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OFFICIAL RECORDSOF THE

WORLD HEALTH ORGANIZATION

No. 24

ANNUAL REPORT OF THE DIRECTOR-GENERALTO THE

WORLD HEALTH ASSEMBLYAND TO THE

UNITED NATIONS

1949

WORLD HEALTH ORGANIZATION

Palais des Nations, Geneva

March 1950

ABBREVIATIONS

The following abbreviations are used in the Official Records of the World HealthOrganization :

ACC Administrative Committee on Co-ordination

ECE - Economic Commission for Europe

FAO Food and Agriculture Organization

IBE International Bureau of Education

ICAO - International Civil Aviation Organization

ILO International Labour Organization (Office)

IMCO Intergovernmental Maritime Consultative Organization

IRO International Refugee Organization

ITO International Trade Organization

ITU International Telecommunication Union

OIHP - Office International d'Hygiène Publique

PASB - Pan American Sanitary Bureau

PASO Pan American Sanitary Organization

TAB Technical Assistance Board

TAC Technical Assistance Coinmittee

UNESCO - United Nations Educational, Scientific and Cultural Organization

UNICEF United Nations International Children's Emergency Fund

UNRPR United Nations Relief for Palestine Refugees

UNRRA - United Nations Relief and Rehabilitation Administration

WFUNA - World Federation of United Nations Associations

TABLE OF CONTENTS

INTRODUCTION

CHAPTER 1. ADVISORY SERVICES TO GO-VERNMENTS

Campaigns against communicable dis-eases

Physical, mental and social well-beingOrganization of public health servicesProfessional and technical education

CHAPTER 2. ACTION TAKEN BY GOVERN-MENTS ASSISTED BY WHO

Eastern Mediterranean RegionWestern Pacific R gionSouth-East Asia RegionEuropean RegionAfrican RegionRegion of the Americas

CHAPTER 3. NEW DEVELOPMENTS IN TECH-NICAL SERVICES

EpidemiologyHealth statisticsBiological standardizationUnification of pharmacopoeias and

pharmaceuticalsHabit-forming drugsCo-ordination of researchEditorial and reference services

CHAPTER 4. RELATIONS WITH OTHERINTERNATIONAL ORGANIZATIONS . . .

United NationsSpecialized agenciesNon-governmental and other organ-

izations

CHAPTER 5. PUBLIC INFORMATION . . .

CHAPTER 6. CONSTITUTIONAL AND LEGALMATTERS

MembershipAttendance at sessions of the Exe-

cutive BoardAssociate Members and other ter-

ritoriesRegulations regarding nomenclature

with respect to diseases and causesof death

Denunciation of the Rome Agreementof 1907

Privileges and immunities

PageV

1

1

71013

23

233032374647

CHAPTER 7. ADMINISTRATION AND FINANCE

Special problemsStaffFinance

Page

808081

ANNEX 1. Membership of the WorldHealth Organization (31 De-cember 1949) 82

ANNEX 2. Membership of the ExecutiveBoard (31 December 1949) . 83

ANNEX 3. Membership of expert com-mittees (31 December 1949) 84

ANNEX 4. Conferences and meetingscalled by WHO in 1949 . . 88

ANNEX 5. Conferences and meetingscalled by the United Nationsand specialized agencies in 1949

52 at which WHO was represented 89

52 ANNEX 6. Conferences and meetings of56 non-governmental and other57 organizations in 1949 at which

WHO was represented . . . 92

ANNEX 7. Tentative schedule of meetingsto be called by WHO in 1950 93

ANNEX 8. Selected list of technicalarticles and reports issued by

70 WHO during 1949 95

ANNEX 9. Status of contributions to thebudgets for 1948 and 1949 andto the working capital fund 101

73 ANNEX 10. Organizational charts . . . . 105

75 ANNEX 11. Senior officials of the WorldHealth Organization (31 De-cember 1949) 110

59606162

7072

77

77

78

78

7979

MAPS

1. World Health Organization fieldactivities in 1949 at the request ofgovernments

2. Regions and regional offices of theWorld Health Organization . . . .

3. Network of epidemiological radio-telegraph communications

INTRODUCTION

The annual report on the work of the World Health Organization is, by its very nature ,

a record of the collaboration of governments and peoples in the endeavour to raise levels ofhealth throughout the world. The pages that follow are, therefore, much more than a chronicleof progress by an organization ; they reflect the growing realization of governments that manyhealth problems require for their effective solution the united action of all the nations. Thesepages indicate also the readiness of countries to give as well as to accept assistance in thisgreat common task.

The programme and policies of the World Health Organization for the year 1949 werelaid down by the First Health Assembly, which was convened in Geneva in June 1948 ; theywere based on the recommendations of the Interim Commission of WHO, and were to somedegree a continuation of its work. The programme was directed towards aiding governmentsin controlling and preventing disease, in co-ordinating and stimulating public-health workand in strengthening public-health administrations. Particular emphasis was laid on theproblems presented by three major diseases-malaria, tuberculosis and venereal diseases-and on the promotion of measures for positive health. The Assembly also set up machineryfor expanding the inherited technical services of the Organization (in international epidemio-logy, biological standardization, etc.) and approved the provision of fellowships, medicalliterature and teaching equipment, as well as emergency services to governments. In addition,a large publications programme was recommended.'

Following on these decisions, the Second Health Assembly, held in Rome in July 1949,although mostly concerned with reviewing the Organization's activities in 1948 and withplanning for 1950, prescribed the following additional activities for 1949 as preliminary stepstowards fulfilling the expanded 1950 programme. In regard to malaria, plans were to beworked out jointly with FAO for long-term programmes in 1950 in areas where, side by sidewith the control of malaria and the raising of general standards of health, world foodproduction might be increased. Work on health statistics was to be extended ; assistance wasto be given in the work of modernizing UNRRA-donated penicillin plants and arranging forthe availability of essential medical supplies, particularly for the war-damaged countries ofEurope ; assistance was also to be given to the United Nations project for the relief of Palestinerefugees ; finally, increased, emphasis was to be laid on medical training, sanitation andnursing. 2

The Executive Board, at its third and fourth sessions, held during the year, gave effectto the decisions of the Assembly and worked out the details of the Organization's futureprogramme. At its third session (Geneva, February-March) it also devoted itself to thepreparation of the programme and budget for 1950, and at the fourth (Geneva, July), muchattention was given to formulating measures designed to ensure the optimum efficiency inthe Organization and to facilitate the work of the Third Health Assembly.s The recommenda-tions of the Board have played an important part in the progress made by WHO during 1949.

1 For the report on the First World Health Assembly, see Off. Rec. World Hlth Org., 13.2 For the report on the Second World Health Assembly, see Oft. Rec. World Hlth Org., 21.3 For the membership of the Executive Board, see Annex 2. For the reports on its third and fourth

sessions, see Off. Rec. World Hlth Org., 17 and 23.

VI ANNUAL REPORT OF THE DIRECTOR-GENERAL

Services to Governments

One indication of the progress of the Organization's work during 1949 is to be found inthe marked increase both in the direct services provided by WHO and in the number ofcountries receiving these services.

Experience has shown that little is to be gained by sending experts from one country toanother which is at a different level of economic development and by introducing techniquesused in some areas into other areas to which they are not necessarily applicable. WHO hastherefore preferred to assist governments to improve their own public-health services andto equip themselves to solve their own particular problems. The report of the year 1949 showsthat the Organization, though still at an early stage of development, is capable of strengtheninggovernment services in this way.

In answer to requests for assistance, WHO consultants-specialists in communicablediseases, public-health administrators, nurses and sanitary engineers-have been sent tomore than half of the Member countries on a short-term basis, to make surveys and giveadvice on public-health programmes. The first WHO advisory and demonstration projectshave been established ; ten teams have undertaken active work in South-East Asia and theMediterranean, and by the end of the year others had been sent to the Western Pacific andthe Americas. They have employed new methods and have helped governments to carry onintensive campaigns both for the eradication of disease and for the promotion of positivehealth. An unforeseen but valuable effect of the sending of these teams has been that inmany cases their arrival has brought about a marked increase of interest and activity on thepart of the healfh administrations in the areas. Besides providing some of the team members,governments have often set up similar projects or teams of their own, which have workedeither side by side with the WHO teams, or sometimes in other parts of the country on entirelydifferent projects.

During the year WHO awarded over two hundred fellowships and provided medicalliterature, teaching equipment and emergency supplies. It is noteworthy that certain WHOservices are being found valuable even by countries technically advanced in the field of health.As the wide range of the Organization's services becomes better known and as more requestsfor those services are received, it may be expected that the programme of direct assistanceto governments will be Lubstantially increased.

Technical Services

In order to keep pace with the number of direct services provided, WHO has also hadto expand its activities in technical research.

New developments in connexion with the technical services inherited from the HealthOrganization of the League of Nations and from other international organizations haveincluded the preparation by WHO of the first international pharmacopoeia. Other develop-ments include the introduction of daily radio broadcasts into WHO's intelligence servicein the fight against epidemics, the drafting of modern Sanitary Regulations to replace theInternational Sanitary Conventions, the establishment of international standards for newbiological products (including penicillin " G " and streptomycin), contributions to the inter-national control of addiction-producing drugs, the compilation of world health statistics, andthe launching of a scheme for international research in tuberculosis. The technical publicationsof the Organization have been improved and are widely distributed, and its expert committeesprovide a guide to international opinion on technical subjects and advise the Organizationon projects to be undertaken.

INTRODUCTION VII

Relations with Other Organizations

As a specialized agency, WHO must maintain effective relations with other organizations.It participates, with the United Nations and with other specialized agencies, in the planningand carrying out of co-ordinated joint projects. This joint action is ensured mainly throughthe United Nations Administrative Committee on Co-ordination and its sub-committees.

An important development during 1949-as a result of co-operation with the UnitedNations International Children's Emergency Fund-was the extension of the BCG campaignagainst tuberculosis, under the auspices of the Joint Enterprise,4 throughout Europe and tomany other parts of the world-for example, to India and to the Western Pacific Region.Another outstanding example of co-operation was the United Nations project for the reliefof Palestine refugees, in which WHO assisted by providing funds and technical advice, andby carrying out a most successful campaign against malaria. Joint projects have also beensuccessfully undertaken with FAO, UNESCO and IL0,5 and the Organization ha> participatedin the work of the Technical Assistance Board, a body recently set up by the United Nationsto administer the expanded programme of technical assistance for economic development ofunder-developed countries. WHO was the first specialized agency to make provision in itsprogramme and budget for this expanded programme, which may mean a very substantialincrease in its activities.

Administration

A fourth direction in which progress has been made is in the reorganization of the Secre-tariat to meet the needs of expanding activities.° In this connexion, the meeting in January1950 of the Standing Committee on Administration and Finance-set up by the ExecutiveBoard to examine the proposed programme and budget for 1951 and to study the organizationand administration of the Secretariat-is expected to produce recommendations of greatvalue to the Organization.

During 1949, many administrative obstacles were encountered, the chief ones being theinadequacy of the budget to provide for the programme (the First Health Assembly adopteda programme requiring for its full implementation about $7,000,000, but the budget waslimited to some $5,000,000), the ever-present difficulty of obtaining the desired geographicaldistribution of staff, and the problem of housing the Headquarters staff. In solving this lastproblem, the Organization is grateful to the Swiss Government, whose generous attitudeso greatly facilitated negotiations. Work on enlarging the Palais des Nations to accommodateWHO will shortly be begun. However, in its first full year of operation, although obviouslyunable to carry out all the activities proposed, WHO was able to make a start ; it gainedexperience, laid a foundation for more extensive work, and, at the end of the year, was in aposition to begin implementation of the enlarged programme for 1950 which was voted bythe Second Health Assembly.

Regionalization

Considerable progress has been made in regionalization, as provided for in the Constitu-tion of the World Health Organization. Several meetings of regional committees were heldduring the year : the Regional Office for South-East Asia in New Delhi began to function on

January, and in Alexandria the Regional Office for the Eastern Mediterranean started

4 Composed of UNICEF, and the Danish Red Cross and its Scandinavian associates.5 For details, see Chapter 4.6 For organizational charts, see Annex 10.

VIII ANNUAL REPORT OF THE DIRECTOR-GENERAL

operations on 1 July. The Special Office for Europe was maintained at Headquarters, andby the end of the year a majority of the European countries had signified their wish to set upa regional office.

Although integration of the Pan American Sanitary Organization with WHO is stillnot complete, its initial agreement with the Organization came into effect on 1 July, andduring the greater part of the year the Pan American Sanitary Bureau served as the RegionalOffice for the Americas.

By means of these regional offices, the process of decentralization has already begunIt is proposed to decentralize further in 1950, and to maintain at Headquarters only thefunctions of co-ordination, planning of programmes, research, the dissemination of informationand a general supervision of operations in the field, leaving to the regional offices the detailedcontrol of all projects undertaken.

Membership

Finally, and most important, there has been progress towards the goal of worldwidemembership. In 1949 twelve more countries became Members, bringing the total to 68.7

The Organization, however, received a serious setback at the end of the year, when oneof its Member States, Bulgaria, gave notice of its withdrawal from active participation. Thisfact is recorded with regret, since Bulgaria, together with the other non-participating Members(the USSR, Byelorussia and the Ukraine) could usefully contribute to the knowledge andexperience necessary for the building-up of services to assist an ever-increasing number ofpeople throughout the world. This withdrawal seems to mark a step away from needfulinternational co-operation and from the one-world concept that seems basic to the healthand happiness of mankind.

In this volume an attempt is made to outline what has been done in 1949, but only thecompletion of the many tasks still ahead will put that work into true perspective.

These tasks will have as their objective health, as defined in the Organization's Constitu-tion-" a state of complete physical, mental and social well-being "-and few of us, probably,yet realize the full significance of all the three elements of this definition. Health as a stateof mental and social well-being must be sought by most people today in a general environmentwhich has little resemblance to that in which their forefathers lived. The attainment of healthin these two senses must be measured in terms of the adaptability of the individual-and ofgroups and nations-to change in a world of ever more powerful aeroplanes, of radio, films andtelevision, and of weapons of war of a terrible efficacity. Progress in international under-standing, in good will and co-operation, is today not only something good and desirable initself ; it has become a prerequisite to survival.

The close human relationships imposed by the modern social structure demand a higherdegree than ever before of individual maturity and of social responsibility in its widestimplications. The success of individuals and groups in achieving integration both withinthemselves and with one another will be essentially a measure of progress in " mental andsocial well-being ". Failure may meán nothing less than the extinction of whole nations--perhaps of the race itself.

BROCK HISHOLM, M.D.

Director-General

7 These countries are : Bolivia, Costa Rica, Ecuador, Guatemala, Honduras, Israel, Korea, Lebanon,Luxembourg, Paraguay, Peru and Uruguay. For complete list of Members, see Annex 1.

CHAPTER 1

ADVISORY SERVICES TO GOVERNMENTS

The year 1949 has been one of rapid develop-ment of WHO's assistance to governmentswhich ask for help in improving their servicesin both general and specific fields of health. Thishelp has taken the form of encouraging govern-ments to develop their own national and localhealth services in preference to establishingindependent WHO projects.

The growing demand for this kind of assistanceand the decentralization of activities have led tochanges in organization both at Headquartersand in the field. Thus, the former practice ofsending field missions to countries has beendiscontinued ; regional offices have been built up,with advisers on general public-health servicesand .on specialized services, and field operationshave been carried out by demonstration teamsand short-term consultants. An increasingnumber of joint activities have been engaged inwith UNICEF and other organizations, WHOproviding technical guidance and advice in awide variety of fields. Another developmentwhich has influenced the planning of activitiesis the growing recognition of the importance ofprofessional and technical education.

Up to 1949, WHO had provided assistance inonly a small number of specific fields, such as the

control of malaria, tuberculosis and venerealdiseases, and the more general programmes whichwould assist in strengthening national healthadministrations, e.g., in environmental sanitation,technical training and health education of thepublic, therefore developed more slowly. In 1949,as the necessary specialists became available,activities in these fields were started. A beginningwas also made in expanding specialized demonstra-tions to cover public health activities of a moregeneral nature ; the organization of healthdemonstration areas on a large scale has remainedin the planning stage, however, pending therealization of the programme of technicalassistance for economic development.

The staff at Headquarters has been primarilyengaged in research 1 and in planning for andsupervising field activities. The expert com-mittees of WHO have made a valuable contribu-tion to the work by providing internationalscientific opinion on a wide range of subjects,2guiding Member States in setting up their pro-grammes, and assisting the specialized staff ofthe Organization in making plans for newactivities.

The following pages summarize the advisoryservices extended to governments in 1949.

Campaigns against Communicable Diseases

In assisting governments to intensify theirefforts to achieve effective eradication or controlof several of the major diseases, WHO has placedparticular emphasis on malaria, tuberculosisand venereal diseases, all of which figured on thelist of priorities drawn up by the First HealthAssembly.

Another reason for concentrating on thesethree communicable diseases is that the knowledgeof techniques for their control permits the carryingout of large-scale operations, whereas most of theother communicable diseases are still at the" study " stage (see p. 54).

A beginning has been made in the control ofmalaria and venereal diseases by establishingdemonstration projects, in close co-operation

with the governments of the countries concerned ;in tuberculosis, assistance to governments hasso far chiefly consisted in making surveys andgiving technical advice, WHO collaboratingclosely with UNICEF in the research and evalua-tion aspects of the BCG campaign.

Increased attention has been given to thepossibilities of combining work on environmentalsanitation, insect control and water-borne diseases.The further development of combined techniques

1 For selected list of technical articles issued byWHO during the year, see Annex 8.

2 For membership of expert committees, seeAnnex 3 ; for geographical distribution of themembership, see fig. 1.

- 1 --

2 ANNUAL REPORT OF THE DIRECTOR-GENERAL

FIGURE 1. GEOGRAPHICAL DISTRIBUTION OF MEMBERSHIP OF WHO EXPERT COMMITTEES*

(31 December 1949)

ALGERIA 40

BELGIUM 41

BRAZIL 41u RCANADA U. 41

CEYLON

%7HO

CHINA 41

CHILE

CZECHOSLOVAKIA urn uu 41

DENMARK

EGYPT 41U 41

FRANCE

INDIA 0 41 40 11 40

IRELAND 40 IRITALY 41

MEXICO

MOROCCO 41

NETHERLANDS 41 40 40 40

NORWAY urn. 41

PAKISTAN 0PHILIPPINES UrnPOLAND 41 4D

S. RHODESIA IlUlSENEGAL 41

SWEDEN 40

SWITZERLAND

TANGANYIKA urn I 41

TUNISIA 41

TURKEY

UGANDA 0UNION OF S.AFR. urn 41

U. K.

U. S. A. 0VENEZUELA u. 41

YUGOSLAVIA 41

ceD / c,....v

,;:. .. dck- 6-, Nr <k: o co* .. * A%

tZ4" c; ,9 ., :3 ,, ,z A, t-) (k- xr

c.,,its. '' ( GD ç 4 <k ::. <k C.) 2.4r

C4.34 I ," 41 44 4k.

44, I''' 4': 1? 414 Iá'. 4.3.. 'k'' 415042

* Includes joint committees with FAO and ILO

ADVISORY SERVICES TO GOVERNMENTS 3

in these fields may well lead to an expansion ofactivities against communicable diseases.

Malaria

WHO has continued its efforts to assist in theeradication of malaria throughout the world.During 1949, demonstration teams in malariacontrol were established in various countries, inaccordance with the pattern proposed by theExpert Committee on Malaria. By the end of theyear, seven teams were operating-four indifferent provinces of India, one in Thailand,one in Afghanistan, and one in Pakistan, andpreparations for an eighth, in Iran, were underway.

Six of the teams were established with theco-operation of UNICEF, which supplied equip-ment, transport, insecticides and drugs, WHOproviding the leading personnel ; for the seventh,WHO itself provided the supplies. The govern-ments at whose request the teams were providedco-operated actively in the projects by assigninga corresponding number of officers to work withthe team leaders and members, by providing allnecessary subordinate personnel, and by meetingexpenses in local currency.

A team normally consisted of a malariologist,an entomologist, a sanitary engineer and apublic health nurse, but the composition variedaccording to the particular situation in thecountry. The teams were instructed to startinsecticide spraying operations after a shortpreliminary survey. In two countries wheresufficient epidemiological data were not available,however, spraying operations, after extensivesurveys, were limited to small experimentalsections of the total areas which are to be putunder control in 1950. In November and De-cember, an expert from Headquarters visited allthe teams operating in India, Pakistan, andThailand, and held meetings at the regional officewith the team leaders from India and Pakistan.

Although the entomological data are verypromising, it is, of course, too early to reportupon the effect which the year's operations inthese areas may have had on the prevalence ofmalaria. Besides offering technical assistanceto the national health departments, however,the teams have helped in many other indirectways : first, by drawing the attention of thepublic and the authorities to the problem ofmalaria and to the possibilities for its control,thereby facilitating and stimulating the develop-ment of antimalaria programmes by the healthauthorities ; secondly, by supplying the healthdepartments with appropriate epidemiologicaldata on the areas covered (in particular, informa-tion on the identification of the vector species,the tiN,p-limits of malaria transmission and thereaction of the vector species to residual DDT,as sprayed on the particular type of house wallsprevailing in the country) ; thirdly, by training

the personnel needed for extending malariacontrol programmes ; and, fourthly, by taking fulladvantage of the favourable reaction of personswho, after the residual insecticide spraying, havebegun to take an interest in other public-healthactivities.

The WHO public-health nurse in each team,working with at least one-and more oftenseveral-of the national public-health nurses,health visitors or midwives, as in-service trainees,is naturally the agent for such developments ;but the team leader himself, the entomologistor the sanitary engineer have been quick to seizethe opportunity of helping the health departmentsin other fields such as kala-azar, plague epidemio-logy and control, environmental sanitation andsanitary engineering. If the team leader is atrained medical officer of health, his influence onthe organization of public-health services in thearea is not inconsiderable, and it may be saidthat the malaria control operations have led tothe tackling of a number of other public-healthproblems.

In the Eastern Mediterranean region, the controlof malaria among refugees, carried out by theUnited Nations Relief to Palestine Refugeesunder the technical leadership of WHO, wasvery successful. The protection of such largenumbers of destitute refugees, often shelteredonly in tents, often moving from place to placein a malarious country, was a great achievement.It would appear that for the first time in historythe problem of malaria control in a refugeepopulation, exposed to risk under the worstpossible conditions, was successfully and econo-mically solved, thanks to residual insecticidemethods (see p. 24).

During the year under review, various countriesasked for WHO consultants on malaria, eitherto give technical advice or to lecture and givedemonstrations at institutes of malariology. Oneconsultant was assigned to the Far EasternUNICEF mission, with headquarters in Bangkok,and in this capacity visited a number of countriesin the Western Pacific, Eastern Mediterraneanand South-East Asia regions.

Lectures were delivered by WHO staff membersat the Tropical Institute in Basle, Switzerland,at the All-India Institute of Hygiene in Calcutta,and in Rome during the Second World HealthAssembly. An informal meeting of the malario-logists who took part in the Assembly was alsoheld in Rome.

WHO assisted the Italian Government (Com-mission for the Study of the Reorganization of theHealth Care Service) to carry out, in collaborationwith the Rockefeller Foundation, a survey of theantimalaria organization in that country.Training institutes in Delhi, Karachi and RoshPina were also helped to extend their trainingfacilities and to accept WHO Fellows. Trainingcourses in Rome, on the lines recommended byWHO, were organized jointly by the Institute


of Malariology and the Institute of Public Health.In all, 23 short or long-term fellowships inmalaria were awarded during the year.

The Expert Committee on Malaria held itsthird session in Geneva from 10 to 17 August. 3At this session, the joint WHO/FAO projects forincreased food production in malarious areaswere discussed.

The committee also gave its opinion as to thepattern of work which WHO should follow inits long-term malaria programme and formulatedtechnical advice that might serve as guidance togovernments ; it recommended that antilarvalmeasures should be abandoned wherever residualinsecticide spraying controls transmission ofmalaria ; it issued a warning against the difficultiesand drawbacks of attempting vector specieseradication in countries wishing to undertakesuch projects ; it considered the problem of theintroduction or reintroduction of anophelinespecies in countries which are free or have beenfree of them, emphasizing the point that thebest safeguard consists in a rigid antimosquitosanitation in and around seaports and airports ;and it suggested ways in which WHO couldencourage the use and production of insecticidesin order to render them available to all malariouscountries. Finally, it drafted a set of recommenda-tions on malaria control to be sent, with theapproval of the Executive Board, to the govern-ments of the malarious countries.

By the end of the year, 47 correspondingmembers had been appointed from some 33different countries for additional expert advice.

At the session of the Expert Committee onInsecticides, held in May in Cagliari, Sardinia 4(see also p. 56), several items concerning malariawere discussed, and an opportunity was given toinspect some of the field work in the anophelineeradication campaign.

The Organization was represented at the sixthsession of the FAO Council, held in Paris inJune 1949, and at the ninth session of ECOSOC,in Geneva, in connexion with the availability ofinsecticides. A WHO representative was alsopresent at the annual meeting of Indian malario-logists at the Malaria Institute in Delhi.

Routine work of planning and collectinginformation on malaria was carried out, parti-cularly in connexion with future joint projectswith FAO to increase world food production andraise standards of health. A Joint FAO/WHOWorking Party was proposed in order to screenproposals of areas submitted by governments toeither Organization. Joint groups would thenbe sent to survey the areas with a view toproceeding to the final selection. It is hoped that

3 The report on the session will be published asWorld Hlth Org. techn. Rep. Ser. 1950, 8.

For the report on the session, see World HlthOrg. techn. Rep. Ser. 1950, 4.

the funds that may be available for technicalassistance will make it possible to put such" area selection surveys " into operation in 1950.

Tuberculosis

During 1949, WHO's work on tuberculosis hasbeen expanded, particularly in association withUNICEF, and has been largely decentralized andtransferred to the regions.

The decision of the WHO/UNICEF JointCommittee on Health Policy that the scope of theassistance requested by certain countries shouldbe extended to include the provision of laboratoryand x-ray equipment and streptomycin suppliesmade it necessary for WHO to provide thetechnical advice on these supplies and to sendadvisers on technical procedure to many countries.In this connexion, two WHO experts worked inclose co-operation with UNICEF in Paris duringthe last three months of the year and gave adviceon the procurement of equipment. Anotherexpert was assigned to UNICEF for specialduties with the BCG campaign in the EasternMediterranean.

Through its Tuberculosis Research Office inCopenhagen, WHO has co-operated with UNICEFin the evaluation of mass BCG campaigns inEurope, North Africa, South-East Asia and theEastern Mediterranean (see page 61), and, alsowith UNICEF, is assisting in the establishmentof a BCG laboratory in Mexico City. Consultantsin streptomycin have visited many countries inEurope (Poland, Czechoslovakia, Yugoslavia,Greece and Italy) to supervise the streptomycinwork which has been done by means of theUNICEF supplies allocated to these countries,and arrangements were made, also in co-operationwith UNICEF, for a special meeting to be heldearly in 1950, at which local problems in methodsof therapy in many European countries will bediscussed.

With regard to decentralization, tuberculosisadvisers were appointed to the Region of theAmericas and to the Eastern MediterraneanRegion, and negotiations were in progress at theend of the year for the appointment of a similaradviser to South-East Asia. Proposals were alsoconsidered for joint WHO/UNICEF assistancein the Western Pacific, with special reference toBCG vaccination campaigns and their relationto general tuberculosis-control programmes. Thework in Europe was supervised from Headquarters.

The Expert Committee on Tuberculosis,enlarged to include nine members, held its fourthsession in Copenhagen from 26 to 30 July.4Particular attention was given to the need fortraining personnel in tuberculosis-control and

410.

5 The report on the session will be publishedas World Hlth Org. techn. Rep. Ser. 1950, 7.


setting up training centres in all branches oftuberculosis work. Suggestions were made forcontrol in countries with undeveloped and under-developed programmes, and attention was drawnto the inadvisability of the unrestricted distribu-tion and indiscriminate use of streptomycin. Thecommittee also recommended that those countrieswhich were in urgent need of additional hospitalbeds should be encouraged to use simple andinexpensive types of building for institutionaltreatment of the tuberculous. Approval wasgiven to the recommendation of the Conferenceon European BCG Programmes that BCG controlstations should be established in suitable placesand that BCG vaccination should be taught in allmedical and nursing schools.

The committee also made recommendations tothe Tuberculosis Research Office and to the jointEnterprise of UN10EF-the Danish Red Crossand its partners from Norway and Sweden-which has been responsible for the BCG vaccina-tion campaigns.

Plans have been made for a sub-committee onstreptomycin to be convened in 1950.

Special assistance to governments includedadvice to various countries on laboratory equip-ment and x-ray techniques ; the organizationand administration of mass x-ray programmes inEgypt ; the continuation of training courses fornurses in Greece and China ; and advice to Turkeyon the establishment of a teaching and trainingcentre in Istanbul. Lectures were given in severalcentres in India on different aspects of work ontuberculosis, and, following visits to variouscountries in South-East Asia, proposals wereconsidered for the development of a specialresearch project in the Province of Madras, andthe establishment of training centres in India,Ceylon and Burma. A study of tuberculosisfacilities in Italy was made in connexion with thegeneral Italian health survey. Arrangementswere made to supply staff and equipment for ademonstration team to be sent to El Salvador,the team to consist of a medical officer, an x-raytechnician, a laboratory technician and a nurse.

During the year, short surveys were made orcompleted in Europe (Belgium, Greece, Hungary,Italy, Poland and Switzerland), in the EasternMediterranean (Aden, Cyprus, Egypt, Ethiopia,the Hashemite Kingdom of the Jordan, Iran,Iraq, Lebanon, Saudi Arabia, Syria and Turkey)in Ceylon and in nineteen countries of theAmericas. The real value of these surveys liesin the fact that they enable regional advisers tobe ready, without extensive special investigations,to advise on proposed health projects and onpriorities in the allocation of the relativelylimited number of personnel and supplies availablefor assistance. Reports on visits and tours,

provided at the request of the countries concerned,have proved of great value in helping localauthorities to overcome many difficulties of apurely technical nature.

Towards the end of the year, WHO assistedUNICEF in preparations for the Conference ofStreptomycin Experts, to be called in Paris in1950, under the auspices of UNICEF.

Many technical documents were prepared (seeAnnex 8), and a complete list of books and filmson tuberculosis was compiled, for distribution tothe regions in 1950. Twenty-one fellowships intuberculosis were awarded.

The cordial relations existing between WHO,the joint Enterprise, the International Unionagainst Tuberculosis and the League of Red CrossSocieties led to a recommendation by the ExpertCommittee on Tuberculosis that all availableresources should be utilized by calling frequentmeetings of representatives from each of theorganizations working jointly on tuberculosiscontrol.

Venereal Diseases

In execution of the programme approved by theFirst and Second Health Assemblies 6 WHO hasincreased its services to governments, in an effortto intensify venereal-disease control, nationallyand internationally. During 1949, at the requestof the governments concerned, two venereal-disease control demonstration teams began opera-tions, one in India and one in Egypt, and by theend of the year preparations were under way fortwo additional teams, in the Dominican Republicand Haiti respectively, to combat yaws and ruralsyphilis.

In some instances the equipment for the demon-stration teams has been supplied by UNICEF ;WHO has provided the personnel, consistingnormally of a venereal-disease control officer ortreponematosis expert, a laboratory specialistskilled in treponematosis serology, a public-healthnurse and, in some instances, a health educator.The governments are contributing facilities for theteams and local personnel as correspondingmembers. Areas in which the demonstrationsare taking place are also being used as provisionaltraining centres for national field and laboratorypersonnel assigned by the health administrations.

WHO has further collaborated with UNICEFin programmes approved by the joint Committeeon Health Policy, and has given technicalassistance (including advisers, short-time consul-tants, medical literature and fellowships) in thedevelopment of venereal-disease campaigns in

6 011. Rec. World HIth Org. 13, 128 ; 21, 155


Europe, South-East Asia and the Americas,UNICEF providing the supplies and equipment.WHO also assigned a short-time consultant to theFar Eastern UNICEF mission for assistance in alarge-scale yaws programme in the WesternPacific.

Other advisory services in venereal-diseasecontrol were provided at the request of Guatemala,Mexico, the Philippines and the United States ofAmerica. In the Eastern Mediterranean, assistancewas given to several national anti-venereal-disease campaigns, and work has begun on anextensive project of bejel control. Surveys weremade of various European countries, and visitingexperts lectured on penicillin therapy and modernlaboratory methods.

On the basis of the recommendations of theExpert Committee on Venereal Infections, and,following a request from the United States PublicHealth Service, WHO appointed a temporarystudy-group in 1949-the WHO Syphilis StudyCommission to the United States of America.During a three months' period, this Commission,composed of seven venereologists from variousparts of the world, visited venereal-diseasecentres and other institutions in the United States,in order to evaluate the effectiveness of thecontrol methods in use (especially the presentstatus of penicillin therapy in syphilis), from thepoint of view of their national and internationalimportance. The report of the findings of thisgroup was presented to the third session of theExpert Committee on Venereal Infections.

During the year under review, clinical demon-strations on the treatment of early syphilis withpenicillin alone were organized, under the auspicesof WHO, in several university clinics (in Athens,Copenhagen, Madras, Oslo, Paris, Rotterdam andStockholm), and arrangements were made toorganize similar demonstrations in additionalclinics in Europe, the Eastern Mediterranean andAfrica. The exchange of sera and antigens fortest performance evaluation and standardization,arranged by WHO in Bulgaria and Ethiopiaduring 1948, was also extended to nationallaboratories in Denmark, Finland, Italy andthe United Kingdom.

At the third session of the Expert Committeeon Venereal Infections, held in Washington,D.C., from 10 to 20 October,7 considerableemphasis was laid on technical orientation,control techniques, the statement of the WHOSyphilis Study Commission to the United States,antibiotic therapy in syphilis and related diseases,and serological and laboratory aspects. Thecommittee reiterated the opinion that a majoreffort should be concentrated on combatinginfectious, prenatal and infantile syphilis by the

use of modern public-health methods. It felt,however, that recent developments justifieda broader consideration of the entire group oftreponematoses, from both the technical andadministrative points of view, and that trepone-matoses, particularly yaws and bejel, should forman important part of the WHO programme.

The Sub-Committee on Serology and LaboratoryAspects also met in Washington, from 12 to20 October,8 and made detailed recommendations,later adopted by the expert committee, for theorganization of the international serologicalconference to be held in 1951.

The maritime aspects of venereal-disease controlhave also been emphasized in WHO's programme,in accordance with the views of the HealthAssembly. New problems in epidemiology,disease prevention, and therapy among seafarers,which have arisen because of the introductionof new technical methods, were considered by aspecial study-group appointed by the expertcommittee, and later examined by the ILO/WHOJoint Expert Committee on the Hygiene ofSeafarers at its first session, held in Geneva inDecember. One of the recommendations madeby the joint committee was to the effect that,in the planned programme of WHO undertechnical assistance, high priority should begiven to establishing venereal-disease controldemonstration projects in major ports of under-developed areas.

At the request of Belgium, France, the Nether-lands and Switzerland, a preparatory meetingfor the establishment of a Rhine River Anti-Venereal-Disease Commission was held in Genevain May. Representatives from these countriesand from the French Zone of Germany, theUnited Kingdom and the United States of Americaattended and, in co-operation with ILO, drew upa programme for co-ordination of venereal-disease control among Rhine River boatmen. As abasis for this co-ordination, venereal-disease treat-ment facilities and services along the Rhine fromBasle to Rotterdam were surveyed during the yearLater, in December, WHO was represented atthe ILO's Special Tripartite Conference concerningRhine boatmen, held in Geneva, which discussedthe availability of medical treatment for boatmenon the Rhine.

The expansion of services to governments hasresulted in an increased demand for supplies andmedical literature and for current informationon laboratory, therapeutic and other aspects ofvenereal-disease control and treponematoses. Aconsiderable number of technical publicationson different aspects of venereal diseases wereissued by WHO during the year (Annex 8).The fellowships programme was greatly increased ;

7 The report on the session will be published as 8 The report on the session will be published asWorld Hlth Org. techn. Rep. Ser. 1950, 13. World Hlth Org. techn. Rep. Ser. 1950, 14.


facilities were given to many countries to enablethem to send Fellows to appropriate areas tostudy recent developments, particularly thetreatment of syphilis with penicillin and syphilisdiagnosis with cardiolipin ; 27 fellowships in allwere approved during the year. Other projectsincluded assistance in setting up training coursesin the Philippines and preparations for an inter-national training centre in Poland.0

WHO was represented at the 1949 Assembly ofthe International Union against Venereal Diseases,held in Rome in October 1949.

During the year, material was assembled for thepublication of the next international venereal-disease treatment centre list, under the BrusselsAgreement of 1924, and for the revision of theindividual treatment booklet. Both of thesepublications will be available in 1950.

Physical, Mental and Social Well-Being

A number of closely allied activities requiredof WHO under its Constitution may be con-veniently grouped together under the generaltitle " Physical, Mental and Social Well-Being."These include measures designed to improvematernal and child health, nutrition, and mentalhealth, measures which all help the Organizationto foster the preventive aspects of its work, since,by co-ordinating these activities with others,a positive approach to health may be introducedinto those of the Organization's projects whichare focused on a particular disease or condition.The co-operation of specialists in nursing andhealth education in the planning of these pro-grammes for assistance has been of the utmostvalue.

Wherever it has been possible to provide specialdemonstrations or consultant services, WHO hastried by these means to show governments thenecessity of integrating these preventive activitiesinto their general public-health services. It wasnot possible in 1949 to provide specialized staffto advise governments on other social aspects ofpublic-health programmes, or on the closelyrelated problem of the provision of social medicalservices for workers, but it is hoped that this maybe possible in 1950.

Maternal and Child Health

The Expert Committee on Maternal and ChildHealth held its first session in late January, andadvised on a maternal and child health programmefor WHO. It laid special stress on the importanceof public-health education, the training of healthpersonnel, and the need for the organization andexpansion of maternal and child health services."The appointment of a panel of correspondingmembers was recommended, to give additionalexpert advice. During 1949, WHO began todevelop the programme, both at Headquartersand in the field, along the lines laid down by theexpert committee and approved by the FirstHealth Assembly."

a See Special Office for Europe, p. 4410 00. Rec. World Hlth Org. 19, 35-48n Off. Rec. World Hlth Org. 13, 302

In the field, the first maternal and child healthdemonstration team, assigned at the request ofa government, consisted of one paediatrician andone -instructor in paediatric nursing ; it beganwork in India (New Delhi) in October. In Egypt,at the Government's request, medical and nursingconsultants started an evaluation survey ofprogrammes in December, and at the end of theyear arrangements were under way for a jointUNICEF/WHO team for South Korea, whichwill begin operations early in 1950. Further,nurses were recruited for Brunei and Sarawak,and also for a more comprehensive team to helporganize UNICEF/WHO maternal and childhealth demonstrations in Malaya.

Another important step in initiating fieldactivities of assistance to governments was theinclusion of one public-health nurse with eachof the six teams working in malaria demonstrationprojects. Other nurses were added to theseteams by the governments concerned, andmaternity and child health work was startedin each of the areas in which teams were operating.As a result, a request was made for a paediatricianto be available for teams in India.

A beginning was also made in the provision ofsurvey and consultation services to individualcountries and in the development of programmes ofaction. A special full-time WHO medical adviseron maternal and child health was attached to theUNICEF headquarters of the Far East Missidnin Bangkok, and general reports were made onhealth conditions in Malaya, Borneo, Brunei,Sarawak, Singapore, Hong Kong, the Philippines,Thailand, Afghanistan, India, Pakistan andCeylon.

Full-time regional advisers were attached to theoffice for Europe and to the South-East AsiaRegional Office, and plans were made to attachothers to the Eastern Mediterranean Region andto the Region of the Americas. At the requestof the Government of Ecuador, an expert consul-tant on child health was sent to that country toassist in organizing the relief programme followingthe earthquake (see also p. 10). He remainedto advise on feeding and immunization pro-

ANNUAL REPORT OF THE DIRECTOR-GENERAL

grammes and to promote public-health measuresrelating to maternal and child health.

By the end of the year, the European regionaladviser had visited France, Belgium, Denmark,Sweden and Finland ; various WHO maternaland child health programmes were discussedduring these visits, and conditions and trainingfacilities were examined. In France, at therequest of the national Government, and inco-operation with UNICEF, WHO made specialstudies on poliomyelitis and care of prematureinfants, and obtained equipment through UNICEFto increase facilities for treatment. Arrangementswere initiated, but not completed, to send expertsto Bulgaria in response to a request for advice onorganization of maternal and child health services.A maternal and child health adviser made acomprehensive three months' survey in Italy aspart of the joint Italian Government/WHO/Rockefeller Foundation project.

An important part of the Organization's workin this sphere was the collection of informationand statistics on causes and methods of reducingmaternal, infant and childhood mortality andmorbidity, and on the social aspects of maternaland child health programmes. The materialsin this field are extremely varied, including thephysical, social and mental aspects of maternitycare and the care of infants and children. Aspecial information unit was set up to compile,file and analyse the material, and to facilitate thedissemination of information to governments,workers in the field, expert committees, and theSecret ariat .

WHO undertook to review available informationon such subjects as school health, handicappedchildren, dental health, maternal and childhealth in under-developed countries, homelesschildren and maternal and child health legislation,the resulting material to serve as a basis formonographs or research projects and to be usedby expert committees. Selected lists of availablebooks, journals and health education pamphlets,concerned with social paediatrics, clinical paedia-trics, gynaecology and obstetrics, were publishedin the WHO Library News,12 and informationwas collected on the care of the premature infant,in preparation for the first meeting, in 1950, of anExpert Group on Prematurity. Initial prepara-tions were also undertaken for a meeting of anExpert Group on School Health and for thesecond session of the Expert Committee onMaternal and Child Health in 1950.

" For a list of technical papers published oravailable on request 5 see Annex S.

Many discussions were held and informalvisits exchanged with experts in maternal andchild health in various countries, and technicaladvice was given by means of WHO's participa-tion in conferences, seminars and programmes ofother specialized agencies and .non-govermentalorganizations. Of particular interest were theUNICEF course in social paediatrics in Oxford,England, which was planned by the Ministry ofHealth with the assistance of WHO ; the SocialWelfare Seminar of Arabic countries, in Lebanon,called by the United Nations Department ofSocial Affairs ; and UNESCO's Conference onVagrancy in Children, in Charleroi, Belgium.Several meetings of the Organization Committeeof the Sixth International Paediatric Congress(Zurich, July 1950), were attended and a WHOexhibition was planned. By the end of 1949,arrangements were under way for a WHO/UNICEF post-congress seminar in social paedia-trics, to be held in Geneva in August 1950, and,in this connexion, certain children's institutionsin Geneva were visited with the object of securingassistance in demonstrating maternal and childhealth programmes to the students attending theseminar.

Close relations were maintained with UNICEF,and many joint operations were planned, bothwith UNICEF and also with the InternationalUnion for Child Welfare, the latter publishingtechnical papers on " The World Health Organ-ization and the Training of Personnel in Maternaland Child Health " and " Immunization againstthe Principal Communicable Diseases of Child-hood " in its Review."

At the end of the year preparations were beingcompleted by the Government of India for aninformal four-day symposium on maternal andchild health, organized by the regional adviseron maternal and child health, which began on30 December in New Delhi.

During the year, twenty-seven fellowships inmaternal and child health were awarded.

Mental Health

In order to fulfil the responsibilities in regardto mental health specified in its Constitution,WHO initiated a long-range programme in thisfield during 1949.

The first session of the Expert Committee onMental Health, established by the Second HealthAssembly, was held in Geneva from 29 Augustto 2 September." Extensive recommendationswere made on technical policies and prioritiesfor WHO's mental-health programme ; particular

International Child Welfare Review, 1949, 3,No. 5

14 For the report on the session, see World HlthOrg. techn. Rep. Ser. 1950, 9.


emphasis was laid upon the encouragement of theapplication of psychiatric knowledge to thepreventive aspect of mental-health work, theestablishment of departments of mental hygienein national institutes of public health, and therevision of the curriculum in the medical educationof officers of public health and other public-health workers, especially public-health nursesand health visitors.

On the basis of the general recommendationsmade during the session, the committee decidedto examine in greater detail at its next sessionthe problem of the mental-health education ofall types of health workers. It also made recom-mendations on research into the problems ofalcoholism and drug addiction, and emphasizedthe necessity of integrating the Organization'smental-health work into its other field pro-grammes. In this connexion, the committeerecommended that a descriptive glossary of thediagnostic terms should be prepared, to be usedin conjunction with the psychiatric section of theManual of the International Statistical Classificationof Diseases, Injuries and Causes of Death. Workon this glossary has now been begun.

During the year under review, WHO co-operated in some of the projects of the UnitedNations Social Commission. Technical reportson the psychiatric aspects of the prevention ofcrime and treatment of the offender, and on thepsychiatric examination of offenders prior tosentence, were submitted to the United NationsDepartment of Social Activities, and, at therequest of that department, another report," The Psychiatric Aspects of the Etiology,Prevention and Treatment of Juvenile Delin-quency ", was begun. In response to a requestfrom the United Nations that WHO shouldcollaborate in the United Nations Study ofHomeless Children, arrangements were made fora report on the current state of scientific knowledgeconcerning the effects of the disruption of normalparental relationships on the mental health anddevelopment of children.

Collaboration with UNESCO was developed,and a WHO expert on mental health attendedthree meetings convened by UNESCO in con-nexion with its project for the study of tensionsaffecting international understanding. WHO wasalso represented at the Congress on the Educationof Maladjusted Children, and at meetings calledby the World Federation of Mental Health,with which close relations were maintained. TheFederation was of considerable assistance as achannel for the collection of information, andarrangements were made with it to develop thisspecific service on behalf of WHO through contactwith its affiliated professional bodies in differentcountries.

WHO also co-operated with the RockefellerFoundation in the mental-health aspects of theItalian health survey, and discussions were held

with a group of Swiss psychiatrists on the subjectof mental-health teaching facilities in Switzerland.

A considerable amount of information onvarious aspects of mental health was collected,and towards the end of the year WHO made astart in providing mental-health services togovernments by sending an expert consultantin response to a request from the PhilippineGovernment for assistance in surveying mental-health facilities and making recommendationsregarding their development. Austria was alsovisited at the request of the Government, inorder to discuss proposals for the development of amental-health programme in that country. Othervisits were paid to psychiatric training institutionsin Switzerland, France and the United Kingdom.

Nutrition

Although in 1948 steps were taken to establisha nutrition section, it was not until May 1949that arrangements were completed and thatactivities started. Initial efforts were directedtowards developing plans in accordance with thegeneral policy of the Organization.

Both the World Health Assembly and theAnnual Conference of FAO had stressed the needfor close co-operation between the headquartersand regional staffs of the two organizations. Inorder to ensure that this was established and asound foundation laid for its maintenance,a WHO expert visited the headquarters of FAOin Washington, and its activities, internal manage-ment and programme for the future were reviewed.Plans were subsequently completed for fullco-operation between the two organizations in allactivities relating to nutrition.

A meeting of the Joint FAO/WHO ExpertCommittee on Nutrition 15 was held in Genevafrom 24 to 28 October. This committee, composedof five members designated by FAO, five byWHO, observers from ILO and UNESCO, anda joint Secretariat, considered the programmesof both organizations. Endorsing WHO's pro-gramme, it recommended specific action onendemic goitre and kwashiorkor, or malignantmalnutrition, and also suggested that WHOshould promote and take part in investigationsof such problems as nutritional diseases of theeye, assessment of nutritional status and theabove-mentioned kwashiorkor.16

As requested by the Second Health Assembly,"the committee considered and made recommen-

16 Established by authority of First HealthAssembly Off. Rec. World Hlth Org. 13, 308

16 Details of the recommendations are given inthe report on the session, to be published as WorldHlth Org. techrt. Rep. Ser. 1950, 16.

17 Resolution WHA2.13. Off. Rec. World HlthOrg. 21, 21


dations on the establishment of joint FAO/WHOnational nutrition committees and the manu-facture of synthetic vitamins in under-developedareas.

In 1949, a circular letter was addressed toMember States requesting information on theincidence of endemic goitre, the measures takento control it, and the effectiveness of thesemeasures ; by the end of the year, most countrieshad supplied this information. Information wasalso collected, from available literature and by.means of correspondence, on the incidence andrelated problems of kwashiorkor.

As pointed out in the Annual Report of theDirector-General for 1948,18 a circular letter hadbeen addressed to Member Governments seekinginformation on regulations controlling the importand sale of Skimmed milk. The replies receivedfrom 41 countries showed that there was nouniformity of pattern in the regulations in force,which ranged from the prohibition of the importand sale of skimmed milk to the absence of anyregulations at all. A noticeable feature of thereports from some countries was that althoughthe regulations prohibited or strictly controlledthe import and sale of skimmed milk, they hadbeen relaxed to meet the needs of emergencyfeeding programmes.

Two particularly useful visits were made duringthe year, one to Guatemala, to attend the openingof the Institute of Nutrition of Central Americaand Panama, the other to the French Cameroons,to take part in the Inter-African Conference on

Nutrition. These visits proved to be of greatvalue to WHO in developing relations with anumber of governments. In Guatemala, theprogramme of the Institute and its integrationinto the nutrition programme of WHO werediscussed with the Director of the Institute, anemployee of the Pan American Sanitary Bureau.The conference in the Cameroons was called bythe French Government at the instigation of theTripartite Committee for Africa. It gave anopportunity to the representative of WHO tomeet medical personnel and others working onnutrition and related problems in Central Africa,and to learn at first hand the extent of the nutri-tion problems in the area. It is possible that, asa result of this visit, a foundation was laid forco-operation between WHO and the administra-tive authorities of these territories, most ofwhich are non-self-governing.

At the end of 1949, field activities were justbeginning. At the request of the United StatesGovernment, a consultant was sent to thatcountry to advise on various aspects of Vitamin Band the anaemias. Arrangements were also madefor a consultant on endemic goitre to. begin workin Ceylon in February 1950. Plans were madewith FAO for a joint enquiry and report on thenutritional services in Egypt, and the possibilityof conducting a jpint nutrition course in Turkeywas discussed with government officials on a visitto that country. Negotiations were also under wayto send two consultants to the Republic of thePhilippines.

Organization of Public-Health Services

One of the principal functions of WHO is toassist governments to develop efficient healthservices. It has become increasingly apparentthat the keystone of such health services isa sound public-health administration. Assistancehas therefore been given to governments inestablishing or strengthening their public-healthadministrations and in organizing their public-health services, including environmental sani-tation, nursing and the health education of thepublic.

Certain field activities under the broad headingof " Organization of Public-Health Services "were carried out by WHO throughout 1949, butit was only during the latter half of the yearthat staff was assigned to Headquarters toorganize specific programmes and to prepare theground for expanded services to governments.

A beginning was also made in integrating thetechniques of the organization of public-health

18 011. Rec. World Hlth Org. 16, 16

services in specific projects undertaken by WHO.For example, specialized teams in malaria controlwere enlarged to include a public-health nurse, asa nucleus for future activities in nursing andmaternal and child health ; a public-healtheducator was attached to one of the teams forvenereal-disease control, to stimulate interest inhealth education. Particular attention was paidto the preparation of the programme for thehealth education of the public, as an indispensablemethod by which public-health administratorsmay create an awareness of the need for andvalue of community health services.

Public- Health Administration

During 1949, certain governments were assistedin public-health administration by health per-sonnel sent from WHO into the field. One ofthese field activities was undertaken in responseto a request for advice and assistance following


the earthquake in Ecuador. The consultant inthis case (see also " Maternal and Child Health ",p. 7) advised on measures to offset the disruptionof public-health services caused by the earthquake,and particularly on the establishment of centresfor medical care and the re-equipment of institu-tions.

A medical health officer and a public-healthnurse were assigned to the UNESCO fundamentaleducation project in Haiti, and plans were madefor improvements in sanitation, general livingconditions and basic facilities in that country.Other medical health officers advised on public-health organization in Greece, Turkey, Ethiopiaand China, and in the refugee camps in the EasternMediterranean Region.

In order to assist governments to benefitfrom experience accumulated abroad, 25 fellow-ships in public-health administration wereawarded. Many of these were for full academictraining in schools of hygiene or public health ;some were for shorter periods for the observationof public-health services. During the year, thesystems and methods of public-health administra-tion employed in various countries were alsoinvestigated.

In Europe, the most important project inpublic-health administration was the Italianhealth survey, undertaken by the Government ofItaly with the co-operation of the RockefellerFoundation and WHO. This survey includedall aspects of public-health services. WHOprovided experts in malaria, tuberculosis, venerealdiseases, maternal and child health, environmentalsanitation, industrial health, public-health statis-tics, laboratory services, and port and airportsanitation.

Attention was also paid to some problems which,although not strictly problems of public-healthadministration, are closely related to it. Collabora-tion with the International Dental Federationcontinued, and, with the assistance of the Inter-national Medico-Scientific Federation, informationwas collected on physical training with a view topreparing a programme for the consideration ofthe Third Health Assembly.

In co-operation with ILO, a Joint ExpertCommittee on the Hygiene of Seafarers was setup, and plans were made for the establishmentof the ILO/WHO Joint Expert Committee onIndustrial Hygiene and also for studies on leisuretime programmes for young workers.

WHO co-operated with the Trusteeship Councilof the United Nations in the revision of theStandard Form and Questionnaire to be used insecuring uniform information on health conditionsin non-self-governing territories and trust terri-

tories respectively, and in September called ameeting of a panel of experts from Belgium,France and the United Kingdom, which met inGeneva from 19 to 24 September and drew uprecommendations for submission to the UnitedNations.

Representatives of WHO also attended meetingsof the ILO Permanent Migration Committee andAdvisory Committee on Recreation, at whichtopics relating to public-health administrationwere discussed.

At the end of the year, plans were being madefor a meeting of the Expert Committee on Public-Health Administration, to be established in1950, as approved by the Second Health Assemblywhen adopting the programme and budget for1950.19

Environmental Sanitation

Until plans could be put into effect for thepermanent establishment of work on environ-mental sanitation, a short-term consultant wasappointed to make the necessary technicalpreparations for the first session of the ExpertCommittee on Environmental Sanitation, todraw up a programme for WHO's future workon the subject, and to take part in variousprojects which were already under way.

The Expert Committee held its first session inGeneva from 12 to 17 September. Its proposalsfor activities to be undertaken by WHO includeda recommendation that the Organization shouldpromote the inclusion of sanitary engineering ingovernmental health programmes and that thetraining of sanitation experts should be givenhigh priority. It also recommended that thecontrol of such pandemic diseases as cholera andplague should form part of a comprehensivepublic-health policy.29

Services to governments during the yearincluded expert advice on measures to be takento improve water supply and sewage disposalin Egypt, in connexion with the control ofbilharziasis ; advice and demonstrations in Afgha-nistan, where an outbreak of louse-born typhushad occurred in July ; and a consultant, sent tothe United States of America to advise on thecollection and disposal of garbage and refuse.A consultant was also provided for the ItalianGovernment, to assist with that part of theRockefeller/WHO Italian health survey whichconcerned sanitary conditions.

In connexion with UNRPR, assistance wasprovided to improve sanitary conditions in therefugee camps in Syria, the Hashemite Kingdomof the Jordan, and Lebanon. After the camps had

19 CV. Rec. World Hlth Org. 21, 4620 The report on the session will be published as

World Hlth Org. techn. Rep. Ser. 1950, 10.


been surveyed, technical advice was given onmeasures to be introduced. Funds were alsoallocated to provide the necessary sanitationfacilities and to extend needed water lines (seep. 24).

In Ethiopia, WHO continued to assist in theorganization and conducting of training coursesfor sanitarians. In China, the consultant servicesof a sanitary engineer, posted in Shanghai, werecontinued, and instruction was given in simple,necessary sanitary measures. WHO also gaveadvice on the question of the possible inclusionof sanitary engineering courses in the School ofHygiene to be established in Geneva.

The Organization was represented at theUnited Nations International Conference onConservation and Utilization of Resources, heldfrom 17 August to 6 September in New York, andat the Sub-Committee on Housing of ECE, heldin March in Geneva, in connexion with problemsof environmental sanitation.

Four fellowships in sanitary engineering wereawarded during the year.

Health Education of the Public

In accordance with the recommendation of theFirst and Second Health Assemblies that healtheducation of the public should be included in theprogramme of the Organization," activities inthis field were begun in the summer of 1949.A programme was drawn up for assisting govern-ments to develop methods and techniques forhealth education of the public. Much attentionwas given to the means by which these techniquescould be used in many of the demonstrationservices to governments, and the programme wastherefore planned both as an independent serviceto governments and as a service to be used even-tually in many other aspects of WHO's work.

The activities were mainly devoted to a pre-liminary study and investigation of existingprogrammes and needs in various countries.Field visits and investigations were made inEngland, France and the Netherlands by a short-time consultant. In India, an expert on healtheducation appointed to the headquarters staffvisited institutions and lectured in Madras,Calcutta and New Delhi, and the services of aWHO consultant were requested in connexionwith a WHO/UNICEF programme in the All-India Institute of Public Health, in Calcutta.

In co-operation with UNICEF and the RegionalOffice for South-East Asia, plans were made toassist the national and local health and educationauthorities in Sarawak by assigning a trainedand experienced health educator to guide thedevelopment of a teacher-training demonstrationin health education.

With UNESCO, initial steps were taken toextend the health education aspects of the jointWHO/UNESCO fundamental education projectin Haiti, to which a qualified public-healtheducator and a public-health nurse were assigned.A health educator was also assigned to thevenereal-disease demonstration team in Egypt.

WHO was represented at the Asian Seminaron Rural Adult Education, held at Mysore,India, from 2 November to 14 December, underthe joint auspices of UNESCO and the Govern-ment of India, and at the Latin American Seminaron Illiteracy, convened by UNESCO and heldin Rio de Janeiro from 27 July to 3 September.

Nursing

In order to assist national health administra-tions, if they so wish, to plan for an adequatenumber of well-trained nurses, the Second HealthAssembly decided that an Expert Committeeon Nursing should be established," and theappointment of members to this committee wasimmediately begun. By the end of 1949, planshad been made for the first meeting, in February1950, of qualified nurses from Chile, Finland,France, India, New Zealand, Switzerland, theUnited Kingdom and the United States ofAmerica. Among other questions, the committeeis to consider the education of the professionalnurse and the training of auxiliary nursingpersonnel, co-operation with other specializedagencies and non-governmental organizations, andthe WHO programmes for 1950 and 1951.

During the latter part of the year, nursingexperts were appointed to the Secretariat, andwork was begun on collecting information bearingon all aspects of the nursing profession, particularattention being paid to training, legislation onnursing, and employment conditions in thenursing profession in different countries. Fivefellowships for public health nursing were awarded.Nurses were also recruited for field work.

At the request of various governments, assis-tance was given to training institutions engagedin the technical education of nurses and midwives.Nurse teachers were 'assigned to the Sotiria Sana-torium in Athens, the College of Nursing in Delhi,and the Red Cross School of Nursing in AddisAbaba-the first school of its kind in Ethiopia-which had been established with the assistanceof WHO.

A nurse was sent to Egypt to investigate theneeds, conditions of training and organizationof nurses, with a view to WHO's co-operation

22 Resolution WHA2.77, Og. Rec. World Hlth Org.21 Og Rec. World Hlth Org. 13, 99, 308 ; 21, 164 21, 46


in specific projects in that country. Another wasassigned to a maternal and child health team inSouth Korea to provide technical assistance inthe establishment of a demonstration andteaching unit.

Public-health nurses were recruited for theUNESCO fundamental education project inHaiti, and for WHO/UNICEF projects demon-strating control of malaria and tuberculosis in thefield. In further collaboration with UNICEF,preparations were completed for three WHO/

UNICEF nursing and midwifery training projectsin Malay, Sarawak and Brunei, to begin earlyin 1950. A joint project with the RockefellerFoundation for the study of the work of theassistante sociale in France and the health visitorin England was also contemplated.

By the end of the year, plans were being madeto appoint nursing advisers to some of the regionaloffices. Fifteen nurses in all had been employedfor duty in the field, and preparations were inhand for an extended programme in 1950.

Professional and Technical Education

WHO's functions in the field of professional andtechnical education can be divided into twocategories.

First, the treatment of education as an indi-vidual subject, which embraces studies of trends,methods and programmes, the interchange of in-formation, the international pooling of experienceand the indirect stimulation of national trainingprogrammes.

Secondly, direct assistance to countries in thedevelopment of training resources and in thetraining of medical and related personnel, whichhas taken the form of advice on individualtraining institutions, the provision of teachingpersonnel, the sponsoring of group studies (courses,seminars and specialized study teams), and theprovision of fellowships, medical supplies andliterature, and teaching equipment.

Special attention has also been paid to theintegration of training into various specificWHO programmes, and to the co-ordination ofWHO training programmes with those of otheragencies.

Educational Institutions and Training Courses

As WHO has extended the range of its servicesand has gradually collected information on thetrends in training and the needs of the variouscountries, the shortage of adequately trainedpersonnel for health wo'rk in general and forspecial public-health projects in particular hasbecome more and more apparent. During theearly part of the year, therefore, the Organizationbegan to formulate a broad programme of trainingfor the growing number of specialized personnelnecessitated by the ever-increasing demands.The Executive Board, at its third session, proposedthe adoption of a basic educational policy, whichwas subsequently approved by the Second HealthAssembly when adopting the programme andbudget for 1950."

" 011. Rec. World Hlth. Org. 21, 46

The gravity of the situation and the problems tobe solved were also recognized by the regionalcommittees. At the second session of the RegionalCommittee for South-East Asia the need forestablishing or strengthening national centres forthe training of health personnel was emphasized.The Regional Committee for the Eastern Mediter-ranean, at its second session, not only recom-mended regional training activities, but alsocharged the Regional Director with the respon-sibility of encouraging the interchange of technicalhealth personnel within the region for moreeffective utilization of the available resources.

Initial steps taken during 1949 towards imple-menting this expanded programme includedthe establishment of the Expert Committee onProfessional and Technical Education of Medicaland Auxiliary Personnel. This committee willmeet early in 1950, and experts in education havebeen invited from Belgium, Chile, Hungary,India, Sweden, Turkey, the USSR, the UnitedKingdom and the United States of America.The committee will consider, among otherproblems, the world situation with regard toprofessionally trained personnel, WHO's pro-gramme in this connexion, and specific suggestionsas to future work.

WHO took an active part, in close collaborationwith UNESCO, in sponsoring the creation of aCouncil for the Co-ordination of InternationalCongresses of Medical Sciences, which was ulti-mately established at a conference held in Brusselsin April 1949. In accordance with principles ofcollaboration approved by the Health Assembly,WHO will continue its active support of theCouncil within the limits of budgetary appro-priations.

In an effort to assist in the widest possibledissemination of technical information, WHOhas proposed that medical congresses shouldorganize international advanced courses to takeplace during their various meetings, in order totake full advantage of the presence and knowledge


of leading world specialists in many branches ofmedicine. Several congresses have adopted thisidea and will put it into effect in 1950.

Co-operation with UNESCO was also continuedin connexion with technical training and audio-visual teaching material. Close liaison wasmaintained, through UNESCO, with the InterimCommittee of Universities, and directly with theWorld Medical Association, in an attempt topromote co-ordination of activities in medicaleducation. WHO also collaborated with ILOon vocational education and with UNICEF oninternational courses in social paediatrics andin the training of local auxiliary personnel inChina and Malaya.

The systematic collection of information on theneed for trained personnel in all parts of theworld and on resources for training in medicineand related fields was continued. Interestedauthorities and institutions were supplied withlists of medical schools and with informationon such subjects as the organization of, andtrends in, medical education ; advice was givenon the organization of training institutions andcourses of an international character.

Training programmes for auxiliary personnelwere continued in Ethiopia and China, and in othercountries teachers were appointed and assistancegiven for the setting-up of new courses in medicalinstitutions. Encouragement was also given tothe Swiss plan (in which the Rockefeller Founda-tion is also interested) to establish a School ofHygiene in Geneva which would develop coursesof an international character in addition toserving national needs.

Fellowships

The programme of fellowships for the trainingof health specialists, which was introduced in1946 as part of the UNRRA scheme to stimulate

'the spread of new medical knowledge among thewar-stricken UNRRA-aided countries, has beenconsiderably extended during 1949.24 It becameavailable to all Member States of the Organization,and a Fellowship Manual detailing the servicesoffered was sent to governments. By the end ofthe year, more than 40 countries had applied forfellowships, and awards had been made coveringa wide range of subjects in public health, clinicalmedicine and basic medical sciences.

When WHO first assumed the administration ofa fellowship programme, early in 1947, thesubjects chosen for study naturally tended torelate to the immediate needs for reconstruction,which, in some of the UNRRA-aided countries,

24 For a comparison of the number of fellowshipsstarted during 1947, 1998 (UNICEF fellowshipsto UNRRA-aided countries), and 1949, see fig. 2.

consisted of the rehabilitation of general medicalwork, the building up of special skeleton servicesand the establishment of teaching institutions.In 1948, the trend was towards granting fellow-ships in public health and preventive medicine,the number of fellowships of this type makingup 61% of the total number granted, with theremaining 39% in basic medical sciences. Later,when priorities were indicated in the generalprogramme of the Organization, the same policywas reflected in the granting of fellowships, andby the end of 1949 more than three-fourths ofthose awarded were in specialized subjects relatedto public health."

Fellows were studying in an increasing numberof countries in 1949, as a result of WHO's usingto greater advantage the facilities available inthe countries adjacent to the Fellows' countriesof origin." By making awards to local personnelengaged in demonstration projects and by placingother Fellows in those projects for field practice,WHO has tried to strengthen, as far as possible,the joint programmes which are being planned orcarried out by governments with the assistance ofthe Organization. In the future, assistance totraining institutions, for example, and demonstra-tions of nursing and environmental sanitationwill make it possible to award more fellowshipsin those particular fields, thus providing trainedpersonnel to continue subsequently in their owncountries the carrying-out of projects which havebeen begun with the assistance of WHO.

During the year, additional countries undertookpartial payment of the cost of the fellowshipsgranted. Several countries contributed to theinternational travelling expenses of their Fellowsin local currency ; others helped by grantingFellows, wherever possible, the free use of theirnationally-owned transport facilities. Thesecountries were thus able to secure either additionalfellowships within the allotments, or extensionsof the periods of study for their Fellows.

Whenever possible, Fellows have attendedspecial condensed courses, thus saving both theirown time and that of the teaching institutions.The practice of awarding fellowships for groupcourses, or to teams of workers from the samecountry and with the same interests, will beintroduced into the 1950 programme, andwherever feasible arrangements have already beenmade for such courses.

Both long and short-term fellowships have beenfound necessary for the training of the variousgroups and individuals. For junior candidates,especially those training in public-health adminis-tration, one-year courses in schools of publichealth have often been found to be the mostsuitable ; special students have also been registered

25 The proportion of fellowships awarded forstudy in different subjects is shown in fig. 3.

26 The proportion of fellowships awarded forstudy in different countries in shown in fig. 4.


FIGURE 2. WHO FELLOWSHIPS BEGUN DURING 1947, 1948 AND 1949

EUROPE

HUMBER OF FELLOWSH I PS

0 5 10 20 30 40 SO 60 70 8011 1 1

5

ALBANIA

1 1 Ili 111

6

BELGIUM

I BULGARIA

5

o

17 27

AUSTRIA

FRANCE

GREECE

16

20 27

HUNGARY

17 18

4 22

NETHERLANDS

1

3

1 NORWAY

1 SWEDEN1

ITALY

FINLAND

E. M EDITER

S. E. ASIA

W. PACIFIC

EGYPT

9

ETHIOPIA

2

IRAN

6

LEBANON

PAKISTAN

7

TURKEY

4

AFGHANISTAN

CEYLON

\ N43 52

CZECHOSLOVAKIA

POLAND

67

45

Provided only froUNRRA funds & availableonly tq "UNRRA receivingcountries."

EEM1947 1948 1949

75

01

INDIA

CHINA\\\

AMERICAS

4 6

PHILIPPINES

KOREA S.

5 10 20 30 40 50NUMBER OF FELLOWSHIPS

60 70

150

80


FIGURE 3. PROPORTION OF FELLOWSHIPS AWARDED FOR STUDY IN DIFFERENT SUBJECTS

OTHER MEDICALSUBJ ECT

(14)

BASIC MEDICALSCIENCES

(9)

PUBLIC HEALTHADMINISTRATION

(18)

INTERNALMEDICINE

(7)

OTHER HEALTHACTIVITIES

(18)

MATERNAL ANDCHILD HEALTH

(20)

NURSING( 2 )

COMMUNICABLEDISEASES

(76)

FIGURE 4. PROPORTION OF FELLOWSHIPS AWARDED FOR STUDY IN DIFFERENT COUNTRIES

OTHER COUNTRIES I-6

CZECHOSLOVAKIA

ITALY

DENMARK

SWEDEN

U.S.A.

000004000000004000 *****

40000 ****** 0410000 ****** 000000000004000.000000000004000400000000.000.0000000004.00

I

000000000000000.0000000000000

0000000000000.00000000000

000000000000 ***** 00

000000.00000.

.000004,0

0

11110k

UNITED KINGDOM

SWITZERLAND

* Algiers, Belgium, Brazil, Cyprus, Egypt, Finland, Guatemala, India, Mexico, Netherlands,Norway, Paraguay, Poland, Portugal, USSR, Yugoslavia.


at such schools, where they take general courseswith special emphasis on their main programmesof study. But there are, and probably therealways will be, some senior specialists for whomshorter courses or short-term tours or visits aremore effective as " refresher " courses, or forthe observation of new techniques and the renewalof interrupted contacts. During 1949, the averageduration of all these various types of fellowshipswas six months.

A collateral scheme of individual fellowshipsfor South-East Asia was financed by UNICEFbut administered by WHO, in implementationof the joint programme of the two organizations.This programme included about 55 fellowshipsfor South-East Asia and the Western Pacific,chiefly in social paediatrics and related fields.The allocations to the individual countries,however, did not permit the number of fellowshipsoriginally planned to be provided in every case,and administrative procedure was delayed con-siderably owing to events in the areas concerned.

In addition to administering WHO fellow-ships and co-operating with UNICEF, the Organ-ization has been at the disposal of Member Statesto give advice and to help them in placing theirown Fellows, and has also supplied information toorganizations and individuals concerned. It hasalso kept in close contact with UNESCO, theUnited Nations Division of Social Affairs and otherspecialized agencies interested in fellowships, bymeans of exchange of information, discussions ontechnical questions and personal contacts.

Reports from Former WHO FellowsIn order to supply information on the activities

of WHO Fellows after the termination of theirfellowships, an analysis has been made of thereplies from 115 Fellows to follow-up question-naires. Of these Fellows, 30 had been promotedand 25 had been more suitably placed accordingto their fields of study and had assumed additionalduties in their respective national public-healthorganizations.

Some were pioneers in, or had contributed to,the organization of mass radiography, tuberculosiscontrol and BCG vaccination. Others had intro-duced new techniques in chest surgery, anaesthe-sia, bronchoscopy, cardiology, encephalography,radiology, endocrinology and industrial hygiene.Two Fellows who had studied blood transfusionand the organization of blood banks had becomeleaders in this field in their countries after havingpublished important papers on the subject. Somehad become leaders in mental health, childguidance, or brain surgery, others in dentistry ;and some were specialists in serum and vaccineproduction, the treatment and prevention ofinfectious diseases, and epidemiology.

One Fellow, formerly engaged in public-healthadministration, had been made director of a post-

graduate school of public health ; another hadbeen deputed to plan the reorganization of a cityhealth department ; another to establish thenational medical statistics. Several had becomespecialists in the field of industrial health ; somewere teachers. A nurse had undertaken thereorganization of industrial health nursing. Fellowstrained as sanitary engineers, hospital architectsand hospital administrators were reported to betaking an active part in the organization of theappropriate services in their respective countries.Study abroad enabled some Fellows to publishmaterial relating to their special subjects on theirreturn. One of the ex-Fellows is now leader of amalaria team, and another is an understudy.Two ex-Fellows are members of the WHOSecretariat.

Forty of the answers indicated that the Fellowsare keeping in constant touch with other ex-Fellows in their own countries ; other answersstressed the continuous contact of Fellows withprofessors, clinics and editors of journals in thecountries which they visited while holding fellow-ships. Forty-four made positive suggestions,chiefly for an organization of WHO ex-Fellows,for the exchange of new medical informationand for subscriptions to medical periodicals.27Short return trips to former countries of studywere also suggested, in order to renew contactsafter several years had elapsed.

The status of fellowships during the year bybeneficiary country, including UNICEF fellow-ships, is given in Table I (pp. 19-20). Table H(pp. 21-22) summarizes the fellowship awardsmade during the year by country and by fieldof study. It should be noted that the numberof awards during 1949 is not the same as thatfor fellowships started during the year. Figures2, 3 and 4 are based on statistics of Fellowswho have actually begun their studies.

Exchange of Scientific Information

In order to meet the increasing demands forreliable information on recent achievements in themedical sciences, it was necessary to facilitateand expedite the exchange of this type of informa-tion. This has been done by sending out teamsof visiting experts, holding seminars and confer-ences, and providing assistance to nationalhealth institutions by establishing specializedtraining centres or organizing courses.

During the year, various countries in Europewere visited (Austria, Belgium, Czechoslovakia,Denmark, Finland, Hungary, the Netherlands,Norway, Poland and Sweden) ; their medical andhealth needs were reviewed, and the varioustypes of assistance which might be most valuable

" These suggestions are being closely studied bythe Director-General.


to them were studied. Preliminary consultationswith the various government and universityofficials resulted in an increased interest in theservices offered by WHO and in a number ofconcrete proposals of projects in which WHO couldbe of assistance. In consequence, help was givenin establishing a State Medical Library andMedical Documentation Centre in Czechoslovakia,and in organizing training centres in anaesthesio-logy in Czechoslovakia and Denmark, and inbiochemistry in Poland. Plans were made to meetrequests for study seminars on highly specializedproblems connected with syphilis and on infantmetabolism ; the seminar on the latter subjectis to be held in six countries ; other plans wereunder way for an international team of specialistsin the treatment of congenital heart disease tovisit Austria and Czechoslovakia. In co-operationwith the United Nations Department of SocialAffairs, WHO also worked on the developmentof a special rehabilitation programme for Europe.

Although this type of activity has been confinedto Europe during the past year, through theSpecial Office for Europe, it is expected thatsimilar services will be extended to other areasin 1950.

Medical Supplies, Literature and TeachingEquipment

WHO Headquarters, in co-operation with theRegional Office of the Americas, has providedgovernments with teaching equipment andliterature, and consultants and teams in thefield with medical supplies, special teachingequipment and literature. Advisory services havebeen extended to governments which haverequested assistance in solving their equipmentand procurement problems, and in some cases ofemergency WHO has procured and arranged forthe delivery of equipment and supplies.

Before supplies are actually procured, informa-tion on specifications and needs is collected, andprice quotations secured from different sourcesfor comparison ; and before the supplies or equip-ment are dispatched, arrangements are madefor prompt delivery. A major difficulty has beento ensure the delivery of supplies to consultantsand demonstration teams before operations aredue to begin. Supplies sent in response toemergency calls from governments, purchased ona reimbursable basis, have included light portablerespirators, sent to India in connexion with anoutbreak of poliomyelitis, and vaccine and DDTsupplied to Afghanistan to assist in combatingthe outbreak of typhus reported from Kabul.For governments, consultants, and teams in thefield, the medical supplies and special teachingequipment procured have comprised a widevariety of items, ranging from specialized equip-

ment, such as x-ray units for mass chest surveys,compound microscopes and simple folding handlenses, to large quantities of DDT for malaria,penicillin for venereal diseases, and smallquantities of sulfone derivatives for leprosy..

In order to assist governments requestingadvice on their procurement problems, WHOcollected information (on the suitability of varioustypes of equipment to particular needs, specifica-tions, sources of supply and price ranges) whichenabled many of the governments to place ordersdirectly with sources of supply. South Africa wasgiven information on sources of supply of vaccineduring a smallpox epidemic ; and Israel and Italyreceived information which enabled them topurchase diphtheria toxoids and influenza vaccine.At the end of the year, at the request of theRegional Committee for South-East Asia, materialwas also being collected which would make itpossible for countries within the region to producetheir own medical supplies : information on therequirements of the area, its physical facilities,raw materials, and resources in trained technicalpersonnel. Methods of utilizing existing inter-national economic machinery were developed,and the ways in which manufacturers and con-sumers might be brought together were investi-gated. This information is being placed at thedisposal of the countries interested.

The names of qualified persons were given toseveral Member States in response to requests forinformation as to the availability of techniciansto assist in organizing the medical supply branchesof their health services. In connexion with plansto set up a panel of experts to advise on x-rayequipment, UNICEF was supplied with thenames of leading radiologists and physicists inseveral European countries. Information onequipment was also sent to institutions requestingadvice on establishing new departments or onincreasing their facilities for the training of medicaland related personnel.

In the provision of supplies, WHO has beenfortunate in having the services of its regionaloffices and the close co-operation of the UNESCOScientific Apparatus Information Service, thesupply divisions of the International Committeeof the Red Cross, the International Centre forRelief for Civilian Populations, national healthadministrations, and associations of manufac-turers.

Co-operation has been maintained withUNESCO on its book coupon scheme. WHOcontributed towards the scheme by providingsome of the financial backing required for thebook coupons, and in meetings of experts calledby UNESCO a WHO representative took partin the discussions on the extension of the schemeto include educational films and scientificapparatus.


TABLE I. DISTRIBUTION PER BENEFICIARY COUNTRIES OF WHO FELLOWSHIPAPPLICATIONS RECEIVED DURING 1949, AND NUMBER OF FELLOWS WHO HAVE

BEGUN OR COMPLETED THEIR STUDIES, OR ARE STUDYING IN THE FIELD

Countries and regions Applications receivedduring the year

Fellowships begunduring the year

Fellowshipscompleted during

the year

Fellows in the fieldat the endof the year

Albania 5 5 - 5Austria 23 10 14 2Belgium 1 1 - 1

Bulgaria 3 1 1 -Czechoslovakia 10 9 22 3Finland 17 7 11 4France 10 5 1 4Greece 2 3 4 1

Hungary - 1 4Ireland - - -Italy 8 8 13 1

Netherlands 3 3 3Norway 3 1 - 1

Poland 20 14 16 3Portugal - - - -Roumania - - - -Sweden 2 1 - 1

United Kingdom 1 - - -Yugoslavia 26 30 28 19

Total for Europe 134 99 117 45

Australia - - -China 25 5 67 17Korea 2 2 - 2Philippines 6 5 - 5

Total for W. Pacific 33 12 67 24

Afghanistan 5 2 - 2Burma - - - -Ceylon 6 6 2 4India 19 18 2 16Thailand ' 8 5 3 2

Total for S.E. Asia 38 31 7 24

Egypt 12 9 4 5Ethiopia 5 2 1 1

Iran 19 6 6 -Iraq 2 - - -Israel 1 1 - 1

Lebanon 2 1 - 1

Pakistan 7 7 - 7Saudi Arabia - - - -Syria 1 - -Turkey 4 4 1 3

Total for E. Mediterranean 53 30 12 18

Brazil 1 1 - 1Haiti 4 3 - 3Mexico 2 1 - 1

Paraguay 1 - - -USA 9 4 4Venezuela 3 - - -

Total for Americas 20 9 4 5

TOTAL FOR ALL COUNTRIES 278 181 207 116

20 ANNUAL REPORT OF THE HIRECTOR-GENERAL

UNICEF Fellowships

Countries and regions

Hong Kong

Applications receivedduring the year

5

Fellowships begunduring the year

Fellowshipscompleted during

the year

Fellows in the fieldat the endof the year

India 14 14 4 10Indonesia 2 2 2Malaya 1

Pakistan 4Philippines . 11 3 3Singapore 3Thailand 5 5 5

TOTAL 45 24 6 18

ADVISORY SERVICES TO GOVERNMENTS ?1,

TABLE II. WHO FELLOWSHIP AWARDS DURING 1949,BY SUBJECTS AND COUNTRIES OF ORIGIN

Public health and other prioritysubjects Other subjects

CountryVg.31d

AVst

.I

to 41' . ''1.:',.. 7'.. 2 t 4 o

5

Albania 5 5Austria 3 - - 2 1 1 3 1 11Belgium 1 1

Bulgaria 2 2Czechoslovakia 1 - 7 - - 3 1 - -- 2 14Finland - - 2 3 3 1 - - - 9France - - 5 - - 1 - - - 6Greece 1 1 - 1 3Hungary 1 - 1 - - - - 1 3Italy 3 - 1 2 6Netherlands - - 2 - - 1 - - - - 8Norway 1 1

Poland 1 - 3 - 1 2 - 4 - 1 12Sweden 2 2Yugoslavia 1 - 6 - 4 3 3 4 4 1 26

Total for Europe 8 1 33 5 11 12 6 10 8 10 104

China 1 1 2 - 4 - - - 1 - 9Korea 2 -- 2Philippines 1 1 2 - - 1 - - - - 5

Total for W. Pacific 2 2 6 - 4 1 - - 1 - 16

Afghanistan - 3 1 4Ceylon 4 2 s 6India 9 - 4 - - ),. - - - 2 18Thailand - - 6 - 1 1 - - - - 8

Total for S.E. Asia 9 - 17 - 4 4 - - - 2 36

Egypt 2 - 8 - - 1 - - - - 11Ethiopia 2 2Iran - 8" . 8Iraq 1 1

Israel 1 1

Leb,anon 1 1

Pakistan -_ - 4 - 2 - - 1 - - 7Turkey 3 1 4

Total for E. Mediterranean 3 - 27 - 3 1 - 1 - - 35

Brazil 1 1

Haiti 3 3Mexico __ 1 1 2USA 3 1 1 - - 1 1 __ __ 7

Venezuela 2 1 3

Total for Americas 3 1 8 - 1 1 - 1 1 - 16

TOTAL FOR ALL COUNTRIES 25 4 91 5 23 19 6 12 10 12 207

* Including malaria, tuberculosis, venereal diseases and epidemiology.

22 ANNUAL REPORT or THE DIRECTOR-GENERAL

Country

UNICEF Fellowships

Public-health Communicable Maternal and Other health Surgery Totalnursing diseases child health activities

India - 7 6 1 - 14Indonesia - 2 - - 2Philippines . 1 - - 3 2 6

Thailand 1 - 3 1 - 5

TOTAL 2 9 9 5 2 27

CHAPTER 2

ACTION TAKEN BY GOVERNMENTS ASSISTED BY WHO

Rule 5 (a) of the Rules of Procedure of theWorld Health Assembly requires that a summaryanalysis of annual reports from Member Statesunder Articles 61 and 62 of the Constitutionshould be included in the annual report of theDirector-General. The Executive Board at itsfourth session (Geneva, 8-19 July 1949) decidedthat, in agreement with Member States, a standardform of questionnaire should be established whichwould facilitate the preparation both of theinitial reports and of the subsequent analysis,and would also contain information suitable forinclusion in an International Health Yearbook.A draft questionnaire was therefore preparedfor submission to governments for their commentsand suggestions. Pending the adoption of this

draft, Members were advised that the reportswhich should have been submitted by 1 Novemberwere no longer required.

This chapter cannot, therefore, be based oninformation received directly from governments,but includes, for the most part, informationwhich is available from reports from members ofthe staff of WHO, with a summary of WHO'sservices in the various regions and countries.'Regions have been grouped according to thedelimitation of geographical areas decided by theFirst World Health Assembly.2 In addition tothe action undertaken in the individual countrieswith the assistance of WHO, the activities ofthe established regional offices and of the SpecialOffice for Europe have been outlined.

Eastern Mediterranean Region a

The first session of the Regional Committeefor the Eastern Mediterranean was convened inCairo from 7 to 10 February. Representativeswere present from Egypt, Ethiopia, France, Iran,Iraq, Lebanon, Pakistan, Saudi Arabia, Syria,Turkey and the United Kingdom, and observersfrom the United Nations, FAO, ICAO, ILO andUNESCO. The Director-General of WHO alsoattended the session.

Health needs and problems in the region werediscussed, and Sir Aly Tewfik Shousha, Pasha,was chosen Director of the Regional Office, forwhich Alexandria was selected as headquarters.These decisions were later approved by theExecutive Board.4

The regional office started operations inAlexandria on 1 July. The functions of theAlexandria Sanitary Bureau were taken over,with the accompanying responsibilities of givingand receiving epidemiological information ; anactive section on public information was estab-lished ; the staff was gradually increased ; and, as

1 See also map 1, on p. 111, which indicatesservices granted at the formal request of govern-ments under broad general headings. This mapdoes not, however, include the activities of advisersassigned to regional offices.

2 og. Rec. World Illth Org. 13,330. See also map 2,on p. 112, showing regions and regional offices.

requests for assistance were received from govern-ments, operations were expanded.

During the year, WHO teams set up for anti-malaria demonstrations began to operate, inco-operation with the governments concernedand with UNICEF, which furnished supplies.Advisers on tuberculosis, venereal diseases andpublic-health administration were assigned to thestaff of the regional office, and the chief of themission to Ethiopia was transferred to the officeas regional adviser in sanitary engineering.

Consultants assigned temporarily to the regionconducted tuberculosis surveys and advised onx-ray techniques ; one consultant seconded toUNICEF assisted in mass BCG vaccinationcampaigns carried on by the Joint Enterprise.Towards the end of the year, a thorough investi-gation of the problem of bejel was made in Syria,the Hashemite Kingdom of the Jordan, Lebanonand Iraq, as a basis for a proposed regional bejel

This region comprises Egypt, Saudi Arabia,Iraq, Syria, Lebanon, Israel, Hashemite Kingdomof the Jordan, Yemen, Iran, Turkey, Pakistan,Ethiopia, Eritrea, Tripolitania, British Somaliland,French Somaliland, Aden and Cyprus. It wasdelineated by the First and Second Health Assem-blies. See og. Rec. World Hlth. Org. 13, 330 ; 21,17 and 53.

4 Off. Rec. World Hlth Org. 17, 16

- 2a -


project. Draft plans for this project includea survey team with facilities for examining15,000 persons, a demonstration control team totreat at least 30,000 patients, the training oflocal personnel, and assistance in the developmentof national programmes on the control of bejel.

At the end of the year, WHO's participation ina programme proposed by the United Nations,on the the control of venereal diseases amongchildren and pregnant women in Palestine, wasbeing considered with UNICEF.

The second session of the regional committeewas originally scheduled for Alexandria, butwas eventually held in Geneva, from 12 to15 October,5 because of the disturbed situationin some of the countries in the region. Delegatesfrom ten Member States attended the meeting ;the Hashemite Kingdom of the Jordan wasrepresented by the delegate from Iraq, anddelegates from France and the United Kingdomrepresented the countries for which they

are responsible. The health problems of thevarious countries were reviewed, and proposalsand requests for assistance presented. Thecommittee also examined the health problemsaffecting the region as a whole and made specificrecommendations. Emphasis was placed on :(1) the paramount need for developing adequatepublic-health administration and creating specialdepartments for tuberculosis and maternal andchild health ; (2) the urgency of providingfacilities for training health personnel within theregion ; (3) the importance of disseminatingtechnical knowledge and fostering co-operativeaction ; and (4) the extreme urgency of takingmeasures for the resettlement of the Arab refugees.

Preparations were under way at the end of theyear for an informal meeting with representativesof the international organizations which haveoffices within the region, when methods ofco-ordination of regional work and the exchangeof information within the region will be discussed.

Aid to Refugees

One of the most important projects in whichWHO participated in the Eastern MediterraneanRegion was the organization of medical servicesin Syria, the Hashemite Kingdom of the Jordan,and Lebanon, to assist with the United Nationsrelief project for Palestine refugees.5

At the request of UNRPR, and in agreementwith the three non-governmental agencies re-sponsible for the field services, WHO appointeda medical officer with special experience to givetechnical advice on the health aspects of theproject and to co-ordinate epidemic controland sanitary measures. Another expert wasseconded to act as chief medical officer of thefield staff of the American Friends ServiceCommittee. Certain funds were allocated forsupplies for health projects, close co-operationbeing maintained with UNICEF in this connexion.

Based on reports from WHO personnel assignedto the area, the following statement summarizesthose aspects of the project in which WHO hasp articipated :

During February, the camps were placed underthe control of the three voluntary agenciesconcerned, and arrangements were made forrecruiting Arab doctors and nurses. By the end

5 For report on the session, see og. Rec. World111th Org. 25, Annex 10.

6 According to the latest available report, therecipients of relief from UNRPR were in the areasof Arab Palestine, Gaza, Iraq, Israel, Jordan,Lebanon and Syria ; the total number of refugeeswho are unable to return to their homes is estimatedto be over one million.

of the month, practically every camp had a skeletonmedical staff.

Medical services originally offered in the camps,i.e., through camp clinics, a camp medical servicehospital, and a bacteriology laboratory, wereexpanded to include the provision of sanitarysupplies, treatment for eye and skin conditions atgeneral clinics and schools, a school health service,a tuberculosis control programme including BCGvaccination, and diphtheria immunization. BySeptember, policlinics were available in all campsin the Gaza area and six mobile clinics had beenset up to serve the villages ; approximately 700beds were available to refugees in hospitals adminis-tered or subsidized by the agencies ; and a supplyof drugs had been provided. By the end of theyear, a dental service had álso been provided in oneof the areas.

Early in the year, on the recommendation of theWHO technical adviser to UNRPR, and withthe approval of both the Director-General ofWHO and the Executive Secretary of UNICEF, acontract for 1,200 prefabricated latrines wasapproved ; these, as well as digging tools andcleansing utensils, were provided from the WHOgrant. By November, the latrine facilities averagedabout 2.5 per hundred population, and furtherconstruction was planned. Camps in some of theareas had adequate bathing facilities ; a few hadhot water. Water lines were extended to thecamps, and by the end of the year water was beingprovided in fairly adequate quantities and was ofreasonably good quality in most areas.

The use of gammexane, a new insecticide, waseffective in reducing the excessive number offlies ; benzinehexachloride 10 % dust mixed withrock phosfate was also used continuously andwith moderate success on fly-breeding places,

ACTION TAKEN BY GOVERNMENTS ASSISTED BY WHO 25

After WHO consultants and sanitary engineershad made surveys of the incidence of malariaamong the refugees in the Gaza area which showedthe problem to be urgent, an antimalaria ca mpaignwas organized ; this has given outstanding results.In September, a DDT residual spray campaignwas started ; by the end of October approximately825,000 persons had received protection, a totalarea of 9,028,996 square metres having beensprayed. Late reports indicated that the DDTspraying was being continued and that planswere being made for a campaign on insect-control, including control of fleas and lice.

A diphtheria immunization programme in Rafahwas completed, in which 14,000 out of 70,000children between six months and fourteen yearsof age were immunized by double injections ofalum-precipitated toxoid. A survey of the nutri-tional situation was made, and it appears that thestate of nutrition of the refugees has improvedduring the year. A maternal and child healthprogramme was also carried out under the super-vision of a Quaker nurse-midwife assisted byfour Palestinian assistants, and about 100 localmidwives.

At the end of November, the general healthconditions of the Palestinian refugees were reportedto be fairly satisfactory. No serious epidemicshad broken out ; out of the total refugee population,14,000 cases of conjunctivitis and trachoma,6,123 cases of malaria, 4,000 cases of entericinfection, 311 cases of tuberculosis and 16 casesof diphtheria were reported. Some cases of typhuswere reported near Hebron, and, as smallpoxwas present in three districts of Arab Palestine,mass smallpox vaccination was started in Jerichoand Nablus. BCG campaigns were finished inLebanon and Syria in October, and in Trans-jordan in November, and were expected to becompleted in the Arab towns and camps of ArabPalestine, and in Gaza, by the end of the year.

The following activities were carried out in theindividual countries in the region.

Aden

At the request of the Government, a surveyon tuberculosis was made in Aden during theyear.

Cyprus

Tuberculosis problems in Cyprus were surveyedby a WHO consultant.

Egypt

Following a visit by the Headquarters expert ontuberculosis, a survey was made of tuberculosisproblems in Egypt, and mass radiology examina-tions were started at the request of the Govern-ment. A WHO x-ray consultant assisted insetting up the x-ray apparatus, arrangedcampaigns, inspected cities in the Delta region,and trained students and workers in Cairo,

Megalla-El-Kobra and Alexandria. Medicalfollow-up of the cases examined was continued.In addition, a BCG campaign was started by theJoint Enterprise in December, and an investiga-tion of the results of the campaign was madeby a member of the Tuberculosis ResearchOffice.

Future projects being considered for Egypt atthe end of the year included tuberculosis controldemonstrations with the assistance of WHOexperts and the establishment of a tuberculosistraining centre.

Egypt also requested assistance in venereal-disease control. A consultant was assigned tomake a preliminary survey, and after its comple-tion arrangements were made to establish ademonstration team with headquarters in Tanta.A health educator, serologist, medical officer andnurse were appointed to the team ; programmeswere drawn up, and procurement of the necessaryequipment, supplies (including a serological labo-ratory unit, procaine penicillin, etc.) and litera-ture was begun. The regional bejel survey wasinitiated by an investigation of bejel in Egypt,and the Government requested supplies ofpenicillin from UNICEF for the treatment ofchildren and pregnant women suffering fromcongenital syphilis.

In response to a request from the authorities,maternal and child health programmes in Egyptwere being surveyed and evaluated by WHOexperts at the end of the year. Consultation onnutritional services was also planned.

The OIHP/WHO Study-Group on Schistoso-miasis, which met in Cairo in October, emphasizedthe danger of developing irrigation projects forincreased food production without propersafeguards against this disease. In this connexion,a sanitary engineer assigned to the regionaloffice started a special study of the areas wherethe disease is prevalent.

Eleven fellowships were awarded to Egyptduring 1949, two for the study of public-healthadministration, eight for the study of com-municable diseases, and one for the study ofother public-health activities.

In recognition of WHO's assistance to Egyptin arresting the cholera epidemic in 1948,7 an" Anticholera Memorial Medal " was formallypresented to the Organization by the EgyptianGovernment.

Ethiopia

At the beginning of the year, the chief of themission in Ethiopia visited Kenya, Uganda, Sudanand Eritrea, and other countries in East Africa,to investigate epidemiological problems, social

7 00. Rec. World MO; Org., 9, 47


conditions, education and training and public-health organization in those areas. In the reportson these visits, attention was drawn to the factthat Ethiopia would profit greatly by closercontact and co-operation with neighbouringcountries which have common problems, and thatthe chief aim should be towards a co-ordination ofeffort throughout the whole of East Africa.

During the early part of the year, the missionwas changed to an office, and subsequently thedirection of the work in Ethiopia was graduallytransferred to the Regional Office for the EasternMediterranean, which began to operate in July,and the number of personnel stationed perma-nently in Ethiopia (a public-health administrator,sanitary engineer, sanitary inspector, two nursesand a secretary) was gradually reduced. Theformer office closed in September.

Ethiopia's training programme for local healthpersonnel, including demonstrations of effectivework in environmental sanitation and nursing,was continued and expanded with the assistanceof WHO. The great need for trained Ethiopianpersonnel, rather than for the importation offoreign technical personnel, led to emphasisbeing placed on a fellowship programme, sup-plemented by periodical visits of experts inpublic-health administration.

A Nurses' Association was formed ; courses fornursing auxiliaries were established ; and on1 July the first school for nurses was opened inAddis Ababa, WHO contributing by supplyingteaching material and nurses' uniforms, and byplanning and directing the courses of training.Eight fellowships were requested for the trainingof nurses and midwives, who would later directthe courses in this school.

Great progress was also made in the training ofmedical assistants, dressers and sanitary inspec-tors. At the request of the Ministry of Education,a first-aid and sanitation course was given toschool dressers in Addis Ababa. By the end of theyear, about 80% of the Addis Ababa municipalsanitary inspectors had some formal training,and were capable of making a notable improve-ment in the sanitation of the city and exercisingconsiderable influence over the whole of Ethiopia.On the closing of the WHO office, these courseswere continued by a British health inspector,aided by two Ethiopian advanced sanitaryinspectors.

During the year, the exchange of sera andantigens for test performance evaluation andstandardization, which had been arranged in anational laboratory in Addis Ababa in 1948, wascontinued. Other activities included the direc-tion of courses at the Medical Assistants' School ;completion of a course for dressers at the HaileSelassie Hospital ; the continuation of the first-

aid and home-nursing courses for the EmpressMcnen School for Girls ; efforts to obtain approvalof a series of health regulations and to establisha health statistics school ; and participation in theEthiopian Medical Association, the EthiopianNursing Association, the Ethiopian Red Crossand the Medical Advisory Board, which last body,when formally established, will be the highesthealth authority in Ethiopia.

An important step was taken when, after threeyears of effort, it was finally agreed to include arepresentative of the Ministry of Educationon the Medical Education Board established bythe Ministry of Health.

Two fellowships were awarded during the yearand two Fellows were in the ficld. A long-termrequest for fellowships, based on a seven-yearprogramme (including basic education for doctors,nurses, midwives and sanitary engineers) wasreceived.

Hashemite Kingdom of the Jordan

In connexion with the bejel survey beingundertaken in the region, an expert on venerealdiseases visited several areas in the HashemiteKingdom of the Jordan, including Bethlehem,Hebron, the Hamallah - Nablus - Janin area,Jericho, Amman, Adwan, Sweileh, Fsaih and theJarash-Irbid-Mafraq area. Surveys were made ofpopulation groups in the areas, but only a fewcases of bejel were discovered, mostly north ofthe Jarash-Irbid-Mafraq area. Refugee camps inthe Gaza district were also inspected and foundto be free from bejel.

A survey of tuberculosis problems was alsocompleted during the year.

The Minister of Health and public-healthadministration officers were interviewed in orderto ascertain needs for health services in relationto plans for a regional programme.

Iran

Because of the gravity of the malaria situa-tion in Iran, and the resultant loss of life anddeleterious effect on economic development, thecontrol of malaria has been given a place ofprimary importance in the Government's healthprogrammes.

A survey of the malaria situation in Iran andof the possibilities of training personnel for acampaign against the disease was made early inthe year by two WHO experts, one a malario-logist and one a sanitary engineer, who alsocarried out a small demonstration in and aroundChalux and the Caspian littoral, using personnelsupplied by the Government. Recommendationsmade by these experts were followed with satis-factory results. The Government selected ten


areas and carried out extensive control measuresby DDT spraying during the year.

In view of the satisfactory results of thesedemonstrations, the Government prepared anextensive control programme for 1950. Followingan official request for a malaria advisory unit,WHO decided to assist in this programme byestablishing a malaria demonstration team inIran. By the end of the year an entomologisthad been appointed, other members of the teamwere being recruited, transport had been provided,and it was hoped to start operations early in theyear. The Government has also taken measuresto control trachoma, smallpox and leprosyunder its Seven-Year Health Plan. It hasrequested further co-operation in improvingthe tuberculosis situation, a survey of which wascompleted by WHO during the year. Assistancewas also given to the Iran Foundation in connexionwith the recruitment of trained sanitary engineersfor a proposed nation-wide sanitation programme.

Eight fellowships were awarded for the studyof communicable diseases.

Iraq

In response to a request from the VenerealDisease Division of the Royal College of Medicine,Baghdad, for assistance in organizing penicillinprojects for Iraq, arrangements were made forthe provision of necessary supplies.

In preparation for a large-scale programme,surveys on bejel were made by two WHO consul-tants, preparatory to initiating bejel controldemonstrations by a team to be set up in 1950.Consideration was given to the advantages ofestablishing team headquarters in the RoyalIraq Medical College in Baghdad, and the Govern-ment of Iraq offered to build a laboratory for theproject (if WHO would supply the equipment) andto provide accommodation for the team and forany future WHO teams.

During the year, a tuberculosis survey wascarried out at the request of the Government, andone fellowship was awarded for the study ofcommunicable diseases.

Israel

Israel became a Member of the Organization inJune 1949. In March, a member of the Tuber-culosis Research Office went to Israel to investigatethe possibilities of undertaking a study of thevalue of the BCG campaign to be carried out bythe Joint Enterprise. This campaign startedat the beginning of November, when examinationswere conducted in the schools of Tel-Aviv,Haifa and Jerusalem.

Towards the end of the year, an official from. he Regional Office for the Eastern Mediterranean

visited the public-health services of Haifa,Tel-Aviv, Beth-Lid Immigration Camp, Affulah,Nazareth, Tiberias, Rosh-Pina, Amir Settlement,Jaffa and Jerusalem to discuss the best way ofintegrating the existing health agencies into anational health organization -one of the mosturgent problems in the country. Arrangementswere made for consultants to visit Israel in orderto discuss specialized problems, particularly inthe fields of mental health, industrial medicineand tuberculosis. The need fot trained districtmedical officers and public-health nurses appearedto be urgent, and a long-term plan of fellowshipsto meet this need was considered.

Assistance was also given in the form of teachingequipment for the Rosh-Pina Station and for theInstitute of Israel. One fellowship was awarded.

Lebanon

Lebanon became a Member of the Organizationin January 1949.

In March a member of the WHO TuberculosisResearch Office investigated the possibilities ofundertaking a scientifically controlled study onthe value of BCG for the city and suburbs ofBeirut. A campaign was started by the JointEnterprise in October. A survey on tuberculosiswas also completed during the year.

Towards the end of the year, experts in venerealdiseases visited the American university inBeirut to investigate the laboratory facilitiesoffered for the proposed bejel project. Variousother institutions and hospitals in Beirut werevisited, and surveys made of the regions of Akkat,Saida-Sour and Jabal A'mel, where no cases ofbejel or of excessive incidence of syphilis wereencountered. The authorities indicated theirwillingness to co-operate in the transmission ofspecimens if the proposed bejel laboratory shouldbe situated in Lebanon.

A WHO expert attended a Social WelfareSeminar of Arabic countries and reported onmaternal and child health conditions in Lebanonand Syria.

In November, an official from the regionaloffice in Alexandria visited Lebanon with theobject of acquiring information on, and discussing,public-health problems which were of concernto the regional programme. The provision offellowships, consultant services, supplies, anddemonstration programmes was considered. TheGovernment agreed that the reorganization ofnational health services was a necessity, andsuggested a programme of fellowships for trainingfull-time personnel. A plan was also investigatedfor establishing a postgraduate training course onpublic health, to be developed by the Americanand French universities in Beirut under theauspices of the Government and with the


co-operation of WHO. Such a national pro-gramme would provide regional training for doctorsof neighbouring countries and, if successful,would be a nucleus for the development of apermanent regional school for public health.

Consultations took place between the Ministerof Health and the regional adviser in public-health administration on problems in thatparticular field.

Late in the year, official requests were receivedfor consultant services in connexion with ageneral malaria survey, and also in the fields ofpublic-health administration and environmentalsanitation. As a result of a visit to the library ofthe American university at Beirut, the possibilitywas also being considered of making a grant formodern books on public health in exchange for aregional supply of micro-films. The extensivecollection of medical and public-health journalsand the already existing film and photographicduplication service could, with some additionalequipment, become the basis for a regionalmicro-film service.

One fellowship was awarded for the study ofpublic-health administration.

Pakistan .

In order to assist the Government of Pakistanin its efforts to eradicate malaria, . WHO, assistedby UNICEF, established a malaria controldemonstration team in East Pakistan. The teamis composed of a malariologist, a public-healthengineer, an entomologist appointed by theGovernment, and a public-health nurse ; nationalmembers are provided by the Government, andsupplies and equipment have been provided byWHO and UNICEF. Reports on the projectare summarized below :

After a pre-operational survey had been com-pleted, the area was divided into 20 administrativeunits, with the headquarters of the project atGouripur, in the Mymensingh district of EastBengal, and a sub-centre at Iswarganj. In theepidemiological and entomological surveys, 3,000children were examined and 10,000 specimenscollected.

The operational phase was delayed because ofthe late arrival of supplies. UNICEF delivered36 sprayers by air in July, but the remainder ofthe equipment and supplies for the project hadto be borrowed from the Government. As onlysix tons of DDT were available, protection couldbe afforded only to a population of 36,000, livingin an area of 65 square miles, instead of 120,000persons, as originally planned.

Even though there had been an annual epidemicin the Mymensingh district during the last decade,with spleen rates as high as 80%, up to the end of

November no malaria transmission had beendetected in either the sprayed or the check areas.In the unsprayed area of the Dowhakhola Union,where there was a high death rate in 1943, it isnow difficult to detect a palpable spleen. A. philip-pinensis has been almost entirely absent in bothareas. Exceptional meteorological conditions haveresulted in two floods during the year, instead ofthe usual one ; this has rendered conditions un-favourable for mosquito breeding.

The lack of transmission must therefore beinterpreted with caution. With the cessation ofthe rains and a receding water table, breeding ofA. philippinensis may begin soon., but the advancedseason, with falling temperature, may curb thetrend.

The post-operational survey started in December1949.

During the period following the termination ofthe operational phase, the members of the teamassisted in other spheres of public health ; theteam-leader and public-health nurse helped toestablish a kala-azar programme ; the public-health nurse set up a school for training nursery-school peronnel ; and the public-health engineer isacting as adviser in environmental sanitation tothe Government of East Bengal until February1950.

In addition, the malaria expert at Headquartersvisited the team, as well as malaria laboratoriesand institutions in East Bengal, Decca andKarachi. An expert from the AgriculturalDivision of FAO investigated conditions tosecure data for the joint FAO/WHO malariacontrol project to increase food production andraise standards of health. At the end of theyear the Government was planning to extend itsantimalaria schemes in 1950 to three additionaldistricts in East Bengal. Teaching equipmentwas being supplied for the Malaria Institute atKarachi.

At the request of the Government a BCGvaccination programme was undertaken by theJoint Enterprise. Expert advice on maternaland child health programmes was also given byWHO.

A short survey of venereal-disease services inthe country was made by the adviser from theregional office, who lectured on penicillin treat-ment of syphilis to sanitary engineers at theMalaria Institute in Decca. A visit was alsopaid to Pakistan in connexion with the antibejelproj ect.

Members of the joint OIHP/WHO CholeraStudy-Group visited the country in November ;as a result of their recommendations, a WHOcholera control team is being organized forPakistan for 1950.

In November, health authorities in Pakistanwere interviewed by the Regional Directorregarding their needs for assistance in buildingup public-health services in the country. It wasfound that hospitals and other public-health


institutions in Lahore and Karachi needed equip-ment and trained technical personnel. Theemphasis seemed to be more on curative than onpreventive medicine and on urban rather than onrural sanitation. The Malaria Institute atKarachi, started after the partition and proposedas a training centre for regional fellowships, needsstill more equipment and strengthening of itstechnical staff, if it is to fulfil this purpose.Nurses are needed for the Army School of Nursingin Rawalpindi. Much work still needs to bedone on venereal diseases, tuberculosis andmaternal and child health.

At the end of the year, a proposal to set upa tuberculosis teaching and training centre wasbeing considered by WHO and UNICEF. Sevenfellowships were awarded during the year.

Saudi Arabia

A tuberculosis survey of Saudi Arabia wascompleted during the year.

Syria

At the suggestion of the Syrian Government,attention was given to the possibility of using theDjezireh Area of North Syria as an FAO/WHOdemonstration area for the improvement of healthconditions and for the increase of food production.The Djezireh area is now known to be infectedextensively with Bilharzia haemotobium, 5,000cases of human infection having been recordedin the last year ; it was agreed, therefore, thata thorough survey, including the collection ofinformation on the incidence of malaria andbejel, should precede any programme in thearea. At the end of the year, an official requestwas being considered for the appointment of aWHO adviser to the regional office to be attachedto an already existing national team of expertsfrom the public works, agriculture and irrigationservices in Syria. FAO was also being consultedin this connexion.

In view of the reported extent of bejel indifferent parts of the country, the Governmentof Syria requested assistance in controlling thedisease. A WHO consultant was assigned tomake a preliminary survey, and the Governmentagreed to the suggestion that a demonstrationproject on bejel should be combined with theproposed FAO/WHO malaria project in theDjezireh area.

A tuberculosis survey was completed, and,

in September, a WHO expert on maternal andchild health visited the country.

In November, a member of the regionaloffice staff inspected public-health services andteaching institutions and discussed with theauthorities the need for fellowships, consultants'advice, equipment, etc. The health authoritiesplaced particular emphasis on maternal and childhealth care, the most urgent need. At the end ofthe year action was being taken to secure theservices of a consultant in this field, and toassist in organizing a national service to cover allaspects of health for mothers and children inaccordance with a scheme provided by the public-health services of Syria.

Turkey

In response to the Government's request forassistance in modernizing its methods of nation-wide malaria control, a sanitary engineer wassent to Turkey to advise on techniques andprogrammes ; a consignment of insecticides wassupplied for demonstration purposes. The countrywas also visited by a consultant on public-healthadministration, at the request of the Government.

A survey on tuberculosis was made, andassistance was given in the planning of a teachingand training centre to be established in Istanbul.At the end of the year, preliminary arrangementsfor a demonstration team were being discussed.

Another WHO consultant was assigned toTurkey to study and report on the status ofvenereal-disease control services. Visits were paidto venereal-disease treatment centres in Ankara,Istanbul and Ismir, and a survey was made ofavailable measures for control, with a view to thepossibility of launching a joint project with theassistance of UNICEF. Contacts were madewith the relevant authorities in the Ministry ofHealth and in the main hospitals and institutions,and a supply of penicillin was delivered to theGovernment for demonstration purposes. Infor-mation as to available literature on venerealdiseases was also supplied, and Turkey wasvisited in connexion with the antibejel project.

In November, officers of the health administra-tion in Istanbul and Ankara were interviewedconcerning the dominant health problems of thecountry, and the possible ways and means ofdeveloping national institutions for malaria,nutrition and tuberculosis, and nursing institu-tions, both national and regional.

Four fellowships were awarded during the year.


Western Pacific Region 8

No regional organization for the WesternPacific region has as yet been set up, and con-sequently WHO's services during 1949, in responseto requests for assistance from various countrieswithin the region, chiefly took the form of fellow-ships, continued aid to China, the organization of acampaign against yaws in Indonesia to begin in1950, a demonstration team in maternal andchild health sent to Korea and a maternal andchild health consultant to other countries, and,finally, assistance in developing many importantprogrammes in the Philippines-in malaria,venereal diseases, environmental sanitation, nutri-tion and mental health.

WHO has co-operated with UNICEF byassigning consultants and a senior medical officerto the Far Eastern Mission of UNICEF and bygiving advice on the health projects to bedeveloped with UNICEF assistance.

Details of assistance to the countries withinthe region are given below.

China

During 1948, the programme of aid to China inits public-health activities was the largest of thosecarried out by WHO, in continuation of theassistance formerly granted by UNRRA. In 1949,however, because of the spread of the civil war,WHO's activities were somewhat curtailed. InFebruary, the former field mission was trans-formed into a field office, which remained inShanghai during the year. The office functionedfairly normally ; the Chinese edition of theChronicle of the World Health Organization wascontinued, relations with UNICEF were main-tained, and WHO representatives co-operated inall possible ways with the Chinese health adminis-tration.

Although somewhat curtailed, field work wascarried on in various areas of China, withoutpolitical discrimination. WHO's field activitiescontinued to be directed mainly towards thetraining of personnel. During the first nine monthsassistance was given in the teaching of tuber-culosis nursing in Canton, Hangchow, Ningpo andShanghai. In Shanghai, a tuberculosis nurse gaveadvice at the Shanghai Tuberculosis ControlCentre, where she also worked on the BCG

8 This region comprises Australia, China, Indo-china, Indonesia, Japan, Korea, New Zealand,Republic of the Philippines and the Malay Penin-sula (provisional). It was delineated by the FirstHealth Assembly. See 011. Rec. World Hlth. Org.13, 330.

campaign, supervised a mass x-ray examinationof some 5,000 Chinese children, and taught atthe IRO temporary sanatorium for Russianpatients. With local assistance she producedtwo manuals for the guidance of nurses andattendants. Training in nursing was also givenat the Chungshan Hospital in Sining.

A surgeon, assigned to the Fong Pin Hospitalin Canton, assisted in running the hospital,and conducted training courses for youngsurgeons.

Another WHO consulting surgeon remained inNorthern China throughout the year-despiteunsettled conditions-first in Shichianchuangand later in Tientsin and Peiping, where heorganized and participated in hospital servicesand in training courses (the material beingsupplied by UNICEF), advised on plans for theestablishment of a training centre near Peiping,and helped in the organization of a nationalhealth service.

One of his early reports, quoted below, gives aclear picture of some of the results obtained fromthe training courses.

The results of the first training course, whichended on 12 February as per schedule, are highlyencouraging : most of the students can nowsterilize their simple supplies, and can carry outimmunizations and simple but important sanitarymeasures ; they can delouse clothes by hot air,and can construct satisfactory latrines. Theyhave made sanitary surveys and readily recognizedefects in the water supply and breeding places forflies and insects. They can conduct deliveries ona phantom (model) and, using each other assubjects, carry out satisfactory first-aid measures,such as giving artificial respiration, applyingbandages, splints and plaster casts and transportingpatients. They can draw blood from a vein andgive intravenous and hypodermic injections. Inthe laboratory they are able to recognize eggs ofthe usual intestinal parasites under the microscopeand can stain and demonstrate tubercle bacilli inthe sputum. They know, theoretically, at least,the characteristics of the common infectiousdiseases.

Other field activities concerned the control ofepidemics. Health authorities interested incampaigns against cholera, typhoid and schisto-somiasis (bilharziasis-serious in SouthwestChekiang) were given expert advice by WHOconsultants on methods of control. Conditionsprevailing in various areas were studied andreported on. The Plague Prevention Bureau inFoochow was assisted in launching a large-scale


plague control campaign, WHO contributingequipment and supplies. WHO also suppliedsulfa derivatives for an antitrachoma campaignin Shanghai.

In addition, a WHO bacteriologist assistedin the work of the Shanghai Branch Institute forBiological Production ; and aid was given, atUNESCO's request, in an audio-visual healtheducation project for the province of Szechucan.A large number of technical documents wereproduced as the result of surveys and researchby WHO personnel stationed in China.

Nine fellowships were awarded for study invarious fields such as communicable diseases,maternal and child health, public-health adminis-tration, sanitation and basic medical sciences.

Indonesia 9

The Government of Indonesia having requestedexpert advice regarding a project against yaws,a venereal-disease consultant, on the staff of theRegional Office for South-East Asia, visitedIndonesia in December to consult and assistthe health authorities in preparing a plan ofoperation for this project, for which UNICEF hasearmarked $700,000 to be spent on supplies.Arrangements were made for a WHO specialistin yaws to be sent to Indonesia for a period ofsix months.

Another WHO consultant, assigned to theUNICEF Far Eastern Mission, gave advice onmalaria problems within the country.

Two UNICEF fellowships were administered,both for the study of communicable diseases.

Malay Peninsula, North Borneo, Brunei andSarawak

A WHO consultant assigned to the UNICEFFar Eastern Mission visited Malaya and NorthBorneo to advise on malaria problems in thearea. Requests for joint WHO/UNICEF assis-tance on tuberculosis projects, with specialreference to BCG vaccination, were also receivedfrom Malaya and Singapore.

Technical assistance in connexion with maternaland child health programmes was given by aWHO consultant in North Borneo and Malaya.

0 Not yet a Member of WHO at the end of theyear,

At the end of the year, nurses had been recruitedto organize projects in this field in both Bruneiand Sarawak, and a more comprehensive teamwas being planned for Malaya.

Republic of the Philippines

In response to a request from the Governmentof the Philippines, a WHO consultant and anadviser from the Regional Office for South-EastAsia assisted the health authorities in planninga national campaign to combat venereal diseasesand also in working out a yaws-syphilis pro-gramme, the supplies to be provided by UNICEF.

In addition, a WHO consultant gave technicalassistance in setting up a maternal and childhealth project, assistance also being given byUNICEF ; another consultant was assigned toassist with the organization of a mental healthprogramme and, specifically, to do preparatorywork in connexion with a proposed WHO/UNICEF project on child guidance clinics.

A WHO sanitary engineer was sent to thePhilippines to give advice on national sanitationprogrammes, and a WHO consultant attached tothe UNICEF Far Eastern Mission gave advice onproblems of malaria control.

At the end of the year, a request for jointWHO/UNICEF assistance on tuberculosis prob-lems, with special reference to BCG vaccination,and another for a demonstration team in nutrition(to consist of a medical public-health nutritionist,a hospital dietician and a medical biochemist)were being considered.

Five fellowships were awarded, one for studyin public-health administration, one for study insanitation, two for the study of communicablediseases and one for study in other public-healthservices.

South Korea

South Korea became a Member of the Organiza-tion in August 1949.

At the request of the Government, a maternaland child health team was appointed to adviseon the organization of services in that field, tostart a children's centre (a training institute ofchild health in Seoul) with UNICEF help, andto carry out model teaching in both socialand clinical paediatrics (and obstetrics). A paedia-trician and a public-health nurse have beenappointed, and operations will begin early in 1950.

Two WHO fellowships for the study of com-municable diseases were awarded during 1949.


South-East Asia Region

The Regional Office for South-East Asia beganto operate on 1 January 1949, with headquartersin New Delhi. The staff, which was at firstvery small, has gradually increased ; adequateoffice space was secured by the end of the year ;office services, a library and an active informationsection were organized ; communications betweenNew Delhi and Headquarters were ensured bya weekly air pouch service.

An adviser in maternal and child health wasassigned to the technical staff late in the year.Consultants in malaria, tuberculosis and venerealdiseases visited the region, and operations, in theform of surveys and demonstration teams, werewell under way. Of special note was the activeparticipation of the governments of the countriesin which demonstration teams were established ;they supplied personnel, and local currency forexpenses incurred in the country, and, in somecases, set up parallel projects.

In November, the Joint OIHP/WHO Study-Group on Cholera met in New Delhi, and touredthe cholera areas of the region. In December,the region was visited by the chiefs of the sectionson malaria and tuberculosis at Headquarters.At a meeting arranged for seven malaria demon-stration team leaders, the need for expandingactivities and the problems of supplies, equipmentand exchange of information during 1949 and1950 were discussed.

From 26 to 28 September, the Regional Com-mittee held its second session in New Delhi.11 Inaddition to the representatives of the MemberStates within the region, delegates from Franceand Portugal were present as representatives ofthe countries for which they are responsible ;representatives of the United Nations, the special-ized agencies with offices in the region, and theIndian Red Cross attended the session, and alsothe Assistant Director-General in charge ofoperations at Headquarters. The immediatehealth problems of the countries in the regionwere considered, and suggestions were made forthe programme of 1950 and 1951. In additionto the major programmes of WHO, specialemphasis was placed on the acute need for assis-tance in relation to medical supplies, housing andthe strengthening of national training centres.

Co-operation was maintained with the special-ized agencies having offices in Delhi and alsowith UNICEF, particularly with regard tomalaria demonstration teams, proposed tuber-culosis centres and a joint anti-venereal-diseaseprogramme.

10 This region comprises Burma., Thailand, Ceylon,Afghanistan, India and possibly the Malay Penin-sula (report included in the Western Pacific Region).It was delineated by the First Health Assembly.See 09. Rec. World Hltli Org. 13, 330.

11 For report on the session, see og. Rec. WorldHltlz Org. 25, Annex 11.

Close collaboration was maintained with theUNICEF Mission to the Far East, and a WHOmedical officer vas appointed to represent theOrganization at the UNICEF office in Bangkok,Numerous projects were worked out for both theSouth-East Asia and Western Pacific regions.

In co-operation with the Government of India,arrangements were completed with FAO forconducting agricultural economic surveys ofareas where WHO/UNICEF malaria controlprojects are in progress. A similar survey wascompleted in the area being controlled by theWHO malaria team in Thailand.

Details of the operations carried out within thevarious countries will be found below.

Afghanistan

During the early part of 1949, a three-months'survey of the malaria situation in Afghanistanwas carried out by a small team of expertsappointed by WHO. This was followed by a pilotdemonstration project.

The reports of both the survey and the pilotproject emphasized the seriousness of the malariaproblem and the need for a full-scale demonstra-tion, which Afghanistan has requested for 1950.The following details may be of interest.

The survey team working in ten different loca-lities in the Eastern Province incriminated bothA. culicifacies and A. superpictus as the vectorspecies, and carried out studies on their bionomics.The survey was followed by a small-scale demon-stration of malaria control by DDT residual sprayingin an area containing a maximum of 15,000 people.The team, consisting of an entomologist and amalaria inspector, started operations in July 1949,and finished at the end of October. This was thefirst time that malaria control by insecticidespraying had been demonstrated in this country ;up till then only anti-larval measures had beenpractised.

The demonstration unit was established in theLaghman District of the Eastern Province, betweenthe Allingar and Allishong Rivers, a well-populatedrice-growing area where malaria is hyperendemic.The headquarters of the team were established inKalatussiraj.

In July the pre-operational phase was started ;it continued into August, when DDT spraying wasbegun ; the operational phase was completed bythe end of August.

It was shown by the post-operational survey thatanopheles densities were controlled 12 weeks afterspraying, and, further, that control might beeffected even if the population slept out of doorsduring the summer months.

In response to a request for assistance in organ-izing venereal-disease control measures, a WHOconsultant carried out a preliminary survey, whichrevealed a very high incidence of these diseases


and the urgent need for initiating a national anti-venereal-disease programme, including the re-organization of the laboratory services. A WHO/UNICEF demonstration project during 1950 isvisualized as a result of this survey.

Emergency assistance was requested when anoutbreak of louse-borne typhus occurred inJuly. A loan of typhus vaccine was obtained fromthe Government of India ; supplies were imme-diately despatched by air through the PanAmerican Sanitary Bureau, Washington, andtechnical assistance was provided in organizingcontrol services. In addition, demonstrationswere given of methods to be adopted to preventan increased yearly incidence of this disease,which occurs during the winter months. Thepublic-health sanitarian sent to Afghanistanto help with this problem finished his assignmentin November, and at the end of the year a healthofficer was appointed to demonstrate the tech-niques of typhus control during the first threemonths of 1950, to cover the worst of the epidemicseason.

A WHO medical officer, assisted by UNICEF,investigated needs in the field of maternal andchild health, in preparation for a joint projectrequested by the Government. Proposals weremade for local training of nurses and midwivesand for assistance in paediatric services.

In addition to supplies for typhus control, suchas DDT, spraying equipment, vaccines andsyringes, etc., Afghanistan was allotted medicalliterature and equipment. During the year fourfellowships were awarded ; three for the studyof communicable diseases and one for study inmaternal and child health.

Afghanistan's chief need is the organization ofpublic-health services. It is expected that anexpert in health administration will be assignedfor a two-year period to assist in the establishmentof these services along modern lines.

Burma

Plans for giving technical assistance to Burmawere delayed by disturbed conditions in thecountry. WHO collaborated with UNICEF in ateaching and training project, however, for whichit was envisaged that a centre would be establishedin Rangoon. In this connexion, the chief of theTuberculosis Section at Headquarters paid avisit to Burma during 1949.

With the assistance of UNICEF, an anti-venereal-disease campaign was organized duringthe year, a WHO consultant giving technicaladvice. This included the establishment of amodern venereal-disease clinic with the necessarylaboratory facilities.

In maternal and child health, a training pro-gramme for nurses and midwives was proposed ;advice on this programme was given by a WHOconsultant, and supplies will be provided byUNICEF.

Other urgent needs were for professors in themedical college, and for laboratory and teachingequipment, the bulk of which was lost during thewar. WHO provided a considerable sum for thepurchase of such equipment in 1949.

Eight fellowships were applied for, but owingto the disturbed conditions in the country theycould not be taken up.

Ceylon

To assist anti-tuberculosis programmes inCeylon in 1949, BCG vaccination was carried outby the Joint Enterprise and a short survey oftuberculosis services was made. The WHOconsultant who conducted the survey found thecountry suitable for the establishment of aUNICEF/WHO teaching and training centre,possibly at Colombo, with which BCG work couldbe integrated and which would offer postgraduatetraining to medical students and other personnelfrom Burma and Thailand.

With a view to the development of a projectagainst venereal diseases with the assistance ofWHO and UNICEF, a WHO consultant dis-cussed problems with the health administrationand held a seminar on venereal-disease control,oriented to present the public-health, social andmedical aspects of venereal diseases, with lecturesand demonstrations. The Department of Medicaland Sanitary Services issued a publicationentitled Modern Concepts of Syphilis Control,in which the consultant, the members of theWHO venereal-disease demonstration team inIndia, and the medical officer in charge ofvenereal-disease control in Ceylon collaborated.

In connexion with WHO/UNICEF programmesin maternal and child health, another WHOexpert visited Ceylon. At the end of the year, anutritionist was being recruited for a survey ofthe endemic goitre situation.

A survey of filariasis in the island was alsomade by WHO ; detailed recommendations forcontrol measures to combat this disease weresubmitted, and assistance given in training thenecessary field and laboratory personnel to carryout such measures.

WHO allotted a small sum in its budget for1949 for the purchase of medical literature andteaching equipment for Ceylon.

Ceylon has a well-organized public-healthservice, but needs the temporary services of alaboratory specialist to develop its medicalresearch institute. The Government has alsoasked for assistance in providing teaching equip-ment and personnel for its school of nursing.

In a campaign against malaria, Ceylon hascarried out a very successful country-wide DDTspraying programme, which resulted in a greatreduction of the disease. Technical advice on the


advisability of undertaking a malaria eradicationcampaign has been requested, and at the end ofthe year plans were being made to send a WHOconsultant to help with this problem.

Six fellowships were awarded during the year,four for the study of communicable diseases andtwo for study in maternal and child health.

India

In India, projects in malaria control, under thetechnical supervision of WHO, with suppliesfurnished by UNICEF, have been pushed ahead.Three demonstration projects were establishedduring 1949, one at Terai in the United Pi ovinces,one in the Jeypore Hills in Orissa, and one atMalnad in Mysore ; and by the end of the yeara fourth was being established at Ernad in theMalabar District. In addition to controlling thelocal malaria situation and training technicalpersonnel, the teams assigned to these areas havedemonstrated large-scale DDT control. As thecontrol of malaria is such an important part of theactivities of WHO, and as the work done inthese first demonstration areas may providevaluable information on setting up and conductingfuture demonstrations, it is described in somedetail below. It is, of course, too early to discussthe results of the projects.

Team No. 1 - Terai

The Terai was first visited by two experts, forthe purpose of choosing an area for the demonstra-tion project. Temporary headquarters weresubsequently established in an abandoned sugarfactory-the only suitable place-at Gokulnagar,District of Nainital. The team leader arrived inthe Terai in April 1949, followed by the public-health nurse, and the entomologist and the othermembers of the team were appointed by theIndian Government during May and June.

The Terai has a superficial area of about 650square miles, and is divided by the main roadbetween Bareilly and Nainital. The section tothe west of the road was chosen as the demonstra-tion area, and that to the east as the check area.An indication of the seriousness of the disease inthe region is the fact that out of 520 villages,104 were entirely abandoned on account of malaria.The population of the demonstration area, originallyestimated to be 32,209, was found to be 26,000 ;12,000 of these persons were being protected bya United Provinces malaria control team operatingside by side with the WHO project. When theoriginal team leader resigned in September onaccount of ill-health, he was replaced by a memberof the Malaria Institute of India until a WHOrelief arrived at the beginning of December.During October, because of a resumption ofactivities at the sugar factory, the headquartersof the team were moved to Haldwani (to the north)which was more central and provided moreamenities for the team.

The pre-operational survey was started in April,and spraying began at the end of May. Despitepoor lines of communication, other initial diffi-culties, and the monsoon, which started on 26 June,the initial spraying of all accessible villages wascompleted by the first week in July. The opera-tional period ended in the middle of July, andpost-operative investigations were continued untilOctober, when a second spraying of some of thevillages in the demonstration area was carriedout. Early reports on the first spraying showedthat some mosquitoes (anophelines and culicines)were found in sprayed premises. Replastering ofwalls was recorded in about 7 % of the houses,and reroofing in 23 %. In some villages, replas-tering and reroofing of as many as 90 % of thehouses was recorded. It is too early to statewhether the number of mosquitoes found was dueto rapid deterioration of the in secticide or highdeposit of smoke on the treated surfaces, or whe-ther the quality of the DDT was not up to thenecessary standard. This matter is being investi-gated. The public-health nurse visited over 55villages, treated malaria victims, and found casesof other infectious diseases. A second entomologicalunit was established at Setuya, towards the easternborder of the area, from which a survey of EastTerai, which will be sprayed next year, was begun.

The breeding of the vector, A. fluviatelis, hasincreased. The larvae of A. minimus have not yetbeen found. Up to the time at which the reportof the demonstration team was written, no infectedmosquito had been found in any village in thedemonstration area. At the end of the year, theteam was investigating the causes of the widevariation in the residual action of the DDT sprayedin the villages of the area. It is interesting tonote that on the basis of a rumour that Terai wasno longer deadly on account of malaria, 250 refugeefamilies had arrived in this area and more wereexpected.

Team No. 2 - Jeypore Hills Tracts

In the Jeypore Hills Tracts the area selectedfor demonstrations was located in a long, narrowflat-bottomed valley running north from Rayagadato Ambordala. The road and railway betweenthese cities divide the valley into two parts ;the region to the east (about 450 square miles)was chosen as the demonstration area and thatto the west (about 500 square miles) as the checkarea. The headquarters of the team were in Raya-gada, and for administrative purposes the demon-stration area was divided into four sections. Itspopulation is estimated to be 56,000. BetweenAugust and January the transmission period in thearea reached a peak ; the vectors are A. fluviatelis,A. minimus and A. vurana.

The team leader arrived in Rayagada in May,the WHO public-health nurse in July, and theentomologist and the national members appointedby the Indian Government in June and July.In May, the pre-operational survey was startedand was continued until the operational phase,which began in July. By the end of August,when spraying was stopped because of the mon-soons, 36,000 persons had been protected. BetweenAugust and October all team members concentrated


on public-health propaganda, and when the rainsceased at the end of October spraying was continuedand the whole area completed.

Throughout the area, active help was given tothe public-health nurse. Several small clinicswere started ; paludrine was distributed ; andacute malaria cases were treated in the villages,where child-welfare education was also carried onwith the help of the local nursing staff.

By the end of the year, the post-operationalsurvey had been begun.

Team No. 3 - Malnad

The site chosen for this demonstration projectwas in the Mysore State near the town of Sagar.The superficial area is large (748 square miles)but sparsely populated (67 inhabitants per squaremile only).

The team leader arrived in June, as did themalariologist and entomologist appointed by theIndian Government, and also the national officialsappointed to work with the members of the team ;the public-health nurse came in July.

The pre-operation survey was carried outbetween July and August ; DDT spraying opera-tions started on 12 August and were completedby 1 November. UNICEF supplies, equipmentand transport arrived on schec' ule, and problemswhich arose in other areas owing to delayed arrivalof supplies were thus avoided.

The post-operational survey was begun and iscontinuing.

In November the team assisted the State autho-rities in dealing with a plague outbreak in ShimogaTown, where satisfactory results were obtainedby the use of residual DDT spraying modified toact as a pulicide.

Team No. 4 - Ernad

It was decided that the fourth demonstrationproject should be established in the MalabarDistrict.

The headquarters of the team will be inNalambor, Ernad Taluk. The area to be put undercontrol is the western part of Ernad Taluk, to becompared with an area in the western part ofWaluvanada, Taluk. The district lies about 20to 30 miles from the sea, south-east of Calicut,and has an area of about 600 square miles. Thevector is known to be A. fluviatilis, and malariais hyperendemic, hampering the production ofrice and the development of the timber industry.Communications are good, and there will be ade-quate accommodation for the team.

The team arrived in the demonstration area inDecember and the pre-operational survey wasbegun. Supplies, equipment and transport willshortly be delivered. It is expected that theoperational phase will begin in January 1950.

WHO malaria consultants and sanitaryengineers visited India in connexion with theteams and with malaria problems in general ;

the work of all the teams was inspected at thethe end of the year by the chief of section at Head-quarters ; a consultant assigned to the UNICEFFar Eastern Mission also advised regularly onmalaria problems ; a special course was organ-ized at the Malaria Institute of India, and themalaria engineer gave lectures at some of thetraining institutions.

In conjunction with the malaria demonstrationprojects, FAO agreed to assign an agriculturaleconomist to co-operate with WHO and thenational government, and an expert from theFAO Agricultural Division made a short tourof India and Pakistan to conduct surveys. Inorder to assess the economic effect of malariacontrol, it is planned to make such a survey ineach of the four areas selected for malaria-controldemonstration projects, to serve as a basis forcomparison after a few years when malaria isunder control ; ways of developing the agriculturaleconomy of the area under demonstration mayalso be found by means of the surveys.

A WHO demonstration project was alsoestablished in India for venereal diseases, thearea chosen being Simla (Himachal Pradesh),which, in a preliminary survey, appeared to beheavily infected.

The team was composed of the team leader, whoarrived in India in April, a serologist and venereo-logist, local staff, and a public-health nurse, whojoined the team in October. Actual work began inJune, in the Ripon hospital, where cases of earlysyphilis were treated. In July a training programmefor about 155 persons was initiated. In Decembertwo national teams, each consisting of a clinician,a serologist and a nurse, began training with theWHO team. By the end of the year, large-scaletraining programmes were under way, and alsomass blood-testing surveys of the local population,organized conferences and demonstrations. Alecture at the team laboratory included an accountof modern serologic techniques and a demonstrationof the Meinicke and VDRL (using the cardiolipinantigen) tests.

A temporary venereal-disease consultant co-operated closely with the team in working outtraining programmes. He surveyed venereal-disease services in Simla, Delhi, Calcutta, Madras,Bangalore, Mysore and Bombay, addressing manyseminars, where he aroused much interest in thepublic-health aspect of the programmes. At theend of 1949 arrangements were being made for theestablishment of six satellite teams in six of themore important provinces in India. This willinvolve training the technical personnel required,as well as the provision of a certain amount oflaboratory equipment and supplies for treatment(from UNICEF sources) ang the possible appoint-ment of WHO technicians for a limited period.

WHO also advised on a clinical demonstrationscheme for the treatment of early syphilis with


procaine penicillin, which was established atMadras.

In connexion with the BCG work undertakenby six teams under the auspices of the JointEnterprise, a WHO research team was sent toIndia to obtain information on tuberculin testing.A WHO consultant on tuberculosis examinedproposals for the selection of areas in whichtraining centres are to be established, the BCGwork in India to be integrated with these centres.In December, the chief of the section at Head-quarters also discussed training centres withofficials at the regional office. A plan of operationsfor the establishment of three such centres inNew Delhi, Patna and Trivandrum was beingprepared, and possibilities of assisting in theMadarapalli Research Project and thoracic surgeryunit at Val lore were considered. A conference ofIndian tuberculosis workers held in Bombayduring the year was attended and addressed bythe tuberculosis consultant from Headquarters.

In the field of maternal and child health, a" reconnaissance " team consisting of a paedia-trician and paediatric nurse was assigned toIndia, and arrived in New Delhi in October. Theteam members visited numerous hospitals, trainingcentres, child welfare centres and health units invarious parts of the country, and at the end of theyear they were seeking the most suitable locationfor a demonstration area. The nurse assignedto the team represented WHO at a meeting ofthe Trained Nurses Association of India inBombay in November, and at the end of themonth began to teach paediatric nursing at theCollege of Nursing in New Delhi. Other assistancehas also been given in strengthening the teachingstaff of this college and in providing teachingequipment. The adviser in maternal and childhealth to the regional office arrived in Indiain November, and prepared a symposium onmaternal and child health, which started inNew Delhi on 30 December. Nearly sixtymaternal and child health workers from all overIndia attended, including doctors, nurses, mid-wives, social workers and educationists.

A Headquarters expert on health education ofthe public also visited India in September, anddelivered lectures in Madras, Calcutta and NewDelhi, after attending part of the UNESCOSeminar on Rural Education in Mysore. Thequestion of providing a consultant in healtheducation to assist the All-India Institute ofPublic Health, Calcutta, was discussed.

Poliomyelitis, comparatively rare in India,where it has riot been recorded as reaching epi-demic proportions, became more serious during theyear in Bombay and a few other centres. At therequest of the Government, special literatureand iron lungs and portable respirators were made

available. A consultant, a nurse and a physio-therapist will shortly be sent to assist in theorganization of polio research and of rehabilitationservices in the country.

One of the principal recommendations made bythe Joint OIHP/WHO Study-Group on Cholera,at its meeting in New Delhi in November, wasthat two cholera control teams should be setup. One of these is being planned for the CauveryDelta region of Madras Province, India, for 1950.The group expressed appreciation of the researchwork being carried out by the Indian ResearchFund Association.

Laboratory and teaching equipment wereprovided, especially for the use of the MalariaInstitute of India, in which special courses havebeen arranged ; one consignment of maternaland child health equipment and supplies andthree of literature were also sent to India.

Eighteen fellowships were awarded, nine ofwhich were for study in public-health administra-tion. Fourteen others were administered byWHO for UNICEF.

Thailand

A WHO consultant on malaria was sent toThailand. Later, at the request of the Govern-ment, a malaria demonstration project wasestablished by WHO with supplies furnished byUNICEF.

The Thailand team has had two main. objec-tives : (1) to establish the vectors of malaria inThailand, and to study their bionomics ; and(2) to demonstrate modern methods of malariacontrol to the Government.

The first phase of the demonstration was startedin July, when the team leader arrived in thecountry. The area chosen was in the Serapeedistrict near Chiengmai, in the north of Thailand.The headquarters of the team, consisting of anentomologist, a malaria inspector, a laboratoryassistant and two insect collectors, were establishedin Chiengmai. Based on a recent population censusand a census of buildings, the estimated size of thearea to be sprayed was approximately 51,151,890square feet.

In August, when the team reached full strength,the programme began to expand, and by Novemberthe first objective had been reached. It asestablished that the vector was A. minimus, andsufficient information regarding its habits andcharacteristics was available on which to base aDDT spraying campaign for 1950.

The Thailand team reported during themonth of November that work was proceedingtowards defining accurately the habits ofA. minimus so that the application of DDT as aresidual insecticide would be effective. One of thechief difficulties met with was :the fact that themosquito preferred to rest on dark objects hangingon the walls rather than on the walls themselves.This was due apparently to the transparency of the


interlaced bamboo walls which were commonin the demonstration area. Another disturbingfinding was that 21.7 % of the minimus caughtwere found in bamboo clumps outside dwellingsand other man-made shelters.12 The unevensurface of the plaited bamboo required moreDDT than a smooth plastered wall of equaldimensions. Statistics submitted so far showedthat there was an average of approximately threeinhabitants per house in the demonstration area,and that the average surface in each house whichwould be sprayed would be about 3,200 squarefeet, or about 100 square metres per inhabitant,instead of 50 square metres. As the demonstrationprojects had been based on a maximum of 50square metres per capita (which had been foundcorrect by all teams), it was to be expected thatthe cost per capita of this demonstration would behigher than in other countries unless some modifi-cation of the spraying technique could be devised.

At the end of the year, plans for the demonstra-tion in 1950 were well advanced. All supplies,equipment and transport were delivered, and theteam was increased by the addition of a public-health nurse and a public-health sanitarian. Inaddition to appointing a team of national officialsworking with the WHO personnel, the ThailandGovernment established a parallel project adjoiningthe Serapee, which, although operating inde-pendently, was under the technical direction of theWHO team leader.

In co-operation with the Government and WHO,a FAO economist was engaged in an agriculturaleconomic survey of the area.

The team was visited by the chief of sectionfrom Headquarters, and the WHO malariaconsultant assigned to the UNICEF Mission to theFar East, with headquarters in Bangkok, alsoadvised on malaria problems in Thailand.

In anticipation of campaigns against tuber-culosis, a plan of operations for a UNICEF/WHOtuberculosis and training project was under wayat the end of the year ; work on this project willbegin in 1950.

At the request of the Government, Thailandwas visited by a consultant on venereal diseasesin November, and plans are far advanced for aproject in yaws control for 1950, to be carriedout with the assistance of WHO and UNICEF.A plan of operations is also under way for WHO/UNICEF assistance in improving the services inmaternal and child health. A WHO consultantvisited Thailand to advise on this project.

One consignment of equipment and suppliesand four of literature were provided for the useof the malaria team. Literature on maternaland child health was also sent. Eight fellowshipswere awarded, six for the study of communicablediseases and one each for study in maternal andchild health and other public-health services ;five UNICEF fellowships were administered.

European Region 13

Special Office for Europe

A Special Office for Europe was established on1 January 1949 at Headquarters in Geneva, toadminister the regular WHO advisory anddemonstration programmes in Europe pendingthe setting up of a full regional office. By theend of the year, 14 of the 27 Member States inthe region had agreed to the establishment of aregional office.

The routine work of the Office throughoutthe year was done by a small staff, an economymade possible by the fact that the Office waslocated at Headquarters. As the year advancedand the special problems of Europe crystallized,various members of the Headquarters staff wereassigned to the Special Office for short or longperiods as advisers on the field programmesundertaken.

12 This type of wall will have an effect upon theamount of DDT used.

13 This region comprises the whole of Europe,including Greece but excluding Turkey, accordingto decisions of- the First and Second HealthAssemblies, og. Rec. World Hlth Org. 13, 330 ; 21, 53.

In co-operation with the Industry and MaterialsDivision of the Economic Commission for Europe,WHO, through its Supply Section and the SpecialOffice, has administered programmes to meetthe medical supply problems in the region. Atechnical conference was held in Geneva inFebruary, at which Poland, Czechoslovakia andYugoslavia were represented, and plans weredrawn up by which assistance has been grantedin rehabilitating the UNRRA-donated penicillinplants in Europe. Advice has been given ontechnical production and on the sources, costand availability of equipment for modern peni-cillin production plants, and plans have beendeveloped to a point where they have arousedthe interest of other countries which are beginningto produce penicillin.

WHO also co-operated with ECE in evolvingother co-operative programmes such as theprovision of biological and pharmaceutical pro-ducts (streptomycin, DDT and other materialsfor malaria control), specialized medical equip-ment for hospitals and laboratories (includingspare parts and replacements for UNRRA-


donated equipment), teaching equipment fortraining centres, and other programmes designedto overcome shortage of health personnel. Theseprogrammes were based on priorities set up byEuropean Member States at a conference heldin November 1948.

In the technically highly-developed region ofEurope there was not a great demand for theservices of consultants in basic health needs,except in the post-war problems of venerealdiseases, tuberculosis and maternal and childhealth. To advise on particular aspects of theseproblems in various countries, short-term consul-tants and WHO technicians were provided ;general public-health advisers were also employedin several countries, and individual experts weresent out to advise on other special problems.

The largest single project organized andadministered by the Special Office was in co-operation with the Rockefeller Foundation,assistance being given to the Italian Governmentin a survey of its health services."

An interesting development was a request fromthe Government of Albania for undergraduatefellowships, the first of its kind to be receivedby WHO. As Albania had no medical school,five such fellowships were granted for study atCharles University, Prague.

Allotment of funds for medical literature andteaching equipment to European countries pro-ceeded piecemeal at the beginning of the year,to meet only urgent requests. As informationon needs became more complete, general allot-ments were issued in the second half of the year,and their number was much increased.

It was found by experience and by the typeof requests received that a programme based onthe priorities voted by the Health Assembly wasnot entirely suitable for the special needs ofEurope. Preliminary enquiry having indicatedthat specialist personnel could be made availablefor several projects which might be of interest toEuropean countries, a series of visits was madeto 17 countries, with the object of exploring thespecific needs of individual countries and thefacilities available in the region.

By the end of the year, formal requests hadnot yet been received from all the countriesvisited, but the following specific projects hadeither been agreed upon with the governments, or

14 For details of survey, see Italy, p. 43.

were being actively discussed with them, or hadalready been begun :

(1) A State medical library and medicaldocumentation centre, set up by the Govern-ment of Czechoslovakia in Prague.

(2) Two anaesthesiology training centres, oneto be located in Prague and the other inCopenhagen.

(3) A biochemistry training centre, to be setup in Wroclaw by the Government of Poland.

(4) A venereal-diseases training centre inWarsaw.

(5) An antibiotic training centre at theDepartment of Biochemistry in the SuperiorHealth Institute in Rome.

(6) Three study seminars, to be conducted byvisiting experts, to promote the exchange ofinformation on highly-specialized problems inthe control of syphilis, in infant metabolismand in congenital heart disease. Two focalpoints were being contemplated for the syphilisstudy seminar-one in Western and the otherin Northern Europe. It was thought that theinfant metabolism seminar might be held inthe Netherlands and Sweden, and that membersof the congenital heart-disease team, recruitedfrom Sweden, might visit Austria and Czecho-slovakia.

In addition, the United Nations Departmentof Social Affairs has sought the co-operation ofWHO and other specialized agencies in developingsocial rehabilitation programmes for such Euro-pean countries as wish for assistance. It is hopedthat this project, which is at present beingdiscussed, will be begun in 1950.

WHO's contribution to these various schemeswill consist in supplying books, periodicals, basicequipment, technical advice, teaching staff, andgrants for specific purposes.

Details of operations being carried out in thecountries of the region are given below.

Albania

In the early part of the year, detailed discussionstook place with the Chief of the InternationalDivision of the Ministry of Foreign Affairs inAlbania regarding advisory services in the fourpriority fields, for which funds ha,d been availablesince the latter part of 1948. Provisional agree-


ment was reached on a programme for demon-strating the control of fuberculosis and syphilis.

Subsequently, however, the health authoritiesindicated that outside experts were not requiredfor a demonstration programme on the use ofpenicillin and streptomycin (the supplies to beprovided by WHO), and WHO therefore invitedthem to nominate their own experts to join in ageneral study tour of countries in which thesedrugs are at the present time widely used.

The Government was also consulted by WHOin connexion with sending an expert in malariato Albania to help organise a programme for1950.

General books and periodicals were supplied,and five fellowships were awarded to under-graduate students from Albania with the co-operation of the Ministry of Health of Czecho-slovakia.

Austria

At the Government's request, two WHOexperts visited Austria during the year, one tolecture on the modern treatment of syphilis atuniversity clinics in Graz, Innsbruck and Vienna,and the other to assist in the development of amental health programme.

In connexion with the BCG vaccinationcampaign which is being carried on by the JointEnterprise, the Austrian Ministry of SocialWelfare signed an agreement in December underwhich WHO will establish central statisticalservices in Vienna for collecting and compilinginformation on the campaign.

During the latter part of the year, numerousconferences were held with officials of the Ministryof Public Welfare regarding the needs of thecountry in relation to the services offered byWHO. The Government has already submittedrequests for 1950 and 1951 as a result of theseconferences, and by the end of the year arrange-ments were nearing completion for a visit of theWHO congenital heart-disease team, composedof experts from Sweden, in 1950. This team willdemonstrate and discuss the diagnosis andmanagement of congenital heart diseases, and willperform operations on selected cases.

General books and periodicals were supplied byWHO, and eleven fellowships were awarded, threeof which were for the study of communicablediseases.

Belgium

In March, the health authorities in Belgium andrepresentatives of the International Union againstVenereal Diseases were interviewed regarding

a project for the control of venereal diseases anda proposed Rhine River Commission, also fortheir control. Subsequently, in response to aformal request from Belgium and other interestedcountries, a preparatory meeting for constitutingthe commission was called, and was held inGeneva from 30 May to 1 June. Belgium wasrepresented at this meeting, and an expert fromBelgium participated in a group survey ofvenereal-disease treatment facilities along theRhine which was organized by WHO.

Arrangements were made to send penicillin toLiége for demonstrations of treatment of earlysyphilis with procaine penicillin aluminium-mo-nostearate.

During the year, WHO completed a surveyof tuberculosis prevalence in Belgium ; a regionaladviser gave expert advice on maternal andchild health, and another expert visited Belgiumto confer with various health officials on plansfor 1950 and 1951, drawing attention to the typesof assistance available through WHO. As aresult of this latter visit, the Government wasplanning, at the end of the year, to send three ofBelgium's leading paediatricians to take part inan infant metabolism seminar in the Netherlandsin 1950.

One fellowship was awarded to Belgium.

Bulgaria 16

In reply to a request from the Government forassistance in its projects for malaria and insectcontrol, a WHO consultant visited Bulgaria toexamine the proposed plan, and WHO recom-mended that UNICEF should provide the suppliesand equipment requested by the BulgarianGovernment.

In response to other requests from the Govern-ment, help was given in campaigns againstsyphilis by treatment with penicillin, and aWHO expert in venereal diseases, assigned asconsultant for the WHO/UNICEF syphilis eradi-cation programmes, carried out a lecture tour inBulgaria. Work on the serological test per-formance evaluation scheme, extended to Sofiain 1948, was also continued.

Books and periodicals, chiefly relating tomalaria and venereal-disease control, weresupplied, and two fellowships were awarded, bothfor the study of communicable diseases.

Byelorussian SSR 16

General books and periodicals were suppliedto the Byelorussian SSR, although funds were

15 In December, announced its intention towithdraw from WHO.

16 Stated in 1948 that it no longer considereditself to be a Member of WHO.

40 ' ANNUAL REPORT OF THE DIRECTOR-GENERAL

insufficient to fulfil completely the one large requestmade in 1948 ($35,000).

Czechoslovakia

In response to a request from the Government,a WHO consultant on tuberculosis visited Czecho-slovakia to give expert advice in connexion withstreptomycin supplies provided by UNICEF.WHO also began the compilation of statistics onthe results of the BCG vaccination campaign,which, in Czechoslovakia, was completed by theJoint Enterprise during the year.

After the possibilities of launching a generalWHO/UNICEF programme for the control ofvenereal diseases had been surveyed by a WHOconsultant, the Czechoslovak health authoritiesurged the development of the Slovak programmeinto a nation-wide campaign. With this in view,further preliminary investigations on programmeproposals were made by two WHO experts, oneof whom made a lecture tour throughout thecountry. The programme was finally extended toBohemia and Moravia, and penicillin and labora-tory equipment were supplied. During December,a WHO consultant visited Czechoslovakia tofollow up and report on the progress of thecampaigns in Bohemia, Moravia and Slovakia.

Czechoslovakia was represented at a technicalconference, held in Geneva in February, at whichplans were drawn up for the rehabilitation ofUNRRA-donated penicillin plants in Europe,and the Czechoslovak plant, which beganoperating in May, was visited by the Director-General of WHO during the course of a tour ofCzechoslovakia.

As a result of discussions during the latterpart of the year between various health officialsand a WHO expert, Czechoslovakia has under-taken and will participate in the followingspecific projects particularly suited to its ownneeds and to those of the war-damaged countriesin Europe :

(1) A State medical library and medicaldocumentation centre has been set up inPrague by the Government, with the assistanceof WHO. This was done by combining existingmedical libraries, including that of CharlesUniversity, to provide documentation andmicrofilm duplicating services to neighbouringcountries without charge. WHO supplied micro-film equipment, books and periodicals and wasalso asked for technical advice on organizationalproblems. An expert on microfilm copying

services was sent to Prague during Decemberto give advice on this project.

(2) The Czechoslovak Government has alsoundertaken to set up in Prague an anaesthe-siology training centre based on the universitysurgical clinics. This centre will provide a one-year specialist course for 12 to 15 students,two-thirds of whom will come from neigh-bouring countries under the WHO fellowshipscheme. In consultation with prominentanaesthesiologists, WHO has supplied or orderedmost of the equipment needed and not availablein the country (six gas machines of threedifferent models, accessories, drugs and cyclo-propane), and the Organization is proceedingwith the recruitment of two instructors for theteaching staff.

(3) At the end of the year plans were also beingmade for a congenital heart-disease team,composed of experts from Sweden, to visitCzechoslovakia in 1950 at the request of theGovernment.

Fourteen fellowships were awarded to Czecho-slovakia, seven for the study of communicablediseases, one for study in public-health adminis-tration ; three in other public-health activities,and three in other subjects.

Denmark

At the beginning of the year, a model treatmentscheme, based on treatment of early syphiliswith procaine penicillin aluminium-monostearate,was established in Denmark at the Copenhagenuniversity clinic. The serological test performanceevaluation was also extended to Denmark, and,at the request of the Government, Copenhagenwas visited in May by a WHO consultant onvenereal diseases, who surveyed the situationand gave lectures on penicillin therapy andmodern laboratory methods to medical anduniversity societies.

In Copenhagen, discussions on maternal andchild health services took place between theDanish authorities and a regional adviser fromWHO.

At the end of the year, after needs had beeninvestigated and possibilities for WHO assistancediscussed, the Government requested aid insetting up an anaesthesiology training centre forthe Nordic group of countries similar to the oneestablished in Czechoslovakia. It was proposedto use the surgical departments of the universityand municipal hospitals for this purpose, and toopen the first one-year course to twenty physi-cians from the Scandinavian countries. WHOprovided the necessary teaching equipment forthe centre.


Finland

At the request of the Finnish Government,technical assistance was given in connexionwith WHO/UNICEF programmes on maternaland child health.

A WHO consultant went to Finland to adviseon a joint WHO/UNICEF project in venereal-disease control, and gave lectures on variousaspects of the programme. A clinical demon-stration scheme for the treatment of earlysyphilis with penicillin alone was establishedin the university clinic of Helsinki, and arrange-ments were also made to include that city in theserological test performance evaluation scheme.

After the completion of the BCG campaigncarried on by the Joint Enterprise, a WHOresearch group visited the country. It reportedthat the testing and vaccinations were carriedout entirely by Finnish personnel and that mostof the work had been done in a very short time.Vaccination appeared to have been comprehensive,covering all age groups of the population, andthere seemed to be a strong central organizationfor tuberculosis control in the country ; this mayWell offer unique opportunities for intensiveinvestigation into the effect of BCG on tuber-culosis mortality rates.

Books and periodicals, chiefly relating tovenereal-disease control, were supplied, and ninefellowships were awarded (two for the study ofcommunicable diseases, three for study in public-health nursing, three in maternal and childhealth and one in other public-health activities).

At the end of the year, plans were being madeto hold a syphilis study seminar in Finland in1950, and Finland was planning to send threeof her physicians to the training centre foranaesthesiology in Copenhagen, as well as severalpaediatricians to Stockholm to take part in thework of the infant metabolism seminar.

France

In response to a request, a regional adviser onmaternal and child health visited France. Specialstudies on poliomyelitis and premature-babycare were made, and equipment to improve theseservices was obtained through UNICEF. WHOhas co-operated with UNICEF in the workof the BCG pilot station and in the creation of aChildren's Centre in Paris, sponsored by theFrench Government, and will continue to providetechnical advice.

Demonstrations of treatment of early syphiliswith procaine penicillin aluminium-monostearate

were organized by WHO at the Hôpital St. Louisand in Professor Gougerot's clinic in Paris,penicillin supplies also being obtained. Finalarrangements were made for similar demonstrationschemes in clinics in Bordeaux, Lyons andStrasbourg.

In response to a request for the creation of aRhine River Anti-Venereal-Disease Commission,a preparatory meeting, at which France wasrepresented, was held in Geneva in May. Anexpert from France also participated in a WHOsurvey of venereal-disease treatment centresalong the course of the Rhine.

Visits to France were made by the Director-General and other representatives of the Head-quarters staff, who conferred with public-healthofficials and went to see institutions and trainingcentres in Paris and Nancy ; by the Chief of theMental Health Section at Headquarters, whointerviewed officials in various psychiatric traininginstitutions ; and by a consultant in healtheducation of the public. Health authorities wereconsulted regarding specific needs for assistanceand the availability of facilities for regionalprojects. The Government was also consultedon the allotment of the sum provided for medicalliterature and teaching equipment. Six fellow-ships were awarded to France during the year,of which five were for the study of communicablediseases.

At the end of the year discussions wereproceeding with the Government on possibleWHO assistance in establishing an anaesthesiologytraining centre and in holding a syphilis studyseminar for Western Europe centred in Paris.

Germany 17

In response to a request from several interestedcountries-including Germany-for an Anti-Venereal Disease Commission of the Rhine, apreparatory committee was held in Geneva inMay, in which occupying Powers were invited toparticipate. Treatment facilities along the Rhineriver were surveyed later.

In May, the expert on tuberculosis from Head-quarters visited the new sanatorium and thenurses' training school at Wehrawald, Todtmoos,in the French Zone of Germany. The trainingschool was also visited by the expert on nursing.

Greece

Programmes in malaria and tuberculosis controlin Greece progressed normally. In February, the

17 Not yet a Member of WHO at the end ofthe year.


field mission, with its general public-healthadviser, nurse and sanitary engineer, was trans-formed into a field office, in accordance withWHO policy. Members of the mission werewithdrawn gradually, but the chief of the officeremained for most of the year, to advise on public-health administration.

The School of Hygiene continued to exercisegeneral control over the malaria campaign for1949, and consultants on malaria visited Greecein that connexion. The airspray part of thecampaign, whis h had been controlled by relevantsections of UNRRA and WHO, was continued asin earlier years.

When WHO, which had housed the Secretariatof the National Tuberculosis Association ofGreece, terminated its mission in that country,the Secretariat moved to the Chest Institute ofAthens, where the Chief of the TuberculosisSection conferred with offi ials on questions ofadministration and policy. The WHO offi_eassisted in the preparation of information onstreptomycin treatment oi tubercular meningitisand miliary tuberculosis in Athens, and prepareda full review of earlier statistics of the Strepto-mycin Centre in the Children's Hospital.

WHO consultants on streptomycin treatmentcentres and diagnostic laboratory services alsovisited Greece during the year, and assistance wasprovided for setting up three laboratories intuberculosis diagnosis in Athens and Salonika.These services were provided in connexion withthe UNICEF supply programme.

In connexion with the BCG vaccination cam-paign carried on by the Joint Enterprise, aWHO statistician assisted in the organizationof field statistical services.

The public-health nurse taught tuberculosisnursing, set up general training courses, and wassubsequently assigned specifically to assist inorganizing a tuberculosis nurse training schoolat Sotiria sanatorium, the first of its kind inGreece.

In March, arrangements were made to extendthe venereal-disease control programme to Greece,and two consultants were assigned to thatcountry in connexion with UNICEF/WHOprogramme development. In August, Greecewas visited by a further WHO expert in venerealdiseases, who discussed with the health adminis-tration the possibility of making a sample venereal-disease survey preparatory to a proposed jointWHO/UNICEF control programme. Arrange-ments were also made for a penicillin demonstra-tion scheme in Athens.

New efforts were made, in co-operation with theUnited States Mission, towards the rehabilitationof the crippled.

Books and periodicals were supOied for thePiraeus Institute, and two consignments of charts,films with a cinema projector, etc., for the AthensSchool of Hygiene. Three fellowships wereawarded.

Before wiihdrawing from Greece towards theend of the year, the chief of the WHO office inGreece conferred with offi _ials regarding thecountry's need for assistance and the possibilitiesof participation by Greece in programmes plannedfor the European region in 1950.

Hungary

At the request of the Government, UNICEFand WHO assisted Hungary in a programme ofmalaria control ; a WHO consultant was assignedto the cpuntry for a period of two months. Asurvey on tuberculosis was completed, and aWHO consultant on streptomycin advised on theuse of streptomycin supplied by UNICEF.

Hungary, in launching campaigns againstsyphilis by treatment with penicillin, called 6nWHO and UNICEF for assistance, and in thisconnexion a WHO expert inspected clinics andtreatment centres and lectured at the universitiesof Budapest and Pecs.

In October, public-health offi ials in Hungarywere interviewed by a WHO representative withregard to the need for assistance in health projects.Towards the end of the year assistance wasrequested in establishing a virus research andtraining centre.

Medical periodicals were provided, and threeWHO fellowships were awarded, one for study inpublic-health administration, one in communicablediseases and one in surgery.

Iceland

Under the auspices of WHO and UNICEF, aco-operative programme has been undertaken inIceland, to obtain information as to the specificityof the tuberculin test and the significance of non-specific reactions ; the possibility of undertakinga study on tuberculosis infection and morbidityhas also been discussed with the health autho-rities.

Iceland offers an exceptional opportunity forsuch studies. With a population of 140,000, itspeculiar location makes it possible to trace everyperson leaving or entering the country, an idealcondition for setting up a complete national roster'in connexion with its tuberculosis service, thehead of which is a competent specialist who isanxious to collaborate in international research.


Ireland

A WHO representative visited Ireland towardsthe end of the year to discuss needs for assistanceon health programmes and to investigate thefacilities for regional programmes.

Italy

In January, the WHO field mission in Italy,with its two medical offi_ers (one a generalpublic-health adviser) was transformed into afield office, and the personnel was graduallyreduced until, at the end of December, it consistedof one finance and administrative officer only,assigned specifically for the health surveydescribed below.

The nation-wide survey of public health admi-nistration in Italy, for which plans were made in1948, was begun in July and carried out during1949 by the Government and the RockefellerFoundation, assisted by WHO. In this project,the Italian Government surveyed its own healthservices ; the Rockefeller Foundation co-ordinatedthis survey, principally by providing foreigncounterparts to Italian specialists in (a) publichealth organization, (b) health service work,(c) environmental sanitation, (d) medical careand hospital work, (e) juridical and administrativeaspects of health services, and (f) health insuranceand social welfare. WHO helped with the plansand itinerary, and provided some of the experts,either from its Secretariat or by recruitingtemporary consultants from outside the Organ-ization. WHO also provided the executivesecretary during the preliminary period of thesurvey, the abovementioned finance and admi-nistrative officer, and local funds from a sumformerly made available to the WHO missionby the Italian Government. WHO staff engagedin the survey included experts in environmentalsanitation, maternal and child health, venerealdiseases, tuberculosis, malaria, industrial health,public-health statistics, laboratory services, andport and airport sanitation. The survey led toa series of important recommendations, madeat a general conference held in Stresa from15 to 20 September.

In January it was decided that the Instituteof Malariology in Rome should set up a one-month's course and that the Institute of PublicHealth should arrange a two-months' course oninsect control, including field work. Arrangementswere made by the Chief of the Malaria Section atWHO Headquarters, who went to Rome inJanuary, and by WHO malaria consultants whospent short periods of time in Italy.

Several experts on venereal diseases visitedItaly during the course of 1949. A consultanton programme development advised the Govern-ment on its projects against venereal diseases, in

which it was assisted by WHO and UNICEF,and the serological test performance evaluationscheme was extended to a national laboratoryin Naples.

A survey on tuberculosis was also made.

At a meeting in Rome of the Italian FAONational Nutrition Committee, Italy's nutritionproblems were discussed and the committeeindicated the way in which WHO and FAO couldassist. WHO was also represented at a meeting ofthe delegation of the International Union of ChildWelfare which was sent to Italy ; the meetingdiscussed, inter alia, the feeding programme forItalian children.

Medical literature, films, information and othersupplies were provided for Italy during the year,and six fellowships were awarded, of which threewere for study in public-health administration, onefor the study of communicable diseases, and twofor study in maternal and child health.

Further needs for and possibilities of assistancewere discussed with Italian health authorities.A project planned for 1950 is the establishmentof an antibiotic training centre at the Departmentof Biochemistry, in the Superior Health Institutein Rome, to afford basic training in antibiotics,research, and practice in current methods ofpenicillin production. This centre will utilizean UNRRA-donated penicillin plant which isbeing modernized by the Government.

Luxembourg

Luxembourg became a Member of the Organ-ization in June 1949. A WHO representativevisited the country in order to investigate needsfor health programmes and facilities for projectsplanned for the European region.

Monaco

At the end of the year, the Government ofMonaco was being consulted on details connectedwith the allocation of funds set aside for medicalliterature and teaching equipment.

Netherlands

In March, a WHO expert visited the Nether-lands to interview health authorities and represen-tatives of the International Union against VenerealDiseases regarding a request received from severalof the European countries for an Anti-Venereal-Disease Commission of the Rhine. The 1950port demonstration project for control of venerealdisease was also discussed. The Netherlands


took part . in a preparatory meeting subsequentlycalled by WHO in Geneva, at which plans for theCommission were drawn up, and was alsorepresented by an expert on the' venereal diseaseRhine river survey group.

During the year, demonstrations of the treat-ment of early syphilis with procaine penicillinaluminium-monostearate were established at theRotterdam municipal clinic, and a survey wasmade of venereal disease treatment centres alongthe course of the Rhine. A tuberculosis surveywas also completed.

Consultants in the health education of thepublic and in professional and technical trainingvisited the Netherlands, and plans were made forthe organization of a school of public health atthe Institute of Preventive Medicine in Leyden,WHO to assist by supplying travel grants, fellow-ships, and teaching equipment.

At the end of the year, following a visit by aWHO representative, who investigated needs forassistance on health programmes and thefacilities available, the Government requestedthe services of specialized teams. Plans were beingmade to hold an infant metabolism seminar, atwhich specialists would discuss particular problemswith WHO experts.

The Government is also being consulted as to thesum provided for medical

literature and teaching equipment. Three fellow-ships were awarded.

Norway

In January, a model treatment scheme, basedon the treatment of early syphilis with procainepenicillin aluminium-monostearate, was estab-lished in Norway at the Oslo university clinic.A consultant on venereal diseases, who visitedNorway in May, made a survey of the situationand lectured to medical students and societies inBergen and Oslo, and at a meeting of Norwegianpublic-health officers.

Expert advice was given on professional andtechnical education, and on maternal and childhealth.

Plans were made for paediatricians to go toStockholm in 1950 to take part in the seminarson infant metabolism, for physicians to studyat the training centre for anaesthesiology inCopenhagen, and for experts to meet the syphilisteams in Helsinki.

One fellowship was awarded for study in basicmedical sciences, and at the end of the year theGovernment was being consulted on the allocation

of the sum provided for medical literature andteaching equipment.

Poland

In Poland, a WHO x-ray consultant conducteddemonstrations of x-ray technology, at the requestof the Government, and assisted in the publicationof the first manual on x-ray techniques producedin that country. In response to an additionalrequest, a consultant on streptomycin gaveadvice to streptomycin workers who were usingsupplies provided by UNICEF. A survey ontuberculosis was completed during the year.

In connexion with the BCG campaign conductedby the Joint Enterprise, which ended during theyear, a WHO research group visited Poland tomake a pilot study of the information available,for the purpose of working out a uniform schemeof analysis of methods for eventual internationalcomparison.

The WHO/UNICEF consultant on venerealdiseases extended his Scandinavian tour toinclude Warsaw, where he lectured on venerealdiseases to various universities and medicalbodies. Another consultant also advised onWHO/UNICEF programmes, and the chief ofthe section on venereal diseases at Headquartersdiscussed new anti-venereal-disease programmeswith the Polish authorities.

During his visit, a provisional agreement wasreached on the establishment, with WHO'sassistance, of a two-months' training course invenereal-disease control. This course will beopen to a maximum of ten Fellows from Europeancountries with similar health patterns. It willinclude field demonstrations on the administrationof mass anti-syphilis campaigns, with specialemphasis on new investigative and treatmenttechniques.

A technical expert on penicillin productionfrom Poland attended the meeting convened byWHO in Geneva in February, and the Governmentsubsequently collaborated in a programmedesigned to modernize Poland's UNRRA-donatedpenicillin production plant.

Another project under discussion at the end ofthe year was the establishment in Wroclaw,Poland, of an advanced biochemistry trainingcentre for Eastern European countries, for whichWHO would provide some of the teaching staffand essential teaching equipment not availablein Poland.

In addition to general supplies of books andperiodicals and special publications on venerealdisease, colour film and processing chemicals


were sent to Warsaw for use in photographinga national exhibit on venereal diseases. Basicliterature was also supplied to the paediatricclinic of the University ofWarsaw.

Twelve fellowships were awarded, three for thestudy of communicable diseases, one for studyin maternal and child health, four in surgery, andfour in other subjects.

Portugal

At the request of the Government, an expertconsultant on tuberculosis visited Portugal, todiscuss in particular BCG vaccination and x-rayinvestigative techniques.

Two fellowships were awarded for study inpublic-health nursing, and at the end of the yearthe Government was being consulted on the allo-cation the sum provided for medical literatureand teaching equipment.

Health authorities in Portugal were interviewedregarding their needs for assistance on healthprogrammes and the possibilities of Poland'sparticipation in projects planned for the Europeanregion.

Roumania

WHO gave expert advice on anti-syphilis andmalaria control programmes in Roumania forwhich supplies were provided by UNICEF.Visits to Roumania of appropriate WHO expertswere still pending at the end of the year. Althoughfunds were available, no candidates for WHOfellowships were nominated in 1949, and norequests were made for supplies of medicalliterature and teaching equipment.

Sweden

In January, a model treatment scheme, basedon treatment of early syphilis with procainepenicillin aluminium-monostearate, was estab-lished in Sweden at the Stockholm universityclinic. In May, a consultant in venereal diseaseslectured to medical and university societies inStockholm, and made a survey of conditions.

A regional adviser on maternal and child healthalso visited Sweden during the year.

An infant metabolism seminar, where specialistswill discuss special problems with WHO, wasbeing planned for 1950. The Government has

offered funds to cover the" necessary preliminaryexpenditure. Sweden also made arrangementsto send a number of physicians to Copenhagenin 1950 to take courses at the training centre foranaesthesiology.

In the summer, a representative from Head-quarters visited Sweden to meet Fellows whohad been placed there, to see the institutionsavailable to them, and to discuss generally thequestion of fellowships.

Switzerland

In response to a request from Switzerland andother interested European countries for thecreation of a Rhine River Anti-Venereal-DiseaseCommission, a preparatory meeting was held inGeneva in May, at which Switzerland wasrepresented ; a Rhine river survey group, to whicha Swiss expert was appointed, surveyed venereal-disease treatment facilities along the course ofthe Rhine.

Advice and assistance was given in the planningof a post-congress seminar in social paediatrics inGeneva, to follow the Sixth International Congressof Paediatrics which is to be held in 1950.

Visits were also paid to psychiatric traininginstitutions. A number of discussions were heldand contacts made concerning the development ofthe University of Geneva's Institute of Hygieneinto an international training centre.

Special attention was paid to the question ofcourses in sanitary engineering and public-health administration.

The Swiss Central Bureau for PsychiatricNurses was visited for the purpose of securinginformation on its control of the training andcertification of these nurses.

Ukrainian SSR 18

General books and periodicals were suppliedto the Ukrainian SSR. Funds were sufficient topermit WHO to fulfil the one large requestmade in 1948 ($78,000).

United Kingdom

At the request of the Government, a consultantwas provided to advise on a large-scale whoopingcough immunization campaign in the UnitedKingdom. .

The serological test performance evaluationscheme was extended to a national laboratoryin London.

18 Stated in 1948 that it no longer considereditself to be a Member of WHO.


During the year, various addresses were givenand technical papers read by WHO representa-tives ; a lecture was given in May before theRoyal Society of Medicine by the mental healthexpert at Headquarters, who also visited differentinstitutions and clinics in London ; in July, apaper on tuberculosis, written by the expert atHeadquarters and entitled " Tuberculosis as aWorld Problem ", was read by the Secretary ofthe National Association for the Preventionof Tuberculosis before the Commonwealth andEmpire Conference ; and in August the WHOnutrition expert visited the Institute of ChildHealth, where he gave a short address to thepostgraduate class briefly outlining the work ofWHO. He discussed nutrition problems with theDirector of the Dunn Nutrition Laboratories,Cambridge, and also with the Ministry of Healthin London.

A visit was paid by the WHO consultant onhealth education of the public, and a WHOrepresentative interviewed the health authoritiesregarding specific needs and facilities availablefor projects planned for Europe in 1950.

Yugoslavia

At the request of the Yugoslav Government,WHO malaria consultants were assigned to assistin the Government's malaria control campaign.They carried out a number of surveys andattended several meetings of malaria workers.

The consultants were sent by the Yugoslavauthorities to an area west of Zagreb for thepurpose of studying the methods of malariacontrol and attempting to improve the effiiencyof techniques and recording. They also carriedout ecological and bionomic studies of ano-phelines in relation to DDT, gave short coursesof training to foremen, and devised methods ofassessing the results of the campaign.

Towards the end of April, a WHO entomologistwas sent to Yugoslavia for a period of abouttwo months ; he carried out 2,000 tests onmosquitos in an attempt to identify the actualvector in certain areas.

The objectives of the WHO mission to Yugo-slavia were considered to have been fulfilled early

in June, by which time the Yugoslav experts werethemselves in a position to solve local malariaproblems. An intensive demonstration andlecture programme was conducted by WHOexperts assigned to the mission ; successfulcontacts were made with scientists and otherworkers, research into new methods (bothentomological and engineering) connected withmalaria control was stimulated, and Yugoslaviawas given the benefit of experience gained inother parts of the world. The experts also studiedand made recommendations on techniques to beemployed in using the anti-malaria supplies sentby UNICEF.

A WHO consultant on venereal diseases madea lecture tour through Yugoslavia in March, inconnexion with a campaign against syphilis bypenicillin treatment in which WHO and UNICEFwere assisting. Professors of dermato-syphilologyand the chiefs of most of the treatment centres inYugoslavia held conferences, attended the lec-tures, and discussed plans for a campaign againstvenereal diseases.

The Government of Yugoslavia collaborated inthe programme Of rehabilitation of UNRRA-donated penicillin plants which was initiatedat a technical conference convened by WHO inGeneva in February. The Government sub-sequently decided to purchase an additionalpenicillin plant and requested technical advicefrom WHO on the matter.

In the campaign against tuberculosis, the BCGvaccination programme was carried out by theJoint Enterprise. A WHO expert visited Yugo-slavia in connexion with the establishment ofstreptomycin treatment centres, and an x-rayconsultant arrived in October to advise on equip-ment to be provided by UNICEF.

General books and periodicals, and specialpublications on venereal diseases, and fiveconsignments of malaria equipment and supplieswere provided. Twenty-six fellowships wereawarded to Yugoslavia : one for study in public-health administration ; six for the study ofcommunicable diseases ; four for study in maternaland child health ; four in internal medicine ;three in surgery ; four in the basic medical sciences,and four others.

African Region 19

As the Regional Office for the African Regionhas not yet been established and as few requests

19 This region comprises those parts of Africanot included in the Eastern Mediterranean region(i.e., approximately, those parts south of the200 N. parallel). It was delineated in detail bythe First Health Assembly. See 011. Rec. WorldHlth Org. 13, 330

for services have been received, WHO has notso far organized any specific programmes ofassistance to governments within the region.However, representatives of the Organizationattending conferences in the region have madelimited investigations and have offered suggestionsin one or two fields of health.


In the early part of the year, the chief represen-tative of WHO in Ethiopia visited Uganda,Kenya and other countries in East Africa, inorder to investigate existing facilities for thetraining of personnel.

A member of the Secretariat of the UnitedNations Department for Trusteeship, temporarilyseconded to WHO, attended the South AfricanS,ientific Conference in Johannesburg, whichbegan on 17 October, and subsequently visited anumber of the non-self-governing and trustterritories in Africa. As a result of his study toar,arrangements were made for the collection ofinformation on venereal diseases in some of theterritories visited, and the possibilities of organ-izing a training centre in Durban, Cape Town,Port Hale or Witwatersrand were also discussed.A number of the authorities seemed desirous ofsecuring assistance in making surveys of tuber-culosis problems, and in developing BCG vaccina-tion techniques and other branches of anti-tuberculosis control.

A study of teaching methods suited to theeducational standards of African nurses was alsosuggested, and will be considered by the ExpertCommittee on Nursing. Conferences on thissubject were held with appropriate governmentoffLials.

The Director of the South African School forMedical Research conferred with WHO on studiesbeing made and possibilities of co-operation inmalaria control, sewage disposal and the trainingof sanitation personnel.

The Inter-African Conference on Nutrition, heldin the French Cameroons, was also attended by arepresentative of WHO. At this conferenceinformation on nutrition and related subjects inCentral Africa was obtained, and suggestionswere made on ways in which WHO might usefullyco-operate with the governments in the area toassist them with their nutrition problems.

The Second Health Assembly approved theconvening of a Malaria Conference in EquatorialAfrica in 1950. A WHO malaria consultant hasbeen appointed to make a preparatory study ofthe malaria situation in the various territoriesof the African region and to prepare for theconference, which will probably be held inNovember (either in Nairobi (Kenya) or Entebbe(Uganda)). This conference will be followed by ameeting of the WHO Expert Committee onMalaria.

Details concerning individual countries in theregion are given below.

Belgian Congo

Lists of films in French, suitable for use intear hing medical and related subjects, togetherwith indications as to where the films could beobtained, were supplied to the Belgian Congo.

An expert from Leopoldville, Belgian Congo,discussed at WHO Headquarters the questionof tuberculosis control in the area, with particularreference to the employment of BCG vaccination.

Liberia

In answer to an enquiry, the Liberian Founda-tion was advised that WHO could assist in healthwork in Liberia if the Government would submita formal request for such assistance.

Union of South Africa

Following outbreaks of smallpox in the Unionof South Africa, WHO was requested to furnishinformation on supplies of smallpox vaccine.The information provided, including data onavailability, sources of supply, prices and timerequired for delivery, was collected from Denmark,France, the Netherlands, Switzerland, the UnitedKingdom and the United States of America.

Region of the Americas .°

Although integration of the Pan AmericanSanitary Organization with WHO is not yetcomplete, on 1 July, after the Second HealthAssembly had approved the Initial Agreement(which had been signed on 24 May by the Director-General of WHO and the Director of the PanAmerican Sanitary Bureau in Washington), theBureau began to serve offi:ially as the RegionalOffi.ce of the Americas. It had acted unoffi. iallyin this capacity since the beginning of May.The agreement further provided that the PanAmerican Sanitary Conference, through theDirecting Council, should serve as the regional

" This region comprises the Americas, in acccird-ance with a decision of the First Health Assembly.See Off. Rec. World Hlth Org. 13, 331

committee of WHO, within the provisions of theConstitution.

The Pan American Sanitary Organizationcomprises the following States Members ofWHO : Argentina, Bolivia, Brazil, Canada, Chile,Costa Rica, Dominican Republic, Ecuador, ElSalvador, Guatemala, Haiti, Honduras, Mexico,Paraguay, Peru, United States of America,Uruguay and Venezuela ; and the followingnon-Members : Colombia, Cuba, Nicaragua andPanama.

The third meeting of the Directing Council,serving for the first time as regional committeeof the World Health Organization, was held inLima, Peru, from 6 to 13 October. It was precededand followed by meetings of the ExecutiveCommittee. At the Council meeting, in addition to


representatives of most of the States mentionedabove, delegates were also present from France,the Netherlands and the United Kingdom, inaccordance with the unanimous resolution thatparticipation in the regional committee should beopen to representatives of the Danish, French,British and Dutch territories included in thearea. The Director-General of WHO also attendedthe meeting.

Acting as the regional committee, the Councildiscussed the programme and budget for 1950and 1951. Besides making various budgetaryrecommendations, it decided to modify the staffrules of the Pan American Sanitary Bureau so as tomake them conform more closely to those of WHO ;and to celebrate World Health Day and PanAmerican Health Day jointly on 7 April ; proposedthe establishment of certain sections in theregional office to plan and administer some of themajor WHO programmes ; and recommendedthat, in order to take full advantage of thetechnical, economic and administrative serviceswhich the Bureau was equipped to render, theWHO programmes in the region should beco-ordinated with those of the Pan AmericanSanitary Organization.

The Pan American Sanitary Bureau, with itslarge staff and extensive activities, has continuedto serve the countries within the Americas as aseparate organization, and performed manyservices for the Organization during 1949.

Two extremely important ways in which theregional office has served not only the countrieswithin the region but all the Member States ofWHO are in the administration of fellowshipsand the procurement of supplies. The verylarge fellowship programme entailed negotiationswith institutions and services for the placingof Fellows assigned to the United States, arrangingfor their travel, watching their progress andreporting monthly to Headquarters. As WHO'spurchasing agent for medical supplies, the Officehas provided supplies and equipment to WHOMembers throughout the world. Supplies sentboth to the Americas and overseas included suchitems as medical literature, penicillin, typhusvaccine and DDT supplies, iron lungs, sprayers,laboratory units, projectors and films, massx-ray dispensary units and transport vehicles,including river boats.

Continuing to act as the regional centre ofepidemiological statistics and information, thePan American Sanitary Bureau has regularlyexchanged reports of communicable diseaseswith WHO Headquarters and the Singaporeoffice. In October, the Director of the Divisionof Health Statistics from Headquarters visited

Washington and discussed the statistical workbeing carried out by the regional office andstatistical problems affecting the Americas.

The Section on Public Information distributedWHO publications, issued press releases, andcirculated information about WHO on WorldHealth Day and Pan American Health Day.

In the early part of the year, WHO expertconsultants were assigned to Latin America fortuberculosis survey work in connexion withBCG campaigns or general tuberculosis controlprogrammes. One of the projects undertakenwith UNICEF assistance was the production ofBCG vaccine in Mexico.

By the end of 1949, other programmes beingdeveloped in Latin America in conjunction withUNICEF were : (1) a campaign against yaws andrural syphilis (in the Dominican Republic andHaiti) ; (2) insect-control programmes (in theCentral American States) ; (3) an immunizationcampaign against diphtheria and whooping-cough(in Chile and Colombia) ; (4) a typhus controlprogramme (in Bolivia and Peru) ; and, withUNICEF and FAO, a nutrition programme (inCosta Rica, El Salvador, Guatemala, Hondurasand Nicaragua).21

A joint programme for adult education is beingcarried out by UNESCO and the Organization ofAmerican States, with the Regional Office for theAmericas advising on health teaching. WHO hasalso been helping to plan the proposed UnitedNations seminar on the social problems of theIndian populations in various countries of LatinAmerica.

The regional office has assisted Headquarterswith recruitment, the personnel recruitedincluding the following : a nurse for the projectin Haiti, an expert on maternal and child healthto help with the emergency situation in Ecuador,a team of experts on poliomyelitis sent to India,an expert and administrative officers for thetuberculosis survey team in Central and SouthAmerica, and an officer to accompany the pre-liminary UNICEF survey teams on disinsectionand nutrition.

Arrangements were made by the regionaloffice for the meetings of the WHO ExpertCommittee on Venereal Infections and its Sub-Committee on Serology and Laboratory Aspects,

21 FAO is to supply technical advice for thisprogramme.


held in Washington in October. It also assistedin arranging for and planning the itinerary of theSyphilis Study Commission which paid a three-months' visit to the United States of America.

Most of the needs in the Americas are stillbeing met by the Pan American Sanitary Organ-ization itself. It should perhaps be pointed outthat of the eighteen countries in the Americaswhich have ratified the WHO Constitution,eight have become Members only this year, andthat, therefore, relatively few requests for serviceshave been received by WHO ; many more maybe expected in the future. The following notesapply to those operations which were carried outunder the auspices of WHO.

Argenthut

In Argentina, experts from WHO made a surveyon tuberculosis, with special reference to BCGwork.

Bolivia

Bolivia became a Member of WHO on 23December 1949.

A survey was made on tuberculosis by WHOin connexion with BCG work. At the end of 1949a joint project of typhus control was beingplanned, the supplies to be provided by UNICEF.

Brazil

Brazil was visited in September by the Director-General of the Organization, who, together withthe expert on statistics from Headquarters, metwith public-health officials and visited variousinstitutions and schools of public health in Riode Janeiro and São Paulo. A survey on tuber-culosis and BCG was made.

WHO was represented at the Latin AmericanSeminar on Illiteracy, a part of the UNESCOadult education project, held in Rio de Janeirofrom 27 July to 3 September, and at the end ofthe year a medical officer was being recruitedto participate in a joint project between theGovernment, WHO and UNESCO in education,agriculture and health. This will be set up in thenorth-eastern part of the country.

WHO was also represented at the Second PanAmerican Congress of Social Service, held inRio de Janeiro from 2 to 9 July.

One fellowship was awarded for the study ofcommunicable diseases.

British Honduras

A campaign in insect-control was beingdeveloped in British Honduras during 1949 withthe assistance of WHO and UNICEF.

Chile

In Chile, a survey on tuberculosis with referenceto BCG vaccination was made, and, at the end ofthe year, WHO and UNICEF were also planningto assist in an immunization campaign againstdiphtheria and whooping-cough.

Medical literature and teaching equipment wereordered.

Colombia 22

In Colombia, a survey on tuberculosis was made.At the end of the year, a WHO consultant wasbeing recruited to advise on a national campaignagainst diphtheria and whooping-cough in whichWHO and UNICEF will assist.

WHO was requested to assist in the funda-mental education project being carried out inColombia by UNESCO, should the project beextended to include health education.

Costa Rica

Costa Rica became a Member of the Organ-ization in March 1949. A survey on tuberculosiswas made. The expert on health statistics atHeadquarters visited institutes and nationalhospitals, and conferred with public-health author-ities. At the end of the year, insect-controlprogrammes were being developed, in whichWHO and UNICEF will assist, and a similarjoint project in nutrition was being planned.

Medical literature and equipment were supplied.

Cuba 22

A survey on tuberculosis was made in Cuba.The Organization was represented at the secondsession of the Economic Commission for LatinAmerica, held in Havana from 29 May to 14 June.

Dominican Republic

A survey on tuberculosis was made in theDominican Republic. Health institutions werevisited by the WHO expert on health statistics.At the end of the year, plans were well advancedfor a campaign for the eradication of yaws andrural syphilis, to be carried on in 1950 withUNICEF assistance.

Ecuador

Ecuador became a Member of the Organizationin March 1949.

An expert consultant in public health, withspecial reference to maternal and child health,was assigned to Ecuador to give assistance inthe area where the earthquake occurred. Condi-

22 Not yet a Member of WHO at the end of theyear.


tions were surveyed ; feeding and other pro-grammes were administered ; and recommenda-tions were made to UNICEF, which will providesupplies, for the re-equipment of institutions.The expert in health statistics from Headquartersvisited institutions in Guayaquil and gavelectures.

The tuberculosis situation was surveyed, andmedical literature and teaching equipment weresupplied.

El Salvador

A survey on tuberculosis was made in El Sal-vador, and plans for a WHO tuberculosis demon-stration project, requested by the Government,were completed ; at the end of 1949, personnelwas being recruited and mass x-ray dispensarynnits, as well as medical literature and teachingequipment, were sent to El Salvador. An insect-control programme was also being developed,supplies to be provided by UNICEF. Adviceon the feeding programme being carried out bythe country was furnished by WHO, and planswere being made for a project in nutrition, inwhich WHO and UNICEF will assist.

Guatemala

Guatemala became a Member of WHO on26 August 1949.

The expert on nutrition from Headquartersattended the opening of the Institute of Nutritionof Central America and Panama (located inGuatemala City), at which integration of theprogramme in the nutrition programme of WHOwas discussed. The WHO expert on healthstatistics also visited Guatemala, where he con-ferred with officials of the Ministry of Health onhealth problems in the country.

A survey on tuberculosis was made, and WHOprovided fellowships for one or two Haitians toattend a PASB seminar on venereal diseases heldin Guatemala. At the end of the year, a jointinsect-control programme and a similar jointproject in nutrition were being planned for 1950,to be carried out with assistance from WHO andUNICEF.

Haiti

a consultant on venereal diseases visited thecountry.

WHO supplied a public-health officer, ex-perienced in health education of the public, anda public-health nurse for the UNESCO pilotproject in fundamental education which was beingconducted in Haiti.

A survey on tuberculosis was made ; threefellowships were granted ; and medical literatureand teaching equipment were provided.

Honduras

Honduras became a Member of the Organiza-tion in April 1949.

During 1949, a survey on tuberculosis was made,with special reference to BCG vaccination. Atthe end of the year, plans were under way foran insect-control programme and a project innutrition, to be carried out with assistancefrom WHO and UNICEF.

Mexico

At the request of the Mexican Government, aconsultant on malaria was assigned to the country,and gave lectures on malaria control measures.A WHO consultant in venereal diseases was alsosent to Mexico to advise on the United States-Mexican border programme. A survey on tuber-culosis was made, and a WHO expert investigatedthe preliminary arrangements made for a BCGlaboratory, to be established in 1950 with fundsprovided by UNICEF. In this laboratory,extensive BCG vaccination will be carried out, andfrom it BCG will be supplied to a number ofcountries in the Americas.

Two fellowships were awarded, one for thestudy of communicable diseases and the otherfor study in the basic medical sciences ; medicalliterature and teaching equipment were provided.

Nicaragua 28

A joint programme of insect-control for Nica-ragua has been examined, and plans have beenformulated to carry it out, with the assistanceof WHO and UNICEF. A nutrition programmewas also being considered during 1949, to becarried out in collaboration with UNICEF.

PaTIATTIA sa

At the request of the Government, a WHO team A survey on tuberculosis was made in Panama.to combat yaws and rural syphilis in Haiti wasbeing set up at the end of the year, the suppliesbeing provided by UNICEF, and in this connexion year.

28 Not yet a Member of WHO at the end of the


Paraguay

Paraguay became a Member of the Organizationin January 1949.

A survey was made on BCG work in the controlof tuberculosis.

Peru

Peru became a Member of the Organization on11 November 1949.

A BCG survey of the country was made underthe auspices of WHO, and a WHO tuberculosisconsultant went to Peru in October, visitedinstitutions and discussed problems of control.

In connexion with the October meeting of theDirecting Council of the Pan American SanitaryBureau, serving as the WHO regional committee,the Director-General of WHO, together with theexpert on health statistics from -Headquarters,visited Peru and held discussions with healthofficials in Lima.

WHO co-opetated with the United Nationsin making studies in coca-leaf chewing. At the endof the year a project in typhus control was beingdeveloped, with assistance from WHO andUNICEF.

Puerto Rico

A survey on tuberculosis was made in PuertoRico.

United States of America

At the request of the United States PublicHealth Service, a WHO consultant on nutrition-expert in vitamin B and the anaernias-was sentto the United States, where he visited institutesand nutrition services and discussed methods forthe analysis of vitamins in foodstuffs, co-ordinationof services, and nutrition education. He alsoconducted a seminar at the National Institutes ofHealth in Bethesda, Maryland.

A consultant in malaria, also assigned to theUnited States, gave lectures on the exo-erythro-cytic cycles, and in September a WHO sanitaryengineer was seconded for two months as consult-ant to the United States Public Health Serviceto advise on procedures in environmental sanita-tion, with particular reference to the sanitarytipping of refuse.

In October, the regional adviser on tuberculosisexamined procedures in the tuberculosis diagnosticlaboratories of the Health Department of theState of New York, in Albany, and discussedtuberculosis control problems.

At the request of the Government, a WHOconsultant advised on the United States-Mexicanborder programme on the control of venerealdiseases.

Lectures were given by the WHO expert inhealth statistics at the School of Hygiene inJohns Hopkins University. The United Statesauthorities assisted the regional office in arrangingfor the Syphilis Study Commission to the UnitedStates, which was sent at the invitation of theUnited States Public Health Service to visitvarious venereal-disease centres and clinics duringa three months' period, and also for the thirdsession of the Expert Committee on VenerealInfections and the first session of its Sub-Committee on Serology and Laboratory Aspects,held in Washington in October (see also Chapter1, section Venereal Diseases ", p. 5).

Seven fellowships were awarded, three of whichwere for study of public-health administration inEurope.

Uruguay

Uruguay became a Member of WHO in April1949.

A survey on tuberculosis was made.WHO was represented at the Fourth Conference

of the American States Members of the Inter-national Labour Organization, held in Montevideofrom 25 April to 7 May.

Venezuela

In August, at the request of the Government,a WHO consultant in malaria was assigned toVenezuela, and at the end of the year he wasteaching in the international malaria coursesat Maracay.

During the year, a survey on tuberculosis wasmade.

A WHO expert consultant in venereal diseasesexamined a venereal-disease programme forVenezuela and gave advice as to future needs.The establishment of a serological laboratoryand training centre is contemplated. An expertserologist was appointed to head the project,which is to start on 1 January 1950.

The expert on health statistics from Head-quarters gave a series of lectures in the CentralUniversity in Caracas, under the auspices of theMinistry of Health.

Medical literature and teaching equipment weresupplied, and a request has been received forconsultants in psychiatric nursing and psychiatricsocial work in 1950.

Three fellowships were awarded, two for thestudy of communicable diseases and one forstudy in maternal and child health.

C HAPTE R 3

NEW DEVELOPMENTS IN TECHNICAL SERVICES

The work of providing governments withessential technical information on internationalaspects of diseases and public-health, which isan important function of WHO, was activelypursued during the year under review. This workis done at Headquarters, and is distinct from, butvital to, the advisory services to governmentswhich are planned at Headquarters and carriedout in the regions. It includes certain fundamentalactivities, such as work in epidemiology, healthstatistics, and therapeutic substances (biologicalstandardization, the unification of pharmaco-poeias, and habit-forming drugs), the co-ordina-tion of research, and editorial and referenceservices.

In summarizing the work accomplished during1949, special mention should be made of the

completion of the first edition of the Pharmaco-poea Internationalis, which has its origin in thework begun by the Health Organization of theLeague of Nations in 1937. The marked improve-ment in the speed with which epidemiologicalinformation is disseminated, thanks to theestablishment of daily radio broadcasts ; theadoption of biological standards for new drugs ;and the establishment of a tuberculosis researchoffice in Copenhagen should also be noted.

Important studies and investigations on com-municable diseases were made and, in some cases,preparations were begun for demonstrations inthe control of these diseases, to be carried out byother units of the Secretariat.

A summary of developments during 1949 isgiven below.

Epidemiology

In dealing with the control of epidemic diseases,WHO has not tried to substitute its services forthose of national governments. However, it isin a position to do what single national healthadministrations cannot do : it collects epidemio-logical information from all countries anddistributes it all over the world ; it verifies theapplication of the International Sanitary Conven-tions by the various health administrations, andrecently it has been preparing modern WHORegulations to replace these conventions. Throughits expert committees it obtains up-to-dateknowledge on the various communicable diseasesand, by making this available to national admi-nistrations, assists them in taking measuresappropriate to their own countries.

Sometimes the technical advice formulated byan expert committee can be used directly ;sometimes it requires an actual demonstration byan expert consultant or a team in order to giveone country the concrete experience of others.WHO's work on epidemiology has included themaking of plans for such demonstrations.

Administration of International Sanitary Con-ventions

During 1949, in administering the InternationalSanitary Conventions, WHO dealt with a seriesof international disputes relating to quarantinematters and succeeded in having each case settled

" out of court ". The action taken in the variouscases was noted by the Section on Quarantine.of the Expert Committee on InternationalEpidemiology and Quarantine (Geneva, 13 De-cember),1 which considered that the procedurefollowed in handling complaints had beensatisfactory.

With a view to ensuring the further applicationof the provisions of the Sanitary Conventions,the Organization continued to develop its statu-tory epidemiological and notification servicesduring the year. Information on the incidenceand spread of pestilential diseases was suppliedregularly to national health administrations bytelegram and by subsequent printed confirmation,additional details appearing in the WeeklyEpidemiological Record.

An important expansion of the notificationservice was the establishment, on a permanentbasis, of the epidemiological radio-telegraphicbulletin, which was broadcast daily to healthadministrations from Geneva.2 This bulletincontained data on the occurrence of quarantinablediseases and on quarantine measures imposed orwithdrawn. Information about Africa, Europeand the Americas from this bulletin was also

1 Report to be published as World Hlth Org.Techn. Rep. Ser, 1950, 20

2 From Geneva Station, 08.00, 09.10 and 15.00GMT.

- 52 -

NEW DEVELOPMENTS IN TECHNICAL SERVICES 53

broadcast by the government-owned wirelessstation of Saigon for the benefit of health adminis-trations of the Western Pacific area. Thesebroadcasts, which have already proved their worthin practice, may constitute a valuable element inthe new system of international epidemic controlto be governed by the WHO Sanitary Regulationswhich are in course of preparation.

With the object of standardizing the contentsof future cables and reducing cable expenses,WHO compiled a new code (CODEPID), con-taining some 6,000 current phrases suggested byvarious health administrations, and submittedit to regional epidemiological stations for checkingand amplification.

In June, an up-to-date list of ports acceptinginternational quarantine messages by wireless waspublished as a supplement to the W eekly Epidemio-logical Record.

Singapore Epidemiological Intelligence Station

The Singapore Epidemiological IntelligenceStation, operating as a branch office of Head-quarters, carried out the functions of collecting,studying, collating and disseminating epidemio-logical information throughout the Far East bymeans of radio-bulletins, telegraph and post.The radio station at Colombo, Ceylon, wasadded.to the network of radio stations regularlybroadcasting epidemiological information receivedfrom the Station.

The Singapore Station continued to publish aweekly printed bulletin and, in addition, everytwo months, a statistical supplement givingcumulative epidemiological data. In the exerciseof the powers delegated to its Director, it carriedout routine administration of InternationalSanitary Conventions in the zone, and success-fully negotiated several disputes and appeals onthe application of quarantine measures.

In November a revised supplement was issued,giving quarantine requirements of health adminis-trations in the zone, briging up to date theinformation first issued in this form in 1948.

Through the efforts of the Singapore Station,liaison with a number of ports in China was re-established after the change of government.

Other Offices

The epidemiological intelligence units in theRegional Office in Alexandria and in the PanAmerican Sanitary Bureau in Washington, whichacts as the Regional Office for the Americas,have co-operated with the epidemiologicalinformation and notifications services at Head-quarters and with the Singapore Station in theprompt exchange of information and publica-tions.3

3 For map (No, 3) showing network of epidemio-logical radio-telegraph communications, see p. 113.

At a meeting held in Geneva on 15 and 16 De-cember, the heads of the epidemiological intelligenceservices in Geneva, Alexandria and Singaporediscussed their respective functions and theapportionment of the work. The decisions takenon standardization of broadcasts of epidemio-logical bulletins and on distribution of periodicalsare expected to result in increased efficiency anddecreased costs.

Revision of International Sanitary Conventions

During 1949, definite progress was made withthe revision of the International Sanitary Conven-tions. On the basis of the principles approvedby the Second Health Assembly, WHO prepareda draft text of the International Sanitary Regu-lations. These Regulations were considered,together with a series of observations fromgovernments, international organizations and theSecretariat, at the second session of the ExpertCommittee on International Epidemiology andQuarantine, held in Geneva between 5 and14 December. The technical recommendationsoriginating from the expert committees or studygroups on plague, cholera, yellow fever, insec-ticides and environmental sanitation were alsosubmitted to the committee. The committeeaccepted the provisional texts of the SanitaryRegulations ; it adopted draft SupplementaryRegulations for the sanitary control of the MeccaPilgrimage, and recommended safety and sanitarystandards for the protection of Mecca pilgrimstravelling by sea or air. These documents willbe sent to Member States and interested inter-national agencies for their observations beforebeing presented to the World Health Assembly.

Epidemiological Statistics and Information

In the field of epidemiological statistics andinformation, the most important undertaking in1949 was the collection of missing or incompletedata, so that Annual Epidemiological and VitalStatistics, 1939-1946, might be published in 1950.A considerable number of questionnaires onthis subject were sent to health administrationsand statistical services.

During the year, twelve numbers of the Epi-demiological and Vital Statistics Report wereprepared. The tables contained in this publicationrefer to the principal epidemic diseases, give themost recent figures, and compare them with thoseof the three previous years. A series of articlesand notes on epidemiological or demographicsubjects was also published.

In September, a small " Epidemic WatchUnit " was set up to detect incipient epidemicsand to give warning of their occurrence whenevernecessary. This is done by keeping a carefulwatch on the returns relating to communicablediseases and by checking recent figures againstthose of previous weeks and of the correspondingperiods for the preceding years. In order to make


these comparisons effective, a series of tablesand graphs has been prepared, showing, forselected countries, the maximum, median andminimum prevalence of the most importantcommunicable diseases over a number of years.Once an abnormal situation is detected, theorigin and geographical distribution of the out-break is studied and, if it is considered to beof sufficient importance, it is described in theW eekly Epidemiological Record or mentioned inthe epidemiological daily broadcast.

Yellow Fever

After the yellow-fever vaccines of the Instituutvoor Tropische Hygiene, Amsterdam, and of theInstitut Pasteur, Paris, had been subjected tocontrol potency titration, both vaccines wereapproved by WHO for the issue of internationalcertificates. Further, on the recommendationof the Yellow-Fever Panel, WHO accepted theapplication of the Instituut voor TropischeHygiene for its designation as a yellow-fevervaccine-testing station, under article 36 (11)of the International Sanitary Convention forAerial Navigation, 1944.

Requests that the yellow-fever vaccines pro-duced at the Yellow-Fever Laboratories atBogota, Colombia, and at Rio de Janeiro, Brazil,be given full WHO approval, instead of thequalified approval previously accorded, weresubmitted to the Yellow-Fever Panel for con-sideration.

Enquiries were also made of the Yellow-FeverPanel and of other experts as to (1) the infecti-bility of Aedes aegypti with yellow fever and asto the possible reversion of 17 D vaccine virus toa state of virulence, (2) the possibility of standard-izing the methods of potency titration in routineuse at the various testing laboratories for thecontrol of yellow fever, and (3) the desirabilityor otherwise of modifying the existing standardrequirement for yellow-fever vaccine, namely,that 1 ml. shall contain not less than 150,000 MLDfor the mouse.

Those members of the Yellow-Fever Panel withspecial experience in the epidemiology of yellowfever met in Geneva from 1 to 6 December,at first as a separate body and later in jointsession with the Expert Committee on Inter-.national Epidemiology and Quarantine. Duringtheir meetings, they revised the delineationpreviously made by UNRRA of the yellow-fever" endemic " areas in Africa and the WesternHemisphere, and defined the terms " Aedesaegypti index " and " yellow-fever areas ". Theyfurther recommended measures for the inter-national control of yellow fever and advocatedmethods by which WHO might co-ordinateyellow-fever research.4

Report to be published as World Hlth Org..echn. Rep. Ser. 1950, 29

Epidemiological Studies

Plague

WHO began its study of plague by setting upa joint study-group on plague with the OfficeInternational d'Hygiène Publique. In the lightof the recommendations made at the two meetingsof the study group in 1948, and after consultationswith plague experts during the Fourth Inter-national Congress on Tropical Medicine inWashington (June 1948), WHO prepared a fieldprogramme for 1950, which was approved by theSecond Health Assembly.5 This programme callsfor field projects in which new methods of ratand flea destruction will be used in an attempt toeliminate plague as a threat to humanity.

The Expert Committee on Plague was set upduring the year, and at its first session, whichtook place in Geneva from 19 to 24 September,5it approved the principle of the plague eradicationprogramme.

An adviser on plague and cholera has beenappointed to the Regional Office for South-EastAsia, and is undertaking a preliminary study inendemic plague areas in India.

As information on the epidemiology of plaguein Africa is at present meagre, the expert com-mittee drafted a questionnaire on the subject forcirculation to the plague-infected countries ofAfrica, and a document on the nomenclature ofreservoirs and vectors of plague prepared by aformer member of the plague study-group will,after revision, be recommended as a standardwork on the subject. Material is also beingcollected for the preparation of an up-to-datemanual on plague.

Cholera

Also in conjunction with the Office Inter-national d'Hygiène Publique, WHO is under-taking the study of the cholera problem. Inaccordance with the recommendations made bythe Joint OIHP/WHO Study-Group in 1948, theIndian Research Fund Association re-orientatedits research programme for cholera in 1949, and,with a grant-in-aid of $10,000 from the OIHP,the Indian authorities began a study of thefactors concerned in the endemicity of cholerain India, and started field research in the endemicarea of the Cauvery delta in Madras province.

The third session of the joint study-group washeld in New Delhi in November, in collaborationwith the Cholera Advisory Committee of theIndian Research Fund Association. The membersof the study-group made a preliminary tour ofsome of the cholera areas in India and Pakistan,visited institutes where research is in progress,and held discussions with health administrators

5 oll. Rec. World Hlth Org. 21, 1806 Report to be published as World Hlth Org.

techn. Rep. Ser. 1950, 11


and research workers. They also toured thecholera field investigation area and inspected thefield laboratory in Trichinopoly, where masslaboratory investigation is being undertaken.

The study-group endorsed the cholera fieldprogramme for 1950, as approved by the SecondHealth Assembly ;7 it stressed the urgency oferadication methods and recommended the initia-tion of the programmes in India and Pakistanas soon as possible. An adviser on cholera andplague has been appointed to the Regional Officefor South-East Asia, to make a preliminary studyof the organization of field work and to collaboratewith those engaged in research now in progress inIndia.

Smallpox

In 1948 a joint OIHP/WHO Study-Group onSmallpox recommended that further studies andobservations be made on the means of preparingan active but pure dry vaccine. This work wasin progress during 1949 at the Animal VaccineInstitute, Paris, where it was found possible,through treatment with an antiseptic " Rocal ",to improve the purity of the dry vaccine formerlyproduced at the Institute. The pure lymphvaccine appears to be somewhat less potent whenobtained in this way, and methods for removingthe antiseptic and thereby enhancing its potencyare now being studied. Preliminary informationfrom India, where the vaccine is being tried outin the &Id, suggests satisfactory " takes ".

The successful production of a dry vaccinewill go a long way towards solving the vaccina-tion difficulties in rural areas, particularly inthose tropical countries where smallpox epidemicsare still frequent.

Plans are being made for holding a meetingof an expert committee (or study group) onsmallpox in 1950, to discuss the results of thiswork and to deal with other problems. A meet-ing of medical officers responsible for vaccina-tion in tropical areas is also to be convened inorder to determine the methods which are mostlikely to secure universal vaccination in un-developed areas.

African Rickettsioses

The Joint OIPH/WHO Study Group on Typhus,which met in Paris in 1948, called attention tothe importance of rickettsial infections in Africa,to their variety and to the need for clarifying thepossibly rickettsial etiology of some diseasesprevailing in certain territories. In September1949 a special Study Group on African Rickett-sioses held a preliminary meeting in Paris. Bypreparing a technical questionnaire on the

7 Ofi. Rec. World Filth Org. 21, 178

subject, this group paved the way for a meetingof specialists from the various territories ofAfrica, which will be held in Brazzaville inFebruary 1950.

Bilharziasis

An expert study group, set up jointly with theOffice International d'Hygi&te Publique to studythe African forms of bilharziasis, i.e., the Bilharziahaematobium and Bilharzia mansoni infections,met in Cairo from 24 to 29 October.8 It visitedinfected areas in Egypt, observed demonstra-tions of the curative treatment of patients andof preventive work (which destroys the inter-mediate hosts of the parasites in infected watercourses) and participated in meetings with anumber of bilharziasis specialists working inEgypt. The experts emphasized the need forfurther research into methods which might leadto better results than those obtained in thepresent standard use of the antimonial com-pounds. They also advocated a detailed surveyof bilharziasis in Africa, stressing the danger ofdeveloping irrigation schemes in infected areas,where, without the application of proper sanitarysafeguards, a widespread infestation of thepopulation might result.

Trachoma

Following the recommendations of the JointOIHP/WHO Study Group on Trachoma, whichmet in Paris in October 1948,8 material has beencollected on the incidence and geographicaldistribution of trachoma throughout the world.This material, based on literature covering thelast 15 years, will be published in the form of amonograph in the monthly Epidemiological andVital Statistics Report. Information was alsocollected on the results obtained by the use ofvarious forms of treatment, including sulfa drugsand antibiotics. A separate monograph will bepublished on this subject.

Poliomyelitis 1°

During the year arrangements were made,chiefly with the National Foundation for InfantileParalysis, to supply available literature on polio-myelitis to the Regional Offices for the EasternMediterranean and South-East Asia.

Various laboratories were approached with aview to ascertaining ways in which WHO canbe of assistance to them in their work. Theselaboratories were also requested to keep WHOinformed on the research which they are under-taking and on any results achieved, particularlyas regards possible prophylaxis.

In answer to a circular letter regarding thedesirability of forming an international stock

Report to be published as World Hlth Org.techrz. Rep. Ser. 1950, 17

9 For Report see Off. Rec. World HlthOrg. 19, 2719 See also Chapter 2, p. 36. and Chapter 4, p. 74.


of iron lungs, replies had been received fromvarious European countries by the end of 1949 ;thge replies were analysed for the considerationof the Executive Board.

Influenza "

Arrangements were made with the WorldInfluenza Centre whereby screened strains ofswine influenza virus would be submitted to theCentre for comparison with human strains. Thesecomparative studies should shed light on theepidemiology of the disease from the standpointof animal-human relationship, inter-epidemicreservoirs of the virus, and mutation phenomena.

Rabies

In accordance with the terms of the resolutionon the subject adopted by the Executive Boardat its second session,12 a questionnaire wasprepared requesting rabies authorities through-out the world to submit their opinions on variouscontroversial topics. These opinions will be usedas a guide for the Expert Committee on Rabies,which will meet early in 1950.

Preparations have also been made for fieldtrials in the use of serum-vaccine prophylaxis inhuman beings and of a new vaccine for the controland eradication of rabies in dogs ; a manufacturerhas agreed to supply the necessary biologicalproducts free of cost, and it is planned to carryout experiments in suitable countries in 1950,if approval is obtained from the expert com-mittee.

Brucellosis

Steps were taken during 1949 to designateapproximately ten brucellosis centres through-

out the world for operations in 1950. Thesecentres will undertake the preparation and test-ing of standard antigens, diagnosis and thera-peutic research, and will also act as teachingcentres for laboratory workers.

In this domain, as in the related fields ofveterinary public-health interest, including bovinetuberculosis, rabies and psittacosis, WHO hasundertaken activities with a view to correlatingthem with the work which is being done by otherinternational agencies, such as FAO, UNICEF,and the International Office of Epizootics.

Insecticides 18

The Expert Committee on Insecticides heldits first session in Cagliari, Sardinia, from 10 to15 May 1949.14

This committee, the first of its kind to havea variable membership adaptable to the questionsbefore it, devoted its first session to makingrecommendations on specifications for insecticidesand apparatus for their use, and to drawing updisinsection measures for quarantine purposes.It had the opportunity of gaining first-handknowledge of the work carried out in Sardinia(under the auspices of the Italian Governmentand the Rockefeller Foundation) in freeing theisland from anopheline vectors of malaria bymeans of insecticides. In addition, it was ableto examine the measures developed for prevent-ing the reinfestation of the island from the seaor the air, and had the benefit of a report on thedisinsection of aircraft." The committee wastherefore in a position to make concrete sugges-tions to the Expert Committee on InternationalEpidemiology and Quarantine for the draftingof WHO Regulations on the disinsection ofships and aircraft.

Health Statistics

The Expert Committee on Health Statistics,established in accordance with a resolution ofthe First World Health Assembly," held its firstsession in Geneva from 23 to 28 May 1949.11 Itreviewed important questions in the field ofinternational health statistics, particularly fromthe point of view of improving the internationalcomparability of data and national medicalstatistical services. Among other recommenda-tions, it suggested the establishment of two sub-committees, one to study the question of thedefinition of stillbirth and abortion, and the otherthe problems of registration and statistical presen-tation of cancer cases. It also recommended thesetting-up of a third sub-committee, to initiateaction in the field of hospital statistics, primary

n See also p. 6112 Off. Rec. World Hlth 07g. 14, 2218 See also Chapter 1. p. 4.14 For the report on the session, see World Huth

Org. techn. Rep. Ser. 1950, 4

attention to be given to the application of thenew international statistical classification ofdiseases, injuries, and causes of death, andrelated subjects." The committee further recom-mended the setting-up of a focal unit in theOrganization for maintaining relationship withnational committees on health statistics.

With a view to establishing vital and healthstatistics services in under-developed areas andimproving those services already in existence,the committee recommended that conferencesshould be convened within the regions concerned,to be attended by specialists or qualified represen-tatives of the areas and one or more WHO

15 By Dr. J. Duguet. See Bull. World Hlth Org.1949, 2, 155-191

18 011. Rec. World Hlth Org. 13, 30417 For the report on the session, see World Hlth

Org. techn. Rep. Ser. 1950, 518 These three sub-committees were subsequently

established by the Executive Board at its fourthsession-Off. Rec. World Hlth Org. 22, 3


experts in health statistics. It was also emphasizedthat competent statistical advisory committeesshould be consulted before any projects for theimprovement of health conditions of under-developed areas are initiated.

The committee also recommended that instruc-tion in medical recording procedures and elemen-tary statistical methodology should be given to allmedical students, instruction in more advancedstatistics to medical and other graduates, andinstruction in basic medical statistics to non-medical persons engaged in medical coding,keeping of hospital records, etc.

Acting on the recommendations of the expertcommittee, the Second Health Assembly approvedan expansion of the WHO programme on healthstatistics," and preparations for carrying outthe expanded programme were immediatelybegun. Recruitment of the necessary personnelto cope with the additional duties and tasksinvolved is proceeding, within the limits ofbudgetary provisions.

During the year under review, vital statisticsfor all the countries and for the most importantcities of the world-from the standpoint of inter-national health-were regularly published in theEpidemiological and Vital Statistics Report. Afirst article on " The Evolution of Mortality inEurope during the Twentieth Century " wasincluded in the Report for April, and was widelyquoted by medical journals and organs of publicinformation. This article, which traces thecourse of death-rates in some selected countriesof Europe during the first 47 years of the twentiethcentury, will be followed by other studies onsignificant changes in mortality by attributes.Progress was made in the collection of vitalstatistics for a special volume of the annualpublication Epidemiological and Vital Statistics,covering the war period, 1939-1946, during whichits publication was suspended.

Volume 1 of the Manual of the InternationalStatistical Classification of Diseases, Injuries, andCauses of Death was published in English inJanuary 1949, and the French and Spanisheditions are likely to appear by the beginningof February 1950. The alphabetical index(Volume 2) of the Manual, in English, contain-ing approximately 60,000 terms, will also bepublished at the beginning of the year. In addi-tion to the diagnoses given in the tabular list

of inclusions (contained in Volume 1), termscollected from the different nomenclatures andnosological lists in use in the United States ofAmerica, Canada and the United Kingdom areincluded in the corresponding parts of the index,the manuscript of which was prepared by govern-mental agencies of Canada and the United Statesunder the general guidance of the Index Sub-Committee appointed by the Interim Commission.

Two statistical studies, in particular, are indica-tive of the scope of the work undertaken duringthe year. One is the compilation of statistics ofmortality by cause of death, sex and age-groupsin several European countries, a study which isbeing published in the Epidemiological and VitalStatistics Report. The other is the collection ofstatistical material dealing with cancer mortalityfrom selected countries in Europe over an ex-tended period of time during the twentiethcentury, by specification of site of the tumour,supplemented by statistics of mortality fromneoplasms for particular time-reference periods asclassified by sex and proper age-groups. A similarstudy has been begun for tuberculosis.

WHO has already done a considerable amountof work in gathering relevant material, bothstatistical and bibliographical, for the study" Wastage of Human Life ", which is being pro-duced in collaboration with other United Nationsagencies.

Some progress was made during the year onplans for organizing the collection and eventualpublication of statistics of morbidity in itsdifferent aspects. Simultaneously, a masterregistry of demographic data, which will facilitatethe handling of requests for demographic material,was set up.

These various series of statistics, collected andcompiled, enabled the Organization to respondquickly and fully to many requests for specialstatistical information received from govern-ments and responsible institutions or persons.It also provided a fund of information readilyavailable to other divisions and sections of theSecretariat in the organization of their work invarious fields.

Throughout the year, advice was given tonational technical administrations, particularlyin problems of analysis of medical statistics andthose connected with the international statisticalclassification of morbidity-mortality.

Biological Standardization

The Expert Committee on Biological Standard-ization held its third session in London from 2 to7 May.2° It adopted new international standardsfor vitamin B and blood groups ABO ; inter-national reference preparations for streptomycinand dihydrostreptomycin ; and international

19 Off. Rec. World Hlth. Org., 21, 2820 For the report on the session, see World filth

Org. techn. Rep. Ser. 1950, 2

standards of replacement for digitalis, sulfars-fen amine and androsterone. A preparation ofpenicillin G (II) was chosen to serve as the secondinternational standard for penicillin. -The with-drawal of the international standard of oestradiolmonobenzoate as from 1 January 1951 wasagreed upon. The committee also accepted thefollowing recommendations of the Sub-Committeeon Fat-Soluble Vitamins : that the internationalstandard for vitamin A should be the crystallinevitamin A acetate ; that the old international


standard of vitamin A, consisting of B-carotene,should become the standard for provitamin A ;and that a preparation of vitamin D, should beadopted as the new international standard forvitamin D (the old standard to be maintainedonly as an international reference preparation).

It was further recommended that certainstudies already in progress should be continued-for example, on Ogawa and Inaba choleravaccines and diagnostic antisera. In the lightof recent research on the antigenic structure ofcholera vibrios, the establishment of referencediagnostic material was postponed until moreknowledge had been gained on the strains to beemployed. The testing of the vaccines, however,is to proceed.

The members discussed in relation to Article2 (t) of the Constitution, the question of wideningthe scope of the committee so as to make thestandardization of diagnostic techniques possiblein certain domains where the lack of uniformityleads to fallacious results. Antisera were set upfor the serodiagnosis of the typhus group offevers, and, in response to the committee'srequest for international opinion as to the use-fulness of these sera, three commentaries havebeen received from leading specialists in France,the United States and India.

Because of certain doubts as to the immuniz-ing potency of many smallpox vaccines, thecommittee recommended that the seed vacciniavirus used in different countries for the prepara-tion of such vaccines should be tested in rabbitschallenged with freshly isolated human variolavirus. As it was considered that this testingcould best be carried out in India, the Govern-ment of India was requested to accord the neces-sary facilities for this work.

The committee examined seventeen mono-graphs-with five appendices dealing with sub-stances for which international biological standardsexist-which had been submitted by the ExpertCommittee on the Unification of Pharmacopoeias.These monographs will be redrafted on the basisof the comments and textual alterations suggestedby the committee.

It was considered that certain decisions of theexpert committee should be brought to the noticeof the public as soon as possible, and to this endnotes were inserted in the Chronicle of the W orldHealth Organization concerning the withdrawalof certain hormones, changes in the unitage oftetanus antitoxin to equal that of the UnitedStates standard, and other matters.

In 1948, UNICEF had requested the ExpertCommittee on Biological Standardization toapprove the laboratories producing BCG vaccinefor the UNICEF vaccination campaign. A setof minimum requirements to which the labora-tories should conform in order to afford a gua-rantee of safety for the vaccine was thereforedrawn up, and the Chairman of the committeesubsequently inspected the BCG-producing labora-tories of Algiers, Göteborg, Bergen and Mexico.Reports on these laboratories, approved by theother members of the committee, were submitted

to the UNICEF/WHO Joint Committee onHealth Policy.

In August 1949, UNICEF further requestedthat the expert committee undertake periodicactivity testing of BCG and consider the possibili-ties of utilizing the Paris BCG Pilot Station. Inorder to obtain first-hand knowledge as to thepracticability of such a scheme, the pilot stationwas accordingly visited. The expert committeewas informed that in the opinion of the Director-General this station, together with one or two'similar institutions in other parts of the world,would provide an adequate means of testing theactivity, not only of BCG vaccine, but of variouskinds of tuberculin in relation to the internationalstandard. Such an institution might furtherprove useful in deciding such questions as therespective merits of various PPD preparationsfor which an international standard had beenproposed.

WHO and the expert committee were represen-ted at the Conference on European BCG Vaccina-tion Programmes, held in Copenhagen in Sep-tember. At this conference it was decided thatlocal BCG production centres should be estab-lished to supply the vaccine for the various vac-cination campaigns and that these centres shouldconform to the minimum requirements for BCGproduction framed by the expert committee andbe subject to its inspection and approval. Theviews of the expert committee on certain aspectsof the production of BCG vaccine and the uni-formity of potency were explained, and theConference recommended that, in close co-opera-tion with WHO, comparative studies of thedifferent BCG vaccines in use should be carriedout and control stations for the evaluation ofBCG vaccination established. Finally, stressingthe importance of using standardized tuberculinin performing the skin test, the Conferencerequested the expert committee to make definiterecommendations on a method of tuberculinassay.

The expert committee was also representedat the meeting of the Sub-Committee on Serologyand Laboratory Aspects of the Expert Committeeon Venereal Infections, which agreed that theestablishment of a standard for cardiolipin antigenwould be desirable and referred this question tothe expert committee.

During the year, in response to a requestaddressed to WHO by a group of British Rhexperts, a grant was awarded to enable two Rhspecialists from Copenhagen and Lund to discusswith British experts certain problems connectedwith the nomenclature of two blood groupsystems, " Lewis " and " Lutheran ".

The National Institute for Medical Research(now transferred from Hampstead to Mill Hill,London) and the State Serum Institute in Copen-hagen have continued the preparation, mainten-ance and distribution of international standards.The institutes supplied the WHO regional officeswith a stock of international standards, in orderthat they might undertake the distribution ofthem to countries within their areas.


Unification of Pharmacopoeias and Pharmaceuticals

Toward the end of 1948, in accordance withthe instructions of the First Health Assembly,"a unit was established to deal with the unificationof pharmacopoeias. This unit immediately beganto prepare the texts of the monographs andappendices to be included in the PharmacopoeaInternationalis (Ph. I.),22 directing its effortstowards the establishment of general principlesfor the checking and assembling of materialpreviously prepared by the League of Nationsand the Expert Committee on the Unificationof Pharmacopoeias and towards the revision ofexisting monographs and appendices. Materialon specific points (description, identification,physical specifications, impurities, assays, etc.)was prepared on subjects to be considered bythe Expert Committee, for example, on interna-tional chemical and physical nomenclature, theestablishment of international non-proprietarynames for drugs, and the control, inscription,labelling and advertising of habit-forming andother drugs and specialities.

The Expert Committee on the Unification ofPharmacopoeias held two sessions during 1949,one from 20 to 30 April" and the other from26 September to 5 October." The greater partof both sessions was devoted to the considerationof the draft monographs and appendices to beincluded in the Ph. I., for which the revision ofthe first proofs, according to the principles agreedupon by the expert committee, was, by the endof the year, nearing completion. It was expectedthat the English texts of 195 monographs and35 appendices, together with the preface, indexand notices referring to trademarks and patents,to appear in the first edition, would be ready forpublication early in 1950. Considerable work wasalso done on the French texts, which will not,however, be finally established until the Englishhas been completed. A French terminology forassays, reagents, etc., corresponding to theEnglish technical expressions, has been drawnup, and work on the Spanish text has been begun.

Structural formulae and chemical names,reports on and revised figures for melting-range,melting-temperature, congealing-temperature andboiling range, densities and solubilities wereamended and approved. In considering a revised

21 011. Rec. World HIM Org., 13, 30722 Title and agreed abbreviation for the new

publication as approved by the Expert Committeeon the Unification of Pharmacopoeias at its fourthsession. It was further agreed at this session thatthe publication should include a statement to theeffect that it is not intended to be official in anycountry unless adopted by the pharmacopoeialauthority of that country.

23 For the report on the fourth session, see WorldHlth Org. techn. Rep. Ser. 1950, 1

24 Report on the fifth session, to be publ' ed asWorld Hlth Org. techn. Rep. Ser. 1950, 12

table of usual and maximal doses, together withthe comments of a number of national medicalassociations and the World Medical Association,the committee agreed that doses should not begiven for drugs not described in the monographsand that in some instances maximal dosesshould not be stated even for those described,either because the drugs are not very toxic orbecause their maximum posology cannot beprecisely determined at present. A table of dosesfor infants and children will be prepared for anaddendum to the Ph. I., and appendices dealingwith biological assays on antitoxic sera will alsobe included.

As the proposal of agreements and regulationson the control of drugs is a constitutional functionof the World Health Organization, the com-mittee recommended that research on the control,as well as the advertising and labelling, of pharma-ceuticals moving in international commerce shouldbe undertaken at once. Available informationwas therefore collected from various countries,with a view to unifying the methods employedfor such control, ascertaining the regulations inforce, and facilitating international commerce.

Acting on a recommendation of the ExecutiveBoard at its third session " that a mechanismshould be established for giving a single name toevery habit-forming drug subject to internationalcontrol " 25 the committee agreed to provideinternational non-proprietary names for suchdrugs. Further, it considered the question ofestablishing a system of common nomenclaturefor new pharmaceutical products moving ininternational commerce and recommended thatnon-proprietary names should be selected forthose which are to be included in the Ph. I.

In response to a request to the committeefrom the Expert Committee on Mental Health,a list of synonyms, including non-proprietarynames and trademarks for such drugs, is beingprepared for publication as a supplement to anissue of the Bulletin of the W orld Health Or ganiza-tion.

As the expert committee can be convened onlytwice a year, correspondence has been carriedon with the members, in order to obtain theircomments on the proposed texts and the amend-ments submitted. These comments and sugges-tions for changes represented over 330 pages ofmimeographed text, only part of which wasconsidered by the committee, examination of therest being the responsibility of the Chairman andSecretariat. The Chairman also undertook finalrevision of all the texts to be inserted ; the com-mittee members prepared draft monographs andappendices on a number of new drugs (to beincluded in an addendum to the first edition),

25 Off. Rec. World Hlth Org., 17, 15


and took over the revision of methods of alka-loidal assays of crude drugs, reagents and testsolutions, solubilities at 20°, densities at 20°,assay on Ergot, limit tests for sulfates, arsenicand heavy metals, etc.

Relations were established and maintainedwith international organizations dealing withrelated subjects, particularly with the Interna-tional Union of Chemistry and the InternationalPharmaceutical Federation. A request from theFederation for the establishment of officialrelations with WHO will be presented to theExecutive Board.

Close co-operation was also maintained withother expert committees, to which appropriatemonographs on drugs were submitted for com-ment. The Expert Committee on BiologicalStandardization was particularly helpful in con-nexion with biological assays.

During the year, all information collected andassembled was made available to other sectionsof the Organization, and information was suppliedon request to organizations and individuals inmany countries, notably in Austria, Canada andYugoslavia.

Habit-forming Drugs

The Expert Committee on Habit-formingDrugs 26 met for the first time from 24 to29 January 1949, Apart from questions concern-ing proprietary medicines, the committee gavespecial consideration to the notifications receivedfrom the governments of the United States ofAmerica and the United Kingdom regarding theaddiction-producing character of metopon. Sub-stances belonging to the pethidine and methadonegroups were also considered, and precautionarymeasures with regard to synthetic substances ofthis type were recommended.

An important point to note is that on 1 De-cember 1949, with the coming into force of theprotocol bringing under international controldrugs outide the scope of the Convention of13 July 1931, the control of dihydrocodeine andderivatives and of the new synthetic substancesof pethidine and methadone type is now possible.

The committee considered a request from theGovernment of France regarding valbine, andagreed that exemption of this preparation fromthe provisions of the 1925 Convention shouldnot be granted, and recommended that thisdecision be notified to the Economic and SocialCouncil of the United Nations for transmissionto the French Government, which accepted thedecision.

Diacetylmorphine, the new synthetic sub-stances and the recent method of producing newmorphine derivatives of the morphinan type werealso considered. The committee recommendedprecautionary measures with regard to syntheticsubstances : with a view to " accelerating theapplication in similar cases of the principle con-tained in this recommendation on chemicalcompounds of the dolantin and amidone types ",the Economic and Social Council subsequentlyrequested the Secretary-General of the UnitedNations to transmit to all Governments therecommendation " that each Government shouldendeavour to apply at the earliest possible moment

26 Title subsequently changed to " ExpertCommittee on Drug§ liable to produce Addiction." 28 011. Rec. World Hlth. Org., 19, 29

provisions whereby drugs of a particular chemicaltype, analogues of which have been proved tobe habit-forming (for example, analogues ofdolantin and amidone), could be placed undercontrol until such time as they have been shownnot to be habit-forming ",27

As a result of the ambiguities which the com-mittee encountered in designating the variousdrugs discussed, it recognized the need for givinga common name to drugs used internationally,and recommended that " a mechanism shouldbe established whereby every habit-forming drugsubject to international control can be given asingle name to be used for all internationalpurposes ". The report of the committee, approvedby the Executive Board, was referred to theEconomic and Social Council."

During the year, investigations undertakenwere principally concerned with the effect ofcoca-leaf chewing in certain South Americanregions and the problems of marihuana smoking.Information on opiates and new synthetic habit-forming drugs was collected for the considerationof the next meeting of the committee, to takeplace early in 1950.

WHO has given advice to other bodies of theUnited Nations, particularly to the PermanentCentral Opium Board and the Drug SupervisoryBody, and has maintained close relations withthe Narcotics Commission of the Economic andSocial Council and with the United NationsNarcotics Division. Finally, the Organizationentered into relations with various scientificbodies and research workers concerned with theproblem of alcoholism. Particular emphasis wasplaced on questions concerning the etiology ofalcoholism, the new methods of treatment, includ-ing tetraethylthiuram disulfide (known underthe names of antabuse and abstinyl) and theresults obtained by the group " AlcoholicsAnonymous " in the United States and similarbodies in other countries.

27 ECOSOC Resolution 246 (IX) 6

NEw DEVELOPMENTS IN TECHNICAL SERVICES 61

Co-ordination of Research

Important activities under this head includethe establishment of a link between recentscientific discoveries and the various projects ofthe Organization, assistance in co-ordinating theresults of scientific research, the fostering - ofresearch in new subjects, and maintenance ofliaison with world research centres.

In 1949 the Tuberculosis Research Office wasestablished in Copenhagen. The activities of theoffice, and those of the World Influenza Centre(created in 1948 as a joint enterprise of WHOand the Medical Research Council of GreatBritain) and of the World Salmonella Centre aredescribed below. New projects included researchin antibiotics.29

World Influenza Centre

In 1949, the World Influenza Centre, locatedin the National Institute for Medical Research,London, had the first opportunity of proving itsvalue when an epidemic of influenza, apparentlyoriginating in Sardinia in September 1948, spreadto Italy, Switzerland, Austria, France, acrossinto northern Spain, thence to eastern Germany,Belgium and the Netherlands, across the Channelto Great Britain and eventually by sea to Ireland,the Scandinavian countries and Iceland.

Strains sent to the centre from Italy, Swit-zerland, France, the Netherlands, Great Britainand Iceland were found to be of the A-prime type,i.e., of that serological sub-strain of A whichprey ailed in many parts of the world in 1947.They were slightly different from the 1947A-primes, though more homogeneous amongstthemselves. Some of these strains are still beingstudied ; there is already evidence, however, thatthere was a real country-to-country spread in1948-1949 rather than a successive activation ofendemic influenza in different countries.

Of other strains sent to the centre, from Sweden,Czechoslovakia , Hungary, Germany, Turkey,Ocean Island (Pacific), Canada and the UnitedStates of America, and sera from Yugoslavia,some proved to be Influenza B or to be A strainshaving doubtful relationship to the westernEuropean outbreak ; one of each of the strainsof virus examined (from Hungary, Ocean Island,Canada and the United States of America),however, was of the A-prime type,

These viruses were also studied by the NationalInstitute for Medical Research, where, by theaid of electron-micrography, they were foundto exist largely in the form of slender filaments,a phenomenon which may prove to be commonto recently isolated A-viruses.

Although the centre was able to obtain valuableinformation from collaborating laboratories, there

29 See section on Special Office for Europe,Chapter 2, p. 37.

is great need for information and newly isolatedstrains to be sent more promptly. Arrangementswere made whereby Dr. T. P. Magill's laboratoryat Long Island Medical College, Brooklyn, NewYork, recognized as the " strain study centre forthe Americas ", will in future receive informationand strains from North and South America andissue reagents to laboratories in those continents.Close contact will be maintained between thislaboratory and that of the World Centre.

An unofficial conference on influenza, organizedby the World Influenza Centre, was held at theNational Institute for Medical Research from11 to 14 July. At this meeting, specialists ininfluenza research discussed international colla-boration, with special reference to the possibilityof obtaining greater uniformity in the diagnostictechniques used in different laboratories.

During the year, visiting workers from variouscountries in Europe and from Egypt, India andthe United States of America spent up to threeor four weeks studying techniques in the laboratoryof the centre.

Tuberculosis Research Office

A Tuberculosis Research Office was establishedin Copenhagen in February 1949. This office hasundertaken research in tuberculosis, more parti-cularly in connexion with the mass BCG vaccina-tion being carried out by the Danish Red Crossand its Scandinavian associates, with the assist-ance of UNICEF (known as the Joint Enterprise).At the end of 1949, this campaign had beencompleted in Czechoslovakia, Finland and Poland,and was continuing in Austria, Greece, Italy andYugoslavia. It had been extended to Lebanon,Israel, Egypt and the Arab refugees in the MiddleEast, and also to North Africa, India, Pakistanand Ceylon. During the year, members of theResearch Office visited various countries in con-nexion with this campaign (Norway, Finland,Iceland, Austria, Czechoslovakia, Yugoslavia,Greece, Lebanon, Israel, France, Italy, PuertoRico, Japan, Egypt, and India) atid secured first-hand information on the field work, and surveyedand discussed possibilities for research.

As a result, the activities of the office weredeveloped and rapidly extended. A considerablenumber of observations on tuberculin-testingwere made, and records of BCG vaccination-of unique significance because of the wide geo-graphic coverage and the uniformity of materialsand techniques used-were collected. A pilotstudy was made of the information obtained inthe campaign in Poland. The purpose of thisstudy was to work out a uniform system foranalysis and presentation, so that statistics andresults thus obtained would be comparable notonly for various districts and population groupswithin a country, but also internationally forwidely separated areas and different races. The


basic material from the Czechoslovak campaignwas also compiled, and final documentation willbe completed in 1950. Similar work was begunfor other countries from which statistical datahad been or were being collected.

For countries where the campaign had onlyjust begun or was continuing, steps were takento ensure that statistical work was properlycarried out or improved. Trained statisticianswere sent to assist in the organization of fieldstatistical services in various countries and tosupervise and train local statistical personnelengaged in the work. At the end of the year, twostatisticians had been working for several monthsin Yugoslavia and Greece ; a third had returnedfrom duties in Beirut and Cairo ; and a detailedmanual for field statistical work had been compiledand distributed.

Owing to the scarcity of statisticians experi-enced in medical matters, attention was also givento the training of young statisticians for work inconnexion with the BCG campaign and in sta-tistical analysis.

In December, an agreement was signed withthe Austrian Ministry of Social Welfare, settingup a central statistical service in Vienna tocollect and compile the material of the campaignin Austria, including observations on post-vaccination tuberculin testing, which is to becarried out on a country-wide basis.

To assess the effects of the BCG vaccinationin terms of changes in tuberculosis mortality andmorbidity, a long-range evaluation programmeof a pilot nature was set up in Finland (see p. 41).Supplementing this programme, a detailed analysisof Finnish tuberculosis mortality for the pastfifty years was prepared.

In co-operation with the State Serum Instituteof Denmark and the Joint Enterprise, a fieldstudy was undertaken on the influence of the age

and dosage of BCG vaccine and the temperatureof storage on its allergy-producing qualities. Afirst trial was carried out on a total of 5,000 schoolchildren. Efforts are being made to work outsuitable methods for field standardization of thevaccine.

Studies of the practical techniques of tuberculintesting have been and are being developed todetermine the suitability of the various tests indifferent geographic areas. On the basis of thesestudies, the Moro test has been shown to beinadequate as a single pre-vaccination test incertain tropical countries.

The need for clarification on the specificityof the tuberculin test and the significance of thenon-specific reactions was emphasized by themass vaccination campaign. A special researchteam was therefore organized, to obtain scientificinformation on this problem. The team has begunits work in India, and a co-operative programme oftuberculin testing of a similar nature has beenstarted in Iceland. Further programmes ofintensive study on the incidence of infection andthe morbidity of tuberculosis have also beenplanned for certain areas in India and discussedwith health authorities in Iceland.

World Salmonella Centre

By the end of 1949, the World SalmonellaCentre, established at the State Serum Institutein Copenhagen and maintained by WHO, wascollaborating with 31 regional salmonella centres.It had supplied laboratories with 2,059 test strainsand 667 ampoules of test sera, amounting toabout 5 litres of serum, and had received fordiagnosis 151 cultures, among which there wereseveral new types which were analysed andpublished.

Editorial and Reference Services

Publications and Other Editorial Services

An extensive programme of publications for1949, most of them representing publicationsformerly undertaken by the Health Organizationof the League of Nations or the Office Interna-tional d'Hygiène Publique, had been proposedby the Interim Commission to the First WorldHealth Assembly. The Assembly decided,however, to defer some of these publications, andsevere budgetary limitations delayed the recruit-ment of adequate staff, particularly in the earlierhalf of the year. The volume of publications wastherefore considerably less than had been planned.

The 1949 volumes of the Bulletin of the WorldHealth Organization and the Chronicle of the W orldHealth Organization appeared for the first timein a completely re-styled form. Every effort hasbeen made to maintain in these publications, and

especially the Bulletin, high standards of editing,translation and production. Articles in theBulletin have been abstracted in leading abstract-ing journals, and material from the Chroniclehas been widely reproduced in the medical press.

Reports of expert committees and otheradvisory bodies were published in the OfficialRecords of the W orld Health Organization. In- thelatter part of the year it was decided that suchreports should in future be included in a newseries with the title World Health Organization :Technical Report Series, and the first few numberswere prepared for publication early in 1950.

A list of publications actually printed in 1949 isgiven in table I (p. 66). In addition, at the end of theyear, the following was in proof form : most ofthe text of the Pharmacopoea Internationalis(English edition) and of the Manual of the Interna-tional Statistical Classification of Diseases, Injuries


and Causes of Death, vol. 1 (French and Spanisheditions) ; and approximately a fifth of the con-solidated volume of the Annual Epidemiologicaland Vital Statistics for the years 1939 to 1946.

At the end of 1948, the first number of theInternational Digest of Health Legislation had beenpublished. In the first quarter of 1949 a studywas made of the problems implicit in an attemptto make the Digest a satisfactory source of infor-mation on health legislation throughout the world.Preparation of the Digest has involved extensiveresearch, and during 1949 limitations of staff didnot permit the publication of more than onenumber.

Apart from the WHO publications enumeratedabove, the English text of the Annual Report onthe Results of Radiotherapy in Cancer of theUterine Cervix (fifth volume) was translated intoFrench, and editorial assistance was given in thepreparation of the volume, published jointly bythe British Empire Cancer Campaign, London ;the Donner Foundation, Philadelphia ; the Cancer-f oreningen, Stockholm ; and the World HealthOrganization. This volume amounted to 245 pagesin English and 248 pages in French.

Ten numbers of the Official Records and a 1949edition of a Handbook of Basic Documents for useat the Second Health Assembly were publishedduring the year. The latter contains the Con-stitution, Convention on the Privileges andImmunities of Specialized Agencies, and Rulesand Regulations of the organs of WHO and ofits expert committees. The Official Recordsvolumes published included the proceedings ofthe First and Second World Health Assemblies,the reports of the first four sessions of the Exe-cutive Board, the first annual report of theDirector-General, the programme and budgetestimates for 1950, and two volumes containingreports of expert committees.

During 1949 a great proportion of the WHOpublications were distributed free of charge.Criteria for free distribution naturally vary con-siderably according to the publication. TheChronicle, for example, has been sent to healthinstitutions or public-health experts on request,as it is considered a useful medium for stimulatinginterest in WHO among health workers and alsofor drawing attention to other WHO publications,which are announced and publicized in eachnumber of the Chronicle (for example, the Chroniclecontains short summaries of the technical paperspublished in the Bulletin). If better arrangementsfor sales can be made in the future, the policyof distribution of the Chronicle will be recon-sidered. Criteria for distribution of other publica-tions are much more restrictive.

All requests for free copies of publications werecarefully considered ; if they did not appear tofall within the permitted categories, a price listwas sent with the suggestion that the enquirermight care to subscribe to them.

There was a steady increase in the number oflegitimate requests for free distribution of WHOpublications (see fig. 1). The total number ofaddresses on the free mailing list for each publica-

tion is shown in table II (p. 67), and the numberof subscriptions to all WHO publications intable III (p. 67). Table IV (p. 68) shows theprincipal classes of recipients of free copies ofWHO publications.

Arrangements for sales have been made throughthe United Nations Geneva Office, which appointsan agent in each country. Most agents are generalbooksellers with no special interests or connexionsin the health field, and they have therefore notundertaken any active measures to bring WHOpublications to the notice of potential subscribers.

Taking into account the proportion of freedistribution and the lack of publicity for WHOpublications, however, the upward trend of salesof the Bulletin, Chronicle and Digest in 1949 wasconsidered to be very satisfactory. The increasein the number of subscriptions is shown in fig. 2.The total receipts from the sale of publications in1949 amounted to $ 25,172, this figure includingonly monies actually received by the Organization.The total amount invoiced during 1949 was$ 50,010, of which $ 37,805 was in respect oforders for the Manual.

Figures 1 and 2 and tables H and IV refer onlyto regular distribution, and do not include thelarge special distributions of certain numbers ofthe Official Records which are sent as part of thedocumentation of the World Health Assembly,the General Assembly of the United Nations, andsessions of the Economic and Social Council.

By the end of 1949, the total number of medicaland health periodicals with which WHO publica-tions were exchanged amounted to 781.

Translations

The total volume of translations completed in1949 is shown in table V (p. 68). The unit usedfor estimating the volume of material translated isthe " page ", which represents a page of normaltypescript in double spacing.

In the examination of such figures, due regardshould be paid to the wide variation of thematetial translated and of the time required.While it may be possible over a long period tostrike a rough average of the number of pagesdone per translator, it is obviously impossiblein the case of technical papers to measure outputsolely in terms of pages produced.

The output for 1949 represents an increase ofmore than 25% over that for 1948. Changes inthe material requiring translation are, however,not only quantitative but qualitative ; thegrowing number of expert committees and thedevelopment of technical publications have in-creased the proportion of highly technical textsrequiring translation. In 1949 arrangements weremade for occasional translation of some of themore technical texts outside the Organization,where it was possible to find translators intoFrench with suitable technical qualifications.This has proved a useful auxiliary method ofobtaining translations of technical material, and

6 4 ANNUAL REPORT OF THE DIRECTOR-GENERAL

FIGURE 1. NUMBER OF WHO PUBLICATIONS DISTRIBUTED FREE OF CHARGE

OCTOBER- OCTOBRE 1946

nDECEMBER - DECEMBRE 1949

FIGURE 2. NUMBER OF SUBSCRIPTIONS TO WHO PUBLICATIONS

SOO

400

300

200

100

F71 JUNE- JUIN 1948

ri MARCH - MARS 1949

[7, OCTOBER - OCTOBRE 1949

A

SOO

400

300

200

100

0

vino 503 7

A = Bulletin of the World Health Organization D -= International Digest of Health LegislationB = Chronicle of the W orld Health Organization E = Epidemiological and Vital Statistics ReportC = Of ficial Records of the World Health Orga- and W eekly Epidemiological Record

nization F = Epidemiological and Vital Statistics Report


it will probably be further developed. A verycareful revision of such translations is, however,necessary.

Library and Reference Services

During 1949, a progressive increase in the workof the Library has reflected the development ofthe technical activities of the Organization. Asnew technical sections have come into being, theresources of the Library in particular subjectswere often found to be inadequate. The Libraryhas had to take into consideration a balancedrepresentation of subjects, and also the need forthe collection to be representative of the languagesrequired by an international secretariat and forother international purposes.

Current periodicals have been circulated regu-larly to members of the Secretariat in accordancewith their varying technical and linguistic require-ments ; over 15,000 issues were circulated during1949.

A collection of fifty current periodicals has beenmaintained in a special reference room establishedfor the convenience of the Secretariat. Currentdocuments of WHO, the United Nations and itsSpecialized Agencies are also available, and ananalytical index of these documents is kept inthis room.

Further, because of the serious delay in thepublication of important printed indexes tocurrent periodical medical literature, articles ofinterest to the WHO Secretariat are selected frommore than 800 journals and indexed by authorand subject. As part of the work of assemblingmaterial for the International Digest of HealthLegislation, a card index of health legislation isalso maintained.

Recent acquisitions to the Library are listedin the Library News, which also includes otherrelevant bibliographical information. This is cir-culated in mimeographed form to staff membersat Headquarters and in regional offices, and alsoon request to health administrations, medicallibraries, and other suitable recipients.

A considerable part of the Library's resourceshas been devoted to the preparation of ordersfor medical literature on behalf of requestinggovernments. These orders, sometimes comprisingseveral thousand titles, are usually received in avery imperfect state, many of the titles being

identifiable only after prolonged search in biblio-graphical reference works. Apart from theimperfections of the lists received, works requestedare often out of print or completely out of date,and in such cases suitable alternatives have tobe found. In spite of the great amount of timethat has been spent on this work, considerablearrears have accumulated.

Statistics of routine Library activities for theyear are shown in table VI (p. 69).

During 1949, WHO was represented at meetingsin New York of the Working Group on Publica-tions of the Administrative Committee on Co-ordination ; for the purposes of this working group,detailed information was prepared on the classi-fication of WHO documents, distribution andsales policy, types of distribution, and printingprogrammes. The Organization also participatedin a meeting of terminology experts convenedin New York by the United Nations, and preparedand submitted relevant information for discussionat this meeting. Similarly, it was represented ata meeting in Geneva of European members of theLibrary Co-ordinating Committee of the UnitedNations Organizations.

In Paris, a representative of WHO attendedthe International Conference on Science Abstract-ing, and, in February, the third meeting of theExecutive Committee of UNESCO'S Interim Co-ordinating Committee on Medical and BiologicalAbstracting, both convened by UNESCO. InJune, a meeting of the full committee took place,at which it was decided that its terms of referenceshould be extended, and its title correspondinglychanged to the " Co-ordinating Committee onAbstracting and Indexing in the Medical andBiological Sciences ".

One of the recommendations of this committee,that a World List of Medical and BiologicalPeriodicals, with appropriate abbreviations, shouldbe published, was further considered at a meetingof several members of the Executive Committeecalled by UNESCO in October. A representativeof WHO attended all these meetings and partici-pated in the discussions.

During 1949 UNESCO'S activities in the co-ordination of medical and biological abstractingand indexing services were supported by WHO,both by participation in meetings and by afinancial grant.


TABLE L LIST OF PUBLICATIONS PRINTED DURING 1949

Title No. of issues Number of pages(all languages) English French Spanish Russian Total

Chronicle of the W orld HealthOrganization 44 330 350 258 296 1,234

Bulletin of the W orld HealthOr ganization 4 346 372 -- 718

Manual of the International Statis-tical Classification of Diseases,Injuries and Causes of Death . 1 552 552

International Digest of HealthLegislation 2 204 216 420

W eekly Epidemiological Record . . 53 508 (bilingual) 508

Epidemiological and Vital Statis-tics Report 11 236 (bilingual) 236

Official Records of the W orld HealthOrganization :No. 12. Supplementary Report

of the Interim Commissionto the First W orld HealthAssembly 2 76 76 152

No. 13. First World HealthAssembly 2 400 400 800

No. 14. Reports of the ExecutiveBoard, First and SecondSessions 2 108 108 216

No. 15. Reports of Expert Com-mittees to the Executive Board 2 44 44 88

No. 16. Annual Report of theDirector-General to the W orldHealth Assembly and to theUnited Nations, 1948 . . . . 2 52 52 104

No. 17. Report of the ExecutiveBoard, Third Session . . . . 2 84 84 168

No. 18. Programme and BudgetEstimates for 1950 . . . . 2 170 170 - - 340

No. 19. Reports of Expert Com-mittees and other AdvisoryBodies to the Executive Board 2 48 48 - - 96

No. 20. Financial Report 1 sep-ternber-31 December 1948 andReport of the External Auditor 2 22 22 - - 44

No. 21. Second World HealthAssembly 2 432 440 - - 872

No. 22. 'Report of the ExecutiveBoard, F ourth Session . . . . 2 56 56 112

Handbook of Basic Documents 2 54 54 - 108

Agenda, Second W orld HealthAssembly 2 11 11 - - 22

List of WHO Publications . . 2 6 6 - 12

TOTAL 143 3,739 2,509 258 296 6,802

* Excluding the Chinese edition.


TABLE II

NUMBER OF ADDRESSES ON THE FREE MAILING LIST FOR EACH WHO PUBLICATION

October 1948 31 December1949

Bulletin of the W orld Health Organization English 536 683French 494 594

Total 1,030 1,277

Chronicle of the W orld Health Organization English 1,818 2,538French 1,400 1,615Spanish 407 864Chinese 600 980Russian 88 98

Total 4,313 6,095

Official Records of the W orld Health Organization . . English 324 527French 258 338

Total 582 865

International Digest of Health Legislation English 258 388French 163 254

Total 421 642

Epidemiological and Vital Statistics Report bilingual 1,458 1,473

W eekly Epidemiological Record bilingual 706 759

TABLE III. NUMBER OF SUBSCRIPTIONS TO WHO PUBLICATIONS

Early June1948

30 March1949

30 October1949

Bulletin of the W orld Health Organization . . English 243 353French 90 112

Total 320 333 465

Chronicle of the W orld Health Organization . . English 153 299French 46 61Spanish 11 14Russian 6 9

Total 195 216 383

Official Records of the W orld Health Organization English 89 124French 18 25

Total 105 107 149

International Digest of Health Legislation . . English 100 166French 20 28

Total 106 120 194

Epidemiological and Vital Statistics Report,together with the W eekly EpidemiologicalRecord bilingual 134 133 206

Epidemiological and Vital Statistics Report . . bilingual 104 114 167


TABLE TV

PRINCIPAL CLASSES OF RECIPIENTS OF FREE COPIES OF WHO PERIODICALS

National and local health administra-tions

OfficialRecords

+

BulletinInternational

Chronicle Digest ofHealth

Legislation

,

WeeklyEpidemio-

logicalRecord

Epidemiolo-gical and Vital

StatisticsReport

Ministries of External Affairs + +

Central and local quarantine adminis-trations + ±

Governmental and non-governmentalstatistical institutions +

Governmental and non-governmentalhealth and research institutions . . . + H- +

United Nations and specialized agencies + + + - +

Inter-governmental organizations . ,-1-

Non-governmental organizations ad-mitted into relationship with WHO . + __I:- -

Depository libraries A_ --i- + ± - +

Medical and other libraries --t- + H- + - H-

Medical journals -1-- + - -4-

Public health experts ..... +

TABLE V. TOTAL VOLUME OF TRANSLATIONS DONE IN 1949 *

Into : Pages

English 1,756

French 10,514

Spanish 433

Russian 735

TOTAL 13,438

* Excluding the translation of the Chronicle into Chinese.

TABLE VI. STATISTICS OF ROUTINE LIBRARY ACTIVITIES DURING 1949

WHO Library Catalogue Loans Periodicals Index to technicalliterature

Supply of medical literatureto governments and teams in

the field

Documents of theOrganization, United Nations

and Specialized Agencies

Books ordered Workscatalogued

Cardsmade

From WHOLibrary

Fmm TJNLibrary

Periodicalsnewly

received

Issues circulatedto

Secretariat

Articlesindexed

Cardsmade Books

.Periodicals Number

receivedNumberindexed

January 124 60 400 90 114 20 1,300 200 500 68 398 * *

February 85 87 850 95 226 26 1,200 150 547 162 267 * *

March 102 136 686 82 188 27 1,200 250 1,208 15 176 * *

April 93 123 405 114 135 13 1,871 250 1,186 185 461 * *

May 123 157 399 290 315 32 975 402 1,210 582 145 * *

June 165 114 684 146 314 14 594 341 1,213 115 1,536 * *

July 120 160 486 188 269 14 1,791 327 1,569 431 172 * *

August 113 124 916 181 183 14 1,365 310 1,495 156 83 1,100 354September 53 84 465 157 294 6 536 147 574 701 83 1,600 535October 156 181 615 252 265 29 1,288 396 1,808 580 151 1,800 355November 602 300 2,581 316 342 40 1,890 305 1,510 215 51 2,200 395December 206 338 2,032 555 230 29 1,077 1,206 3,358 370 26 1,900 359

TOTAL 1,942 1,864 10,519 2,466 2,875 264 15,087 4,284 16,178 . 3,580 3,549 8,600 1,998

* Statistics not available.

CHAPTER 4

RELATIONS WIT H OT HE R INTE RNATIONAL ORGANIZATIONS

Throughout 1949, WHO's relations with theUnited Nations, the other specialized agencies,and appropriate non-governmental organizationswere maintained by means of mutual representa-tion at meetings, inter-secretariat planning, andexchange of reports and documents. In thisconnexion, WHO has attempted to keep the otherorganizations fully informed on its developments

and, conversely, has kept its own personnelinformed on the activities of other agencies. Theextent of the co-operation which has been achievedbetween WHO, the United Nations and thespecialized agencies is indicated by the numberof joint projects which have been undertakenand successfully developed during 1949.

United Nations

General Liaison

Liaison with the United Nations is primarilythe responsibility of the WHO liaison offie atLake Success ; but at United Nations conferencesheld in Europe, at certain meetings on technicalsubjects convened in various countries, andoccasionally at some of the more importantmeetings called in New York, WHO has beenrepresented by members of its Headquarters staff.

The Director-General attended the two sessionsof the Administrative Committee on Co-ordinationwhich were held during the year, both of whichtook place at Lake Success. WHO officials alsorepresented the Organization at meetings of thePreparatory Committee of the ACC and of someof its subsidiary bodies, such as the ConsultativeCommittee on Administrative Questions (onproblems of personnel and the woik of the Inter-national Civil Service Advisory Board), theConsultative Committee on Public Information,the United Nations Film Board and the Consulta-tive Committee on Statistical Matters. WHO alsotook part in meetings of the following technicalgroups attached to ACC : Housing and Town andCountry Planning, Migration, Fellowships, Publi-cations, the Continuing Needs of Children, andTechnical Assistance. The Organization alsoco-operated with UNICEF in the preparatorywoi k for establishing an international children'scentre.

Technical assistance and children's needs aretwo questions of particular interest to WHO. Inthe past year governments have undertaken,through the United Nations, to work togetheron the solution of the urgent problems of the

1 For lists of meetings convened by WHO orattended by WHO during 1949, and for tentativeschedule of meetings in 1950, see Annexes 4,5, 6 and 7.

need of under-developed countries for technicalassistance and the provision of adequate careand opportunities for children. These twoquestions have cut across the organizationalstructure of the United Nations and the specializedagencies, and the proposals for joint actionwhich have been worked out show considerablepromise for the increasing flexibility and effective-ness of inter-agency co-ordination in the future.

Since a healthy working population is a pre-requisite to the raising of economic standards,WHO has an important contribution to make tothe programme of technical assistance foreconomic development. After discussing methodsof collecting and administering the funds for thisprogramme, the Economic and Social Councildecided that the best method would be to financeit from a special fund which the United Nationswould collect and would then disburse to theoperating agencies, in accordance with recom-mendations of a board composed of the Secretary-General and the Directors-General or theirrepresentatives.2 The work of this TechnicalAssistance Board, as it is called, is to be subjectto general supervision and review by a TechnicalAssistance Committee composed of the membersof the Council. This plan was approved by theGeneral Assembly ; WHO was represented at thepreparatory meeting of the Technical AssistanceBoard in December ; and proposals which theOrganization considered to be useful contributionsto economic development have been included inits future programmes.

It was at the suggestion of both UNICEF andWHO that the ACC set up the Working Party onthe Continuing Needs of Children. The conclusionsof this working party were considered by the

2 Resolution 222 IX

- 70 -

RELATIONS WITH OTHER INTERNATIONAL ORGANIZATIONS 71

Social Commission, which has now asked theSecretary-General for a further report on thesubject. WHO, with the support of certain otheragencies, has pointed out that the needs ofchildren are too vast to be met by an emergencyprogramme, and has advocated specific inter-national machinery to co-ordinate action and toensure that each particular section of the workshall be carried out by the international organwhich possesses the appropriate technical compe-tence. Action on the proposal to establish aninternational children's centre is described under" Special Projects " below.

Besides being represented at meetings of theGeneral Assembly whenever subjects bearing onits programme were considered, WHO took anactive part in the work of the Assembly's SpecialCommittee on Information transmitted underArticle 73e of the Charter, and the AdvisoryCommittee on Administrative and BudgetaryQuestions. Most of WHO's liaison work, however,is with the Economic and Social Council, whichis responsible for co-ordinating the activitiesof the specialized agencies and the United Nations.

During 1949, the main work of the Economicand Social Council was concerned with the pro-posals for technical assistance. WHO was,however, also closely interested in other subjectsconsidered by the Council, and proposed twoitems for its agenda : (1) action to increase theavailability of DDT and other insecticides forcombating malaria in agricultural areas, and (2) ajoint programme of co-operation between govern-ments, FAO and WHO to increase world foodproduction and raise standards of health.

The first item, which originated from a recom-mendation of the Expert Committee on Malaria,resulted in the adoption of a resolution by theCouncil recommending that Member Governmentsshould facilitate free trade in insecticides and inraw materials and equipment for their production ;that technical assistance should be given toencourage the production of insecticides in under-developed countries where such production ispossible ; that the attention of governmentsshould be drawn to the recommendations ofWHO regarding the correct labelling of insec-ticides ; and that the Secretary-General of theUnited Nations should continue his study of thissubject. Towards the end of the year, the Director-General sent a further letter to the Secretary-General, requesting action. As regards thesecond item, the Council was informed of thedetailed plans worked out and approved byboth FAO and WHO for the joint project onfood production and improved health conditions,and of the relevant resolutions passed by theSecond Health Assembly.

Among other Council resolutions of particularinterest to WHO were those on the status of

women (in which attention was drawn to theworldwide shortage of health workers, especiallyof nurses, and certain measures were recommendedto WHO) ; 8 on precautionary measures for thecontrol of synthetic narcotic substances (seepage 60) ; 4 on the loan of certain medical andhealth material from the Central Library inGeneva ; 5 on a request to WHO and UNICEFto give urgent attention to possible measures foremergency assistance to the Republic of Ecuador,which was suffering from the after-effects of anearthquake (see pages 6, 10 and 49) ; 6 and variousresolutions on co-ordination and administrativematters.

In the subordinate bodies of the Economic andSocial Council, close working relations weremaintained with the Social Commission and theDepartment of Social Affairs, particularly onsuch subjects as social welfare, a special rehabilita-tion programme envisaged for European countries,fellowships, juvenile delinquency, homelesschildren, and the prevention of crime and treat-ment of offenders. Active liaison was continuedwith other commissions, and with their committeesand sub-committees, on' a variety of subjects ofinterest to WHO, such as human rights, popula-tion, narcotic drugs, transport and communica-tions, statistics (in connexion with a joint study onthe wastage of human life) and economics andemployment. WHO also took part in the workof the Department of Economic Affairs (on theconservation of natural resources) and of theRegional Economic Commissions for Europe(ECE), Asia and the Far East (ECAFE) and LatinAmerica (ECLA). In conjunction with ECE,WHO considered supply problems of concern toEuropean countries and studied projects inhousing and town planning.

WHO also co-operated with the TrusteeshipCouncil and its committees, and gave assistancein the revision of the Standard Form and Question-naire designed to secure useful information fromnon-self-governing and trust territories.

Special Projects

An ever-increasing number of joint projectshas been undertaken in collaboration with theUnited Nations International Children's Emer-gency Fund, one of the temporary organs of theUnited Nations. As the character of the pro-gramme of UNICEF changed from outright emer-gency relief to the provision of assistance, andparticularly supplies, for long-range health pro-jects, co-operation between that organization andWHO became closer. All operations of mutualinterest are subject to the principles formulated gy

Resolution 242 (IX) FResolution 246 (IX) G

5 Resolution 260 (IX)6 Resolution 254 (IX)


the Joint Committee on Health Policy, UNICEF/WHO, and require the assent of both the Exe-cutive Director of UNICEF and the Director-General of WHO. Joint projects include : (1) theBCG campaign, which is being carried on jointlyby UNICEF and the Danish Red Cross with itsScandinavian associates (known as the JointEnterprise), and for which WHO has giventechnical advice, followed by research on anddevelopment of statistics on evaluation ; (2) fellow-ships, of which WHO administered 27 for UNICEFin 1949 ; (3) projects in the control of malaria,tuberculosis, venereal diseases and other com-municable diseases, and in maternal and childhealth, nutrition, environmental sanitation andhealth education, for which WHO providestechnical advice and UNICEF has usuallyprovided the supplies ; (4) plans concerning thecontinuing needs of children (see above) and theChildren's Centre.

In relation to the Children's Centre, theExecutive Board at its fourth session decided inprinciple that WHO should assist, in co-operationwith UNICEF, in the establishment of such acentre in Paris, by the French Government,and authorized the Director-General to concludean agreement with UNICEF, subject to certainconditions.7 The terms of the agreement (whichhad been formulated by the end of the year inan exchange of letters with the Executive Directorof UNICEF) cover the following points : (1) admi-nistration of the Centre by the Government ofFrance ; (2) its recognition as a national institu-

tion ; (3) allocations to the Centre by the ExecutiveBoard of UNICEF ; (4) provision that projectsinvolving expenditure require the approval of theJoint Committee on Health Policy, UNICEF/WHO ; and (5) establishment of a technicaladvisory committee as a co-ordinating body.These arrangements were approved by the Exe-cutive Board of UNICEF in November.

WHO has seconded the technical personnelnecessary for UNICEF, and the regional officeshave also co-operated with the Fund. Meetingsof the UNICEF Executive Board, ProgrammeCommittee and Medical Sub-Committee havebeen regularly attended by representatives ofWHO. During 1949, plans were made to extendWHO/UNICEF projects into Latin America,in co-operation with the Regional Office for theAmericas. A medical officer has been assignedas WHO representative to the UNICEF FarEast Mission, to implement the health aspects ofthe Far Eastern programme.

Another task of the United Nations in whichWHO has assisted is the United Nations Relieffor Palestine Refugees. Operating jointlywith the United Nations, the International RedCross Committee, the League of Red CrossSocieties, the American Friends Service Committeeand UNICEF, WHO has provided personnel,allotted funds, given technical advice, directed acampaign against malaria, and studied andreported on the long-term implications of thissituation (see page 24).

Specialized Agencies

FAO

The excellent working relations between FAOand WHO were strengthened during 1949, andplans for joint projects were further advanced.The joint FAO/WHO project of malaria controland agricultural development to increase foodproduction and raise standards of health is oneof the most popular inter-agency co-operativeprojects yet developed. Planning continues, andif funds become available field work may beginin 1950.

The first session of the Joint FAO/WHOCommittee on Nutrition, held in Geneva from24 to 29 October, defined the responsibilitiesof the two organizations in this field and indicatedplans for additional collaboration. Co-operationon problems of rural welfare was also continued.

ICAO

Common interests with ICAO have steadilydeveloped, particularly in connexion withincreasing the effectiveness of the International

7 011. Rec. World Hlth Org., 22, 5

Sanitary Conventions where they apply to airnavigation or transport and to the disinsection ofaircraft.

ILOTwo joint committees were set up with the

International Labour Organization : the JointILO/WHO Expert Committee on the Hygieneof Seafarers, which met for the first time inDecember, and a Joint ILO/WHO Expert Com-mittee on Occupational Hygiene, which is to meetin 1950. As both organizations have an interestin the maritime aspects of venereal diseases, aspecial project has been the co-ordination ofvenereal-disease control along the Rhine Riverbasin. In addition, ILO has co-operatedactively in the work of WHO on the SanitaryConventions and Regulations as they affectmigrant workers.

IROWhile the International Refugee Organization

is a temporary international organization, someaspects of its work have a direct relation tosimilar activities of WHO, i.e., the health condi-tions of migrants and the continuing needs of

RELATIONS WITH OTHER INTERNATIONAL ORGANIZATIONS 73

children. During 1949, WHO continued to giveexpert advice to IRO as required, and the twoorganizations worked side by side on the Per-manent Migration Committee, the Economicand Social Council and the Administrative Com-mittee on Co-ordination.

UNESCO

WHO has continued and expanded its co-operation with the United Nations EducationalScientific and Cultural Organization in variousfields, notably in the basic sciences and education.In 1949 these efforts resulted in the establishmentof the Permanent Council for the Co-ordination ofInternational Congresses of Medical Sciences, andthe Second Health Assembly approved principlesfor continued co-operation with UNESCO inthe support of this Council.'

WHO, together with the United Nations andother specialized agencies, continued to co-operatewith UNESCO in its fundamental educationproject in Haiti. It also worked with UNESCOin planning, with the Netherlands health adminis-tration, a travelling international health exhibit,and in compiling a catalogue of selected filmson child care and welfare.

Other common fields of activity included :international fellowships programmes ; the co-ordination of medical courses in universities(Interim Committee of the International Associa-tion of Universities) ; audio-visual teaching

material ; abstracting and indexing in the medicaland biological sciences ; tensions affecting inter-national understanding ; and vagrancy in children.Steps were also taken to develop liaison betweenthe appropriate technicians of UNESCO andWHO for work on adult education. UNESCOhas given valuable advice and assistance toWHO in work connected with broadcasting,recording, medical literature and supplies.

Other Specialized Agencies

Contacts with the International MonetaryFund and the International Bank for Reconstruc-tion and Development during 1949 were mainlymade through meetings of the AdministrativeCommittee on Co-ordination. It is anticipatedthat relations will be maintained in the futurechiefly in connexion with joint missions and plansfor advancing the programme of technicalassistance. The Bank has offered to advise WHOon the Belgian proposal for a world health defencefund, made at the Second Health Assembly.'

Informal working relations have been continuedwith the Interim Commission of the InternationalTrade Organization and with the PreparatoryCommittee of the Inter-Governmental MaritimeConsultative Organization, in view of the impor-tance to international water-borne commerce ofWHO's activities in epidemiology and quarantine.

Non-Governmental and Other Organizations

From its inception, the Organization hasrecognized the mutual benefits to be derived fromrelations with non-governmental organizationswhich are active in health work. At the end of1949, eighteen international non-governmentalorganizations had official relations with WHO."

In addition to assisting in the development, andsometimes in the operation, of programmes,these non-governmental bodies have given WHOthe benefit of their experience and have enabledit to keep in touch with public opinion in theirrespective fields. For example, following arequest from the United Nations Commission onHuman Rights for advice on Article 7 of thedraft Covenant on Human Rights (which states," No one shall be subjected to any form ofphysical mutilation or medical or scientificexperimentation against his will "), WHO hasasked the International Council of Nurses andthe World Medical Association to study theproposed text and to express an opinion. Thesetwo non-govermental organizations have alsobeen consulted on the question of establishingan international code of medical ethics, a pro-posal submitted by the League of Red Cross

Resolution WHA2.5, O. Rec. World Hlth Org.21, 19

9 Off. Rec. World Hlth Org. 21, 126

Societies in association with a national medicalassociation.

Plans for future activity in tuberculosisenvisage even closer co-operation with the Inter-national Union against Tuberculosis and theLeague of Red Cross Societies ; the InternationalUnion against Venereal Diseases has co-operatedclosely with WHO in many aspects of thatproblem ; and the World Federation for Mental

10 The list of these organizations is as follows :Biometric SocietyCouncil for the Co-ordination of International

Congresses of Medical SciencesInter-American Association of Sanitary Engi-

neeringInternational Academy of Forensic and Social

MedicineInternational Association for the Prevention

of BlindnessInternational Council of NursesInternational Dental FederationInternational Hospital FederationInternational Leprosy AssociationInternational Red Cross CommitteeInternational Union against CancerInternational Union against TuberculosisInternational Union against Venereal DiseasesInternational Union for Child WelfareLeague of Red Cross SocietiesWorld Federation of United Nations Associa-

tionsWorld Federation for Mental HealthWorld Medical Association.


Health has assisted in the collection of basicinformation required in the planning of WHO'smental health programmes. (Details of collabo-ration with these and other non-governmentalorganizations are given under the appropriatesubjects.)

In an effort to explore all available sources ofinformation and advice, WHO has co-operatedon an informal basis with many other organ-izations concerned with health problems, such asthe National Foundation for Infantile Paralysis,the International Offi e of Epizootics, the Inter-national Union of Chemistry and the International

Pharmaceutical Federation. The InternationalCentre for Relief of Civilian Populations has beenextremely helpful to WHO in connexion withequipment and supply.

WHO has also taken part in projects carriedon by these other organizations ; it has givenassistance to the Rockefeller Foundation and theItalian Government in connexion with the Italianhealth survey, and has co-operated actively withthe Office International d'Hygiène Publique insetting up joint study-groups on plague, cholera,smallpox, African rickettsioses, bilharziasis andtrachoma.

CHAPTER 5

PUBLIC INFORMATION

In the field of public information, WHO hasmade serious efforts to widen operations in variousdirections, to regionalize services, to ensureadequate publicity for various policy meetings,to assist governments with arrangements for thecelebration of World Health Day, to prepare,with UNESCO, a catalogue of films dealing withchild care and welfare, and to promote co-opera-tion with the United Nations and specializedagencies in all relevaht fields of common interest.

Simultaneou'sly with the expansion of activitiesin press and radio, plans have beem worked outduring the year for utilizing visual material toa larger extent and for taking greater advantageof the possibilities offered by the medium ofpublications.

The following are the high-lights of the workaccomplished during 1949.

Press

During the year, some 200 press releasescovering the meetings of WHO and describingcurrent activities of the Organization were issuedfrom Headquarters and the regional offices tolocal and foreign correspondents, cabled to LakeSuccess for worldwide distribution, and mailedto magazine editors and medical and scientificwriters, and also to representatives of non-governmental organizations. The total mailinglist covered 52 countries.

WHO also arranged numerous press conferences,and gave assistance to a number of free-lancewriters and correspondents who prepared articlesand features on WHO for newspapers, magazinesand periodicals.

Publications

The basic information leaflet about WHO(" WHO-What It is ... How It Works ... WhatIt Does ...") was entirely revised, and publishedin English, French, Portuguese, Russian, Spanish,Arabic, Swedish, Danish and Norwegian. It iscontemplated that this leaflet, for which demandhas increased continuously during the year, willbe issued in other languages through the regionaloffices.

The distribution of the WHO Newsletter, amonthly four-page publication, issued in Englishand French from Geneva and in Spanish andPortuguese from Washington, has been consider-ably increased. The number of English and Frenchcopies was around 6,000 in December 1948 ; it

reached 19,000 in the corresponding month of1949.

The " Special Features " series, released atirregular intervals and containing short, popular-ized scientific articles by experts and staff mem-bers, met with widespread success. Most of thesearticles were reproduced in toto or in part byvarious newspapers and magazines.

In response to many requests, at the end of1949 WHO was preparing to publish an illustratedbooklet describing the activities of the Organiza-tion.

Approximately 60 articles of varying lengthwere prepared on request for manuals, magazinesand publications of governmental and non-governmental organizations.

Radio

The appointment of a radio officer at Head-quarters in August made it possible to establisha regular radio service relaying news and featuresabout WHO. Bi-weekly talks on WHO currentevents were broadcast from Geneva (Tuesdaysand Fridays at 18.30 GMT over theY Europeanshortwave service of UN Radio on 6,672 kilocyclesin the 44-metre band).

The United Nations Latin American RadioService, which goes out over ten transmitters andis relayed by 60 affiliated stations, included weeklyradio talks, given in Spanish, covering the acti-vities of WHO.

More than 200 recordings of speeches of dele-gates, experts and medical personalities weremade for radio ; special transcriptions wereprepared and inserted in regular programmes ofthe BBC and other national radio networks,among others, the American, Swiss, Australian,South African, Scandinavian and French net-works, and that of New Zealand.

A series of broadcasting scripts and recordingson health probl ,ms was also prepared for distribu-tion through UNESCO channels ; and, advantagebeing taken of the meetings of the UNESCO RadioCommission in Paris through personal contactswith directors of radio stations, further methodswere arranged for introducing WHO broadcastmaterial in national radio systems.

Visual Media

Several hundred photographs illustratingvarious WHO activities were supplied for world-wide distribution. At Headquarters a newly

- 75 -


organized photo-file, containing about 400 ori-ginals, was set up, and at the end of the yearsimilar files were being established in the regionaloffices.

In the portrayal of WHO activities in docu-mentaries and screen magazines the Organizationhas continued to co-operate with the UnitedNations Film Division ; for this purpose, arrange-ments were made for filming the activities of theTuberculosis Research Office in Copenhagen andthe World Influenza Centre in London, and theMalayan Film Unit produced 600 metres of filmmaterial on the work of the Singapore Epidemio-logical Intelligence Station ; this will be used bythe Ciné journal Suisse and also as raw materialfor the Film Division in Lake Success.

Many exhibits were organized. In addition tovisual material displayed in Rome during theSecond Health Assembly (see below), displayswere arranged for the United Nations Daycelebration in Geneva, for the meeting of theUnited States Public Health Association in NewYork, for the second session of the RegionalCommittee for South-East Asia in New Delhi,and for various student conferences.

Plans have also been worked out for an inter-national travelling health exhibit to be jointlyprepared by the Netherlands Health Administra-tion, UNESCO and WHO.

Regionalization

In order to adapt informational material tothe needs of the various countries, partial decen-tralization of the public information service waseffected. Information officers were appointed tothe regional offices in Alexandria and New Delhi ;assistance was given to both offices in organizingpublic information sections, and close channelsof communication were established between thesesections and Geneva. Early in 1950 it is hopedthat a similar service will also be established inconnexion with the Pan American SanitaryBureau, Regional Office for the Americas.

Second World Health Assembly

WHO mobilized all informational media forthe purpose of giving wide publicity to theproceedings of the Second World Health Assemblyin Rome. Advance information was provided in" Assembly kits " (containing various types ofbackground material on WHO and a brief outlineof the proposed 1950 programme), 2,000 of whichwere distributed in English, 750 in French, and500 in Italian, additional copies being mailed tonewspapers, magazines and radio stations. Duringthe Assembly, 62 press releases, issued in Romein both English and Italian, were cabled to NewYork and Geneva for wider distribution ; bymeans of the facilities offered by the ItalianGovernment, a daily radio transmission fromRome to Lake Success was specially arrangedand brief bulletins were telephoned twice dailyto the Italian national radio network ; 47 record-

ings in a dozen languages were airmailed todifferent national radio stations for local broad-cast ; an exhibit consisting of illustrated maps,charts and photographic enlargements showingsome of the important activities of WHO wasdisplayed in the Palazzo Venezia ; and, finally,26 films on health subjects received from severalcountries were shown for the benefit of doctors,medical students, and others who took part inan international " Seminar on World Health ",arranged with the World Federation of UnitedNations Associations.

World Health Day

In response to requests for information andsuggestions for the celebration of World HealthDay on 22 July, a special " information kit " wasassembled and sent to Member States. Thematerial in this kit outlined in popular termsseveral internationally significant health prob-lems, various aspects of international team workon health matters, and WHO's work during thepast year ; it also included a set of six glossyprints from the photo-files. In the preparationof material for 1950, maximum advantage willbe taken of the reports received from variouscountries on their first celebration of WorldHealth Day.

Catalogue of Films on Child Care and Welfare

As a joint project with UNESCO, WHO hasstarted a catalogue of selected documentariesdealing with child care and welfare, to be printedduring 1950. This will mark a stage in the jointeffort to encourage the production and dissemina-tion of films devoted to such problems. In addi-tion, a group of 20 to 25 documentaries on thistopic are to be collected for showing at nationaland international meetings on maternal and childcare.

As indicated above, WHO has always followeda policy of close co-operation with the informationdivisions and centres of the United Nations andof the other specialized agencies. This collabora-tion has helped to overcome some of the difficul-ties, caused by the staff and financial limitations,which have had to be faced during 1949.

The activities of WHO in public informationshould be viewed against a background of con-tinuously growing public interest in the Organiza-tion, on the one hand, and the attempts of aseriously limited staff to satisfy an increasingdemand for information, on the other. Even morethan during the previous year, the Organizationhas found itself in the advantageous and, at thesame time, exacting situation of facing a buyers'market for which production can never meet theactual requirements of the demand. Manyrequests for informational material, both printedand visual, have had to be turned down, or tableduntil such time as an increase in finances willmake expansion of various services possible.

CHAPTER 6

CONSTITUTIONAL AND LEGAL MATTERS

Membership

By the end of 1948 the World Health Organiza-tion had 56 Member States. During 1949 thisfigure was increased by the addition of twelvecountries, eleven of which became Members bydepositing their instruments of acceptance withthe Secretary-General of the United Nations.The Second World Health Assembly admittedthe twelfth, Korea, in accordance with the pro-cedure laid down in Article 6 of the Constitution).The new Members, in order of date of admission,were as follows : 2 Paraguay, 4 January 1949 ;Lebanon, 19 January 1949 ; Ecuador, 1 March1949 ; Costa Rica, 17 March 1949 ; Honduras,8 April 1949 ; Uruguay, 22 April 1949 ; Luxem-bourg, 3 June 1949 ; Israel, 21 June 1949 ; Korea,17 August 1949 ; Guatemala, 26 August 1949 ;Peru, 11 November 1949 ; and Bolivia, 23 Decem-ber 1949.

The Health Assembly examined for the secondtime an application from the Republic of SanMarino, but could not accept it because of thefinancial reservations attached.

In February 1949, telegrams were receivedfrom the Vice-Ministers of Health of the Unionof Soviet Socialist Republics, the ByelorussianSoviet Socialist Republic and the UkrainianSoviet Socialist Republic respectively, announ-cing that these countries no longer consideredthemselves Members of the World Health Orga-nization. In reply, a telegram was sent to eachof them stressing the necessity for their parti-cipation in the work of the Organization andproposing meetings between representatives ofWHO-the Chairman of the Executive Boardand the Director-General-and the competent

authorities of their governments so that thereasons for their decision might be adequatelydiscussed. Member Governments were alsourged to take all possible steps to induce theUnion of Soviet Socialist Republics, the UkrainianSoviet Socialist Republic and the ByelorussianSoviet Socialist Republic to reconsider theirposition. WHO was later advised by several ofthese governments that, in answer to lettersaddressed to the three countries, they also hadbeen informed that these countries no longerconsidered themselves Members of the WorldHealth Organization.

The Executive Board, at its third session,authorized its Chairman to send a further telegramto each of the three countries concerned, and theSecond Health Assembly once more invited thesecountries to participate in the sessions of theAssembly and, where appropriate, of the Board.On 23 June 1949, the resolution passed by theHealth Assembly 8 was communicated to thethree governments by the Director-General, whoagain suggested the initiation of conversationsbetween representatives of the governments andWHO. Up to the end of the year, no reply hadbeen received to the various communicationssent by WHO.

In a letter dated 29 November 1949, theGovernment of the Bulgarian People's Republicgave notice of its decision to withdraw from theWorld Health Organization. All States Membersof the World Health Organization were notifiedof this communication and informed that itwould be placed before the Executive Boardduring its fifth session.

Attendance at Sessions of the Executive Board

Rule 80 of the Rules of Procedure of the WorldHealth Assembly and Rule 4 of those of theExecutive Board make it the duty of the Director-General to report to the Health Assembly absencesof members of the Board from any two consecu-

tive sessions. It is therefore brought to theattention of the Assembly that the membersdesignated by the Union of Soviet SocialistRepublics and by the Byelorussian Soviet SocialistRepublic did not attend either the third or thefourth session of the Executive Board, held from

1 Resolution WHA2.99, Off. Rec. World Hlth Org.21, 54 8 Resolution WHA2.90, Off. Rec. World Hlth Org.

2 For complete list of Members, see Annex 1. 21, 52

- 77 -


21 February to 9 March 1949 and from 8 to absent from the second session of the Executive19 July 1949 respectively. Board, held from 25 October to 11 November

The members from these countries were also 1948, as reported to the Second Health Assembly.

Associate Members and other Territories

Rights and obligations of Associate Membersof WHO and of those other territories or groupsof territories not responsible for the conduct ofthcir international affairs were considered bythe Fir St Health Assembly, and thcir status inthe principal organs of the Organization (theHealth Assembly and Executive Board) wasdefined.°

During 1949, with the establishment of regionalcommittees, these rights and obligations againhad to be determined, this time with referenceto the regions. After studies had been made andinformation ccI1Jcted, the Second Health Assem-bly was able to define the phrase " Member Statesin the Region " in the sense of Article 47 of theConstitution, and to establish the rights andobligations of Associate Members and of otherterritories.

The resolution adopted on this subject 5 wasgiven practical effect at meetings of the RegionalCommittees for South-East Asia, the EasternMediterranean and the Americas, where therepresentatives of non-Members were invited to

take part in the work on the same basis as thoseof Members.

The Second Health Assembly also proposedthat the previously adopted Convention on thePrivileges and Immunities of Specialized Agenciesand its Annex VII should be extended to applyto Associate Members and other territories orgroups of territories not responsible for the conductof their international relations.° The ExecutiveBoard gave this problem further study at its fourthsession, and recommended that an additionalparagraph should be inserted in Annex VII ofthe Convention and that, pending the considera-tion of the revised Annex by the Assembly, andits entry into force, Member States should beinvited to apply its provisions to representativesof Associate Members and of the territories inquestion.°

This decision was transmitted to all MemberStates, which were also requested to send inobservations and suggestions for the considera-tion of the Health Assembly. By the end of theyear, several countries had announced theirapproval of this recommendation.

Regulations regarding Nomenclaturewith respect to Diseases and Causes of Death

WHO Regulations No. 1, regarding nomencla-ture (including the compilation and publicationof statistics) with respect to diseases and causesof death, were unanimously adopted by theFirst Health Assembly.° Later, as the entryinto force of the Regulations was fixed at a datetwelve months after their adoption by theAssembly, it was found necessary to draw upSupplementary Regulations in order to makeprovision for States joining the Organizationsubsequent to the First Health Assembly. TheseSupplementary Regulations, by which the Regula-tions may be applied to all Member States ofWHO, were approved by the Second HealthAssembly.°

The 54 countries which were Members at thetime of the First Health Assembly were notifiedof this decision on 29 August, and the Supple-mentary Regulations came into force for theseMembers two months after the notification,except in the case of those exercising their rightsof rejection or reservation.

Other countries which joined the Organizationsubsequent to the First Health Assembly were

4 Off. Rec. World Hlth Org. 13, 3375 Resolution WHA2.103, Off. Rec. World Hlth

Org. 21, 55Resolution WHA2.105, Off. Rec. World Hlth

Org. 21, 56

also notified of the Regulations and were givena period of twelve months after notification inwhich to exercise their rights.

No rejections of the Regulations have beenreceived. On the other hand, reservations regard-ing the scope of the provisions of RegulationsNo. 1 have been made by the following 15 coun-tries : Australia, Burma, Ceylon, China, Hungary,India, Iccland, Israel, the Netherlands, New Zea-land, Sweden, Switzerland, the Union of SouthAfrica, the United Kingdom and Yugoslavia.The Netherlands subsequently withdrew itsreservations.

The most far-reaching of the reservations wereformulated by the Government of China, whichannounced on 30 November that, owing to thedifficulties encountered in applying the Regula-tions under present conditions, it wished toreserve its rights, as regards both RegulationsNo. 1 and the Supplementary Regulations.

The full text of the remarks formulated bythe various countries will be brought to theattention of all Member States of the WorldHealth Organization.

7 Off. Rec. World Hlth Org. 22, 88 Off. Rec. World Hlth Org. 13, 335

Resolution WHA2.93, Off. Rec. World HlthOrg. 21, 53

CONSTITUTIONAL AND LEGAL MATTERS 79

Denunciation of the Rome Agreement of 1907

The Protocol concerning the Office Interna-tional d'Hygiène Publique, signed in New Yorkon 22 July 1946, provided for the eventual abroga-tion of the Rome Agreement of 1907 (setting upthe Office International d'Hygiène Publique) bythe mutual consent of the parties concerned or,in the event of such abrogation not taking place,for denunciation of the Agreement by the Statesparties to the Protocol.

Since it seemed unlikely that the Agreementcould be so abrogated, the Executive Board atits third session invited those Member Statesinvolved to denounce the Agreement before14 November 1949. The Second World HealthAssembly passed a similar resolution,12 and thetexts of both resolutions were communicated tothe appropriate Member States.

By the end of the year, after both the Office

International d'Hygiène Publique and the ItalianGovernment, the depositary of the Agreement,had taken similar steps to remind participatingcountries of the opportunities for denunciationand the obligations involved, the great majorityof the 56 countries concerned had denouncedthe Agreement. At a meeting of the Finance andTransfer Committee of the Office, held in Decem-ber, it was decided to take the matter up withthe governments concerned and to convene thePermanent Committee of the Office, preferablyat the time of the Third Health Assembly, inorder to take a decision as to the future of theOffice.

This decision may be the final step leading tothe taking over of the work and functions of theOffice, as wt 11 as its assets and liabilities, by theWorld Health Organization.

Privileges and Immunities

Up to the time of the Second Health Assembly(June 1949) only two countries had acceded tothe Convention on the Privil zes and Immunitiesof Specialized Agencies, including its Annex VII,namely, the Netherlands (2 December 1948) andIndia (10 February 1949). The Second HealthAssembly therefore passed a resolution callingupon the remaining Member States to take allnecessary legislative steps to accede to the Con-vention at an early date."

On 16 August the United Kingdom acceded tothe Convention, with certain reservations. TheSwiss Government stated that it thought itunnecessary to replace the existing agreementwith WHO (defining WHO's legal status inSwitzerland 12) by an instrument of a similarkind, and the following States announced theirintention of applying the provisions of the Con-vention de facto until such time as it becameenforceable de jure : Australia, Belgium, theDominican Republic, Greece, Israel, Luxembourgand, to some extent, Denmark and the Unionof South Africa.

A list of all officials of WHO to whom the pro-visions of the Convention would apply was com-municated to the various Member States. From

" Resolution WHA2.83, Off. Rec. World HlthOrg. 21, 50

11 Resolution WHA2.92, Off. Rec. World HlthOrg. 21, 52

the standpoint of facilitating the work of WHOin its assistance to countries, it would be desirablefor all Member Governments to accede to theConvention as soon as possible.

Agreement with the Indian Government

On 25 June the Second Health Assemblyapproved an agreement with the Indian Govern-ment concerning the priviLges, immunities andfacilities of the Organization in India.13

The Indian Government was informed of thisdecision, and on 9 November 1949 the Agreementbetween the World Health Organization and theGovernment was signed.

Agreement with the Egyptian Government

Negotiations with the Egyptian Governmentwere continued in order to conclude an agree-ment granting to the World Health Organizationthe privileges, immuniti3s and facilities necessaryfor the accomplishment of functions of the Orga-nization in Egypt.

On 12 December 1949 the Egyptian Govern-ment submitted a counter proposal, which wasbeing examined when the year ended.

12 Effective as from 17 July 194812 Resolution WHA2.81, off. Rec. World Hlth

Org. 21, 49

CHAPTER 7

ADMINISTRATION AND FINANCE

Special Problems

The problem of securing permanent accom-modation for the Headquarters of WHO maybe considered as having been solved during theyear under review, when the Second HealthAssembly decided to accept-subject to certainconditions which were subsequently fulfilled-theoffer of the United Nations to provide space inthe Palais des Nations, which would be enlargedfor this purpose.' This solution presented advan-tages for both organizations from the point ofview of economy and administrative efficiency.

The cost of the new construction is estimatedat from three and a half to four million Swissfrancs. Of this total sum, the Swiss Governmentgenerously offered to contribute three million,and WHO will provide the remainder. Theoffices provided will form one block, for whichthe United Nations will grant the Organization arenewable lease for 99 years, to be entered in theLand Register of the Canton of Geneva. Buildingoperations will be the responsibility of the UnitedNations and will be started in the late spring of1950 ; the entire building as reconstructed willremain the property of the United Nations.Pending completion of this new construction,WHO has rented barracks in the vicinity of thePalais des Nations, where part of the staff istemporarily accommodated.

Another administrative problem faced by theOrganization during the year concerned thearrangements for the Second Health Assembly,which was convened in Rome, with all thedifficulties involved in holding an Assembly awayfrom Headquarters. The cost of the Second HealthAssembly-$3,000 more than it would have beenin Geneva-was less than budgeted for becauseof the numerous services provided, and the largeproportion of the expenses borne, by the ItalianGovernment.

During the latter part of the year, there werewidespread revaluations of national currencies.As a result of the implications of these revalua-tions, the Director-General consulted with officialsof the United Nations and other specializedagencies with a view to adopting such co-ordinatedadjustments as could properly be introduced tosave costs without inflicting hardships. Afterstudy, WHO decided to reduce, in the regionsaffected by the change, the US dollar equivalentsof salaries and allowances for staff, and of traveland per diem allowances (in lieu of subsistence)not only for WHO officials but for members ofexpert committees and of the Executive Boardwho were eligible for such allowances.

Staff

The staff of the Organization was increasedduring the year in order to cope with a rapidlyexpanding programme of activities in all fields.The increases are shown in the following table :

HeadquartersOther :

19491 January

186

31 December

335

Regional offices . . . 1 81Advisory a nd de-

mo nstrati on staff 30 50New York Liaison

Office 29 9Singapore Epidemio-

logical Station . 13 9Copenhagen Research

Office73

32181

Total 259 516

Resolution WHA2.61, 011. Rec. World Hltlz, Org.21, 37

In recruiting the additional staff, every effor-was made to ensure the widest practicable geotgraphical distribution. In spite of the difficultiesencountered, at the end of the year the Secreta-tariat represented a wider distribution than hadbeen achieved previously, and efforts in thisdirection will be continued.

On 1 December, following a classificationsurvey of all posts in the Secretariat, carried outby two independent classification analysts, auniform plan of grades and salaries, based onduties and responsibilities, was put into effect.2

In accordance with a decision of the ExecutiveBoard,3 WHO joined the United Nations JointStaff Pension Fund, which provides retirement,disability or death benefits for all eligibleemployees as from 1 May 1949. The regulationsof the Fund apply to all full-time staff members

2 For list of senior officials, see Annex 11.3 011. Rec. World Hills Org. 22, 12

- 80 -

ADMINISTRATION AND FINANCE 81

under 60 years of age at the time of appointment,who are under contract for one year or more orwho have completed a year's employment andwho are not contributing to, or participating in,a national pension scheme. Staff memberscontribute 7% of their basic salary to the PensionFund and the Organization contributes 14%.Those members who are not eligible for thePension Fund participate in the Provident Fund,to which the employee and the Organization eachcontribute an amount equal to 6% of the basicsalary, and from which participants are entitledto withdraw the total accumulation of both

amounts at retirement age or on termination ofemployment.

A health insurance scheme was also adoptedduring the year which insures all staff members,without exception, against accident or sickness,whether contracted in service or otherwise. Thescheme covers medical and hospital expenses,payment of salary for a specified period, andcompensation to dependants in case of deathresulting from accident. The cost of the insuranceis divided between the staff members and theOrganization, the members' share varying accord-ing to salary and official station.

Finance

At the end of the year, the contributions to the1948 budget received from Member Statesamounted to $3,992,547 (82.15%). Fifty-oneStates had paid in full, and two in part ; and theunpaid balance (contributions from 19 States)amounted to $867,676 (17.85%). For the 1949budget, a total of $3,698,669.50 (73.29%) wasreceived by the end of the year : full contributionswere paid by 40 States and partial paymentsmade by four, the unpaid balance (contributionsof 27 States) amounting to $1,347,623.50 (or26.71 %).4 It should be noted that countriesfrom which contributions to the 1948 budgetwere due included some which ' had signed theArrangement setting up the Interim Commission,5whether Members of the Organization or not.

The Second World Health Assembly voted toincrease the working capital fund by $1,449,437,in order to provide a total fund of $4,000,000.6The subsequent admission of new Membersincreased this total to $4,012,493. By 31 December1949, eleven Members had made the necessaryadvances to the fund in full and two in part ;a total of $218,980.52 (15%) had been received ;unpaid advances amounted to $1,242,940.33(or 85%).

At thè end of 1949, the delay in receipt ofcontributions was a matter of concern. In thereport of the external auditor to the Second HealthAssembly on the 1948 accounts, it was stated that,

4 For detailed statement of contributions, seeAnnex 9.

Off. Rec. World Hlth Org. 2, 110g Resolution WHA2.66, Off. Rec. World Hlth

Org. 21, 40

as a result of the non-receipt of contributions andadvances to the working capital fund, the Organ-ization was in an unsound financial position.7

These delays, which continued throughoutthe year, would have resulted in a much moreserious situation if the Organization had not beenable to defer the final settlement of the loan fromthe United Nations (see below) and to draw onthe special UNRRA fund. Without this fund,it would have been forced to use about $1,500,000of the working capital fund, into which, at thatdate, Members had paid only some $2,300,000,thus leaving in the fund only approximately$800,000 in cash. It is therefore apparent thatthe financial position of the Organization willcontinue to be serious unless contributions arereceived without delay, and advances to theworking capital fund promptly made.

As was stated in the Annual Report of theDirector-General for 1948,8 WHO (includingits Interim Commission) borrowed a total of$2,550,000 from the United Nations pendingreceipt of contributions from Members ; $1,250,000of this sum has been repaid ; the balance of$1,300,000 falls due in 1950, as follows : January-$201,500 ; April-$457,317 ; July-$641,183.

Financial arrangements have been made tomeet these payments.

At the end of the year two countries (Ceylonand Yugoslavia) had contributed to the supple-mental budget of the Organization for 1950(programme of technical assistance).

7 Off. Rec. World Hlth Org. 20, 98 Off. Rec. World Hlth Org. 16, 42


Annex 1

MEMBERSHIP OF THE WORLD HEALTH ORGANIZATION

(31 December 1949)

States which have accepted or ratified the Constitution of WHO, signed in New York on 22 July 1946 : 1

State

Afghanistan (37)Albania (13)Argentina (56)Australia (28)

Date of acceptance orratification

19 April 194826 May 194722 October 19482 February 1948

State

Israel (64)Italy (10)Jordan, the Hashemite

Kingdom of the (9) .

Date of acceptance orratification

21 June 194911 April 1947

7 April 1947Austria (15) 30 June 1947 Korea, Republic of (65) 17 August 1949Belgium (49) 25 June 1948 Lebanon (58) 19 January 1949Bolivia (68) 23 December 1949 Liberia (7) . . . ... .. 14 March 1947Brazil (39) 2 June 1948 Luxembourg (63) 3 June 1949Bulgaria (41) 9 June 1948 Mexico (35) 7 April 1948Burma (50) 1 July 1948 Monaco (53) 8 July 1948Byelorussian SSR (34) 7 April 1948 Netherlands (12) 25 April 1947Canada (3) 29 August 1946 New Zealand (5) 10 December 1946Ceylon (52) 7 July 1948 Norway (18) 18 August 1947Chile (55) 15 October 1948 Pakistan (48) 23 June 1948China (1) 22 J uly 1946 Paraguay (57) 4 January 1949Costa Rica (60) 17 March 1949 Peru (67) 11 November 1949Czechoslovakia (30) 1 March 1948 Philippines, Republic of theDenmark (36) 19 April 1948 (54) 9 July 1948Dominican Republic (45) 21 June 1948 Poland (38) 6 May 1948

Ecuador (59) 1 March 1949 Portugal (29) 13 February 1948

Egypt (25)El Salvador (47)

16 December 194722 June 1948

Roumania (40)Saudi Arabia (14)Sweden (19)

8 June 194826 May 194728 August 1947

Ethiopia (11)Finland (22)

11 April 19477 October 1947

Switzerland (8)Syria (6)

26 March 194718 December 1946

France (42) 16 June 1948 Thailand (21) 26 September 1947Greece (31) 12 March 1948 Turkey (26) 2 January 1948Guatemala (66) 26 August 1949 Ukrainian SSR (33) . . . 3 April 1948Haiti (17) 12 August 1947 Union of South Africa (16) . . 7 August 1947Honduras (61) 8 April 1949 Union of Soviet SocialistHungary (43) 17 June 1948 Republics (32) 24 March 1948Iceland (44) 17 June 1948 United Kingdom (2) . . . . 22 July 1946India (27) 12 January 1948 United States of America (46) . 21 June 1948Iran (4) 23 November 1946 Uruguay (62) 22 April 1949Iraq (20) 23 September 1947 Venezuela (51) 7 July 1948Ireland (23) 20 October 1947 Yugoslavia (24) 19 November 1947

1 The chronological order of acceptance or ratification is indicated by the figures in brackets follow-ing the name of each country.

ANNEX 2 83

Annex 2

MEMBERSHIP OF THE EXECUTIVE BOARD

(31 December 1949)

Member. States entitled to designate persons to serve on the Executive Board :

1. Brazil2. Byelorussian SSR3. China 24. Egypt5. France6. India7. Mexico8. Netherlands9. Philippines, Republic of the

Unexpired termof office,

one yeartwo yearsone yearone yearone yeartwo yearsone yeartwo yearsthree years

Persons serving on the Executive Board

Sir Arcot Mudaliar (India), ChairmanDr. J. Zozaya (Mexico), Vice-ChairmanDr. H. S. Gear (Union of South Africa),

ChairmanDr. V. J. Babecki (Poland)Dr. N. Evstafiev (Byelorussian SSR)Dr. J. A. Höjer (Sweden)Dr. H. Hyde (United States of America)Professor M. De Laet (Netherlands)

Unexpired termof office1

10. Poland two years11. Sweden three years12. Turkey three years13. Union of South Africa two years14. USSR one year15. United Kingdom three years16. United States of America three years17. Venezuela three years18. Yugoslavia two years

at the end of 1949 :

Dr. M. D. Mackenzie (United Kingdom)Dr. M. Nazif Bey (Egypt)

V ice- Professor J. Parisot (France)Dr. G. H. de Paula Souza (Brazil)Dr. A. Stampar (Yugoslavia)Dr. E. Tejera (Venezuela)Dr. E. Tok (Turkey)Dr. A. Villarama (Philippines, Republic of the)Dr. N. A. Vinogradov (USSR)

1 As from 8 July 1949.2 The Chinese Government has not yet designated a person to replace Dr. W. W. Yung, former

member of the Board.


Annex 3

MEMBERSHIP OF EXPERT COMMITTEES

(31 December 1949)

The following experts have been appointed to serve as members of expert committees :

Expert Committee on Biological StandardizationProfesseur E. Grasset, Directeur de l'Institut

d'Hygiène, Geneva, SwitzerlandDr. A. A. Miles, Director, Department of Biological

Standards, National Institute for MedicalResearch, Medical Research Council, London,United Kingdom

Dr. J. Orskov, Director, State Serum Institute,Copenhagen, Denmark

Major-General Sir Sahib Singh Sokhey, Director,Haffkine Institute, Bombay, India

Dr. W. Aeg. Timmerman, Director, Rijksinstituutvoor de Volksgezondheid, Utrecht, Netherlands

Professeur J. Tréfouél, Directeur de l'InstitutPasteur, Paris, France

Dr. M. V. Veldee, Medical Director, Hyland Labo-ratories, Los Angeles, Calif., USA

Sub-Committee on Fat-soluble VitaminsM. A, Chevallier, Professeur de Physique biologique

l'Université de Strasbourg, FranceMiss K. H. Coward, D.Sc. Head, Nutrition Depart-

ment, School of Pharmacy, University of London,United Kingdom

N. B. Guerrant, Professor of Biochemistry, Depart-ment of Agricultural and Biological Chemistry,Pennsylvania State College, State College, Pa.,USA

B. C. P. Jansen, Professor of Physiological Che-mistry, University of Amsterdam, Netherlands

Sir Edward Mellanby, Medical Research Council,London, United Kingdom

Dr. E. M. Nelson, Chief, Division of Vitamins,Food and Drug Administration, Washington,D.C., USA

Dr. Nicolaysen, Professor of Nutritional Research ;Director, Institute for Nutritional Research,University of Oslo, Norway.

Dr. F. Verzár, Professor of Physiology, Universityof Basel, Switzerland

Expert Committee on Environmental SanitationProfessor R. De León, Dean, Engineering School,

Central University of Venezuela, Caracas,Venezuela

Dr. G. Macdonald, Director, Ross Institute ofTropical Medicine, London School of Hygieneand Tropical Medicine, London, United Kingdom

M. Petrik, Professor of Public Health Engineering,Institute of Hygiene, Zagreb, Yugoslavia

V. Puntoni, Professor of Hygiene, University ofRome, Italy

K. Subrahmanyan, Professor of Sanitary Engineer-ing, All-India Institute of Hygiene and PublicHealth, Calcutta, India

A. Wolman, Professor of Sanitary Engineering,Johns Hopkins University, Baltimore, Md.,USA

Expert Committee on Habit-forming DrugsDr. J. J. Bouquet, ex-Pharmacien des Hôpitaux de

Tunis et ex-Inspecteur des Pharmacies de Tunisie,Tunis, Tunisia

Dr. H. P. Chu, Professor of Pharmacology ;President, National Medical College, Shanghai,China

Dr. N. B. Eddy, Medical Officer, National Institutesof Health, US Public Health Service, Bethesda,Md., USA

J. R. Nicholls, D.Sc., Deputy Government Chemist,Government Laboratory, Department of theGovernment Chemist, London, United Kingdom

Expert Committee on Health StatisticsDr. D. Curiel, Chief, Division of Epidemiology and

Vital Statistics, Ministry of Health and SocialWelfare, Caracas, Venezuela

Dr. P. F. Denoix, Chef des Services techniques etde la Section du Cancer, Institut nationald'Hygiène, Paris, France

Dr. H. L. Dunn, Chief, National Office of VitalStatistics, US Public Health Service, Washington,D.C., USA

Dr. M. Kacprzak, Professor of Hygiene ; Director,State School of Hygiene ; President, NationalHealth Council, Warsaw, Poland

Dr. P. Stocks, Chief Medical Statistician, GeneralRegister Office of England and Wales, London,United Kingdom

Expert Committee on InsecticidesMédecin-Lieutenant-Colonel J. Duguet, Médecin-

Expert du Centre d'Examen médical du Per-sonnel navigant de l'Aviation, Service de Santé,Paris, France

Dr. R. A. E. Galley, Secretary, Inter-DepartmentalInsecticides Committees, Agricultural ResearchCouncil, London, United Kingdom

Title changed subsequently to " Expert Com-mittee on Drugs liable to produce Addiction ".

ANNEX 3 85

S. W. Simmons, Senior Scientist ; Chief, TechnicalDevelopment Division, Communicable DiseaseCenter, US Public Health Service, Savannah,Ga., USA

Expert Committee on International Epidemio-logy and Quarantine

Dr. R. Dujarric de la Rivière, Sous-Directeur del'Institut Pasteur, Paris, France

Dr. G. L. Dunnahoo, Medical Director, ForeignQuarantine Division, US Public Health Service,Washington, D.C., USA

Dr. H. S. Gear, Deputy Chief Health Officer, UnionHealth Department, Cape Town, Union ofSouth Africa

Dr. G. D. Hemmes, Inspector of Public Health,Utrecht, Netherlands

Dr. M. D. Mackenzie, Principal Medical Officer,Ministry of Health, London, United Kingdom

Dr. J. D. McCormack, Deputy Chief MedicalAdviser, Department of Health, Dublin, Ireland

Dr. M. Nazif Bey, Under-Secretary of State forMedical Affairs, Ministry of Public Health,Cairo, Egypt

Dr. K. C. K. E. Raja, Director-General of HealthServices, New Delhi, India

Dr. G. H. de Paula Souza, Director, Faculty ofHygiene and Public Health, University of SaoPaulo, Brazil

Ex Officio Member :Dr. M. T. Morgan, Chairman, Comité permanent

de l'Office International d'Hygiène Publique ;Port of London Health Authority, London,United Kingdom

Quarantine Section


Dr. H. S. Gear, Deputy Chief Health Officer, UnionHealth Department, Cape Town, Union ofSouth Africa

Dr. M. D. Mackenzie, Principal Medical Officer,Ministry of Health, London, United Kingdom

Dr. M. Nazif Bey, Under-Secretary of State forMedical Affairs, Ministry of Public Health,Cairo, Egypt

Dr. K. C. K. E. Raja, Director-General of HealthServices, New Delhi, India

Dr. G. H. de Paula Souza, Director, Faculty ofHygiene and Public Health, University of SaoPaulo, Brazil

Expert Committee on MalariaMajor-General Sir Gordon Covell, Adviser on

Malaria, Ministry of Health ; Director, MalariaLaboratory, Horton Hospital, Epsom, Surrey,United Kingdom

Dr. A. Gabaldón, Chief, Division of Malariology,Ministry of Health and Social Welfare, Maracay,Venezuela

Dr. P. F. Russell, Malaria Adviser, InternationalHealth Division, Rockefeller Foundation, NewYork, N.Y., USA

Lieutenant-Colonel J. Singh, Director, MalariaInstitute of India ; Additional Deputy Director-General of Health Services, Delhi, India

Professor N. H. Swellengrebel, Director, Institutefor Tropical Hygiene, Amsterdam, Netherlands

Médecin-Général Inspecteur M. A. Vaucel, Directeurdu Service de Santé colonial, Ministère de laFrance d'Outre-mer, Paris, France

Dr. D. Bagster Wilson, Director, East AfricanMalaria Unit, Muheza, Tanganyika

Expert Committee on Maternal and ChildHealth

Miss T. K. Adranvala, Chief Nursing Superinten-dent, Directorate General of Health Services,New Delhi, India

Dr. I. H. Alantar, Professor of Paediatrics, Directorof Children's Clinic, University of Istanbul,Turkey

Mme. Y. Feyerick-Nèvejan, Directrice générale del'CEuvre nationale de l'Enfance, Brussels, Belgium

Dr. F. G6mez, Director, Children's Hospital,Mexico City, D.F., Mexico

Dr. J. 1,rejcar, Professor of Pediatrics, Universityof Prague, Czechoslovakia

Dr. Dorothy M. Taylor, Senior Medical Officer forMaternity and Child Welfare, Ministry of Health,London, United Kingdom

Dr. Marion Yang, State Director of Maternal andChild Health Services, Ministry of Health,Nanking, China

Expert Committee on Mental HealthDr. L. Yti-Lin-Ch'eng, Provincial Mental Hospital,

Taipeh City, Formosa, ChinaProfessor T. Ferguson Rodger, Department of

Psychological Medicine, University of Glasgow,United Kingdom

Professor J. Hadlik, Director, Psychiatric Clinic,University of Palacky, Olomouc, Czechoslovakia

Dr. W. C. Menninger, The Menninger Foundation,Topeka, Kansas, USA -

A. C. Pacheco e Silva, Professor of Clinical Psy-chiatry, University of Sao Paulo, Brazil

Expert Committee on PlagueDr. G. Blanc, Directeur de l'Institut Pasteur du

Maroc, Casablanca, Morocco.Dr. A. Castro, Head of the Brazilian Plague Service,

Ministry of Education and Health, Rio deJaneiro, Brazil

D. H. S. Davis, Head, Plague Control Service,Union Health Department, Johannesburg, Unionof South Africa

Dr. P. C. C. Garnham, Reader in Medical Parasi-tology, London School of Hygiene and TropicalMedicine, London, United Kingdom

Dr. K. F. Meyer, Director, Hooper Foundation,University of California Medical School, SanFrancisco, Calif., USA

Major-General Sir Sahib Singh Sokhey, Director,Haffkine Institute, Bombay, India


Expert Committee on TuberculosisDr. M. S. Abaza Bey, Adviser, Misr Weaving and

Spinning Co., Cairo, EgyptDr. J. I. Bald6, Chief, Tuberculosis Division,

Ministry of Public Health, Caracas, VenezuelaDr. P. V. Benjamin, Tuberculosis Adviser, Directo-

rate General of Health Services, New Delhi,India

Dr. E. Bernard, Professeur à la Faculté de Médecinede l'Université de Paris, France

Dr. I. Gonda, Chief, Tuberculosis Control Division,Department of Public Health for Slovakia,Bratislava, Czechoslovakia

Dr. P. M. d'Arcy Hart, Director, TuberculosisResearch Unit, National Institute for MedicalResearch, Medical Research Council, London,United Kingdom

Dr. H. E. Hilleboe, Commissioner of Health,New York State Department of Health, Albany,N.Y., USA

Dr. J. H. Holm, Chief, Tuberculosis Division, StateSerum Institute, Copenhagen, Denmark

Patzel on Tuberculin-Testing and BCG VaccinationDr. J. Bretey, Chef du Service de la Tuberculose A

l'Institut Pasteur, Paris, FranceDr. R. G. Ferguson, Director of Tuberculosis,

Fort San, Saskatchewan, CanadaF. R. G. Heaf, David Davies Professor of Tuber-

culosis, Welsh National School of Medicine,Cardiff, Wales, United Kingdom

Expert Committee on the Unification of Phar-macopoeias

Professor H. Baggesgaard- Rasmussen, Ph. D.,Department of Pharmaceutical Chemistry,Danish School of Pharmacy ; Member of theDanish Pharmacopoeia Commission, Copenhagen,Denmark

Professor E. Fullerton Cook, Ph. D., Chairman,Committee of Revision of the Pharmacopoeiaof the United States of America, Philadelphia,Pa., USA

Professor I. R. Fahmy, Ph. D., Department ofPharmacognosy, Fouad I University ; Secretary,Egyptian Pharmacopoeia Commission, Cairo,Egypt

Professor H. Flit.k, Dr. Sc. Nat., Department ofPharmacognosy, Eidgenössische technische Hoch-schule ; Member of the Federal Commission ofthe Pharmacopoeia, Zürich, Switzerland

Dr. C. H. Hampshire, Secretary, British Pharma-copoeia Commission, London, United Kingdom

Dr. R. Hazard, Professeur de Pharmacologie et deMatière médicale h. la Faculté de Médecine del'Université de Paris ; Membre de la Commissionde la Pharmacopée francaise, Paris, France

Professor D. van Os, Dr. Sc. Nat., Department ofPharmaceutical Chemistry and Toxicology, Uni-versity of Groningen ; Chairman of the Nether-lands Pharmacopoeia Commission, Groningen,Netherlands

Expert Committee on Venereal InfectionsDr. W. E. Coutts, Professor of Venereology ; Chief,

Department of Social Hygiene, Public Health -Administration, Santiago, Chile

Dr. R. Degos, Professeur agrégé à la Faculté deMédecine de Paris, France

Dr. M. Grzybowski, Professor of Dermatology,Clinic of Dermatology, University of Warsaw,Poland

Dr. S. Hellerstrom, Professor of Dermato-syphilo-logy, University of Stockholm, Sweden

Dr. E. H. Hermans, Medical Director, VenerealDiseases, Port of Rotterdam, Netherlands

Dr. J. F. Mahoney, Director, City of New YorkDepartment of Health, Bureau of Laboratories,New York, N.Y., USA

Dr. G. L. McElligott, Director, Venereal DiseasesDepartment, St. Mary's Hospital ; VenerealDisease Adviser, Ministry of Health, London,United Kingdom

Dr. I. H. Nagi, Chief, Venereal Disease Division,Ministry of Public Health, Cairo, Egypt

Dr. R. V. Rajam, Professor of Venereology,Government General Hospital, Madras, India

Sub-Committee on Serology and Laboratory AspectsA. Harris, Senior Serologist, Venereal Disease

Research Laboratory, US Public Health Service,Staten Island, N.Y., USA

Dr. P. Krag, Assistant Director, SerodiagnosticDepartment, State Serum Institute, Copenhagen,Denmark

Dr. R. Laporte, Chef du Service de Sérologie,Institut Pasteur, Paris, France

Dr. I. N. Orpwood Price, Director, Public HealthLaboratory Service, Venereal Disease ReferenceLaboratory, St. Peter's Hospital, London, UnitedKingdom

Yellow-Fever PanelDr. W. S. SA Antunes, Director, National Yellow

Fever Service, Ministry of Education and Health,Rio de Janeiro, Brazil


Médecin-Général C. Durieux, Directeur de l'Ins-titut Pasteur de l'Afrique Occidentale Française,Dakar, Sénégal

Dr. A. F. Mahaffy, formerly Director, Yellow FeverResearch Institute, Entebbe, Uganda

Médecin-Général Inspecteur Peltier, ancien Direc-teur général de la Santé publique en AfriqueOccidentale Française, Dakar, Sénégal

Médecin-Colonel G. Saleun, Adjoint technique duDirecteur du Service de Santé colonial, Ministèrede la France d'Outre-mer, Paris, France

Dr. R. M. Taylor, Field Director, Laboratories ofthe International Health Division, RockefellerInstitute for Medical Research, New York City,N.Y., USA

Dr. M. V. Veldee, Medical Director, Hyland Labo-ratories, Los Angeles, Calif., USA

Joint FAO/WHO Expert Committee on Nutrition

WHO Members :G. Bergami, Professor of Biochemistry and Physio-

logy ; Director, Istituto della Nutrizione delConsiglio Nazionale delle Ricerche, Rome, Italy

ANNEX 3 87

Dr. J. F. Brock, Professor of Practice of Medicine,University of Cape Town, Union of South Africa

Professor J. de Castro, Director, Institute ofNutrition, University of Brazil, Rio de Janeiro,Brazil

Dr. J. Salcedo, Director of Field Operations,U.S. Public Health Service in the Philippines ;Director, Institute of Nutrition, Manila, Republicof the Philippines

Dr. W. H. Sebrell, Medical Director, U.S. PublicHealth Service ; Director, Institute of Experi-mental Biology and Medicine, Bethesda, Md.,USA

FAO Members:Professor M. J. L. Dols, State Adviser on Nutrition ;

Professor of Nutritional Science, University ofAmsterdam, Netherlands

Lord Horder, Adviser to the Ministry of Food,London, United Kingdom

Dr. V. N. Patwardhan, Director, Nutrition ResearchLaboratories, Coonoor, India

Dr. Hazel K. Stiebeling, Chief, Bureau of HumanNutrition and Home Economics, U.S. Depart-ment of Agriculture, Washington, D.C., USA

Professeur E. F. Terroine, Directeur du Centrenational de Coordination des Etudes et Re-cherches sur la Nutrition et l'Alimentation,Centre national de la Recherche scientifique,Paris, France

Joint ILO/WHO Expert Committee on theHygiene of SeafarersWHO Members:

Dr. T. B. H. Anderson, Medical Officer in Charge,U.S. Marine Hospital, Stapleton, Staten Island,N.Y., USA

Dr. K. Evang, Director-General of Public Health,Oslo, Norway

Dr. H. N. C. V. Kelaart, Divisional Medical Super-intendent of Health, Department of Medical andSanitary Services, Colombo, Ceylon

Dr. H. O. Reid, Ministry of National Health andWelfare, Ottawa, Canada

ILO Members:O. Becu, Président de la Fédération internationale

des Transports ouvriers, Brussels, BelgiumCaptain O. I. Loennechen, Vice-President, Norwe-

gian Shipowners' Federation, Oslo, NorwayR. Snedden, General Manager, In ernational

Shipping Federaticn, London, United KingdomT. Yates, President, National Union of Seamen,

London, United Kingdom

Joint OIHP/WHO Study-Group on AfricanRickettsioses

Dr. E. Aujaleu, Directeur de l'Hygiène sociale,Ministère de la Santé publique, Paris, France

Dr. G. Blanc, Directeur de l'Institut Pasteur duMaroc, Casablanca, Morocco

Dr. P. C. C. Garnham, Reader in Medical Parasi-tology, London School of Hygiene and TropicalMedicine, London, United Kingdom

Professeur J. A. H. Rodhain, Institut de Médecinetropicale Prince Léopold, Antwerp, Belgium

Médecin-Général Inspecteur M. A. Vaucel, Directeurdu Service de Santé colonial, Ministère de laFrance d'Outre-mer, Paris, France

Joint OIHP/WHO Study-Group on AfricanSchistosomiasis (Bilharziasis)

Dr. M. Abdel-Azim Bey, Director-General, Depart-ment of Rural Hygiene, Ministry of PublicHealth, Cairo, Egypt

Dr. D. M. Blair, Director of Preventive Services,Department of Health, Salisbury, SouthernRhodesia

Dr. J. Gaud, Directeur de l'Institut d'Hygiène duMaroc, Rabat, Morocco

Dr. W. H,. Wright, Scientist Director ; Chief,Laboratory of Tropical Diseases, National Insti-tutes of Health, USA Public Health Service,Bethesda, Md., USA

Joint OIHP/WHO Study-Group on CholeraLt.-Colonel M. Jafar, Director-General of Health,

Karachi, PakistanDr. C. G. Pandit, Secretary, Indian Research Fund

Association, New Delhi, IndiaMédecin-Général Inspecteur M. A. Vaucel, Direc-

teur du Service de Santé colonial, Ministère de laFrance d'Outre-Mer, Paris, France

Joint OIHP/WHO Study-Group on SmallpoxDr. E. T. Conybeare, Medical Officer, Ministry

of Health, London, United KingdomProfesseur A. Lemierre, Membre de l'Académie de

Médecine, Paris, FranceDr. R. E. Muckenfuss, Assistant Commissioner,

New York City Department of Health, New York,N.Y., USA

Dr. C. G. Pandit, Secretary, Indian Research FundAssociation, New Delhi, India

Joint OIHP/WHO Study-Group on TrachomaDr. G. Blanc, Directeur de l'Institut Pasteur du

Maroc, Casablanca, MoroccoDr. C. G. Pandit, Secretary, Indian Research Fund

Association, New Delhi, IndiaDr. A. F. El Tobgui, Professor of Ophthalmology,

Fouad I University, Cairo, EgyptDr. P. F. Toulant, Professeur de Clinique ophtal-

mologique, Faculté de Médecine d'Alger, Algeria


Annex 4

CONFERENCES AND MEETINGS CALLED BY WHO IN 1949 1

24-29 January

24-29 January28-29 January

7-10 February

15-17 February

16 February

21 February-9 March4-9 April

11-14 April

20-30 April

26-30 April

2-7 May

10-14 May

23-28 May30 May-1 June

1-4 June

13 June-2 July8-19 July18 July26-30 July10-17 August15 August-15 November29 August-3 September8-11 September

12-17 September

19-21 September

19-24 September26-28 September

Expert Committee on Maternal and Child Health, firstsession

Expert Committee on Habit-forming Drugs, 2 first sessionWHO/UNESCO : Executive Committee of the Organizing

Committee for the Co-ordination of InternationalCongresses of Medical Sciences

Regional Committee for the Eastern Mediterranean, firstsession

WHO/ECE ; Meeting of Experts on the Rehabilitationof UNRRA Penicillin Plants

Executive Board, Working Party for the Review of theProgramme and Budget for 1950

Executive Board, third sessionWHO/UNESCO : Conference to establish the Permanent

Council for the Co-ordination of International Con-gresses of Medical Sciences

UNICEF/WHO : Joint Committee on Health Policy,third session

Expert Committee on the Unification of Pharmacopoeias,fourth session

Expert Committee on Biological Standardization, Sub-Committee on Fat-soluble Vitamins

Expert Committee on Biological Standardization, thirdsession

Expert Committee on Insecticides, first session

Expert Committee on Health Statistics, first sessionPreparatory Meeting for the International Anti-Venereal-

Disease Commission of the RhineWHO/UNESCO : Interim Co-ordinating Committee on

Medical and Biological AbstractingSecond World Health AssemblyExecutive Board, fourth sessionStanding Committee on Administration and FinanceExpert Committee on Tuberculosis, fourth sessionExpert Committee on Malaria, third sessionSyphilis Study Commission to the USAExpert Committee on Mental Health, first sessionUNICEF/WHO : Joint Enterprise Meeting on BCG

Vaccination Programme (Group 3)Expert Committee on Environmental Sanitation, first

sessionPanel of Experts on the Revision of the Questionnaire

for Trusteeship Territories, and the Standard Formfor Non-self-governing Territories

Expert Committee on Plague, first sessionRegional Committee for South-East Asia, second session

GenevaGeneva

Paris

Cairo

Geneva

GenevaGeneva

Brussels

Geneva

Geneva

London

LondonCagliari

(Sardinia)Geneva

Geneva

ParisRomeGenevaGenevaCopenhagenGenevaWashingtonGeneva

Copenhagen

Geneva

GenevaGenevaNew Delhi

1 This list does not include meetings of committees of the Assembly or Executive Board whichwere convened in conjunction with their sessions. Some of the joint meetings were called by the otheragency attending.

2 Title subsequently changed to " Expert Committee on Drugs liable to produce Addiction ".

ANNEX 5 89

26 September-5 October

10-20 October12-15 October

12-20 October

24-29 October24-29 Ocfober

28-29 October

15-21 November24-26 November1-6 December5-14 December

12-17 December

Expert Committee on Unification of Pharmacopoeias,fifth session

Expert Committee on Venereal Infections, third sessionRegional Committee for the Eastern Mediterranean,

second sessionExpert Committee on Venereal Infections, Sub-Committee

on Serology and Laboratory Aspects, first sessionFAO/WHO : Joint Committee on Nutrition, first sessionOIHP/WHO : Joint Study-Group on African Schistoso-

miasis (Bilharziasis)WHO/UNESCO .: Co-ordinating Committee on Abstract-

ing and Indexing in the Medical and BiologicalSciences, Executive Committee

OIHP/WHO : Joint Study-Group on CholeraExecutive Board, Building CommitteeYellow-Fever PanelExpert Committee on International Epidemiology and

Quarantine, second sessionILO/WHO : Joint Expert Committee on the Hygiene of

Seafarers, first session

Annex 5

GenevaWashington

Geneva

WashingtonGeneva

Cairo

ParisNew DelhiGenevaGeneva

Geneva

Geneva

CONFERENCES AND MEETINGS CALLED BY THE UNITED NATIONSAND SPECIALIZED AGENCIES IN 1949 AT WHICH WHO WAS REPRESENTED

13-27 January17-18 January

19 January20-21 January22 January24-28 January

24 January-25 March27-28 January

3 February7 February-18 March7-12 February14-16 February

15 February23 February4-8 March9-10 March16-22 March

21-30 March

21 March-11 April

24-25 March28 March

28 March-5 April

29 March

ILO : Permanent Migration Committee, third sessionAdministrative Committee on Co-ordination (ACC) :

Consultative Committee on Public Information,eighth session

ACC : United Nations Film Board, quarterly meetingUNICEF : Programme CommitteeUNICEF : Administrative Budget CommitteeUNESCO : Preliminary Conference on Community

Studies (Tensions Project)Trusteeship Council, fourth sessionACC : Consultative Committee on Administrative Ques-

tions, fourth sessionUNICEF : Executive Board, 45th and 46th sessionsEconomic and Social Council, eighth sessionUNESCO : Executive Board, fourteenth sessionACC : United Nations Technical Working Group on

Housing and Town and Country PlanningACC : Preparatory Committee, seventh sessionUNICEF : Executive Board, 47th sessionILO : Governing Body, 108th sessionUNICEF : Executive Board, 48th-51st sessionsACC : International Civil Service Advisory Board, first

sessionECOSOC : Transport and Communications Commission,

third sessionECOSOC : Economic and Employment Commission,

Sub-Commission on Economic DevelopmentUNESCO : Executive Board, extraordinary sessionECOSOC : Economic Commission for Europe, Sub-

Committee on HousingECOSOC : Economic Commission for Asia and the Far

East, Committee of the WholeIRO : General Council, second session

Geneva

Lake SuccessLake SuccessLake SuccessLake Success

ParisLake Success

Lake SuccessLake SuccessLake SuccessParis

Lake SuccessLake SuccessLake SuccessGenevaLake Success

Lake Success

Lake Success

Lake SuccessParis

Geneva

BangkokGeneva


31 March-1 April ECOSOC : Preliminary Meeting of Working Party onExpanded Programme for Technical Assistance forEconomic Development of Under-developed Coun-tries

31 March-2 April UNESCO : United States National Committee, secondConference

4 April UN : Committee of Experts on Salary, Allowance andLeave Systems

4 April ECOSOC : Working Party on Expanded Programme forTechnical Assistance for Economic Development ofUnder-developed Countries

11-12 April ACC : Consultative Committee on Administrative Ques-tions, fifth session

11-12 April ACC : Consultative Committee on Public Information,ninth session

13 April ACC : United Nations Film Board, quarterly meeting20-22 April ECOSOC : Committee on Statistical Classification,

third session25-28 April ECOSOC : Social Commission, Agenda Committee25 April-6 May ECOSOC : United Nations Statistical Commission,

fourth session25 April-7 May ILO : Fourth Conference of American States Members2-20 May ECOSOC : Social Commission, fourth session5 May ACC : Working Group on Publications9-21 May ECOSOC : Economic Commission for Europe, fourth

session9-26 May ECOSOC : Economic and Employment Commission,

fourth session9 May-20 June ECOSOC : Commission on Human Rights, fifth session16 May ACC : Preparatory Committee, eighth session16 May-3 June ECOSOC : Commission on Narcotic Drugs, fourth session18 May Administrative Committee on Co-ordination, seventh

session29 May-14 June ECOSOC : Economic Commission for Latin America,

second session3-4 June ILO : Governing Body, 109th session6 June ACC : United Nations Film Board, quarterly meeting7 June ACC : Consultative Committee on Public Information,

special session7 June ICAO : General Assembly, third session8 June-2 July ILO : International Labour Conference, 32nd session9-15 June UNESCO : Executive Board, sixteenth session13-18 June ECOSOC: Permanent Central Opium Board, 53rd session13-24 June FAO : Council, sixth session15-30 June Trusteeship Council, fifth session20-25 June UNESCO : International Conference on Science Ab-

stracting27 June-1 July UNICEF : Executive Board, 52nd-57th sessions28 June IRO : General Council, third session4-12 July UNESCO/International Bureau of Education (IBE) :

Twelfth International Conference on Public Educa-tion

5-6 July ACC : Consultative Committee on Public Information,tenth session

5 July-15 August Economic and Social Council, ninth session18-19 July ACC: Consultative Committee on Administrative Ques-

tions, sixth session, held jointly with the Committeeof Experts on Salary, Allowance and Leave Systems

27 July-3 September UNESCO : Latin American Seminar on Illiteracy9 August ACC : Preparatory Committee, ninth session15 August-8 September UN : Social Welfare Seminar in the Middle East16-24 August UNESCO : Committee of Experts on Engineering

Sciences17 August-6 September ECOSOC : United Nations Scientific Conference on

Conservation and Utilization of Resources25 August UN : Special Committee on Information transmitted

under Article 73e of the Charter

Washington

Cleveland

Lake Success

Lake Success

Geneva

Lake SuccessLake Success

GenevaLake Success

GenevaMontevideoLake SuccessLake Success

- Geneva


Lake Success

HavanaGenevaLake Success

Lake SuccessMontrealGenevaParisGenevaParisLake Success

ParisParisGeneva

Geneva

GenevaGeneva

Lake SuccessRio de JaneiroGenevaBeirut

Paris

Lake Success

Lake Success

ANNEX 5 91

1-10 September12 September


12-23 September

15-16 September

15 September-4 October18-25 September19 September-1 October20 September-10 December20-21 September

26 September

26-30 September28 September

4-6 October

6 October

6-8 October

7 October11 October11 October

12 October12-17 October

12-18 October

19 October20-21 October

20-29 October

24-27 October

31 October-3 November2-5 November2 November-4 December14 November14 November21 November21 November

23 November23-30 November

24 November28 November-17 December

30 November

5 December

5-7 December

5-10 December

ILO : Permanent Agricultural Committee, third sessionTiN : Advisory Committee on Administrative and

Budgetary QuestionsFAO : Near East Pre-Conference Regional MeetingFAO : Technical Committee on the Physiological Re-

quirements of Calories and NutrientsECOSOC : United Nations Statistical Commission, Sub-

Commission on Statistical Sampling, third sessionACC : Consultative Committee on Administrative Ques-

tions, Working Party on Codes of ExpenditureUNESCO : Executive Board, seventeenth sessionFAO : Latin American Pre-Conference Regional MeetingUNESCO : General Conference, fourth sessionUN : General Assembly, fourth sessionUNESCO : International Bureau of Universities, Interim

Committee of UniversitiesECOSOC : Permanent Central Opium Board, 54th

sessionFAO : Far East Pre-Conference Regional MeetingInformal Meeting of Representatives of UN, ILO,

UNESCO and WHO on Rehabilitation of Handi-capped Children

UNESCO : Meeting of Experts on the Book CouponsScheme

ACC : Working Party on the Continuing Needs ofChildren, first session

UNESCO : Council for the Co-ordination of InternationalCongresses of Medical Sciences

ACC : Preparatory Committee, tenth sessionIRO : General Council, fourth sessionAdministrative Committee on Co-ordination, eighth

sessionACC : United Nations Film Board, quarterly meetingECOSOC : Economic Commission for Asia and the Far

East, Ad Hoc Sub-Committee on TravelECOSOC : Economic Commission for Asia and the Far

East, Committee on Industry and TradeFAO : European Pre-Conference Regional MeetingACC : Consultative Committee on Administrative Ques-

tions, seventh sessionECOSOC : Economic Commission for Asia and the Far

East, fifth sessionILO : Meeting of Officers of the Committee of Social

Security ExpertsILO : Advisory Committee on Recreation, first sessionUNICEF : Executive Board, 58th-62nd sessionsUNESCO : Asian Seminar on Rural Adult EducationECOSOC : Permanent Central Opium Board, 55th sessionFAO : Council, seventh sessionFAO : Conference, fifth sessionACC : Working Party on the Continuing Needs of Chil-

dren, second sessionUN : Seminar of Latin America Programme CommitteeUNESCO : International Symposium on High Altitude

PhysiologyUNESCO : Executive Board, eighteenth sessionUN : Cycle d'Etudes français en Matière d'Etudes

socialesUNESCO Meeting of Experts to consider the Extension

of the Book Coupons Scheme to Scientific and Edu-cational Films

ILO : Special Tripartite Conference concerning RhineBoatmen

UNESCO : Meeting on Establishment of InternationalInstitute of the Arid Zone

ILO : Advisory Committee on Juvenile Employment

Geneva

Lake SuccessBeirut

Washington

Geneva

Lake SuccessParisQuitoParisLake Success

Paris

GenevaSingapore

Geneva

Paris

Lake Success

ParisLake SuccessGeneva


Singapore

SingaporeRome

Lake Success

Singapore

GenevaGenevaLake SuccessMysoreGenevaWashingtonWashington


LimaParis

Paris

Paris

Geneva

ParisGeneva

o2 ANNUAL REPORT OF THE DIRECTOR-GENERAL

7 December

8 December13-14 December15 December15-16 December

29 December

6-9 January

ECOSOC : Ad Hoc Committee on the Implementation ofRecommendations on Economic and Social Matters

ECOSOC : Social Commission, fifth sessionUN : Technical Assistance Board, first meetingACC : Preparatory Committee, eleventh sessionUNESCO : Meeting of Experts on Study of Technique

of International ConferencesILO : Governing Body, 110th session

Annex 6

CONFERENCES AND MEETINGS OF NON-GOVERNMENTALAND OTHER ORGANIZATIONS IN 1949 AT WHICH

WHO WAS REPRESENTED

30 January-5 February2-22 February6-7 February

11-12 March

11-13 March

4-9 April

20-27 April

21 April-12 August

28-29 April

17-20 May23-27 May27-28 May

30 May-3 June30 May-4 June1-3 June

29 June-2 July

2-9 July18-22 July

27 July-3 August8-13 August18-20 August

22-27 August22 August-1 September

24-26 August

26 August-3 September

28 August-3 September

World Federation for Mental Health, Executive Board,second meeting

South African Health CongressSeventh Pacific Science CongressAmerican Medical Association, 55th Congress on Medical

EducationCouncil for Co-ordination of International Congresses of

Medical Sciences, Executive Committee, first sessionWorld Federation for Mental Health, meeting of the

Bureau of the Executive BoardCouncil for the Co-ordination of International Congresses

of Medical Sciences, First General AssemblyInternational Student Service Conference on Health

Problems in UniversitiesDiplomatic Conference for the Establishment of Inter-

national Conventions for the Protection of WarVictims

Consultative Non-Governmental Organizations, InterimCommittee

International Conference on PoliomyelitisRoyal Sanitary Institute, Annual Health CongressCouncil for Co-ordination of International Congresses of

Medical Sciences, Executive Committee, secondsession

Seventh International Congress on Rheumatic DiseasesInternational Hospital CongressUnion OSE, Meeting on Rehabilitation of Tuberculosis

PatientsConsultative Non-Governmental Organizations, Second

General ConferenceSecond Pan American Congress of Social ServiceSecond International Congress for the Education of

Maladjusted ChildrenInternational Students' CongressIztth International Veterinary CongressWorld Federation for Mental Health, meeting of the

Bureau of the Executive BoardWorld Federation for Mental Health, Second AssemblyInternational Union for the Protection of Nature, Inter-

national Technical ConferenceWorld Council for Early Childhood Education, Working

ConferenceInternational Union for the Scientific Investigation of

Population, General AssemblyInternational Pharmaceutical Federation, 13th General

Assembly


ParisMysore

AmsterdamCapetownNew Zealand

Chicago

Paris

Geneva

Brussels

Haslev,Denmark

Geneva

GenevaParisBrighton

ParisNew YorkAmsterdam

Paris

GenevaRio de Janeiro

Amsterd amReadingLondon

GenevaGeneva

Lake Success

Paris

Geneva

Amsterdam

ANNEX 7 93

30 August-2 September5-10 September

5-10 September


12-17 September


19-24 September

26 September-2 October28 September

3-8 October

6-7 October

10-15 October17-28 October20 October

20 October

25-28 October

2-5 November5 November

15-18 November

November27-31 December

Second International Biometric Conference GenevaInternational Statistical Institute, General Meeting,

26th sessionWorld Federation of United Nations Associations,

Fourth Annual Plenary AssemblyFirst Regional Nurses' CongressInternational Union against Venereal Diseases, 26th

General AssemblyInternational Study Weeks for Child Victims of the War,

Third International ConferenceNinth International Congress on PsychotechnicsInternational Union of Family Organizations, Interna-

tional Family ConferenceInternational Water Supply Association, International

ConferenceSecond Regional Nurses' CongressInternational Union for Child Welfare, Executive Com-

mittee, eighth sessionInternational Social Security Association, Ninth General

AssemblyCouncil for the Co-ordination of International Congresses

of Medical Sciences, Executive Committee, thirdsession

World Medical Association, Third General AssemblyAfrican Regional Scientific ConferenceSixth International Congress of Paediatrics, Organizing

Committee, fourth sessionSwiss Committee of Non-Governmental Organizations,

preparatory meetingAmerican Public Health Association, 77th Annual

MeetingSecond Pan American Congress of PediatricsCouncil for the Co-ordination of International Congresses

of Medical Sciences, Executive Committee, extra-ordinary meeting

Indian Research Fund Association, Cholera AdvisoryCommittee

Trained Nurses' Association of India, Annual MeetingIndian Conference of Social Work

Annex 7

Berne

RomeSan José

Rome

BasleBerne

Rome

AmsterdamLima

Geneva

Rome

ParisLondonJohannesburg

Zurich

Geneva

New YorkMexico City

Paris

New DelhiBombayNew Delhi

TENTATIVE SCHEDULE OF MEETINGS TO BE CALLED BY WHO IN 1950

6 January

9-14 January

16 January6-11 February

20-26 February27 February-3 March

February

6-10 March

March

Executive Board, Standing Committee on Administrationand Finance

Expert Committee on Drugs liable to produce Addiction,second session

Executive Board, fifth sessionExpert Committee on Professional and Technical Educa-

tion of Medical and Auxiliary Personnel, firstsession

Expert Committee on Nursing, first sessionExpert Committee on Health Statistics, Sub-Committee

on the Definition of Stillbirth and Abortion, firstsession

Joint OIHP/WHO Study-Group on African Rickett-sioses, second session

Expert Committee on Health Statistics, Sub-Committeeon Cancer Statistics, first session

Expert Committee on International Epidemiology andQuarantine, Legal Sub-Committee

Geneva

GenevaGeneva

GenevaGeneva

Paris

Brazzaville

Paris

Geneva

94 ANMITAL REPORT OF THE DIRECTOR-GENERAL

11-15 April

17 April17-22 April20-29 April

24-28 AprilApril8 MayMay

26-30 June

JuneJuly

AugustSeptemberSeptember

September

SeptemberSeptemberSeptember

NovemberNovember

Month not yet decided :

Spring

Spring

Autumn

AutumnAutumn

Autumn

Autumn

Winter

Expert Committee on Health Statistics, Sub-Committeeon Hospital Statistics, first session

Expert Group Meeting on Prematurity, first sessionExpert Committee on Rabies, first sessionExpert Committee on the Unification of Pharmacopoeias,

sixth sessionExpert Committee on Health Statistics, second sessionExpert Committee on Antibiotics, first sessionThird World Health AssemblyExpert Committee on Venereal Infections, Sub-Commit-

tee on Serology and Laboratory Aspects, secondsession

Joint ILO/WHO Expert Committee on OccupationalHygiene, first session

Executive Board, sixth sessionExpert Committee on Maternal and Child Health, second

sessionExpert Group Meeting on School Health, first sessionExpert Committee on Tuberculosis, fifth sessionCommittee for the Study of Chemotherapeutics in Tuber-

culosisRegional Committee for the Eastern Mediterranean, third

sessionRegional Committee for South-East Asia, third sessionExpert Committee on Venereal Infections, fourth sessionRegional Committee for the Americas, second session

Malaria Conference in Equatorial AfricaExpert Committee on Malaria, fourth session

Expert Committee on Biological Standardization, fourthsession

Constituting Meeting of the Anti-Venereal-Disease Com-mission of the Rhine

Expert Committee on Venereal Infections, Sub-Com-mittee on Serology and Laboratory Aspects, thirdsession

Expert Committee on Mental Health, second sessionJoint ILO/WHO Expert Committee on Hygiene of

Seafarers, second sessionExpert Committee on Public Health Administration,

first sessionExpert Committee on Environmental Sanitation, second

sessionExpert Committee on International Epidemiology and

Quarantine, third session

GenevaGenevaGeneva

New YorkGeneva-Geneva

GenevaGeneva

GenevaGeneva

AnkaraColombo-Ciudad

Trujillo,DominicanRepublic

AfricaAfrica

Geneva

Geneva

Geneva

Geneva

ANNEX 8 95

Annex 8

SELECTED LIST OF TECHNICAL ARTICLES AND REPORTS ISSUED

BY WHO DURING 1949

Unless otherwise stated, these documents were issued by WHO in English and French, inprinted or mimeographed form. The list does not include ; (1) reports of expert committeeswhich were issued in mimeographed form in 1948 but not printed until 1949 ; or (2) shortarticles on technical subjects published in the Chronicle of the World Health Organization.In the case of articles and reports which were first issued in mimeographed form and havesubsequently been, OY will shortly be, printed, the reference symbol and number of the mimeo-graphed document are given in parenthesis after the reference to the printed publication.

Biological Standardization

Title

Expert Committee on Biological Standardization, Report on theThird Session

Complete Analysis of the Specific Antigen of the Cholera Vibrio andits Practical Applications, by D. J. GALLUT

On the Standardization of Methods of Assaying and TestingStaphylococcus Toxoid, by P. MERCIER and J. PILLET

Standardization of Diphtheria Toxoid : Some Theoretical andPractical Considerations, by N. K. jERNE and O. MAALOE

Tetanus Toxin and Antitoxin, from the Department of BiologicalStandards, National Institute for Medical Research, London

Dextro-Tubocurarine Chloride : A Provisional British Standard,from the Department of Biological Standards, National Institutefor Medical Research, London

Standardization of the Cobra (Naja Flava) Antibody : A Compa-rative Study by the Method of Assay at Various Levels and bythe Selected Antivenene Single-level Method, by E. GRASSET

The Biological Unit of Activity : Its Status and Scope, byA. A. MILES

Nomenclature of the Rhesus Typing Sera, by J. J. VAN LOGHEM, Jr.

Distribu tion of Lyophilized Culture of BCG for Production ofBCG Vaccine, by J. HOLM

Provisional International Standard for Anti-A and Anti-B BloodGrouping Sera

The Proposed Third International Digitalis Standard, from theDepartment of Biological Standards, National Institute forMedical Research, London

Reference Vaccines for the Immunization of Rabbits, to produce0-Antisera for the Distinction of Cholera Vibrios from Non-Cholera Vibrios, by P. BRUCE WHITE

Standardization of Diagnostic Agglutination Tests : Typhoid andParatyphoid A and B Fevers, by A. FELIX

Detection of Tubercle Bacilli, by W. AEG. TIMMERMANThe Standardization of Liver Extracts, by E. LESTER SMITH

Standardization of Serological Tests for the Diagnosis of the TyphusGroup of Fevers : Survey of Recent Work, by A. FELIX

Comparison of the Sensitizing Properties of PPD (USA), PPD(Denmark) and International Standard Old Tuberculin in theGuinea Pig, by D. A. LONG

Lyophilized Cholera Cultures, by S. S. SOKHEY

Reference

World Hlth Org. Techn.1950, 3 (WHO/BS/70)

Bull. World Hlth Org.39-43 (WHO/BS/69)

Bull. World Hlth Org.45-48




Bull. World69-83

Bull. World205-213

Bull. World215-225

WHO/BS/45

WHO/BS/49

WHO/BS/51

WHO/BS/52

Rep. Ser

1949, 2,

1949, 2,

1949, 2,

1949, 2,

1949, 2,

Hlth Org. 1949, 2,

Hlth Org. 1949, 2,

Hlth Org. 1949, 2,

To be publishedHlth Org. 1950,

WHO/BS/57



WHO/BS/64

WHO/BS/66

in Bull. World2 (WHO/BS/53)

in Bull. World2 (WHO/BS/61)in Bull. World2 (WHO/BS/63)


EpidemiologyTide

Expert Committee on International Epidemiology and Quarantine,Report on the Second Session

Expert Committee on International Epidemiology and Quarantine,Section on Quarantine, Report on the Second Session

Expert Committee on Plague, Report on the First Session

Yellow-Fever Panel, Report on the First Session

Joint OIHP/WHO Study-Group on African Rickettsioses, Reporton the First Session

Endemicity of Cholera in India : A Preliminary Report, byS. SWAROOP

Joint OIHP/WHO Study-Group on African Bilharziasis

Joint OIHP/WHO Study-Group on Cholera, Report on the ThirdSession

Remarks on the Principles which should serve as a Guide in theDrawing-up of WHO Sanitary Regulations to replace theExisting International Sanitary Conventions, by A. R. DUJARRICDE LA RIVIÈRE

A Preliminary Note on Bejel, by M. SIDKY

Expert Consultation on Active Immunization against CommonCommunicable Diseases of Childhood

Disinfestation of Rice, by R. POLLITZERNomenclature of Reservoirs and Vectors of Plague, by

A. MACCHIAVELLO

The Spread of Plague in the Southern and Central Divisions of theBombay Province and the Plague Endemic Centres in India, byM. SHARIF

Outline of Plague Control Field Work, by A. MACCHIAVELLOClassification of Human Cases of Plague, based on Clinical, Epide-

miological and Laboratory Data, by A. CASTROSyphilis and Gonorrhoea in Germany, by T. GUTHEEvolution of Mortality in Europe during the Twentieth Century,

by M. PASCUA

Prevalence of Plague in the World in Recent Years, by P. M. KAUL

Paracholera (El Tor) : Enteritis Choleriformis El Tor van Loghem,by C. E. DE MOOR

Schistosomiasis (Bilharziasis) : A World Problem, by Sir ALYTEWFIK SHOUSHA, Pasha

Schistosomiasis Mansoni : A Survey of its Distribution in Brazil, byJ. A. MEIRA

The Rickettsioses in Equatorial Africa : " Congolese Red Fever ",by M. GAUD

Distribution of Wild-Rodent Plague, by P. C. C. GARNHAM

Habit-forming Drugs

Expert Committee on Habit-forming Drugs,' Report on the FirstSession

Evidence on the Addiction Potentiality of Compounds of theDolantine and Methadone Types : Note by N. B. EDDY

Reference

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Epid/28)

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Q/30)

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Plague/13)

To be published in World Hlth Org.team. Rep. Ser. (WHO(YF/4Rev. 1)

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Typhus/2)

WHO/Cholera/5

To be published in World Hlth 07g.techn. Rep. Ser. (WHO/Bilharz./1)

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Cholera/6)

Off. Rec. World Hlth Org. 19, 12-15(WHO/Epid./17 Rev. 2)

WHO/Epid/18 Rev. 1 ; WHO/VD/16 Rev. 1

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Epid/19 ;WHO/MCH/12)

WHO/Plague/8To be published in Bull. World

Hlth Org. (WHO/Plague/9)To be published in Bull. World

Hlth Org. (WHO/Plague/10)

WHO/Plague/11WHO/Plague/12 Rev. 1

Epid. vital Stat. Rep. 1949, 2, 1-15Epid. vital Stat. Rep. 1949, 2, 64-80

Epid. vital Stat. Rep. 1949, 2,143-162

Bull. World Hlth Org. 1949, 2, 5-17



Bull. World Hlth Org. 1949, 2,257-270


Off. Rec. World Hlth Org. 19, 29-34

Off. Rec. World Hlth Org. 19, 32-33

Title subsequently changed t " Expert Committee on Drugs liable to produce Addiction."

ANNEX 8 97

Title

Diacetylmorphine (Heroin) : Memorandum by H. FISCHEROn Pethidine and Methadone Derivatives, by P. 0. WOLFF

Notification by the Government of the United States of Americaconcerning Metopon Hydrochloride

On Dolantine and Methadone Derivatives, by P. 0. WOLFFAdditional Information on MorpholylethylmorphineSituation regarding Diacetylmorphine

Health Statistics

Expert Committee on Health Statistics, Report on the First Session

On the Question of Stillbirth DefinitionStillbirth and Abortion, by P. STOCKSTeaching of Health Statistics and Training of Health Statistics

PersonnelVital Statistics in Under-Developed Areas, by P. F. DENOIXCancer Statistics, by P. F. DENOIXCancer Statistics : Methods and Functioning of Permanent Cancer

Inquiry, by P. F. DENOIXThe Cancer Records Scheme in England and Wales, by P. STOCKSMultiple Causes of Death entered on Certificates in England and

Wales, by P. STOCKS

Note on the Notification of Cases of Infectious Diseases in EuropeanCountries

Residence Allocation of Births and Deaths for Statistical Purposes :Procedure in England and Wales, by P. STOCKS

Note on the Inquiry into the Results of Radiotherapy in Cancer ofthe Uterine Cervix

Manual of the International Statistical Classification of Diseases,Injuries, and Causes of Death, Vols. 1 and 2 (in English)

Training in Health Statistics, by L. HERSCH

Malaria and Insecticides

ExPert Committee on Malaria, Report on the Third Session

Availability of Insecticides for the Control of MalariaMalaria Control in the State of Israel, by G. G. MERExpert Committee on Insecticides, Report on the First Session

Disinsectization of Aircraft : Study made in connexion with theRevision of International Conventions, by J. DUGUET

Report on the Standardization of Aircraft Disinsectization Methods,by J. DUGUET

Maternal and Child Health 2

Expert Committee on Maternal and Child Health, Report on theFirst Session

A Plan for the Control of Skin Diseases in Childhood, with anAnnex on Yaws, by T. B. TURNER

2 See also " Epidemiology

Reference

Ofl. Rec. World Hlth Org.. 19, 33-34


WHO/HFD/2

WHO/HFD/5WHO/HFD/15 Add. 1WHO/HFD/16

To be published in World filth Org.techn. Rep. Ser. (WHO/HS/19)

WHO/HS/3WHO/HS/4WHO/HS/5

WHO/HS/6WHO/HS/7WHO/HS/7 Add. 1

WHO/HS/8WHO/HS/9

WHO/HS/10

WHO/HS/11

WHO/HS/12

WHO/HS/15

To be published in World Hlth Org,techn. Rep. Ser. (WHO/MAL/32.Corr. 1, and Rev. 1)

WHO/Mal/31 ; WHO/Insecticides/4WHO/Mal/33

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Insec-ticides/5)

Bull. World Hlth Org. 1949, 2;155-191 (WHO/Insecticides/1 ;WHO/Q/25) "

WHO/Insecticides/2 ; WHO/Q/26

09. Rec. World Hlth Org. 19, 35-46(WHO/MCH/8 Rev. 1)

WHO/MCH/2


Title

Programme for the Development of School Health ServicesImmunization against Principal Communicable Diseases of Child-

hood : Plan for an International ProgrammeDental Health of Children and Pregnant MothersDiscussion of ILO Interest in Maternity Protection and the Health

of Children and Young Workers, by MILDRED FAIRCHILD

Plan for Maternal and Child Health in Countries with UndevelopedProgramme

Handicapped ChildrenTraining of Personnel in Maternal and Child HealthExpert Consultation on Active Immunization against Common

Communicable Diseases of Childhood

Cyanosis of Infants produced by High Nitrate Concentration inRurals Wells

Yaws

The Responsibility of the Maternal and Child Health Workerrespect of Mental Health

Reference

WHO/MCH/4WHO/MCH/5

WHO/MCH/6

WHO/MCH/7

WHO/MCH/9

WHO/MCH/10WHO/MCH/11

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Epid/19 ;WHO/MCH/12)

WHO/MCH/13

WHO/MCH/14 ; WHO/VD/55in Off. Rec. World Hlth Org. 19, 44

Mental Health 3

Expert Committee on Mental Health, Report on the First Session

Medical Aspects of the Causes and Prevention of Crime and theTreatment of Offenders, by M. S. GUTTMACHER

Plan for the Scientific Examination of Offenders prior to Sentence,by M. S. GUTTMACHER

Nutrition

Joint FAO/WHO Expert Committee on Nutrition, Report on theFirst Session

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Ment/2)

Bull. World Hlth Oyg. 1949, 2,279-288

To be published in Bull. World HlthOrg. 1949, 2 (WHO/Ment/2)

To be published in World HUh Oyg.techn. Rep. Ser. (WHO/NUT/2and Add. 1)

Organization of Public Health Services, Education and Training

Expert Committee on Environmental Sanitation, Report on theFirst Session

The Present Shortage of Nurses, Midwives and Auxiliary NursingPersonnel

Notes on the Health-Personnel Training Programme of the Anglo-Egyptian Sudan, by D. A. MESSINEZY

Recommendations for the Revision of the Provisional Question-naire of the Trusteeship Council

Recommendations for the Revision of the Standard Form of theDepartment of Trusteeship and Information from Non-Self-Governing Territories

Tuberculosis

Expert Committee on Tuberculosis, Report on the Fourth Session

Inexpensive Buildings in the Treatment of TuberculosisReport on a Visit to Certain European Countries in connexion with

the Use of Streptomycin supplied by UNICEF

To be published in World HUh Org.techn. Rep. Ser. (WHO/Env.San. 3)

011. Rec. World HUh Org. 19, 45-46

Bull. World HUh Org. 1949, 2,289-298

WHO/PHA/1

WHO/PHA/2

To be published in World Hlth Org.techn. Rep. Ser. (WHO/TBC/15)

WHO/TBC/22

WHO/TBC/19

3 See also " Maternal and Child Health " and " Venereal Diseases."

ANNEX 8 99

Title

A Summary of the Work of the Expert Committee on Tuberculosis WHO/TBC/5and the Action taken

The Tubercle Bacillus Summaries of a Symposium held in Lau-sanne, 22-25 April 1949

The Tuberculosis Problem in AdenThe Tuberculosis Control Programme

I)

The Tuberculosis Problem in CyprusThe Tuberculosis Control Programme

in ArgentinaBelgiumBoliviaBrazilCeylonChile

in EgyptEthiopiaGreeceHungary

The TuberculOsis Problem in Iran, Iraq, Lebanon, Saudi Arabia,Syria and Transjordan

The Tuberculosis Control Programme in ItalyParaguayPeruPolandSwitzerland

71 Turkey

77

)7

71

17

17

Unification of Pharmacopoeias

Expert Committee on the Unification of Pharmacopoeias, Reporton the Fourth Session

Expert Committee on the Unification of Pharmacopoeias, Reporton the Fifth Session

'General Principles for a System of International Non-proprietaryNames

Venereal Diseases

Expert Committee on Venereal Infections, Report on the ThirdSession

The Antisyphilis Demonstration Programme in Italy-Survey andRecommendations

Serum Concentrations following Five Treatment Schedules withProcaine Penicillin in Oil with Aluminium Monostearate, byD. K. KITCHEN, E. W. THOMAS, C. R. REIN. (Reproduced fromJ. invest. Derm. 12, 111)

Present Status of Penicillin Therapy for Syphilis, by C. R. REIN,D. K. KITCHEN and E. W. THOMAS

Experiences with Single and Multiple Treatment Schedules of EarlySyphilis with Procaine Penicillin in Oil with Aluminium Mono-stearate, by E. W. THOMAS, C. R. REIN and D. R. KITCHEN(Reproduced from Amer. J. Syph. 33, 523)

An International Anti-Venereal-Disease Commission of the RhineReference List : Cardiolipin Antigen in the Serodiagnosis of SyphilisSurvey of Venereal Diseases in Afghanistan

A Project for combating Bej el in the Eastern Mediterranean RegionA Venereal-Disease Control Programme for the Czech Countries of

Bohemia and Moravia

4 See also " Epidemiology ".

Ref eren ce


WHO/TBC/11WHO/TBC/26WHO/TBC/8WHO/TBC/25WHO/TBC/27WHO/TBC/14WHO/TBC/21

WHO/TBC/12WHO/TBC/13WHO/TBC/6WHO/TBC/16WHO/TBC/18

WHO/TBC/10

WHO/TBC/9WHO/TBC/24WHO/TBC/28WHO/TBC/17WHO/TBC/7WHO/TBC/23

World Hlth Org. techn. Rep. Ser.1950, 1 (WHO/Pharm/70)

To be published in World Hlth Org.techn. Rep. Ser. (WHO/Pharm/88)

WHO/Pharm/90

To be published in World Hlth Org.techn. Rep. Ser. (WHO/VD/54)

WHO/VD/14

WHO/VD/17

WHO/VD/18

WHO/VD/19

WHO/VD/20 Ve. 1WHO/VD/21

To be published in Bull. WorldMa Org. 1950, 2 (WHO/VD/22)

WHO/VD/23WHO/VD/24

loo ANNUAL REPORT OF THE DIRECTOR-GENERAL

Title

The Anti-Venereal-Disease Programme in the PhilippinesVenereal Disease in the Scandinavian Countries and PolandPan American Sanitary Bureau/World Health Organization

Venereal Disease Programmes in Development or Operation in theWestern Hemisphere with Particular Reference to the Yaws/Syphilis Project in Haiti

Bej el

Psychological Aspect of Promiscuity and Prostitution

Maritime Aspects of Venereal-Disease ControlDistribution of Venereal-Disease Literature to Health Administra-

tions, Medical Institutions, etc.Complement Fixation Reactions with Cardiolipin Antigen com-

pared with Kahn Reactions, by A. A. BEKIERKUNST and F.MILGROM

Expert Committee on yenereal Infections, Sub-Committee onSerology and Laboratory Aspects, Report on the First Session

Venereal Diseases in the NetherlandsIs Bejel Syphilis ? by F. AKRAWIPenicillin Requirements and ProductionThe Antisyphilis Demonstration Programme in Italy : Interim

Progress Note IIObservations on Penicillin Treatment of Syphilis, by R. DEGOSHealth Education : Venereal DiseasesWidespread Use of Small Doses of Penicillin for Causes other than

Venereal Diseases and Possible Influence on Manifestations ofEarly Syphilis, by W. E. COUTTS

Memorandum on Penicillin in Early Syphilis, by E. W. THOMAS

Prenatal and Infantile Syphilis, by N. R. INGRAHAMA Statement by the WHO Syphilis Study Commission to the United

States presented to the Expert Committee on Venereal Infections

Memorandum on Bej el, by T. B. TURNERLaboratory Activities in a Serologic Testing Phase of the WHO

Programme, by A. HARRISPreliminary Note on the Treatment of Syphilis with Penicillin

Procaine and Aluminium Monostearate in Rotterdam, byE. H. HERMANS

Venereal Diseases in Ethiopia : Survey and Recommendations,by T. GUTHE

International Control of Venereal Disease : Excerpts from theReport on the Second Session of the Expert Committee onVenereal Diseases

Observations on the Serodiagnosis of Syphilis, by J. F. MAHONEYand MARGARET R. ZWALLY

Rapid Treatment of Syphilis with Penieillin. ; I. A Survey of theProblem. IL Penicillin in Prenatal and Infantile Syphilis. ByE. W. THOMAS

Reference

WHO/VD/25WHO/VD/26WHO/VD/28 and Corr. 1

WHO/VD/29WHO/VD/30 and Add. 1 ; WHO/

Ment/12 and Add. 1WHO/VD/33WHO/VD/36

To be published in Bull. WorldHlth Org. 1950, 2 (WHO/VD/37)

To be published in World Huth Org.teclm. Rep. Ser. (WHO/VD/38and Corr. 1)

WHO/VD/39WHO/VD/40WHO/VD/41WHO/VD/42

WHO/VD/43WHO/VD/45WHO/VD/46 Rev. 1

WHO/VD/47WHO/VD/48To be published in World Hlth Org

techn. Rep. Ser. (WHO/VD/49Rev. 1)

WHO/VD/50WHO/VD/51

WHO/VD/52




Bull. World Hlth Org. 1949, 2,233-248 and 249-255

ANNEX 9 101

Annex 9

STATUS OF CONTRIBUTIONS TO THE BUDGETS FOR 1948 AND 1949

AND TO THE WORKING CAPITAL FUND

Status of Contributions to the Budget for 1949

(Position at 31 December 1949)

Member

AfghanistanAlbaniaArgentinaAustraliaAustriaBelgiumBoliviaBrazilBulgariaBurmaByelorussian SSR

Amount assessedUS $

2,4152,013

89,36595,000

8,85665,212

4,02589,365

6,8432,415

10,466

Amount collectedUS $

2,415--95,000

8,85665,212-89,365-

2,415-

Amount uncollectedUS $-2,013

89,365---

4,025-6,843-

10,466Canada 154,577 50,233.65 104,343.35Ceylon 2,013 2,013 -Chile 21,737 - 21,737China 289,832 289,832Costa Rica 2,013 2,013Czechoslovakia 43,475 - 43,475Denmark 38,242 38,242 -Dominican Republic 2,415 --- 2,415Ecuador 2,415 - 2,415Egypt 38,242 38,242El Salvador 2,415 2,415 -Ethiopia 4,025 4,025Finland 6,843 6,843France 289,832 289,832Greece 8,C51 8,051 -Guatemala 2,415 - 2,415Haiti 2,013 2,013 -Honduras 2,013 2,013 __Hungary 9,661 - 9,661Iceland 2,013 2,013 -India 156,992 815.85 156,176.15Iran 21,737 - 21,737Iraq 8,051 - 8,051Ireland 17,309 17,309 -Israel 5,636 2,013 3,623Italy 101,441 - 101,441Jordan, The Hashemite Kingdom of the . 2,013 2,013 -Lebanon 2,818 2,818Liberia 2,013 2,013Luxembourg 2,415 2,415 -Mexico 30,593 - 30,593Monaco 2,013 2,013Netherlands 67,627 67,627 -New Zealand 24,153 24,153Norway 24,153 24,153 -Pakistan 33,814 33,814 -Paraguay 2,013 - 2,013Peru 9,661 -- 9,661Philippines 14,089 14,089 -Poland 45,890 - 45,890

Expressed in United States dollars.


Member

Portugal

Amount assessedUS $

18,920


18,920

Amount uncollectedUS $-

Rournania 16,907 973 15,934Saudi Arabia 4,025 4,025 -South Korea 2,013 2,013 -Sweden 98,623 98,623 -Switzerland 48,305 48,305 -Syria 5,636 - 5,636Thailand 12,881 12,881 -Turkey 43,877 43,877 -Ukrainian SSR 40,657 - 40,657Union of South Africa 53,941 53,941 -Union of Soviet Socialist Republics 306,337 - 306,337United Kingdom 554,706 554,706 -United States of America 1,926,978 1,926,978 -Uruguay 8,856 - 8,856Venezuela 12,881 12,881Yugoslavia 16,102 16,102

TOTAL 5,046,293 3,698,669.50 1,347,623.50

Status of Contributions to the Budget for 1948 2


Member

AfghanistanAlbania

Amount assessedUS

2,3321,944


2,3321,944

Amount uncollectedUS

-Argentina 86,300 - 86,300Australia 91,742 91,742 -Austria 8,552 8,552 -Belgium 62,976 62,976 -Bolivia 1,705 - 1,705Brazil 86,300 86,300 -Bulgaria 6,608 3,304 3,304Burma 2,332 2,332 -Byelorussian SSR 10,107 - 10,107Canada 149,275 149,275 -Ceylon 1,944 1,944 -Chile 20,992 - 20,992China 279,891 - 279,891Colombia* 7,504 - 7,504Costa Rica 853 853 -Cuba * 5,969 - 5,969Czechoslovakia 41,983 41,983Denmark 36,930 36,930 -Dominican Republic 2,332 2,332 -Ecuador 1,023 - 1,023Egypt 36,930 36,930El Salvador 2,332 2,332Ethiopia 3,887 3,887Finland 6,608 6,608France 279,891 279,891Greece 7,775 7,775Guatemala * 1,023 - 1,023

* Indicates non-Members of WHO at that time, the amount mentioned being their participation inthe reimbursement of the UN loan to the Interim Commission, in accordance with the arrangement signedby them on 22 July 1946.

2 Expressed in United States dollars.

ANNEX 9 103

Member

HaitiHonduras

Amount assessedUS $

1,944853

Amount collectedUS $.

1,944853

-Amount unc ollectedUS $

-Hungary 9,330 3,100 6,230Iceland 1,944 1,944 -India 151,608 151,608 -Iran 20,992 20,992 -Italy 97,962 - 97,962Jordan, The Hashemite Kingdom of the 1,944 - -Lebanon 1,194 1,194Liberia 1,944 1,944Luxembourg 1,023 1,023Mexico 29,544 29,544Monaco 1,944 1,944 -Netherlands 65,308 65,308 -New Zealand 23,324 23,324 -Nicaragua * 853 - 853Norway 23,324 23,324 -Pakistan 32,653 32,653 -Panama * 1,023 - 1,023Paraguay 853 - 853Peru * 4.093 - 4,093Philippines 13,606 13,606 -Poland 44,316 44,316Portugal 18,270 18,270Roumania 16,327 16,327Saudi Arabia 3,887 3,887Sweden 95,240 95,240Switzerland 46,649 46,649Syria 5,443 5,443Thailand 12,439 12,439Turkey 42,372 42,372 -Ukrainian SSR 39,263 - 39,263Union of South Africa 52,090 52,090 -Union of Soviet Socialist Republics 295,829 - 295,829United Kingdom 535,679 535,679 -United States of America 1,860,884 1,860,884 -Uruguay 3,752 - 3,752Venezuela 12,439 12,439 -Yugoslavia 15,550 15,550

TOTAL 4,860,223 3,992,547 867,676

Status of Additional Advances to Working Capital Fund 8


Amount of Amount not yetMember additional advance Amount advanced advanced

US $ US $ US $

Afhganistan 690.80 - 690.80Albania 576.17 576.17Argentina 25,553.64 25,553.64Australia 27,164.51 - 27,164.51

* Indicates non-Members of WHO at that time, the amount mentioned being their participation inthe reimbursement of the UN loan to the Interim Commission, in accordance with the arrangementsigned by them on 22 July 1946.

3 Expressed in United States dollars.


Member

Austria

Amount ofadditional advance

US $

2,531.93

Amount advancedUS $

2,531.93

Amount not yetadvanced

US $-Belgium 18,647.63 - 18,647.63Brazil 25,553.64 3,541.00 22,012.64Bulgaria 1,956.77 - 1,956.77Burma 690.80 690.80 -Byelorussian S S R 2,993.47 - 2,993.47Canada 44,201.27 44,201.27Ceylon 576.17 576.17Chile 6,216.21 6,216.21China 82,878.12 - 82,878.12Costa Rica 1,471.29 - 1,471.29Czechoslovakia 12,431.42 - 12,431.42Denmark 10,934.18 - 10,934.18Dominican Republic 690.80 - 690.80Ecuador 1,765.15 - 1,765.15Egypt 10,934.18 10,934.18 -El Salvador 690.80 - 690.80Ethiopia 1,159.33 - 1,150.33Finland 1,256.77 - 1,956.77France 82,878.12 - 82,878.12Greece 2,302.67 2,302.67 -Guatemala 1,922 - 1,922Haiti 576.17 576.17Honduras 1,471.29 1,471.29Hungary 2,762.21 2,762.21Iceland 576.17 - 576.17India 44,892.07 - 44,892.07Iran 6,216.21 - 6,216.21Iraq 2,302.67 - 2,302.67Ireland 4,949.25 - 4,949.25Israel 4,485 - 4,485

Italy 29,007.64 - 29,007.64Jordan, The Hashemite Kingdom of the . 576.17 - 576.17Lebanon 2,059.01 2,059.01Liberia 576.17 - 576.17Luxembourg 1,765.15 1,765.15 -Mexico 8,748.15 - 8,748.15Monaco 576.17 576.17 -Netherlands 19.338.43 19,338.43New Zealand 6,906.01 - 6,906.01Norway 6,906.01 6,906.01 -Pakistan 9,670.21 - 9,670.21Paraguay 1,471.29 - 1,471.29

Peru 7,688 - 7,688Philippines 4,029.17 - 4,029.17Poland 13,122.22 - 13,122.22Portugal 5,409.78 5,409.78Roumania 4,834.61 4,834.61Saudi Arabia 1,151.33 -- 1,151.33South Korea 1,602 1,602 -Sweden 28,201.21 - 28,201.21Switzerland 13,813.02 6,499.94 7,313.08Syria 1,611.87 - 1,611.87Thailand 3,683.27 3,683.27 -Turkey 12,517.05 12,547.05Ukrainian SSR 11,624.99 11,624.99Union of South Africa 15,423.89 15,423.89Union of Soviet Socialist Republics . 87,596.10 - 87,596.10United Kingdom 158,618.97 158,618.97United States of America 551,023.59 551,023.59Uruguay 6,471.88 6,471.88Venezuela 3,683.27 - - 3,683.27Yugoslavia 4,604.34 4,604.34

TOTAL 1,461,930.85 218,990.52 1,242,940.33

DIVISION OFPUBLIC INFORMATION

Annex 10ORGANIZATIONAL CHARTS

IHEALTH ASSEMBLY

IEXECUT I VE BOARD

REGIONAL OFFICE

EUROPE

AFRICA

EASTERNMEDITERRANEAN

SOUTH-EASTASIA

WESTERNPACIFIC

AMERICAS

OFFICE OF THEDIRECTOR-GENERAL

Provisional structure of theWorld Health OrganizationDate 10 November 1949

]

DIVISION OF CO-ORDINATIONOF PLAN ING AND LIAISON

Director-Conero_l

DEPARTMENT OFTECHNICAL SERVICES

DEPARTMENT OfOPERATIONAL SERVICES

DEPARTMENT OFADMINISTRATION AND FINANCE

wmo 913o

DEPARTMENT OFTECHNICAL SERVICES

Provisional structure of tneWorld Health OrganizationDate 10 November 1949

DIVISION OFEPIDEMIOLOGY

DIVISION OFHEALTH STATISTICS

DIVISION OFTHERAPEUTIC SUBSTANCES

Mmcto,Oeneral

1

DIVISION OF EDITORIALAND

REFERENCE SERVICES

a

SECTIONS SECTIONS SECTIONS SECTIONS

SANITARY CONVENTIONSAND QUARANTINE STATISTICAL STUDIES BIOLOGICAL

STANDARDIZATION EDITORIAL

TECHNOLOGICAL MORBIDITY STATiSTICS PHARMACEUTICAL TRANSLATION

EPIDEMIOLOGICALSTUDIES

INTERNATIONAL NOMENCLATUREOF DISEASES

AND CAUSES OF DEATHHABIT FORMING DRUGS PUBLICATION

EPIDEMIOLOGICALSTATISTICS ANDINFORMATION

CO-ORDINATION OF RESEARCH LIBRARY AND REFERENCE

HA..SINGAPORE EPIDEMIOLOGICALINTELLIGENCE STATION

TUBERCULOSISRESEARCH

COPENHAGEN

WHO 9128

DEPARTMENT OFOPERATIONAL SERVICES

Provis onal structure of theWorld Health OrganizationOa te 10 November 194 9

Mftator.Okileral

DIVISION OFORGANIZATION

OF PUBLIC HEALTHSERVICES

SECTIONS

PUBLIC HEALTHADMINISTRATION

NURSING

HEALTH EDUCATIONOF THE PUBLIC

ENVIRONMENTALSANITATION

DIVISION OFCOMMUNICABLE

DISEASESERVICES

SECTIONS

MALARIA

TUBERCULOSIS

VENEREAL DISEASE

OTHER COMMUNICABLEDISEASES

DIVISION OFPROMOTIONOF HEALTH

SECTIONS

MATERNAL ANDCHILD HEALTH

MENTAL HEALTH

sHNUTRITION

DIVISION OFPROFESSIONAL AND

TECHNICAL EDUCATION

SECTIONS

EDUCATIONAL INSTITUTIONSAND TRAINING COURSES

FELLOWSHIPS

EXCHANGE OFSCIENTIFIC INFORMATION

MEOICAL SUPPLIESLITERATURE AND

TEACHING EQUIPMENT

rLEGAL OFFICE

DEPARTMENT OF

ADMINISTRATION AND FINANCE

OFFICE OFINTERNAL AUDIT

Prov is ional structure of theWorld health Organizat ionDa t e 19 No v em be r 19119

DIVISION OFADMINISTRATIVEMANAGEMENT AND

PERSONNEL

ADMINISTRATIVEMANAGEMENTSECTION

J

PERSONNELSECTION

OFFICE OFCONFERENCE AND

GENERAL SERVICES

DirectotsGontra

DIVISION OFBUDGET AND FINANCE

FINANCE ANDACCOUNTS SECTION

BUDGETSECTION

vino 9126 ,

REGIONALCOMMITTEE

PLANNING ANDOPERATIONS

FIELD PROGRAMMES (1)

ADVISORY SERVICES (2)

CONSULTING SERVICES

DEMONSTRATION TEAMS

(1) Field programmes are conducted, upon requestsENVIRONMENTAL SANITATION, MATERNAL AND CHILD HEALTH, TUBERCULOSIS AND VENEREAL DISEASES.

Provisional structure of theWorld Health OrganizationDa te 10 November 19'49

Dirvaters,Gmer.1OFFICE OF THE

REGIONAL DIRECTOR

PUBLICINFORMATION

EPIDEMIOLOGICALINTELLIGENCE ANDHEALTH STATISTICS

ADMINISTRATIONAND FINANCE

i

BUDGET AND FINANCE

PERSONNEL

GENERAL SERVICES

of Governmemts, in MALARIA, MENTAL HEALTH, NUTRITION, NURSING, PUBLIC HEALTH ADMINISTRATION, HEALTH EDUCATION OF THE PUBLIC,

(2 )REGIONAL ADVISERS are assigned as part of the respective programmes in a region and attached, for administration control and official station, to the Regional Office.

They are technically responsible (through the Regional Director) to Headquarters.

WHO 9131


Annex 11

SENIOR OFFICIALS OF THE WORLD HEALTH ORGANIZATION

Dr. W. P. FORREST

Mr. J. HANDLER

Dr. R. GamierDr. Y. BIRAUD:Dr. M. PASCUADr. N. HOWARD-JONES

Dr. M. EliotDr. W. BONNE

(31 December 1949)

Dr. Brock Chisholm Director-General

OFFICE OF THE DIRECTOR-GENERAL

Acting Director

Acting Director

Division of Co-ordination of Planningand Liaison

Division of Public Information

DEPARTMENT OF TECHNICAL SERVICES

Assistant Director-GeneralDirectorActing DirectorDirector

Division of EpidemiologyDivision of Health StatisticsDivision of Editorial and Reference

Services

DEPARTMENT OF OPERATIONAL SERVICES

Assistant Director-GeneralDirector

Dr. I. FANG Acting DirectorDr. E. GRZEGORZEWSKI Acting Director

Mr. M. P. SiegelMr. H. GRANT

Division of Communicable DiseaseServices

Division of Promotion of HealthDivision of Professional and Technical

Education

DEPARTMENT OF ADMINISTRATION AND FINANCE

Acting Assistant Director-GeneralActing Director Division of Administrative Manage-

ment and Personnel

REGIONAL OFFICE FOR THE EASTERN MEDITERRANEAN

Sir Aly T. Shousha, PashaCol. M. AFRIDI

Dr. C. ManiDr. S. CHELLAPPAH

Dr. F. Soper

Dr. N. Begg

DirectorDeputy Director

REGIONAL OFFICE FOR SOUTH-EAST ASIA

DirectorDeputy Director

REGIONAL OFFICE FOR THE AMERICAS

Acting Director

SPECIAL OFFICE FOR EUROPE

Acting Director

.1/401ilkilkt

MAP 1

WORLD HEALTH ORGANIZATIONFIELD ACTIVITIES IN 1949AT THE REQUEST OF GOVERNMENTS

I OACIIISIN 1949 JOINTACTIVITY

TUBERCULOSIS

MALARIA A

VENEREAL DISEASES Ilk

* PUBLIC HEALTH ADMINISTRATIONNURSING AND SANITATION

HI MATERNAL. AND CHILD HEALTH MNUTRITION AND MENTAL HEALTHPROF. AND TECHNICAL EDUCATION 0INCL. FELLOWSHIPS

SYMBOLS INDICATE MAJOR PURPOSE OF ACTIVITIES ONLYFOR INSTANCE, IN CHINA AND ETHIOPIA, THE SYMBOLFOR PROFESSIONAL AND TECHNICAL EDUCATION COVERSA VARIETY OF ACTIVITIES

WHO 5048

-

MAP 2. REGIONS AND REGIONAL OFFICES OF THE WORLD HEALTH ORGANIZATION

,

WASHINGTON

4:MzZy, ,

1 European regionSpecial Office for Europe, Geneva

African region

1111E111Eastern Mediterranean region

Regional Office, Alexandria

South-East Asia regionRegional Office, New Delhi

Unmarked areas have not yet been assigned

Western Pacific region

Region of the AmericasActing Regional Office, Pan American SanitaryBureau, Washington

MAP 3. NETWORK OF EPIDEMIOLOGICAL RADIO-TELEGRAPH COMMUNICATIONS

06:2

GENEVAGENEVB-PRANGINS

rok-Yo

SINGAPOREKRANJI R.N.

RATAVI.

TANANARIVEMADAGASCAR

vo

17110 5obs

Collecting and distribution centres ofepidemiological information

0 WHO Headquarters, Geneva

0 Other centresWireless stations transmitting WHO bulletins

Daily world-wide bulletins issued by WHO,Geneva

Weekly bulletin of the Singapore Epide-miological Intelligence Station

Weekly bulletin of the Alexandria HegionaOffice

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