REPORT EXECUTIVE BOARD

OFFICIAL RECORDSOF THE

WORLD HEALTH ORGANIZATIONNo. 25

REPORTOF THE

EXECUTIVE BOARD

FIFTH SESSION

HELD IN GENEVA FROM 16 JANUARY TO 2 FEBRUARY 1950

PART I

WORLD HEALTH ORGANIZATION

Palais des Nations, Geneva

March 1950

ABBREVIATIONS

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

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 BureauPASO Pan American Sanitary Organization

TAB - Technical Assistance Board

TAC - Technical Assistance Committee

UNESCO - United Nations Educational, Scientific and Cultural Organization

UNICEF - United Nations International Children's Emergency FundUNRPR - United Nations Relief for Palestine RefugeesUNRRA - United Nations Relief and Rehabilitation AdministrationWFUNA - World Federation of United Nations Associations

NOTE

This volume contains the report (and relevant annexes) of the fifth sessionof the Executive Board. The minutes of this session have been deposited in mimeo-graphed form in the departments of health of Member Governments of the WorldHealth Organization.

TABLE OF CONTENTS

Page

Introduction 1

1. CONSTITUTIONAL AND PROCEDURAL MATTERS 1

1.1 Action taken by Certain Countries with regard to Membership of WHO 1

1.2 Amendments to the Constitution of the World Health Organization 1

1.3 Amendments to the Rules of Procedure of the World Health Assembly 1

1.4 Form of Annual Reports from Member States 1

1.5 Voluntary Contributions to the Supplemental Operating Programme 21.6 General Programme of Work covering a Specific Period 21.7 Proposed Programme and Budget Estimates for 1951 21.8 Arrangements for the Third and Fourth World Health Assemblies 21.8.1 Agenda for the Third World Health Assembly 21.8.2 Appointment of an Ad Hoc Committee to examine, before the Meeting of the Third World

Health Assembly,(a) the Report and Accounts for the Year 1949 and the Auditor's Report thereon . 2(b) the Reports of any Expert Committees which may become Available 2

1.8.3 Representation of the Executive Board at the Third World Health Assembly 21.8.4 Place of the Fourth World Health Assembly 31.8.5 Date of the Fourth World Health Assembly 31.9 Arrangements for Meetings of the Executive Board 31.9.1 Timetable of Meetings of the Executive Board 31.9.2 Possibility of fixing a Closing Date for the Session early in Each Session of the Executive

Board 31.9.3 Time and Place of Next Session of the Executive Board 31.10 Resignation of Dr. Raymond Gautier, Assistant Director-General in charge of the

Department of Technical Services 3

2. CENTRAL TECHNICAL SERVICES 4

2.1 Epidemiology 42.1.1 Expert Committee on International Epidemiology and Quarantine : Report on the Second

Session 42.1.2 Principles to govern WHO Sanitary Regulations 42.1.3 Expert Committee on Plague : Report on the First Session 52.1.4 Yellow Fever 52.1.4.1 Yellow-Fever Panel : Report on the First Session 52.1.4.2 Application for Full Approval by WHO of the Yellow-Fever Vaccines produced at the

Yellow-Fever Laboratories in Bogotá and Rio de Janeiro 52.1.5 Leprosy 52.1.6 Bilharziasis (Schistosomiasis) 52.1.6.1 Note on Schistosomiasis mansoni presented by Professor de Paula Souza 52.1.6.2 Joint OIHP/WHO Study-Group on African Schistosomiasis : Report on the First Session 62.1.6.3 Danger of Spread of Bilharziasis (Schistosomiasis) through Irrigation 62.1.7 Technical Collaboration with the Office International d'Hygiène Publique 62.1.8 Joint OIHP/WHO Study-Group on African Rickettsioses : Report on the Preliminary

Session 62.1.9 Joint OIHP/WHO Study-Group on Cholera : Report on the Third Session 62.1.10 Use of Respirators in the Treatment of Poliomyelitis and Proposed Organization of a

System of International Loan of such Apparatus 62.1.11 Infectious Diarrhoea 62.1.12 Dental Caries 72.1.13 Allergic Diseases 72.2 Statistics 72.2.1 Present Administrative Arrangements in WHO in the Sphere of Statistics (Health, Epi-

demiology, Medical and Vital) 7

2.3 Therapeutic Substances 72.3.1 International Biological Standards 7

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2.3.2 Unification of Pharmacopoeias 72.3.2.1 Expert Committee on the Unification of Pharmacopeias : Report on the Fifth Session 7

2.3.2.2 Non-proprietary Names for Drugs 82.3.3 Expert Committee on Habit-forming Drugs : Report on the Second Session 82.3.4 Research in Antibiotics 82.3.5 Rabies Prophylaxis 82.4 Publications 82.4.1 Publication of an International Health Yearbook 82.4.2 World List of Medical and Biological Periodicals (WHO/UNESCO) 92.4.3 Supplementary Latin Index to the Manual of the International Statistical Classification

of Diseases, Injuries and Causes of Death 9

3. ADVISORY SERVICES 9

3.1 Population Problems 93.2 Communicable Diseases 93.2.1 Expert Committee on Malaria : Report on the Third Session 93.2.2 Insecticides : Production and Distribution of DDT 103.2.3 Expert Committee on Tuberculosis 113.2.3.1 Report on the Fourth Session 113.2.3.2 Resolution of the Executive Committee of the League of Red Cross Societies on Partici-

pation in the Tuberculosis Campaign 11

3.2.4 Expert Committee on Venereal Infections : Report on the Third Session ; Sub-Committeeon Serology and Laboratory Aspects, Report on the First Session ; and Report of theWHO Syphilis Study Commission to the United States 11

3.2.5 Expert Committee on Mental Health : Report on the First Session ... .. . 123.2.6 Report of the Joint FAO/WHO Expert Committee on Nutrition 123.2.7 Expert Committee on Environmental Sanitation : Report on the First Session . 133.3 Public Health Administration 133.3.1 Revision of the Trusteeship Council Questionnaire and the Standard Form for Non-

Self-Governing Territories 133.3.2 Creation, Improvement and Development of National Health Services 133.3.3 Fellowship Programmes 133.4 Medical Supplies 133.4.1 Freer Flow of Medical Supplies 133.4.2 Programme Supplies to Governments 143.4.3 Expanded Programme of Technical Assistance for Under-Developed Countries : Supplies 14

4. EXPERT COMMITTEES 14

4.1 Timetable, Place and Agenda of Sessions of Expert Committees 144.2 Views of the Executive Board on Reports of Expert Committees 144.3 Sending of Experts at the Request of Governments 144.4 Regulations for Expert Advisory Panels and Committees 15

5. REGIONAL ORGANIZATIONS 15

5.1 Relations between WHO, the Regional Organizations of WHO and International Govern-mental and Non-Governmental Organizations 15

5.2 Regulations for the Operation of Regional Offices 155.3 Regional Organization for Europe 155.4 Regional Organization for the Eastern Mediterranean 155.4.1 Regional Committee for the Eastern Mediterranean : Report on the Second Session 155.4.2 Agreement with the Government of Egypt concerning the Extension of Privileges and

Immunities to the Regional Organization for the Eastern Mediterranean Region . . . . 155.5 Regional Organization for South-East Asia 155.5.1 Regional Committee for South-East Asia : Report on the Second Session 155.6 Regional Organization for the Americas 165.6.1 Pan American Sanitary Organization : Report on the Eighth Meeting of the Executive

Committee and on the Third Meeting of the Directing Council 165.6.2 Oath of Office of the Director 16

6. JOINT ACTIVITIES 16

6.1 Co-ordination with the United Nations and Specialized Agencies 166.1.1 Co-ordination on Administrative and Financial Matters 166.1.2 Problem of the Proliferation and Overlapping of the Programmes of the United Nations

and Specialized Agencies ............... . . . . . . . . . . . . . . 16

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6.1.3 Action taken by the Economic and Social Council of the United Nations on Matters ofConcern to WHO 17

6.1.4 Proposed Rewording of Article 7 of the International Covenant on Human Rights : Reportof the Working Party 17

6.2 UNICEF 176.2.1 General Relations between WHO and UNICEF 176.2.2 Continuing Needs of Children 176.2.3 Paris Children's Centre 186.3 Joint ILO/WHO Committee on the Hygiene of Seafarers 186.4 Relations with Non-Governmental Organizations 186.4.1 Non-Governmental and Sectional Organizations 186.4.2 Working Principles laid down by the First World Health Assembly for Admission to

Official Relationship with WHO 186.4.3 Admission into Official Relations with the World Health Organization 18

Establishment of an International Code of Deontology 196.6 National WHO Committees 19

7. ADMINISTRATION AND FINANCE 19

7.1 Report of the Standing Committee on Administration and Finance ....... . 197.1.1 Adoption of the Report 197.1.2 Technical Assistance for Economic Development of Under-Developed Countries . 197.1.3 Expenditure Level for 1950 207.1.4 Operating Programme and Budget for 1951 217.1.4.1 Appropriation Resolution 217.1.4.2 Working Capital Fund Resolution 217.1.5 Suspension of Financial Regulations 13 and 16 (e) with regard to Unused 1949 Balances 217.1.6 Status of Contributions 217.1.7 Transportation Expenses for Regional Committees 227.1.8 Organizational Structure and Administrative Efficiency 227.1.9 Conclusions 227.2 Arrangements for Accommodation for Headquarters Office 227.3 Budget 237.3.1 Report on Transfers between Chapters within Sections of the 1949 Budget and Transfers

between Sections in Parts and between Parts 237.3.2 Proposed Transfers between Chapters within Section 3, Part II, of the 1950 Appropriation

Resolution 237.3.3 Currency of Contributions 237.3.4 Report of the United Nations Advisory Committee on Administrative and Budgetary

Questions on the Budget of the World Health Organization for 1950 237.3.5 World Health Defence Fund 237.4 Finance and Accounts 247.4.1 Reimbursement of Expenses of Sleeper Accommodation when Travelling by Air -

Members of the Executive Board and Members of Expert Committees 247.4.2 Per Diem Allowances for Members of the Executive Board and Members of Expert

Committees 247.4.3 Reimbursement of Travelling Expenses of Members of the Executive Board 247.5 Personnel 247.5.1 Adjustments in Basic Salary and Allowances of Persons stationed in Areas affected by

Currency Revaluations 247.5.2 Retirement and Pension Fund 247.5.3 Recruitment of Staff 247.5.4 Amendments to Staff Rules 257.5.5 Tax Equalization 257.5.6 Geographic Distribution of Staff 25

LIST OF ANNEXES

1. List of Attendances 262. Membership of Committees and Working Parties 273. Action taken by Certain Countries with regard to Membership of WHO 284. Amendments to the Rules of Procedure of the World Health Assembly 295. General Programme of Work covering a Specific Period 306. Present Administrative Arrangements in WHO in the Sphere of Statistics (Health,

Epidemiological, Medical and Vital) 35

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7. Non-proprietary Names for Drugs 398. Creation, Improvement and Development of National Health Services (Note presented by

Dr. G. H. de Paula Souza) 409. Draft Regulations for Expert Advisory Panels and Committees 41

10. Regional Committee for the Eastern Mediterranean : Report on the Second Session 4411. Regional Committee for South-East Asia : Report on the Second Session 4812. Regional Organization for the Americas (Pan American Sanitary Organization) : Summary

of Resolutions and Decisions of the Eighth Meeting of the Executive Committee and of theThird Meeting of the Directing Council 52

13. General Relations between WHO and UNICEF : Report on WHO/UNICEF Activities . . 6314. Summary of the First and Second Reports of the Standing Committee on Non-Governmental

Organizations 6515. Establishment of an International Code of Deontology 6716. Agreement concerning the Premises to be used for the Headquarters of WHO in Geneva 6817. 1950 Budget : Proposed Transfers between Chapters within Section 3, Part II, of the 1950

Appropriation Resolution 7118. Currency of Contributions 7219. Extracts from the Report of the UN Advisory Committee on Administrative and Budgetary

Questions on the Budget of WHO for 1950 7620. Administrative Adjustments as a Result of Revaluation of Currencies 7921. Retirement and Pension Fund 8022. Amendments to Staff Rules 81

INTRODUCTION

The fifth session of the Executive Board was held in the Palais des Nations, Geneva, from 16 Januaryto 2 February, 195o, under the Chairmanship of Sir Arcot Mudaliar (India), with Dr. H. S. Gear (Unionof South Africa) and Dr. J. Zozaya (Mexico) as Vice-Chairmen ; Dr. M. Nazif Bey (Egypt) and ProfessorM. De Laet (Netherlands) were elected as Rapporteurs for the fifth session. However, Dr. M. Nazif Beybeing unable to attend all the meetings, the Board elected Dr. A. Villarama (Republic of the Philippines)as Rapporteur in his place.1

The Board considered in detail the revised programme for 1950 and the proposed programme andbudget estimates for 1951, together with the reports of the Standing Committee on Administration andFinance, submitting them with its comments to the Third Health Assembly. In further preparation forthe Assembly, it requested the Director-General to prepare the agenda on the basis of the draft proposed.

The reports of expert committees were discussed in detail and the opinions of the Board were incor-porated in the resolutions relevant to particular reports.

The Board also considered with great interest the reports of the regional committees, while notingthat the procedure for the preparation and examination of such reports would have to be developed.

During the course of 25 meetings, the Board took the decisions contained in the following report.

1. CONSTITUTIONAL AND PROCEDURAL MATTERS

1.1 Action taken by Certain Countries withregard to Membership of WHO

The following resolutions were adopted :

I. The Executive Board

REQUESTS the Director-General to place on theagenda of the Third World Health Assembly thequestion of the three countries which have inti-mated that they consider themselves no longerMembers of the World Health Organization.

II. The Executive BoardREQUESTS the Director-General to place on the

agenda of the Third World Health Assembly thequestion of the communication received from theGovernment of Bulgaria.2

1.2 Amendments to the Constitution of theWorld Health Organization

The following resolution was adopted :

The Executive Board(1) NOTES the several proposals to amend theConstitution made by the Governments of Austra-lia, Denmark, India, Norway and Sweden whichhad been circulated to Member States in accor-dance with Article 73 of the Constitution ; and(2) DECIDES to place this matter on the agenda ofthe Third World Health Assembly.

Since Professor De Laet was unable to attend thetwenty-third, twenty-fourth and twenty-fifth meetings ofthe Board, owing to illness, Professor Dujarric de la Ri-vière, at the request of the Chairman, appointed M. PaulBertrand, one of his advisers, to act as Rapporteur.

2 See Annex 3.

1.3 Amendments to the Rules of Procedureof the World Health Assembly


The Executive Board(I) APPROVES the amendments to the Rules ofProcedure of the World Health Assembly 3 and

(2) TRANSMITS these amendments to the ThirdWorld Health Assembly for consideration.

1.4 Form of Annual Reports from MemberStates


I. The Executive Board,

Having considered the obligation laid on eachMember State by Article 61 of the WHO Consti-tution to "report annually to the Organization onthe action taken and progress achieved in improv-ing the health of its people",

(1) IS OF OPINION that this obligation may bemet by Member States, the health administrationsof which normally publish an annual report, byforwarding such a report to the Organization ;

(2) BELIEVES that other Member States may beaided in the fulfilling of their obligation by a listof headings under which information is desiredby the Organization, even though they may notbe in a position to furnish all this information ;and therefore

(3) REQUESTS the Director-General to send toMember States a draft list with a view to obtaining

3 See Annex 4.

2 EXECUTIVE BOARD, FIFTH SESSION, PART I

their observations and suggestions, and incorpor-ating them where appropriate in a revised listto be submitted for approval to the Board, priorto its distribution to Member States.

II. The Executive Board

AGREES that the reports by Member States underArticle 61, collected annually through regionaloffices of the Organization, may usefully serve inthe preparation of a series of monographs which,if found desirable, might be grouped in the formof an international health yearbook or of a similarperiodical publication.

1.5 Voluntary Contributions to the Supple-mental Operating Programme 4


The Executive Board

(I) NOTES the voluntary contributions by thegovernments of Yugoslavia and of Ceylon towardsthe financing of the supplemental operating pro-gramme approved by the Second World HealthAssembly ;

(2) RECOGNIZES that decision on the ultimatearrangements to be made about these contributionswill be made by the governments concerned inthe light of decisions to be taken by the TechnicalAssistance Conference ;

(3) REQUESTS the Director-General to inform allMember Governments of its appreciation of theaction of these two governments.

1.6 General Programme of Work coveringa Specific Period


The Executive Board

(I) APPROVES the general programme of workcovering a specific period, as amended ; 5 and

(2) TRANSMITS it to the Third World HealthAssembly.

1.7 Proposed Programme and Budget Esti-mates for 1951

In accordance with the terms of Article 34 of theConstitution, the Director-General submitted theproposed programme and budget estimates for1951 to the fifth session of the Executive Board,and the Board, in accordance with Rule 75 of theRules of Procedure of the World Health Assembly,has examined the Director-General's budget esti-mates and made its recommendations thereon 6 andforwards these to the Third World Health Assembly.

4 og. Rec. World Hlth Org. 21, 2785 See Annex 5.8 See Part II of the Board's report (09. Rec. World

Hlth Org. 26, is.

1.8 Arrangements for the Third and FourthWorld Health Assemblies

1.8.1 Agenda for the Third W orld Health Assembly

The following resolution was adopted :The Executive Board

APPROVES the provisional agenda for the ThirdWorld Health Assembly, as amended, on theunderstanding that the Committee on Adminis-tration and Finance will appoint a working partyon legal and constitutional matters to considersuch items as the committee may allocate to them.

1.8.2 Appointment of an ad hoc committee toexamine, before the meeting of the ThirdWorld Health Assembly,(a) the report and accounts for the year 1949

and the Auditor's report thereon ;(b) the reports of any expert committees

which may become available.


Considering that there will not be a formalsession of the Executive Board between the timeof the receipt of the report of the External Auditoron the accounts of the Organization for the year1949 and the date of the convening of the ThirdWorld Health Assembly ; and

Considering the requirement that the comments,if any, of the Board on such report be made to theThird World Health Assembly,

The Executive Board

(I) RESOLVES that an ad hoc committee of theExecutive Board, consisting of Dr. G. H. de PaulaSouza, Professor J. Parisot and Dr. A. Villarama,is authorized to meet one day before the date ofthe convening of the Third World Health Assemblyto consider the report of the External Auditor(on the accounts of the Organization for the year1949) and to submit to the Third World HealthAssembly on behalf of the Board such comments,if any, as it deems necessary ; and

(2) AUTHORIZES the said ad hoc committee toexamine and report upon such expert committeereports as may become available after the closeof the fifth session of the Board.

1.8.3 Representation of the Executive Board at theThird World Health Assembly

The following resolution was adopted :The Executive Board,Having considered the procedure for examining

the 1951 programme and budget ; andTaking note of its instructions from the Second

World Health Assembly with regard to thismatter, including the instructions to review theorganizational structure and administrative effi-ciency,

(r) DECIDES that the consideration of the pro-gramme and budget estimates for i95i by the

REPORT OF THE EXECUTIVE BOARD 3

Third Health Assembly will be facilitated if theBoard submits a complete report on its examinationand review, and also arranges for the Board to beofficially represented at the Assembly ;

(2) REQUESTS the Director-General to arrangefor the printing of the report of the fifth sessionof the Board in two parts, one part to be devotedexclusively to the Board's comments and recom-mendations on the programme and budget esti-mates for 1951, including its review of the organi-zational structure and administrative efficiency ;and

(3) DECIDES, further, that the Board shall beofficially represented at the Third Health Assemblyby :

Sir Arcot L. MudaliarDr. H. S. GearDr. J. Zozaya ;

(4) RECOMMENDS to the Third World HealthAssembly the adoption of the following resolution :

The Third World Health Assembly

(1) INSTRUCTS the Committee on Programme tomake a broad appraisal of the proposed pro-gramme together with the comments and recom-mendations of the Executive Board ;

(2) INSTRUCTS the Committee on Administrationand Finance to review the broad financialaspects of the programme and budget togetherwith the comments and recommendations of theExecutive Board ; and

(3) INSTRUCTS the Committees on Programmeand on Administration and Finance to meetjointly early in the session at a time establishedby the General Committee to make joint recom-mendations to the Health Assembly on thetotal amount of the budget and the amountsthereof to be devoted to each part of the budget,i.e., Part I, Organizational Meetings ; Part II,Operating Programme ; Part III, AdministrativeServices.

1.8.4 Place of the Fourth World Health Assembly


The Executive Board,Expressing its recognition of the invitation by

the United States to the Organization that theFourth World Health Assembly should be held inWashington,

REQUESTS the Director-General, in consultationwith the United States Government, to explore thecost of holding the Fourth World Health Assemblyin Washington and to report thereon to the ThirdWorld Health Assembly.

1.8.5 Date of the Fourth World Health AssemblyThe following resolution was adopted :The Executive BoardPROPOSES that the Fourth World Health Assem-

bly shall be convened during the first days of May1951.

1.9 Arrangements for Meetings of the Exe-cutive Board

1.9.1 Timetable of Meetings of the Executive Board

After consideration of the proposal made byDr. Mackenzie,' the following resolution wasadopted :

The Executive BoardDECIDES to review its timetable at the session

immediately following the Third World HealthAssembly.

1.9.2 Possibility of fixing a Closing Date for theSession early in Each Session of the ExecutiveBoard

The following resolution was adopted :The Executive BoardDECIDES that on the third day of each session

the Board should fix a target date for the closingof the session.

1.9.3 Time and Place of the Next Session of theExecutive Board

The following resolution was adopted :The Executive BoardDECIDES to hold its sixth session at Geneva,

Switzerland, the opening meeting to be held notlater than one week after the close of the ThirdWorld Health Assembly, at io a.m. at the Palaisdes Nations.

1.10 Resignation of Dr. Raymond Gautier,Assistant Director-General in charge ofthe Department of Technical Services

Several 'members of the Executive Board havingexpressed their great regret at the impendingdeparture of Dr. Gautier and their admiration forhis work in the sphere of international publichealth, the Executive Board unanimously approvedthe following resolution :

The Executive BoardEXPRESSES its deep appreciation of the long and

distinguished services of Dr. Raymond Gautier tointernational health and in particular for his workwith the World Health Organization.

7 That in normal circumstances the Board shouldhold full sessions in January and September and, if neces-sary, a short meeting immediately following the HealthAssembl y.


2. CENTRAL TECHNICAL SERVICES

2.1 Epidemiology

2.1.1 Expert Committee on International Epide-miology and Quarantine : Report on theSecond Session


The Executive Board

(1) DECIDES to submit, for observations, to Mem-ber States and to interested international agencies,the draft International Sanitary Regulations andSupplementary Regulations relating to the Protec-tion of the Mecca Pilgrimage prepared by theExpert Committee on International Epidemiologyand Quarantine ;

(2) DECIDES to refer to the United Nations andICAO the draft Safety and Sanitary Standards forPilgrim Ships and Aircraft prepared by the sameexpert committee ;

(3) NOTES the report of the Expert Committeeon International Epidemiology and Quarantine onits second session,8 and

(4) AUTHORIZES its publication ;

(5) NOTES the report of the Quarantine Sectionof the Expert Committee on International Epide-miology and Quarantine on its second session, and,

(6) EXPRESSES its satisfaction that a number ofcomplaints by governments relating to sanitarymeasures taken by other governments exceedingthe provisions of the International Sanitary Con-ventions have been settled without recourse toformal proceedings.

Taking into account the recommendations of theexpert committee in considering relevant itemson its agenda,

(7) TRANSMITS the report to the Third WorldHealth Assembly ; and

(8) POINTS OUT that recommendations of expertcommittees which concern WHO policy and opera-tions remain recommendations unless and untilthey are implemented by the Executive Board orthe World Health Assembly in adopting andputting into action the annual programme of WHO.

2.1.2 Principles to govern WHO Sanitary Regu-lations


The Executive Board,

Considering the necessity for determining theprocedure to be followed with a view to the adoptionof the International Sanitary Regulations,

(1) DECIDES, in accordance with the instructionsof the Second World Health Assembly, to submitto a legal sub-committee the text of the draft

International Sanitary Regulations, as well asthe draft preamble and protocolary clauses to beincorporated therein ;

(2) REQUESTS the Director-General to send thedocument thus prepared to governments andappropriate international bodies for comments ;

(3) ENTRUSTS the Expert Committee on Interna-tional Epidemiology and Quarantine with therevision of its draf t Regulations in the light of thecomments received from governments and inter-natkmal bodies ;

(4) REQUESTS the Third World Health Assemblyto consider the advisability of forming a specialcommittee, to meet two to three weeks beforethe Fourth World Health Assembly, to discussthe revised draft Regulations with a view to theiradoption by that Assembly, the special committeeto be composed of delegations from MemberStates, comprising epidemiologists, legal experts,and experts in quarantine and transportation ;

(5) NOTES the resolution adopted by the SecondWorld Health Assembly9 concerning the "needfor eliminating quarantine restrictions of doubtfulmedical value which interfere with internationaltrade and travel, and ... the present unsatisfactorytendency to multiply the number of immunizationcertificates required from travellers" ;

(6) RECOMMENDS that the Third World HealthAssembly invite Member States to adopt therecommendations made by the Expert Committeeon International Epidemiology and Quarantineas regards the form of international certificates ofvaccination and the provisions concerning them,according to which :

(a) the international certificate of vaccinationagainst yellow fever would be considered to bevalid ten days after the vaccination and forsix years from the date thereof ;(b) for the ordinary traveller the internationalcertificates of vaccination against cholera wouldbe valid after a single injection and for a periodof six months following that injection ;(c) the international certificates of vaccinationagainst cholera and smallpox would be signedby a medical practitioner whose identity wouldhave to be authenticated by an official stampor whose signature would have to be authenti-cated by a person legally qualified to do so ;(d) vaccination certificates against cholera orsmallpox made out by a medical officer belongingto the Armed Forces or to a national or localhealth service would not have to be authenticatedotherwise than by affixation of the officialstamp of the service concerned ;

(7) ENTRUSTS the Legal Sub-Committee of theExpert Committee on International Epidemiologyand Quarantine with the examination of the inter-national certificate of vaccination against smallpox,

To be published as World filth Org. techn. Rep. °Resolution WHA2.15, 09. Rec. World Filth Org.Ser. 1950, 20. 21, 22


prior to its coming before the Third Health Assem-bly, to determine whether any changes should beintroduced in its form in order that it may beused while the existing International SanitaryConventions remain in force ; and

(8) DECIDES that the mention of the duration ofvalidity in the certificate be deleted until theWHO Regulations come into force.

The legal sub-committee or consultants shouldalso consider the question of additional measureswhich might need to be taken to deal with legalproblems involved in the transition from existingInternational Sanitary Conventions to the newregulations and make any necessary recommenda-tions in regard thereto for consideration at thenext meeting of the Executive Board ;(9) ENTRUSTS the Expert Committee on Insecti-cides and the Secretariat with the task of collectingthe technical information necessary to enable thecommittee - to which would be added specialistsin the construction and operation of ships andaircraft, as well as port health officers - to providethe Expert Committee on International Epidemio-logy and Quarantine, on the occasion of a jointmeeting in October 1950, with the details requiredby the latter committee regarding :

(a) the practical value, from an epidemiologicalpoint of view, of the disinsection of ships, inrespect of various types of insects ;(b) the methods of disinsection considered bestin the light of present knowledge ; and(c) the practical possibilities of disinsectingships of different types and tonnage, as well as thetime required for the operations, and their cost.

2.1.3 Expert Committee on Plague: Report on theFirst Session


(r) NOTES the report of the Expert Committeeon Plague on its first session," and(2) AUTHORIZES its publication ;

Taking into account the recommendations of theexpert committee in considering relevant itemson its agenda,(3) TRANSMITS the report to the Third WorldHealth Assembly ;

(4) POINTS our that recommendations of expertcommittees which concern WHO policy and opera-tions remain recommendations unless and untilthey are implemented by the Executive Boardor the World Health Assembly in adopting andputting into action the annual programme ofWHO ; and

(5) DRAWS ATTENTION to the statements includedin the annex to the report concerning the dangersinherent in the use of ro8o as a rodenticide.

2.1.4 Yellow Fever

2.1.4.1 Yellow-Fever Panel: Report on the FirstSession. The following resolution was adopted :

1-1) To be published as World Hlth Org. techn. Rep.Ser. 1950, 11.

The Executive Board

(1) NOTES the report of the Yellow-Fever Panelon its first session,u and




(4) POINTS OUT that recommendations of expertcommittees which concern WHO policy and opera-tions remain recommendations unless and untilthey are implemented by the Executive Board orthe World Health Assembly in adopting and puttinginto action the annual programme of WHO.

2.1.4.2 Application for Full Approval by WHO ofthe Yellow-Fever Vaccines produced at the Y ellow-Fever Laboratories in Bogotd and Rio de Janeiro.The following resolution was adopted ;

The Executive BoardDECIDES to accord, for the issue of international

certificates, full approval to the yellow-fevervaccines produced by the yellow-fever laboratoriesat Bogotá and Rio de Janeiro.

2.1.5 Leprosy

The following resolution was adopted :Having drawn attention to the provisions of the

resolution adopted by the Second World HealthAssembly 12 concerning the 1950 programme,

The Executive BoardNOTES that the Second World Health Assembly

made budgetary provision for a meeting of anexpert committee only and not for the other ser-vices.

2.1.6 Bilharziasis (Schistosomiasis) 18

2.1.6.1 Note on Schistosomiasis mansoni presentedby Professor de Paula Souza. The Board noted thepaper presented by Professor de Paula Souza,"4and the observations made by Dr. Villarama onSchistosomiasis japonicum as a public-health prob-lem in the Philippines.'"

11 To be published as World Hlth Org. techn. Rep.Ser. 1950, 19.

12 Resolution WHA2.43, 011. Rec. World Hlth Org.21, 30

13 By decision of the Board, " bilharziasis " becomesthe recognized designation of this condition.

" The note emphasized the medical and sanitaryimportance of bilharziasis and recommended that " theWorld Health Organization, having in view the globalproblems of schistosomiasis, should gather specialistsin this subject to study plans and measures of prophy-laxis in order to reduce the incidence of this parasite ".

18 Dr. Villarama endorsed the views expressed by Dr. dePaula Souza, and stated that the survey of schistosomiasisjaponicum should not be confined to Egypt but shouldinclude all countries menaced by the disease. He quotedthe example of the Philippines where, as a result ofthe Japanese invasion, the population had been greatlyaffected.


2.1.6.2 Joint OIHP /WHO Study-Group on AfricanSchistosomiasis: Report on the First Session.The following resolution was adopted :

The Executive Board

(I) NOTES the report of the Joint OIHP/WHOStudy-Group on African Schistosomiasis on itsfirst session," and

(2) AUTHORIZES itS publication ;

(3) REQUESTS the Director-General

(a) to make the necessary arrangements for thecarrying out of the bilharziasis surveys recom-mended by the study-group, and(b) to take appropriate steps for the revisionof the international designation of bilharziasisand its causative agents.

2.1.6.3 Danger of Spread of Bilharziasis (Schisto-somiasis) through Irrigation. The following reso-lution was adopted :


Considering the danger to health entailed by theestablishment of irrigation schemes in areas wherebilharziasis is present, if the necessary sanitaryprecautions are not taken at all stages of thedevelopment of the schemes,

REQUESTS the Director-General

(a) to call the attention of governments andof the appropriate bodies and specialized agen-cies of the United Nations interested in irri-gation to such danger and to the safeguardsrecommended by the joint OIHP/WHO Study-Group on African Schistosomiasis ; and

(b) to make appropriate arrangements to providethe said governments and organizations withthe technical advice which they may require.

2.1.7 Technical Collaboration with the Office Inter-national d'Hygiène Publique


The Executive Board

(I) NOTES with satisfaction the allocation of a sumof 24 million French francs on the 1950 budgetof the Office International d'Hygiène Publiquefor the continuation of epidemiological workalready undertaken jointly by OIHP and WHO andfor the extension of such work ;

(2) NOTES the very satisfactory technical resultsobtained by the meetings in 1948 and 1949 of thejoint OIHP/WHO study-groups on cholera, plague,typhus and other rickettsioses, smallpox, theAfrican forms of bilharziasis and trachoma ;

(3) EXPRESSES its appreciation of the collaborationextended by OIHP as regards the study of com-municable diseases ;

" To be published as World Hlth Org. techn. Rep. Ser.1950, 17.

(4) APPROVES the continuation of the workundertaken on cholera,17 bilharziasis," and rickett-sioses ;

(5) APPROVES the extension of the work to yellowfever ; 2°

(6) APPROVES also its extension to other commu-nicable diseases, which in the opinion of the Presi-dent and Director of the Office Internationald'Hygiène Publique and the Director-General ofWHO necessitate study in 1950 under the auspicesof those two organizations, subject to the decisionsreached in this respect being referred to the Board,except in case of emergency ;(7) REQUESTS the Director-General to make, inagreement with the President and Director of theOffice, the arrangements necessary for holdinga meeting of the Finance and Transfer Committeeand the Permanent Committee of the Office inGeneva, should it be decided to convene them onthe occasion of the Third World Health Assembly.

2.1.8 Joint OIHP /WHO Study-Group on AfricanRickettsioses: Report on the PreliminarySession

The Board noted the report of the Joint OIHP/WHO Study-Group on African Rickettsioses onits preliminary session.

2.1.9 Joint OIHP IWHO Study-Group on Cholera:Report on the Third Session


(I) NOTES the report of the Joint OIHP/WHOStudy-Group on Cholera on its third session ;and(2) AUTHORIZES its publication.

2.I.I0 Use of Respirators in the Treatment ofPoliomyelitis and Proposed Organization ofa System of International Loan of suchApparatus

The Board noted the report on the use of respira-tors in the treatment of poliomyelitis and theorganization of a system of international Loan ofsuch apparatus. The report will be published indue course.

2.1.11 Infectious Diarrhoea


(I) NOTES the request of the Finnish Governmentfor assistance in the control of infantile diarrhoea ;and

17 Joint OIHP-WHO study-group and field studies inthe Tanjore area (India)

18 Research on molluscocides if such proves practicableand appropriate with the funds available, otherwiseholding a meeting of a study-group on the Americanforms of bilharziasis in conjunction with the conferencedealing with bilharziasis planned for July 1950, at Recife,by the Brazilian Hygiene Society

19 Meeting of a study-group on Asiatic rickettsioses29 Delineation of the southern boundaries of the yellow-

fever endemic area of Africa21 To be published as World Hlth Org. techn. Rep. Ser.

2950, 18.


(2) REFERS it to the Director-General for anyappropriate action possible.

2.1.12 Dental Caries


(t) NOTES the memorandum on dental cariespresented by the WHO Committee for Finland ;and

(2) REFERS it to the Director-General for appro-priate action within the budgetary limits of theOrganization.

2.1.13 Allergic Diseases


(1) NOTES the memorandum on allergic diseasessubmitted by the WHO Committee for Finland ;and

(2) REFERS it to the Director-General for appro-priate action within the budgetary limits of theOrganization.

2.2 Statistics

2.2.1 Present Administrative Arrangements inWHO in the Sphere of Statistics (Health,Epidemiology, Medical and Vital).

The Board noted the document entitled "PresentAdministrative Arrangements in WHO in theSphere of Statistics (Health, Epidemiology, Medicaland Vital)".22

2.3 Therapeutic Substances

2.3.1 International Biological Standards


PROPOSES to the Third World Health Assembly theadoption of the following recommendations :

The Assembly,In virtue of articles 2 (u) and 21 (d) and (e)

of the Constitution,

(1) RECOMMENDS

(a) that Member States of the Organizationrecognize officially the international standardpreparations and units enumerated below :

International standard Internationalpreparations units

Diphtheria antitoxin 0.0628 mg.Tetanus antitoxin 0.3094 mg.Anti-dysentery serum (Shiga) 0.0500 mg.Scarlet fever antitoxinStaphylococcus alpha antitoxin 0.5000 mg.Anti-pneumococcus serum (Type I) o.o886 mg.Anti-pneumococcus serum

(Type II)Gas-gangrene antitoxin (Perfrin-

gens)Gas-gangrene antitoxin (Vibrion

septique)

0.0894 mg'

0.2660 mg.

0.2377 mg.

International standardpreparations

Gas-gangrene antitoxin ((Edema-tiens)

Gas-gangrene antitoxin (Histoly-ticus) 0.3575

Gas-gangrene antitoxin (Sordelli) 0.1334Anti-A blood group serum . . -Anti-B blood group serum . .

Old tuberculin 0.01Diphtheria antitoxin for floccula-

tion testVitamin A acetate 0.000344 mg.Provitamin A (beta-carotene) . o.00o6 mg.Vitamin B, (Pure synthetic vitamin

131) 0.003Vitamin B12 (Pure crystalline)Vitamin C (I-ascorbic acid) . . . 0.05 mg.Vitamin D3 (crystalline) . . . . 0.000025 mg.Vitamin E (alpha-tocopherol ace-

tate) 1.o mg.NeorsphenamineSulpharsphenamineInsulin (Pure crystalline insulin) . oPituitary (Posterior lobe) powder oDigitalis 76Ouabain -Androsterone 0.1 mg.Corpus luteum hormone (Proges-

terone) 1.o mg.Chorionic gonadotrophin 0.1 mg.Serum gonadotrophin 0.25 mg.Prolactin (galactin or mammotro-

phin) o.r mg.Heparin 0.0077 mg.Penicillin G o.0006 mg.Streptomycin

* Unit potency to be assigned at the next session ofthe Expert Committee on Biological Standardization.

Internationalunits

0.2681 mg.

mg.mg.

ml.

mg.

.0455

.5

.o

mg.mg.mg.

(b) that these standards and units be intro-duced into the national pharmacopoeias toserve as a reference for assay :(c) that in those countries which do not pos-sess a national pharmacopoeia, the potencyappearing on the labels of biological productsbe expressed in international units ;

(2) INVITES the Director-General to enquireperiodically from Members regarding the usebeing made of international standards in theircountries.

2.3.2 Unification of Pharmacopoeias

2.3.2.1 Expert Committee on the Unification ofPharmacopeias : Report on the Fifth Session.The following resolution was adopted :

The Executive Board(I) NOTES the report of the Expert Committee onthe Unification of Pharmacopoeias on its fifthsession ; 23 and


(3) RECOMMENDS the adoption of the followingresolution by the Third World Health Assembly :

The Third World Health Assembly(1) APPROVES of the Pharmacopoea Internationa-lis ; and

22 To be published as World Hlth Org. techn. Rep. Ser.22 See Annex 6. 1950, 12.


(2) RECOMMENDS the eventual inclusion of itsprovisions in the national pharmacopoeias afterthe adoption of the said provisions by the autho-rities responsible for the pharmacopoeias.

2.3.2.2 Non-proprietary Names for Drugs. Thefollowing resolution was adopted :

The Executive Board

(I) REQUESTS the Director-General to circulateto governments for their information the principlesenumerated by the Expert Committee, on theUnification of Pharmacopeias ; 24 and

(2) RECOMMENDS tO the Third World HealthAssembly the adoption of the following resolution :

The Third World Health Assembly,Recognizing the desirability that a system

of non-proprietary names be established inter-nationally for such new pharmaceutical productsas might be contemplated for later insertion inthe Pharmacopoea Internationalis,

(I) APPROVES the general principles enumeratedby the Expert Committee on the Unification ofPharmacopoeias at its fifth session ; and

(2) RESOLVES as follows :

(a) the Expert Committee on the Unificationof Pharmacopoeias should undertake theselection and approval of non-proprietarynames for drugs which might be described inlater editions of the Pharmacopoea Interna-tionalis ;

(b) such names as are from time to timeselected and approved by the Expert Commit-tee should be communicated by the Director-General to national pharmacopoeial authori-ties, together with a recommendation thatthese names be officially recognized and ap-proved, and, if the substances are eventuallyincluded in the national pharmacopoeia,adopted as pharmacopoeial names ;(c) such recommendations shall further includea request that such measures as may be deemedappropriate by States Members be taken witha view to preventing the use of the namesselected for unauthorized purposes, and inparticular to prevent the granting of exclusiveproprietary rights in these names to the manu-facturer.

2.3.3 Expert Committee on Habit-forming Drugs:Report on the Second Session

The following resolution was adopted ;The Executive Board

(I) RECOMMENDS that the Director-General takesteps to secure information on the use or dispens-ability of diacetylmorphine in the various countriesthrough governments ;(2) DECIDES to change the denomination of theExpert Committee on Habit-forming Drugs to"Expert Committee on Drugs liable to produceAddiction" ;

See Annex 7.

(3) ADOPTS 25 the report of the Expert Committeeon Habit-forming Drugs on its second session ; 26and

(4) AUTHORIZES its publication.

2.3.4 Research in Antibiotics


The Executive Board

(I) NOTES the status of the project on research inantibiotics ; and

(2) DECIDES to refer to the first meeting of theExpert Committee on Antibiotics the training andresearch facilities in antibiotics available in theDepartment of Biochemistry in the Istituto Supe-riore di Smith in Rome ;

(3) AUTHORIZES the Director-General, in order toavoid delay in providing training facilities at thisinstitute, should this be recommended by theexpert committee, to proceed with preliminaryarrangements and to report to the next meetingof the Executive Board.

2.3.5 Rabies Prophylaxis



On condition that the Expert Committee onRabies at its first session early in 1950 so advises,

AUTHORIZES the undertaking of WHO-sponsoredfield-trials with a minimum of delay in (a) the useof a new hyper-immune serum-vaccine prophylac-tic measure against rabies in human beings, and(b) the use of a new egg-adapted virus vaccine indogs for the control and eradication of rabies.

2.4 Publications

2.4.1 Publication of an International Health Year-book



Having noted and considered ResolutionWHA2.37 of the Second World Health Assembly "requesting the comments of the Board on thepossible form, content, periodicity and usefulnessof an International Health Yearbook,

RECOMMENDS that the proposal to publish anInternational Health Yearbook be deferred forfuture consideration.

25 The report of this expert committee was adoptedby the Board, instead of being merely noted, becauseof the responsibilities of WHO under the Charter of theUnited Nations and the relationship of WHO to the Narco-tics Commission of the Economic and Social Council.


27 011, Rec. World Hlth Org. 21, 28


2.4.2 World List of Medical and Biological Perio-dicals (WHO /UNESCO)



Having considered proposals made by the Co-ordinating Committee on Abstracting and Index-ing in the Medical and Biological Sciences ofUNESCO for the publication of a World List ofMedical and Biological Periodicals, and the esti-mates of the cost thereof,

RESOLVES that the World Health Organizationshould share equally with UNESCO the cost ofproduction of such a publication, providing thatWHO participation in the work of the Co-ordinatingCommittee on Abstracting and Indexing in theMedical and Biological Sciences shall not exceedthe $6,000 approved by the Second World HealthAssembly and subject to the following conditions :

(a) the List should be issued as a joint UNESCO/WHO publication ;

(b) a sufficient number of copies should be madeavailable without charge to WHO for distribu-tion to Member States, national health adminis-trations, and certain national medical libraries ;

3.1 Population Problems

(c) any receipts from sales should, after deduc-tion of any additional expenses which UNESCOmay have incurred in the production of the List,be shared equally between UNESCO and WHO.

2.4.3 Supplementary Latin Index to the Manualof the International Statistical Classificationof Diseases, Injuries and Causes of Death

The following resolution was adopted :The Executive Board,Considering that certain countries, in compiling

morbidity and mortality statistics, are not ableto utilize the English or the French or the Spanishedition of the Manual of the International StatisticalClassification of Diseases, Injuries and Causes ofDeath ;

Considering that a Latin Supplementary Indexwould facilitate the application of the Manualin those countries using Latin medical terms,

RESOLVES that WHO prepare and publish aLatin Supplementary Index to the Manual of theInternational Statistical Classification of Diseases,Injuries and Causes of Death, the Director-Generalto report later on the possibility of making financialprovision for this work.

3. ADVISORY SERVICES

The following resolution was adopted :The Executive BoardRESOLVES to request the Director-General to

co-operate on a wide basis with the United Nationsand the specialized agencies on questions c.9ncernedwith population problems.

3.2 Communicable Diseases

3.2.1. Expert Committee on Malaria : Report onthe Third Session 28

After discussion of the report of the ExpertCommittee on Malaria on its third session, thefollowing resolutions were adopted :

I. (Publication of the Report)

The Executive Board(I) NOTES the report of the Expert CommitteeMalaria on its third session ; and



(4) POINTS OUT that recommendations of expertcommittees which concern WHO policy and opera-tions remain recommendations unless and untilthey are implemented by the Executive Board orthe World Health Assembly in adopting and puttinginto action the annual programme of WHO.

II. (Recommendations to Governments)

The Executive Board

(I) APPROVES the "Recommendations to Govern-ments" detailed in sub-section 5.6 of the report ;and

(2) REQUESTS the Director-General to circulatethem to all Member Governments of countrieswhere malaria is a problem, at the same time callingthe attention of such Member Governments to the

on other important recommendations of the commit-tee, viz :


28 To be published as World Hlth Org. techn. Rep. Ser.1950, 8.

2

(a) that the relative merits and disadvantages ofmalaria control by residual spraying or byanopheline species eradication be given seriousconsideration before extensive antimalaria pro-grammes are undertaken ;

(b) that larval control in rural areas be aban-doned where residual insecticides are extensivelyapplied and found to be effective.


III. (Long-term Policy of WHO in the Field ofMalaria)

The Executive Board(I) APPROVES the relevant recommendations ofthe expert committee detailed in sub-section 6.5of the report ; and

(2) RESOLVES :

(a) that in any WHO programme of technicalassistance to under-developed areas wheremalaria is a major problem, malaria control begiven highest priority ;

(b) that the first years of a long-term programmeshould provide for assistance to governments insuch a way that all countries where malariais a major problem be enabled to establish anadequate malaria-control organization, and fur-ther, that in every one of these countries at leastone malaria-control project be in operation ;

(c) that WHO should not hesitate to carry outpilot trials of malaria control by demonstrationteams in areas where no previous residual sprayinghas been done or where previous work leaves thematter of control by this method open to reason-able doubt or even where the identity of themalaria vector has not been proved ;

(d) that collaboration with FAO in assistinggovernments in the control of malaria, wherethe latter interferes with agricultural and econo-mic development, be intensified ;

(e) that WHO provide for the training of selectedcandidates for antimalaria projects when nosuitably trained personnel are otherwise avail-able ;

(/) that the demonstration teams, althoughremaining directly responsible to WHO, shouldbe instructed to fit themselves into the frame-work of the respective departments of health orof the malaria services if such exist.

IV . (Co-ordination of Research on Antimalarials)

The Executive Board(I) APPROVES the recommendation concerning theco-ordination of research on malaria therapeutics ;and

(2) REQUESTS the Director-General to draw theattention of the Member Governments to the bene-fit that might be derived in achieving co-ordinationof national institutes undertaking research of thisnature, such co-ordination resting on the basicprinciples outlined by the committee in sub-section2.3 of the report.

V. (Specifications of Insecticides)"

The Executive BoardREQUESTS the Expert Committee on Insecticides

to draft the specifications of the most important

39 A report on this subject is being prepared by theDepartment of Economic Affairs of the United Nationsat the request of the Economic and Social Council. SeeECOSOC (VIII) Resolution 184.

insecticides and/ or their formulations with a viewto circulating them to the governments.

VI. (Antimalarial Supplies)

The Executive Board

REQUESTS the Director-General to continue hisendeavours to facilitate, through the appropriatebodies of the Economic and Social Council, theobtaining of antimalarial supplies requested by thegovernments ; and further to explore the possibilityin the co-operative programme with UNICEFand with the collaboration of the above-men-tioned bodies of the Economic and Social Councilof aiding the production of basic forms of insecti-cides and / or their formulations in those non-manufacturing countries in which the necessarypreconditions exist for the economical developmentof such production.

VII. (Malaria Conference in Equatorial Africa)

The Executive Board

RESOLVES that the Malaria Conference in Equa-torial Africa be convened in 195o if the Director-General is satisfied that the preparations for theconference are adequate.

VIII. (Prevention of the Introduction of Anophelinesinto Areas which are free, OY have been freed,from them)

The Executive Board

REFERS to the Third World Health Assemblythe Committee's recommendation on prevention ofthe introduction of anophelines into areas whichare free, or have been freed, from them.

IX. (Darling Foundation and Prize)

The Executive Board

(1) APPROVES the regulations of the DarlingFoundation and Prize as given in an annex to thereport of the expert committee ; and

(2) REQUESTS the Director-General to take thenecessary action for the modification of the deedof foundation registered with the Conseil d'Etatof the Republic and Canton of Geneva.

3.2.2. Insecticides: Production and Distribution ofDDT


The Executive Board

(I) NOTES the resolution of the ninth session of theEconomic and Social Council " and the resolutionadopted by the Regional Committee of the WorldHealth Organization for the South-East AsiaRegion ; " and

ECOSOC (IX) Resolution 2253' Annex ri

REPORT OF THE EXECUTIVE BOARD II

(2) PROPOSES to the Third World Health Assemblythe adoption of the following resolution :

The Third World Health Assembly(1) EXPRESSES its appreciation of the actiontaken by the Economic and Social Council at itsninth session, relating to the availability ofinsecticides ;(2) EMPHASIZES the importance of ensuring thefree flow of insecticides necessary for public-health work into countries which do not producethese commodities ; and(3) REQUESTS the Director-General to bring theresolution of the Economic and Social Council tothe attention of all Member countries.

3.2.3. Expert Committee on Tuberculosis

3.2.3.1 Report on the Fourth Session. The followingresolution was adopted :

The Executive Board(r) NOTES the report of the Expert Committee onTuberculosis on its fourth session ; 32 and


Taking into account the recommendations of theexpert committee in considering relevant items onits agenda,


(4) POINTS our that recommendations of expertcommittees which concern WHO policy and ope-rations remain recommendations unless and untilthey are implemented by the Executive Board orthe World Health Assembly in adopting andputting into action the annual programme of WHO.

3.2.3.2 Resolution of the Executive Committee ofthe League of Red Cross Societies on Participationin the Tuberculosis Campaign. The following reso-lution was adopted :

The Executive Board(r) NOTES the Resolution adopted by the Execu-tive Committee of the League of Red Cross Societiesconcerning the international tuberculosis cam-paign ;


33 The text of the resolution is as follows :

" The Executive Committee,Realizing the importance of the international tubercu-

losis campaign now being carried out as a joint enterprisebetween Scandinavian Societies, United Nations Inter-national Children's Emergency Fund, World HealthOrganization and the Ministry of Health in each partici-pating country,

Recommends that the national societies in the respec-tive countries take as active a part in the campaign aspossible and

Authorizes the Secretary-General to accept the member-ship of the League in a sub-committee recommended bythe Expert Committee on Tuberculosis of the WorldHeaJth Organization to deal with the future planningof the campaign, on the full understanding that theindependent position of the Red Cross shall be completelyprotected. "

(2) EXPRESSES its appreciation of the recommen-dation made to the National Red Cross Societies totake as active a part as possible in this campaign ;

(3) APPROVES the recommendation of the expertcommittee to call together, at suitable intervals,representatives of the organizations which will beworking jointly in tuberculosis control.

3.2.4 Expert Committee on Venereal Infections:Report on the Third Session; Sub-Committeeon Serology and Laboratory Aspects: Reporton the First Session; and Report of the WHOSyphilis Study Commission to the UnitedStates


I. (Publication of the Report of the Committee)

The Executive Board(I) NOTES the report of the Expert Committee onVenereal Infections on its third session ; 34 and




(4.) POINTS OUT that recommendations of expertcommittees which concern WHO policy andoperations remain recommendations except as theyare implemented by the Executive Board or theWorld Health Assembly in adopting and puttinginto action the annual programme of WHO.

II. (Developments and Perspectives)

The Executive Board(r) APPROVES the recommendation of the expertcommittee on venereal-disease activities, develop-ments and perspectives of WHO (sub-section2.1 of the report) ; and

(2) EMPHASIZES the importance of priority beinggiven to economically under-developed areas witha high prevalence of venereal disease (and/or othertreponematoses).

(International Health Regulations and Mari-time Aspects of Venereal-Disease Control)

The Executive Board(I) APPROVES the recommendation of the expertcommittee regarding international health regula-tions and maritime aspects of venereal-diseasecontrol (sub-section 2.2 of the report) ;

(2) CALLS the attention of Member Governmentsto the importance of more countries adhering tothe International Agreement of Brussels and tothe establishment of venereal-disease programmesin major ports ; and



(3) REQUESTS the Director-General to take thenecessary steps for the early publication and distri-bution of the revised edition of the individualtreatment booklet and the WHO internationalvenereal-disease treatment centre list.

IV. (Treponematoses)

The Executive Board(I) APPROVES the recommendations of the expertcommittee regarding treponematoses (sub-section2.3 of the report) ;

(2) REQUESTS the Director-General to give fullsupport to the syphilis-yaws project in the islandof Haiti and the Dominican Republic and the WHObej el project in the Eastern Mediterranean Area ;and

(3) RECOMMENDS that an Expert Committee onTreponematoses and Venereal Infections should beformed, merging the existing Expert Committee onVenereal Infections with the Expert Committee onTreponematoses proposed under the technicalassistance programme for 1950, with appropriatestudy-groups or sub-committees as required in thespecific sectors.

V. (Serodiagnosis)

The Executive BoardNOTES the statement of the expert committee on

serodiagnosis and laboratory aspects (section 4 ofthe report).

VI. (Publication of the Report of the Sub-Com-mittee)

The Executive Board(1) APPROVES the publication of the report of theSub-Committee on Serology and Laboratory As-pects 35 accepted by the Expert Committee onVenereal Infections ; and

(2) REQUESTS the Director-General to draw theattention of Member Governments to :

(a) the desirability of national laboratoriesguiding standardization work in serology, and(b) the holding of the international serologyconference, approved by the Health Assembly,

and to facilitate the arrangements for this confer-ence in every way possible.

VII. (Report of the WHO Syphilis Study Commis-sion to the USA)

The Executive Board(1) NOTES the statement of the Syphilis StudyCommission to the USA ; and

(2) RECOMMENDS that the report of the Commis-sion " be made available as soon as possible tohealth administrations and other interestedparties.


" To be published as World Hlth Org, techn, Rep. Ser.1950, 15.

3.2.5 Expert Committee on Mental Health: Reporton the First Session



After consideration of the report of the ExpertCommittee on Mental Health on its first session,held in Geneva from 29 August to 2 September1949,37

(I) REQUESTS the Director-General to base theservices provided by the Organization in the fieldof mental health on the priorities recommended inthe report and, in carrying out WHO programmesin other fields, to take into consideration thoserecommendations of the committee which refer tothem ;

(2) AUTHORIZES the convening of the expert meet-ings on drug addiction and alcoholism recommendedby the committee as part of the participation ofthe Organization in the programmes sponsored bythe United Nations ;

(3) AUTHORIZES the publication of the report ;



(5) POINTS OUT that recommendations of theexpert committees which concern WHO policy andoperations remain recommendations unless anduntil they are implemented by the Executive Boardor the World Health Assembly in adopting andputting into action the annual programme ofWHO.

3.2.6 Report of the Joint FAO/WHO ExpertCommittee on Nutrition


I. (Publication of the Report)

The Executive Board(I) NOTES the report of the Joint FAO/WHOExpert Committee on Nutrition on its sessionheld in Geneva from 24-28 October 1949 ; 38

(2) NOTES with satisfaction the establishment offull liaison between FAO and WHO in the field ofnutrition, as demonstrated by the meeting ofthis committee ;

(3) AUTHORIZES the publication of the report,;

Taking into account the recommendations ofthe expert committee in considering relevant itemson its agenda,(4) TRANSMITS the report to the Third WorldHealth Xssembly ;

(5) POINTS OUT that recommendations of expertcommittees which concern WHO policy and ope-




rations remain recommendations unless and untilthey are implemented by the Executive Board orthe World Health Assembly in adopting and put-ting into action the annual programme of WHO ;and

(6) REQUESTS the Director-General, in preparingWHO programmes in nutrition, to follow the com-mittee's recommendations in so far as they apply.

II. (Formation of National FAO/WHO NutritionCommittees)

The Executive Board

(r) NOTES the comments of the Joint FAO/WHOExpert Committee on Nutrition on the formationof national FAO/WHO nutrition committees ;

(2) DECIDES that the question of forming nationaljoint FAO/WHO nutrition committees shall beconsidered in conjunction with the promotion ofnational WHO committees.

III. (Manufacture of Synthetic Vitamins in Under-developed Countries)

The Executive Board

RECOMMENDS to the Third World Health Assem-bly the adoption of the following resolution :

The Third World Health Assembly(r) NOTES the report of the Joint FAO/WHOExpert Committee on Nutrition on the difficultiesof the manufacture of synthetic vitamins inunder-developed countries ;(2) NOTES the Executive Board's comment thatthe most satisfactory way of improving nutritionis by the provision of natural foods in suchquantities and proportions that the diet is wellbalanced and supplies in sufficient amounts allthe nutrients needed for health ;(3) RESOLVES that the World Health Organi-zation should supply to any country manu-facturing or contemplating the manufacture ofsynthetic vitamins any information or assistancewhich may be available.

3.2.7 Expert Committee on Environmental Sani-tation: Report on the First Session


The Executive Board

(I) NOTES the report of the Expert Committee onEnvironmental Sanitation on its first session ; "and


Taking into account the recommendations ofthe expert committee in considering relevant itemson its agenda,


(4) POINTS OUT that recommendations of expertcommittees which concern- WHO policy and ope-rations remain recommendations unless and untilthey are implemented by the Executive Board orthe World Health Assembly in adopting and puttinginto action the annual programme of WHO.

3.3 Public-Health Administration

3.3.1 Revision of the Trusteeship Council Question-naire and the Standard Form for Non-Self-Governing Territories


The Executive Board(r) NOTES with approval the resolutions on infor-mation from the non-self-governing territoriesadopted by the United Nations General Assemblyon 2 December 1949 ; 4° and

(2) REQUESTS the Director-General to continue toassist the United Nations in its work regardingthe non-self-governing territories.

3.3.2 Creation, Improvement and Development ofNational Health Services


The Executive Board

(1) NOTES the document put forward by Dr. dePaula Souza,4' which it considers to be of impor-tance in the fields of organization of public healthservices and health statistics ; and

(2) REQUESTS the Director-General to include itin the documentation for the Third World HealthAssembly.

3.3.3 Fellowship Programmes

The Board decided that it did not propose at thisstage to make any conditions for the granting offellowships, and to leave it to the Director-Generalto take necessary decisions, based upon (r) furtherexperience in the programme ; (2) the findings andrecommendations of the Expert Committee onTraining, and (3) the advice of regional direc-tors.

3.4 Medical Supplies

3.4.1 Freer Flow of Medical Supplies

The following resolution was adopted :The Executive Board,Considering that equitable distribution and

adequate quantities of medical supplies are essen-tial for improving the standard of health ; and

Considering that in some countries considerableproduction facilities are available while othercountries, especially those economically under-

General Assembly Resolutions 331 (iv), 332 (iv),89 To be published as World Hlth Org. techn. Rep. Ser. 333 (iv) and 336 (iv)

1930, 10. 41- See Annex 8.


developed countries where health standards arelow and which are in need of medical supplies, findit difficult to import them in the required quantitieson account of tariffs and import and exportrestrictions,

RECOMMENDS to the Third World Health Assemblythe adoption of the following resolution :


REQUESTS the Director-General to draw theattention of the Economic and Social Councilat its next session to the consideration of theproposal that countries facilitate as muchas possible the free flow, into the countrieswhere they are needed, of essential diagnostic,therapeutic, prophylactic, teaching and researchequipment and supplies, and raw materials andmachinery for their production, by measureswhich they deem appropriate with regard totariffs, import and export restrictions.

3.4.2 Programme Supplies to Governments


The Executive Board

DECIDES to defer consideration of the request sfrom the Governments of Hungary, India, Poland ,

Portugal and Thailand for programme suppliespending the production of a report by the Director-General on the methods by which the Board mightdischarge its obligations to "examine in advanceand in detail and approve" 42 such projects.

3.4.3 Expanded Programme of Technical Assist-ance for Under-Developed Countries :Supplies

The following resolution was adopted :The Executive Board,Recognizing that in many cases governments

are prevented from carrying out important pro-grammes mainly because of the difficulties inobtaining necessary supplies,

RECOMMENDS that the World Health Organiza-tion should furnish supplies for such programmesto the maximum extent possible, following thegeneral policies of the United Nations in theirtechnical assistance programme.

4. EXPERT COMMITTEES

4.1 Timetable, Place and Agenda of Sessionsof Expert Committees


The Executive Board

DECIDES

(a) that meetings of expert committees shouldbe held in soft currency areas wheneverpossible ; and

(b) that Member Governments should be keptinformed of these meetings and sent a copyof the provisional agenda and the names of themembers of expert committees.

4.2 Views of the Executive Board on Reportsof Expert Committees 42


The Executive BoardDECIDES that the following note shall be appended

to all expert committee reports examined at thefifth session of the Board :

The Executive Board(1) NOTES the report ; and


42 011. Rec. World Hith Org. 18, p. V" Regulations and Rules of Procedure for Expert

Committees, and their Sub-committees, Regulation 24

Taking into account the recommendations ofthe expert committee in considering relevantitems on its agenda,


(4) POINTS OUT that recommendations of expertcommittees which concern WHO policy andoperations remain recommendations unless anduntil they are implemented by the ExecutiveBoard or the World Health Assembly in adoptingand putting into action the annual programmeof WHO.

4.3 Sending of Experts at the Request ofGovernments

The Board considered the proposal made by theGovernment of Czechoslovakia in a letter to theDirector-General dated 19 October 1949 44 andadopted the following resolution :

44 The Government proposed that each expert committeeshould draw up a comprehensive list of experts who arecompetent and willing to advise WHO Members, the liststo be approved by the Executive Board or by the HealthAssembly, and put at the disposal of Member States.Meanwhile, experts to be sent should be approved by theDirector-General or his deputy or the Assistant Directors-General. On completing his work, every expert shouldpresent a report to the government of the country whichhe has visited.


The Executive Board,Having examined the proposition of the Govern-

ment of Czechoslovakia ;

IS OF OPINION that in general the procedureenvisaged appears not to be practicable.

4.4 Regulations for Expert Advisory Panelsand Committees


(I) APPROVES the Draft Regulations" for ExpertAdvisory Panels and Committees ;

(2) TRANSMITS them to the Third World HealthAssembly for consideration ;

(3) RECOMMENDS to the Third Assembly that inthe revision of Annex VII of the Convention onPrivileges and Immunities of Specialized Agenciesconsideration be given to the extension of theprovisions of Clause 2 to members of expert advi-sory panels, in the exercise of their functions assuch ; and

(4) REQUESTS the Director-General not to appointmembers of the Executive Board to expert advisorypanels or committees, unless exceptional circum-stances warrant such appointments.

5. REGIONAL ORGANIZATIONS

5.1 Relations between WHO, the RegionalOrganizations of WHO and InternationalGovernmental and Non - GovernmentalOrganizations

The following resolution was adopted :The Executive BoardREQUESTS the Director-General to study the

question of the relationship between the WorldHealth Organization, the regional organizations ofWHO and international governmental and non-governmental organizations, and to report on thisquestion to an early session of the Executive Board.

5.2 Regulations for the Operation of RegionalOffices

The Board, at its third session, requested theDirector-General to prepare, for presentation to thefourth or fifth session of the Board, detailed regula-tions for the operation of regional offices." At itspresent session, the Board noted that since theregional ofrices were integral parts of the Organi-zation, they were subject to the regulations and ruleswhich govern all action at Headquarters, and thatthe necessity for separate regulations for regionaloffices had not yet arisen.

5.3 Regional Organization for Europe

In the light of the discussions which had takenplace, and notwithstanding the resolution adoptedat its fourth session,47 the Executive Board decidedthat a meeting of the Regional Committee forEurope should not be held until Member States inEurope had been given a further opportunity toexpress opinions. The Director-General was re-quested to fix a date for the meeting of the regionalcommittee after taking into account opinions

45 See Annex 9.° 011. Rec. World Hlth Org. 17, 17, item 6.747 O. Rec. World Hlth Org. 22, jo, item 4.1.2

expressed by representatives of Member States inEurope during the course of the Third WorldHealth Assembly.

5.4 Regional Organization for the EasternMediterranean

5.4.1 Regional Committee for the Eastern Mediter-ranean: Report on the Second Session

The Board noted with satisfaction the reportof the second session of the Regional Committeefor the Eastern Mediterranean, held in Genevafrom 12 to 15 October 1949."

5.4.2 Agreement with the Government of Egyptconcerning the Extension of Privileges andImmunities to the Regional Organization forthe Eastern Mediterranean Region


(1) NOTES the situation concerning the negotia-tions with the Government of Egypt for an agree-ment extending privileges and immunities to theRegional Organization for the Eastern Mediter-ranean Region and the lease of the premises inAlexandria ; and

(2) REQUESTS the Director-General to continuesuch negotiations and to report thereon to theThird World Health Assembly ; and

(3) REQUESTS the Government of Egypt to expe-dite these negotiations.

5.5 Regional Organization for South-EastAsia

5.5.1 Regional Committee for South-East Asia:Report on the Second Session

In noting with satisfaction the report of thesecond session of the Regional Committee for

44 See Annex io.

EXECUTIVE BOARD, FIFTH SESSION, PART I

South-East Asia, held in New Delhi from 26 to28 September 1949," the Board recognized thatthe procedure for presenting such reports had yetto be developed and a procedure for examiningthem had not yet been arrived at.

With regard to the resolution in Section 1.5 ofthe report regarding representation of the South-East Asia Region on the Executive Board, theBoard requested the Director-General to put thisquestion on the agenda of the Third World HealthAssembly.

5.6 Regional Organization for the Americas

5.6.1 Pan American Sanitary Organization: Re-ports on the Eighth Meeting of the ExecutiveCommittee and on the Third Meeting of theDirecting Council

The Board noted with satisfaction the reports onthe eighth meeting of the Pan American SanitaryOrganization Executive Committee and the thirdmeeting of its Directing Council,50 and decidedto reconsider at its next session the various ques-tions raised. Meanwhile, the Board requested theDirector-General to consult with the Director of thePan American Sanitary Bureau with a view to

studying what additional measures may be taken,bearing in mind Article 54 of the Constitution, andto report to the next session of the Board.

5.6.2 Oath of Office of the Director

The following resolution was adopted :The Executive Board,Having considered Article 37 of the Constitution

of the World Health Organization and Article 19(B) 51 of the Constitution of the Pan AmericanSanitary Organization concerning the internationalcharacter of its personnel ;

Having considered Articles 2 and 4 of theInitial Agreement signed at Washington on 24 May1949 between the World Health Organization andthe Pan American Sanitary Organization ; and

Having considered the terms of PftvisionalStaff Regulation 2,

RESOLVES to interpret the oath of office of theDirector of the Regional Office for the Americasof the World Health Organization as allowing him,in matters pertaining to the work of the Pan Ame-rican Sanitary Organization and the Pan AmericanSanitary Bureau, to take instructions from thosebodies.

6. JOINT ACTIVITIES

6.1 Co-ordination with the United Nationsand Specialized Agencies

6.1.1 Co-ordination on Administrative and Finan-cial Matters


The Executive Board

(I) TAKES NOTE of the actions of the FourthSession of the General Assembly regarding mattersaffecting the World Health Organization ; and

(2) REQUESTS the Director-General to inform theUnited Nations through the Secretary-General ofthe actions taken in this respect by the Board.

6.1.2 Problem of the Proliferation and Overlappingof the Programmes of the United Nations andof the Specialized Agencies


The Executive Board

(1) WELCOMES the action of the United NationsGeneral Assembly on the problem of the prolifera-tion and overlapping of the programmes of theUnited Nations and the specialized agencies ; and

49 See Annex II.50 See Annex 12.

(2) REQUESTS the DirectorGeneral. to :

(a) bring the General Assembly's resolution onthis subject to the attention of the Third WorldHealth Assembly ; and

(b) inform the United Nations through theSecretary-General of the World Health Organi-zation's awareness of this important problem;indicating that, in order to eliminate prolifera-tion and overlapping., the programmes of theWorld Health Organization are considered byrepresentatives of its Member governments in itsregional committees,' Executive Board and theWorld Health Assembly before they are adopted ;the Organization initiates its programmes withvarious degrees of priority for many reasons,including finance, and has made and willcontinue to make every effort to co-ordinate itsactivities with those of the other internationalorganizations through the mechanism of theAdministrative Committee on Co-ordination andtaking into full account the observations of theEconomic and Social Council ; and

41 " B. In the performance of their duties, the Direc-tor and all personnel of the Pan American SanitaryBureau shall not seek nor receive instructions from anygovernment or from any authority external to the PanAmerican Sanitary Organization. They shall refrainfrom any action which is incompatible with their positionas international officers. Each Member Government,on its part, shall undertake to respect -the exclusivelyinternational character of the Director and the personneland shall not seek to influence them."


(3) REQUESTS the Director-General to inform theUnited Nations through the Secretary-General ofthe actions taken in this respect by the Board.

6.1.3 Action taken by the Economic and SocialCouncil of the United Nations on Matters ofConcern to WHO

The Board noted the decisions of the Economicand Social Council relevant to matters of concernto WHO.

6.1.4 Proposed Rewording of Article 7 of the Inter-national Covenant on Human Rights: Reportof the Working Party

The following resolution was adopted :The Executive Board,Having considered the request for an advisory

opinion on Article 7 of the International Covenanton Human Rights transmitted to the Director-General by the Assistant Secretary-General, De-partment of Social Affairs of the United Nations,

TRANSMITS to the Director-General the viewsexpressed by the majority of the working party onArticle 7 of the draft International Covenant onHuman Rights for consideration in framing hisreply to this request.

6.2 UNICEF

6.2.1 General Relations between WHO andUNICEF

The Board noted the report on WHO/UNICEFactivities and the table showing details of UNICEFindividual fellowships in South-East Asia admi-nistered by WHO.52

6.2.2 Continuing Needs of Children

After taking note of the resolution passed by theSocial Commission of the United Nations on13 December 1949 concerning the continuing needsof children, and the recommendations of theDirector-General on this subject, the Board adoptedthe following resolution :

The Executive Board,Further to its resolution of the fourth session ; 53Having considered the decisions taken by the

Preparatory Committee of the AdministrativeCommittee on Co-ordination, which met in Genevaon 9 August 1949," the preliminary report of theworking party established by the ACC on the"Continuing Needs of Children from the Interna-tional Viewpoint",55 the resolution passed by theSocial Commission of the Economic and SocialCouncil at its io8th meeting, fifth session,56 andthe records of the discussions held ; 57

52 See Annex 13.'a Og. Rec. World Hlell Org. 22, 6, item 2.254 UN Document E/CN/5/177, Corr. 1, and Add.55 UN Document E/CN/5/177 and Add. r56 UN Document E/CN/5/18657 UN Documents E/CN/5/SR./Io7, io8 and 109

Conscious of the continuing needs of children inthe health, welfare, education and related fields,of the necessity of having a co-ordinated approachby the United Nations and the specialized agenciesconcerned with meeting these needs, and of thepresent shortage of supplies and equipment forthese purposes, and wishing to contribute towardsmeeting these needs in accordance with Article 2 (I)of the Constitution of the World Health Organi-zation and in co-operation with the United Nationsand the specialized agencies,


(a) to provide the assistance needed by theSecretary-General of the United Nations in com-pliance with the resolution of the Social Com-mission ; and

(b) to take into consideration the followingsuggestions in his consultations with the Secre-tary-General of the United Nations :

(i) A non-technical committee of the Econo-mic and Social Council on children should beestablished to assist in meeting the continuingneeds of children by supplementing the pro-grammes of the United Nations organs con-cerned with children (such as the Social Corn-mission, FAO, ILO, UNESCO and WHO)through the provision of supplies and equip-ment ;

(ii) It is desirable that under this Committeefor Children, serving as an allocating organ,there should be a Fund. This Fund wouldserve as a supply administration for thecollection of funds and the procurement anddistribution of supplies to be used for assistanceto governments for the demonstration anddevelopment of programmes of maternal andchild health, child welfare and education,which are designed to meet the continuing oremergency needs of children, and are developedby the governments with the technical adviceand assistance of the United Nations SocialCommission and the specialized agenciesconcerned ;

(iii) The ACC should establish a Children'sCo-ordinating Committee, consisting of techni-cal representatives of the United Nations andthose specialized agencies which assist govern-ments in their maternal and child health,family and child welfare as well as educationprogrammes, to consider types of programmesto be assisted, make recommendations to theCommittee for Children for allocations fromits Fund to the United Nations and thespecialized agencies for supplies for such pro-grammes, including co-ordinating programmesinvolving two or more agencies ;

(iv) The participating organs of the UnitedNations and the specialized agencies, singly orjointly, should be responsible for assistinggovernments with consultative services inplanning, initiating and operating the projectsin their respective fields. They should beresponsible for negotiating the programme


proposals with the governments, for approvingthe plans of operation and for presenting tothe Children's Co-ordinating Committee atintervals the programme of supplies that willbe needed by them to implement the pro-.gramme ;

(v) In emergency situations the ACC shouldbe authorized to approach directly the admi-nistration of the Fund to attain quick actionfor purposes of relief, either by utilizingreserve funds, or by undertaking special drivesfor additional funds.

6.2.3 Paris Children's Centre

The Board noted the following unanimous con-clusions of the WHO Members of the Joint Com-mittee on Health Policy, UNICEF/WHO, that :

(1) the statute of the French Government settingup a children's centre in Paris was satisfactory ;

(2) the exchange of letters between the Execu-tive Secretary of UNICEF and the Director-General of WHO was satisfactory and might beregarded as constituting an agreement ;

(3) in replying to the Executive Director ofUNICEF, the Director-General should conveythe acceptance by the Executive Board of WHOof the arrangements proposed in exchange ofletters, at the same time making it clear that allhealth projects undertaken by the Centre withUNICEF contributions should be referred to theJoint Committee on Health Policy of WHO/UNICEF in accordance with the procedurealready laid down.

The Board warmly congratulated the FrenchGovernment on its initiative in setting up thiscentre and wished every possible success to thisnew venture.

6.3 Joint ILO/WHO Committee on the Hy-giene of Seafarers


The Executive Board(1) NOTES the report of the first session of theJoint ILO/WHO Committee on the Hygiene ofSeafarers ;

(2) EXPRESSES its appreciation of the work accom-plished ; and

(3) REQUESTS the Director-General to transmit tothe Joint Commit tee the comments of the Exe-cutive Board.

6.4 Relations with Non-Governmental Orga-nizations 58

6.4.1 Non-Governmental and Sectional Organiza-tions

This question had been deferred from the fourthsession 59 and, after consideration of the first report

58 See Annex 14.59 011 . Rec. World HIM Org. 22, item 2.3.1, resolution III

of the Standing Committee on Non-GovernmentalOrganizations,6° the Board voted by rollcall andtook the following decision by six votes to four(with two abstentions and six absent) :

The Executive BoardDECIDES against the admission of "sectional"

organizations into official relationship with theWorld Health Organization.

6.4.2 Working Principles laid down by the FirstWorld Health Assembly for Admission toOfficial Relationship with WHO


The Executive BoardRECOMMENDS to the Third World Health

Assembly that the working principles governingthe admission into official relations with the WorldHealth Organization of non-governmental organi-zations be amended as shown in Annex 14.

6.4.3 Admission into Official Relations with theWorld Health Organization


The Executive BoardDECIDES

(1) To establish official relations with the follow-ing organizations on the basis of the criteria laiddown in Official Records of the World Health Orga-nization, No. 13, pages 326-7 : Fédération Interna-tionale Pharmaceutique, International Federationof Housing and Town Planning, InternationalLeague against Rheumatism.

(2) To postpone consideration in the followingcases :

(a) International Audiology Conference, untilits organizational character has developed further- although great interest was shown in thework of the Conference ;

(b) International Society for Blood Transfusion,pending further information as to present statusof the organization, including finance, andwhether or not there is any permanent member-ship apart from attendance at congresses ;

(c) International College of Surgeons, untilfurther enquiries have been made ;

(d) American College of Chest Physicians,pending the result of further enquiries as tothe international character of this organiza-tion ,

(e) Medical Women's International Association,pending further consideration of its constitutionin relation with that of the World MedicalAssociation, which already has official relationswith the World Health Organization ;

65 Summary given in Annex 54.


(f) International Union against Alcoholism,pending a further report by the Director-General.

6.5 Establishment of an International Codeof Deontology

The following resolution was adopted by theBoard, and it was decided at the same time toannex to the report of the fifth session a copy ofthe letter received by the Director-General fromthe World Medical Association :

The Executive Board(I) NOTES that a Code of Medical Ethics has beenadopted by the World Medical Association ;

(2) REQUESTS the Director-General(a) to communicate to the World MedicalAssociation the appreciation of the ExecutiveBoard of the World Health Organization forits work on this subject ; and

(b) to transmit to the World Medical Associa-tion the record of the discussion of the Board onthis subject.

6.6 National WHO Committees


The Executive Board,Considering that national WHO committees

should further the work of WHO in carrying out anumber of essential supporting and advisoryfunctions for the benefit of the Organization aswell as for national administrations,


(a) to explore the various possible ways inwhich such committees could be established ;

(b) to inform the Third World Health Assemblyof the results of his investigations.

7. ADMINISTRATION AND FINANCE

7.1 Report of the Standing Committee onAdministration and Finance

7.1.1 Adoption of the Report


Whereas the Second World Health Assembly 62

directed that the Executive Board in its reviewof the annual budget estimates should includeconsideration of :

(I) the adequacy of the budget estimates tomeet health needs ;

(2) whether the programme follows the generalprogramme of work approved by the HealthAssembly ;

(3) whether the programme envisaged can becarried out during the budget year ; and

(4) the broad financial implications of thebudget estimates with a general statement ofthe information on which any such considerationsare based ; and

Whereas the Second World Health Assembly 63

requested the Executive Board to examine theorganizational structure so that the Third WorldHealth Assembly might be assisted in ensuring theadministrative efficiency of the Organization andestablishing general lines of policy in this respect ;and

Whereas pursuant to the aforementioned theExecutive Board at its fourth session 64 establisheda Standing Committee on Administration andFinance consisting of seven of its members with

61 See Annex 13.62 Resolution WHA2.62, 05. Rec. World Hlth

21, 3862 Resolution WHA2.78, 05. Rec. World Hlth

21, 4664 05. Rec. World Hlth Org. 22, ii, item 4.2.3

Org.

Org.

instructions to review the budget estimates for1951, examine the organizational structure, reviewthe procedure to be adopted by the Third WorldHealth Assembly in considering the programme andbudget for 1951 and report to the Executive Boardits conclusions and recommendations thereon,

The Executive Board,Having considered the report of the Standing

Committee on Administration and Finance,

(1) ADOPTS the report of the Standing Committeeon Administration and Finance as amended by theExecutive Board ; and

(2) ADOPTS the following specific resolutions anddecisions.

7.1.2 Technical Assistance for Economic Develop-ment of Under-Developed Countries


In accordance with the instructions of the SecondWorld Health Assembly contained in ResolutionWHA2.75 which "authorized it to act on behalf ofthe World Health Assembly until its next meet-ing",65

The Executive Board,Having considered the appropriate resolutions of

the Economic and Social Council and the GeneralAssembly of the United Nations,


The Third World Health Assembly,Believing that the programme of technical

assistance for economic development of under-developed countries, outlined by the Economic

og. Rec. World. Hlth Org. 21, 44


and Social Council at its eighth and ninthsessions, offers an opportunity of improving theliving standards of the inhabitants of the under-developed countries of the world ;

Believing that WHO has a significant part toplay in this programme ; and

Noting that this fact was recognized, in thepreliminary discussions which took place on theinitiative of the Secretary-General of the UnitedNations, in the discussion at the ninth session ofthe Economic and Social Council and at thefourth session of the General Assembly ;

Noting that the General Assembly of theUnited Nations, subject to the final concurrenceof the Special Technical Assistance Conferenceto be convened in the near future, approved theEconomic and Social Council's proposal that22 % of the funds contributed to the Secretary-General's Special Account for Technical Assist-ance should be allocated to WHO, togetherwith any such further sums drawn from theproposed reserve fund as may be subsequentlyagreed by the Technical Assistance Board ;

Confirming its interest in and approval ofGeneral Assembly Resolution 200 (III) withparticular reference to paragraph (4) (d) thereofwhich reads

The technical assistance furnished shall (i) notbe a means of foreign economic and politicalinterference in the internal affairs of the countryconcerned and shall not be accompanied by anyconsideration of a political nature ; (ii) be givenonly to or through governments ; (iii) be designedto meet the needs of the country concerned ; (iv) beprovided, as far as possible, in the form which thatcountry desires ; (v) be of high quality and technicalcompetence ;

Having noted with interest and approval theresolution adopted by the General Assemblyat its 242nd plenary meeting on 16 November1949 which approves ECOSOC Resolution 222(IX) A of 15 August 1949 and the principlesestablished by the Economic and Social Councilentitled "Observations on and Guiding Principlesof 'an Expanded Programme of TechnicalAssistance for Economic Development" ;

Having considered the programme proposedby the Director-General for the WHO partici-pation in the United Nations programme oftechnical assistance for economic developmentof under-developed countries, as forwarded bythe Executive Board, and the Board's recom-mendations thereon,

(I) APPROVES that part of the programme con-tained id Official Recorde No. 23 entitled "TheProposed Programme and Budget Estimates forTechnical Assistance for Economic Developmentof Under-Developed Countries for the SecondPeriod", as amended, to be WHO's proposalsfor participation in the second period of theprogramme of technical assistance for economicdevelopment and to the extent required tomodify the supplemental operating programmeof advisory and technical services approved bythe Second World Health Assembly for the firstperiod ;

(2) AUTHORIZES the Executive Board to act onbehalf of the World Health Assembly until itsnext plenary session in connexion with anyaspect of this programme ;

(3) EMPOWERS the Executive Board to :

(i) consider appropriate resolutions of theEconomic and Social Council and the GeneralAssembly in connexion with the programmeof technical assistance for economic develop-ment, and to instruct the Director-Generalaccordingly ;

(ii) authorize the Director-General to parti-cipate in the deliberations of the TechnicalAssistance Board and to represent WHO atmeetings of the Technical Assistance Confer-ence and the Technical Assistance Committeeand the Economic and Social Council ;

(iii) authorize the Director-General to nego-tiate for and accept in 1950 and 1951 suchfunds as will be made available from the"Special Account" established by the GeneralAssembly on the recommendation of theEconomic and Social Council subject to anyconditions established by the Executive Boardor the World Health Assembly provided thatany conditions attached to the provision ofsuch funds are consistent with the principlescontained in General Assembly Resolution200 (III) with specific reference to paragraph4 (d) thereof, and with Article 57 of the Consti-tution ;

(iv) authorize the Director-General to admi-nister the programme of technical assistance asapproved in (1) above, as soon as and to theextent that funds are made available, subjectto policies or procedures established by theHealth Assembly and the Executive Board,and in conformity with Resolution 222 (IX) Aof the ninth session of the Economic and SocialCouncil ;

(v) authorize the Director-General to theextent that he receives requests from govern-ments desiring assistance under the provisionsof the United Nations programme of technicalassistance for the economic development ofunder-developed countries to undertake appro-priate technical assistance activities in so faras these are approved by the Technical Assist-ance Board even though such governmentsmay not be members of the World HealthOrganization.

7.1.3 Expenditure Level for 1950


The Executive Board,Taking note of the resolution adopted by the

General Assembly of the United Nations on24 November 1949 66 which recommends that eachspecialized agency keep its expenditure each yearfrom its regular budget within the amount offunds reasonably expected to be received in respect

66 UN Document A/H47, Part C


of that year, and that the programme of expendi-ture be reviewed periodically during the year sothat if necessary it can be adjusted to keep it asfar as possible within the limits of the anticipatedannual receipts ;

Having considered the current financial positionas set forth in document EB 5/78,67

(I) FINDS that the current financial position is notas anticipated by the World Health Assembly atthe time of the adoption of the 1950 budget ;

(2) FINDS that carrying out an expenditure pro-gramme at the maximum level of the approved1950 budget will place WHO in a serious financialposition ;

(3) REQUESTS the Director-General to carry outan expenditure programme under the approved1950 budget at a rate which shall not exceed anannual expenditure of $6,300,000 until such timeas the Third World Health Assembly considers thethen current financial position in relation to the1950 programme and budget and gives appropriatedirection ;

(4) AUTHORIZES the Director-General to takesuch decisions as he considers necessary effectivelyto carry out this expenditure limitation.

7.1.4 Operating Programme and Budget for 1951

7.1.4.1 Appropriation Resolution. The Board ap-proved the form of the appropriation resolutionproposed for 1951 and accepted the suggestion of theStanding Committee on Administration and Fin-ance that the Board should recommend to theThird World Health Assembly the deletion orrevision of paragraph II of the proposed appro-priation resolution 68 of the Assembly.

7.1.4.2 Working Capital Fund Resolution. TheBoard accepted the suggestion of the StandingCommittee on Administration and Finance thatthe Board should recommend to the Third WorldHealth Assembly that the amount of the workingcapital fund should be discussed after funds havebeen appropriated for the regular budget for 1951,

7.1.5 Suspension of Financial Regulations 13 andx6 (e) with regard to Unused 1949 Balances


I. The Executive Board,

Having considered the report of the Director-General on the financial position of the Organi-zation ;

Noting with concern that 26.71 % of the 1949assessment has not been collected, and that 17.85 %of the 1948 assessment was still outstanding, as at31 December 1949 ;

Deprecating the necessity of heavy calls havingto be made on the working capital fund in order to

Og. Rec. World Hlth Org. 26, Annex011. Rec. World filth Org. 23, 20

finance operations pending receipt of contribu-tions ;

Seriously pre-occupied lest delays in the paymentof contributions might jeopardize the execution ofprogrammes as approved by the Health Assemblies,

AGAIN APPEALS to States Members to acquitthemselves promptly of their financial obligationsto the Organization.

II. The Executive Board,

Considering that the unused balance of the 1949appropriation is in fact not available in cash inhand ;

Considering, further, that the deduction inapplication of the Financial Regulations 13 and16 (e) of this balance from the 1951 assessment mayfurther aggravate the financial position in 1951,due to the unsatisfactory collection of contribu-tions,


Whereas in accordance with Financial Regu-lations 13 and 16 (e) the unused balance of the1949 appropriation is to be taken into accountin assessing Member States in 1951 ;

Whereas this balance is in fact not availablein cash in hand ;

Whereas the deduction of this amount fromthe 1951 assessment may entail heavy inroads onthe working capital fund due to the unsatisfactorycollection of contributions, thus further aggra-vating the general financial position in 1951,


(1) RESOLVES, following the recommendations ofthe Executive Board, to suspend the applicationof Financial Regulations 13 and 16 (e) in regardto the unused balance of the 1949 appropriations ;and

(2) DECIDES that this balance be placed in asuspense account, reserving its decision as to theultimate fate of the sums placed in this account.

7.1.6 Status of Contributions



In pursuance of Resolution WHA2.56,

Having considered the Director-General's reporton the results of his enquiries into delays in paymentof contributions owing by Members of the Organi-zation ;

Having observed therefrom that a number ofMembers are in arrears for one year ; and

Considering that the Board is not expected tomeet again before the Third World Health Assem-bly,

69 011. Rec. World Hlth Org. 21, 35


(I) REQUESTS the Director-General to pursue hisenquiries and to submit to the Third World HealthAssembly on behalf of the Board a full report onthe circumstances of each case in which a Member,at the time of the opening of that Assembly, is inarrears for one year ; and

(2) RECOMMENDS to the Third World HealthAssembly that it take action in pursuance ofArticle 7 of the Constitution, against any Memberwhose contribution in respect of 1948 is still unpaid.

7.1.7 Transportation Expenses for Regional Com-mittees

The following resolution was adopted :The Executive Board,Having noted the recommendation received

from the Regional Committee for the EasternMediterranean that it authorize the Director-General to provide transportation expenses ofrepresentatives to all meetings of the regionalcommittee ; and

Having considered the heavy additional expen-diture which would result,

CONFIRMS its decision 70 that reimbursement oftransportation expenses of one representative ofeach Member State be authorized for the firstmeeting of each regional committee only, and thatreimbursement for such expenditure should notbe authorized for subsequent meetings of regionalcommittees.

7.1.8 Organizational Structure and Administra-tive Efficiency


(1) APPROVES that part of the report of theStanding Committee on Administration and Fi-nance dealing with organizational structure andadministrative efficiency ; and

(2) REQUESTS the Standing Committee on Admi-nistration and Finance to study these mattersfurther in the future, taking into considerationchanges which may be made by the Director-Gene-ral as the result of the requirements of the Organi-zation, including the technical assistance pro-gramme.

7.1.9 Conclusions


I. The Executive Board,Having noted the considerations submitted by

the Standing Committee in its report on theregular programme and budget estimates for 1951proposed by the Director-General in EB5/44,71

(1) CONSIDERS that a budget of $7,300,000 isfinancially sound for 1951 and would allow theprogramme to be continued in 1951 at the levelapproved for 1950 by the Second World HealthAssembly ;

7° Off. Rec. World Hlth Org. 14, 26, item 4.1.4n This document, as amended, has been published as

Official Records No. 23.

(2) CONSIDERS that the $200,000 which will beavailable from the UNRRA Special Fund in 1951should be applied as a deduction from the amountof $7,300,000 before the assessment of MemberGovernments on their contributions to the 1951budget ;

(3) REQUESTS the Director-General to submit tothe Third World Health Assembly a statementwhich will indicate the adjustments which canbe made in order to reduce the total to $7,300,000by reducing estimates in areas other than thosedesignated for priority consideration by the Firstand Second World Health Assemblies.

II. The Executive Board

RECOMMENDS to the Third World Health Assem-bly that it adopt the following resolution :

The Third World Health AssemblyAUTHORIZES and DIRECTS the Executive Board

to establish late in 1950, or early in 1951, in thelight of the financial position of the Organiza-tion at that time and as estimated for 1951, thelevel of expenditure to be maintained during thefirst six months of 1951, it being left to theFourth World Health Assembly to consider thelevel of expenditure for the last six months of1951.

7.2 Arrangements for Accommodation forHeadquarters Office

The following resolution was adopted :The Executive Board,Noting the report of the Building Committee on

the progress of negotiations with the Secretary-General of the United Nations as regards theenlargement of the Palais des Nations to providesuitable accommodation for WHO Headquartersoffice in Geneva,72

(1) ENDORSES the opinion of the Building Com-mittee that a 99-years' lease offered by the Secre-tary-General of the United Nations, renewable onthe expiration of its original term, annotated in theLand Registry of the Canton of Geneva, providessufficient security of tenure for WHO ;

(2) CONFIRMS the delegation of full powers to theBuilding Committee to take a final decision bothas regards the construction project and the condi-tions of occupancy ;

(3) REQUESTS the Building Committee to holdthemselves at the disposal of the Director-Generalthroughout the duration of the construction worksto decide on behalf of the Executive Board anyquestion arising in connexion therewith whichnormally would have to be referred to the Board ;

(4) EXPRESSES on behalf of WHO, to the SwissGovernment, its sincere appreciation for their

72 The report of the Building Committee is not repro-duced as an annex, but for the " Agreement concerningthe Premises to be used for the Headquarters of the WorldHealth Organization in Geneva ", negotiated betweenthe United Nations and WHO, see Annex 16.


generous offer to contribute the amount of 3,000,000Swiss francs towards the cost of the new construc-tion ;

(5) RESOLVES to recommend to the Third WorldHealth Assembly the adoption of the followingresolution :

The Third World Health Assembly,

Noting the report of the Executive Board onthe arrangements made with the United Nationsin regard to the accommodation for WHO'sHeadquarters office in Geneva ;

Considering that these arrangements adequa-tely safeguard the interests of WHO,

(I) APPROVES them in their entirety ;

(2) EXPRESSES to the United Nations its appre-ciation for the spirit of understanding they haveshown in this matter ;

(3) REITERATES its thanks to the Swiss Govern-ment for their generous contribution towardsthe expenses of the new construction ;

(4) RESOLVES :

(a) to establish a separate Building Fund of4,000,000 Swiss francs into which would beplaced the amount of 3,000,000 Swiss francscontributed by the Swiss Government and anamount of 1,000,000 Swiss francs (US $233,645)to be taken, notwithstanding the provisionsof Financial Regulations 13 and 16 (e), fromthe balance of unused appropriations for1949 ;

(b) that the Building Fund shall be availablefor the purposes of new construction with theunderstanding that should any balancesremain at the completion of the constructionwork, they would be used in accordance withthe provisions of the Financial Regulations,particularly Regulation 16 ;

(c) that the Fund shall remain available untilthe construction project is completed, not-withstanding the provisions of FinancialRegulation 13.

7.3 Budget

7.3.1 Report on Transfers between Chapters withinSections of the 1949 Budget and Transfersbetween Sections in Parts and between Parts


The Executive Board

(I) CONFIRMS its approval by correspondence ofthe transfer of an amount of $30,000 from Section 2(Secretariat) to Section 3 (Regional Offices) of the1949 appropriation ; and

(2) TAKES NOTE of the various amounts trans-ferred between chapters within Sections 5, 6 and 7of the 1949 appropriation.

7.3.2 Proposed Transfers between Chapters withinSection 3, Part II, of the 1950 AppropriationResolution

The following resolution was adopted :In the interests of administrative efficiency,The Executive BoardAUTHORIZES the Director-General to transfer

various amounts between Chapters 3.1, 3.4, 3.5and 3.7 within Section 3, Part II, of the 1950appropriation resolution, as set forth in Annex Iof document EB5/1o2.73

7.3.3 Currency of Contributions

The following resolution was adopted :The Executive Board,Having considered the efforts made by the

Director-General to implement the tentative planenvisaged under the resolution adopted at thefourth session ; 74 and

Taking note of the difficulties which have beenencountered by the Director-General in his endea-vours to develop a plan which may make possiblethe acceptance of contributions in currencies otherthan US dollars or Swiss francs,

CONCURS IN :

(1) the Director-General's opinion that it will benecessary to accept contributions to the 1950budget in US dollars or Swiss francs ; and

(2) the Director-General's desire that this mattershould be given further study, including its consi-deration by the Administrative Committee onCo-ordination.

7.3.4 Report of the United Nations AdvisoryCommittee on Administrative and BudgetaryQuestions on the Budget of the World HealthOrganization for 1950


(r) NOTES the report 75 of the United NationsAdvisory Committee on Administrative and Budge-tary Questions on the budget of the World HealthOrganization for 1950 ; and

(2) REQUESTS the Director-General to notify theSecretary-General of the United Nations that theExecutive Board has considered the report, at thesame time calling attention to the discrepancies insome of the figures.

7.3.5 World Health Defence Fund

The Board noted that enquiries made of theInternational Monetary Fund and the Interna-tional Bank for Reconstruction and Developmenthad shown that these bodies had no observations tomake on this subject for the present and that afurther report on future developments would bemade by the Director-General to the Third WorldHealth Assembly.

" See Annex 17.74 See Annex 18.75 See Annex 19.


7.4 Finance and Accounts

7.4.1 Reimbursement of Expenses of Sleeper Accom-modation when Travelling by Air - Membersof the Executive Board and Members ofExpert Committees

The following resolution was adopted :The Executive BoardRESOLVES that so long as air sleeper accommo-

dation involves hea-yy additional cost it shall nothenceforth be included in the reimbursable trans-portation expenses of members of the ExecutiveBoard and the expert committees.

7.4.2 Per Diem Allowances for Members of theExecutive Board and Members of ExpertCommittees

The following resolution was adopted :The Executive Board,Considering the possible effect on per diem

allowances of the devaluation of currency,

REQUESTS the Director-General to apply the sameratio of reduction to the daily living allowances ofmembers of the Board and members of expertcommittees meeting in countries affected by thedevaluation as he has applied, or may find itnecessary to apply in the future, to the travel perdiem allowances of staff members.

7.4.3 Reimbursement of Travelling Expenses ofMembers of the Executive Board

The following resolution was adopted :The Executive Board,Recognizing(a) that the functions and composition of theWorld Health Assembly as set forth in theConstitution are distinct and different from thoseof the Executive Board ;(b) that the independent nature of the Execu-tive Board should be safeguarded ;

(c) that, under the resolutions adopted by theFirst and Second World Health Assemblies,"those Member States which have as one of theirdelegates to the World Health Assembly amember of the Executive Board are in practiceentitled to the reimbursement of transportationcosts in respect of two delegates to the WorldHealth Assembly when a meeting of the ExecutiveBoard has been arranged to take place imme-diately before or immediately after the WorldHealth Assembly ;

(d) that the restriction of the present provisionfor the reimbursement of transportation costswould inevitably create difficulties and mightinflict hardship on some Member States,

(I) CONSIDERS that the provisions at present inforce relating to the reimbursement of transpor-tation costs of delegates and members of theExecutive Board should be retained ; and

78 Off. Rec. World Hlth Org. 13, 198 and 317 ; andResolution WHA2.46, Og. Rec. World HIth Org. 21, 31

(2) URGES all Member States to restrict as far aspossible their claims on the Organization fortransportation costs.

7.5 Personnel

7.5.1 Adjustments in Basic Salary and Allowancesof Persons stationed in Areas affected byCurrency Revaluations

The following resolution was adopted :The Executive Board,Taking note of the measures already undertaken

by the Director-General to reduce administrativecosts in revaluation areas by reductions in fellow-ship stipends and travel per diem and his plan foradjusting salaries and allowances, as well as othertypes of payment,

APPROVES the measures taken by the Director-General and the principles upon which thesedecisions were based."

7.5.2 Retirement and Pension Fund


(I) NOTES the report of the Director-General onthe negotiations with the United Nations asregards WHO's participation in the United NationsJoint Staff Pension Fund ;

(2) AGREES with the proposed text 78 of Articles 7and 8 of the draft agreement for the admission ofWHO into the United Nations Joint Staff PensionFund ; and

(3) AUTHORIZES the Director-General to sign theagreement containing these two clauses.

7.5.3 Recruitment of Staff

The following resolution was adopted :The Executive Board,Considering the decision of the First World

Health Assembly to refer the question of therecruitment of qualified personnel from nationalhealth institutions to the Executive Board forconsideration and study ; and

Considering the steps taken by the Director-General in requesting the views of Member Govern-ments on this question ; and

Noting with satisfaction that of the twenty-fiveMember Governments replying, sixteen were uncon-ditionally favourable, seven were favourable withcertain reservations, one was noncommittal, andonly one was unfavourable ; and

Recognizing that WHO should continue toencourage all governments to make availablequalified personnel,

(I) RECOMMENDS that all Member Governmentsof WHO, which have not already done so, shouldtake steps to establish in their appropriate laws ofservice, provisions for :

(a) the grant of leave of absence for membersof their technical national health, medical and

77 See Annex 20.78 See Annex 21.


educational institutions, to serve the WorldHealth Organization 'without losing their rightsor privileges acquired by previous service intheir countries ; and(b) recognition for service credit and acceptancein the national official curriculum or record ofservices for the services rendered to the WorldHealth Organization ; and

(2) REQUESTS the Director-General to communi-cate this decision to all Member Governments.

7.5.4 Amendments to Staff Rules


(1) NOTES the revisions and additions " made bythe Director-General in Staff Rules op, 050, o6o,150, 300, 550, 681, 843.4, 890, 920, 945, 1200 and15oo ; and

(2) CONFIRMS the action taken.

7.5.5 Tax Equalization

The following resolution was adopted :The Executive Board,After considering the report made by the Direc-

tor-General on the decision, made in consultation

7° Seto Annex 22.

3

with the Chairman, to reimburse staff members inrespect of their 1950 national taxes,

CONFIRMS that decision ; consequently the Direc-tor-General is authorized to reimburse staffmembers for national taxes (including State taxeswhich they are obliged to pay) paid by them onsalaries and allowances received from the WorldHealth Organization during 1950.

7.5.6 Geographic Distribution of Staff

The Standing Committee on Administrationand Finance having recommended that a study ofthe problem of geographic distribution of staffshould be made by the Board rather than by theCommittee, the Board considered the matter veryfully and adopted the following resolution :

The Executive Board

(1) NOTES the statement on geographic distributionof staff and the progress so far made ;

(2) NOTES that the Director-General is endeavour-ing to obtain as far as possible a proper geographicdistribution of staff ; and

(3) REQUESTS the Director-General to take note ofthe views expressed by the members of the Boardand to submit a statement to the seventh sessionof the Executive Board, when the budget for 1952will be presented.

Annex 1

LIST OF ATTENDANCES

1. Members, Alternates and Advisers

Sir Arcot L. MUDALIAR, Vice-Chancellor, Univer-sity of Madras, Chairman.

Dr. J. ZOZAYA, Technical Adviser, Ministry ofHealth and Welfare, Mexico City, Vice-Chairman.

Dr. H. S. GEAR, Deputy Chief Health Officer forthe Union of South Africa, Cape Town, Vice-Chairman.

Adviser :

Mr. C. H. TALJAARD, Secretary, South AfricanLegation, Brussels.

Dr. C. L. GONZALEZ, Director of Public Health,Ministry of Health and Social Welfare, Caracas.

Alternate :Dr. H. RODRIGUEZ, Chief Epidemiologist of

Health Unit, Caracas.

Dr. J. A. HöJER, General Director, Swedish MedicalBoard, Stockholm.

Dr. H. HYDE, Medical Director, US Public HealthService, Washington, D.C.

Alternate :

Mr. H. B. CALDERWOOD, Expert, InternationalOrganization Affairs, Office of United NationsEconomic and Social Affairs, Department ofState, Washington, D.C.

Advisers :

Dr. F. J. BRADY, Medical Director, US PublicHealth Service, Washington, D.C.

Mr. H. G. HANSON, Executive Officer, USPublic Health Service, Washington, D.C.

Mr. A. ROSEMAN, United States Representativefor Specialized Agency Affairs at Geneva.

Professor M. DE LAET, Secrétaire général du Minis-tère de la Santé publique et de la Famine,Brussels.

Alternate :Dr. C. VAN DEN BERG, Director-General for

International Health Affairs, Ministry of SocialAffairs, The Hague.

Advisers :M. F. BLONDEEL, Délégation permanente de

Belgique auprès de l'Office européen desNations Unies, Geneva.

Dr. G. D. HEMMES, Inspecteur de la Santé pu-blique, Utrecht.

Dr. Melville MACKENZIE, Principal Medical Offi-cer, Ministry of Health, London.

Alternates :Dr. R. H. BARRETT, Medical Officer, Ministry

of Health, London.Mr. T. LINDSAY, Principal Assistant Secretary,

Ministry of Health, London.Dr. A. M. W. RAE, Deputy Chief Medical Offi-

cer, Colonial Office, London.

Advisers :Mr. L. G. MASON, Senior Organization Officer,

H.M. Treasury, London.Mr. F. A. MELLS, Senior Executive Officer,

Ministry of Health, London.Miss K. V. GREEN, Executive Officer, Ministry

of Health, London.

Dr. M. NAZIF Bey, Assistant Under-Secretary ofState, Ministry of Public Health, Cairo.

Professor J. PARISOT, Professeur d'Hygiène et deMédecine sociale à la Faculté de Médecine deNancy.

Alternate :Dr. A. R. DUJARRIC DE LA RIVIÈRE, Sous-Direc-

teur de l'Institut Pasteur, Paris.

Advisers :Dr. L. E. BERNARD, Relations extérieures, Minis-

tère de la Santé publique et de la Population,Paris.

M. P. BERTRAND, Délégué permanent de laFrance auprès de l'Office européen des NationsUnies, Geneva.

Médecin-général Inspecteur M. A. VAUCEL,Directeur du Service de Santé colonial duMinistère de la France d'Outre-Mer, Paris.

Dr. G. H. DE PAULA SOUZA, Director and Professor,Faculty of Hygiene and Public Health, Univer-sity of Sao Paulo.

Dr. A. STAMPAR, President of the Yugoslav Aca-demy of Sciences and Arts ; Professor of PublicHealth and Social Medicine, University ofZagreb.

Dr. E. 'Fox, Under-Secretary of State, Ministryof Health and Social Assistance, Ankara.

Dr. A. VILLARAMA, Secretary (Minister) of Health,Department of Health, Manila.

Advisers :Mr. R. I. VILLANUEVA, Philippine Legation,

London.Mr. B. VILLARAMA, Private Secretary, Manila.

ANNEX 2 27

2. Members Absent

Members designated by the Byelorussian SSR,by China, by Poland and by the USSR.

3. Representatives of the United Nations andother International Organizations

UNITED NATIONS

*Mr. B. CELINSKI, Division of Narcotic Drugs.M. L. GROS, Department of Social Affairs, Geneva.Mr. A. LETHBRIDGE, Head of Administrative and

Financial Services, Geneva.Mrs. A. MYRDAL, Principal Director, Department

of Social Affairs, Lake Success.Mr. J. SZAPIRO, Director, Information Centre,

Geneva.

FOOD AND AGRICULTURE ORGANIZATION(FAO)

Dr. J. M. LATSKY, Nutrition Representative forEurope.

INTERNATIONAL LABOUR ORGANIZATION(ILO)

Dr. A. GRUT, Chief, Industrial Hygiene Section.Mr. J. L. MOWAT, Chief, Maritime Section.

INTERNATIONAL REFUGEE ORGANIZATION(IRO)

Dr. R. L. COIGNY, Director, Health Division.

INTERNATIONAL TELECOMMUNICATION UNION(ITU)

Mr. H. TOWNSHEND, Assistant Secretary-General.

UNITED NATIONS EDUCATIONAL, SCIENTIFICAND CULTURAL ORGANIZATION (UNESCO)

Dr. Irina M. ZIIUKOVA, Head of Division of AppliedSciences, Department of Natural Sciences.

UNITED NATIONS INTERNATIONALCHILDREN'S EMERGENCY FUND (UNICEF)

Mr. M. PATE, Executive Director.

OFFICE INTERNATIONAL D'HYGIENEPUBLIQUE (OIHP)

Dr. M. GAUD, Président de la Cbmmission du Trans-fert et des Finances.

4. Observers

WORLD MEDICAL ASSOCIATION

Dr. J. MAYSTRE, Liaison Officer with WHO,Geneva.

SWISS FEDERAL COUNCIL

*M. J. D. GRANDJEAN, Département politiquefédéral, Service des Organisations internationales,Bern.

* Attended for discussion on accomodation for Head-* Attended for discussion on addiction-producing drugs. quarters Office.

Annex 2

MEMBERSHIP OF COMMITTEES AND WORKING PARTIES

1 . Standing Committee on Non-GovernmentalOrganizations

Dr. de Paula Souza, Chairman ; Dr. Mackenzie,Dr. Tok, 1 Dr. Villarama. 2

2. Standing Committee on Administrationand Finance 3

Dr. Gear, Chairman ; Dr. Nazif Bey, Vice-Chair-man ; Dr. van den Berg (representing ProfessorDe Laet), Dr. Hyde, Dr. Mackenzie, Dr. Stampar,Dr. Villarama.

1 Replacing Dr. Gear, who had resigned from thecommittee.

2 Dr. Babecki, also a member of this committee, wasabsent.

3 This committee, which was appointed at the fourthsession of the Board, met before and during the fifthsession to examine the organizational structure and toconsider the 1951 budget estimates.

3. Building Committee

Dr. van den Berg (representing Professor DeLaet), Dr. Hi5jer, M. Toussaint (representing Pro-fessor Parisot).

4. WHO Members of the Joint Committeeon Health Policy, UNICEF/WHO

Dr. Höjer, Dr. Hyde, Dr. Mackenzie, Dr. Stampar.

Alternates : Dr. van den Berg, Dr. Gear.

5. Working Party on Draft Regulations forExpert Advisory Panels and Committees

Dr. Höjer, Chairman ; Dr. Dujarric de la Rivière,Dr. Gear, Dr. Hyde, Dr. Mackenzie, Dr. de PaulaSouza, Dr. Stampar.

28 REPORT OF THE EXECUTIVE BOARD, FIFTH SESSION, PART I

6. Working Party on Human Rights

Professor De Laet, Chairman; Dr. Barrett, Dr.Dujarric de la Rivière, Dr. Höjer, Dr. Hyde, Dr.Zozaya.

7. Working Party on the Preparation of theWHO Sanitary Regulations

Dr. Mackenzie, Chairman; Mr. Calderwood(representing Dr. Hyde), Dr. Gaud (OIHP), Dr.

Hemmes (representing Dr. van den Berg), Dr. IN er,Dr. de Paula Souza, Médecin-général InspecteurVaucel (representing Professor Parisot).

8. Working Party on Technical Collaborationwith OIHP

Dr. Mackenzie, Chairman; Mr. Calderwood(representing Dr. Hyde), Dr. Gaud (OIHP), Dr. dePaula Souza, Médecin-général Inspecteur Vaucel(representing Professor Parisot).

[From EB/5/45]15 December 1949

Annex 3

ACTION TAKEN BY CERTAIN COUNTRIES WITH REGARD TO MEMBERSHIPOF WHO 1

1. Text of Letter from the Minister for ForeignAffairs of the People's Republic of Bul-garia to the Director-General of WHO,dated 29 November 1949. (Translation.)

Sir,

The Second World Health Assembly, held lastJune in Rome, offered the opportunity for ageneral and comprehensive study of the activityof the World Health Organization from its creationin 1946 to the present. Several Members, includingBulgaria, addressed to the Assembly justifiedcriticisms concerning the methods adopted by theOrganization in the pursuit of its aims and con-cerning the results obtained. It would not, how-ever, appear that the suggestions made by theseMembers have been taken into consideration orhave had an effect on the general trends of theOrganization.

The Bulgarian authorities concerned have there-fore been led to examine seriously whether thecontinuing participation of Bulgaria in the WorldHealth Organization would be justified and oppor-tune under these conditions. Unfortunately theycan only reiterate that the activities of the Organi-zation and the practical results obtained arecompletely insufficient, above all in the domain ofmutual assistance in the international health field,whilst the methods and policies adopted areadjudged inadequate in relation to the tasksentrusted to the Organization at its inception.

1 See item of the Board's report.

Bearing in mind the foregoing considerations,the Government of the People's Republic ofBulgaria has decided to withdraw from the WorldHealth Organization and has instructed me toinform you that it no longer considers itself to bea Member of the Organization.

I have the honour to be, etc.

(Signed) V. PoPromovMinister for Foreign Agairs

2. Text of Letter from the Acting Director-General of WHO to the Minister for ForeignAffairs of the People's Republic of Bul-garia, dated 12 December 1949. (Trans-lation.)

Sir,

I have the honour to acknowledge receipt ofyour letter of 29 November 1949 (Ref. 45513-12-VII) by which you inform me of the decision of theGovernment of the People's Republic of Bulgariato withdraw from the World Health Organizationand to consider itself no longer a Member of thisOrganization.

The message which you have sent me will beexamined by the Executive Board of the WorldHealth Organization at its forthcoming session tobe held in Geneva, beginning 16 January 1950.


(Signed) R. GAUTIERActing Director-General

ANNEX 4

[From EB 5/6 and EB 5/7]r November 1949

Annex 4

AMENDMENTS TO THE RULES OF PROCEDURE OF THEWORLD HEALTH ASSEMBLY ,

Rule 16

This rule has been amended to read as follows :(a) Each Member, Associate Member and parti-cipating intergovernmental and related non-governmental organization shall communicate tothe Director-General, if possible fifteen days beforethe date fixed for the opening of the session of theHealth Assembly, the names of its representatives,including all alternates, advisers and secretaries.(b) The credentials of delegates of Members andof the representatives of Associate Members shallbe delivered to the Director-General, if possiblenot less than one day before the opening of thesession of the Health Assembly. Such credentialsshall be issued by the Head of State or by the Minis-ter for Foreign Affairs or by the Minister of Healthor by other appropriate authority, or in the caseof the representatives of Associate Members bythe appropriate authority.

Rule 18

The words "twelve delegates" have been replacedby the words "eighteen delegates".

Rule 19

This rule has been amended to read as follows :The Committee on Nominations, having regard

to an equitable geographic distribution and toexperience and personal competence, shall propose(a) to the Health Assembly from among the dele-gates nominations for the offices of the Presidentand three Vice-Presidents of the Health Assembly,

1 See item 1.3 of the Board's report.

for the offices of chairmen of each of the maincommittees, and for the members of the GeneralCommittee to be elected under Rule 25, and (b)to each of the main committees, set up underRule 27, nominations from among the delegatesfor the offices of vice-chairman and rapporteur.

The proposals of the Committee on Nominationsshall be communicated to the Assembly or to themain committees respectively, two hours at leastbefore the meeting during which the election isto take place.

Rule 26

The following addition has been made to para-graph (a) :

Whenever practicable, the General Committeeshall make known a few days in advance the dateand hour of meetings of the Health Assemblyand of the committees.

Rule 27

The following addition has been made at theend of the rule :

The chairmen of these committees shall beelected by the Health Assembly after considerationof the report of the Committee on Nominations.

Rule 29

The words "a chairman and a vice-chairman,"have been replaced by the words "a vice-chairmanand a rapporteur".

Rule 74

It has been decided to omit the words "if theHealth Assembly so decides".


[EB 5/14 Add. 4, Rev. I]30 January 1950

Annex 5

GENERAL PROGRAMME OF WORK COVERING A SPECIFIC PERIOD

1. Authority

The Executive Board, having taken note ofChapter VI, Article 28 (g) of the WHO Constitu-tion, whereby the Board is obliged "to submit tothe Health Assembly for consideration and aPprovala general programme of work covering a specificperiod" ; and of the following resolution of theSecond World Health Assembly :2

Whereas Article 28 (g) of the Constitutionprovides that the Executive Board shall submitto the Health Assembly for consideration andapproval a general programme of work coveringa specific period . . .

The Second World Health AssemblyREQUESTS the Board to submit recommen-

dations to the Third World Health Assemblypursuant to Article 28 (g) of the Constitution . . .

submits to the Third World Health Assemblythe general programme of work covering a specificperiod.

2. Elaboration of the Programme of Work

The Executive Board at its fourth session decidedthat the specific period to be considered for theprogramme of work should be limited to a maxi-mum of five years, that Members be invited tocommunicate their views on the general programmeof work to the Director-General, and that theDirector-General be requested to prepare a docu-ment taking into consideration the views expressed.The views of Members were discussed at the fifthsession of the Board. The present document waselaborated as the result of the discussion, and itembodies the general opinion of the Board regard-ing the programme of work for a specific period.

3. General Principles

The Board considered that the programme ofwork should conform to the following generalprinciples. It should be designed to provide orassist in providing :

(a) services calculated to improve the healthof all peoples. It is therefore desirable that allcountries, including trusteeship and non-self-governing territories, should participate in thework of the Organization ;

(b) services to governments which will assistthem in developing their health services, and

I See item 1.6 of the Board's report.2 Resolution WHA2.62, Off. Rec. World Hlth Org. 21,

38

which, except in regard to such services as demon-stration teams which would normally be jointoperations of the government and WHO, willnot be operations carried on directly by the Organ-ization. For example, WHO will not normallycarry out direct medical or scientific research assuch, but will endeavour to co-ordinate and stimu-late research ;

(c) services to governments only upon theirspecific request ;

(d) such services to governments as will fosterthe greatest possible degree of self-reliance andinitiative in national and community healthservices and are suitable for integration into thesocial, constitutional and administrative structureof the peoples and governments concerned ;

(e) services which will be available withoutdiscrimination to all Member States.

4. Specific Period

The specific period to be set for the generalprogramme of work should be one of four yearscomprising 1952-1955 inclusive. The period offour years was adopted as a compromise betweenthe views of certain members who were in favourof three years, and others who advocated sixyears. Taken together with the 1951 programme,it would provide for five years of the Organiza-tion's life.

5. The Form and the Content of the Pro-gramme of Work

The programme of work should supply broadgeneral lines of policy which the Director-Generalwould use as a framework for the orderly develop-ment of annual programmes and budgets withinthe period chosen. In the interest of adaptabilityand flexibility it was not considered desirable todraw up a detailed programme.

In view of the rapidity of the evolution of medicalscience at the present time, the Board consideredthat the programme to be drawn up should beflexible and open to periodic review. New problemsmay arise and new techniques and methods ofapproach to current problems may be developedin the course of the next few years. Problemswhich 'today do not appear to recommend them-selves for action on the international plane maywell, as the result of discoveries at present unpre-dictable, become suitable for such action, or evencall for action, before the end of the specific period.With these considerations in view, and in orderthat there might be at all times a smooth andorderly evolution of the programme, it was consi-dered that the Board should review it each year.

ANNEX 5 3I

Thus the Board could recommend to the HealthAssembly any change of emphasis rendered neces-sary by experience gained or by new scientificdevelopments. It was thought that this system waspreferable to one whereby the programme wouldbe reviewed only at the end of the specific period,and a new programme drawn up for a subsequentperiod.

As regards the methods of implementation ofthe programme, the Board confined itself to theenunciation of certain broad general principleswhich are contained in the following section. TheBoard considered that the details of methods tobe employed should be the responsibility of theDirector-General, based on policies prescribed bythe World Health Assembly, the regional organiza-tions and the Executive Board, in accordancewith the requirements of the different programmesat any particular time and taking into accountthe recommendations of the relevant expert com-mittees.

The Board did not consider it advisable to attemptto delineate any detailed programme for the region-al services, as this is an obvious responsibilityof the regional organizations. For their guidance,however, the Board has set out some generalstatements of policy, and calls upon the regionalorganizations to elaborate regional programmesfor the four-year period along these general lines.The Board expects this work to be completed intime for its seventh session.

6. General ObservationsThe Board considered that the work of the

Organization must be based upon the genuineprinciple of decentralization, and also consideredthat decentralization can best be effected throughthe regional organizations provided for in theConstitution. The Board trusts that the HealthAssembly will pursue such a policy as will fullyimplement the provisions of Chapter XI of theConstitution in all regions within the shortestpossible time.

An international organization such as WHO,with its essentially complex relationships, mustachieve the maximum degree of efficient decentra-lization. One of the main reasons for the establish-ment of regional organizations is that they shouldensure that the services provided actually reachthe people of the countries concerned with theminimum of intermediary mechanism. The fact ofsetting up regional offices does not necessarily meanthat decentralization has been accomplished, but isonly an essential step towards it, and the regionalcommittees now have, and certainly must assume,the full responsibility for completing the processand putting into effect the maximum of genuinedecentralization.

The Board considered that there are certainfunctions of the Organization which do not lendthemselves to decentralization, but are best carriedout by Headquarters.

7. Criteria for the Selection of Activities tobe included in the Programme of Work

In view of the vast array of activities in whichthe Organization might legitimately engage, theBoard felt it necessary to establish certain criteria

upon which it could base its recommendations forthe selection or rejection of proposed activities.The Board has found these criteria to be usefuland suggests that the Health Assembly may wishto adopt them.

International Feasibility and Acceptability

WHO will embark only upon such programmesas are internationally acceptable and of which thetechniques involved have been considered to besound and to have passed beyond the experimentalstage. It cannot be regarded as sufficient that theactivities to be selected should be those which arelikely to be desired or requested by Member States.They must (apart from those involving emergencyaction) also be activities in which the States inwhich they might be carried out would be able toparticipate both morally and materially, whichthey would be in a position to continue after thecessation of such activities as had been undertakenby WHO, and from which the population con-cerned, including those of under-developed coun-tries, appeared to be sufficiently evolved to be ableto benefit. Certain activities, however worthwhile,may well be impracticable because of internal orinternational economic and political factors.

Universal Nature of the Problem

Activities should be chosen from which thelargest possible number of Member States are likelyto benefit, either directly or indirectly ; however,not only global but also regional and local deside-rata must all be taken into account. The regionalcommittees have undertaken, and must in thefuture increasingly undertake, the importantresponsibility of surveying regional problems,bringing them to the attention of Headquarters,and arranging for regional machinery and forbringing to the attention of governments problemsof purely local significance.

Possibility of Assessing Progress and Results

The question is often asked, and it will undoub-tedly be asked with increasing frequency duringthe next five years-what has the World HealthOrganization accomplished which would not havebeen done without it ? Activities to be selected forthis first specific period should therefore, as faras possible, be such that the results achievedmay be measurable, and may at the end of theperiod be demonstrable to and readily understoodby governments. For example, activities which willshow a dramatic fall in the incidence of malaria orvenereal diseases, or in maternal and infant mor-tality in a given area, will be readily appreciated bythe public. It is hoped that this criterium may wellbecome progressively less important in the choiceof programmes for subsequent specific periods.At the same time, it must be clearly realized thatcertain health problems of an urgent nature or ofglobal importance should be tackled irrespectiveof the possibility of assessing their results.

Financial Feasibility

The funds available to the Organization arerecognized to be small In comparison with thenumber and magnitude of the tasks which might


reasonably be undertaken, and they must there-fore be invested in those activities which arelikely to prove most fruitful. The Board had todecide whether it wished to- recommend to theHealth Assembly a short list of activities to becarried out on a large scale, or a long list of activitiesto be carried out on a small scale, and it deferredthis decision pending the receipt of the reportsrequested from regional committees. The Boardhad in mind that some activities will show greaterresults for a given expenditure than others couldshow for the same expenditure. The fact that itmight be possible to finance a particular activitywas not considered to be adequate. Activitiesshould be selected which are likely to show themaximum results for the minimum outlay, andwhich would give greater results for the sum tobe expended than other comparable activities ofequal importance.

Availability of Qualified Personnel

Before an item is given a place in the generalprogramme of work for a specific period, fullconsideration should be given to the question of theavailability of qualified personnel to carry out theactivity envisaged.

"Traditional" International Services

Consolidation, maintenance and development ofits "traditional" or so-called "statutory" serviceswill enable WHO to continue to perform a taskwhich can be performed only through an interna-tional health organization, and which may becomprehensively defined as international standar-dization and co-ordination. These services andtheir specific objectives are listed below, in section 8.

Co-operative Services

The World Health Organization is a party tocertain agreements under which it collaborateswith the United Nations and with other specia-lized agencies in international activities in thefield of health.

8. The Major Headings of the Programmeof Work

"Traditional" International Services

The "traditional" international services areglobal or international in contrast to the regionalservices, and therefore are administered fromHeadquarters. They are classified as follows :

(a) health statistics services, which in co-opera-tion with the health statistics departments ofgovernments will supply all countries with reli-able statistical information ;

(b) epidemiological intelligence, with a view todeveloping a simple and efficient epidemiologicalintelligence service, making as full use as possibleof the regional offices ;(c) international health regulations and qua-rantine, with the objective of controlling interna-

tional spread of disease with the minimuminterference with trade and travel compatiblewith modern knowledge ;

(d) adoption and encouragement of the applica-tion of international standards for biologicalsand pharmaceuticals and other medical arma-mentaria ;

(e) unification of pharmacopoeias ;

(f) standardization of international medicalnomenclatures ;

(g) co-ordination and encouragement of researchin the field of public health, by assisting andco-operating with national institutions ;(h) editorial, publications, reference and lin-guistic services ;

(i) work on addiction-producing drugs ;(j) emergency action when required.

To the above "traditional" international servicesshould be added :

(k) adoption of nutritional standards ;(1) standardization of routine laboratory testsand clinical tests for periodic health examina-tions ;

(m) study of population problems in collaborationwith the United Nations ;(n) study and co-ordination of different methodsof prophylactic health examination ;(o) readiness to initiate schemes with other inter-national agencies, for example, to study healthproblems affecting more than one region.

Co-operative Services

WHO is obliged to undertake certain activitiesunder Article 57 of the Charter of the UnitedNations and under Articles 2, 18 (i), 69 and 72 ofthe WHO Constitution. In the terms of theagreements with the United Nations and withother specialized agencies, WHO is bound tosupply services and to give assistance and adviceto other United Nations bodies such as the Trustee-ship Council and the Social Commission and theCommission on Human Rights of the Economicand Social Council. It has always been the policyof the Organization to promote co-ordination ofthe programmes of WHO with those of the UnitedNations and specialized agencies, and to collabo-rate to the fullest extent possible with such agen-cies.

Professional and Technical Education and Trainingof Medical and Auxiliary Personnel

It is necessary that certain standards be laiddown to which all countries should attempt toconform in their campaigns to modernize theircourses for the training of doctors and otherworkers in the health field. Not only do standardsin medical education require to be raised in manycountries, but there should be a re-orientation ofthe studies of all medical, nursing, sanitary andother auxiliary personnel, undergraduate and post-graduate, in the direction of increased emphasis

ANNEX 5 33

on modern public-health (including preventive andsocial) aspects of medicine.

The disproportion between the advances made inmedical science in recent years and the smallpercentage of the world's population which benefitsfrom them can be reduced only by expansion andadaptation of national health programmes. Forthis to be done there must be in each country atleast a nucleus of health workers who have acquiredthe new skills and knowledge and who will passthem on to colleagues and students, who in theirturn will bring them within reach of the commu-nity.

The Executive Board considered that extensionand promotion of higher standards of professionaland technical education and training of doctors,dentists, sanitarians, pharmacists, nurses, mid-wives, health visitors, technicians and other auxi-liary health personnel, by such methods as thegranting of fellowships and the promotion ofextended teaching facilities, is an investment whichproduces benefits out of all proportion to the originaloutlay, and considered that governments shouldgive much greater weight to this matter in theirplanning and budgeting. This is an activity theresults of which it would be possible to assess atthe end of a four-year period of intensive effort.

Advisoryments

and Demonstration Services to Govern-

Article 2 (c) of the Constitution states that WHOshall "assist governments, upon request, in streng-thening health services". It is in implementationof this article that the advisory and demonstrationservices to governments are designed, and all ofthe services considered under this heading canmake an essential contribution towards achievingthe objective.

The services envisaged under this heading mustbe regarded as regional, since they deal with localneeds and local problems. Such needs and prob-lems can best be met regionally, and the servicesshould therefore be implemented by the regionalorganizations, where such exist, the role of Head-quarters being confined to general planning andsupervision, technical guidance and budgetarycontrol. As regards technical guidance, Headquar-ters has an important responsibility in the choiceof advisers sent to countries. These should beselected not only on a basis of technical qualifica-tions, but also bearing in mind their experience indealing with peoples of different cultural back-grounds and economic level. Data concerning thedifferent countries should be assembled at Head-quarters and used in the briefing of advisers tosupplement their own previous experience.

The service which provides for professional andtechnical education and training is also an indis-pensable complement of this part of the programme.Work towards the training of adequate numbersof health workers must march abreast with efforts

towards the manning of public-health serviceswith a competent full-time staff.

A necessary adjunct to this part of the pro-gramme will be an attempt to establish objectivesfor countries to aim at in the organization oftheir public-health services and the carrying-outof their health programmes.

The Board did not consider it advisable at thistime to put forward measurable objectives in thisfield. In this class of activities, it appears that nodefinitive targets can be set. The Board calls theattention of regional committees to the necessityof encouraging governments to set targets andthereafter of making joint assessment with theregional organization at regular intervals. TheBoard accordingly requests the regional commit-tees to study this matter in detail and to reportthereon to the seventh session.

Having indicated the desirability of decentrali-zation of effort, the Board considers that it wouldbe undesirable for it to enter into any detailedrecommendations for the programme of work forthe years 1952 to 1955, and that it is the dutyand function of the regional committees to providethe Board in reasonable detail with such advice aswill enable it at its seventh session to supplementthis programme with those details.

The Board considered that the advisory anddemonstration services may take the form ofassistance to be offered to governments in thefollowing main fields :

Organization of Health Services. - The ExecutiveBoard considered that the primary objective ofthese services should be to assist the governmentof every Member State in building up as strong acentral and community health structure as pos-sible, provided with the relevant specializedservices necessary to meet modern health require-ments, competent to carry out an effective healthprogramme, with facilities for research in public-health techniques and procedures, and with afull-time highly-trained staff, enjoying a properfinancial and social status and thoroughly imbuedwith the social and preventive attitude to healthproblems. No such target can be the aim of anannual programme, but the Executive Boardconsidered that this must be a major item in theprogramme of WHO for the four years 1952 to1955. An adequate and effective nursing service,suited to the culture and economy of the country,is an essential element in the development of anypublic-health programme. The inclusion of thenursing aspects in most field programmes of WHOand the demonstration of modern nursing tech-niques in the field should be a part of the generalprogramme of assistance to national health admi-nistrations.

The Board considered that the principle of full-time employment in public-health work should bepromoted, and that WHO should aim at encouragingall governments to put that principle into effect.


Communicable Diseases. - Under the heading ofcommunicable diseases fall to be included thecontrol and possible eradication, general or focal,of such communicable diseases as shall have beenfound to be susceptible to this approach. Whilecomplete eradication of any disease would be anover-ambitious objective for the specific period,the Organization should attempt, in co-operationwith the governments concerned, to achievemeasurable reduction or even complete focaleradication of selected diseases in selected areas.The field of possible achievement which theeradication technique has opened up is vast, andit is for WHO to assist governments in exploringit, by inspiring and encouraging national healthdepartments, and by ensuring a full circulation ofthe available technical guidance and help.

In the present state of knowledge it wouldappear that malaria, venereal disease and tubercu-losis are the most important communicable diseasesin connexion with which governments will wish forassistance, while typhus, plague, cholera, bilhar-ziasis, smallpox and leprosy should also receiveconsideration, and methods of combating otherdiseases should be continuously studied.

Physical, Mental and Social Well-being. - WHOis fully aware that many factors concerning theeconomic and social conditions of the peoplesconcerned have a great bearing on problems ofhealth, and, bearing these in mind, suggests thatsteps should be taken to assist governments in thepromotion of certain measures which are essentialto the attainment of "complete physical, mentaland social well-being ", and which involve modifi-cations in the habits of life of the people concerned.These measures therefore include assistance togovernments in the following directions :

(1) Maternal and Child Health. -A useful targetfor the specific period might be to assist govern-ments to reduce maternal and infant mortalityrates in countries where they are highest, and toimprove and modernize maternal and child-health programmes in countries where they arepoorly developed.

(2) Nutrition. - The work of FAO in connexionwith the production and management of foodshould be supplemented by that of WHO inrelation to food as a factor in maintaining health,and the two organizations should co-operateclosely in bringing to the attention of governmentsthe principles on which nutrition should be based.Collaboration between FAO and WHO consti-tutes one of the earliest examples of effectiveco-operation between two specialized agencies.It should be emphasized to health administra-tions that every country should take into consi-deration the nutrition standards laid down forthe region, and, where necessary, for groupswithin the region. An important part of the

nutrition programme should be the training ofnutritionists and dieticians.

(3) Environmental Health and Sanitation. -Many millions of people are victims of diseasesdue to environmental factors which can often becorrected by the rational application of knowntechniques. These techniques have not beenfully utilized, either because they have beenunknown or inaccessible to those concerned, orbecause they have rightly or wrongly beenconsidered to be economically impracticable.WHO should assist by disseminating technicalknowledge, by exploiting the ingenuity withwhich workers in different countries have adap-ted techniques to local economic and environ-mental conditions, and by advising governmentshow to make the best use of available funds.The health education aspect of environmentalhealth must not be overlooked, and full conside-ration will be given to problems of housing andrural sanitation, it being always borne in mindthat these vary from region to region. The trainingof specialized hygienists, sanitarians and publichealth engineers and the encouragement of train-ing facilities in sanitary service will be oneof the activities included under "Professionaland Technical Education".

(4) Mental Health. - The planned application ofpreventive mental-hygiene measures at an earlystage of a country's evolution would reduce theneed for expenditure on therapeutic facilitieswhich has arisen in countries in which suchmeasures have not been applied until theyappeared spontaneously in what has come to beregarded as the normal course of development.In both well-developed and under-developedcommunities psychological factors may wellfrustrate the attempts of health administratorsto change behaviour in a direction favourable tohealth. There are two objectives in the field ofmental health which the Organization mightwell aim at in the specific period, namely,assistance to governments in the initiation ofmental-health work in countries in which it hasnot yet been given a place in the national healthprogramme, and in the application of modernpsychological knowledge and techniques to thebreaking down of psychological resistance to theadoption of new patterns of health behaviour.In carrying out the programme, full accountwill be taken of the social approach to theproblems involved. The training of psychia-trists and mental-health specialists, and assist-ance in the establishment of institutions for thispurpose, will come under the activities includedin "Professional and Technical Education."

(5) Medical Social Activities. - The socialaspects of health services and medical care havebeen increasingly recognized as essential elementsin a general health programme the objective of

ANNEX 6 35

which is the attainment of well-being for allpeople. Attention should be given to the questionof how health services can be effectively utilizedby all. Social health therefore should becomepart of a general programme and should permeateall activities for the promotion of health.

Health Education. - The most carefully plannedattempts to put modern public-health and medicalknowledge into application will fail in a communitywhich has not been made receptive to it by aprogramme of health education. Health educationmust be carried out by members of the communityconcerned, but WHO has a clear-cut part to playin arousing interest in the subj ect in countrieswhich have hitherto paid it little attention, inproviding teaching for the teachers and the leadersof communities, and in assisting in the developmentof methods and techniques. It is an activity whichis complementary to all the other activities, forwithout it it would be impossible to attain a fullmeasure of success in the other fields. It is pointedout that UNESCO has a most constructive role toplay in this field and it should be one of jointendeavour between the two organizations.

Health Demonstration Areas. - The healthdemonstration area is characteristic of WHO'sapproach, namely, the demonstration and modifi-cation of technical and administrative methodsfor the benefit of those to whom they wouldotherwise have remained unknown or inaccessible.The value and importance of each of these areaswill rest as much on its capacity to provide know-ledge, experience and tangible results for thebenefit of all analogous countries with similarproblems as on its capacity directly to benefit the

country in which the area is situated. Healthdemonstration area programmes are necessarilyplanned without a definite time-limit, but theyshould usually contain objectives with a prescribedtime-limit.

Health Statistics. - The Board emphasized thefact that the field of health statistics is one in whichmost countries fall short of modern standards andrequirements, and considered that one of theobjectives which WHO should set itself in thespecific period should be the establishment, incollaboration with the governments concerned, ofsatisfactory health statistical services in as manycountries as possible, so as to make availablestatistics based upon international standards.

Medical Supply Advisory Services. - Because ofthe economic situation in the world to-day, thelack of medical supplies is frequently one of themost serious handicaps to the effective carrying outof public-health measures. The role of WHOshould include :

(a) medical supply advisory services to govern-ments upon request. WHO will not only advisegovernments regarding the procurement of supplies,but also on the way in which they may set up theirmedical supply services ;

(b) stimulation of any available processes whichmay ptoduce increased availability of medicalsupplies and equipment in countries or areaslacking them. This will be done in co-operationwith the appropriate bodies of the United Nations ;

(c) assistance to governments in developingtheir own resources in the manufacture of healthsupplies.

[EB 5/76]II January 1950

Annex 6

PRESENT ADMINISTRATIVE ARRANGEMENTS IN THE WHO SECRETARIATIN THE FIELD OF STATISTICS

(Health, Epidemiological, Medical and Vital) 1

1. Historical

The statistical functions of WHO were inheritedfrom the Office International d'Hygiène Publique,the League of Nations' Health Section and theHealth Division of UNRRA. In these institutionsthe statistical work was a mere offshoot of theirbasic epidemiological functions, i.e., figures ongeneral mortality, infant mortality, etc., werecollected as a complement to or as a substitute forfigures on mortality and morbidity from specificcommunicable diseases ; similarly, figures on popu-

I See item 2.2.1 of the Board's report.

lation were collected merely to compute rates.Thus, in the parent organizations, the routinestatistical work, i.e., the collection, computation,study and publication of figures, was done by thestaff of their epidemiological intelligence services.Similarly, the periodicals issued, whether weekly,monthly or yearly, were essentially epidemiologicalperiodicals and named as such.

In the League of Nations' Health Section, theonly statistical staff was that of the EpidemiologicalIntelligence Service, and it naturally became afunction of that service to do whatever statisticalcomputations were required by other units orservices (on nutrition, cancer, tuberculosis, infant

REPORT OF THE EXECUTIVE BOARD, FIFTH SESSION, PART I

mortality, etc.). Its staff was also entrusted with thepreparation of the 1938 revision of the Internatio-nal Lists of Causes of Death, and with the issue ofthe corresponding international Manual. It parti-cipated also in the early stages of the preparationof the 1948 revision.'

When, at the end of 1946, the Interim Commis-sion of WHO took over the functions of its parentbodies, the remaining personnel of the Epidemio-logical Intelligence Service of the League consti-tuted the nucleus of its epidemiological and statis-tical staff. This staff was reinforced by officerstransferred from UNRRA and OIHP for thenotifications work related to the administration ofinternational sanitary conventions.

In 1947, and up to the end of 1948, the epidemio-logical intelligence and the statistical work, togetherwith the preparation of the sixth decennial revisionof the International Lists of Diseases and Causesof Death, were left concentrated in the Divisionof Epidemiology and Public Health Statistics.

The natural expansion of the work relating toepidemic diseases on the one hand, and to healthstatistics on the other, made it desirable to sepa-rate, in so far as practicable, the activities relatingto these two fields, while retaining in the Divisionof Epidemiology the machinery required forepidemiological intelligence as an essential toolfor the administration of international sanitaryconventions. The change was effected in twostages.

Immediately after the First World HealthAssembly, when the Secretariat was given adefinite structure, a Section of Statistical Studieswas set up within the Division of Epidemiologyand Public Health Statistics to deal with nomen-clature of disease and related subjects, to giveadvice on statistical methods to all sections of theSecretariat, and to act as the secretariat of theExpert Committee on Health Statistics.

Early in 1949, this Section was renamed "Sectionof Health Statistics" and separated from theDivision of Epidemiology, the statistical clerkswho dealt with vital statistics being transferredto it.

Later in 1949 this Section was raised to thelevel of a Division.

2. Present Situation as regards Routine Col-lection and Publication of Statistical Data

It is noteworthy that the separation mentionedabove has not broken down the continuity of theroutine statistical work, which remains unaltered,although carried out by separate administrativeunits.

The epidemiological and statistical returnsreceived directly from the health and statisticalauthorities of all countries pass systematically forextraction of their contents through :

2 The preparation of the 1929 revision had been madeby specialists outside this service.

(1) the Notifications Unit of the SanitaryConventions and Quarantine Section, for extrac-tion of data relating to pestilential diseases forissue in daily broadcast bulletins and in theW eekly Epidemiological Record ;

(2) the Section of Epidemiological Statisticsand Information, for extraction of data on commu-nicable diseases ; and

(3) the Division of Health Statistics, forextraction of data on births, deaths and popula-tion.

Each unit elaborates the data it has extracted.Co-ordination again prevails in the publication ofthe data.

The Section of Epidemiological Statistics pro-duces tables on communicable diseases, theDivision of Health Statistics produces tables onvital statistics and mortality by causes, and allthese tables are incorporated side by side in themonthly Epidemiological and Vital Statistics Report,or in the volumes of the Annual Epidemiologicaland Vital Statistics.

Care is exercised to avoid overlapping and dupli-cation. Thus, one section only (Sanitary Conven-tions and Quarantine) checks on the reception ofreturns from countries and claims any which maybe missing ; one section only (EpidemiologicalStatistics and Information) centralizes the varioustables required for the above-mentioned periodicals,edits the latter, and sends to the national adminis-trations the statistical questionnaires requiredfor the preparation of the volumes of AnnualEpidemiological and Vital Statistics, even thoughthese questionnaires have been filled out, in sofar as the material available permitted, by theunits responsible respectively for communicablediseases and for vital statistics.

One section only (Health Statistics) carries outthe liaison with the United Nations statisticalservices, to obtain therefrom population anddemographic data. There again, overlapping ofthe services is avoided at the international level,as also duplication of work to fill in questionnairesat the national level.

The Section of Epidemiological Statistics and theDivision of Health Statistics keep their respectiverecords on strictly parallel lines ; these records arestrictly complementary, and none are duplicated.

The original returns, bulletins and reports fromcountries are, after extraction, kept for referencewithin reach of the staff of both units.

Two reasons explain the lack of duplicationbetween the Epidemiological Statistics and HealthStatistics units ; first, the fact that, in spite ofchanges in names and lines of authority, a simpleand well-proved system has been maintainedunaltered and is applied by a personnel of commonorigin and training, working in a single office ;and secondly, the good will and mutual under-standing of the officers in charge of the respectiveunits.

ANNEX 6 37

It must be emphasized that the present absenceof duplication is possible only if the present satis-factory psychological conditions remain unim-paired, and if the units concerned in statisticalwork continue to share the same quarters, oroccupy contiguous offices.

Apart from the functions described above, whichare carried out in common by sections of theDivision of Epidemiology and the Division ofHealth Statistics, each of the latter has of courseits own separate responsibilities in the statisticalfield.

3. Statistical Work peculiar to the Divisionof Epidemiology

In the Division of Epidemiology, the Notifica-tions Unit of the Sanitary Conventions and Qua-rantine Section extracts, collates and issues in theform of daily broadcast bulletins, followed by theprinted W eekly Epidemiological Record , informationconcerning the "pestilential" diseases.

As this information calls for immediate actionon the part of national quarantine administrations,the work of this unit requires particular speed andalso priority as regards reception of the nationalepidemiological and statistical returns. Thesereturns are further abstracted, as regards commu-nicable diseases, by the Section of EpidemiologicalStatistics and Information.

The recently created Epidemic Watch Unit inthat section compares the figures freshly recordedwith those of previous weeks and those of thesame season in previous years, with a view todetecting any abnormality of trend and to disco-vering incipient epidemics. A special series oftables and graphs showing the median and maxi-mum prevalence in years past of the most importantcommunicable diseases in various countries isused as a basis for comparisons. Any epidemic ofinternational importance thus discovered, togetherwith its geographical distribution, is studied bythe unit and, if deemed justified, is brought to thenotice of health administrations in the W eeklyEpidemiological Record.

The figures relating to communicable diseasesabstracted by the Section of EpidemiologicalStatistics and Information not only serve as abasis for monthly and annual publications, asmentioned above, but also provide the staff of theSection of Epidemiological Studies in the Divisionof Epidemiology and other administrative units,such as the Sections on Venereal Diseases, Malaria,etc., with material for study and for special publi-cations.

The figures are also used to answer requests forinformation from health administrations and re-search workers.

4. Statistical Work of the Division of HealthStatistics

In the Division of Health Statistics, a BasicCurrent Activities Unit attends to the systematicextraction of data on births, deaths, and causes of

death relating to different countries and also to agreat number of selected towns throughout theworld, the corresponding tables from this statisticaldocumentation appearing in a regular manner inthe Epidemiological and Vital Statistics Report.Following explicit suggestions made by the ExpertCommittee on Health Statistics of the Organiza-tion, supplementary tabular information for someselected countries on mortality by sex and age-groups, and causes of death, with appropriate dataon population by the pertinent characteristics,also appears in this publication.

This unit of the Division is also responsible forthe collection of material on administrative andpublic-health statistics (data on number and kindsof anti-tuberculosis dispensaries, tuberculosis sana-toria and hospitals, venereal-diseases dispensaries,anti-alcoholic dispensaries and sanatoria, vaccina-tions, maternity and child welfare dispensaries andinstitutions) and statistics of curative medicine(data on institutions, hospital, homes of differentkinds - general, mental, nervous diseases, cripples,contagious, gynaecological and obstetrical, eye,incurables, etc. - both public and private) as wellas statistics of medical and public-health personnel(data on number of medical students, practitioners,doctors, dental students and dentists, pharma-cists, midwives, etc.), all of this data to be obtainedfrom the annual reports to be submitted byMember States in fulfilment of Article 61 of theConstitution. The information so gathered will bepublished in some kind of international healthyearbook or in the Epidemiological and VitalStatistics Report, or in some special publication, ifit is decided not to issue a yearbook.

The Basic Current Activities Unit is alsoentrusted with the task of preparing a series ofstatistical handbooks, giving the cogent facts andregulations on vital statistics and medical certifi-cation for the different countries, the records to becollated and presented according to a uniformmethod, which will help to establish similarities anddissimilarities among the basic systems of vitalstatistics of several countries. This importantactivity was also recommended by the expertcommittee and approved by the Second WorldHealth Assembly.3

The creation of national committees on healthstatistics in some countries for the purpose ofgiving impulse to the betterment of nationalhealth statistics, for co-ordinating the statisticalwork carried out by the various national depart-ments, for making studies of problems and ques-tions on medical statistics which might present agreat national or international interest, etc., wasa new idea put forward by the InternationalConference for the Sixth Decennial Revision ofthe International Lists of Diseases and Causes ofDeath, convened in Paris in 1948, and acceptedby the First World Health Assembly. Obviouslythis conception might prove to be in the future apowerful instrument for the improvement, both

28Resolution WHA2.38, Off. Rec. World Hlth. Oyg., 21,


generally and particularly, of national healthstatistics, with considerable repercussions in thefield of international comparability of data, andtherefore this Division will be given the assignment,when adequate personnel is available, of trying tofoster the establishment of as many nationalcommittees as circumstances recommend, and ofdistributing to other countries information on theprogress in the field of health statistics obtainedby the action of national committees and other-wise, and of following up closely the studies andexperimental work carried out by them.

This unit also answers the numerous requests forinformation on medical and health statistics of acurrent character coming from government depart-ments, institutions, other sections of the Secretariatand responsible persons, and is also commissionedto co-ordinate details of work with the Section ofEpidemiological Statistics of the Division of Epi-demiology. Its specific duties also cover thechecking and control of questionnaires to be sentto governments by United Nations agencies.

The Division of Health Statistics comprises,besides the unit described above, the three follow-ing sections ; Section on Morbidity Statistics ;Section on Statistical Classification of Diseases,Injuries, and Causes of Death ; Section on Statis-tical Studies and Advisory Service. The tasks andduties of these three sections are as follows :

Section on Morbidity Statistics

The work of the Section on Morbidity Statisticsis concerned chiefly with the collection, classifica-tion, tabulation and general study of statistics ofnon-communicable diseases and of aspects ofinfectious diseases, statistics which are not forurgent and immediate use, as this phase of themproperly belongs to the Division of Epidemiology,as explained above. The results of the Section'swork will appear either in the Epidemiological andVital Statistics Report or in special publications ifcircumstances of various kinds justify it.

The principal sectors of the programme of acti-vities for this section are :

(I) morbidity and mortality by tuberculosis,cancer, malaria, venereal diseases ;

(2) infant and childhood morbidity and mor-tality, and maternal statistics ;

(3) morbidity and mortality by alcoholism,accidents, violence, mental diseases, etc. ;

(4) statistics of physical defects and senility ;

(5) morbidity and mortality for general andspecial population groups (army, navy, schools,sickness insurance, surveys, etc.).

This section will be concerned not only with thegeneral study of the figures and records of thesesectors of medical statistics, but also, as one of its

most important duties, with presenting suggestionsfor the improvement of the quality of data in therespective fields by the action of the nationalcommittees already referred to, or by concertedinternational efforts, or by sending consultants tothe countries which need them.

As is well recognized, the levels of health ofindividuals, of countries, and of nations cannotbe measured only in terms of figures and indexesof mortality, however important these may be,and for public health, in formulating programmesand in action, data on actual prevalence of sicknessand study of records of morbidity are theoreticallyof far higher usefulness and more immediate appli-cation than reports on past mortality, this conclu-sion applying not only to statistics of communi-cable diseases but to all diseases and physicaldefects, generally and in particular. This is thegreat field of the future in medical and healthstatistics. But it should be duly acknowledged thatan immense effort of basic ordering, interpretationand collection of statistics is needed in this sphere,as most of the information on morbidity and defectsis nationally, and much more so internationally,stffi faulty, partial, irregular, dissimilar or lacking.Therefore a very great and continuous amountof work - routine, study, suggestions - will berequired from this section on this complex problem,so fit for international action, and principles anddirectives enunciated by the WHO Expert Com-mittee on Health Statistics, which is alreadytackling in its programme of work some aspects ofthese questions, will undoubtedly be most helpfuland useful for the activities of this section, ofwhich great hopes can be entertained when it isproperly and competently staffed ; the wide appli-cation of the new International Lists for the Statis-tical Classification of Diseases, Injuries, and Causesof Death will prove to be an important factor alsowithin this range of work.

Section on Statistical Classification of Diseases,Injuries, and Causes of Death

The Section on Statistical Classification of Dis-eases, Injuries, and Causes of Death is assignedthe following functions :

(1) All matters regarding the InternationalStatistical Classification of Diseases, Injuries, andCauses of Death, the application and use of theManual, and therefore the presentation of sugges-tions for modifying in the future the actual lists aspractical experience recommends it. An importantpart of this job is to implement the recommenda-tion made by the expert committee on the need forsetting up in the section a clearing centre, properlystaffed both at Headquarters and in a centralnational office, with long experience in questionsof adscription of rubrics, double classification,

ANNEX 7 39

interpretation of medical titles of morbidity-mortality, etc., for solving the problems thatwill probably arise in this connexion.

(2) Follow-up of WHO Regulations No. I,which implies a great deal of correspondence andcross-correspondence.

(3) Studies on the international comparabilityof health statistics as derived from the statisticalclassification actually in use and those used in thepast.

(4) Editing of Volumes i and 2 of the Manualof the International Statistical Classification ofDiseases, Injuries, and Causes of Death, in foreignlanguages.

(5) Training in the use of the Manual and there-fore related problems of fellowships, etc., in thissector. Preparation of the informative bookletelaborating and illustrating the provisions alreadycontained in the Manual.

(6) Assistance to the secretary of the expertcommittee on subject-matters pertaining to theabove-mentioned activities.

Section on Statistical Studies and Advisory Service

The Section on Statistical Studies and AdvisoryService is the necessary complement of the Division,and its staff will be entrusted with the followingduties :

(I) To give advice and help to other sectionsof the WHO Secretariat on suitable statisticalmethodology to be applied in their studies or experi-mental work. Taking into account the fact thatthe application of statistical methods and numeri-cal analysis in the study of many health problemsis indispensable, this section should normally rendergood service to the rest of the technical depart-ments in relation to the planning and developmentof some of their programmes, if consulted in duetime, that is to say, usually before the programmesare put into practice.

(2) To assemble documentation on environ-mental factors and other circumstances influencingmorbidity and mortality. This field is, of course,vast, and, taking a pragmatical attitude, thesection will concentrate on getting the pertinentbibliographical files and records on those problemsof more immediate concern to WHO.

(3) To carry out research on questions of medicaland health statistics so as to contribute in itsproper sphere to the elucidation of importantdemographic and biological phenomena. Obviouslythis type of activity is closely linked up with thosepreviously mentioned for the section and for othersections of the Division.

(4) To prepare, for the immediate use of theDivision, or more generally for WHO, a set ofdiagrammatic illustrations of the most importantfacts relating to international demography, parti-cularly those having a close relation and bearingon the work of WHO.

It is fully realized that it might not always bepossible to carry out the above-mentioned func-tions with only the small staff attached to thissection, however great the ability and industry ofits members might be, and therefore this section,working in a realistic spirit, should approach,whenever necessary, specialists or particularlycompetent bodies, either directly or through theExpert Committee on Health Statistics. Consi-dering the great importance and delicacy of thiskind of work, the Director of the Division willexercise immediate supervision over its labours andwill collaborate in the performance of its work.

It is obvious that the functions described above,some of them quite new in the international sphere,must always be exercised with a certain degree ofadaptability and flexibility, and therefore someslight modifications may be made later in theexercise of the functions of the Division asexperience may dictate, although these modifi-cations will probably be made within the generalframework already described.

Annex 7

NON-PROPRIETARY NAMES FOR DRUGS

In order to avoid the difficulties which arisefrom the multiplication of names for the samemedicinal substance, the World Health Organiza-tion should adopt the practice of recognizing asapproved names certain non-proprietary nameswhich may be used freely by manufacturers.

1 See item 2.3.2.2 of the Board's report.

[From EB 5/52]5 January 1950

The intention is that, if any of the drugs towhich those approved names are applied shouldeventually be described in the PharmacopoeaInternationalis or in a national pharmacopoeia, theapproved name should be its official title. On theother hand, the recognition of an approved namedoes not imply that the substance will necessarilybe included in the Pharmacopoea Internationalis.


Requests from manufacturers and others forapproved names for products which appear likelyto come into established use might be considered.Such requests should be accompanied by :

(a) reports of pharmacological and clinicalinvestigations on the drug concerned ;(b) a number of suggestions for a suitable name,having regard to the need to avoid similarity toexisting trademarks and other current names.

If a manufacturer should desire to issue under aproprietary name a drug for which an approvedname has been provided, it is recommended thatthe label shall bear the approved name of thesubstance.

The following general principles are stated forguidance in devising new names :

(r) Names should, preferably, be free from anyanatomical, physiological, pathological or thera-peutic suggestion.(2) An attempt should first be made to form aname by the combination of syllables from thescientific chemical name, in such a way as toindicate the significant groupings of the com-pound.(3) Names should, in general, not exceed foursyllables.

(4) Names should be distinctive in sound andspelling, and should not be liable to confusionwith names already in use.

(5) Names which are difficult to pronounce or toremember should be avoided.

(6) The addition of a terminal capital letter ornumber should be avoided.

(7) Names already used in the national pharma-copoeias or officially adopted in any country, orwhich are included in New and Non-officialRemedies should receive preferential considera-tion.

(8) The following terminations should be used :

Latin

- inum

- inum

- osidum- olum

- alum- onum

- enum

Annex 8

English

- ine for alkaloids and organicbases

- in for glycerides and neutralprinciples

- oside for glycosides- ol for alcohols and phenols

(-OH group)- al for aldehydes- one for ketones and other sub-

stances containing the COgroup

- ene for hydrocarbons.

[From EB 5 /81]16 January 1950

CREATION, IMPROVEMENT AND DEVELOPMENT OF NATIONALHEALTH SERVICES 1

Note presented by Dr G. H. DE PAULA SOUZA

It is obvious that well organized national healthservices are of paramount importance to individualcountries, but they also constitute a great help forany programme in the international sphere.Unfortunately, very few countries have attainedhigh standards, and a limited number only haveat their disposal a minimum of efficient technicalfacilities and administrative machineries for suchwork.

Any international effort to improve healthstandards depends strictly, in the long run, on thecreation, development and improvement of nationalhealth services.

It seems to the Brazilian Government that,before any programme on a large scale is establishedon the international level, a worldwide or at leastregional appraisal of the health conditions andexisting technical facilities should be made. Thispoint of view was on several occasions brought tothe attention of the Executive Board and theHealth Assembly and general agreement followedsuch statements.

1 See item 3.3.2 of the Board's report.

Past experience, both of the PanamericanSanitary Bureau and also of the Health Organiza-tion of the League of Nations, has shown howdifficult it is to gather appropriate informationfrom the different countries. A continuous andsystematic survey would be useful in giving anup-to-date picture of the health conditions andworking facilities, which would imply a strictco-operation with the national services.

In connexion with such problems, an importantfactor to be considered is related to the availablestatistical information. Such information is variedin extent, quality and accuracy, not only regardingthe different countries, but also, within eachcountry, the different regions. An approach tothe problem of obtaining comparable data shouldbe made possible by organizations like WHO.

The Brazilian Government, which is as deeplyinterested in obtaining accurate information ofwhat occurs elsewhere as it is in collecting informa-tion on its own territory, would look favourablyon systematic organized effort in such a direction,and asks the Executive Board to include thissubject on the agenda of the Third World HealthAssembly.

ANNEX 9 41

[From EB 5/105 Rev. 1]I February 1950

Annex 9

DRAFT REGULATIONS FOR EXPERT ADVISORY PANELS AND COMMITTEES 1

Efficiency, as well as economy, make it necessaryto limit the number of experts participating indiscussions on any given subject ; on the otherhand, it is difficult, in a small group of experts, toobtain adequate representation of the variousbranches of knowledge which bear upon its subject,and of the diversified forms of local experience andtrends of thought prevailing in the various partsof the world.

These apparently conflicting requirements maybe reconciled by giving expert committees, when-ever desirable, flexible membership.

This may be done by setting up advisory panelsof experts conversant with all the requiredbranches of knowledge and forms of experienceneeded to cover adequately a particular subj ectand providing adequate geographical represen-tation.

From these panels will be drawn the membersof the expert committees, selection being madeaccording to the agenda of each session.

1. Definitions

On the basis of the above principles :

IA An expert advisory panel consists of expertsfrom whom WHO expects technical advice on aparticular subject :

(a) by correspondence ;(b) at meetings to which they may be convened.

1.2 A member of an advisory panel is an expert,appointed by the Director-General, who undertakesto contribute by correspondence and withoutremuneration technical information or reports ondevelopments within his own field, either periodi-cally or on request from the Director-General.

1.3 An expert committee is a committee estab-lished by the World Health Assembly or the Execu-tive Board to deal with a particular subject matterand consisting of a group of experts convened forthe purpose by the Director-General.

1.4 A member of an expert committee is an expertconvened to a session of that committee ; he retainssuch status until the next session of the committee.

2. Competence and Functions of Expert Advi-sory Panels and Committees

2.1 The purposes and functions of expert advisorypanels and committees, in their respective technicalfields and in accordance with their terms of refer-ence, are :

1 See item 4.4 of the Board's report.

4

2.1.1 to take stock of the latest available know-ledge and expert information and make it availableto WHO, i.e., its Assembly, Executive Board,committees and Director-General, and to MemberStates ;2.1.2 to formulate, on the basis of such know-ledge, technical recommendations which take intoaccount opinions and practices in different coun-tries ;2.1.3 to make recommendations with a view toinitiating, stimulating and co-ordinating research,in order to increase and supplement existing know-ledge, as may be necessary for complying with theterms of reference.

2.2 Expert committees, unless so requested, shallnot advise WHO on questions of administrativepolicy as such.

2.3 Expert committees have no administrativeor executive authority, unless such authority isformally and explicitly entrusted to them by theWorld Health Assembly or by the ExecutiveBoard.

3. Authority to Establish Expert AdvisoryPanels and Committees

3.1 The World Health Assembly 2 and the Execu-tive Board8 have authority to establish anddissolve expert committees and to fix the numberof their members.

3.2 The Director-General has authority to invitenot more than two additional experts beyond themembership authorized under paragraph 3.1 to asession of an expert committee, if its agendarequires this increased membership.

3.3 The Director-General has authority to es-tablish expert advisory panels and to lay downtheir terms of reference and the duration of theiroffice.

4. Selection and Appointment of Membersof Expert Advisory Panels and Committees

4.1 The members of expert advisory panels andcommitttees shall be selected and appointed bythe Director-General. All such appointments shallbe reported to the Executive Board at its nextsession.

4.2 The selection of these members shall be basedprimarily upon their ability and technical experi-ence. Due regard shall be paid to adequategeographical distribution.

2 Article 18 (e) of the Constitution of WHO3 Article 38 of the Constitution of WHO


4.3 The Director-General shall, before appointingmembers of an expert advisory panel, consult withthe national administrations concerned.

5. International Status of Members

5.1 In the exercise of their functions, the membersof the expert advisory panels and committees shallrank as international experts serving the Organi-zation exclusively ; as such they may not requestor receive instructions from any government orauthority outside the Organization.

They shall enj oy such privileges and immunitiesas are envisaged in the Constitution 4 and set forthin the Convention on the Privileges and Immunitiesof the Specialized Agencies and in Annex VIIthereof.

5.2 In accordance with the administrative regula-tions of the Organization, members shall be entitledto a refund of travelling expenses necessitated bytheir attendance at sessions of the committees, andalso to a daily living allowance during such sessions.These allowances shall not be regarded as remu-neration.

6. Members' Term of Office

6.1 Members of expert advisory panels shall beappointed for such period as the Director-Generalmay determine, but not exceeding five years.

Such period shall be cut short if and when thepanel is dissolved and, in exceptional cases, at thediscretion of the Director-General.

Members shall be eligible for reappointment if thepanel's existence is renewed.

6.2 Members of an expert advisory panel invitedby the Director-General to serve on the relatedexpert committee shall be members of that com-mittee during the period of the session to whichthey are convened and until the next session.

They may be convened to several successivesessions of the said expert committee, at the dis-cretion of the Director-General, according to theirspecial knowledge and experience, to the subjectson the agenda of the sessions, and the need forcontinuity.

6.3 When not convened to a particular session,members of the panel may nevertheless attend it,if they so wish, and if so authorized by the Director-General, but in that case they shall do so at theirown expense and shall not take part in the pro-ceedings.

7. Chairmen and Vice-Chairmen

7.1 At the beginning of each session the expertcommittee shall elect a chairman to direct itsdebates.

7.2 It shall also elect a vice-chairman to replacethe chairman in case of resignation, absence orinability to carry out effectively his functions.

4 Article 67 (b) of the Constitution of WHO

8. Secretaryship of Expert Committees

8.1 In accordance with Article 32 of the Consti-tution, the Director-General is ex-officio secretaryof all expert committees. He may delegate thesefunctions.

8.2 The Director-General, or his representative,may at any time make either oral or written state-ments to the committee concerning any questionunder consideration.

8.3 The discussion of the committee shall beinvalid unless the Director-General or his repre-sentative is present.

8.4 The Director-General or his representativeshall assist the committee in drawing up the reportof the session.

8.5 The Director-General or his representativeshall appoint the time and place of each session andconvene the members of the committee.

9. Agenda

9.1 The Director-General or his representativeshall prepare the draft agenda for each session andtransmit it in reasonable time to the members ofthe committee, to the members of the ExecutiveBoard and to Member Governments.

9.2 The agenda shall include any subject withinthe competence of the committee proposed by theHealth Assembly, the Board or the Director-General.

10. Expert Sub-Committees

I0.1 For the study of special problems a com-mittee may suggest the setting-up, temporarily orpermanently, of specialized sub-committees, andmay make suggestions as to their composition.

10.2 A committee may also suggest the formationof joint sub-committees consisting of specialistsin its own technical field and of specialists inanother field, whose collaboration it considersnecessary for the success of its work.

10.3 The Health Assembly, or the Board, shalldecide upon the setting-up of such sub-committees,whether established singly or jointly with othercommittees or sub-committees of WHO or ofother organizations.

10.4 The rules governing the functions of thecommittees, the appointment of their members,the election of their chairmen and vice-chairmen,and procedure, shall also, mutatis mutandis, applyto the sub-committees.

10.5 Membership of a committee does not entailmembership of its sub-committees, nor a right toattend their sessions.

io.6 Each sub-committee shall, with the assistanceof its Secretary, draw up a report covering eachsession and approve it before the end of the session.This report shall be submitted, through the Direc-tor-General, to the parent committee.

10.7 The report of a joint sub-committe shallnormally be transmitted to the parent committees.

ANNEX 9 43

o.8 Nevertheless, the report of a sub-committeemay, in certain cases, be communicated by theDirector-General to the Board or to the HealthAssembly for information or urgent action.

11. Reports on Sessions of Committees

II a For each session the committee shall, withthe assistance of its Secretary, draw up a reportsetting forth the committee's findings, observationsand recommendations.

11.2 This report shall be approved by the com-mittee before the end of the session.

11.3 If the committee is not unanimous in itsfindings, any divergent views shall be recorded inor appended to the report.

11.4 The committee's report shall be submittedby the Director-General to the Board for appro-priate action.

11.5 In case of urgency the Director-General may,however, submit the report to the Health Assemblydirectly or take such other action as may benecessary on the report. Any such action shall bereported to the Board and the Health Assemblyat their next session.

11.6 The Board shall decide when any report ofthe committee or of a sub-committee is to bepublished and shall be free to accompany such areport by a statement approving it in whole or inpart, or setting forth its own views on the subject.The text of a report of a committee or sub-com-mittee may not be modified without the consentof the committee or sub-committee by which itwas drawn up.

11.7 Signed contributions should not be includedin the text of the committee's report or in itsannexes.

11.8 The Director-General may publish anyrelevant document falling within the committee'stechnical field and emanating from its membersor from any other source, if he considers publica-tion desirable.

12. Rules of Procedure

The committees and sub-committees shall con-duct their debates in accordance with the rules ofprocedure set forth in the appendix to the presentRegulations. 5

13. Joint Committees

13.1 Persons representing the World Health Orga-nization, serving as experts on j oint committees

' Not reproduced here. See Off, Rec. World Hlth Org.13, 376.

set up by the Organization in conjunction withother organizations, shall, in respect of methodof appointment, status, grant of travel and subsis-tence allowances, and terms of office, be subject toRegulations 3, 4, 5 and 6 of the present Regulations.

13.2 Experts are appointed by the Organizationto joint committees by reason of their specializedknowledge and technical competence ; they shallretain complete freedom of opinion and expression.Nevertheless, in any collective decision liable toentail administrative, financial or moral responsi-bility for the appointing organization, they cannotcommit the Organization without the specificauthority of the Director-General.

13.3 The questions which the Organization wishesto place on the agenda of a joint committee shallbe formulated by the Director-General on his owninitiative, on the instructions of the Health Assem-bly or of the Board, or upon the suggestion of anyone of the expert members of such committee.

13.4 Persons representing the Organization onany joint committee shall report to the Director-General upon their participation in all sessionsthey attend. This special report shall be supple-mentary to the collective report of the joint com-mittee itself, and paragraphs 11.6, 11.7 and 11.8of the present Regulations shall apply to it, asalso to the above-mentioned collective report, butin the latter case with due regard to the provisionsof the agreements with the organizations con-cerned.

13.5 The apportionment of the expenses that maybe incurred by any joint committee shall be deter-mined before each session by the Director-Generalof the Organization and the competent officials ofthe other organizations concerned.

14. Interim Provisions

14.1 The above provisions shall apply as from thedate of their approval by the World Health Assem-bly, without regard io the duration of the appoint-ments already made on expert committees.

14.2 Expert advisory panels are hereby estab-lished in every field in which an expert committeehas been established by the World Health Assemblyor the Executive Board.

14.3 All experts appointed on expert committees,whether as members or as corresponding experts,shall be considered as members of the expertadvisory panels established in the same fieldsunder paragraph 14.2.

14.4 Their membership on the expert advisorypanels shall be of five years' duration, unless ashorter period is fixed by the Director-Generalunder paragraph 6.1.


[From EB 5/9]8 November 1949

Annex 10

REGIONAL COMMITTEE FOR THE EASTERN MEDITERRANEAN

REPORT ON THE SECOND SESSION 1

The second session of the Regional Committee forthe Eastern Mediterranean, held in the Palais desNations, Geneva, Switzerland, from 12 tO 15 Octo-ber 1949, under the alternate Chairmanship ofDr. Neil Karabuda (Turkey) and Mr. H. Bahar(Pakistan), Vice-Chairmen,2 was attended byrepresentatives of the following countries : Egypt,Ethiopia, France, Iran, Iraq, Israel, the HashemiteKingdom of the Jordan, Lebanon, Pakistan, SaudiArabia, Syria, Turkey and the United Kingdom.Observers from FAO and ILO also attended.

Brief addresses were given by Sir Aly Shousha,Pasha, Regional Director of the Eastern Mediter-ranean Regional Office ; Dr. W. P. Forrest, onbehalf of the Director-General of WHO ; and Dr.Neil Karabuda (Turkey).

National health problems, resources in terms ofexperts, institutions and exchange facilities, andurgent needs for health development were outlined.A summary of resolutions and decisions follows.

1. Adoption of the Provisional Agenda

The committee adopted the provisional agenda,and postponed to its third session consideration ofamendments to the Rules of Procedure proposedby the representative of the United Kingdom.

2. WHO Activities in the Region during 1949

The committee noted the report of the RegionalDirector and the comments thereon by the repre-sentatives of Turkey, Pakistan, Lebanon andEgypt.

3. Programme Sub -Committee

The committee established a Sub-Committee onProgramme to consider programmes for 1950, thecommittee to be a committee of the whole.3

Acting on the proposals of the sub-committee,the committee adopted the following decisionsand resolutions.

4. Programme for 1950

After discussing in detail the summary statementsof programme and requirements for 1950 fromeach country and the facilities available for assist-

1 See item 5.4.1 of the Board's report.2 In the absence of the Chairman, Dr. N. Scandar,

Pasha (Egypt)Officers elected : H.E. Dr. M. Nazif Bey (Egypt)

Chairman ; Dr. Rachad Pharaon (Saudi Arabia) Vice-Chairman ; and Dr. M. Aziz Bey (United Kingdom)Rapporteur.

ance in meeting the needs of the various membersof the region, the committee decided to refer theserequests to the Regional Director for action inaccordance with the accepted procedure.

4.1 Specific Problems

4.1.1 Public-Health Administration. The committeeadopted the following resolution :

The Regional Committee,Considering

(1) that public-health administration is a funda-mental problem that uniformly concerns all thecountries of the region ;(2) that without a basic health organization itis impossible to operate long-term programmesfor promotion of national health ;(3) that a sound health organization calls forspecialized personnel, medical and non-medical,including nurses, sanitary engineers and trainedassistants ;(4) that some countries in the region are stillin the preliminary stage of development of theirpublic-health services ;

RECOMMENDS

r. that countries(a) make adequate allocations in their nation-al budgets for development of organizedpublic-health services on a national basis ;(b) provide funds for adequate training of thenecessary personnel ; and

2. that the Regional Office(a) give all possible assistance to the countriesin the region by :

(i) encouraging and promoting the deve-lopment and improvement of the nationalhealth services ;(ii) extending facilities for training by fel-lowships ; and(iii) providing expert advice ;

(b) give priority to those regional pro-grammes which are directly concerned with thetraining and development of strong nationalhealth administrations, in accordance withthe decisions of the World Health Assembly.

4.1.1.1 Public Health Organization. The commit-tee (1) noted that the advisory services of an experton public-health administration were available inthe regional office ; (2) recognized that establish-ment of a demonstration area in the region would

ANNEX IO 45

involve commitments by a government willing toparticipate in establishing such an area, and (3)noted the offers to participate in a demonstrationarea in the region made by the representatives ofEgypt, Iran and Pakistan.

4.1.1.2 Environmental Sanitation. The committeenoted that the advisory services of an expert onenvironmental sanitation were available in theregional office.

4.1.1.3 Nursing. The committee adopted the fol-lowing resolution :

The Regional Committee(1) NOTES that the advisory services of anexpert in nursing will be available in the regionaloffice in the near future ; and(2) REQUESTS the Regional Director in themeantime to negotiate for such advisory servicesfrom the Rockfeller Foundation.

4.1.1.4 Health Education of the Public. The com-mittee adopted the following resolution :

The Regional Committee(1) NOTES that expert advisory services onhealth education are now available from Head-quarters ;(2) NOTES that the facilities of the HealthPropaganda Section of the Egyptian Ministry ofHealth are available to other Members in theregion in connexion with their health educationprogrammes ;(3) RECOGNIZES that although health educationof the public is primarily a national problem,additional assistance would enable Membercountries to expand their activies ; and(4) RECOMMENDS that the regional office pro-duce health educational material in the form oflibraries, films, models and exhibits, etc., suitablefor local needs, such material to be made avail-able to the Member nations for use in theirnational health campaigns.

4.1.2 Control of Communicable Diseases. Thecommittee adopted the following resolutions :

4.1.2.1 Malaria

I. The Regional Committee(1) NOTES the decision of the Second WorldHealth Assembly to assist the Malaria Instituteof Pakistan to enable it to hold courses in mala-riology for the region ;(2) CONSIDERS that such courses are urgentlyneeded for the rapid development of the malariaprogramme in the region ; and(3) RECOMMENDS that the regional office takeimmediate steps to assist in organizing thesecourses as early as possible.

II. In view of reports of unsatisfactory resultsobtained with DDT in Lebanon and Israel,

The Regional Committee(I) RECOMMENDS that the regional office under-take to investigate such reports ; and

(2) NOTES the offer by the representative fromIsrael that the facilities of the GovernmentMalaria Research Station in Israel may be uti-lized for these investigations.

4.1.2.2 Bejel

The Regional Committee,

Having considered

1. The particular susceptibility of treponematato penicillin treatment ;

2. The extent and the regional character ofbej el ;

3. The prevalence of the disease in infants andlower age groups ;

4. The desirability of further study of the natureand extent of the problem ; as well as

5. The social and economic necessity for deve-loping practical control measures to combat thedisease effectively on a large scale,

(I) APPROVES

1. The action taken by WHO following theinitial proposal of Iraq at the First WorldHealth Assembly to include bej el among theactivities of WHO ;

2. The project outlined for attacking theproblem in the Eastern Mediterranean area ;

(2) RECOGNIZES that the problem is of import-ance to the region ; and

(3) RECOMMENDS

1. That action be taken by the RegionalDirector and the Director-General of WHO forfurther development and implementation ofthis project ;

2. That budgetary provisions be made byWHO under the 1950 syphilis control pro-gramme to initiate the proposals ; and

3. That appropriate action be taken forUNICEF participation - to the extent offurnishing supplies and equipment - in theactivities of the demonstration area for bej elcontrol, proposed in document WHO/VD/23,and in subsequent large-scale programmes.

4.1.2.3 Tuberculosis

Considering that, in most of the countries ofthe region, tuberculosis control is still in theearly stages of development ;

Considering that the lack of adequate numbersof personnel trained in the modern methods oftuberculosis control is one of the most importantproblems in this field ;

Considering that the closest co-ordination isdesirable between governmental programmesand voluntary activities,

The Regional Committee(1) NOTES with satisfaction the proposals of therepresentatives of Lebanon, Egypt, Pakistan and


Turkey that tuberculosis training projects beinitiated in those countries ; and

(2) RECOMMENDS

(a) that the regional office take every pos-sible step to expand and develop the tuber-culosis control programme in the region byassisting in the organization of regional tuber-culosis training projects in suitable countrieswhere adequate facilities are available ;(b) that, in countries where tuberculosiscontrol departments have not yet been orga-nized, such a department be established withinthe framework of the national health autho-rity ; and(c) that voluntary effort in the antitubercu-losis campaign be encouraged and co-ordinatedwith the governmental programmes.

4.1.2.4 Other Communicable Diseases

I. Cholera

The Regional CommitteeNOTES the report of the Regional Director

regarding the forthcoming study tour of theOIHP/WHO Joint Study-Group on Cholerawhich will render services to Pakistan ;

II. Smallpox

The Regional CommitteeRECOMMENDS to the countries in the region

that vaccination be made compulsory wherethis is not already in force, and that such vacci-nation be free of charge.

III. TrachomaThe Regional Committee

(1) AGREES that trachoma should be consideredas a matter of regional importance, and(2) NOTES with satisfaction the steps which theRegional Director proposes to take for investi-gating the treatment and method of control.

IV. Whooping CoughThe Regional CommitteeRECOMMENDS that the Regional Director

investigate the questions of vaccination againstwhooping cough.

V. LeishmaniasisThe Regional Committee

(I) RECOGNIZES the importance of leishmaniasisin the region ; and(2) RECOMMENDS that the Regional Directorinvestigate the problem of its control andtreatment.

4.1.3 Promotion of Health. The committee adoptedthe following resolutions :

4.1.3.1 Maternal and Child Health

The Regional Committee(1) RECOMMENDS that in countries where amaternal and child health department has notyet been organized, such a department be estab-lished within the framework of the nationalhealth authority ;

(2) DRAWS ATTENTION TO the necessity for thedevelopment of adequate nursing services inorder that the work of such a department maybe effective ; and(3) REQUESTS the Regional Director to draw theattention of UNICEF to the necessity for allo-cation of funds to child health' projects in thisregion.

4.1.3.2 Nutrition

Recognizing the importance of nutrition inhealth programmes and the consequent need foradequate scientific surveys,

The Regional Committee

(I) WELCOMES the proposal for co-ordinatingthe work of the relevant specialized agencies inthis field at the regional level, with particularreference to the Joint FAO/WHO project forassisting in the development of a nationalnutritional training centre in Egypt for tech-nicians and medical personnel, and(2) RECOMMENDS that the Regional Office takethe necessary steps to expedite the creation ofthe proposed national training centre and toutilize its facilities for the training of the variouscategories of personnel from the differentcountries in the region.

4.1.3.3 Mental Health

The Regional Committee(1) NOTES with interest the report submitted onmental health ; and(2) NOTES that the services of a consultantwill be available in 195o.

4.1.4 Professional Technical Education. The com-mittee noted the information submitted regardingassistance to institutes, fellowships, and supply ofmedical literature and teaching equipment.

4.1.5 Interchange of Health Personnel. The com-mittee adopted the following resolution :

In view of the great scarcity of technicalhealth personnel in the region, and the paucityof training facilities ;

Having regard to the desirability of broadeningthe experience of the health personnel in eachcountry ; and

In order to make full use of the experience andfacilities already available in the region so thatthe relatively limited resources for fellowshiptraining may be used in the most efficientmanner,

The Regional Committee(1) RESOLVES that the Regional Director berequested to initiate and expedite negotiationsbetween the health administrations of the regionfor the intra-regional interchange of technicalhealth personnel, so that the resources of theregion may be the more efficiently deployed ; and

(2) CALLS upon all governments in the regionto facilitate these arrangements.

ANNEX 10 47

4.1.6 Medical Supplies. The committee notedthat different categories of assistance in medicalsupplies are available from Headquarters.

4.1.7 Programme for 1951. The committee adoptedthe following resolution :


(1) RECOMMENDS that the activities to berequired in the region during 1951 should besimilar to those proposed for 1950 ; and

(2) CONSIDERS that a programme for 1951 alongthe same general lines as that for 1950, consoli-dated and modified in minor respects wherenecessary, would meet the requirements.

5. Health Problems of Refugees in Palestine

The committee adopted the following resolution :

The Regional Committee,Having reviewed the sad position of the

Palestine refugees ; andConsidering that the continuation of such

conditions may threaten the neighbouring coun-tries from the public health point of view andmay even threaten other countries in otherregions,

(1) NOTES the report of the Chief MedicalOfficer UNRPR seconded by WHO ;

(2) COMMENDS the temporary measures takenby WHO and UNRPR to ameliorate the condi-tion of the refugees ;

(3) REQUESTS the States Members of this region,pending a permanent solution, to urge upon theGeneral Assembly of the United Nations thenecessity for adequate funds to continue thehealth measures ; and

(4) REQUESTS the Regional Director to commu-nicate to the United Nations the unanimousopinion of this committee that immediatemeasures to solve the problem of resettlementare the only solution to the urgent public-healthproblems in view of the present condition ofthe refugees.

6. Epidemiological Services

The committee adopted the following resolutions :

I. Having discussed the quarantine problems ofSaudi Arabia and the French coast of Somaliland,

The Regional CommitteeAGREES that the Member States should refer

such problems direct to the Director-General fortransmission to the relevant expert committeesscheduled to meet in December.

II. The Regional Committee

(1) NOTES the proposals on the Sanitary Con-ventions and Epidemiological Intelligence Ser-vices within WHO, and

(2) REQUESTS the Regional Director to submitthese proposals to the Expert Committee onInternational Epidemiology and Quarantine forits views.

7. Co-ordination of Planning and Operationswith Other International Organizations atRegional Level


The Regional Committee(1) NOTES the methods of co-ordination ofplanning and operations with other internationalorganizations at the regional level ; and(2) NOTES that the Regional Director will conferwith the regional representatives of these organi-zations in the near future ;

Having discussed the co-operative programmebetween governments, FAO and WHO toincrease food production and raise standards ofhealth ; 4 and

Having noted that all the countries in theregion are interested in this programme, andthat FAO has already been consulted on theproposal made by Pakistan,(3) REQUESTS the Regional Director to contactall the Governments in the region as soon aspossible regarding their proposals on this matter,and to collect all the necessary information,including all existing agricultural and healthinformation about the area proposed, any pre-vious surveys, and other relevant material ; and(4) CALLS UPON the Regional Director to stimu-late such action.

8. Administrative and Financial Matters


Considering that it is highly desirable to haveas large an attendance as possible at the regionalmeetings, and that many countries may not bein a position to defray the expenses incurredin attending such meetings,

The Regional CommitteeREQUESTS the Executive Board to reconsider

its decision regarding non-payment of transpor-tation charges.

9. Resolutions of the Second World HealthAssembly

The committee adopted the following resolutions :

I. The Regional CommitteeNOTES those resolutions of the Second World

Health Assembly of particular interest to theregions.

II. The Regional Committee(1) NOTES with satisfaction that the HashemiteKingdom of the Jordan and Pakistan havealready ratified the General Convention on thePrivileges and Immunities of the SpecializedAgencies ;

* Off. Rec. World Hlth Org. 21, Annex 7


(2) NOTES that Turkey has taken steps in thatdirection ; and

(3) CALLS UPON all other Members of the regionto take similar action as early as possible.

III. The Regional Committee

CALLS ON those Members in the region whichhave not denounced the Rome agreement to takesuch action as soon as possible.

IV. The Regional Committee(1) REQUESTS the Regional Director to make thenecessary arrangements for holding a conferencewithin the region for the purpose of studyinghealth statistics and the methods of their initia-tion and improvement in the different countries,and to arrange for the services of a consultantor an adviser ; and(2) NOTES the offer of the representative ofIsrael that the statistical services of his countryare available to assist the Members in the region.

V. The Regional CommitteeNOTES the report of the Regional Director

regarding progress on the negotiations in con-

nection with the Host Agreement with theGovernment of Egypt.

VI. The Regional CommitteeCALLS ON Member States in the region to

waive customs duty on insecticides and pharma-ceuticals required for the welfare of the people.

10. Other Business


The Regional CommitteeREQUESTS the Regional Director to keep the

countries of the region informed on all projectsto be carried out within the region and on thoseprojects which may be postponed by the Direc-tor-General as "approved projects" to be putinto operation when finance becomes available.

11. Time and Place of Third Session

The committee adopted the following resolution :The Regional CommitteeRESOLVES to hold its next meeting in Ankara,

Turkey, in the first week of September 1950.

Annex 11

REGIONAL COMMITTEE FOR SOUTH-EAST ASIA

REPORT ON THE SECOND SESSION 1

The second session of the Regional Committeefor South-East Asia, held in New Delhi, India, from26 to 28 September 1949, under the chairmanshipof Mr. S. W. R. D. Bandaranaike (Ceylon), withDr. Svasti Daengsvang (Thailand) as Vice-Chair-man, was attended by delegates from the followingcountries : Afghanistan, Burma, Ceylon, France,India, Portugal and Thailand. Observers werepresent from the United Nations InformationCentre, FAO, ILO, the Red Cross, UNESCO andUNICEF. The Assistant Director-General of theDepartment of Operational Services of WHO andmembers of the staff attended the meeting. Asummary of resolutions and decisions follows.

1. Adoption of the Provisional Agenda

The committee adopted the provisional agenda.

2. Programme Sub-Committee

The committee established a Sub-Committeeon Programme to consider programme for 1950and 1951, such committee to be a committee of thewhole.


[From EB 5/II]ro November 1949

3. Report of the Regional Director

The committee noted the report of the RegionalDirector and referred the relevant portions tothe Sub-Committee on Programme.

4. Representation of the South-East AsiaRegion on the Executive Board

The committee adopted the following resolu-tion :

Whereas the South-East Asia Region com-prises a vast area with a diversity of peoplesand a multiplicity of health problems needingurgent attention,

The Regional Committee(1) RESOLVES that the representation of theSouth-East Asia Region on the Executive Boardis inadequate ; and while requesting the WorldHealth Assembly for adequate representation,(2) RECOMMENDS that in electing members to theExecutive Board the Assembly be guided not somuch by the number of Members in any region asby factors such as geographical importance, popu-lation, the magnitude and variety of the health

ANNEX II 49

problems of an area and the need for the assist-ance of WHO in solving such problems, andthe ability to contribute to the work of theExecutive Board in carrying out the objectivesof the Organization.

5. Accommodation for Regional Office andStaff


The Regional Committee,Having given due consideration to the posi-

tion of accommodation for the regional officeand staff ; and

Taking into consideration the fact that thepresent location of the regional office wasdecided on the invitation of the Government ofIndia,(I) APPRECIATES the recent allocation of suit-able office accommodation in Patiala House ;and(2) URGES immediate action by the Govern-ment of India to give top priority to the pro-vision of adequate living accommodation withoutwhich the increasing activities of this regioncannot be carried out ; and(3) REQUESTS the Regional Director to reportto the Member States by the end of November1949 how the matter stands together with anyproposals that he may have in this regard.

6. Correspondence on Technical Matters withDirectors of Public Health


The Regional Committee(I) RESOLVES that the Regional Director shouldbe permitted to correspond direct, on technicalmatters, with Directors of national healthservices, and, in the case of federated units, withthe Directors of Health of such units, providedthat in the latter case no action is taken in anymatter involving policy without prior referenceto the central authority ; and(2) RECOMMENDS the governments of the re-gion to grant the Regional Director necessaryfacilities in this regard.

7. Regional Appropriations

The committee was of the opinion that thelimited resources of the countries of this regionshould be concentrated on national health pro-grammes, and that no additional regional appro-priations, as visualised in Article 5o (f) of the WHOConstitution, should be envisaged at this stage.

8. Country Contributions

In view of the acute financial difficulties entailedas a result of the recent devaluation of mostcurrencies in the region, the committee requestedthe Director-General to explore the possibilities ofeasing the situation :

(a) by payment of contributions in localcurrencies in respect of 1949 ; and

(b) by calculating, if possible, contributions for1949 at the pre-devaluation rate of exchange.

9. Medical Supplies

9.1 Results of Devaluation

As a result of the recent devaluation of most ofthe currencies in this region a very acute situationhas arisen with regard to the supply of essentialdrugs and equipment needed for national healthprogrammes, most of which are obtainable onlyfrom dollar currency areas. The committee wasvery anxious that some assistance should be givento governments, and requested the Director-General to give urgent attention to this problemand to investigate possible solutions such as findingsources of supply at specially arranged rates andpossibilities of payment in local currencies.

9.2 Supplies for Af ghanistan

The committee considered the request of the dele-gate of Afghanistan with regard to assistance inthe matter of obtaining the necessary facilities fortransit of medical supplies to Afghanistan. TheCommittee requested the Regional Director togive every possible assistance to the Governmentof Afghanistan in this matter.

10. Reciprocity of Recognition for MedicalQualifications

The committee requested the Director-Generalto go into the whole question in order that theexisting anomalies as regards mutual recognitionof medical qualifications between differentMember countries of the Organization should beeliminated, it being understood that any actiontaken in this matter would not involve the loweringof adequate standards of training.

11. Programmes

ILI Co-ordination of Planning and Operationswith other Organizations in the Region



(1) NOTES with satisfaction the proposal forjoint WHOTA0 projects for controlling diseaseand increasing food production in certaindemonstration areas ; and

In view of the great importance of this pro-posal to the South-East Asia Region,(2) RESOLVES that as large a number of thesedemonstration areas as possible be taken up,the number of such areas being increasedespecially where countries are prepared to meeta substantial portion of the cost involved ; and(3) RECOMMENDS that detailed proposals fromcountries in respect of areas suitable for suchoperations should be submitted to the RegionalDirector as soon as possible.


11.2 Programme for 1950 and 1951

The Regional Committee adopted the reportand the draft resolutions therein, as amended, ofthe Sub-Committee on Programme, as follows :

11.2.1 General. The sub-committee discussedbriefly the general aspects of programme planningand development, particularly the steps involvedin the submission of programme estimates bygovernments and recommendations of the RegionalCommittee through the Regional Director to theDirector-General. The sub-committee then tookup the detailed discussion of the programme re-quests for 1950. Each country made a summarypresentation of its requirements, after which theserequirements were discussed subject by subject.Country programmes were noted and each countrywas requested to present to the Regional Directorthe order of priority in which it would like to haveits requests considered.

With respect to specific subjects the followingdecisions were arrived at :

11.2.2 Public Health. The following draft resolu-tion was adopted :


Considering the. desirability of bringing to-gether the heads of public-health services of thecountries of the region in order to discuss public-health problems of mutual interest ;

REQUESTS the Regional Director to makepreliminary studies on this subject and to takesuch steps as are necessary to arrange thesemeetings at the same time as the meetings of theregional committee.

11.2.3 Environmental Sanitation. The sub-com-mittee discussed the formation of national commit-tees for environmental sanitation and noted thatsome countries had already established such com-mittees. The sub-committee hoped that withthe availability of a regional consultant in envi-ronmental sanitation expert assistance might beavailable in problems of health work in this field.The Regional Director was requested to arrangefor exchange of information.

11.2.3.1 Housing. The sub-committee noted thedifficulties experienced by many countries inobtaining the necessary building materials, and itwas decided that this matter be taken up withECAFE by each individual country. It wasfurther decided that the Director-General of WHObe requested to explore with ECAFE the possibilityof assisting governments in this regard.

With respect to health standards for housing,the sub-committee approved, in principle, theminimum standards as follows :

(a) two living-rooms ; each with a superficialfloor area of 120 sq. ft. ;(b) front and back verandahs ;(c) kitchen with fireplace ; and(d) latrine.

The following draft resolution was adopted :The Regional CommitteeRECOMMENDS that, in view of the need for

ensuring that the health requirements of housingprogrammes receive adequate consideration,governments should consider the desirability ofincluding health and housing under the sameMinistry.

It was decided not to have an advisory panel onhousing for the present, but to concentrate onexchange of information.

11.2.4 Malaria. The following draft resolutionswere adopted :

I. The Regional Committee,Having considered the proposal of the Direc-

tor-General to re-establish the internationalmalaria course in Singapore ; and

Realizing the facilities that are available forteaching at the Malaria Institute, Delhi, and theMalaria Field Training Centre, Ceylon, and theneed to strengthen such national institutions,

RESOLVES that the Director-General be re-quested to give consideration to assisting thesetwo centres in developing malariology trainingcourses which will be made available to othercountries.

II. The Regional Committee,Having taken note of the recommendation of

the Expert Committee on Insecticides and theresolution of the Economic and Social Council ;and

Realizing the importance of the free flow ofinsecticides and equipment connected with theirapplication in the control and eventual eradi-cation of many insect-borne diseases,

RECOMMENDS tO Member countries of theregion the immediate implementation of theresolution of the Economic and Social Councilin so far as it relates to tariffs and import andexport restrictions.

11.2.5 Venereal Diseases. The following draftresolution was adopted :

The Regional Committee(I) NOTES the work which is being carried outby the World Health Organization venerealdiseases demonstration team in Himachal Pra-desh (India) ; and(2) RECOMMENDS to regional governments tosend, wherever practicable, their venereal dis-eases specialists to study the control methods,including laboratory techniques, at the head-quarters of the demonstration team in Simla.

11.2.6 Tuberculosis. The following draft resolu-tion was adopted :

The Regional Committee,Considering the importance of tuberculosis

control in the South-East Asia Region and theurgent need to take active measures to providefor it ; and

In view of the recommendations of the ExpertCommittee on Tuberculosis,

ANNEX II 51

RECOMMENDS

(r) to the regional countries, that as a firstpriority existing BCG programmes should begreatly intensified and, as soon as practicable,steps should be taken to inaugurate such pro-grammes in other countries where this work hasnot yet been started ; and that, as BCG pro-grammes are established, child health services,particularly those of a physician and public-health nurse, should also be made available tochildren found to be in need of care and tofollow up the work started by the BCG teams ;and

(2) to the Director-General, to assist in theestablishment of a national tuberculosis teachingand training centre in a suitable country in theSouth-East Asia Region to provide for thetraining of various types of tuberculosis workerswithin the region.

11.2.7 Other Communicable Diseases

Cholera. The following draft resolution wasadopted :

The Regional Committee(I) WELCOMES the proposal to hold the nextmeeting of the OIHP/WHO Joint Study-Groupon Cholera at the South-East Asia RegionalOffice ; and

(2) APPRECIATES the preliminary work beingcarried out by the Indian Research Fund Asso-ciation.

Plague. The proposal to establish training facilitiesat the Haffkine Institute, Bombay, which would beavailable to the region, was noted.

The sub-committee also noted the recommenda-tions of the Expert Committee on Plague to esta-blish a permanent roving demonstration team toinitiate eradication projects in endemic areas,beginning with India.

Leprosy. The sub-committee expressed its satis-faction with the decision of the Second WorldHealth Assembly in this regard.

Smallpox. The following draft resolution wasadopted :

The Regional CommitteeRECOMMENDS to regional countries to take

necessary steps to ensure that :(a) the lymph used for vaccination is potent ;(b) primary vaccination is made compul-sory ; and(c) revaccination is made compulsory and iscarried out at least three times during thelifetime of the individual.

11.2.8 Maternal and Child Health. The sub-committee noted with great satisfaction that therewas to be a regional adviser in maternal and childhealth, who would explore the existing schemes ofhealth education and health care in schools as wellas maternal and child health services, and decidednot to appoint an advisory school health panel atpresent.

As regards the training of nurses, midwives andancillary health workers, the sub-committee wasof the opinion that it was not possible to adopt oneuniform type of worker but that different levels oftraining would be necessary to meet the require-ments of the region. The Regional Director wasrequested to arrange for exchange of information.

11.2.9 Nutrition. The sub-committee adopted thefollowing draft resolution :


Recognising the extreme importance of nutri-tion in this region,

RECOMMENDS that :

(a) urgent attention be given to the training ofnecessary personnel for the education of thepublic and especially the younger age groups inthis regard ;

(b) studies of regional nutrition problems maybe entrusted to the existing research organiza-tions in India and Ceylon ;

(c) the appointment of national nutrition com-mittees should be pressed forward ;

(d) the Regional Director be requested toarrange for exchange of information ; and

(e) the appointment of a regional nutritionadvisory panel be postponed for the present.

11.2.10 Assistance to Institutions for TechnicalEducation. The sub-committee discussed theeducational and technical training facilities withinthe region and the possibilities for mutual aid.The Regional Director was instructed to obtainfrom countries more complete data and to arrangefor exchange of all available information.

The question of establishing internationalcentres for training of maternal and child healthworkers and malaria control personnel and varioustypes of nursing personnel was discussed at somelength. It was noted that the Health Assemblyhad decided against sponsoring internationalcentres and was in favour of strengthening nationaltraining centres where opportunities for thetraining of personnel from other areas could beoffered. Governments wishing assistance willpresent proposals in the same manner as for otheradvisory and demonstration services.

The sub-committee approved in principle theidea of having medical teaching missions as partof advisory and demonstration services. TheRegional Director was instructed to develop theseprogrammes in consultation with governments.

11.2.11 Fellowships. The sub-committee discussedthe possibility of expanding the fellowship pro-gramme through payment by governments of costof transport to and from the country of study, andthere was general agreement that this was thedesirable procedure. Some countries have alreadyrequested such budget provisions from theirtreasuries. Emphasis was laid on the advisability


of including an adequate number of fellowshipsfor general public health training.

11.2.12 Medical Literature and Teaching Equip-ment. The sub-committee discussed the require-ments for medical literature and special teachingequipment and strongly recommended that specialattention should be given to this region, particu-larly to those countries whose libraries and teachingequipment were lost or destroyed as a result of wardevastation. Several members asked for lists ofbooks to aid them in making selections.

11.2.13 Medical Supplies. The sub-committeeadopted the following draft resolution :

The Regional CommitteeRECOMMENDS that, with a view to assisting

the governments of the South-East Asia Regionin making themselves largely self-sufficient inrespect of medical supplies, including insecti-cides, biological products, galenical preparationsand synthetic drugs, WHO should depute asmall group of experts to survey the needs ofindividual countries and their existing resourcesin raw materials, technical personnel, and insti-tutions capable of assisting in the production ofsuch medical supplies, including the readiness ofgovernments to participate in such projects, andto draw up a programme of development basedon co-operative effort by these governments.The programme should take into consideration

the need for facilitating a free flow of the availableraw materials for drug production between thedifferent countries and for a distribution of thecentres of production in a manner designed topromote the optimum conditions for the manu-facture of the various products. In the begin-ning attention should be concentrated on theproduction of insecticides, sulfa drugs, peni-cillin, streptomycin and synthetic antimalarialdrugs.

11.2.14 Programme for 1951. The sub-committeefavoured the retention of the existing six priorityitems of programme established by the First WorldHealth Assembly, and was against altering oradding to these for the present. There was generalagreement that the programme for 1951 shouldfollow broadly the lines of the 1950 programme.The sub-committee was particularly in favour ofintensifying malaria control during 1951 especiallyin relation to food production. The sub-committeeemphasised the need for WHO to assist in estab-lishing or strengthening national training centreswhich would be available for the training of healthpersonnel within the entire region.

12. Date and Place of Next Meeting

The committee decided to hold its next meetingin Colombo (Ceylon), the date to be fixed by theRegional Director in consultation with the chair-man, according to the rules of procedure.

[From EB 5/25 and EB 5/25 Add. 1]28 November 1949 and 3 January 1950

Annex 12

REGIONAL ORGANIZATION FOR THE AMERICAS(PAN AMERICAN SANITARY ORGANIZATION)

SUMMARY OF RESOLUTIONS AND DECISIONS OF THE EIGHTH MEETINGOF THE EXECUTIVE COMMITTEE AND OF THE THIRD MEETING OF THE DIRECTING COUNCIL

The eighth meeting of the Executive Committeeof the Pan American Sanitary Organization washeld in Lima, Peru, from 3 to 5 October 1949,under the chairmanship of Dr. Alberto Zwanck(Argentina). Dr. Carlos Luis González (Venezuela)was elected vice-chairman, and Dr. Miguel E.Bustamente secretary.

In the final plenary session, held on 5 October1949, the committee adopted the following resolu-tions and decisions.

See item 5.6.1 of the Board's report.

1. Programme and Budget for 1950 - PanAmerican Sanitary Bureau

Whereas after the study of the programmeand budget of the Pan American SanitaryBureau, the seventh meeting of the ExecutiveCommittee (May 1949) recommended U.S.$ 2,000,000.00 as a global sum, as proposedby the delegate of Venezuela, suggesting thatthe Director of the Pan American SanitaryBureau prepare a detailed statement contain-ing the motives and the budget relating tosame for presentation to the Directing Council ;and

ANNEX 12 53

Whereas in the eighth meeting of the ExecutiveCommittee (October 1949) it was found that thedetailed statement regarding the budget sub-mitted by the Director was in general accordancewith the provisions made by the Pan AmericanSanitary Conferences, Directing Councils, andExecutive Committees of the Pan AmericanSanitary Organization,

The Executive Committee

RECOMMENDS

r. That the Directing Council study and givefinal approval to the 1950 budget, on the basisof the detailed statement submitted by theDirector, after careful consideration of the items,for the global sum of U.S. $ 2,000,000.00.

2. That the Directing Council authorize theExecutive Committee to submit to the XIII PanAmerican Sanitary Conference the revision of thesanitary programmes which have been formulatedso far by the Pan American Sanitary Conferences,as well as those recommended by previousmeetings of the Directors of Public Health, ofthe Directing Council, and of the ExecutiveCommittee, and to submit the draft of the newprogramme regarding sanitary activities in theContinent, bearing in mind present scientificprogress, new sanitary techniques, and theresources of the Pan American Sanitary Bureau.

3. That the Directing Council recommend thatthe Executive Committee submit to the XIII PanAmerican Sanitary Conference the working planof the Bureau based on the Pan AmericanSanitary Code, taking into consideration thenecessary co-ordination of world and regionalprogrammes and activities of the World HealthOrganization.

2. Reserve and Emergency Funds - PanAmerican Sanitary Bureau

Whereas the creation of an Emergency Fundand a Reserve Fund for the Pan AmericanSanitary Bureau was decided upon by theDirecting Council of the Pan American SanitaryOrganization in its first meeting, in Buenos Aires ;and

Whereas the Executive Committee expressedits agreement thereto in its seventh meeting heldin Washington,

The Executive CommitteeRESOLVES to recommend that the Directing

Council, in its third meeting in Lima, approvethe project submitted by the Director of thePan American Sanitary Bureau relevant to thecreation of :

1. Emergency Fund. From the free balancesof Bureau cash available at the end of thePan American Sanitary Bureau's fiscal year31 December 1949, U.S. $ 50,000.00 shallbe set aside to be placed in the EmergencyFund of the Pan American Sanitary Bureau.This amount shall be deposited in dollars, orin the form of interest-bearing bonds, in aWashington, D.C. (U.S.A.) Bank ; and the

funds shall be administered by the Director orhis duly authorized representative. Replenish-ment of this fund shall be made throughrepayment by countries receiving goods, orthrough approval by the Executive Committeeof the charge against the general funds of theBureau. The Executive Committee and theDirecting Council shall receive reports on theuse made of the said fund ;

2. Reserve Fund. From the free balances ofBureau cash available at the end of the PanAmerican Sanitary Bureau's fiscal year, 31December 1949, U.S. $ 500,000.00 shall be setaside to be placed in the Reserve Fund of thePan American Sanitary Bureau. This amountshall be deposited in dollars, or in the form ofinterest-bearing bonds, in a Washington, D.C.(U.S.A.) Bank, and the transfer of funds tooperating bank accounts of the Bureau willbe made in each instance with the specificauthorization of the Director. The ExecutiveCommittee and the Directing Council shallreceive the reports on the use made of thesaid fund.

3. Programme and Budget of the WorldHealth Organization and its Regional Officefor the Americas for 1950

Whereas the Directing Council of the PanAmerican Sanitary Organization, when acting asregional committee of the World Health Organi-zation, is authorized to make recommendationsto the Director-General regarding the programmeand budget of the Organization ; and

Whereas the budget of the World HealthOrganization for 1950 has already been approvedby the Second World Health Assembly andincludes a series of activities which concern theWestern Hemisphere,


RESOLVES

1. To recommend to the Directing Council of thePan American Sanitary Organization, in itscapacity as regional committee of the WorldHealth Organization, that it request the Direc-tor-General of the World Health Organization,in accordance with Article 6 of the Agreementbetween the World Health Organization andthe Pan American Sanitary Organization, dated24 May 1949, to devote a reasonable proportionof the budget for regional activities in 1950 tothe normal functioning of the regional office ofthe World Health Organization, and to meet therequests of the American countries ;

2. To recommend to the Directing Council ofthe Pan American Sanitary Organization, asregional committee of the World Health Organi-zation, that it authorize the Director of the PanAmerican Sanitary Bureau to encourage theMember Governments to request the WorldHealth Organization for help in the carrying-out of specific programmes in which they maybe interested, complying with the principlesestablished by the World Health Organization.


4. Programme and Budget of the WorldHealth Organization and its Regional Officefor the Americas for 1951

Whereas the Directing Council of the PanAmerican Sanitary Organization, acting asregional committee of the World Health Organi-zation, has the important function of presentingto the Director-General any suggestions regard-ing the programme and budget of the WorldHealth Organization ; and

Whereas, in order to prepare the budget andprogramme of the World Health Organizationfor 1951, the Executive Board of the WorldHealth Organization must have this informationnot later than November 1949, as it is necessaryto have sufficient time for the formal operationsof procedure and distribution before the meetingof the Third World Health Assembly, whichwill be held in Geneva in May 1950, when theprogramme and budget for 1951 will be approved,


RESOLVES

1. To recommend to the Directing Council ofthe Pan American Sanitary Organization, asregional committee of the World Health Organi-zation, that in its meeting in Lima it take thenecessary measures in order that the ExecutiveBoard of the World Health Organization haveby the said time the suggestions regarding theprogramme and budget of the World HealthOrganization for the Americas for 1951 ;

2. To recommend to the Directing Council thatthe said suggestions be the basis for co-ordinat-ing on a regional level the programmes andbudget of the Pan American Sanitary Bureauwith those of the World Health Organization.

5. Staff Rules - Pan American SanitaryBureau

Whereas the report presented by the specialcommittee appointed by the Director of the PanAmerican Sanitary Bureau, in accordance withResolution IV, Provision No. 1, of the resolutionsof the seventh meeting of the Executive Com-mittee, provides for Staff Rules of the PanAmerican Sanitary Bureau,


RESOLVES to request the Directing Councilto approve the following recommendations madeby the Special Committee on Staff Rules andRegulations :

1. That the Pan American Sanitary Bureauadopt the Staff Rules and Regulations of theWorld Health Organization, suitably modified,with the following exceptions : Regulations 20,27 and 28 ; Rules 550, 61o, 852, 853, 1111,and 1120 ; and all of Section i000, which doesnot apply to the Pan American SanitaryBureau.

2. That the Director continue the studies andnegotiations which are being made regarding

pensions, compensations, and an administra-tive tribunal.3. That when all the pertinent informationmentioned in paragraph i has been obtained,the Executive Committee be authorized todecide on the Regulations and Rules afore-mentioned.4. That until the Executive Committee hasreached a decision regarding paragraph 1,(a) the staff of the Pan American SanitaryBureau continue to participate in the pensionplan of the Pan American Union, (b) thepresent staff insurance plan be continued, and(e) no action be taken concerning the ad-ministrative tribunal.

6. UNICEF -WHO -PASB Programmes to befinanced with Funds from UNICEF forLatin America

The Executive Committee informs the DirectingCouncil that, at present, the countries included inthe United Nations International Children's Emer-gency Fund, World Health Organization, andPan American Sanitary Bureau programmes arebeing visited by representatives of UNICEF andthe Regional Office of the World Health Organi-zation, with the object of preparing agreementsbetween the Governments and UNICEF for thecarrying-out of programmes recommended by theDirector of the Pan American Sanitary Bureau. Itis hoped that the final approval by UNICEF ofthese plans will be given by the Directing Councilof UNICEF about November 1.

7. Canada's Participation

Whereas the XII Pan American SanitaryConference, held in Caracas, Venezuela, recog-nized Canada as a member of future Pan Ameri-can Sanitary Conferences ; and

Whereas it is to be desired that every Ameri-can country form part of the Pan AmericanSanitary Organization,

The Executive CommitteeRESOLVES to express the wish for the incorpora-

tion of Canada into the Pan AmericanSanitary Organization as soon as possible.

8. Participation of the Governments Respon-sible for the Conduct of the InternationalRelations of Territories in the WesternHemisphere

Whereas the Directing Council at its secondmeeting, in Mexico, adopted resolutions regard-ing non.self-governing territories ; and

Whereas the Second World Health Assembly,in Rome, made decisions on the subject ; 2 and

Whereas there are pertinent articles in theConstitution of the World Health Organizationand the Constitution of the Pan American Sani-tary Organization,

a Resolution WHA2.1o3, Off. Rec. World Hlth Org.21, 55

ANNEX 12 55

The Executive CommitteeRESOLVES to submit the problem to the Direct-

ing Council, which will act as the regional com-mittee of the World Health Organization, inorder to determine the manner in which thegovernments responsible for directing the inter-national relations of territories in the WesternHemisphere will participate.

9. Relations with the Organization of Ame-rican States - Pan American SanitaryOrganization

Whereas the draft of the Sub-Committee onRelations for the Agreement between the Councilof the Organization of American States and thePan American Sanitary Organization takes intoaccount the previous draft approved by theExecutive Committee in Resolution IX of theseventh meeting, which took place in Washingtonon 30 May 1949, and the modifications to thesaid draft which were proposed by the Sub-Committee of Inter-American Organizations ofthe Organization of American States on 14 July1949,

The Executive CommitteeRESOLVES to recommend that the Directing

Council approve the wording of the Agreementadopted by the Executive Committee at its eighthmeeting as the Agreement between the Councilof the Organization of American States and thePan American Sanitary Organization.3

10. Agreement between the World HealthOrganization and the Pan American Sani-tary Organization

The Executive Committee, acting as Committeeon Relations, takes pleasure in informing theDirecting Council that the requirements establishedby the XII Pan American Sanitary Conferenceand by the Directing Council in its first twomeetings having been fulfilled, the "Agreementbetween the World Health Organization and thePan American Sanitary Organization" was signedon 24 May 1949 by the respective directors. Thesaid Agreement was approved by the Second WorldHealth Assembly, in Rome, on 30 June 1949, andtook effect officially on i July 1949.

11. Pan American Health Day

Whereas it is convenient that Pan AmericanHealth Day and World Health Day be celebratedjointly, and that this may be done throughoutthe world at a time when the schools of allnations are in session,

The Executive CommitteeRESOLVES to recommend to the Directing

Council that it approve the celebration of PanAmerican Health Day jointly with World HealthDay on 7 April.

3 For the text of the Agreement, see Appendix, p. 61.

12. Modification of the Provisional Agendaof the Third Meeting , Topic IV

Whereas in the provisional agenda of thethird meeting, the following appears : Topic IV.Pan American Sanitary Bureau - Buildingin Washington. Plan for the construction of abuilding for the Bureau in Washington (Execu-tive Committee, seventh meeting, ResolutionVII, paragraph 2) ; and

Whereas the above is related to the determi-nation of permanent headquarters for the PanAmerican Sanitary Bureau, which must be re-solved before proceeding with plans to constructa building in Washington for the Pan AmericanSanit ary Bureau,

The Executive CommitteeRESOLVES to change Topic IV of the provi-

sional agenda to the following : Topic IV. PanAmerican Sanitary Bureau - Determination ofpermanent headquarters for the Pan AmericanSanitary Bureau.

13. Certificates of Immunization against Yel-low Fever

Whereas in accordance with Resolution XVof the seventh meeting of the Executive Com-mittee, held in Washington, the Director of thePan American Sanitary Bureau exchanged viewswith the representatives of the Government ofPortugal during the Second World HealthAssembly in July ; and

Whereas the explanation clarifying the demandfor a certificate of vaccination against yellowfever is based on the fact that Aedes aegyptiexists in the airports of Dakar and Lisbon whereairships in transit between South American andEuropean ports make regular stops ; and,

Since urban yellow fever has not existed onthe American Continent for many years, and,while it is necessary to defend the principlesestablished in matters of international prophy-laxis, the sanitary measures need not inconside-rately hinder the transportation of passengers,

The Executive CommitteeRESOLVES to recommend to the Directing

Council that it instruct the Director of the PanAmerican Sanitary Bureau to take the neccesarysteps to secure the abolition of the requirementof a certificate of vaccination against yellowfever by the Government of Portugal with regardto passengers departing from urban centers inAmerica.

14. Offering of Scholarships by the Govern-ment of Costa Rica

Whereas the representative from Costa Ricahas announced that his country is offering,through the Pan American Sanitary Bureau,which will be responsible for the selection ofcandidates in accordance with the standards setfor scholarships established by the Bureau, sixscholarships for physicians for one year's study inthe Hospital San Juan de Dios, San José, CostaRica ; and


Whereas the scholarships will include thepayment of round trip passage, maintenance,and a stipend of 200 colones monthly,

The Executive CommitteeRESOLVES to thank the Government of Costa

Rica for the scholarships and to recommend thatthe Director of the Pan American SanitaryBureau communicate to the American countriesthe establishment of such scholarships and themanner in which candidates will be selectedthrough the Pan American Sanitary Bureau.

II

The third meeting of the Directing Council ofthe Pan American Sanitary Organization was heldin Lima, Peru, from 6 to 13 October 1949, underthe chairmanship of Dr. Anibal Alvarez López(Peru). Dr. Nacianceno Romero (Chile) waselected vice-chairman, and Dr. Miguel E. Busta-mente and Dr. Jorge Estrella Ruiz, secretaries.

The following resolutions and decisions wereadopted.

1. Programme, Administration and Budgetfor 1950 - Pan American Sanitary Bureau

Whereas the Executive Committee, in itsfinal report of the eighth meeting, in its firstresolution, on the programme and budget of thePan American Sanitary Bureau for 1950, 4 sub-mitted to the Directing Council a budget for aglobal sum of U.S. $2,000,000 with a statementof purposes and itemized classes ; and

Whereas the detailed study carried out duringthe sessions of the Committee on Program,Administration and Budget, and the discussionsand deliberations on the programme submittedon the different items of the budget have indi-cated that it is advisable to reduce the totalamount of the budget and to introduce variousmodifications in the sections included in same ;and

Whereas the present state of development ofthe Pan American Sanitary Bureau is such thatmodifications and reductions can be,made inClasses I, II, and III of the budget Jor 1950without causing undue harm to the normaldevelopment of the specific activities of theBureau,

The Directing CouncilRESOLVES :

r. To approve the budget amounting to$1,742,035.00 for the calendar year of 1950,with reductions of the proposed $2,000,000budget affecting :

(a) Class I in the sum of $52,500.00, inasmuchas it is felt that 15% of the Headquarters

4 See above, p. 52.

administration expenses, as set forth in theDirector's proposed budget, should appro-priately be met by the World Health Organiza-tion, in addition to such other provision asthe World Health Organization may make formeeting expenses of the administration of thePan American Sanitary Bureau as regionaloffice of the World Health Organization withinChapter 3.2 of the 1950 World Health Organi-zation budget ;

(b) Class II in the sum of $139,250.00,having approved the organization and estab-lishment of two zone offices instead of four,which would have meant a new and moreexpanded programme of finance ; and

(c) Class III, in the sum of $66,215.00,pertaining to justified reductions in the Pro-curement Division, and in the Food and DrugSection, and the elimination of the Maternaland Child Health Section, which are expectedto be duly covered by the World HealthOrganization's budget for the Regional Officeof the Americas in the Western Hemisphere ;and the Dental Section, inasmuch as it isconsidered that it is preferable to develop andproperly organize present activities withoutthe creation of new ones.

2. To divide the budget among the four classesas follows :

L Headquarters Adminsitration 297,500.00

II. Zone offices 141,900.00

HI. Central services, field work,and fellowships 602,015.00

IV. Field programmes for the con-trol of communicable diseases " 700,620.00

Total $1,742,035.00

The above items shall be applied for thefinancing of the programme presented by theDirector of the Pan American Sanitary Bureauwith such modifications as have been introducedby the delegates.

3. To authorize the Director of the Pan Ameri-can Sanitary Bureau to transfer funds from oneto another of the above-mentioned items, pro-vided that such transfers will not exceed 10%of the total of the item, informing the ExecutiveCommittee of such action promptly. Sums inexcess of the percentage indicated can beeffected only when the Director obtains previousconsent from a majority of the members of theExecutive Committee.

4. To assign contributions for the collection ofquotas on the basis established by Article No. 6oof the Pan American Sanitary Code.

The 1950 budget of the Pan American SanitaryBureau shall be divided among the MemberGovernments in accordance with the scheduleof contributions adopted by the Council of theOrganization of American States for the budgetof the Pan American Union for the fiscal year1949/50.

ANNEX 12 57

2. Pan American Sanitary Bureau - Emer-gency and Reserve FundsWhereas the Directing Council of the Pan

American Sanitary Organization, in its firstmeeting in Buenos Aires, resolved to arrangefor the allocation of the free balances of thebudget items and the surplus of additionalquotas for the creation of two funds :

(a) an emergency fund, to be used in case ofthe immediate solution of unforeseen emer-gency health problems ;(b) a reserve fund, allocated to insure thenormal operations of the Bureau, to the finan-cing of new programmes or supplementingthose already approved, or for any otherpurpose that the Directing Council may deemnecessary ; and

Whereas the Director of the Pan AmericanSanitary Bureau considers that, in view of thedisbursements made in 1948 and up to Augustof 1949, and the income of 1948 and 1949, it isopportune to determine the amount of thereserve and emergency funds for 1950,

The Directing CouncilRESOLVES

1. To create the Emergency Fund from existingsurplus at the end of the fiscal year of the PanAmerican Sanitary Bureau, 31 December 1949 ;the sum of $50,000 shall be set aside and depo-sited in U.S. dollars in a bank in Washington,D.C. (U.S.A.), and this fund shall be administeredby the Director or by his authorized represen-tative. Reimbursement to the Emergency Fundshall be made by refunding through paymentsfrom countries who may receive materials foremergency services, or by orders approved bythe Executive Committee chargeable to thegeneral funds of the Bureau. The ExecutiveCommittee and the Directing Council shallreceive reports pertaining to the use of suchfunds.

2. To create a Reserve Fund from all freebalances of Bureau cash available at the end ofPan American Sanitary Bureau's fiscal year,31 December 1949 ; any contributions to thebudget of 1949 or previous years received during1950 shall be set aside in the Reserve Fund ofthe Pan American Sanitary Bureau, to be usedas a working capital fund pending decision as toits disposal and the establishment of a permanentWorking Capital Fund by the 1950 Pan Ame-rican Sanitary Conference. This amount shall bedeposited in dollars, or in the form of interest-bearing bonds, in a Washington, D.C. (U.S.A)bank, and the transfer of funds to operatingbank accounts of the Bureau will be made in eachinstance with the specific authorization of theDirector. The Executive Committee and theDirecting Council shall receive the reports onthe use made of the said fund.

3. Programme and Budget of the RegionalOffice of the World Health Organizationfor 1950

Whereas under terms of the Constitution ofthe World Health Organization and the Agree-

5

ment between the Pan American Sanitary Orga-nization and the World Health Organization,signed on 24 May 1949, the Directing Councilof the Pan American Sanitary Organization metas the World Health Organization RegionalCommittee for the Americas on 12 October 1949,and representatives of the United Kingdom,France, and the Netherlands enjoyed full privi-leges ; and

Whereas a relationship was demonstratedbetween the programme and budget of the WorldHealth Organization and of the Pan AmericanSanitary Organization, after a study of thedocuments of the programme and budget for1950 approved by the Second Assembly of theWorld Health Organization, the programme andbudget for 1950 of the Pan American SanitaryBureau, and the third resolution, paragraph I,

of the Executive Committee at its eighthmeeting,5

The Directing Council, as Regional CommitteeRESOLVES

1. To recommend to the World Health Organi-zation that it establish, in the regional office,sections on tuberculosis, malaria, venereal dis-ease, maternal and child health and environ-mental sanitation, and that, through suchsections, the Regional Director consult withMember Governments in order to develop activeprogrammes of technical assistance in thesefields.

2. To recommend to the World Health Organi-zation that an appropriate portion of its fellow-ship funds be allotted to the Region of theAmericas, and that, in the administration ofsuch funds, consideration be given to the valueof training in existing schools and institutionsin all parts of the Americas.

4. Resolution on the Participation of Govern-ments with Non-Self-Governing States orTerritories in the Region of the Americas

The Directing CouncilRESOLVES that the financial participation of

France, Great Britain, the Netherlands, Den-mark, and their dependent territories shall bethe object of correspondence between the Regio-nal Director and metropolitan governments, theDirector presenting the Executive Committeewith the result of li;s investigations, the Execu-tive Committee being further requested to pre-sent a statement to the XIII Conference withrecommendations relating to this matter.

5. Programme and Budget of the RegionalOffice of the World Health Organizationfor 1951

Whereas there exists in the Region of theAmericas the Pan American Sanitary Organi-zation, which carries out its own programmes,and has, in addition, an appropriate officeengaged in health administration ; and

8 See above, p. 53.


Whereas the programmes can be readily deve-loped because of the geography of the regionand the similarity of health problems thatexist in this group of nations ; and

Whereas it is advisable to take advantage ofthe existing technical, economic and adminis-trative services that the Bureau can render toboth organizations, by co-ordinating the pro-grammes to be carried out in the region withthose of the World Health Organization,

The Directing Council, as Regional CommitteeRESOLVES

1. To recommend that the Regional Director,in submitting the programme and budget for1951 to the Director-General of the World HealthOrganization, take into account the aboveconsiderations as they apply to the generalpolicies for this region ; and

2. To recommend that the Regional Directorlikewise consider the requests of Member Govern-ments in certain specific instances.

6. Pan American Sanitary Bureau Staff Rules

Whereas the report presented by the specialcommittee appointed by the Director of thePan American Sanitary Bureau to comply withProvision No. 1, Resolution IV, of the resolu-tions adopted by the Executive Committee inits seventh meeting contains recommendationswhich provide for staff rules of the Pan AmericanSanitary Bureau ; and

Whereas the Executive Committee of the PanAmerican Sanitary Organization, at its eighthmeeting, presented to the Directing Council therecommendations resulting from the detailedstudy of the problem,


r. That the Pan American Sanitary Bureauadopt the Staff Rules and Regulations of theWorld Health Organization duly modified, withthe following exceptions : Articles 20, 27 and28 ; Rules 550, 61o, 852, 853, nil and 1120 ;and all of Section I000, which does not apply inthe case of the Pan American Sanitary Bureau.

2. That the Director of the Bureau continue thestudies and negotiations now being made regard-ing pensions, compensations, and an adminis-trative tribunal.

3. That the Executive Committee be autho-rized to make a decision regarding the Articlesand Rules mentioned in paragraph No. 1, whenall the pertinent information mentioned in thesaid paragraph has been obtained.

4. That until the Executive Committee comesto a decision regarding the above-mentionedparagraph,

(a) the employees of the Pan AmericanSanitary Bureau continue to participate in thepension plan of the Pan American Union,

(b) continue with the present insurance planfor employees, and(c) no provision be made with regard to theadministrative tribunal.

7. Determination of a Permanent Site for thePan American Sanitary Bureau

Whereas the Executive Committee, in itsseventh and eighth meetings, considered theneed for the construction of a building inWashington to house the Pan American SanitaryBureau ; and

Whereas the Executive Committee, in itseighth meeting, realizing that the determinationof a permanent site for the Pan AmericanSanitary Bureau takes precedence over plansfor construction, modified Topic IV on thetentative agenda of the Directing Council toread "Permanent Site of the Pan AmericanSanitary Bureau" ; and

Whereas the conditions under which the PanAmerican Sanitary Bureau was organized 47years ago are not the same,


1. To place the question of the selection ofa permanent site for the Pan American Sani-tary Bureau on the agenda of the XIII PanAmerican Sanitary Conference, to be held inCiudad Trujillo, Dominican Republic, in 1950for final study and decision ; and

2. To appoint a committee to study the ques-tion thoroughly and to report thereon to theConference.

8. Canada's Participation

Whereas the XII Pan American SanitaryConference of Caracas, Venezuela, recognizedCanada as a Member of future Pan AmericanSanitary Conferences ; and

Whereas the Executive Committee expressedthe wish for the incorporation of Canada into thePan American Sanitary Organization as soon aspossible,

The Directing CouncilRESOLVES to confirm the VII Resolution of

the Executive Committee 6 expressing also itswish that the incorporation of Canada into thePan American Sanitary Organization be effectedas soon as possible.

9. Participation of the Governments Respon-sible for the Conduct of the InternationalRelations of Territories in the WesternHemisphere

Whereas the Executive Committee, in Reso-lution VIII of its eighth meeting,6 recommendedthat the Directing Council resolve the manner in

6 See above, p. 54.

ANNEX 12 59

which Denmark, France, the Netherlands, andthe United Kingdom will participate in theDirecting Council ; and

After study of the resolution adopted by theSecond World Health Assembly7 and considera-tion of the statements made by the observersfrom France, the Netherlands, and the terri-tories in the Western Hemisphere under thejurisdiction of the United Kingdom,

The Directing CouncilRESOLVES to invite States Members of the World

Health Organization not having their seats ofgovernment within the Western Hemisphere,which (a) either by reason of their Constitutionconsider certain territories or groups of terri-tories in the Western Hemisphere as part oftheir national territory, or (b) are, responsiblefor the conduct of the international relationsof territories or groups of territories within theWestern Hemisphere, to participate on thesame basis as the American Republics in meet-ings of the Directing Council as regional com-mittee of the World Health Organization.

10. UNICEF / WHO / PASO Programme inLatin America

Whereas the Executive Committee, in itseighth meeting, reported that the countriesconsidered in the UNICEF-WHO-PASO pro-gramme are being visited by representatives ofthe United Nations International Children'sEmergency Fund (UNICEF) and of the RegionalOffice of the World Health Organization, inorder to draw up agreements between theGovernments and UNICEF for carrying outthe programmes recommended by the Directorof the Pan American Sanitary Bureau ; and

Whereas the final approval of UNICEF ofthese plans should be given by the DirectingCouncil of UNICEF about r November 1949,

The Directing Council

RESOLVES to record with pleasure the report ofthe Executive Committee with respect to theprogrammes which should be carried out in LatinAmerica with funds provided by UNICEF.

11. Agreement between the Pan AmericanSanitary Organization and the Organi-zation of American States

Whereas consideration was given to Resolu-tion IX of the Executive Committee in its eighthmeeting,8 the report of the Sub-Committee onInternational Organization of the Council of theOrganization of American States, and the draftAgreement between the Pan American SanitaryOrganization and the Organization of AmericanStates as it was approved on 5 October by theExecutive Committee ;9 and

7 Resolution WHA2.1o3, 011. Rec. World Hlth Org.21, 55.

8 See above, p. 55.9 See Appendix, p. 61.

Whereas the articles of the Charter of theOrganization of American States concerning theinter-American specialized organizations werekept in mind ; and

Whereas consideration was given also to thearticles of the Constitution of the World HealthOrganization concerning the relations betweenthe Pan American Sanitary Organization andthe World Health Organization, and the Agree-ment signed on 24 May 1949 between thesetwo Organizations, which provides that theDirecting Council and the Pan American Sani-tary Bureau shall serve as regional committeeand regional office respectively, of the WorldHealth Organization,


r. To approve the draft Agreement betweenthe Pan American Sanitary Organization and theOrganization of American States.

2. To request the Director of the Pan AmericanSanitary Bureau to transmit a copy of thisdraft Agreement to the Council of the Organi-zation of American States.

3. To authorize the Director to sign the Agree-ment on behalf of the Pan American SanitaryOrganization upon its acceptance by the Councilof the Organization of American States.

4. To appoint a sub-committee of three mem-bers of the Executive Committee to negotiatewith the appropriate representatives of theCouncil of the Organization of American States,with a view to obtaining an agreement on anypoints of difference which may be acceptable tothe two Organizations concerned, in the eventthat the Council of the Organization of AmericanStates does not accept the above-mentioneddraft Agreement approved by the DirectingCouncil. In any such negotiations the saidsub-committee shall bear in mind the discussionof the Agreement which took place in themeeting of the Directing Council.

5. To request the sub-committee to submit areport on the negotiations to the tenth meetingof the Executive Committee, if necessary.

6. To authorize the Executive Committee togive final approval on behalf of the Pan AmericanSanitary Organization to an Agreement with theOrganization of American States.

12. Oath of the Director

Whereas consideration was given to the termsof Article 19 (b) of the Constitution of the PanAmerican Organization, and of Article 37 of theConstitution of the World Health Organizationconcerning the international character of itspersonnel,

The Directing CouncilRESOLVES to interpret the Oath of Office of

the Director of the Pan American SanitaryBureau as allowing him, in matters pertainingto the work of the World Health Organization,to take instructions from that Organization.

6o REPORT OF THE EXECUTIVE BOARD, FIFTH SESSION, PART I

13. Site and Date of the Fourth Meeting

Whereas the XII Pan American Sanitary Con-ference, held in Caracas, Venezuela, in January1947, resolved that the XIII Pan AmericanSanitary Conference would be held in Guatemalain 1950 ; and

Whereas the Government of Guatemala hasofficially announced that it cannot accept theresponsibility of the XIII Pan American Sani-tary Conference ; and

Whereas Article II of the Rules of Procedureand of Debate of the Directing Council of thePan American Sanitary Organization establishesthat the Directing Council is to determine thesite of the next meeting,

The Directing CouncilRESOLVES that the fourth meeting of the

Directing Council of the Pan American SanitaryOrganization shall take place immediately beforeor jointly with the XIII Pan American SanitaryConference, to be held in Ciudad Trujillo, in theDominican Republic.

14. Official Seal

Whereas the Pan American Sanitary Organi-zation has no official seal for its documents,correspondence, or other matters prescribed bylaw ; and

Whereas the Pan American Sanitary Bureauhas been using a seal, the facsimile of whichappears on its publications, correspondence,reports, and other printed material, which hasnot been officially adopted,

The Directing CouncilRESOLVES to approve and adopt, as the

official seal of the Pan American Sanitary Orga-nization, the seal used at present on documentsof the Pan American Sanitary Bureau, recom-mending, also, that the said seal remain in thecustody of the Office of the Secretary-General.

15. Pan American Conferences of NationalDirectors of Health

Whereas the Executive Committee of the PanAmerican Sanitary Organization has recom-mended that the Directing Council express itsviews on the realization of future Pan AmericanConferences of National Directors of Health ; and

Whereas the present constitutional structureof the Pan American Sanitary Organizationprovides for a supreme organ of government,the Pan American Sanitary Conference, which isconvened every four years and serves as aclearing-house for the exchange of informationand ideas concerning the prevention of diseasesand the preservation, promotion, and restitutionof physical and mental health, and furtherprovides for annual meetings of its DirectingCouncil,


1. To recommend to the XIII Pan AmericanSanitary Conference, to be held in 1950, that it

express a conclusive opinion on the advisabilityof abolishing the periodical meetings of theNational Directors of Health, in order to avoiduseless duplication of effort on the part of theMember States ; and

2. To advise the Member States to present, ateach Pan American Sanitary Conference, awritten report, preferably of statistical nature,on the work accomplished between conferences.

16. Pan American and Inter-American Medi-cal Congresses

Whereas it is absolutely necessary to establishadequate standards for organizing national,international and Pan American medical con-gresses, whether official or semi-official, in orderto secure greater benefits through co-ordinationand to avoid duplication of efforts,


RECOMMENDS

1. That, in the organization of their work, thenational medical congresses adopt the standardsset forth by the Co-ordinating Council of Medi-cal Congresses established in Brussels ; and

2. That the Director of the Pan AmericanSanitary Bureau submit to the XIII Pan Ame-rican Sanitary Conference a draft of rules forinter-American or Pan American sanitary confer-ences, official or semi-official.

17. Pan American Health Day

Whereas the World Health Organization in itsSecond Assembly has designated 7 April asWorld Health Day ;10 and

Whereas most of the Member States of thePan American Sanitary Organization belong tothe World Health Organization, and thereforeare subject to the decisions made by it ; and

Whereas the Executive Committee of the PanAmerican Sanitary Organization has recom-mended the approval of the celebration of PanAmerican Health Day jointly with WorldHealth Day ; and has indicated that the Ameri-can States cannot and must not forget thegreat significance in the history of continentalhealth of the date of 2 December 1902, when theFirst Pan American Conference was held,


RESOLVES

1. To approve the celebration of World HealthDay on 7 April ; and

2. To remind its Member States that 2 Decem-ber 1902 is the date when the activities ofthe Pan American Sanitary Organization wereinitiated.

" Resolution WHA2.35, Off. Rec. World Hlth Org.21, 27

ANNEX 12

18. Certificates of Immunization against Yel-low Fever

Whereas, in accordance with Resolution XVadopted by the seventh meeting of the ExecutiveCommittee, held in Washington from May 23-30,

1949, the Director of the Pan American SanitaryBureau exchanged views with the representativesof the Government of Portugal, during theSecond World Health Assembly (Rome, June-July, 1949), and the said representativesbased the demand for a certificate of vaccinationor immunization against yellow fever on thefact that Aedes aegypti exists in the airports ofDakar and Lisbon where airships from SouthAmerica make regular stops ; and

Since urban yellow fever has not existed onthe American Continent for many years, and,while it is necessary to defend the principlesestablished in matters of international prophy-laxis, the sanitary measures need not inconside-rately hinder the transportation of passengers,

The Directing CouncilRESOLVES to instruct the Director of the Pan

American Sanitary Bureau to take the necessaryofficial steps to secure the abolition of the requi-rement of a certificate of vaccination againstyellow fever by the Government of Portugalwith regard to passengers departing from urbancentres in America.

19. Permanent Representatives to the Execu-tive Committee

The Directing CouncilRESOLVES to recommend to the Governments

of the American States comprising the ExecutiveCommittee that its delegates to this Body be,if possible, the same persons who attended thesession when such countries were elected, inorder to maintain unity of purpose in dealing

with the problems confronted by the Committee,and in order that the deliberations can renderthe most satisfactory results for the benefit ofhealth in America.

20. Annual Report of the Directing Councilto the Member Governments

After hearing the draft of the annual reportpresented by Committee III,

The Directing CouncilRESOLVES to approve this report, which will

be sent to the Member Governments, in accord-ance with the dispositions of Sub-Division E ofArticle VIII of the Constitution of the PanAmerican Sanitary Organization.

21. Periodical Meetings of the Directing Coun-cil and of the Executive Committee

The Directing Council expressed its opinion infavour of holding meetings of the DirectingCouncil every two years, one regular annualmeeting of the Executive Committee, and, incase of necessity, a special meeting of the Com-mittee to be convened by the Director of thePan American Sanitary Bureau, and includingthis matter in the agenda of the XIII PanAmerican Sanitary Conference for study andeventual amendment of the pertinent articlesof the Constitution of the Pan American SanitaryOrganization now in effect.

22. Election of Member Countries to the Exe-cutive Committee

The Directing Council elected El Salvador,the United States of America, and Peru to fillthe vacancies on the Executive Committeecreated by the termination of the periods ofoffice of Brazil, Costa Rica, and Mexico.

Appendix

DRAFT AGREEMENT BETWEEN THE COUNCIL OF THE ORGANIZATION OF AMERICAN STATESAND THE PAN AMERICAN SANITARY ORGANIZATION

(Approved by the Eighth Meeting of the Executive Committee of the Pan American Sanitary Organizationon 5 October 1949) n

Whereas the Charter of the Organization of AmericanStates stipulates that it is the duty of the Council of theOrganization to "conclude agreements with the Inter-American Specialized Organizations to determine therelations that shall exist between the respective agencyand the Organization" and sets forth the provisions thatmay be included in such agreements ; and

Whereas Resolution III of the Ninth InternationalConference of American States authorizes the Council ofthe Organization of American States to make a completesurvey of the status and activities of, and to take certainmeasures with reference to, inter-American organizations ;and

11 See Resolution IX, p. 55.

Whereas the resolution adopted by the DirectingCouncil of the Pan American Sanitary Organization in1947 authorized the Director of the Pan American Sani-tary Bureau to study and plan, in agreement with theDirector-General of the Pan American Union, the neces-sary measures for the maintenance of close relationsbetween the two organizations,

The Council of the Organization of American Statesand the Pan American Sanitary Organization have agreedupon the following :

The Pan American Sanitary Organization acts as aninter-American specialized organization in matters ofhealth and as the regional office of the World HealthOrganization in the Americas.


IIThe Pan American Sanitary Organization shall continue

to enjoy the fullest autonomy in the accomplishment ofits purposes, within the limits of the instruments bywhich it may be governed. The Directing Council of thePan American Sanitary Organization shall always takeinto account the recommendations made by the Councilof the Organization of American States, in accordancewith the provisions of the Charter of the said Organi-zation.

IIIThe Pan American Sanitary Organization shall give

technical advice on matters of public health and medicalcare to the Council of the Organization of AmericanStates and its organs, such as the Pan American Union,upon request.

IV

The Council of the Organization of American States,its organs, and the Pan American Union, shall consultwith the Pan American Sanitary Organization on all .matters of public health and medical care which may bebrought to the attention of the former.

V

The Council of the Organization may send observers,with voice but without vote, to the Pan American Sani-tary Conference, the Pan American Conference of NationalDirectors of Health, the meetings of the Directing Counciland of the Executive Committee of the Pan AmericanSanitary Organization, and to other technical meetingsheld or sponsored by the Pan American Sanitary Organi-zation.

VI

The Pan American Sanitary Organization may sendobservers, with voice but without vote, to the Inter-American Conference, as well as to meetings of the organsand the committees of the Council, when they deal withsubjects of interest to the Pan American Sanitary Orga-nization.

VII

The Council of the Organization of American States andthe Pan American Sanitary Organization may recommend,either one to the other, topics for inclusion in the agendaof any of the conferences and meetings mentioned in thetwo preceding articles.

VIII

The Pan American Sanitary Bureau shall inform theCouncil of the Organization of the proposed dates of thePan American Sanitary Conference, of the meetings ofthe Directing Council and of the Executive Committee,and of such other technical meetings which the SanitaryOrganization may convene or sponsor, in order that theCouncil may make such observations as it deems appro-priate with a view to co-ordinating the dates of suchmeetings with those of other conferences. The programmesand regulations of such meetings shall also be sent to theCouncil for its information.

IX

The Pan American Union and the Pan American Sani-tary Bureau shall maintain a full exchange of information,publications, and documents.

X

The Pan American Sanitary Organization shall transmitto the Council of the Organization of American States theproposed budget for the following fiscal year prepared bythe Executive Committee of the Pan American SanitaryOrganization as soon as it is ready, if possible beforeSeptember 15.

XIThe Pan American Union shall forward to the govern-

ments the budget approved by the Pan American SanitaryOrganization, together with a statement of the quota duefrom each government for the maintenance of the Bureau.

XIIThe Pan American Union and the Pan American Sani-

tary Bureau shall co-operate to the fullest extent possiblein the recruitnient and in establishing standards of com-pénsation of personnel, in the interchange and regulationof personnel, and in the reciprocal use of equipment,facilities and services.

XIIIAdministrative arrangements between the Pan Ameri-

can Union and the Pan American Sanitary Bureau relativeto the receipt and disbursement of funds, and to per-sonnel, library facilities, and the utilization of space,equipment, facilities, and services, shall be made by theSecretary-General of the Organization and the Directorof the Pan American Sanitary Bureau.

XIVThe Pan American Sanitary Bureau shall have the

option of including its employees in the Pan AmericanUnion Retirement and Pension Fund, subject to theprovisions of the plan governing its administration.

XV

The Pan American Sanitary Bureau shall transmitannually to the Council of the Organization a report onthe progress of the work of the Pan American SanitaryOrganization. Such report shall contain a statement ofactivities undertaken during the preceding year, as wellas a report of financial operations, including detailedstatements of receipts and expenditures.

XVIAny basic changes contemplated in the structure of the

Pan American Sanitary Organization or in the basis offinancing shall be reported to the Council of the Organi-zation of American States.

XVIIThe present Agreement shall come into force on an

interim basis on the date on which it is signed by theauthorized representative of the Council of the Organi-zation of American States and by the Director of the PanAmerican Sanitary Bureau on behalf of the Pan AmericanSanitary Organization. It shall come into force on adefinitive basis when approved by the Directing Councilof the Pan American Sanitary Organization.

XVIIIThis Agreement may be revised by mutual agreement

between the Council of the Organization of AmericanStates and the Pan American Sanitary Organization, ordenounced, on three months' notice given by either ofthe contracting parties.

ANNEX 13

[From EB 5/93 Rev. r and EB 5/94]2o and 30 January 1950

Annex 13

GENERAL RELATIONS BETWEEN WHO AND UNICEF

REPORT ON WHO /UNICEF ACTIVITIES

At its fourth session the Executive Board re-quested the Director-General to report to the Boardat its fifth session on the developments under thepolicy outlined in the report of the third sessionof the Joint Committee on Health Policy (UNICEF-WHO. 2 The following report may therefore bemade at this time :

No meetings of the Joint Committee on HealthPolicy have been held since April 1949, since theprogrammes already approved by the committeehave covered all projects presented to WHO forapproval. The next meeting will be held as soonas there are matters to be presented to it for policydecisions.

In the past eight months there has been a largeincrease in the number of health projects which,in accordance with the principles and procedureslaid down by the committee at its third session,have been presented for approval to the Director-General of WHO.

A total of 74 projects are already under way orare approved for action. An additional 6o projectsare in preparation. A detailed summary of projectsby subject and region is attached (see Appendix).The summary shows (i) the great importance ofUNICEF's contribution in the field of child health ;(ii) the stimulating effect of a supply programme ;and (iii) the need for having a single authorityresponsible for the technical approval of healthprojects and programmes.

The provision of supplies to governments byUNICEF for health projects has played a mostimportant role in the promotion of many of theseprojects. The availability of a source of suppliesfor these types of project has repeatedly made itpossible for WHO regional directors to initiatediscussions with governments regarding projects,and to assist in developing the technical aspects ofprogrammes requiring these supplies. It has beenincreasingly demonstrated that WHO can act asthe health agency to provide the technical adviceand assistance in the initiation, approval anddevelopment of projects for which supplies willcome from another source.

As to the actual working arrangements betweenUNICEF and WHO, it has become clear that, ifWHO is to provide prompt technical approval ofspecific projects, it is necessary that it be keptfully informed from the beginning on proposals forhealth projects initiated by UNICEF, or preferablythat it actually undertake the initial planningand consultation with governments on all technicalaspects of requested projects.

1 See item 6.2.1 of the Board's report.2 011, Rec. World Hlth Org. 21, 365 and 22, 44

Many informal conferences have been heldbetween the Director-General and the ExecutiveDirector of UNICEF on the steps needed toimplement most effectively the policies and proce-dures agreed to at the third session of the JointCommittee on Health Policy. A number of stepshave been taken, especially in relation to implemen-tation of UNICEF's programme in South-EastAsia and the Western Pacific ; and more recentlywith respect to the region of the Americas, e.g., anagreed form for a bipartite or tripartite plan ofoperations to be undertaken by the governmentconcerned and by UNICEF and WHO has beendrawn up and put into effect in South-East Asiaand the Western Pacific. The same plan is beingcurrently developed for the Americas.

WHO has strengthened its regional advisorystaff in the South-East Asia Region, and is deve-loping a small staff for the Western Pacific Regionto facilitate advice to governments on the technicalaspects of UNICEF projects. Thus, advisers onMCH, tuberculosis, VD-yaws, malaria and nursingare already, or will soon be, available in each ofthese regions, and also for the Americas.

Furthermore, WHO has assigned a full-timeexperienced medical officer of health to the South-East Asia Regional Office for detail as WHOrepresentative in Bangkok. He will work with theUNICEF Mission to the Far East in implementingthe health aspects of the UNICEF programme.Through this medical officer of health, a realco-ordination of the WHO and UNICEF healthprogrammes for children should be effected.

To assure prompt action on these regional pro-grammes, the Director-General has delegatedauthority to the Regional Director in South-EastAsia to approve plans of operation, while at thesame time the Headquarters technical and admi-nistrative staff are kept currently informed on thetechnical projects and the conditions of the agree-ments as they are being developed. A comparableplan is being worked out for the Regional Officefor the Americas.

Under the arrangement agreed to at the thirdsession of the Joint Committee on Health Policy,UNICEF and WHO are developing appropriateprocedures for the reimbursement of WHO forpersonnel assigned to UNICEF projects, and in afew instances for regional advisers in the specialfields in which UNICEF projects on behalf ofchildren fall.

Reference should be made to the BCG programmethat is now carried out jointly by UNICEF and theDanish Red Cross and its Scandinavian partners(formerly known as the Joint Enterprise). Thisprogramme has been developed with the advice


of the WHO Expert Committee on Tuberculosisand the Joint Panel on BCG Vaccination and Tuber-culosis Testing. The representative of the Scandi-navian partners informed the Executive Board ofUNICEF at its meeting in November 1949 oftheir intention to terminate their activities in theJoint Enterprise on 31 December 1950, or as soonthereafter as campaigns now under way, or forwhich commitments have been made, are termi-nated. No new campaigns will be undertaken bythe Scandinavian partners, other than those towhich they have already committed themselves.

In making this announcement, the representa-tive of the Scandinavian countries expressed theview that BCG vaccination is only one part ofthe tuberculosis control programme, and must beintegrated into such a programme. He furtherstated that the experience gained from Europecannot be applied directly elsewhere. He recom-mended that the BCG vaccination work in countriesoutside Europe should in the future fall under theprophylactic tuberculosis work carried out by otherorganizations, possibly on a regional basis. Hereported that the Scandinavian countries would

also in the future be glad to render any assistancein their power in respect of personnel and profes-sional assistance, but without entering into financialobligations.

The whole question of the technical responsibilityfor BC6- projects is therefore to be reviewed in thenear future. Informal talks have been held betweenthe Executive Director of UNICEF and theDirector-General with respect to the part thatWHO could take in meeting future requests fromgovernments for assistance with BCG programmes.

Special mention should be made of the Children'sCentre, Paris. Following the Resolution adoptedat its fourth session by the Executive Board, 3discussions with UNICEF have led to an exchangeof letters to constitute the agreement betweenUNICEF and WHO on joint assistance for theestablishment of the Children's Centre in Paris.This agreement has now received the approval ofthe four WHO members of the Joint Committeeon Health Policy, as fulfilling the conditions laiddown by the Executive Board.

3 Ofi. Rec. World HUI; Org. 22, 5, item 2.1.2

Appendix

JOINT UNICEF/WHO PROGRAMMES

Projects approved and/or under wayTotal of projectsin preparatory

stageSubject Europe Africa E. Med. area S. Asia-E.area W. Pac. area Area 1

Americasof Total

Malaria 3 - 1 5 - - 9 8Tuberculosis * 41Streptomycin 11 - 1 2 - 14 16

Venereal diseases 7 - - - - 2 9 10Maternal and child health . 5 - - 1 4 - 10 14Nutrition 1 - 1 1 5 - 8 5Environmental sanitation . - - - - - 5 5 l

Health education - - - 1 - 1 2Fellowships ** - - 1 2 7 - 10 3Other communicable dis-

eases 3 - - - - 3 6 1

Miscellaneous 1 - 1 - - - 2(UNRPR)

TOTAL . . . 31 - 5 12 16 10 74 60

* Not including BCG.

II

** Not including group training.

TABLE OF UNICEF FELLOWSHIPS AWARDS DURING 1949(By subjects and countries of origin)

Country Public-healthnursing

Communicablediseases

Maternal and childhealth

Other healthactivities Surgery Total

India - 7 6 1 - 14Indonesia - 2 - - 2Thailand 1 - 3 1 - 5Philippines 1 - 3 2 6

TOTAL . . . 2 9 9 5 2 27

ANNEX 14

[From EB 5/87 and EB 3/1o6]18 and 30 January 1950

Annex 14

SUMMARY OF THE FIRST AND SECOND REPORTS OF THE STANDING COMMITTEEON NON-GOVERNMENTAL ORGANIZATIONS

The Standing Committee on Non-GovernmentalOrganizations held four meetings, on 17, 18, 24and 30 January respectively. The followingmembers were present : Dr. G. H. de Paula Souza(Chairman), Miss K.V. Green and Dr. R. H. Barrett,alternates for Dr. Mackenzie, Dr. E. Tok (replacingDr. H. S. Gear, who had resigned) and Mr. R. I.Villanueva (alternate for Dr. A. Villarama).

1. " Sectional" Non-Governmental Organi-zations

The committee was of the opinion that it wasfor the Board to determine whether or not section-alism in itself is, a priori, a reason against consider-ing an application for official relations, or whetherconsideration should be given to the value of thework of each organization on its merits, andrequested the Board's decision on this matter. 2

2. Working Principles governing Admissionof Non-Governmental Organizations intoRelations with WHO

In accordance with the resolution adopted bythe fourth session of the Executive Board, 3 thecommittee considered the working principles go-verning the admission into relations of non-governmental organizations laid down by the FirstWorld Health Assembly. 4

It was felt that the Board and the committeeshould have greater freedom to exercise theirjudgment regarding the value to the World HealthOrganization of the work of an organization whichwas to be brought into official relations with WHO.In its second report, the committee recommendedthat the working principles should be amended asfollows : 5

(1) Criteria to be fulfilled before a Non-Govern-mental Organization becomes Eligible to beconsidered for Relationship with the WorldHealth Organization under Article 71 of theConstitution

The World Health Organization should, inrelation to non-governmental organizations, act inconformity with any relevant resolutions of theGeneral Assembly or Economic and Social Council

I See item 6.4 of the Board's report.See decision taken by the Board at its tenth meeting,

23 January 1950, item 6.4.1 of the Board's report.3 011. Rec. World Huh. org. 22, 74 011. Rec. World Hlth. Org. 13, 326-3275 Approved by the Board at its 24th meeting, 31 January

1950, item 6.4.2 of the Board's report.

of the United Nations, and the following criteriashould be met before an organization can beregarded as eligible to be considered for relation-ship :

(i) The organization shall be concerned withmatters falling within the competence of the WorldHealth Organization.

(ii) The aims and purposes of the organizationshall be in conformity with the spirit, purposesand principles of the Constitution of the WorldHealth Organization.

(iii) The organization shall be of recognized stand-ing and shall represent a substantial proportion ofthe persons organized for the purpose of partici-pating in the particular field of interest in which itoperates. To meet this requirement, a group oforganizations may form a joint committee or otherbody authorized to act for the group as a whole.

(iv) The organization shall have a directing bodyand authority to speak for its members throughits authorized representatives ; evidence of thisauthority shall be presentea if requested.

(v) The organization shall normally be interna-tional in its structure and scope, with memberswho exercise voting rights in relation to its policiesor action.

(vi) Save in exceptional cases, a national organi-zation which is affiliated to an international non-governmental organization covering the samesubject on an international basis shall present itsviews through its government or through theinternational non-governmental organization towhich it is affiliated. A national organization,however, may be included in the list after consul-tation with, and with the consent of, the MemberState concerned, if the activities of the organizationare not covered by any international organizationor if it offers experience upon which the WorldHealth Organization wishes to draw.

(vii) The organization shall not be sectional.

(2) Procedure for admitting Organizations intoRelationship

(i) The Board's Standing Committee on Non-Governmental Organizations, composed of fivemembers, shall consider information submitted bynon-governmental organizations, voluntarily or byinvitation, and shall make recommendations to theBoard ; it may invite any such organization tospeak before it in connexion with the organization'sapplication. Bearing in mind the desirability ofensuring valuable contributions to the work of the

66 11EPORT Or Tilt EXECUTIVÉ 130Altb, Firm StSSION, PART I

World Health Organization in terms both ofquality and quantity, the committee may recom-mend postponement of consideration or rejectionof an application.

(ii) In accordance with the provisions of Article71 of the Constitution, the government concernedshall be consulted with regard to possible approvalof any national organization.

(iii) The Board, after considering the recommen-dations of the Standing Committee on Non-Govern-mental Organizations, shall decide whether anorganization is to be admitted into relation withWHO.

(iv) The Director-General shall inform each orga-nization of the Board's decision on its application.The Director-General shall maintain a list of theorganizations admitted into relation and this listand any amendments thereto shall be circulatedto the Members of the World Health Organization.

(v) This list shall also be circulated to the chair-men of expert committees, who may make recom-mendations or suggeitions for using the services ofany organization where this seems desirable.

(vi) The Board, through its Standing Committeeon Non-Governmental Organizations, shall reviewthe list biennially and shall determine the desira-bility of maintaining relations with the organiza-tions on the list.

(3) Privileges conferred by Relationship with theWorld Health Organization

(i) The right to appoint a representative toparticipate, without right of vote, in its meetingsor in those of the committees and conferencesconvened under its authority, on the followingconditions :

Whenever the Health Assembly, a committee orconference convened under its authority, discussesan item in which a related non-governmentalorganization is particularly interested, such anorganization, on the invitation of the chairman ofthe meeting or on his acceding to a request fromthe organization, shall be entitled to make astatement of an expository nature, and may, withthe consent of the meeting, be invited by thechairman to make, in the course of the discussionof the item before the meeting, an additionalstatement for purposes of clarification.

(ii) Access to non-confidential documentation andsuch other documentation as the Director-Generalmay see fit to make available through such specialdistribution facilities as the World Health Organi-zation may establish.

(iii) The right to submit a memoradum to theDirector-General, who would determine the natureand scope of the circulation.

In the event of a memorandum being submittedwhich the Director-General considers might beplaced on the agenda of the Health Assembly,such memorandum will be placed before theExecutive Board for possible inclusion in theagenda of the Assembly.

3. Admission into Official Relations with theWorld Health Organization

The Committee discussed various applicationsfor relations with WHO, and decided to recommendto the Board the adoption of the following resolu-tion : 6

The Executive BoardDECIDES

(I) To establish official relations with the f ol-lowing organizations on the basis of the criterialaid down in Official Records of the World HealthOrganization, No. 13, pages 326-327 : FédérationInternationale Pharmaceutique, InternationalFederation of Housing and Town Planning,International League against Rheumatism ;

(2) To postpone consideration in the followingcases :

(a) International Audiology Conference, untilits organizational character has developedfurther - although great interest was shownin the work of the Conference ;(b) International Society for Blood Transfu-sion, pending further information as to presentstatus of the organization, including finance,and whether or not there is any permanentmembership apart from attendance at con-gresses ;

(c) International College of Surgeons, untilfurther enquiries have been made ;(d) American College of Chest Physicians,pending the result of further enquiries as tothe international character of this organization;(e) Medical Women's International Associa-tion, pending further consideration of itsconstitution in relation with that of the WorldMedical Association, which already has officialrelations with the World Health Organization ;

(3) Not to establish official relations in thefollowing case :International Union against Alcoholism. This isin accordance with the Board's previous decision,7since this organization is mainly concerned withsocial problems and already has consultativestatus with the Economic and Social Council.

6 Approved by the Board, with an amendment toparagraph (3), at its 24th meeting, 31 January 1950.See item 6.4.3 of the Board's report.

7 Off. Rec. World Hlth Org. 22, 6, item 2.3.1

ANNEX 15

[From EB 5/29 and EB 5/29 Add. z]16 January 1950

Annex 15

ESTABLISHMENT OF AN INTERNATIONAL CODE OF DEONTOLOGY

Text of Letter from the World Medical Association to the Director-General of WHO,dated 9 November 1949

Dear Dr. Chisholm :

I am enclosing herewith in three languages the International Code of Medical Ethics which wasadopted at the Third General Assembly of the World Medical Association in London, in October,1949.2

This Code has been submitted to the national medical associations of the world. Up to the present,ten such associations have signified their approval of this Code.

In connexion with the letter from Dr. W. P. Forrest, dated July 27, 1949, I am, therefore, informingyou of this official Code.

It is the feeling of the World Medical Association that, since it is an Association of national medicalassociations and therefore can speak for them and through them for the practising physicians of theworld, it is the only organization which can draft such a Code and have it accepted by the profession.

I hope, therefore, that your Executive Board will give approval to this Code and help to publicizeit throughout the world.

I have sent a copy of this Code to the International Council of Nurses in compliance with theirrequest.

Sincerely yours(Signed) Louis H. BAUER, M.D.,

Secretary-General

Appendix

INTERNATIONAL CODE OF MEDICAL ETHICS

Duties of Doctors in General

A doctor must always maintain the highest standardsof professional conduct.

A doctor must not allow himself to be influencedmerely by motives of profit.

The following practices are deemed unethical :(a) any self-advertisement except such as is expresslyauthorized by the national code of medical ethics ;(b) taking part in any plan of medical care in whichthe doctor does not have professional independence ;(e) to receive any money in connexion with servicesrendered to a patient other than the acceptance of aproper professional fee, or to pay any money in the samecircumstances without the knowledge of the patient.

Under no circumstances is a doctor permitted to doanything that would weaken the physical or mentalresistance of a human being, except from strictly thera-peutic or prophylactic indications imposed in the interestof the patient.

A doctor is advised to use great caution in publishingdiscoveries. The same applies to methods of treatmentwhose value is not recognized by the profession.

I See item 6.5 of the Board's report.2 See Appendix.

When a doctor is called upon to give evidence or acertificate he should only state that which he canverify.

Duties of Doctors to the Sick

A doctor must always bear in mind the importance ofpreserving human life from the time of conception untildeath.

A doctor owes to his patient complete loyalty and allthe resources of his science. Whenever an examinationor treatment is beyond his capacity he should summonanother who has the necessary ability.

A doctor owes to his patient absolute secrecy on allwhich has been confided to him or which he knowsbecause of the confidence entrusted to him.

A doctor must give the necessary treatment in emer-gency, unless he is assured that it can and will be givenby others.

Duties of Doctors to Each Other

A doctor ought to behave to his colleagues as he wouldhave them behave to him.

A doctor must not entice patients from his colleagues.A doctor must observe the principles of " The Decla-

ration of Geneva " approved by The World MedicalAssociation.


DECLARATION OF GENEVA

Adopted by the General Assembly of The WorldMedical Association at Geneva, Switzerland,

September 1948

At the time of being admitted as member of themedical profession :

I solemnly pledge myself to consecrate my life tothe service of humanity ;

I will give to my teachers the respect and gratitudewhich is their due ;

I will practice my profession with conscience anddignity ;

The health of my patient will be my first considera-tion ;

I will respect the secrets which are confided in me ;

I will maintain, by all the means in my power, thehonour and the noble traditions of the medical pro-fession ;

My colleagues will be my brothers ;I will not permit considerations of religion, nationa-

lity, race, party politics or social standing to intervenebetween my duty and my patient ;

I will maintain the utmost respect for human life,from the time of conception ; even under threat, I willnot use my medical knowledge contrary to the lawsof humanity.

I make these promises solemnly, freely and uponmy honour.

The above International Code of Medical Ethics wasadopted by the Third General Assembly of the WorldMedical Association at London, England, 12 October I949.

Annex 16

AGREEMENT CONCERNING THE PREMISES TO BE USED FOR THE HEADQUARTERSOF THE WORLD HEALTH ORGANIZATION IN GENEVA

The United Nations (hereinafter referred to as"the UN") represented by Mr. Trygve Lie, Secre-tary-General, of the one part ; and

The World Health Organization, (hereinafterreferred to as "the WHO") represented by Dr.Brock Chisholm, Director-General,

of the other part ;

Considering that the First Health Assembly hasselected Geneva as the permanent seat of the WHOafter having consulted with the UN, in accordancewith Article 42 of its Constitution,

Considering that, by virtue of a resolutionadopted in Rome on the 30 June 1949, the SecondWorld Health Assembly has delegated in thefollowing terms full powers to the Executive Boardof the Organization in order to take in the name ofthe World Health Assembly, a final decision :

"The Second World Health Assembly resolvedto delegate to the Executive Board, acting inconcert with the Director-General and subjectto the instruction mentioned ... full powersto take in the name of the World Health Assem-bly the final decision both as to the selection ofthe site and as to the choice of the proposalwhich the Board may deem most advantageousamong the three presented by the Swiss FederalCouncil ... for the provision of the necessaryfunds, up to a limit of 6,000,000 Swiss francsfor the total cost of constructing the building."

Considering that, by virtue of a resolutionadopted by the Executive Board of the WorldHealth Organization on the 16 July 1949, theDirector-General has been authorized to negotiatewith the UN concerning the arrangements to bemade for the premises to be provided for the

I See item 7.2 of the Board's report.

Headquarters' offices of the WHO and to signwith the approval of a Building Committee set upby the Executive Board an agreement in order toimplement such arrangements,

Considering that the said Building Committee onthe 23 January 1950 approved the final draft ofthe present Agreement,

Considering that the Swiss Federal Council hasby a letter dated i February 1950 accepted all thelegal consequences entailed by the stipulations ofthe present instrument in so far as they affect theright of the Swiss authorities created by Articles 4,9 and II of the Agreement between the UnitedNations and the Swiss Confederation on theAriana Site signed at Berne on the II June 1946,and at New York on the i July 1946,

And considering that the Secretary-General ofthe UN has been authorized by resolution of theGeneral Assembly of the UN dated the io Decem-ber 1949 to lease to the WHO premises located inthe Palais des Nations, Geneva (Switzerland) onsuch terms and conditions as the Secretary- Generalmay see fit, provided that any extension or trans-formation of the Palais des Nations necessary toaccomplish this purpose is made by the UN at theexpense of the WHO,

HAVE AGREED TO THE FOLLOWING PROVISIONS :

Article IConstruction of premises

r. The UN hereby undertakes to proceed as soonas possible to extend the Palais des Nations locatedat Geneva (hereinafter referred to as "the Palais")and to carry out internal transformations thereinin accordance with the plan referred to in para-graph 2 of this Article.

2. The plans of such extension and transformationare set forth in Annex A, and this annex shall form

ANNEX 16 69

part and parcel of this Agreement. The details ofthe plans shall be settled by agreement betweenthe parties.

Article IIFinancing of works

1. The WHO shall provide the UN with the fundsnecessary to finance the work the UN has under-taken to perform in Article I of this Agreement.

2. The cost of such work is estimated at from3,500,000 to 4,000,000 Swiss francs.

3. If this estimate should prove insufficient tomeet the expenses actually incurred by the UN toperform the work described in Article I, the WHOshall provide the UN with the necessary funds tomake up the difference.

4. All monies required to be paid by the WHOunder the terms of this Article shall be paid by theWHO in a manner to be worked out by separateagreement between the parties hereto. In anyevent, the WHO undertakes to make the paymentsrequired under the terms of Article I of thisAgreement in sufficient time to allow the UN tomeet any contractual obligations entered into byit in pursuance of that Article.

Article IIIProperty rights

Title to the Palais as extended and transformedunder Article I of this Agreement shall remainexclusively vested in the UN.

Article IVGrant of lease

1. In consideration of the funds to be paid by theWHO to the UN for the purposes set out in thisAgreement, the UN hereby leases to the WHOand the WHO hereby leases from the UN thepremises described in Annex B, attached hereto,2said Annex B forming part and parcel of thisAgreement, for a period of 99 years at a rental ofone Swiss franc (S.f. i.-) per annum payableyearly in advance commencing with the date thislease comes into force.

2. The date on which the lease shall commenceshall be determined by an exchange of lettersbetween the UN and the WHO.

Article VRenewal of lease

1. The UN hereby grants to the WHO the optionto renew the lease under such conditions as maybe agreed upon between the parties hereto inpreference over any other entity offering to leasethe demised premises from the UN on similarterms to those offered by the WHO.

2. The parties hereto shall consult with oneanother not less than three years before the expi-ration of the 99 year term of this lease with a viewto its renewal on such terms and conditions as maybe agreed upon between the parties having regardto the provision of paragraph i of this Article.

2 Not reproduced in this volume.

Article VIObligations regarding third parties

The UN undertakes to incorporate the rightshereby granted to the WHO in any agreementregarding the Palais concluded with a third partyand in order to ensure the observance thereof theUN shall stipulate that any such third party shallbe under a similar obligation to have subsequentassignees of any such third party observe therights of the WHO.

Article VIIRegistration of lease

The present Agreement in its character as alease shall be entered in the Land Registry ofGeneva in accordance with the provisions ofArticle 260 of the Swiss Federal Code of Obligations(Code Fédéral Suisse des Obligations).

Article VIIIUse of Assembly Hall and other conference rooms

The WHO shall have the right to use the Assem-bly Hall, the Council Chamber and all other roomsin the Palais intended for meetings for such periodsand on such terms and conditions as shall beagreed upon from time to time between the partieshereto.

Article IXUse of the Library

1. The WHO shall be entitled to use the Libraryof the UN in Geneva under the same conditionsas other specialized agencies in accordance withthe terms of the resolution adopted by the Econo-mic and Social Council on 6 July 1949 [Resolution260 (IX) ].2. In addition, the UN shall, in so far as its ownrequirements permit, make available to the WHOstorage space in the Library for such parts of theWHO's own library collections, books, and perio-dicals as are not in current use. Such collections,books and periodicals shall be under the care of theWHO library staff which shall observe the rulesestablished by the UN for the security and properuse of the Library premises.

Article XRights of the International Labour Organization

Having regard to the provisions of Articles VIIIand IX of the present Agreement, the rightsexisting in favour of the International LabourOrganization, under Article 4 of the Agreementsigned on 19 July 1946, concerning the executionof the transfer to the UN of certain assets of theLeague of Nations, are expressly reserved.

Article XIWHO's option on available space

1. Should it prove necessary in the future for theWHO to increase the number of its services orpersonnel, the WHO shall enjoy a prior rightagainst all other organizations other than the UNover such space as may be declared available bythe UN in the Palais as extended and transformed.


2. The provisions of paragraph r of this Articleshall not, however, apply to other organizationsalready accommodated or to be accommodatedin the Palais on terms involving the furnishing offunds by any such organizations for the purpose ofextending or transforming the Palais to providesuitable accommodation for any such organizations.In that event the UN shall decide to which organi-zation the available space shall be assigned dueregard being had to the relative requirements ofthe organizations concerned and to the amount offunds any such organizations have furnished orare prepared to furnish for the extension or trans-formation of the Palais.3. The conditions on which space shall be allo-cated to the WHO in pursuance of paragraphsor 2 of the present Article shall be determined byspecial agreement between the parties hereto.4. Should such additional space not be availableto the WHO in the Palais the UN shall at therequest and expense of the WHO extend or trans-form the Palais so as to furnish the WHO with theadditional accommodation required ; the plans forany such extension or transformation shall beestablished by agreement between the parties.5. In so far as circumstances shall permit, theprovisions of the present Agreement, except asotherwise indicated in this Agreement, shall applyto new accommodations made available to theWHO under paragraph 4 of this Article.6. The provisions of Article XII to XX inclusiveshall apply mutatis mutandis to new accommoda-tions made available to the WHO in furtheranceof the terms of paragraph 4 of this Article.

Article XIIManagement and maintenance

r. The UN shall be solely responsible for themanagement and maintenance of the Palaistogether with its annexes and grounds includingthose parts of the building housing the variousservices of the headquarters of the WHO.2. Without restricting the generality of the provi-sions of paragraph r of this Article, the UN shallin pursuance of the terms of paragraph r furnishthe WHO with such utilities (e.g. gas, electricity,heating, hot and cold water, telephones) as willassure the WHO the normal enjoyment of thepremises forming the subject of this Agreement.3. The UN shall provide suitable insurance cover-age against all normal risks incidental to theoccupation of the Palais by the UN and the WHO.Without restricting the generality of the foregoingsuch risks shall include fire, theft and damage bywater.4. Subject to the provisions of Article XIV thecosts involved in furnishing any of the items orservices specified in this Article shall be borneby the WHO on a proportionate basis under theterms of a separate agreement to be worked outbetween the parties.

Article XIIIOther conference and general services

r. The UN shall, in order to avoid any duplication,place at the disposal of the WHO all conference

and general services not heretofore provided forunder the terms of this Agreement which arealready in operation or which might be laterinstalled in the Palais.2. The UN shall be solely responsible for theadministration of the services referred to in para-graph r of this Article.3. The services provided for in paragraph r of thisArticle shall be available to the WHO on the basisof equality of treatment with the UN.4. The WHO shall, in addition, have the right toutilize all services of a public nature installed in thePalais, including, without restricting the generalityof the foregoing, the Post Office, the Bank, therestaurant and its annexes.5. The expenses arising out of furnishing theservices referred to in the preceding paragraphs ofthis Article shall be borne proportionately by theWHO under terms to be fixed under separateagreement between the parties hereto.6. Should the UN in agreement with the WHOwish to utilize any particular service provided bythe WHO, the provisions of the present Articleshall apply, mutatis mutandis, to the parties.

Article XIVRepairs

1. Repairs to the Palais including those partsoccupied by the WHO shall be executed by the UN.Minor repairs to the premises necessary to ensurenormal use shall be at the expense of the WHO,while major repairs shall be at the expense of theUN, in accordance with local usage.2. In the event of any cost being incurred due tothe negligence or wilful act of either party, suchcost shall be borne entirely by the.party responsible.

Article XVInterior modifications

Any interior modification desired by the WHOshall be carried out only after agreement with theUN. Furthermore, any such modification shallonly be carried out by the UN and at the expenseof WHO.

Article XVIRight of access to premises

All persons in the service of the WHO or havingofficial business with it shall have right of access tothe premises forming the subject of this Agreementand the grounds of the Palais. All such personsshall also have the right to park their vehicles(motorcars, motorcycles, bicycles) on the sitesreserved for this purpose under the same conditionsas those affecting persons having official businesswith the UN.

Article XVIIMovable property of WHO

r. The WHO shall furnish the premises which itoccupies.2. All movable property acquired by the WHOshall remain under its exclusive ownership, whetherobtained gratuitously or subject to consideration,

ANNEX 17 71

including books, collections, library periodicals,office equipment and furniture other than fixtures.3. All furniture, office equipment and objectsmade available gratuitously to the WHO by theUN, shall be described in a detailed inventorydrawn up and signed by the parties. The saidfurniture, office equipment and other objects shallbe returned on demand to the UN. In such casethe WHO shall be given reasonable notice.

Article XVIIIContinuance of services

Should the UN be compelled to discontinue themaintenance of the buildings or the operation ofthe services mentioned in Articles XII, XIII andXIV of this Agreement the WHO shall have theright to undertake such maintenance and opera-tion in so far as its own requirements shall dictate.

Article XIXArbitration

f. Any dispute which may arise with regard tothe execution or interpretation of the present

IN WITNESS

Agreement shall be referred to a board of arbitra-tors composed of three members.

2. The UN and the WHO shall each choose onemember and the members so appointed shallchoose a third member as presiding arbitrator.

3. In the event of disagreement on the choice ofthe presiding arbitrator, he shall be designatedby the President of the International Court ofJustice.

4. The board may be seized of an application byeither party.

5. The board shall determine its own procedureand its decisions shall be final and executory.

Article XX

Authentic text

This Agreement has been executed in quadrupli-cate ; two copies are in French and two copies inEnglish, of which the French text alone shall beauthentic.

WHEREOF, the parties hereto have signed this agreement.

For the United Nations :

(Signed) TRYGVE LIE

this fifteenth dayof February 1950 at Lake Success.

Annex 17

For the World Health Organization :

(Signed) BROCK CHISHOLM, M.D.

this tenth dayof February 1950 at Geneva.


1950 BUDGET : PROPOSED TRANSFERS BETWEEN CHAPTERS WITHINSECTION 3, PART II, OF THE 1950 APPROPRIATION RESOLUTION1

Chapter 3.1 : Operating Supervisory Staff

Original amount appropriatedTransferred to Chapter 3.4 - Advisory and Demonstration

Services to GovernmentsTransferred to Chapter 3.7 - Technical Services

Chapter 3.4 :

Revised appropriation

Advisory and Demonstration Services to Governments

Original amount appropriated- Operating Supervisory Staff

- Technical Training of MedicalTransferred from Chapter 3.1Transferred from Chapter 3.5

and Auxiliary PersonnelTransferred from Chapter 3.7

I See item 7.3.2 of the Board's report.

- Technical Services

Revised appropriation

US $ US $

266,850

153,425113,425

266,850

1,819,870153,425

112,88044,875

311,180

2,131,050


Chapter 3.5 : Technical Training of Medical and Auxiliary Personnel us $ US $

Original amount appropriated 779,380Transferred to Chapter 3.4 - Advisory and Demonstration

Services to Governments 112,880

Revised appropriation 666,500

Chapter 3.7 : Technical Services

Original amount appropriated 1,373,470Transferred from Chapter 3.1 - Operating Supervisory Staff . . 113,425

1,486,895Transferred to Chapter 3.4 - Advisory and Demonstration

Services to Governments 44,875

Revised appropriation 1,442,020

SUMMARY

Original Revisedamount appro-

appropriated priationUS $ US $

3.1 Operating Supervisory Staff 266,850 -3.4 Advisory and Demonstration Services to Governments 1,819,870 2,131,0503.5 Technical Training of Medical and Auxiliary Personnel 779,380 666,5003.7 Technical Services 1,373,470 1,442,020

4,239,570 4,239,570

Annex 18

CURRENCY OF CONTRIBUTIONS

The Director-General has been concerned withthe problem of the currency of contributions sincethe inception of WHO and has been determined tofind some means of overcoming the numerousdifficulties involved in accepting contributions incurrencies other than Swiss francs or US dollars.

The question was discussed at the First WorldHealth Assembly 2 and at the first, second andthird sessions of the Executive Board.3

The Second World Health Assembly passed tworesolutions on this subject 4 and at the fourthsession of the Executive Board the followingresolution was adopted :

The Executive Board(r) REQUESTS the Director-General to enter intocommunication with such governments as maybe appropriate with a view to arranging withthe respective central banks local currencycredits from which to meet the expenditures ofthe Organization, the sums withdrawn from thesecredits to be repaid from contributions in thatcurrency from Member States for the ensuingyear ;

(2) AUTHORIZES the Director-General to makesuch arrangements as he deems desirable hereun-

I See item 7.3.3 of the Board's report.2 CV. Rec. World Hlth Org. 13, 178° Og. Rec. World Hlth Org. 14, 14; 14, 30 ; 17, 204 Resolutions WHA2.58 and 65, Og. Rec. World Hlth

Org. 21, 36, 40

[From E135/22 Rev. 1]27 January 1950

der and to report his progress thereon to thefifth session of the Executive Board. 5

As requested by the Board, the Director-Generaladdressed communications to the appropriategovernments in July and October 1949. At thetime of preparation of this document, no replieshave been received from the Governments ofDenmark and France.

A reply dated 7 December 1949 was receivedfrom the Government of Egypt (Appendix r).The Government of Egypt was supplied with theadditional information requested, and the Directorof the Eastern Mediterranean Regional Office wasrequested to follow up this matter direct. A cablefrom the Director of the Eastern MediterraneanRegional Office was received stating in part :

EGYPTIAN GOVERNMENT . . . PREPARED TO AD-VANCE UP TO THIRTY THOUSAND EGYPTIANPOUNDS TO BE PAID BACK PARTLY BY EGYPTIANPOUNDS EQUIVALENT TO EGYPT'S CONTRIBUTIONAND REMAINDER TO BE REPAID IN DOLLARS.

This proposal cannot be accepted withoutfurther action by the World Health Assembly, sincethe Second World Health Assembly, in ResolutionWHA2.58, established the principle that all Mem-ber Governments should have equal rights inpaying their proportionate share of their contribu-

500. Rec. World Hlth Org. 22, II

ANNEX 18 73

tions in such currencies as might be acceptable.The Organization, therefore, could not agree to aproposal which would give such rights only to theEgyptian Government.

An exchange of correspondence with the UnitedKingdom Government, followed by talks withUnited Kingdom Treasury officials, resulted in acommunication from that Government dated10 January 1950 (Appendix 2).

The requirements set forth in paragraph 2 of theabove letter could not be agreed to by the Organi-zation, since they ran counter to the principleslaid down in the Second World Health Assembly'sresolution WHA2.58 referred to above.

The proposal set forth in paragraph 3 of thisletter, namely, that hard-currency resources shouldbe used for the purchase of sterling, is the procedurenow followed by the Organization. One of themain principles of the plan to borrow currenciesfrom various governments was to make it unneces-sary for the Organization to use its hard currencyfor this purpose, and thus enable Member nationsto pay a portion of their contributions in currenciesother than US dollars or Swiss francs. If theproposal set forth in paragraph 3 were followed,the Organization would not be able to accept partpayment of Member nations' contributions in suchcurrencies.

It will be noted from paragraph 4 of this letterthat it is very doubtful whether the Treasurywould be prepared to implement the scheme.

The Director-General also wishes to bring to theattention of the Executive Board a letter, dated30 May 1949, from Dr. Melville Mackenzie (Appen-dix 3), which indicates that even if the Organiza-tion had at its disposal sterling funds, their usewould be limited, because of the export regulationsof the United Kingdom.

An offer was also received from the Governmentof India, through the Director of the South-EastAsia Regional Office, to advance such funds asmight be required for operations of the Organiza-tion in the South-East Asia Region. Unfortunately,through a misunderstanding, this offer was predi-cated on the asumption that the Government ofIndia would be able to deduct the full amount ofsuch advances from its contributions to the WorldHealth Organization, and as such action would bedirectly opposed to the principle laid down byresolution WHA2.58 of the Second World HealthAssembly, this offer could not be accepted. TheDirector of the South-East Asia Regional Officehas made further enquiries to determine whetherthe Government of India would be willing toadvance the necessary sums even though theamount set off against its contribution would belimited to its proportionate share. Although adefinite reply has not yet been received, informationfrom the Regional Director indicates that it isextremely doubtful whether the Government ofIndia would be interested in advancing suchcredits unless the full amount could be offsetagainst India's contribution.

Meanwhile, in an effort to explore all possiblemeans of putting the plan into effect, the Director-General has enquired of some commercial bankingfirms concerning the possibilities of borrowingvarious currencies needed, through their regularcommercial channels. Attached are extracts from

letters received from the Chase National Bank ofthe City of New York (Appendix 4) and Lloydsand National Provincial Foreign Bank, Limited(Appendix 5).

To summarize the situation, the Director-General wishes to point out that it would appearimpossible to implement the plan as far as sterlingand Straits dollars are concerned, which would ruleout application of the plan to any expendituresmade in the United Kingdom and the Malay Straits(the Singapore Office) . If the negotiations with theGovernment of India prove successful, arrange-ments could be made to provide the necessarycurrencies for the Organization's operation in thatarea. The administration could then borrowthrough commercial channels the French francs,Danish kroner and Egyptian pounds necessary toprovide for the Organization's needs in thosecurrencies.

The Director-General wishes, however, to drawthe attention of the Executive Board to the factthat the total expenditure in rupees, Frenchfrancs, Danish kroner and Egyptian pounds willprobably not exceed $370,000 (which amounts tosome 6% of the sum which the Standing Committeeon Administration and Finance is recommendingfor the time being for expenditure in 1950).

The proportionate share of the contribution ofeach Member Government in each of the fourcurrencies involved would be very small, and it isquestionable if the governments would find thatthe advantages of paying such small amounts in thevarious currencies would warrant the financialarrangements which each government would berequired to make.

The Director-General also wishes to invite theattention of the Board to the fact that export andcurrency restrictions in force in the countriesinvolved might further reduce the amount whichcould be used in local currencies. Export restric-tions in many countries make it necessary forpurchases for export to be paid for in hard currency.Likewise, international travel in many countriesmust be paid for in hard currency. The Director-General therefore finds it difficult to estimate theamount which the Organization might in fact beable to use and accept in currencies other thanUS dollars or Swiss francs.

The Director-General also wishes to point out tothe Executive Board that the application of thisscheme would involve a heavy additional adminis-trative burden on the Secretariat in making arran-gements for borrowing the various currencies andin advising the Member Governments of theirshares of repayment, keeping the necessary recordsand ascertaining whether or not the various govern-ments would in fact take advantage of the oppor-tunity of repaying in those currencies.

In view of the many difficulties already encoun-tered in his efforts to implement the plan, theDirector-General wishes for the guidance of theExecutive Board. In any event, the Director-General considers that the problem is of sufficientimportance for him to give it further study. Thisproblem is one in which all the specialized agenciesand the United Nations are interested and it is tobe studied by the Administrative Committee onCo-ordination.


Appendix 1

Text of a Letter from the Egyptian Ministry of Public Healthto the Director-General of WHO, dated 7 December 1949

Sir,

Reference your letter dated July 28, 1949, ref. 205-3-25and further to my letter dated 23 ult. regarding the reso-lution of the Second World Health Assembly to acceptpart of the contributions to the operating budget of WHOin local currencies of Member countries, I have the honourto inform you that the Egyptian Government agrees inprinciple to granting credits to WHO on the lines outlinedin your letter, but would appreciate it if informationwith regard to the amount likely to be expended in 1950by the Organization in Egyptian currency could be sentto this Ministry.


(Signed) Dr. Arx YEHIA BEY,for Dr. M. NAZIF BEY, M.D., D.P.H.

Under Secretary ot State,Ministry of Public Health.

Appendix 2

Text of a Letter from the Ministry of Health, United Kingdom,to the World Health Organization, dated .ro January 1950

D ear Mr. Siegel,

r. You wrote to Mr. Lindsay on the 30th Decemberenclosing draft proposals for using sterl ing for expendi-tures in currencies other than United States dollars andSwiss francs.

2. As was promised at the meeting held in Mr. Lindsay'sroom on 28th December, the Treasury have gone into theproposals very carefully to see if they could be acceptedby His Majesty's Government. But it has been foundthat on two points we should have to ask for importantamendments which by theniselves might cause WHO toalter their views on the practicability of the scheme. Inthe first place we should have to insist that instead ofan option for Member countries to pay a percentage oftheir contributions in sterling, there would have to be ageneral rule applying to all Member countries to pay thefixed percentage in sterling obtained from the sale of eachMember's own currency in London. For if the USAcontinued to pay its whole contribution in dollars, theUK would virtually be receiving only soft currencies inpayment for goods for which they would normally receiveSwiss francs or other hard currency.

3. The second essential amendment would be the elimi-nation of the proposal to borrow sterling in Londonagainst dollar collateral. This would mean that thesterling needed to meet the requirements in the firstwould have to be purchased by the sale of Swiss francs ordollars in the normal way and the collection of partcontributions in sterling in subsequent years would haveto be based on estimates and not on actual expenditurein the previous year. The reason for our objecting toborrowing is that under our exchange control regulationsorganizations with headquarters abroad are not permittedto obtain loans against dollar collateral and any sterlingrequired has to be obtained by the sale of foreign currencyto the UK control.

4. But even if WHO considered that the scheme could beamended to comply with these two conditions, the Treasuryare extremely doubtful whether the real advantage to be

derived from part payment of Members' contributions insterling would be sufficient to justify His Majesty'sGovernment taking on the obligation to provide otherforeign currencies and to allow the export of goods forsterling which would normally be paid for in hard currency.For the object to be achieved is to reduce the currencyburden on Member countries by spreading WHO's expen-diture more evenly over both hard and soft currencycountries. A procedure of collecting part subscriptions insoft currency is not essential for this purpose, for it willbe perfectly possible for WHO to lay down a definite policyof buying more in soft currency areas without any suchscheme, and if it is explained to Member countries thattheir burden is being reduced by a more even distributionof expenditure, they should be satisfied that the desiredresult has been achieved by direct means instead ofindirectly through a complicated procedure of budgetingfor and collecting part of each year's expenditure insterl ing.

I am sending a copy of this letter to Mr. Lindsay atGeneva.

Yours sincerely,(Signed) D. BOUCHER.

Appendix 3

Text of a Letter from Dr. Melville Mackenzie to the WorldHealth Organization, dated 30 May 190

Dear Mr. Siegel,

Thank you for your letter of the 12th April, and pleaseaccept my apologies for the delay in replying.

I agree, of course, that the question of the payment ofcontributions towards World Health Organization budgetexpenditure in 1950 in currencies other than US dollarsor Swiss francs will arise at the Second Health Assembly,and also that the Organization can accept only such othercurrencies as it can, in fact, use.

You suggest that, as the Organization will have consi-derable expenditure in the sterling area, it might advanta-geously accept a portion of the contributions by non-sterling area Members in sterling, provided it could usesuch sterling without restriction. I have made enquiries,but I am afraid that it would not be possible to allow theunrestricted freedom you have in mind. As you willappreciate, the use of sterling and the purchase andexport of goods from the sterling area are subject to cer-tain conditions and controls, and any WHO transactionswould, of course, have to follow the normal procedure.

Thus, whilst WHO would normally be permitted to usesterling contributed by sterling area Members to meetexpenditure in the sterling area or to purchase goods forexport, it could not automatically be allowed to use anysterling it might receive from non-sterling area Membersfor these purposes, for such transactions might run counterto the sterling area exchange controls which require thatexports are paid for in the manner appropriate to thecountry to which the goods are being exported.

I have assumed that your letter refers only to normalregular contributions. Any supplementary programmewill be financed on a voluntary basis under which wewould control the use of any sterling contributed bysterling area Members for the purpose.

Yours sincerely,

(Signed) MELVILLE MACKENZIE.

ANNEX 18 75

Appendix 4

Extract from a Letter from the Chase National Bank ofthe City of New York to the World Health Organization,

dated 27 December 1949

We have at last heard from all of our correspondents inconnection with the inquiry set forth in your letter ofNovember 25th as to whether we would be in a positionto make available to you loans in several foreign currenciesduring the year 1950. For your convenience I have at-tached in tabular form the replies which we have receivedand the terms which our correspondents propose. You willobserve that in four out of five cases our correspondentsand the exchange control authorities were willing toauthorize the loan. In two cases, namely, those of Englandand the Straits Settlements, the reply was in the negative.In the case of the Straits Settlements, however, the matterwas left open for further consideration and we have sentthem a further wire, on which we have not as yet had areply.

So that you may have the full story, I will give you,country by country, the propositions which we havereceived.

(i) Egypt. The National Bank of Egypt agrees in prin-ciple, subject to the approval of their Board, to grant WHOoverdraft facilities up to about 35,000 Egyptian poundsfor one year with the unconditional guarantee of Chase toreimburse them in American dollars for any unpaidbalance not repaid in 12 months. The interest rate whichthey propose to charge is 3%.

(2) India. The National Bank of India, Limited, hasreceived exchange control approval, and is prepared toadvance WHO the rupee equivalent of $100,000 as neededduring 1950, to be repaid in 1951, the interest rate to bethe same as the Reserve Bank of India discount rate, thisrate now being 3%, but under no circumstances would therate they charged be less than 3%.

(3) Straits Settlements. The Mercantile Bank of India,Limited, in Singapore informs us that the Straits Settle-ments exchange control will not approve an overdraft.In turning down the request, however, the exchangecontrol stated that they "would not normally grant anoverdraft in the nature of that proposed, but furtherconsideration will be given to the matter if you (TheMercantile Bank) can ascertain the probable duration ofthe overdraft and the reason preventing the transfer of thenecessary funds from the USA " It is apparent that theydid not fully understand the transaction, and for thisreason we are cabling fuller explanations in the hope thatthey may change their minds. We shall advise you uponreceipt of further word from them.

(4) Denmark. Den Danske Landmansbank Hypothek- ogVekselbank Akt. have agreed to advance approximately1,000,000 kroners against the agreement of Chase toreimburse. They propose charging interest at the rate of4.5% per annum until further advice.

(5) France. The Chase Bank, Paris, a branch of a whollyowned affiliate of The Chase National Bank, has receivedpermission from the exchange control authorities to lendWHO up to 7,000,000 francs. As you are probably aware,the French Banking Syndicate puts a floor under interestrates which may be charged by banks operating in France.In this case, the minimum charge permitted would be5.75% interest, plus a commission of 0.05% monthly onthe highest overdraft during that month. As is usual withloans in France, it would be set up on a 90-day basis, butsubject to renewal.

(6) England. The London Branch of the Chase NationalBank took up with the British exchange control authoritiesthe question of their making a sterling loan to WHO, to berepaid out of the future contributions of the British Govern-ment. The British exchange control refused to grantpermission to our Branch to make the loan, on the groundsthat it was the definite policy of the authorities in Englandto discourage loans of this nature, where the borrowingorganization is in a position to provide collateral in theform of hard currencies such as dollars and Swiss francs.They went so far as to say that the official view is thatwhen there is a shortage of other currencies such assterling, provision should be made for their sterling needsby the sale of the hard currencies. The official in questionwent on to say that this was not a case where facilitieswere required to tide them over for a few months pendingreceipt of sterling contributions, pointing out that therepayment might not be forthcoming until the end of 1951.Our London manager sought to make clear the distinctionbetween WHO, which is an international and charitableorganization, and commercial corporations, in an effortto persuade the exchange control that an exception mightproperly be made in this case. The reply was that thepolicy enunciated was entirely in accord with the Treasury'sestablished practice, and that a number of applications ofthis nature from other similar organizations had also beenrefused. It would appear, therefore, that for the presentat least the answer we received is final, unless you cansuggest some other approach.

In addition to the charges made by our correspondents,our charge for guaranteeing the foreign loans and forhandling the transaction will be a flat commission of 1/2of i %. In connection with the French franc loan, whichwould be handled by our own Paris Office, however, weshall be glad to waive all charges in New York.

I hope that this will give you a clear picture of what canand cannot be done. If your Executive Board decides infavour of borrowing in the countries where loans areauthorized, we should be very pleased to handle the trans-actions for you. Please be sure to let me know if there areany questions which remain unanswered.

II

Extract from a Letter from the Chase National Bank ofthe City of New York to the World Health Organization,

dated 13 January 1950

We have just received a cable from the Mercantile Bankof India in Singapore reporting that despite our furtherexplanations as to the purpose of the loan to you in Straitsdollars, the exchange control has refused to give theirapproval. The situation stands therefore as described inmy letter of December 27th.

Text ofForeign

Appendix 5

a Letter from Lloyds and National ProvincialBank, Limited, to the World Health Organization,

dated 14 January r95o

Dear Sir,

We refer to your letter of 21st December, Ref. : F 8-xLloyds, Geneva, and are now in a position to confirm thetelephone conversation which we had with Mr. Riley twodays ago.

You will appreciate that we have had very little time inwhich to negotiate for modifications or improvements, but


our enquiries by cable and letter have resulted in thefollowing offers :

Pounds sterling. Owing to the attitude of the Bank ofEngland we are unable to offer.

French francs. Agreement in principle has been obtainedfrom the Office des Changes, Paris, for an advance of about7,000,000 French francs for a period of one year. Therate quoted was 6.5% to 7.5%.

Danish kroner. The Danish control's permission to makean advance of the Danish equivalent of US $150,000 hasbeen obtained, facilities to be operative for the financialyear of Ig5o, subject to termination by the lenders givingone month's notice. Rate of interest 5.5% per annumfree of commission.

Strait dollars. Control authority has not been obtained ;we are unable to offer.

Indian rupees. We have Bombay agreement to grantoverdraft facilities to the extent of the equivalent of

US $ roo,000. Rate of interest 4% per annum. Detailsremain to be finalised, and the offer is subject to anenquiry on proposed facilities submitted by the ChaseBank, New York, about a month ago.

Egyptian pounds. Egyptian control authority for over-draft facilities for Egyptian £35,000 obtained, subject toproviso that repayment will be received in Egypt in USdollars if the overdraft is not settled within 12 months.Rate 4% per annum.

It will be understood that the above offers are madesubject to final confirmation, and if the Executive Boardof the World Health Organization decide to use ourservices we shall, of course, endeavour to arrange betterterms if possible. We are at your disposal to amplify thesubmissions and to assist in every way possible.

Yours faithfully,

Annex 19

(Signed) N. HAMPTON,Manager.


EXTRACTS FROM THE REPORT OF THE UNITED NATIONS ADVISORY COMMITTEEON ADMINISTRATIVE AND BUDGETARY QUESTIONS ON THE BUDGET OF WHO

FOR 1950 '

1. The Charter of the United Nations provides inArticle 17, paragraph 3, that "the General Assem-bly shall consider and approve any financial andbudgetary arrangements with specialized agenciesreferred to in Article 57 and shall examine theadministrative budgets of such specialized agencieswith a view to making recommendations to theagencies concerned".

2. At the first part of its first session, the GeneralAssembly resolved that the Advisory Committeeon Administrative and Budgetary Questions should,as one of its functions, "examine on behalf ofthe General Assembly the administrative budgetsof specialized agencies" (resolution 14 (I) A of13 February 1946).

3. The agreements between the United Nationsand the undermentioned agencies provide forconsultation with the United Nations in the pre-paration of their budgets, and for transmittal ofthe budgets for examination by the GeneralAssembly :

International Labour Organization, United Na-tions Educational, Scientific and Cultural Orga-nization, Food and Agriculture Organization,International Civil Aviation Organization, WorldHealth Organization, International Refugee Or-ganization, Universal Postal Union and theInternational Telecommunication Union.

I Dated 6 October 194.g. See item 7.3.4 of the Board'sreport.

4. The agreements concluded with the Interna-tional Bank for Reconstruction and Developmentand the International Monetary Fund provideexceptionally that "in the interpretation of para-graph 3 of Article 17 of the Charter, the UnitedNations will take into consideration that the Bank(Fund) does not rely for its annual budget uponcontributions from its members, and that theappropriate authorities of the Bank (Fund) enjoyfull autonomy in deciding the form and contentof such budget".

5. Accordingly, the Advisory Committee, at thefirst part of its third session of 1949, reviewed theadministrative budgets for 1950 of ILO, UNESCO,FAO, ICAO, WHO and IRO, with the assistanceof representatives of the agencies concerned. Inthe case of UPU, only the preliminary budgetestimates were submitted to the committee. Noestimates were available from ITU and, in conse-quence, the committee confined itself to examiningthe relevant portions of the annual report presentedby this agency to the ninth session of the Economicand Social Council.

6. Details of the budgets or budgetary estimatesof the United Nations and certain specializedagencies appear in information Annex IV to theSecretary-General's budget estimates, as requiredby the provisional financial regulations. Thegross totals proposed in the 1950 budgets areshown in the following summary, together with

ANNEX 19 77

the corresponding figures for the preceding finan-cial year : 2

1949US dollars

1950US dollars

International Labour Organiza-tion 5,185,539 6,023,526

United Nations Educational,Scientific and Cultural Orga-nization 7,780,000 8,847,000

Food and Agriculture Organiza-tion 5,000,000 5,000,000

International Civil Aviation Or-ganization 2,655,685 2,937,607

World Health Organization . . 5,600,000 3 7,501,500 eInternational Refugee Organiza-

tion 4,797,800 4,500,000 5

Sub-total (specialized agen-cies) 31,019,024 34,809,633

United Nations 43,487,128 44,314,398Grand total 74,506,152 79,124,031

7. Contributions from Member States to the i95obudgets of ITU and UPU will, it is anticipated,add approximately $1,200,000 to the above totalfor 1950. In addition, the operational budget ofIRO for the year ending 30 June 1950 has beenapproved at a figure of 8140,932,118, while thesupplemental operating programme of WHO, asapproved by the Second World Health Assembly,is estimated at $10,624,410.

8. The supplemental operating budget of WHO,to be financed by voluntary contributions, is the"technical assistance" budget of WHO. No otheragency has, as yet, presented a formal "technicalassistance budget" to its annual conference.

9. The Economic and Social Council, at its ninthsession, held in Geneva in July-August 1949,discussed a comprehensive programme of technicalassistance, together with its organizational andfinancial aspects. The recommendations nowbefore the General Assembly, Economic and SocialCouncil resolution 222 (IX), provide that contri-butions to the programme up to the full amountof the first $io,000,000 and 70% of the second$io,000,000 will be made available automaticallyby the Secretary-General of the United Nations onthe following basis : United Nations, 23% ; ILO,11% ; FAO, 29% ; UNESCO, 14% ; ICAO, 1% ;WHO, 22%. Under these recommendations allot-ments would be made through the machineryof a Technical Assistance Board, comprising theexecutive heads of the United Nations and theparticipating specialized agencies. The Board

2 These figures are not strictly comparable, inasmuchas the appropriations in certain cases include provisionfor Reserve Fund. In addition, the treatment of miscel-laneous income is not uniformly similar.

3 As revised by the Second World Health Assembly(1949)

4 Exclusive of the supplemental operating budget.6 Fiscal year runs from i July to 30 June. This total

is also exclusive of the operational part of the IRO budget.

would report to the Council through a TechnicalAssistance Committee, a standing committee ofthe Council. In view of the present status of thisprogramme, the Advisory Committee has notconsidered it necessary to review these proposalsor the specific proposals of any of the agencies, buthas confined itself to the administrative budgetsof the agencies mentioned above.

1o. The committee noted during the examinationof these budgets that a number of hopeful stepshave been taken in administrative and budgetaryco-ordination, although a considerable amountremains to be done. As the committee pointed outin its second report of 1949, three agencies havejoined or are in process of joining the joint staffpension scheme, while seven separate schemes havebeen initiated in other agencies ; four agencies haveagreed to co-operate in the joint system for externalaudit. In addition, progress is evident in achievingcommon financial regulations. Details on thesequestions as well as on strictly budgetary questionsare to be found in the observations on particularagencies in the present report.

One member of the Advisory Committeeconsiders that the specialized agencies shouldmake provision in their budgets for the full reim-bursement of expenditures incurred by the UnitedNations in connexion with offices and administra-tive services placed at their disposal. The com-mittee dissents from this view, and desires to pointout that by resolution 210 (III) the GeneralAssembly decided that the Secretary-Generalshould arrange for "adequate reimbursement".

12. The committee's review of the specializedagencies' budgets was completed prior to therecent revaluation of certain national currencies.It has not therefore been possible to take accountin this report of the effects of the revaluation,which are likely to vary, upon these budgets andthat of the United Nations.

World Health OrganizationUS (lanai s

1950 appropriation 7,501,500(excluding $10,624,410 for supple-mental operating budget)

1949 appropriation 5,600,0001948 actual expenses 4,442,874

42. The Second World Health Assembly approveda regular budget of $7,501,500 for the Organizationin 1950, $7,000,000 of which has been assessed toMembers. Of the balance, $400,000 is availablefrom UNRRA funds and estimated contributionsfor 1949 from new Members and casual incomeaccounts for $101,500. At the same time, theWorld Health Assembly approved a supplementalbudget, now designated as WHO's participation inthe technical assistance programme, of $10,624,410.


43. As stated in paragraph 8 above, the AdvisoryCommittee did not deal with the supplementalbudget, in view of the status of the whole technicalassistance programme. As for the "regular"budget, WHO presented its estimates and appro-priations in two parts, namely, administrative($1,417,875) and operational ($6,083,625), largelyfor the purpose of separating indirect or overheadcosts from the direct or technical service costs,according to a schematic outline adopted by theExecutive Board. The committee noted that thenature of the expenditures in both parts of theregular budget is administrative, that power totransfer between the sections of the two parts isdelegated to the Director-General with the concur-rence of the Executive Board, and that the scale ofcontributions for the whole of the regular budgetis identical.

44. With respect to the general level of expendi-ture of WHO, it is noted that the Executive Boardrecommended to the World Health Assemblybudget estimates in the amount of $8,193,000.The Assembly changed this total to $7,501,500only, by decreasing estimates for meetings by$25,000 and transferring certain items to thesupplemental budget, which is to be financed byvoluntary contributions. Committees of the WorldHealth Assembly emphasized the fact that no partof the programme was being eliminated. Prioritiesin the programme remain substantially the sameas in 1949 except for the increased emphasis on themental health programme.

45. The increase of nearly $2,000,000 in the appro-priations is due in the main to the first full year ofcosts for staff recruited throughout 1949 and theincrease in the number of established posts atHeadquarters from 181 to 215 and in the field from183 to 324. Attention is drawn to the fact that$952,535 is provided in the 1950 estimates for thefull-year operation of four regional offices and thehalf-year operation of two other offices, includinga European regional office. The General Assembly,at its 1948 session in Paris, recommended that acautious approach should be made while the

Headquarters of WHO was being staffed and organ-ized, and that the regional nuclei should, at leastinitially, be small and, where appropriate, co-ordi-nated administratively with regional offices of theUnited Nations and other specialized agencies.

46. On the income side of this budget, specialcircumstances have led to arrears on the 1948budget amounting to $942,001 on 31 August 1949(i9% of the budget). The unpaid balance on the1949 budget amounted to $3,693,337.75 at thesame date (73% of the budget). The Director-General has already informed the Secretary-General of the United Nations of the possibilitythat WHO will not be able to meet its obligation torepay $425,000 to the United Nations WorkingCapital Fund in July 1950. The Advisory Com-mittee believes that this situation deserves theserious attention of all the Members of the UnitedNations and of WHO. The Members of WHOmust be prepared to pay more promptly to supportthe programmes they have approved in the WorldHealth Assembly, to find other sources of financing,or to reduce the number of programmes or thespeed at which they are developed. Some savingsmay be achieved through organization and man-agement studies, but these will be small in relationto the costs of technical services.

47. WHO has availed itself of common conferenceand general administrative services with the UnitedNations and the Interim Commisssion of theInternational Trade Organization in the Palaisdes Nations at Geneva. The committee believesthat this practice results in economies for allorganizations concerned, and is glad to note thatthe decisions regarding the Headquarters space forWHO will facilitate the development of suchservices. The committee hopes that the budgetfor 1951 will indicate the cost to WHO of servicessupplied by the United Nations.

48. The committee notes with satisfaction WHO'sco-operation in the development of common per-sonnel standards, a joint system of audit and itsearly participation in the joint staff pensionscheme.

ANNEX 20 79


Annex 20

ADMINISTRATIVE ADJUSTMENTS AS A RESULT OF REVALUATIONOF CURRENCIES 1

1. The revaluation of currencies by some countriesduring the month of September 1949 has givenrise to certain problems of adjustment in paymentsto be made to staff members and Fellows in thosecountries. Following the revaluation, consultationswere held with representatives of the UnitedNations and other specialized agencies as to theaction they proposed to take in dealing with theseproblems. Staff Regulation 16 provides inter aliathat : "The salaries and allowances of the membersof the staff, other than the Deputy and AssistantDirectors-General, shall be determined by theDirector-General, 'following basically the scales ofsalaries and allowances of the United Nations inthe same or comparable locality. Any deviationsfrom the United Nations scales of salaries andallowances which may be necessary for the require-ments of the World Health Organization shall besubject to the approval of, or may be authorizedby, the Executive Board."

2. Travel per Diem

In the case of travel per diem, the Director-General has made, effective i December, the sameadjustment as that adopted by the United Nations,except that in WHO a reduction has been appliedto the per diem paid to the Director-General,Assistant Directors-General, Regional Directors andDirectors, although the United Nations exceptedthe per diem payments to this group of officialsfrom adjustment. The amount of reduction appliedis 20% in all cases. This figure was adopted by theUnited Nations as a fair overall adjustment whichwould be administratively feasible of application.The extent of revaluation varied from less than10% to as much as 30% and, a very considerablepart of all official travel involves visits to countriesWith differing rates of revaluation. In the interestof administrative efficiency in dealing with travelclaims, it was decided to adopt an average adjust-ment rate. The Director-General concurred in theUnited Nations analysis of the problem in the rateselected and has therefore applied the same to WHOtravel in the appropriate areas. The UnitedNations definition of such areas has also beenaccepted for WHO application and is as follows :

Australia, Austria, Belgium, Burma, Ceylon,LDenmark, Egypt, Finland, France, Iraq, Ireland,


Hashemite Kingdom of the Jordan, Luxembourg,Netherlands, New Zealand, Norway, Portugal,Sweden, Thailand, Union of South Africa,United Kingdom.

3. Salaries and Allowances

The matter of adjusting salaries and allowancesof staff paid in other than local currencies in thissituation is extremely complex. The personalcircumstances of staff members located in reva-luation areas vary widely. Some are nationals ofthe countries in which they are located and pre-sumably have few commitments (except for thedeductions from their salaries for insurance andthe provident and pension fund contributions) inother than their home currencies. Others are ontemporary assignments, with full family commit-ments continuing at home, in some cases in coun-tries where no revaluation has occurred. The onlycompletely fair approach would be an individualadjustment in each case. This is obviously notadministratively practicable.

The United Nations has applied percentagereductions to the total earnings of staff in theseareas, taking into account previous cost-of-livingadjustments. Few of WHO's work locations,however, are included in the United Nations listof cities where cost-of-living adjustments havebeen established and for those which are not soincluded there are not at present available compa-rative cost-of-living data. Furthermore, it was notconsidered equitable to apply an adjustment tothe total earning of staff members in view of(I) the deductions of approximately 7.5% for pro-vident and pension funds and for insurance, and(2) the prevalence of financial commitments incurrencies other than that of the duty station. TheUnited Nations Expert Committee on Salary,Allowance and Leave Systems specifically recog-nized this consideration in its recommendationson cost-of-living adjustment, and suggested thatadjustments should apply only to 75% of salaries.

While specific measurable cost-of-living data arenot available for most WHO work locations,reports from field offices indicate a general increasein living costs in revaluation areas. To whatextent this will continue cannot be predicted, butin any case it did not appear equitable to reduceearnings directly in proportion to the percentageof the revaluation. In recognition of this fact, the

8o REPORT OF THE EXECUTIVE BOARD, FIFTH SESSION, PART I

United Nations established its adjustment rates toallow generally for a io % rise in living costs as aresult of revaluation.

In the light of these several considerations thefollowing minus percentage adjustments are beingplaced in effect as from i February 1950, subjectto confirmation by the Board, with respect to75% of the base salary and to i00% of theinstallation allowance, installation grant and expa-triation allowance of staff members stationed inthe countries listed :

Percentage adjustmentStaff members whose official (deduction) applicablestation is in : to 75% of base salary

Australia 20Belgium ioDenmark 20Egypt 20Finland 20Greece 20Hong Kong 20Iceland 20India 20Iraq 20Ireland 20Israel 20Hashemite Kingdom of the Jordan 20Luxembourg ioNetherlands 20New Zealand 20Norway 20Portugal ioStraits Settlements 20Sweden 20

Staff members whose officialstation is in :

Percentage adjustment(deduction) applicableto 75% of base salary

Thailand 15Union of South Africa 20United Kingdom

(including territories whose cur-rency is based directly on sterling) 20

4. Fellowship Stipends

With respect to fellowship stipends, a uniformreduction of 20% has been applied, effective

December, to all fellowships in the countrieslisted below. Considerations of administrativeefficiency and the temporary nature of the Fellow'sstay in any country dictated a single average rateof reduction, as in the case of travel per diem.Countries in which the reduction is applicable areas follows :

Australia, Belgium, Burma, Ceylon, Denmark,Egypt, Finland, France, Greece, Hong Kong,Iceland, India, Iraq, Ireland, Israel, HashemiteKingdom of the Jordan, Luxembourg, Nether-lands, New Zealand, Norway, Portugal, Sweden,Thailand, Union of South Africa, United King-dom.

5. Other Payments such as Grants, etc.

With respect to other types of payments to bemade by the Organization, e.g. a grant to a labora-tory,- it is contemplated that wherever it is appro-riate, the amount to be paid will take into accountthe effect of revaluation.


Annex 21

RETIREMENT AND PENSION FUND 1

Text of Articles 7 and 8 of the Draft A greement for the Admission of W HOinto the United N ations I oint Staff Pension Fund

Article 7

All payments to be made by the Agency to theFund in accordance with the Regulations shall betreated by the Agency as preferred debts whichshall be satisfied immediately after payment ofsalaries due by the Agency to its staff.

Article 8

Should the Agency for any reason interrupt orcease to make its payments to the Fund as requiredunder the Regulations, the Secretary of the Board


shall promptly report the facts to the Board andthe Board shall determine the date as of whichthe Agency shall be deemed to be in default.The Board shall then cause an actuarial valuationof the Fund to be made in order to determine thesum necessary to make good the Agency's shareof the deficiency, if any, revealed by such valuation,which sum shall then become payable by theAgency to the Fund.

Thereafter, upon the death or cessation ofservice with the Agency of each participant in theemployment of the Agency on the date of default,he or his designated beneficiary shall be paid theactuarial equivalent of the benefit to which he

ANNEX 22 81

would have been entitled under Article ro of theRegulations had he left the service of the Agencyon the date of default.

As soon as the Agency has made the additionalcontributions necessary, as determined by actuarialvaluation, to restore to each such participantremaining in the employment of the Agency duringthe period of default his contributory service

prior to default and during the period subsequentto default, the prospective rights of each participantto the benefit provided in the preceding paragraphshall cease and he shall in lieu thereof be entitledto all the rights of a participant credited in accor-dance with the Regulations with contributoryservice from his last date of participation prior todefault.

[From EB 5/61]30 December 1949

Rule 150. Deleted.

Annex 22

AMENDMENTS TO STAFF RULES

Section 300 is retitled : Performance and Conduct.

The following has been deleted :

310. REPORT AT END OF PROBATIONARY PERIOD : see Rule 132.

Rule 320 is renumbered 310.

The following Rules have been added :

320. REPRESENTATION IN INTERNATIONAL MEETINGS

320.1 Staff members may not act as delegates or observers for, or advisers to, their governments320.2 Staff members are occasionally asked to act at international meetings for national societies

to which they belong. While there is no objection to staff members being members ofnational societies in which they are interested, they may not represent these societies atinternational meetings.

The existing text of Rule 550 has been deleted and replaced by the following :

550. TRIBUNAL

An Agreement has been concluded between the WHO and the ILO for the use of the latter'sAdministrative Tribunal in the settlement of disputes as provided in Staff Regulation 28, pendingdefinitive arrangements regarding the availability of the UN Administrative Tribunal for thispurpose.550.1 Disputes which cannot be resolved internally arising between the Organization and a staff

member regarding the fulfilment of the contract of the staff member, or arising out ofdisciplinary action, shall be referred for final decision to the Administrative Tribunal ofthe International Labour Organization.

550.2 A complaint shall be made in accordance with the Statute of the Tribunal and shall not bereceivable by the Tribunal unless the decision contested is a final decision and theperson concerned has exhausted such other means of resisting it as are open to him underthese Staff Rules and in particular Rules 511 to 532.

550.3 A copy of the Statute of the Tribunal shall be made available by the Personnel Office to anystaff member on request.

Rule 681 has been amended to read as follows :

68r. Entitlement

Within the limits specified in Sections 1200 and 1300, a staff member, upon termination ofappointment, shall receive reimbursement of travel and removal expenses for himself and eligibledependants from his official station to his normal place of residence (or another point designatedby him, provided it involves no greater expense to the Organization) except as provided below :

(a) a staff member who, as a condition of appointment, has waived his repatriation rightsduring the first two years (see Rule 142) ;



(b) staff members transferred from the United Nations or a specialized agency shall retainrights to return transportation under the conditions of any current agreement on transfersbetween the Organization and the other international organizations.

Rule 843.4 has been amended as indicated by the figures in italics :

843.4 Notwithstanding the above provisions as regards the two-year limitation, staff membersentitled to the expatriation allowance whose allowance under the preceding provisionswould lapse in the course of 1950 shall continue to receive the allowance until 31 December1950.

Rule 890. Deleted.

Rule 920 has now become 920.1.

Additional text has been inserted as Rules 920.2 and 920.3. The complete text now reads as follows :

920.1 Records of attendance shall be maintained and shall serve as a basis for salary payments.920.2 A staff member unable to report for duty on a work day shall notify his supervisor of that

fact within four hours after the beginning of the work day if physically able to do so.Failure to give such notification without good reason may result in disciplinary action.

920.3 Staff members absent from duty without explanation in excess of fifteen working dayswill be considered to have abandoned their posts and their contracts will be terminatedwithout indemnity provided that the Organization shall make every reasonable attemptto locate such staff members prior to termination of contract.

Rule 945. Deleted.

Rules 1210-1215 have been amended and renumbered as follows :

1210. APPLICABILITY

1211. The Organization will pay, subject to Travel Rules issued by the Director-General, travel expensesand subsistence allowances for staff members when authorized to travel :

(a) upon appointment ;(b) upon subsequent changes of official station ;

(c) upon official business ;(c1) upon home leave ;

(e) upon termination of appointment.

1212. A staff member whose appointment is for a period of not less than one year or who receives anappointment the length of which added to his previously acquired service totals a period of notless than one year shall be entitled to travel expenses and subsistence allowances for the followingdependants : wife, dependent disabled husband, dependent children and dependent brothers andsisters :

(a) from their place of residence to the staff member's official station in connexion with hisappointment ;

(b) from one official station to another if expenses have been authorized under (a) ;(c) from the staff member's official station to a place in his home country and return when he

is entitled to home leave ;(d) from the staff member's official station to a place designated by him upon termination

of his appointment ;provided that the entitlement under (a), (c) and (d) shall be limited to the cost of such journeysbetween the staff member's "normal place of residence" and his official station at the time thejourney is authorized.

1212.1 Staff members who have brought dependants to their official stations at their own expenseand who subsequently become eligible for payment as herein provided may receivereimbursement for such expenses.

1212.2 The entitlement of a qualified staff member who had no dependants at the time qualifiedand who subsequently acquired one or more dependants shall be the same as if he hadhad such dependants at the time he qualified.

ANNEX 22 83

1212.3 If a staff member had dependants who reside at a location other than that of his officialstation, he is entitled to the travel expenses of such dependants as herein provided, not toexceed the amount payable had they resided at his official station.

1212.4 The Organization will pay under Rule 861.1 (b) transportation expenses in connexionwith approved education grants.

1212.5 Entitlement to travel expenses and subsistence allowances for dependent children and / ordependent brothers and sisters as herein provided will be limited to those within the agedefined in Rule 850.

Section 1500 - Miscellaneous Provisions - has been abolished and Rules 151o, 1520 and 1530have been renumbered as op, 050 and o6o.

Section 1500 is now titled : Computation of Payments.Rules 780, 781 and 782 are renumbered 151o, 1511 and 1512.

The following rules have been added :

1520. CURRENCY OF PAYMENTS

All payments to staff members will be made in such currencies as the Director-General maydetermine.

1530. RATES OF EXCHANGE

Rates of exchange to be used will be determined by the Director-General.

REPORT EXECUTIVE BOARD

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