(WPR/RC21 ISRI 1)

SUMMARY RECORD OF THE FIRST MEETING

WHO Conference Hall Tuesday, 1 September 1970 at 9.00 a.m.

CHAIRMAN: Medecin-General J. Rondet (France) later: Dr K. Abhay (Laos)

~ CONTEL~S

y

t·

, /-

1 Formal opening of tne twenty-first session of the Regional Conmtittee and address by retiring Chairman ..•...................••..•......•.....•..•••••••.. 70

2 Election of new officers: Chairman, Vice-Chairman

3

4

5

6

7

8

9

10

and Rapporteurs ...•.....•.....•...............•...........• 71

Address by the Direc tor-General ........ ".................... 71

Address by incoming Chairman ...•......................•.••. 75

Adoption of the agenda ...........................•......... 75

Statement by the Chairman of the Technical Discussions 75

Establishment of the Sub-Committee on Programme and Budget ................................................• 76

Acknowledgement by the Chairman of brief reports received from governments on the progress of their health activities .......................................... 77

Nomination of the Regional Director •••••••••••••••••••••••• 77

Announcements .............................................. 78

-67-

68 REGIONAL COMMITTEE: TWENTY-FIRST SFjSSION

First l.feeting

Tuesday, 1 S~~ember 1970 at 9.00 a.m.

PRESENT

I. Representatives of Member States

AUSTRAlIA

CAMBODIA

CHL.~A

FRANCE

JAPAN

LA0!;

MALAYSIA

NEw ZEALAND

PHILIPPINES

PORTuGAL

REPUBLIC OE' KOREA

SINGAPORE

UNITED KINGDOM

Dr H.M. Franklands Dr D. De Souza Dr L. Rovin Mr K. Adair ¥.r P.W. Carroll

Dr Pruoen Vann

Dr C.K. Chang Dr K.P. Chen

Medeeill-General J. Rondet Dr A. Cheval

Dr T. Takizawa Mr M.. YamasBiki ~1r K. Watanabe Mr N. Maekawa

Dr Khamphai Abhay Dr Phouy Phdutthasak Dr Tiao Jaisvasd Visouthiphongs

Dato (Dr) Haji Abdul Majid Dr Chong ChUIl Hian Dr Abdul Khalid bin Sahan

Dr C.N.D. Ta~lor

Dr J. Azurin Dr G.Balbin Dr T.A. Gomez Dr A.N. Acoslta

bin Ismail 1"

Dr Diego Hora Silva Farreira

Dr M.H. Lee Dr C.D. Min

Dr Kohrhong, Sam

Dr G.H. Choa Dr K.L. Thon~

~ I

I

I

,-SUMMARY RECORD OF THE FIRST MEETING

UNITED STATES OF AMERICA

VIET-NAM

WESTERN SAMOA

Dr M. Beaubien Dr J.K. Shafer Dr L.J. Florio Dr J.P. Keeve Colonel R.T. Jensen

Dr Nguyen Dang Que Dr Nguyen TuanPhong

Honourable Fuimaono Moasope

II. Representatives of the United Nations and Specialized'Agencies

UNITED NATIONS AND UNITED NATIONS DEVELOPMENT PROGRAMME Mr W.M. Harding

III. Representatives of other intergovernmental organizations

SOUTH PACIFIC COMMISSION Medecin-General J. Rondet

IV. Representatives of non-governmental organizations

INTERNATIONAL DENTAL FEDERATION

MEDICAL WOMEN'S INTERNATIONAL ASSOCIATION

INTERNATIONAL COMMITTEE OF CATHOLIC NURSES

INTERNATIONAL COUNCIL OF NURSES

INTERNATIONAL PLANNED PARENTHOOD FEDERATION

LEAGUE OF RED CROSS SOCIETIES

V. WHO Secretariat

DIRECTOR-GENERAL

SECRETARY

Dr F.G. Rojas

Dr I.Y. Zalamea

Mrs M.R. Ordonez

Dr A.M. Maglacas

Dr E.I. de Castro

Mrs G.B. Senador

Dr M.G. Candau

Dr Francisco J. Dy Regional Director

69

70 REGIONAL COMMITTEE: TWENTY-FIRST SESSI9N

I FORMAL OPENING OF THE TWENTY-FIRST SESSION OF THE REGIONAL COMMITTEE AND ADDRESS BY RETIRING CHAIRMAN: Items I and 2 of the Provisional Agenda

Medecin-General RONDET, retiring Chairman, declared the meeting

open and welcomed all the participants. He expressed a special welcome,

on their behalf, to the Director-General whose presence at the session

would give a special impetus to its work. He also extended greetings

to the Regional Director and his staff. Everyone realized the heavy

task invo.lved in preparing these annual meetings which had proved

increasingly successful over the years. The Regional Director had

substantially contributed to that success, which was characterized by

the growing importance of the technical subjects discussed and by the

friendly atmosphere which reigned during the meetings.

Among the various items of the proposed agenda were three

traditional ones, namely, tne Report of the Regional Ditector, the

review pf the programme and budget estimates, and the technical

discussions. Those discussions would certainly be most fruitful in

view of the great importance of the subject chosen and ~lso because of

the special qualifications possessed by the Chairman, Professor K.P. Chen,

Director of the Institute of Public Health of the Natiorial Taiwan

University.

Much had been said in recent )ears of the need for tlhe World Health

Organization to keep pace'with developments in a constantly changing

world. Economic and social progress inevitably gave rise to new problems

for which new solutions must be sought. One such example was the seminar

on urbanization held recently in French Polynesia, the need for which it

would have been difficult to envisage some fifteen year,s ago. Even the

continuing basic prvblenls assumed new dimensions due to environmental

changes. Modern information techniques had an influence on working

methods: their effect was noticeable both in the preparation of the

budget and in the establishment and implementation of programmes. But

such changes were of minor importance; the underlying re~sons for the

very existence of WHO remained the same. They retained all their human

value and woulcl stllmlate everyone attending the meeting to continue

SlOOfARY RECORD OF THE FIRST MEETING

along the path followed for more than twenty years with, it was to be

hoped, the same successful results as had been achieved at previous

sessions.

71

2 ELECTION OF NEW OFFICERS: CHAIRMAN. VICE-CHAIRMAN AND RAPPORTEURS: Item 3 of the Provisionsl Agenda

2.1 Election of Chairman

Dr AZURIN (Philippines) nominated Dr ABHAY (Laos) as Chairman; this

was seconded by Dr TAKIZAWA (Japan).

Decision: Dr ABHAY was unanimously elected.

2.2 Election of Vice-Chairman

Dr QUE (Viet-Nam) nominated Dr LEE (Republic of Korea) as Vice­

Chairman; this was seconded by Dr CHANG (China).

Decision: Dr LEE was unanimously elected.

2.3 Election of Rapporteurs

Dr ISMAIL (Malaysia) nominated Dr AZURIN (Philippines) as Rappprteur

for the English language; this was seconded by Dr TAYLOR (New Zealand).

Dr PHOUTTHASAK (Laos) nominated Dr QUE (Viet-Nam) as Rapporteur for

the French language; this was seconded by Minister FUIMAONO MOASOPE (Western

Samoa).

Decision: Dr AZURIN and Dr QUE were unanimously elected.

3 ADDRESS BY THE DIRECTOR-GENERAL: Item 4 of the Provisional Agenda

Dr CANDAU, Director-General, said that he considered it an honour

and a pleasure to be able to participate in the session and to present

personally his best wishes for its success to the Representatives of the

Member States in the Western Pacific Region.

Instead of commenting on WHO's prinCipal activities during the past

year, he proposed to outline to the participants some of the major pro­

blems facing the Organization in relation to its development programmes.

72 REGIONAL COMMITTEE: TWENTY-FIRST SESSION

Everyone recognized that the role·and structure of techni¢al assistance

in general was arousing worldwide concern. To make the project concept

more useful to the authorities responsible for promoting health, the

presentamb~guity concerning its operational role in furthering develop­

ment must be overcome. Efforts must be directed towards setting up a

more rational project methodology, including formulation, selection and

management. To that end a team of medical specialists, administrators

and systems analysts had been entrusted at Headquarters with the task

of reviewing the present attitude towards the provision of assistance

in the health field particularly to developing countries. Methodclogies

used had to be practical and properly adapted to each country; in that

regard national planners and administrators should be encouraged not

only go give advice but to participate actively in developing new

methods. In face of rapid technological change, managerial equipment

did not always keep pace with the technical ability to sglve health

problems. The gap could be bridged by encouraging individual develop­

ment projects at the national level. Such a project would thus become

a means for promoting a whole series of activities designed to develop

health services in a given period of time.

The Project System Analysis Team already referred to was currently

operating in three distinct areas: (I) Project Technology System

designed to obtain explicit statements on the technology available and

the costs of applying it; (2) Project Selection System aimed at selecting

and formulating technically and operationally feasible, cost-effective

development projects. The Ministry of Health of Malaysia was actively

co-operating by proposing a conceptual model, which would be tested in

an actual problem situation in Malaysia later in the current year;

(3) Project Delivery System intended to assemble various activities

relating to project planning, monitoring and evaluation. Subject to

progress mad~ with the Project Selection System, those activities were

likely to be implemented in the field by mid-1971. Hopefully, this

systems analysis approach should prevent the dispersal of effort

involved in the haphazard application of so-called "modern management

techniques".

1-

SUMMARY RECORD OF THE FIRST MEETING 73

Turning to the. need for improving economic and social conditions,

particularly in the less privileged areas of the world, the Director..;

General- warned that - without adequate safeguards - utilization of the

results of technological and scientific progress could present a very

real hazard to human environment. Paradoxically. greater emphasis

should be laid on science and technology, since they alone could help

t~ evaluate and eventually anticipate the potentially harmful conse­

quences of technological change. Moreover. those consequences could

not be geographically or politically contained. The problems they

posed could not be solved in isolation but required study on a multi­

disciplinary and multi-national basis. The United Nations Conference

on Human Environment to be held in Stockholm in 1972 might provide

guidance concerning the two most crucial issues of the age. namely:

man's adaptation to the new environment he was creating and his efforts

to prevent its progressive deterioration. The threat was not so much

to man as an entity but to the quality of human life, that qllality which

raised man above the animals. Environmental conditions had a profound

effect on man, not only physically but also morally and mentally.

At the request of the Twenty-third World Health Assembly. WHO was

considering ways of carrying out a study of the harmful effects of

various factors modifying the environment at city, country and even

continent level, with a view to instituting an international detection

and warning system. A thorough analysis of all such factors - physical,

chemical. biological and physiological - could. by identifying health

indicators, assist in overcoming the detrimental results of uncontrolled

technology and, through improved health planning, mitigate unreasonable

reaction to technological innovation.

Consideration of environmental problems inevitably raised the

question of population pressures. It was appropriate to re-state WHO's

role in the health aspects of that subject. since misunderstandings

concerning it had all too often arisen. WHO's major objective for the

Second Development Decade was to assist all its Member States to achieve

a higher standard of public health. Within that context and without

promoting or endorsing any particular population policy - which fell

outside its mandate - the Organization was providing assistance upon

74 REGIONAL COMMITTEE: TWENTY-FIRST SESSION

request to Member States in preparing and implementing family planning

programmes, as part of their organized health service. S~ch requests

were on the increase and were being met by WHO's advisory and technical

services, thanks to additional resources farthcOllling frOlll the United

Nations Fund for Population Activities and contributions made to WHO's

Voluntary Fund for Health Promotion; thanks also to increased and more

effective co-operation with the United Nations, specializ~d agencies and

other interested bodies.

But the keystone to all family planning. including i.11lprovement in

maternal and child care, was development of basic health$ervices.

While maternal and infant mortality in developing countries remained

high, couples could not easily be induced to plan the size of their

family. The first priority was to train health personnel in the

problems involved in family planning and to integrate such planning

into the general health services. Medical staff must be available to

provide modern contraceptives and instructions as to their use, as well

as to take remedial measures should anything go wrong. Any misfortune

could have a disastrous effect throughout a whole community by eliminating

all desire to learn about family planning.

Research activities also urgently required strengthening: studies

in the less developed countries into human reproduction and fertility

should be assisted and supplemented by investigations done by inter­

national institutions. That was a major concern of WHO, which was

ready to play a vital role in a vast programme .of medical research on

population problems. with the participation of international and govern­

mental organizations. One of the principal aims of such a programme

would be to learn more about the long-term effects of vatious fertility­

regulating agents. A number of methods that would be effective. safe,

acceptable and cheap must be developed to meet the parti¢ular needs of

individuals and communities.

Educ.ation was another basic problem c'Qnfronting all the organiza­

tions in the United Nations family. Manpower shortages were hindering

economic and social progress in the .emergent nations, and there was an

urgent need for trained personnel in all fields. but par)ticularly in

>.

SUMMARY RECORD OF THE FIRST MEETlNG 7S

those relating to ~aica1and health care. WHO was currently devoting

its efforts towards increasing the number of medical schools. The

type.of training also required revision since all education must be

geared to local conditions and the needs of the community to be served.

WHO was accordingly engaged in encouraging an inter-professional approach

to .. medica1 education so t~1at all categories of health workers would. be

trained together up to the level of competence required of them. Better

use of individual physicians would thus be facilitated through team work.

In conclusion, the Director-Genera1 stressed the inter-dependence

of health and other factors in the process of development. 'The solution

of health proo1ema was closely linked with the solution of problems in

other fields. such as education, science, technology. agricu1tur.e .. and.

industry. Man himself created wealth and only by his own health and

strength could he complete the challenging tasks confronting him 'for the

development of the world in which he. lived. That was the objective set

for themselves by the Members of the United Nations system in the

seventies.

4 . ADDRESS BY INCOMING CHAIRMAN: Item 5 of the Provisional Agenda

The CHAIID1AN requested that his address should be postponed until

Wednesday morning.

5 ADOPTION OF THE AGENDA: Item 6 of~e Provisional Agenda (Document WPR/RC21/1 Rev.2)

The CHAIRl~ moved the adoption of the agenda.

Decision: In the absence of any comments, the agenda was adopted.

6 STATEMENT BY THE CHAIRMAN OF THE TECHNICAL DISCUSSIONS: Item 7 of the Agenda

Dr CHEN (China) stated that the subject of "Health Manpower in the

Developing Countries: Problems and Needs" was of great interest and of

immediate concern to the Region as a whole. He considered that its

discussion at this time was most timely and he hoped that the conclusions

76

reached would be useful to all countries in the Region. There would be

three sessions in all: the afternoon· of Friday, 4 September, which would

start with an initial plenary meeting followed by group discussions;

Saturday morning, 5 September ,. during which the group dischssionswould

continue; and Monday morning, 7 September, when th~ group reports would

be consolidated and discussed in a plenary session. Durinlgthis meeting,

the report of the 'l'echnical Discussions would also be consi~ered. One

working paper ,"Health Manpower;' in the Deyeloping Countries : Problems a~

Needs",aocument WPR/RC21/TD1, had been distributed as a basis for the

discussion. (For postponement of the Technical Discl;ssiot1s and. consider­

ation of draft resolution, see the third meeting, sections 1.2 and 7.2.)

7 ESTABLISHMENT OF THE SDB-COMHI'ITEE ON PROGRAMME A;.~D BUDGET: .Item 8.1 of the Agenda

In accordance with the principle of rotation, it was 'agreed that the

membership this year should be composed of representatives from Cambod.ia,

Laos, MaJ.aysia, Philippines, Portugal, Singapore, United States of America

and Western Samoa.

It was ~sg __ a.s:r.:.e.eA that theSub-Committee would meet at 2.30 on

Thur!;lday afternoon, 3 Septemter, and that, if necessary, a further ,

meeting would take place at 11.00 on Friday morning, 4 September. (FOr

consideration of the report of the Sub-Committee, see the sixth meeting.

section 2.)

Ibe REGIONAL DlREOTOR drew the attention of the Committee to the

fact that in accordance with resolution WP;RC7.R7 adopted by thl\;.

COllIIUit:tee at it~ se.venth sess~on. the sub-cOllllilittee was to consist of

six membet's. As the number of ~lembers in the Region had ,grow'll from

twelve to Qxteen. th~ membership of the sub-committee had. in fact,

consisted of eight members for a numbel;". of years. The CGmmittee agreed

that this situation should be formalized by adopting a resolution

dec.iding. that the.' Sub~c..ot;unittee . o~~ Pr<;>gralllme and Budget ~hould consist

of eight: members plus th~ Ch<lil'!ll8n of the Regional Committee. (For

consideration of dt'a:tt, l'eso::'ution, see the: fourth meetinfh sections

1.1 and;9.2.}

SUMMARY. RECORD OF THE FIRST MEETING

8 ACK."I"OWLEDGEt1ENT BY THE CHAIRMAN OF BRIEF REPORTS RECEIVED FROM GOVERNMENTS ON THE PROGRESS OF THEIR HEAL'rH ACTIVITIES: Item 9 of the. Agenda

The CHAIRMAN acknowledged reports on the progress of health

activities received from the following countries and territor:i:es:

Australia, Cambo~ia, Rong Kong, Laos, New Caledonia and Dependencies,

New Zealand, Papua and New Guinea, Republic of Korea, Timor and

Western Samoa. (For further reports acknowledged, see the second and

third meetings, sections 1 and 2 respectively.)

9 NOHINATION OF' THE REGICNAL DIRECTOR: Item 10 of the bgE:ruia (Document WFR/RC21/3 Rev.l)

71

The CHAIRMAN stated that the Committee, in accordance with Rule 5l

of the Kules of Procedure of the Western Pacific Region, wOulci consider

this item in a private meeting in view of its character.

The DIRECTOR-GENERAL informedl.:he Committee that the private meeting

would be attended only by the Representatives of Member States in the

Region, their alternates and advisers, the Dir~ctor-Genera! and a minimum

of secretariat designated by aim.

The Committee went into a private meeting at 10.30 a.m. and resumed

in a public me_~ing at 1~1O a~_

At the CHAIRMAN's request, the DIRECTOR-GENERAL announced that at

the private meeting, the Committee had adopted the following resolution:

The Regional Committee,

Considering Article 52 of the Constitution, and

In accordance with Rule 51 of its Rules of Procedure,

1. NOHINATES Dr Francisco J. Dy as Regional Director for the

Western Pacific;

2 DECIDES that no names other than that of Dr Dy, the Regional

Director in office. be submitted to the Executive Board; and

3 REQUESTS the Director-General to propose to th~ Execu~ive

Board the appointment of Dr Francisco J. Dy for a further period

of five lear~ from 1 JULY 1971.

78 REGIONAL COMMITTEE: TWENTY-FIRST SESSION

i

The REGIONAL DIRECTOR expressed his appreciation of t~e Committee's

confidence in nominating him for a further term, which he would not have

merited without the able assistance of his staff, both in ~he Regional

Office and in the field. He would do his best to live up to this trust.

10 ANNOUNCEMENTS

The CHAIR}~ suggested that the Committee should follow its usual

practice and meet from 9.00 a.m. to 12.00 noon, with a short recess at

about 10.30 a.m. and from 2.30 to 5.00 with a short recess at about

3.45 p.m., subject to the proviso that these times could b~ altered if

the progress of work required.

It was so agreed.

The meeting rose at 11.15 a.m.