\vORLD HEALTH ORGANIZii.TION

REGIONAL. COMMITTEE

Fourth Session Tokyo 3rd to 8th September, 19.53.

SUMHARY HINUTES OF THE

\iP /RC4/I"iin/2 Rev • 2 22 October 1953

SECONTI MEEriNG HELD AT TOKYO ON 4TH SEPTEMBI!R, 19.53 at

21:40 p.m.

ll, ADDRESS BY CHAIRllofAN

The Chainnan in a short speech referred to the pleasure given to the people of Japan by the holding of the Fourth Session in Tokyo, He thanked the Committee for :the· honour they had paid him in electing him Chairman and said that he interpreted the elec'tion as an honour not only to h:llnself, but also to his ·Government and to- the Public Health profession of Japan• He referred-· to the a.ctivitles of WHO and to tile health consciousness which.'had been aroused. pr. Soda cons''idered the shortage .of trained personnel to be one of' the most serious problems as also were environmental sanitation and mental health, .. Nutrition and the ·control of commtilYidable diseases were otht;r subjects requiring sp:ecial attention. Dr. Soda· enjoined the Committee :to loJork hard and do its bss.t.'to-'rTiake the'· meeting successful.

12, ANNOUNCEM.Ill~TS BY S.EDRETARY

The Secretary referred to the length of tJhe ''Agend.a and the shortness of time available for its discussion, He made four suggestions vJhich, if adopted, t·lOuld em.ble the :eommi tte·e ·to proceed quickly wi t,h its -v1ork.

lJ, STATEH.ENTS BY REPRES.E.'NTATIVllS ON PROGRESS OF Et...-.LTH .~oCTIVITIES LND THE IMPLEMEI~Ta1'ION OF Tiq:RD SESSION RESOLUTIONS

, Dr. Richard K, C, Lee, Representative of the United States, ·referred to tre inalusion of the '!Tust Territory of the Pacific Islands in the Western Pacific Region. As all information concerning the Territory was available in the annual reports of both the High Commissioner and the Director of :Public Health, Dr. Lc:e made only a few remarks. He :.'eferred to -the importance of training health personnel for the Terr::ii:tory. In regard to Guam, he· referred to the construction of a new hospital and the :progress in training of health personnel. There had been simil~ progres·s in· .tUnerican Samoa and in all three Territories, there had been an improvement Li the co-ordi• nation of programmes,

Dr, J. M. Cru:i.k::::hank, Chief R.eprestJntative of the United Kingdom, referred to several difficulties being. faced by all Uni. ted Kingdom Terri tori:'es in arranging long-term programmes, He ir'lfonned the Chairman that he would like the various United Kingdom Represen­tatives to .mak.e brief statements concerning Territories which they represented.

/ Dr, R.E. Anderson

Dr. R. E. Anderson, Hepresentative for the United Kingdom, speaking for the Federation of Malaya referred first to the assistance rec.;ived from too Organization in training nurs.es. It was the object of the i'l.d11linistration to achieve a standard comparable to that of' the Un:Lted Kingdom. For that reason· the placing by the Organization of United Kingdom trained nurses in the Federation would be helpful, Continuing, Dr. Anderson spoke briefly of tha importance which the Gov;;;rnment. attached to the, extension of Rural Health Centres vJbich i'rould be Bstablished and to t.'OO assistance Hhich it was anticipated that the Or-ganization would be able to furnish in regard to the Rural Health T::.~.:lining Centre. The Gov;:,rnment had appreciated the advice given by the Regional Adviser on Treponematoses and hoped to impl6ment the Tr:commendations made. In conclusion, Dr. Anderson referred to tho i:-,neral problems associated with resettlement, the work performed by the L"'ovsrmoont in tl:)a.t. connection, arid of the attendance of Govt;;rnment representatives at, \VHO Conferences.

Dr. J. 11. Liston, Rcpre~entative of the United Kingdom·, described the extraord~nary problem-s <raced 'by the Governmt:lnt of Hongkong as a result of th9 refugee influx •.. four;'(ear.~ ·a.~o the populatiOn was approxiin~tely _,ooo,ooo and today· it 'Was nearly 2,5oo,ooo. He described the resettlement work being undertaken by t.he. Government. Typhoid fever' was a. ·pr~l!em associated with the. presence· of the refugees. t>r. Lisi;,o.rl referred to tn) assistance given.by the Organization 'and UNICEF in initiat:i.Ilg BCG vaccina• tion ·a'rrl Diphtheria lriununization Campaigns. He st~te:d,·· th<H under the circumstances the Governri~t;;nt coUld not claim that' any great progress ·had been made in health during the past year.

Dr. H. J • T. Bijlmer1 Chief Representative of t.lm Netrerlarrls, ··eferred fiirstly to four special healt.h programmes in Netherlands New Guinea. l'he Government were about to commence ·a pilot pr·oject in malaria control with the use of residual insecticides. The leprosy situatiqn ~ci been surveyed by Dr. Sloan· of the South Pacific Commission and the Gover~nt plan:ned 'to .fotm four leprosaria and perhaps a central leprosarium. '?he Regional I .. dvi.s~r · · bn

,-··culosis had visited tho Territory and ···lOuld soon furnish the Gov.~mment T Lth written advice concerning tuberculosis control. The Gov0rnment hoped ~o initiate a mass yal<rs control progra.mm~ using penicillin. A grave problem confronting the Administration was the shortage of' personnE:l and for that reason the awards of wtfO fellowships to the Territo·ry had b8en appreciated. J:t'• BijL"Tler hoped that there would be further awards in 1954 and perhaps ::.n 1955.

Dr. N. Dorais:i:righ.:ti.i~ Repr·::sent.ative of the Unj_ted Kingdom and t:;peaking .for th'-' Colon.v a·f ·singapore, stated that detailed information co~.D.d"bt? 'c;btained from the •.n.nnual Reports. He had brought copies of ths Reports with him arxi they wer~S available for study by tlFJ Committee. From tP.,ese reports it would l.)e s~en that Singapore ,was one of t!w L,.al thiost areas in the East and compared favourably with advanced countries in other parts ofthe world. The progress ha:d been achieved in spite of a shortage of staff' •. He referred to several of the Gov·ernment ·· ~·"~_vities and meritionod the incre.asing new '-demand for \'lesterrt. iri8dicines '".Ld -c.he difficulty in handling all oft. he outpatient department at/Cendances.

/Dr. C. H. Yen

-.) -Dr. c. H. Yen, Chief Representative of China., referred to

four programmes:being undertaken in.the province of Taiwan, A big BOO vaccination campaign was in progress. The OrgaP.ization was also assisting in an important malaria project. Another important project being assisted· by ·the Organization was the control of trachoma. In conclusion, Dr. Yen referred to the extension: of Rural Health Services and the fact that in spite Qf the extensive training programme undertaken, there was stlll a shortt1ge of health workers of many categories.

The Chai.nnan ·announced that a paper prepared by t~ Chief Representative of the Philippines had been distributed,

Pr, Padua listed the projects described in the Report -v;hich were being a$sisted by the Organization, UNICEF and FOA• In conclu­sion, Dr. ·.Padua referred to various disease indices and expressed the hope that improvEnents in them 'vould soon be obtained.

Dr. John 'I. Gunther, Chief Represan::ative of ;;.ustralia;, info~med the Commit1.ee ·· that a short stat0ment had been prepared and would be circulated at the next plenary session, ·

14. REPm T OF THE RffiiOltJ; ·DlEECTOR

The Chairman suggested to the Commi tt.ee 'th:lt b.eca.use· of the length of the .k~genda there be · followed the procedure adopted. at tb~ previous meeting, whereby a sub-committee would b~ set up' :to s'tud,y ,the document and report back to the Cornmi ttee. There were no objections to this proposal and the Chairman desi nated Re r esentatives' of .tlls following com1tries as me ~rs o the su -committee:

China. ~km Zooland Unitecf'States

and Cambodia - should the Representatives arrive in time.

The Chairman d<Jsig.nated the Chief Representative of Nei-r. Zealand as convenor of the sub-comn-J. ttee.

The Cminnan requested the sub-committee to moot during tre week-end, designate a. Rapporteur, and report back to the Committee on Monday.

15. LONG-TERM PROGRAMME FOR APPROIDIATEI.Y A FIVE-Y&I.R PBRIOD

Dr• Regino Padua1 Chief Representative of the Philippines, moved the adoption of the dra.i't resolution contained in doc\.UOOnt 'WP/RC4/4. The resolution was as follows:-

/The Regional Committee

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The Regional Committee

REIT.ERAT.BS the necessity of the development of a long~term programme for the Region;

R.EALIS~ the difficulty of' .i:ts preparation Without adequate data and lnfo.rina.tir;m furnished by Member States;

CALLS o.{)Ce more for the co-operation of aU ~Ieinber States in submitting such data and info .. nnationi and

INSTRUC!S the Regional Director to continu~ . consultation with as many Member States as possible and to prepare, when suffi::c;i.ent data have been accumulated, a long-term programme for discussion and considera~io~ by the Regional Committee in a future session,

Dr. C,H. Yen, Chief Representative of China, seconded the resolution.

In the absence of any objection, the Chairman declared the resolution adopted.

16. ESTABLISHMBNT OF BEI"l'ER RIDIONAL co-OPERATION IN PUBL!C HEALTH

}~. A, Saita1 Representative of Japan, reiterated the support given to this proposal at the Third Session by his Government!! Dr. Regino Padua, Chief Representative of the Philippines,. also supported too proposal and moved tne adoption of the following resolution:

The Regional Committee

HAVING been informed of tre great advantage in

(a) the establislunen t of a olearing centre in the Office of the Regional D,irector for the collection and distribution of information data from and usefuJ. to member countries;

(b) the benefits derived from intra-regional fellowships which fur·ther strengthen frjencUy ties ·which are-the basis of harmonious relations in accordance with th~ preamble of the Constitution of the WHO;

(c) the far-reaching value of seminars l>lhich further establis~ better and closer working relationship and facilitate free exchange of ideas and information essential in developing better health standards and techniques;

INSTRUCTS the Regional Director to continue this prograJTI.me of establishing ~otter co-operation, exChange of infor.mation and intr~regional fellowships.

Dr. H. E. lurbott, Chiof Representative of New Zealand, requasted that copies of the proposed resolution be typed and circulated, The Chairman agreed to Dr. Turbott 1 s suggestion and· announced tl:B t the proposed resolution would be discussed later.

/Rotation of Regional Committee

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17 • ROT.iTION OF RIDIONAL COMMITTEE Ml'ZTIMJS

Dr. Horace DeLicn, Chief Itepresontati ve of tlE United States, raised a procedural point which was commented on by the Secretary, following which Dr. DeLien vd thdrew a proposed resolution. Dr. DeLien, supported too principle of rotation. The. princ:i.ple .. t-T;~.s also , supported by Dr. Regino Padua, .Chief Representative of the Philippines, who proposed that the draft resolution contained in document WP/RCL./9 therefore be appropriately amended, and also t.hat the amendment con­form uith the resolution approved at the Third Session.

Dr. c. H. Yen, Chief Representative of China and Mr. A. Saita., Representative of Jqpan, also supported the principle of rotation. Mr, Saita requested information regarding the costs of the Third and Fourth Sessions •

. The Secretary furnished the Committee with thG costs of the

two Sessions to the Organizatio~.

Jvf.r. Saita expressed· dissatisf:J.ction with the draft resolution because it did not indicate t.pat the extra costs involved in rotating the sites of the meetings would be borne by the host Governments. He also wiShed to have the acceptance of the principle of rotation clearly stated in the resQ~~~ion.

The Vice-Chairman, ,spt;aking as Chief Representat~_:ve . of. the United Kingdom, announced that·when item 1.5 of t~ - ~genda. ·came up for discussion a Representative of the United Ki;l)gd,O!D .. ~uld iasuf? ~n in vita tion for the 6th Me'cting to be held in a United Kingdom territory.

The Secretary then read to the 1-ieeting a ne1-r' draft resol utioil which he thought consistent with the viqws expressed by tho various Representatives.

Dr. H. B. Turbett, Chief Representative of New Zz:!l.nnd1 observed that . the costs to the Organization neeQ.. not necessarily b€; fixed and could be adjusted from year to year.

Dr. DeLien supported the observation made by Dr; .. Turbott. '

The Secretary explained ttr;J. t if thE: sites of the meetings 't·ler~D kno"t1 to him1 he oould · request the Director-General to make · appropriate budge't(ary a.Uoca.tions. . .

Mr •. :Saita stated tha. t he wished to see .il)cluded in the draft resolution .re.f..e·rence to the fact .that the ext:r~~. costs ,:i,:nvolvod in rotating th.e sites of ihe meetings should be bo:rne . by the hoSt goverrnnent:>.

The: Secre·tary confirmed Dr. C.H. Yen's .und·erstanding .or the budgetary plr> cedure .•

Dr. Turbett stated that he wished ·to have an am~:;ncinent made to. the resolution which would cover the point made· by fiJI'. Saita.

/The Secretary· made

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The Secretary made an addition to the draft R~solution covering th~s point, and read to the Committee the revised draft 0f the Resolution as follows:

The Regional Committee

CONSIDEm:NG that the Organization has a limited sum only ava''i,lable f'or· Cotnmi ttee· Heetings · arrl that the extra exp~nses over .idda.boye thci~e nonnally incurred when r-·reetings are ~~l~ at Regional Headquarters must be borne by the host government ·

H.EA.FFIRMS the princ'iple of rotation approved by the Committee ~t its Third Session,

The adoption of the resolution was moved by Dr. Padua and seconded by Dr, Yen, ·

The Ch.'lirman put the resolution to the Meeting,

The results of the voting were as follows;

In i'avollr' 6 Against o abstentions l

one Member did not vote.

The Chairman. declared the resoluti~n adopted.

18. RURAL MhLARIA CONTROL OONF.&IUNCE

The Chairman referred the Committee to documant ~~/RC4/6. Dr. Regino Padua, Chief Representative of the Philippines, moved that:

11 The Regional Committee

NOTTIS the action taken on the Rural, Malaria Control Conference".

Mr .• A, Saita, the Representative of Jap1n, seconded the proposal.

In the absence of any objections the .Chaiman declared the resolu~ion adopted.

19 • REniONAL MhL&il. ~NTROL PROG!Wt1l!S

Dr, Regino Padua. Chief Representativo of the Philippines, r·eviewed rna.laria control prograJ'IITles in the Region. Among the points m3.de were the importance of such progranmes in promoting· economic and social developnent, the ··absence of lOng-term malaria control plans with resulting smali~scale operations arid the assistance being given to __ ._.:..:::i.Jtrations by both the. Organization and other Agencies such as FOA.

Dr. Padua considered· that inst·lila:d- of· viewing malaria control progranunes from a national standpoint; there should be an expansion ·or this comept so a.s to obtain co-ordinated arrl integrated programmes of an inter­country or sub-regional nature,

/He therefore moved

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He therefore moved the ;adoption of the fo11owing resolution:

The R.egional Gol!U'IIi. ttee for the Western Pacific,

KNOl..JING that malaria is still one of the most important public health problems in man;( countries in the Region; that this disease· hP..s to be controlled if success is to be expected from the other programmes designed to promote economic and social.development; and that it is very essential to effect the control of th:i..s disease as soon ~s possible;

R&U.IZlNG that rapid and efficient control of the disease could be ~ffected by undertaking malaria.control in as large an area aspossible, and that such large-scale malaria control progrananes should b~ properly co-ordinated as

.much as po'ssible from an inter-country ··and eventually an inter-regional basis;

RE&U.IZING further, ·that while many of the malaria-stricken countrie-s in the RE"igion a:s:·c anxious to undertake malaria oontrol program~es in as large an area as possible, tinancial considerations have not permitted .t,hem .to do so;

.hCKNOWLIDGE3 1..rl th grateful apprecia. tion the assisi!ance it:nd c~ operation which are being provided by: .. .such Organ~za't(ions as the Mutual Security h.gency of t~ 'United States of America in taking nn active and important part in th r;; extension of malaria control acti vi t;i~s ·. ir. :rnariy countries in.this Region;

HOPES

RE:tUESTS

that such Ore:anisations would continu~e th~ii' Ve<ry valuable assistance·and co-operation;

ll'lGmb'er countries of T.h : Hest\:)rn Pacific to endeavour tQ plan and impl.ement large-scale and long.;.term progrannnes of malaria control to the extent tJ.1at thai.r resources will perrr.i t, and to consider all means of integrating national malaria control progra.lnmes into sub-regional anr.ll ·event1llllly1 regional progrrunmes of· malari<l control.

Dr· C. h. ·ren, Chief Representative of Cljina1 wl:iile in agreement with the Regional conc~pt1 considered th.ti. t it rod be~,n partly att.airod. He requested an elaboration of Dr. Padua •s precise proposals in. regard to tm method of implementation.

In reply., Dr. Pad1.k1. stated ·that h0 vTishoad te· have the concept acoept ed and for too Regional Office to undertake jljs

implementc"ltion, .first on a sub-regional and later on a Regional basis.,

/Dr. Yim thought. that

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Dr. Yen thought that by leavin~ the :implementation to the Regional Office, the desired co~operation would be only partly obtained•: ~ He s·uggested to Dr. Padua that there. be included in the resolution a more specific reference to the countries. On Dr. Padua 1s.· invitation 'he suggested too· following addition to the last sentence of the resolution:

"and INSTRUCTS the Regional Director to. assist the .Member Countries in the integration of such programmes 11 ·•

This amendment was accepted by Dr. Padua.

The Secretary provided same background information and said tm t he would be very pleased, whenever possible, and subject to the availability of funds, to assist in :implementing the proposal. . He referred to the amount of assista.me being given iri this field by other agencies. He suggested that an extension of the concept would be the co-ordination of anti-malaria 'activities between the Regions. In addition, he mentioned the measures being taken ·in parts. of the Region and the absence of malaria from other parts. In conclusion he informed the. Committee that he wotiid be' very pleased to do his· utlnost to have implanented the far-sighted proposal."

The Chairman, in the absence of an,y objection, declared 1Ji1e resolution adopted.

20. J.RRIVJU. OF 'l HE CRMBODIAN'R.EI?RJlSEi~TATIVJ!S

The Chairman welcomed Dr. You Chhin, tha Chief Representative and Dr, Mam-Kom-Sann of Cambodia.

In reply, Dr. You Chhin reciprocated the Chairman's greetings and expressed his tegret that due to an aeroplane · delay he had been unable to arrive earlier.

21. ESTABLISHMENT OF BEI'TER 'REXllO&L 00-0P:.mATION IN PUBLIC HEALTH

The Chairman informed the Commit tee that copies of i:h3 proposed resolution concerning Agenda item 9.2 had been circulated. (See Section 16, page 41 WP/RC4j.Min.2).

Mr. ~A. Sai ta, Representative of Japan, secondsd ·the resolution, tl)e. adoption of which had previously been moved by Dr. Regino Padua, Chief Representative or· the Philippines.

In the absence of any objeqtions, the Chairman deQ].ared the resolution adopted.

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22 • RWIEW OF 1954 RIDIONAL PR0Cifud'11•IE Ji.ND BUOO 1!-"T

The Secretary made a long statement in which he referred to the sources of funds ~vailable to the Organization and to the history, particularly tre recent history, of contributions to Technical ~ssistance Economic Development Funds. The implications of this to the Regional Programme were mentioned as were .i.so the ratrenchment steps which it had been necessary to take. 'I'he Secretary expressed his regret that he had to make such a statement and in conclusion stated that there appeared to be no solution to the problem, other than vigorous ef f"orts by all governments to increase their contributions to the Technical Asdstance Fund. Because of the importance of tm matter, the Secretary said tXJ would have his statement mimeographed and circulated so that Representatives could study it. before the continuation of the discussion of the ·~genda item at .the next plenary session.

23. ANNOUNCJilfmTS BY SECRE.T.i.RY

The Secretary aru10unced the commencement time of the Technical ~cussions for the following day and requested Repr~sentatives wishing to make ·corrections to the Provisional Sumrnary Minutes to do so within 24 hours, otherwise they \.rould be considered t.o be correct.

The Chairman then adjourned the I'1eeting at 5:40 p.m.