d a t i o n s

a r i s i n g o u t of the T e c h n i c a l D i s c u s s i o n s l 8 • S e l e c t i o n of S u b j e c t f o r the T e c h n i c a l

D i s c u s s i o n s in c o n n e x i o n w i t h the

F i f t e e n t h S e s s i o n of t h e R e g i o n a l C o m m i t t e e 1 9 . T i m e a n d P l a c e of t h e S i x t e e n t h Session

of the R e g i o n a l C o m m i t t e e 2 0 . A n y O t h e r B u s i n e s s

2 1 . A d o p t i o n of the F i n a l R e p o r t of the F o u r t e e n t h S e s s i o n

2 2 • AdJ o u r n m e n t

SEA/RClV 斗

SEA/RC1V5 and Add.l? 2 and 5

SEA/RC14/3

SEA/RClV2ii

SEA/RClV25

SEA/RC14/15

S E A / R C 1 4 / 2 6

S U P P L E M E N T A R Y A G E N D A 1 . E x p a n d e d P r o g r a m m e of T e c h n i c a l A s s i s t a n c e s

N e w C o u n t r y P r o g r a m m i n g P r o c e d u r e s S E A / R C 1 4 / 1 6 and A d d . l SEA/RC1斗/17

(25)

S E A / R C l V2 6 R e v . l ANNEX 5

page 1

R E P O R T OF T H E SUB-COMMITTEE O N PROGRAMME Ш ) B U D G E T1

The Sub-Committee on Programme and. Budget m e t on 20 and 2 1 September 196i

to review the proposed programme and b u d g e t estimates for 19бЗ (document S E A / R C 1 4 / 3 ) and to report to the Committee, in accordance w i t h its terms of reference ( S E A / R C 1 4 /2 2) and the suggestions of the last year's Sub-Committee ( S E A / R C D / l A )。 T h e S u b-

Committee consisted of D r Karunaratne (Ceylon), w h o w a s elected Chairman^ D r Mobsby (Burma), Dr Choudhury (India) and Mr B l a i r (United K i n g d o m ) .

Before proceeding to consider the items of its terms of reference a p p e n d e d ,

the Sub-Committee wished to know the procedures w h i c h had been adopted b y the R e g i o n a l Office in developing the programme for the R e g i o n . It was explained that the

programming cycle began early in each year w i t h the receipt of the tentative ceiling allocations from the Director-General. The Area Representatives consulted w i t h

governments before they met with the Regional Office staff in M a r c h . At this m e e t i n g , prospective requests of governmentsд proposals emanating from the D i r e c t o r - G e n e r a l and proposals of the Regional Office staff w e r e considered^ and a tentative programme w a s formed. When this programme w a s c o s t e d , the t o t a l figure often exceeded the provisional allocations., and it w a s then reframed on the basis of technical priorities and urgency of government needs and resources。 E a c h country then received from the Regional Office a suggested programme^ which w a s again discussed vzith representatives of the Regional Office and finally modified^ and w a s incorporated into the Programme a n d Budget document presented to the Regional C o m m i t t e e . Requests w h i c h could n o t b e fitted into the tentative ceiling allocations w e r e included as additional p r o j e c t s requested b y governments b u t for w h i c h n o funds were available (Annex J of d o c u m e n t SEA/RC14/3)-

1• General Review of the Proposed Programme 1.1 New Activities in 1963

2

The Sub—Committee h a d before it W o r k i n g Paper N o . 4 and noted t h a t there w a s some increase in the percentage of new projects as compared with the previous y e a r . They

1 Issued as document SEA/RClV"2

斗,on 22 September 196l

一 Working Papers 1, ) and 4 being distributed to Member governments of the R e g i o n

b u t are n o t reproduced h e r e

(26)

p a r t i c u l a r l y n o t e d the increase in new projects in mental health (projects Burma 37 and Thailand 17),which amounted to $ 28j, out of the total shown on page 斗 of the b u d g e t document under this main subject heading for 19б5 ($ 斗〇 1 斗 斗 )•

The Sub-Committee inquired if this represented a new trend in the regional

a c t i v i t i e s . It was explained that the increased figure represented the current state of readiness of different countries for assistance in this field and was not a new trend j w o r k in t h i s field h a d already been going on.

The Sub-Committee n o t e d w i t h satisfaction that the number of fellowships planned for 1963 was considerably increased. It was explained that the Regional Office tried e v e r y year to award a n u m b e r of technically sound fellowships out of savings accruing in the y e a r of implementation. At this stage ^ the Sub-Committee inquired into the m e t h o d of budgeting for fellowships, and it was explained that in accordance with the p o l i c y of the Organization, the total cost of a fellowship was obligated in the year in w h i c h the award w a s s i g n e d , irrespective of the number of years of study. The only limitations were a maximum period of two years under the Expanded Programme of Technical Assistance and five under the Regular B u d g e t . It was explained that the practice of obligating the provision for longer than the budgetary period was an established policy., w h i c h gave security to the f e l l o w .

1 • 2 Comparison of C o s t of New Activities with Total Cost of Field Activities

In comparing the cost of new activities with the total cost of field activities, the Sub-Committee n o t e d t h a t the bare figures of percentage expenditure on new projects were n o t p a r t i c u l a r l y informative beyond showing that there was a measure of flexibility in the programme planned for 1965 in that money would become available because old projects w e r e t e r m i n a t i n g . The programme was therefore n o t static. It was explained that

funds f o r n e w projects arose f рош "two sources s first» 9 from funds ^released, b y "the

t e r m i n a t i o n of existing p r o j e c t s , and, second, by increase in the over-all allocations b y the D i r e c t o r - G e n e r a l .

(27)

SEA/RC14/26 Rev.l Annex 斗 •—

page 26

1.3 Field Staff ing Trends

The Sub-Committee considered the field staffing trends in some detail and h a d before it Working Paper N o , J .1 The Sub-Committee compared this working paper with

Appendix 3 to the Report of the Sub—Committee at the thirteenth session and .drew attentioi to the changes in the total number of staff provided under main subject headings in the two years. The Sub-Committee asked for an explanation of the decrease under ? TPublic Health Administration" from 75 to 59 field staff. It was stated that the main reason was the termination of some projects in public health programmes^ which released a considerable number of staff,as evidenced by the fall from 28 to 9 in the number of nurses under this subject heading. The Sub-Committee also noted the increase in staff under the main subject heading of "Malaria" from 9〇 to 101. This increase was largely due to the need to provide sub-professional administrative staff to report on programmes in some countries where none such were available locally. The Sub-Committee drew

attention to the increase from 10 to 20 in the number of sanitarians engaged in malaria programmes and the elimination of assistant malariologists. It was explained that as a re suit of experience it had been decided that a sanitarian was better equipped than an assistant malariologistj hence the replacement of one by the other.

The Sub-Committee noted with satisfaction that the number of posts in the Regional Office was stable in the three years 1961, 1962 and 1965, whereas a considerable increase was shown in the total cost of field activities in these years. T h i s , in the opinion of the Sub-Committee^ pointed to sound administrative practices•

2 . Detailed Examination and Analysis of Selected Projects 2,1 Selected Inter-Country Projects

Before selecting inter-country projects for review^ the Sub-Committee requested information on the genesis of these projects. It was explained that inter-country projects were developed in three main ways; (a) they might follow suggestions from headquarters having relevance to global needsj (b) they might be planned when a subject was considered to be of importance to at least two regions^ and (c) when a subject

appeared to have wider application than to a single country within the Region^ it was often desirable to plan for assistance on an inter-country basis о

Working Papers 2, 3 and 斗 are being distributed to Member governments of the Region but are not reproduced here-

(28)

The Sub-Committee expressed itself as generally satisfied with the planning of the inter-country programmes and undertook the examination of four specific projects:

(1) B C G Assessment Team (SEARO 5 )

The Sub-Committee wished to know the reasons for establishing such a team.

It w a s explained that the main functions were to check techniques b y sampling, and

to advise on whether (a) the conversion rate was satisfactory, (b) the correct population groups w e r e b e i n g c o v e r e d , and (c) the general administration and recording methods

were e f f i c i e n t .

(2) Seminar on Filariasis Problems (SEARO 6 8 )

It w a s explained that this had originated from a suggestion by headquarters and that although the South-East Asia Region was interested^ other regions had not found it practicable to p a r t i c i p a t e . Therefore, headquarters had cancelled the project.

In reply to a q u e s t i o n , it was explained that alternative activities in this sphere w o u l d b e planned b y the Regional Office.

(5) Training Course on Epidemiology and Bacteriology on Enteric Infections (SEARO 7〇) It w a s felt that this project was in keeping with the trends, health needs and wishes of the countries of the Region. The Sub-Committee wished to know how the

total cost of $ 56IO had been reached and for what period the training course was planned.

It was explained that w h e n details were known as to where and for how long the course w o u l d b e h e l d , accurate costings would b e m a d e . Pending this, costing was on the basis of a three w e e k s1 c o u r s e , w i t h appropriate allowances for participants from the Region.

(斗) Preliminary Study for Community Water Supply Programme (SEARO 6 3 )

It w a s explained that WHO was prepared to give assistance in any aspect of water supply^ including engineering design and study of resources^ the management and

f i n a n c i a l f i e l d s , rating structures, etc. Short-term consultants could also advise on the economic aspect of water supplies. Advice and recommendations could also be given as to sources of international finance. In conclusion, the Regional Director said that in accordance with the principles enunciated by the World Health Assembly and the instructions which he had received from the Regional Committee, he had tried to stimulate large community water supply projects, but so far no requests from governments h a d b e e n forthcoming•

(29)

SEA/RC14/26 Rev.l Annex 斗 •—

page 5

2.2 Selected Nursing Projects

(1) Nursing Advisory Services (Ceylon 5 3 )

This project followed the pattern of many WHO nursing projects and was concerned with nursing administration, basic and post-graduate training and training of auxiliaries The Sub-Committee decided that the project was designed to meet the needs of the c o u n t r y .

(2) Post-graduate Training of Nurses (India 1)6)

WHO assistance to this project was about to start. The objectives were to

assist in the post-graduate training of nurses in various States in India. Initially WHO would assign a senior nurse educator to a State for nine to twelve months^ according to the needs of the State. She would then be moved to some other State^ in agreement with the Government of India.

(3) Training of Nurse s ^ Kathmandu (Nepal 2 )

This was a long-term undertaking because basic training facilities were lacking before the school was started with WHO aid in 1956 • The school offered a three-and- a-half year course in nurse training. Earlier,a group of nurses had been sent under a WHO fellowship to study midwifery in India。 The school was now able to conduct midwifery training locally. A number of fellowships had already been awarded for nurse-tutors.

2.J Random Sampling of Other Projects

(1) Institute of Public Health, Kabul (Afghanistan J l )

The objective of the project was to assist in the organization and operation of the new Institute of Public Health started by the Government in Kabul • The Institute was meant to undertake trainings initially of auxiliary staff only,, and also field and laboratory research. The assistance planned b y WHO was the provision of one public health specialist (to whom the national Director of the Institute would be a counterpart) and other technical experts, who would assist in the creation of various sections of the Institute. The project would operate in close co-operation with the projects "Training of Sanitarians" (Afghanistan 26) and "Health Education" (Afghanistan 2A as both the latter activities would be transferred to the Institute.

(30)

(2) W a t e r Supply and Sewage Disposal, Greater Calcutta (India 170)

Before proceeding to this and the following project^ financed by"the United Nations Special F u n d , the Sub-Committee asked for some general information as to the method of controlling expenditure of monies received from the United Nations Special F u n d . It was explained that the United Nations Special Fund was a financing agency and that WHO^ as the executing a g e n c y , vías responsible for the control and the expenditure of the f u n d s . The United Nations Special Fund had laid down a general policy that projects financed b y it should fall into one of thre§ main general categories: (a) economic d e v e l o p m e n t , (b) trainings and (c) research^

The Calcutta project could b e regarded as an example of United Nations Special Pund/VfflO p r o j e c t s . The project was designed to be carried out in three phases.

In the f i r s t p h a s e , WHO h a d provided a team of experts who advised on the development and m a n a g e m e n t of water supply and drainage service and related municipal admini s t rat i on • The second phase^ undertaken with United Nations Special Fund support, consisted of

a survey of resources and requirements for installation of water and sewerage systems.

W H O w a s the executing agency for the United Nations Special Fund and was responsible for the technical direction and supervision of the project. The third phase would be the implementation b y the Government of the plans drawn up by the consulting engineers undertaking the survey.

In addition to the firm of consulting engineers, WHO would provide a resident engineer to be financed, from the United Nations Special Fund allocation,

(3) Assistance to Central Public Health Engineering Research Institute, Nagpur (India 176)

This w a s also a project jointly assisted by the United Nations Special Fund and W H O . The United Nations Special Fund h a d provided for equipment to meet the needs of the Institute in fulfilling its function as a major research centre for the whole country The r e s e a r c h programme and the list of necessary equipment had been drawn up on the

advice of a consultant assigned b y W H O . In the implementation of the consultant's r e c o m m e n d a t i o n s , WHCb from its own resources,, would provide a professor in sanitary engineering to advise on the development of the research programme and utilization of the e q u i p m e n t .

(31)

SEA/RC14/26 Rev.l Annex 斗 •—

page 7

(4) Strengthening of Health Services (Indonesia 5 5 )

The pattern of this project was comparable to that of public health projects elsewhere in the Region. The major objectives were the development of a system of health services for rural areas, to be based on auxiliary staff, with qualified

supervision. WHO assistance would be with respect to the organization of the services and the training of staff. An explanation was given of the administrative organization from the centre, through provinces, regencies^ districts and sub-districts, in Indonesia.

(5) National Tuberculosis Programme Pilot Project (Thailand 4 2 )

The objectives of this project were to devise a system of case-finding and

domiciliary treatment and to train national staff. It was explained that the assignmerrc of technicians in certain fields was necessary in order to train national staff in the highly specialized techniques required.

2Л Education and Training Programme

It had already been pointed out in a previous plenary meeting that in the Regional Director1 s Annual Report the figure of 7 per cent, for "Education and Training" y out of the total field expenditure, represented only those projects which were entirely within the major subject heading shown in the Summary of Field Activities (page 4 of document SEA/RC14/5). Many other projects, however^ included substantial elements of education and training, although these projects were included under other main subject headings,

in accordance with a pattern set for all WHO'S regional offices. The Sub-Committee, which had before it Working Paper N o . reflecting other elements of education and training throughout all the activities of the R e g i o n , expressed the view that 斗5 per cent of the field expenditure was an appropriate use of available resources, having regard to the needs of the Region,

3- Examination of the Regional Office Staffing and Budget

The Sub-Committee considered the staffing of the Regional Office and expenditures for Regional Advisers and Area Representatives and posed a series of questions.

Information was requested on w h y individual costs of personnel were n o t shown for 196l as for 1962 and It was explained that a s , during the year of implementation^

the actual costs of ail posts were available up to the end of j u n e , it w a s necessary

Working Papers 3 and 斗 are being distributed to Member governments in the Region but are not reproduced here.

(32)

to make estimates only for the second half of the year; the two together were given as "totals" in respect of the Regional Office (page 15)^ Regional Advisers (page 2 1 ) and Area Representatives (page 2 J ) .

The Sub-Committee asked for an explanation of posts which appeared in document SEA/RC14/3 under the year 1962 which were different from those shown in the 19б2 column in the previous y e a r1 s document (SEA/RC14/3 R e v . l ) . It was stated that there were m a n y factors which might cause change s ^ such as upgrading ^ suppression of a post or introduction of new posts because of changing n e e d s , and that costs might well vary

as a result of modifications in salary scales, cost of living adjustments, etc. 3 approved b y the Executive Board and World Health Assembly from time to time.

The Sub-Committee asked for information about the position of an Administrative Assistant ND б on page 1 5 . It w a s explained that this assistant would be needed in 1962 w h e n the Regional Office moved to its new permanent accommodation. As to w h y the position of Administrative Services Officer on page 1 ) was graded at P-3 in the document under review^ whereas it was P-2 in the previous yearT s document^ it was stated that the post had b e e n regraded and the officer promoted.

The Sub-Committee referred to the narrative on page 8 concerning the Regional Office and requested that in future the Regional Director expand this so that they w o u l d b e in a better position to understand the additions, suppressions and upgrading of p o s t s .

In answer "to a reques"t, "the Regional Director outlined, "the administrative pattern as regards the technical staff in the Regional Office and the functions of the Area R e p r e s e n t a t i v e s , and rnade the specific point that the latter were not supervisors of f i e l d staff; this function was delegated to Regional Advisers in the Regional Office.

The Governments of Nepal and Afghanistan had requested that the Public Health Advisers in those countries be re-designated Area Representativesj in principle, this had been a g r e e d .

It w a s n o t e d that the statutory staff costs of the Regional Office, as outlined on page 1 5 , h a d increased sharply from 196l to 1962. In explanation,it was stated that statutory staff costs^ such as costs of recruitment, home leave and repatriation, could n e v e r be constant from year to year j this accounted for the sharp variations.

(33)

SEA/RC14/26 Rev.l

Annex 4 page 4

Under "Common Services", in the amounts for "Space áñd: equipment services", there was a substantial increase in 1962 and 1965 over 1 9 6 l . It was explained that in A p r i l 1962 it was planned to move to the new building. The costs for 1962 took into account three months in Patiala House and nine months in the new building, where large additional costs would result from the provision of the necessary electricity and for the air-

conditioning plant and lifts.

It was noted that the acquisition of capital assets on pages 15 and 21 showed a very sharp rise in 1962. The Regional Director explained that all the furniture was being replaced, that an internal telephone exchange was being purchased.^ and that other specialized equipment was needed for the new building. The Regional Office had been buying these items gradually, as savings had become available, since 1958•

The figures shown for 196l and 1962 reflected the funds required to complete these purchases. In 1963, no further considerable capital investment was expected, and provision for standard replacements had been included.

It was stated that the total cost of common services was apportioned between the Regional Office and the Regional Advisers on the basis of the number of staff employed under each heading •

The general question of duty travel was discussed at length. The Regional Director explained how and w h y his staff were required to travel to meetings and conferences of all types as well as in connexion with the extensive field activities.

It was pointed out that the -amount of $ JOOOj which was provided for I96j (on page 1 5 b covered travel for "Regional Office", whereas the amounts of $ 3 0 000 under the Regular Budget and $ 10 200 under the Malaria Eradication Special Account (on page 2 1 ) covered the travel of Regional Advisers, and the amount of $ 70 0 0 (on page 2 J ) that of Area Representatives.

A question was asked as to whether it was net possible to reduce the n u m b e r of Assistant Directors of Health Services (appearing in the budget as "Public Health Administration Advisers"). The Regional Director explained their functions• E a c h was responsible for a group of advisers and assumed responsibility for covering the

functions of specialist advisers during their periods of absence as well as responsibilit;

f o r a 1 1 fellowships. The pattern of organization was practically the same in most

regional offices and had proved to be sound and efficient. The work of the Regional Office could not be carried out without these key supervisory posts.

Références

Documents relatifs

ciso (n) del Artículo 2, se redactaron con gran acierto y amplitud de miras. Remon- tándose a los antecedentes de este asunto, el Dr Al-Wahbi recuerda que en los debates de la

De conformidad con la resolución de la 13 Asamblea Mundial de la Salud y de las recomendaciones formuladas por el Comité de Expertos en Paludismo en su octavo informe, se envió

The Committee expressed gratification at the promptness with which the Regional Office had provided assistance to governments in the implementation of resolution W H A 1 8. 3 6

$4 ООО 000 en 1963 au compte spécial pour 1'eradication du paludisme. Ces montants ne sont classés dans aucun chapitre du code des dépenses. Ces prévisions couvrent les

It so happens that a pharmaceutical speciality of an exporting country may include only drugs which have actually been produced in a number of other countries, which may exercise

Certains pays tiennent des statistiques relatives aux travaux du personnel de ser- vice (par exemple, le nombre de repas servis) afin de suivre le volume des activités non médicales

E l Dr VANNUGLI, suplente del Profesor Canaperia, se muestra satisfecho de que el Consejo Ejecutivo, después de haber examinado con cierta rapidez los infor- mes de otros comités

[r]