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WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTE

FIFTY-EIGHTH WORLD HEALTH ASSEMBLY GENEVA, 16-25 MAY 2005

VERBATIM RECORDS OF PLENARY MEETINGS AND LIST OF PARTICIPANTS

' CINQUANTE-HUITIEME, ASSEMBLEE MONDIALE, DELASANTE GENEVE, 16-25 MAl 2005

COMPTES RENDUS IN EXTENSO DES SEANCES PLENIERES ET LISTE DES PARTICIPANTS

GENEVA GENEVE 2006 WHA58/2005/REC/2

WORLD HEALTH ORGANIZATION ORAGNISATION MONDIAL£ DE LA SANTE

FIFTY-EIGHTH WORLD HEALTH ASSEMBLY GENEVA, 16-25 MAY 2005

VERBATIM RECORDS OF PLENARY MEETINGS AND LIST OF PARTICIPANTS

CINQUANTE-HUITIEME ASSEMBLEE MONDIALE DELASANTE GENEVE, 16-25 MAl 2005

COMPTES RENDUS IN EXTENSO DES SEANCES PLENIERES ET LISTE DES PARTICIPANTS

GENEVA GENEVE 2006

PREFACE

The Fifty-eighth World Health Assembly was held at the Palais des Nations, Geneva, from 16 to 25 May 2005, in accordance with the decision of the Executive Board at its 114th session. Its proceedings are issued in three volumes, containing, in addition to other relevant material:

Resolutions, decisions and annex- document WHA58/2005/REC/1

Verbatim records of plenary meetings, list of participants - document WHA5 8/2005/REC/2

Summary records of committees, reports of committees- document WHA58/2005/REC/3

For a list of abbreviations used in these volumes, the officers of the Health Assembly and membership of its committees, the agenda and the list of documents for the session, see preliminary pages of document WHA58/2005/REC/1.

In these verbatim records, speeches delivered in Arabic, Chinese, English, French, Russian or Spanish are reproduced in the language used by the speaker; speeches delivered in other languages are given in the English or French interpretation. The texts include corrections received up to 12 August 2005, the cut-off date announced in the provisional version, and are thus regarded as final.

AVANT-PROPOS

La Cinquante-Huitieme Assemblee mondiale de la Sante s'est tenue au Palais des Nations a Geneve du 16 au 25 mai 2005, conformement a la decision adoptee par le Conseil executif a sa cent quatorzieme session. Ses actes paraissent dans trois volumes contenant notamment:

les resolutions et decisions et l'annexe qui s'y rapportent- document WHA58/2005/REC/1,

les comptes rendus in extenso des seances plenieres et la liste des participants - document WHA58/2005/REC/2,

les proces-verbaux et les rapports des commissions- document WHA58/2005/REC/3.

On trouvera dans les pages preliminaires du document WHA58/2005/REC/1 une liste des abreviations employees dans la documentation de l'OMS, l'ordre dujour et la liste des documents de la session ainsi que la presidence et le secretariat de 1'Assemblee de la Sante et la composition de ses COlUllllSSIOnS.

Les presents comptes rendus in extenso reproduisent dans la langue utili see par 1' orateur les discours prononces en anglais, arabe, chinois, espagnol, franyais ou russe, et dans leur interpretation anglaise ou franyaise les discours prononces dans d'autres langues. Ces comptes rendus comprennent les rectifications reyues jusqu'au 12 aout 2005, date limite annoncee dans leur version provisoire, et sont done consideres comme finals.

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INTRODUCCION

La 58• Asamblea Mundial de la Salud se celebro err e1 Palais des Nations, Ginebra, del 16 a1 25 de mayo de 2005, de acuerdo con la decision adoptada par el Consejo Ejecutivo en su 114a reunion. Sus debates se publican en tres volumenes que contienen, entre otras cosas, el material siguiente:

Resoluciones y decisiones, y anexos: documento WHA58/2005/REC/1

Aetas taquignificas de las sesiones plenarias y lista de participantes: documento WHA58/2005/REC/2

Aetas resumidas de las comisiones y de las mesas redondas e informes de las comisiones: documento WHA58/2005/REC/3.

En las paginas preliminares del documento WHA58/2005/REC/1 figuran una lista de las siglas empleadas en estos volumenes, la composicion de la Mesa de la Asamblea y de sus comisiones, el orden del dia, y la lista de documentos de la reunion.

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CONTENTS

Page

Preface ...... 111

VERBATIM RECORDS OF PLENARY MEETINGS

First plenary meeting

1. Opening of the Assembly ...... 1 2. Address by the Representative of the Secretary-General of the United Nations ...... 2 3. Address by the Representative of the Conseil d'Etat of the Republic and Canton of Geneva ...... 3 4. Address by the President of the Fifty-seventh World Health Assembly ...... 5 5. Musical interlude ...... 7 6. Appointment of the Committee on Credentials ...... 8 7. Election of the Committee on Nominations ...... 9 8. First report of the Committee on Nominations ...... 9 9. Second report of the Committee on Nominations ...... 10

Second plenary meeting

1. Presidential address ...... 13 2. Adoption of the agenda and allocation of items to the main committees ...... 16 3. Announcements ...... 24 4. Reports of the Executive Board on its !14th and !15th sessions ...... 25 5. Address by the Director-General...... 28 6. Invited speakers ...... 33 7. Announcements ...... 39 8. Address by the Director-General (resumed) ...... 40

Third plenary meeting

Address by the Director-General (continued)...... 49

Fourth plenary meeting

Address by the Director-General (continued)...... 80

Fifth plenary meeting

1. First report of the Committee on Credentials...... 111 2. Address by the Director-General (continued)...... 112

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Sixth plenary meeting

Awards...... 143 Presentation of the U:on Bemard Foundation Prize...... 143 Presentation of the Sasakawa Health Prize ...... 144 Presentation of the United Arab Emirates Health Foundation Prize...... 14 7 Francesco Pocchiari Fellowship...... 150

Seventh plenary meeting

1. Announcement...... 151 2. Executive Board: election...... 151 3. Reports of the main committees...... 152 First report of Committee A ...... 152

Eighth plenary meeting

1. Second report of the Committee on Credentials...... 153 2. Reports ofthe main committees (continued)...... 153 Second report of Committee A...... 153 Third report of Committee A...... 154 Fourth report of Committee A...... 159 First report of Committee B ...... 160

Ninth plenary meeting

1. Reports of the main committees (continued)...... 162 Fifth report of Committee A...... 162 Second report of Committee B...... 163 Third report of Committee B...... 163 Sixth report of Committee A...... 164 Fourth report of Committee B...... 164 Seventh report of Committee A...... 165 Fifth report of Committee B...... 166 Eighth report ofCommittee A...... 167 2. Selection of the country or region in which the Fifty-ninth World Health Assembly will be held...... 167

Tenth plenary meeting

Closure of the session...... 169

MEMBERSHIP OF THE HEALTH ASSEMBLY

List of delegates and other participants ...... 175 Representatives of the Executive Board...... 263

Indexes (names ofspeakers; countries and organizations) ......

- Vlll - TABLE DES MATIERES

Page

A vant-propos ...... 111

COMPTE RENDUS IN EXTENSO DES SEANCES PLENIERES

Premiere seance pleniere

1. Ouverture de 1' Assemblee ...... 1 2. Allocution du representant du Secretaire general de !'Organisation des Nations Unies ...... 2 3. Allocution du representant du Conseil d'Etat de la Republique et Canton de Geneve ...... 3 4. Allocution du President de la Cinquante-septieme Assemblee mondiale de la Sante ...... 5 5. Interlude musical ...... 7 6. Constitution de la Commission de Verification des Pouvoirs ...... 8 7. Election de la Commission des Designations ...... 9 8. Premier rapport de la Commission des Designations ...... 9 9. Deuxieme rapport de la Commission des Designations ...... 10

Deuxieme seance pleniere

1. Discours du President de 1'Assemblee ...... 13 2. Adoption de 1' ordre du jour et repartition des points entre les commissions principales ...... 16 3. Communications ...... 24 4. Rapports du Conseil executive sur ses cent quatorzieme et cent quinzieme sessions ...... 25 5. Allocutions du Directeur general ...... 28 6. Intervenants invites ...... 33 7. Communications ...... 39 8. Allocution du Directeur general (reprise) ...... 40

Troisieme seance pleniere

Allocution du Directeur general (suite)...... 49

Quatrieme seance pleniere

Allocution du Directeur general (suite)...... 80

Cinquieme seance pleniere

1. Premier rapport de la Commission de Verification des Pouvoirs ...... 111 2. Allocution du Directeur general (suite)...... 112

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Sixieme seance pleniere

1. Distinctions...... 143 Remise du Prix de la Fondation Leon Bemard ...... 143 Remise du Prix Sasakawa pour la Saute...... 144 Remise du Prix de la Fondation des Emirats arabes unis pour la Saute...... 147 Bourse Francesco Pocchiari ...... 150

Septieme seance pleniere

1. Communication...... 151 2. Conseil executive: election...... 151 3. Rapports des commissions principales ...... 152 Premier rapport de la Commission A...... 152

Huitieme seance pleniere

1. Deuxieme rapport de la Commission de Verification des Pouvoirs...... 153 2. Rapports des commissions principales (suite)...... 153 Deuxieme rapport de la Commission A...... 153 Troisieme rapport de la Commission A ...... 154 Quatrieme rapport de la Commission A...... 159 Premier rapport de la Commission B ...... 160

Neuvieme seance pleniere

1. Rapports des commissions principales (suite)...... 162 Cinquieme rapport de la Commission A ...... 162 Deuxieme rapport de la Commission B ...... 163 Troisieme rapport de la Commission B...... 163 Sixieme rapport de la Commission A...... 164 Quatrieme rapport de la Commission B...... 164 Septieme rapport de la Commission A...... 165 Cinquieme rapport de la Commission B ...... 166 Huitieme rapport de la Commission A...... 167 2. Choix du pays ou de la region ou se tiendra la Cinquante-neuvieme Assemblee mondiale de la Saute...... 167

Dixieme seance pleniere

Cloture de la session...... 169

COMPOSITION DE L' ASSEMBLEE DE LA SANTE

Liste des delegues et autres participants...... 175 Representants du conseil executif...... 263

Index (noms des orateurs ; pays et organisations) ......

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VERBATIM RECORDS OF PLENARY MEETINGS

COMPTES RENDUS IN EXTENSO DESSEANCESPLENIERES

FIRST PLENARY MEETING

Monday, 16 May 2005, at 10:00

President: Mr Muhammad Nasir KHAN (Pakistan) later: Ms E. SALGADO (Spain)

PREMIERE SEANCE PLENIERE

Lundi 16 mai 2005, 10 heures

President: M. Muhammad Nasir KHAN (Pakistan) puis: Mme E. SALGADO (Espagne)

1. OPENING OF THE ASSEMBLY OUVERTURE DEL'ASSEMBLEE

The PRESIDENT:

The Health Assembly is called to order. Distinguished delegates, ladies and gentlemen, as President of the Fifty-seventh World Health Assembly, I have the honour to open the Fifty-eighth World Health Assembly. I now have pleasure in welcoming, on behalf of the Health Assembly and the World Health Organization, our special guests: Mr Sergei Ordzhonikidze, Director-General of the United Nations Office at Geneva, Mr Pierre-Fran<;:ois Unger, Counsellor of State, Head of the Department of Social Action and Health of the Republic and Canton of Geneva, and officials of the Republic, Canton, City and University of Geneva, and of agencies and funds ofthe United Nations system. I also welcome the representatives of the Executive Board. A58NR/1 page 2

2. ADDRESS BY THE REPRESENTATIVE OF THE SECRETARY-GENERAL OF THE UNITED NATIONS ALLOCUTION DU REPRESENTANT DU SECRETAIRE GENERAL DE L'ORGANISATION DES NATIONS UNIES

The PRESIDENT:

Mr Ordzhonikidze, representing the Secretary-General of the United Nations, will now address the Health Assembly.

Mr ORDZHONIKIDZE (Under-Secretary-General of the United Nations, Director-General of the United Nations Office at Geneva, representing the Secretary-General of the United Nations):

Mr President, Director-General, excellencies, ladies and gentlemen, it is a pleasure for me to welcome you all to the Palais des Nations. I have the privilege to convey to you the good wishes of the Secretary-General of the United Nations, Mr Kofi Annan, for the success of this Fifty-eighth World Health Assembly. Health continues to be a central issue on the international agenda, and it is a key concern of the wider United Nations family. The Secretary-General's report, In larger freedom: towards development, security and human rights for all, which outlines concrete proposals for the forthcoming High-Level Plenary Meeting of the General Assembly in September, affirmed health as essential to both security and development. Several of the Millennium Development Goals relate directly to health; improved public health would contribute towards the realization of other Goals as well. These linkages between public health and the wider threats and challenges of the twenty-first century are clearly reflected in the comprehensive agenda before this Health Assembly, and your discussions here will stimulate the forthcoming high-level debates. Despite progress in a number of areas, overall the world is falling short of what is needed to achieve the Millennium Development Goals. As highlighted in The world health report 2005, infant and maternal mortality remains unacceptably high throughout the developing world. As the title of The world health report 2005 indicated, we need to "make every mother and child count", because healthy mothers and children are the bedrock of healthy and prosperous communities. Preventable, and in many cases treatable, infectious diseases continue to ravage developing countries, particularly in sub­ Saharan Africa. While the prevention and treatment of malaria has made some progress, the disease still claims over one million lives a year. As the United Nations General Assembly recognized in its resolution 591256, adopted in December last year, malaria-related ill-health and deaths throughout the world can be eliminated with political commitment and commensurate resources if the public is educated and sensitized about malaria and appropriate health services are made available. HIV I AIDS and tuberculosis continue to pose severe risks for the entire world. Despite increasing political commitment to fighting HIV I AIDS and encouraging signs in a small but growing number of countries, the overall pandemic continues to expand. HIV I AIDS kills more than three million people each year. It undermines social and economic stability and weakens governance and security structures, and hence it poses an unprecedented threat to human development and security. While the number of poliomyelitis cases worldwide has dropped significantly, the fight to eradicate the disease has suffered setbacks recently. It is therefore important to stay focused to ensure that the goal of total eradication is reached. Both familiar and new infectious diseases require a concerted international response. We need to strengthen international health security through better surveillance and monitoring and by strengthening mechanisms for containment. Here we may build on the lessons learnt from the reaction to the outbreak of severe acute respiratory syndrome, which showed that infectious diseases can be contained when effective global institutions, such as WHO, work in close partnership with national health agencies and expert technical institutions. The risk of outbreaks of infectious disease is closely connected with the serious threat of biological terrorism. As the Secretary-General states in his "In larger freedom" report, there will soon be thousands of laboratories around the world capable of producing designer bugs with an awesome lethal potential. We therefore need to strengthen local ASSNR/1 page 3 health systems and ensure that our existing global response mechanisms are adequate. This is why the Secretary-General has urged Member States to provide the Global Outbreak Alert and Response Network with the resources it needs to continue its impressive efforts in monitoring and responding to outbreaks of deadly infectious diseases, whether natural or suspicious. As you recall, the United Nations General Assembly has urged Member States to give high priority to work on the revision of the International Health Regulations. In his "In larger freedom" report, the Secretary-General of the United Nations also called on the World Health Assembly to reinforce these existing mechanisms for timely and effective international cooperation in the containment of outbreaks of infectious diseases. Agreement on a revision would significantly strengthen international health security. The devastating earthquake and tsunami that affected the Indian Ocean on 26 December of last year also presented serious challenges for local and regional health systems. The recent conference in Phuket, Thailand, convened by WHO, drew important lessons from the tsunami response. As the international community works to improve its disaster preparedness and mitigation strategies, we need to ensure that the health dimension, including psychological trauma, is effectively factored in. As I have outlined, tackling the threats and challenges that face the international community - including in the area of public health - calls for firm partnerships among all stakeholders: governments, international organizations, international donors, civil society, the private sector and the media. The provision of vaccinations - one of our most important instruments in the fight against many infectious diseases - is one of the areas where such partnerships have proved to be particularly beneficial, and I hope that we may apply lessons learnt from such partnerships to other areas. Implementation of inclusive strategic frameworks, provision of adequate resources and dissemination of reliable, science-based information need to go hand in hand if we are to turn the advances of science and technology into opportunities for improved health for all. I wish the Health Assembly every success with its deliberations at this critical juncture. Thank you very much.

The PRESIDENT:

Thank you, Mr Ordzhonikidze.

3. ADDRESS BY THE REPRESENTATIVE OF THE CONSEIL D'ETAT OF THE REPUBLIC AND CANTON OF GENEVA ALLOCUTION DU REPRESENTANT DU CONSEIL D'ETAT DE LA REPUBLIQUE ET CANTON DE GENEVE

The PRESIDENT:

I now give the floor to Mr Pierre-Fran<;ois Unger, Counsellor of State, Head of the Department of Social Action and Health of the Republic and Canton of Geneva.

M. UNGER (representant du Conseil d'Etat de la Republique et Canton de Geneve):

Monsieur le President, Messieurs les Directeurs, Excellences, Mesdames et Messieurs les Ministres, Ambassadeurs et delegues, Mesdames et Messieurs, mais surtout chers amis, a 1' occasion de cette Cinquante-Huitieme Assemblee mondiale de la Sante, j'ai le plaisir mais surtout l'honneur de vous souhaiter, au nom des autorites federales, cantonales et communales, une tres cordiale bienvenue a Geneve et en Suisse. Un des messages cles que l'OMS veut transmettre cette annee a nous taus, et a la communaute internationale dans son ensemble, consiste a dire que le bien-etre des societes depend directement de la survie et de la sante tant des meres que des enfants. Lorsque leurs meres restent en vie, lorsqu'elles peuvent s'epanouir, les enfants eux aussi vivent et s'epanouissent. C'est une condition indispensable a la prosperite de nos societes. Lorsque, au contraire, les meres sont malades ou pire decedent, le reste A58NRJ1 page 4 de la famille dans son entier en patit et, au bout du compte, c 'est la communaute dans son ensemble qui souffre. 11 en va evidemment de meme lorsqu'un enfant est malade ou qu'il disparait. Les maladies repetees et la malnutrition, vous le savez bien, affectent la taille, la force, voire le developpement cognitif de I' enfant. C'est finalement sa capacite d'apprendre, de se developper sur le plan complexe bio-psychosocial, sa capacite de travail et done sa capacite d'autonomie qui en realite sont atteintes. II s'agit done d'un enjeu considerable, constitue non seulement d'imperatifs humains, moraux ou ethiques, mais egalement economiques pour le developpement durable. La Banque mondiale avait d'ailleurs, en son temps, estime que, pour chaque dollar investi dans la sante d'un enfant, cela n'etait rien d' autre que sept fois la mise qui etait gagnee grace aux economics realisees dans le domaine tant de la sante et des prestations sociales que de la capacite de l'enfant de s'integrer a la vie active et productive au moment de son passage a l'age adulte. Cela etant dit, il faut helas bien se rendre a 1'evidence : les souffrances et les deces des meres aussi bien que ceux des enfants sont repartis sur notre planete de maniere scandaleusement inegalitaire. Ce sont evidemment, comme d'habitude, dirai-je, les personnes les plus pauvres et defavorisees qui souffrent le plus. Ces deces et ces incapacites resultent essentiellement d'un petit nombre de maladies, qui de surcroit pourraient etre, pour la plupart d'entre elles, prevenues ou traitees facilement. A l'origine de cela: la malnutrition, l'absence d'acces a l'eau, la pauvrete, ]'exclusion sociale, mais aussi le manque d'instruction ou la violence. Par exemple, les femmes qui sont enceintes tres jeunes, qui ont de nombreux enfants, peuvent souffrir de maladies infectieuses endemiques dans certaines regions, et lorsqu'elles sont mal nourries ou anemiques elles ont evidemment une probabilite accrue de mourir. S 'agissant des enfants, la grande maj orite des deces est due a un acces insuffisant a l'eau potable ou encore a la malnutrition, cette derniere, bien entendu, etant comprise comme un manque de nourriture, mais aussi, de plus en plus, comme un mauvais usage de la nutrition lorsque celle-ci est presente. On le sait desormais, l'obesite liee a ce que l'on appelle en franc;;ais la « malbouffe » est reellement elle aussi devenue epidemique. Et pourtant nous disposons aujourd'hui de connaissances et de moyens qui permettraient d'eviter un grand nombre de souffrances et de deces de meres et d'enfants. Malheureusement, une faible part d'entre eux beneficie des interventions a la fois salvatrices et peu couteuses. J'aimerais vous citer un exemple qui sort des generalites dramatiques que je viens d'evoquer, et dans lequel Geneve joue un role important par le biais des programmes de cooperation. L'acces a des soins obstetricaux de qualite, vous le savez, est souvent difficile. Il en resulte frequemment, si ce n'est le deces de la mere et de ]'enfant, des lesions gynecologiques dont les effets sont desastreux a plus d'un titre. C'est le cas, par exemple, de la fistule obstetricale. Les fistules obstetricales trouvent leur origine dans les accouchements qui se passent mal et qui, dans un pays favorise, seraient traites par cesarienne, chose souvent inaccessible pour les femmes eloignees de tout et sans moyens financiers. Le probleme est de nos jours tres important dans les pays les moins avances puisqu'on pense qu'il y a plus d'un million et demi de femmes qui souffrent de ces fistules, avec chaque annee, entre 50 000 et 100 000 nouveaux cas. C'est un sujet tabou, car il touche a l'intimite de la femme: !'incontinence, qui est une forme d'invalidite, induisant un sentiment de honte, et dont il est difficile de parler. Les femmes qui se retrouvent dans cette situation sont exclues, abandonnees de tous et laissees pour compte. Or, actuellement, les capacites des centres chirurgicaux pouvant s'occuper de ce type de maladie ne permettent helas pas de traiter plus de 10% de ces cas. C'est done bel et bien, une fois de plus, la prevention qui reste notre principale arme pour reduire ce probleme. L'acces equitable a !'education est un autre volet important de cette problematique. On le sait bien, quand les filles sont scolarisees, les enfants sont evidemment mieux instruits et en meilleure sante, les deces maternels et infanta-juveniles sont moins nombreux, les perspectives economiques sont plus grandes, les famillesjouissent d'un plus grand bien-etre. Malheureusement, l'UNESCO nous a appris il y a deux ans que deux enfants non scolarises sur trois sont des filles et que deux adultes illettres sur trois sont des femmes. Cela n'est pas tolerable. En fait, pour apporter une reponse satisfaisante aux preoccupations liees a cette problematique, il faut oeuvrer en commun, chacun selon ses moyens, pour atteindre ]'ensemble des objectifs du Millenaire pour le developpement socio-economique. 11 ne faut pas simplement viser les objectifs de reduction de la mortalite infantile et d'amelioration de la sante maternelle, il faut aussi et plus generalement viser ceux de la reduction de l'extreme pauvrete, de la faim, d'une education primaire pour tous, de la promotion de l'egalite des A58NR/1 page 5 sexes et, enfin, de l'autonomie de la femme. Ce sont bien ces mesures qui permettront, par exemple, de ]utter efficacement contre le VIH/SIDA, contre le paludisme ou contre bien d'autres maladies, dans la securite d'un developpement durable. Nous sommes, chacun d'entre nous, les beneficiaires de la creation, quelle que soit l'origine que chacun lui attribue ; nous sommes des lors les garants de sa perennite. Ainsi, assurer une bonne sante aux meres et a leurs enfants n'est pas simplement un devoir humaniste et une obligation ethique pour renforcer la cellule familiale, c'est aussi un investissement indispensable pour tout developpement durable. C'est avec cette conviction que je vous souhaite la plus chaleureuse des bienvenues a Geneve et surtout mes meilleurs voeux pour la reussite de vos travaux. Je vous remercie.

The PRESIDENT:

Thank you, Mr Unger.

4. ADDRESS BY THE PRESIDENT OF THE FIFTY -SEVENTH WORLD HEALTH ASSEMBLY ALLOCUTION DU PRESIDENT DE LA CINQUANTE-SEPTIEME ASSEMBLEE MONDIALE DE LA SANTE

The PRESIDENT:

Bismillah ar-rahman arrahim. Director-General, honourable m1msters of Member States, Regional Directors, distinguished delegates, excellencies, ladies and gentlemen, assalamu alaikum and a very good morning to you. The privilege of serving as the President of the Fifty-seventh World Health Assembly was a distinct honour and source of pride for me personally and for my country, Pakistan. I am leaving the mantle of the presidency of the Health Assembly with beautiful memories and I have made a lot of new friends. I have the conviction that the trust you bestowed on me was not misplaced. The Health Assembly was very special: many challenging issues were discussed; new directions were found on how to meet the challenges in global health; we discussed and stressed the need for all Member States to take the necessary steps to face the health problems created by emergencies. Can we ask ourselves how well we were prepared to meet a disaster like the tsunami. The answer may be a negative one in most of the Member States. The tsunami, spawned by a massive earthquake off Indonesia, struck countries around the Indian Ocean on 26 December 2004, killing 217 000 fellow human beings and devastating large areas of coastline; millions more were displaced, and are homeless or without livelihood. The recovery and rehabilitation plans are still in operation, especially in the hardest hit countries. One thing is clear: scarce resources in many developing countries are the biggest hurdle to coming up with comprehensive emergency preparedness programmes. Thus, global action is extremely necessary, especially global warning systems and response strategies. The world is looking towards us, the health leaders; we who have gathered here will be setting the future direction for global health policy. Our major responsibility will therefore be to satisfy the aspirations of the billions of people on this globe who wish for better health, a better future, equal opportunities and the right to enjoy the benefits of development and progress. There is no doubt that health gains are among the greatest social transformations of our times. Living conditions have dramatically improved for the large majority of human beings. But unfortunately, nearly a billion fellow human beings have been left behind in this health revolution. We must bring these excluded people on board: otherwise, we will not only be creating a larger Third World, but we might create a "Fourth World"- a world of the poorest of the poor- and this would be the biggest tragedy of our times. The Millennium Development Goals provide the new international framework for measuring the attainment of progress towards sustaining development and eliminating poverty. Out of eight A58NR/1 page 6

Millennium Development Goals, three are directly related to health, while four others have a very close relationship with it. This highlights the importance of health in the overall development of nations. And we should strive to meet the Millennium Development Goals because this will bring a dramatic revolution in our countries. We have to address difficult questions: how long will women and children continue to die from preventable causes? How long will we fail to provide simple interventions to save millions of lives? How long will people continue to suffer because of lack of safe drinking-water and basic sanitation? How long will millions of people infected with HIV wait for the delivery of antiretrovirals? How long will tuberculosis and malaria continue to create havoc? How long will we fail to deliver efficient and equitable health-care services, especially to poor and vulnerable populations, who are in most need of them? How can we care for the growing migrant and displaced populations? And will humanity continue to experience the conflict and insane violence - killings and mutilation - that hamper development in so many parts of the world? Look what man is doing to man today. This is the year 2005 and sometimes when you watch the television, one feels we are still in the Dark Ages. This is a sad reflection on humanity. I believe that the answer to all these questions is linked to peace and harmony. Peace is the key. Let us join hands to promote peace and harmony in the world. Let us wage war against the real enemies of mankind: poverty, illiteracy, hate, conflict and disease. I am a great believer in peace. Political leaders have huge responsibilities, whether they are in the Congress, the House of Commons, or the Lok Sabha or the National Assembly of Pakistan. We all have to work together. I am very confident that with vision, realism and commitment, the world could end the first decade of the twenty-first century with some notable accomplishments. It will take global leadership to set the process in motion. This Organization has an important role to play. Times may be changing and we will be on the side of the change process. WHO has done it before: the Global Strategy for Health for All by the Year 2000 unleashed a powerful movement. Inspiration and guidance from Alma-Ata in 1978, with its emphasis on the critical role of primary health care, contributed in no small measure to the health revolution and tangible health gains in the last two decades of the twentieth century. Looking ahead, I am a strong believer that WHO can do it again. A lot of good work has been done, but a lot of work remains to be done. When we are here as one family, I am sure we will overcome all the obstacles that lie in front of us. Together, we will make a difference; alone, we will not make a difference. I would particularly like to mention here the Mexico Statement on Health Research as a landmark event. I believe that a strong national health system is pivotal to delivering healthcare interventions. The need of the hour is to focus more on health system research, where we should evaluate the merits and demerits of currently available health interventions and make an endeavour to discover better health interventions for the future. We want to eradicate poliomyelitis this year; we want to intercept the poliovirus and consign it to the text books. This is a great challenge for the whole Health Assembly. I am confident that the Commission on Social Determinants of Health, like the Commission on Macroeconomics and Health, will bring useful changes in policy-making to remove inequalities in health, especially among the most vulnerable groups. I also request the Health Assembly to consider ageing. Today, we are here; tomorrow, we will be here as elderly persons. There are nearly one billion elderly people in the world today. I think that it is our moral and ethical duty to think about them and have plans for them. I wish to place on record my appreciation for your support during my presidency. I wish to single out the Director-General, Dr Lee Jong-wook, and his staff- his recent visit to Pakistan was a tremendous success; the Regional Director who was there also, as well as many colleagues from the Eastern Mediterranean Region; and I wish to thank all my minister colleagues for supporting me all the time in the last year. There is an old saying: "health is wealth". Let us therefore preserve our wealth as well as the wealth of our fellow human beings and make a special endeavour to provide this wealth to the masses of poor people in the world who are looking towards us and towards WHO with hope. Hope is their biggest possession. Let us try not to disappoint them; let us bring health and smiles to humanity, to the women and children in Africa and Latin America, all over the world, irrespective of their colour, creed or religion. This is our planet, this is our destiny. We have to live together and we have to accept and A58NR/1 page 7 find ways to accommodate and tolerate each other. Nothing is politically right which is morally wrong; it is time that we do the things which are morally right and I believe everything will fall into place. I want to finish on the following note: wherever there is peace, there is God. Thank you very much.

5. MUSICAL INTERLUDE INTERLUDE MUSICAL

The PRESIDENT:

It is now a pleasure to welcome a Quartet of the Vienna Philharmonic Orchestra. I am pleased to inform you that the Vienna Philharmonic Orchestra has been appointed Goodwill Ambassador for the World Health Organization. I shall invite the Federal Minister of Health and Women of Austria, Her Excellency Ms Rauch­ Kallat, to introduce the next part of this opening ceremony. Madam, you have the floor.

Ms RAUCH-KALLAT (Austria):

Thank you very much, Mr President. Director-General, excellencies, ministers and delegates, ladies and gentlemen, as the Austrian Federal Minister of Health and Women, it is a particular honour and pleasure for me to be able to announce to you a special musical offering from Vienna on the occasion of the official opening of the Fifty-eighth World Health Assembly today. In the opinion of many music lovers the Vienna Philharmonic Orchestra is one of the best symphony orchestras in the world and has been described as incomparable because of its particular sound. Above all, due to its annual New Year's concert which is broadcast throughout the world, it is Austria's most well-known and best ambassador. For this reason, the Orchestra does not require a special introduction by me. However, something that very few of us know is that the Vienna Philharmonic has always felt obliged to communicate a humanitarian message through music in everyday life, to enhance people's awareness and to show its social engagement by providing substantial financial help. In the year 2000, the Vienna Philharmonic decided to dedicate € 100 000 every year to charity from the proceeds of the preview of their New Year's concert. In recent years, raising a total of more than € 700 000 to date, it has supported the following: the international campaign against landmines, initiatives for the treatment of traumatized children and young people, aid for victims of the Austrian floods, the Austrian women's catastrophe aid fund, research into epidermolysis, care schemes for homeless people who cannot be resocialized, the medical programme of the Austrian American Foundation, the Austrian Red Cross, SOS Children's Villages, the funding of students of music both nationally and internationally and many other small initiatives. The terrible flood catastrophe in Asia at the end of last year brought interminable suffering to millions of victims and aroused shock and dismay in all of us. In the face of the unimaginable extent of the consequences of the tsunami and the horrific pictures, we saw the Vienna Philharmonic and its honorary member, Lorin Maazel, attempt, within the framework of the New Year's concert of2005, to make a modest gesture of compassion and to join the countless millions around the world who wished to assist the survivors and facilitate reconstruction work in the affected areas. Thus the President of the Orchestra, Dr Clemens Hellsberg, who is with us today, presented Dr Lee Jong-wook, Director­ General of WHO, with a contribution of € 115 000 at the New Year's concert 2005 -on behalf of Lorin Maazel and the Vienna Philharmonic- to be used to provide drinking-water to survivors. In this way, we expressed the sympathy of the Vienna Philharmonic with those people who had lost everything and for whom international solidarity was and is the only hope and, by thus having the initiative broadcast all over the world, we raised a lot more money. This spontaneous emergency aid by the Vienna Philharmonic, its great commitment to charitable causes and its worldwide popularity were among the reasons why the Orchestra was invited A58/VR/l page 8 to act officially, from now on, as WHO's Goodwill Ambassador. This means that, in future, the Vienna Philharmonic as honorary ambassador will dedicate concerts to WHO, perform benefit concerts in support of WHO and include messages from WHO in its publications and concert programmes, thus helping to spread and convey those messages. Other possible activities are also to be carried out in agreement and coordination with WHO. Not only the Vienna Philharmonic, but the whole Republic of Austria, which I am proud to represent here today, sees this nomination as a sign of recognition and honour for the humanitarian work of the Orchestra and the significance of our country for music culture worldwide. In 2006, Austria will assume the Presidency of the European Union at the same time as Mozart year will take place to commemorate the 250th anniversary of the composer's birth. On behalf of the whole Orchestra, four members of the new Goodwill Ambassador of WHO will therefore play for us as a quartet, the Divertimento in D major (KV136) first movement, Allegro, by Wolfgang Amadeus Mozart; as well as a Galop and 8 Ecossaises (D735) by Franz Schubert. Before I hand over to the music of the Vienna Philharmonic Orchestra, I would like to recall briefly the fundamental definition of health in the Constitution of WHO. "Health is a state of complete physical, mental and social well­ being and not merely the absence of disease or infirmity". The mental or psychological well-being quoted here depends to a great extent on the ability to feel the joy of life and this is conveyed to many of us through music. This is how the motto of the Vienna Philharmonic should be understood, which its members always try to realize with and through their music and with which Ludwig Van Beethoven prefaced his Missa Solemnis: "from the heart may it go to the heart". Thank you.

There followed a brief recital by a quartet of the Vienna Philharmonic Orchestra. Suit un bref recital par un quatuor de l'Orchestre philharmonique de Vienne.

Dr HELLSBERG (President of the Vienna Philharmonic):

Ladies and gentlemen, thank you very much. On behalf of the Vienna Philharmonic I want to thank you for the enormous honour that you have done us by appointing us to act as the Goodwill Ambassador of your Organization. But I want not only to thank you for this honour: I can assure you from the bottom of my heart, the Vienna Philharmonic is full of admiration for what you are doing for a better world. Please be sure to take this message home to your countries. You must know that we too, in the future, will support your efforts. Thank you very much.

The PRESIDENT:

Thank you for the beautiful music and I hope that this will set the stage and the tone of peace and harmony in the Health Assembly and in the world. What a beautiful way to start the Health Assembly. Thank you very much. We shall now deal with reality, with the first two items on our provisional agenda. I would ask our distinguished guests to kindly remain seated while the Health Assembly deals with its first two items which should not take very long.

6. APPOINTMENT OF THE COMMITTEE ON CREDENTIALS CONSTITUTION DE LA COMMISSION DE VERIFICATION DES POUVOIRS

The PRESIDENT:

We start with provisional agenda item 1.1, Appointment of the Committee on Credentials. The Health Assembly is required to appoint a Committee on Credentials in accordance with Rule 23 of the Rules of Procedure of the World Health Assembly. In conformity with this Rule, I propose for your approval the following 12 Member States: Algeria, Benin, Bhutan, Chad, Czech Republic, Honduras, Kiribati, Morocco, Peru, Serbia and Montenegro, Slovakia and Yemen. A58NR/1 page 9

Is this proposal acceptable? If there are no comments, I declare the Committee on Credentials, as proposed by me, appointed by the Health Assembly.

7. ELECTION OF THE COMMITTEE ON NOMINATIONS ELECTION DE LA COMMISSION DES DESIGNATIONS

The PRESIDENT:

I shall now proceed with item 1.2 of our provisional agenda, Election of the Committee on Nominations. This item is governed by Rule 24 of the Rules of Procedure of the World Health Assembly. In accordance with this Rule, a list consisting of 24 Member States and the President ex officio has been draw up, which I shall submit to the Health Assembly for its consideration. May I explain that, in compiling this list, the following distribution by region has been applied: Africa: 6 Members; the Americas: 5; Eastern Mediterranean: 2; Europe: 6; South-East Asia: 2; and Western Pacific: 3. I therefore propose to you the following Member States: Bahamas, Bolivia, Bosnia and Herzegovina, Cameroon, China, Comoros, France, Gambia, Guatemala, Guyana, India, Kuwait, Lithuania, Palau, Paraguay, Russian Federation, Senegal, Seychelles, Timor-Leste, Toga, Turkey, United Arab Emirates, United Kingdom of Great Britain and Northern Ireland, and VietNam. Is this proposal acceptable? In the absence of comments, I declare the Committee on Nominations elected. As you know, Rule 25 of the Rules of Procedure, which defines the mandate of the Committee on Nominations, also states that the proposals of the Committee on Nominations "shall be forthwith communicated to the Health Assembly". I will now suspend the meeting so that the Committee on Nominations may meet in Room 7. As soon as the Committee on Nominations has completed its deliberations, we will resume in plenary.

The meeting was suspended at 11:00 and resumed at 12:00. La seance est suspendue a llh et reprend a 12h.

8. FIRST REPORT OF THE COMMITTEE ON NOMINATIONS1 PREMIER RAPPORT DE LA COMMISSION DES DESIGNATIONS1

The PRESIDENT:

We shall now consider the first report of the Committee on Nominations. I shall read this report. The Committee on Nominations, consisting of delegates of the following Member States: Bahamas, Bolivia, Bosnia and Herzegovina, Cameroon, China, Comoros, France, Gambia, Guatemala, Guyana, India, Kuwait, Lithuania, Palau, Paraguay, Russian Federation, Senegal, Seychelles, Timor-Leste, Toga, Turkey, United Arab Emirates, United Kingdom of Great Britain and Northern Ireland, and VietNam and Mr Muhammad Nasir Khan (Pakistan) (ex officio), met on 16 May 2005. In accordance with Rule 25 of the Rules of Procedure of the World Health Assembly and respecting the practice of regional rotation that the Health Assembly has followed for many years in this regard, the Committee decided to propose to the Health Assembly the nomination of Ms Elena Salgado (Spain) for the Office of President of the Fifty-eighth World Health Assembly. Is this proposal from the Committee on Nominations acceptable?

1 See reports of committees in document WHA58/2005/REC/3. 1 Voir les rapports des commissions dans le document WHA58/2005/REC/3. A58/VR/1 page 10

Election of the President Election du President de I'Assemblee

The PRESIDENT:

In the absence of any observations, and as it appears that there are no other proposals, I suggest, in accordance with Rule 80 of the Rules of Procedure, that the Health Assembly approves the nomination submitted by the Committee and elects its President by acclamation.

(Applause/Applaudissements)

Ms Elena Salgado is thereby elected President of the Fifty-eighth World Health Assembly and I invite her to take her seat on the rostrum.

Ms Salgado (Spain) took the presidential chair. Mme Salgado (Espagne) prend place au fauteuil presidentiel.

La PRESIDENT A:

Excelencias, distinguidos ministros, embajadores, delegados, Director General: Deseo dar las gracias a esta Asamblea por la confianza que me han demostrado al elegirme Presidenta de la 58a Asamblea Mondial de la Salud. Quiero expresar mi agradecimiento muy sincero al Dr. Khan, mi antecesor, por su contribuci6n a la ultima Asamblea Mondial de la Salud. Como es habitual, pronunciare unas breves palabras mas tarde; ahora, si les parece bien, seguiremos con nuestro trabajo.

9. SECOND REPORT OF THE COMMITTEE ON NOMINATIONS1 DEUXIEME RAPPORT DE LA COMMISSION DES DESIGNATIONS1

La PRESIDENT A:

Quiero invitar a la Asamblea a examinar el segundo informe de la Comisi6n de Candidaturas. Paso a leer este informe: En su primera sesi6n, celebrada el 16 de mayo de 2005, la Comisi6n de Candidaturas, de conformidad con lo dispuesto en el articulo 25 del Reglamento Interior, acord6 proponer a la Asamblea las siguientes candidaturas: Vicepresidentes de la Asamblea: Sr. Meky (Eritrea); Dr. Fikri (Emiratos Arabes Unidos); Profesor Suchai Charoenratanakul (Tailandia); Dr. Miguel Femandez Galeano (Uruguay); Dra. Annette King (Nueva Zelandia). Comisi6n A: Presidente -Dr. Bijian Sadrizadeh (Republica Islamica del Iran). Comisi6n B: Presidente -Dr. Jerome Walcott (Barbados). Para Ios puestos de la Mesa de la Asamblea cuya provision ha de hacerse por elecci6n en virtud de lo dispuesto en el articulo 31 del Reglamento Interior de la Asamblea, la Comisi6n ha acordado proponer las candidaturas de Ios delegados de Ios 17 paises siguientes: Bhutan, Brasil, China, Congo, Cuba, Estados Unidos de America, Etiopia, Federaci6n de Rusia, Francia, Guinea Ecuatorial, Letonia, Libano, Luxemburgo, Malawi, Mongolia, Reino Unido de Gran Bretafia e Irlanda del Norte, y Zimbabwe. Invito a continuaci6n a la Asamblea a pronunciarse en el orden oportuno sabre las candidaturas propuestas.

1 See reports of committees in document WHA58/2005/REC/3. 1 Voir les rapports des commissions dans le document WHA58/2005/REC/3. A58NR/1 page 11

Election of the five Vice-Presidents Election des cinq vice-presidents de I'Assemblee

La PRESIDENT A:

Comenzaremos eligiendo a los cinco Vicepresidentes de la Asamblea. Puesto que no hay otras sugerencias, propongo que la Asamblea declare a los cinco Vicepresidentes elegidos por aclamaci6n.

(Applause/Applaudissements)

A continuaci6n determinare por sorteo el orden en que se pedin1 a los Vicepresidentes que reemplacen a la Presidenta cuando esta no pueda desempeiiar su funci6n entre las sesiones. Se han escrito los nombres de los cinco Vicepresidentes en cinco hojas que voy a extraer a continuaci6n al azar de esta balsa verde que tiene gran tradici6n en la Asamblea. Primer Vicepresidente, Sr. Meky (Eritrea). Segundo, Dr. Fikri (Emiratos Arabes Unidos). Tercera, Sra. Annette King (Nueva Zelandia). Cuarto, Dr. Suchai Charoenratanakul (Tailandia). Quinto, Dr. Miguel Femandez Galeano (Uruguay). Ruego a los Vicepresidentes que suban a la tribuna y que ocupen su puesto en esta tribuna.

Election of the Chairmen of the main committees Election des presidents des commissions principales

La PRESIDENT A:

A continuaci6n elegiremos el Presidente de la Comisi6n A. Se ha propuesto al Dr. Bijian Sadrizadeh (Republica Islamica del Iran). l,Les parece aceptable esta propuesta? Puesto que no hay ninguna otra propuesta, invito a la Asamblea a declarar al Dr. Sadrizadeh Presidente de la Comisi6n A por aclamaci6n.

(Applause/Applaudissements)

Debemos ahora elegir el Presidente de la Comisi6n B. Se ha propuesto al Dr. Jerome Walcott (Barbados). l,Les parece aceptable esta propuesta? Puesto que no hay ninguna otra propuesta, invito a la Asamblea a declarar al Dr. Walcott (Barbados) Presidente de la Comisi6n B por aclamaci6n.

(Applause/Applaudissements)

Establishment of the General Committee Constitution du Bureau de I' Assemblee

La PRESIDENT A:

A continuaci6n vamos a proceder a establecer la Mesa de la Asamblea. De conformidad con e1 articulo 31 del Reglamento Interior, la Comisi6n de Candidaturas ha propuesto los nombres de 17 paises cuyos delegados, unidos a los de los miembros que acaban de elegirse, constituiran la Mesa de la Asamblea. Estas propuestas hacen posible una distribuci6n geografica equitativa de la Asamblea. Los paises propuestos son los siguientes: Bhutan, Brasil, China, Congo, Cuba, Estados Unidos de America, Etiopia, Federaci6n de Rusia, Francia, Guinea Ecuatorial, Letonia, Libano, Luxemburgo, Malawi, Mongolia, Reino Unido de Gran Bretaiia e Irlanda del Norte y Zimbabwe. l,Consideran aceptable la lista propuesta? Puesto que no hay ninguna otra propuesta, declaro elegidos a esos paises. Los miembros de la Mesa son, por lo tanto, el Presidente y los Vicepresidentes de la Asamblea, los Presidentes de las comisiones principales y los delegados de los 17 paises que acaban ustedes de elegir. A58/VR/1 page 12

Finalmente no podremos tomar ahora la fotografia prevista, porque esta lloviendo. Por consiguiente, la Mesa de la Asamblea celebrara inmediatamente su primera sesi6n en la sala XII de este mismo edificio. Les recuerdo que, de conformidad con el articulo 32 del Reglamento Interior, la participaci6n en la Mesa de la Asamblea se limita a los miembros de la misma, segun la lista que he leido, y a no mas de un representante de las delegaciones de las cuales ningun miembro forma parte de la Mesa. El proximo plena se celebrara en esta misma sala, esta tarde a las 14.30 horas. Muchas gracias a todos. Se levanta la sesi6n.

The meeting rose at 12:15. La seance est levee a 12h15. A58NR/2 page 13

SECOND PLENARY MEETING

Monday, 16 May 2005, at 15:15

President: Ms E. SALGADO (Spain)

DEUXIEME SEANCE PLENIERE

Lundi 16 mai 2005, 15h15

President: Mme E. SALGADO (Espagne)

1. PRESIDENTIAL ADDRESS DISCOURS DU PRESIDENT DEL' ASSEMBLEE

La PRESIDENT A:

Senor Director General de la Organizacion Mundial de la Salud, honorables ministros, excelencias, distinguidos delegados e invitados, senoras y senores, queridos amigos: Permitanme ante todo expresarles mi gratitud a todos por haberme elegido Presidenta de la 58a Asamblea Mundial de la Salud. Es un honor para mi, para Espana, mi pais (que nunca antes habia presidido esta Asamblea), y tambien para la Region de Europa de la Organizacion Mundial de la Salud. Quiero felicitar en primer termino al Dr. Muhammad Nasir Kahn, Ministro de Salud del Pakistan, por su excelente presidencia de la 57a Asamblea Mundial de la Salud. Race ya seis anos, desde que otra mujer, la Dra. M. de Belem Roseira, Ministra de Salud de Portugal, presidio la Asamblea Mundial de la Salud. En las 57 ocasiones precedentes tan solo cuatro mujeres han sido elegidas para ocupar este puesto. Asi pues, permitanme que, como mujer y como ministra del primer gobiemo paritario de la historia de mi pais, destaque este hecho. En particular al iniciarse una Asamblea que se reune bajo un lema que tiene mucho que ver con las mujeres, un lema que nos dice «Cada madre y cada nino contaran». La salud de las mujeres significa mas de la mitad de la salud del mundo, porque ellas, nosotras, representamos algo mas de la mitad de la poblacion mundial. En la mayor parte de los paises, las mujeres constituyen la mayor parte de la fuerza de trabajo del sector de la salud, y en casi todos los sitios, incluidos los paises mas desarrollados, las madres, las esposas, las hijas prestan unos cuidados de salud en el seno de las familias que, en el mejor de los casos complementan, y a veces tienen que sustituir a las carencias de los sistemas formales de salud. En muchos paises, entre ellos el mio, las mujeres viven, en promedio, mas anos que los hombres, pero se quejan, y con razon, de vivirlos con peor salud. Rasta hace muy poco los parametros de normalidad fisiologica se referian solo a lo que es normal en los varones, y todavia hay muchas situaciones de salud frecuentes en las mujeres que reciben poca o ninguna atencion. No se trata de «medicalizan> mas alla de lo razonable las que pueden considerarse situaciones fisiologicas normales de la vida de las mujeres. Se trata de prestar una atencion adecuada a los problemas de salud que son A58NR/2 page 14 en ellas mas frecuentes; de estudiar mas y mejor las situaciones de salud por las que las mujeres atraviesan; cuadros de malestar que son muy poco conocidos y que a veces se etiquetan con cierta ligereza como «difusos» o «funcionales». Comencemos por mencionar lo mas evidente: todos los aiios se producen en el mundo 529 000 defunciones maternas. Al mismo tiempo, 3,3 millones de niiios nacen muertos, mas de 4 millones fallecen dentro de los 28 primeros dias de vida, y 10,6 mill ones mueren antes de cumplir los cinco aiios. Es decir, vivimos en un mundo donde cada minuto una mujer pierde la vida por complicaciones del embarazo y el parto, complicaciones que en su gran mayoria son evitables y, prueba de ello, es que mientras en amplias zonas desfavorecidas del mundo una mujer de cada 16 muere por esta causa, en los paises mas desarrollados solo fallece una de cada 2800. Se estima, por ello, que hasta 100 000 muertes maternas se podrian evitar cada aiio si las mujeres que no desean tener un hijo dispusieran de metodos contraceptivos eficaces y si aquellas que desean tenerlo recibieran una atencion adecuada. Vivimos en un mundo donde el acceso de las mujeres a cuidados profesionales durante el embarazo ha aumentado mucho durante la ultima decada, pero donde todavia hay paises en Ios que estos cuidados solo alcanzan al 35% de las mujeres que los necesitan. Vivimos en un mundo donde todavia se mutila genitalmente a miles de niiias, se les obliga a casarse con hombres que no quieren, y sufren violencia y a veces la muerte si no aceptan esa imposicion; donde muchas mujeres sufren maltrato y explotacion sexual, y tambien coaccion y violencia dentro de las paredes del hogar. Vivimos, desgraciadamente, en un mundo donde la mortalidad de los niiios menores de cinco aiios es 16 veces mayor en unas zonas que en otras, y donde la gran mayoria de las causas mas frecuentes de enfermedad y muerte se pueden evitar, y ademas se sabe como hacerlo. En la mayor parte del mundo, esas causas evitables de enfermedad y de muerte tienen una relacion muy estrecha con el subdesarrollo y tambien con las secuelas de ese subdesarrollo: la desigualdad, la ignorancia, la pobreza; un mundo donde la brecha entre los que tienen y los que no tienen, tambien en el terreno de la salud, no disminuye, y a veces parece que se agranda. Nos hallamos ante una profunda brecha entre los paises de renta alta y los de renta baja, y tambien ante manifiestas desigualdades de salud en el interior de Ios paises. El gran reto de este nuevo siglo es evitar que esa brecha se siga ampliando; es mas, el gran reto es verdaderamente reducirla, por eso las politicas de salud, de atencion de salud y de investigacion en salud deberian tener en cuenta esta realidad, porque la solidaridad en salud no debe ser retorica, debe ser algo que llevemos a la practica. Para hacer llegar a todas las mujeres embarazadas y los niiios un conjunto basico de intervenciones en salud en aquellos paises, 75 paises, donde se concentra la mayor parte de la mortalidad materna e infantil, necesitamos US$ 52 400 millones adicionales a lo largo de los proximos diez aiios, es decir, US$ 5200 millones anuales. Este dinero, por muy alta que parezca la cifra, no es un gasto, es una inversion, es probablemente la mejor inversion, como lo es tambien invertir en agua potable, en vacunas, en mejorar la nutricion dellactante y del niiio pequeiio, en preparar la respuesta a una eventual pandemia de gripe, combatir la resistencia a los antimicrobianos. Es tambien una inversion prevenir y controlar la tuberculosis, el paludismo, el cancer, frenar el consumo de alcohol, en definitiva: fortalecer la capacidad de respuesta frente a los desastres y desarrollar sistemas de seguro social de enfermedad. Es tambien la mejor inversion fomentar estrategias de envejecimiento activo y fomentar tambien la investigacion en salud. Todos estos temas y algunos mas estan en la agenda de esta Asamblea, como tambien lo esta el seguimiento de la aplicacion de las resoluciones de anteriores asambleas. Permitanme referirme brevemente a tres puntos incluidos en el orden del dia de esta 58 3 Asamblea Mundial de la Salud que sin duda atraeran nuestra atencion durante las proximas jornadas. El primero se refiere a la consecucion de los Objetivos de Desarrollo del Milenio relacionados con la salud. Como saben, la Declaracion del Milenio fue firmada solernnemente por 189 Jefes de Estado y de Gobierno en la sede de las Naciones Unidas en septiembre del aiio 2000, hace ya casi cinco aiios. Esta declaracion representa un consenso sin precedentes, y tambien una oportunidad linica para impulsar una vision global del desarrollo basada en los valores de libertad, equidad, solidaridad, tolerancia, respeto por la naturaleza y responsabilidad compartida. Ante esta Asamblea que nos reline aqui se va a presentar una primera evaluacion del grado de logro de Ios objetivos de salud incluidos en la Declaracion. De esa primera evaluacion deberemos extraer conclusiones que nos permitan lograr las metas de salud propuestas para el aiio 2015, o antes, A58NR/2 page 15 si fuera posib1e. Muchas personas estan pendientes de esa eva1uaci6n y de ese esfuerzo. No deberiamos defraudarlas. El segundo asunto que me gustaria destacar es el proyecto de Reglamento Sanitaria Intemacional, un tema de la mayor importancia. El proyecto que se nos ha repartido lleva aiios discutiendose, dos aiios, y esta llamado a sustituir al Reglamento Sanitaria Intemacional del aiio 1969, que todavia esta vigente. Mucho ha cambiado el mundo desde el aiio 1969. Han cambiado tambien los retos de la salud publica, tanto en el piano nacional como en el intemacional. Parece necesario, por lo tanto, dotarse de un instrumento adaptado a las circunstancias actuales, un instrumento eficaz que sea de todos, que cuente con la aprobaci6n de todos y que nos proporcione a todos y a todas, a los ciudadanos y a los Estados, seguridad y confianza. El proyecto de Reglamento Sanitaria Intemacional que se somete a discusi6n es probablemente el mas amplio compromiso que ahora es posible sobre ese tema. En Espaiia tenemos un refran que dice: «Lo mejor es enemigo de lo bueno». De nosotros depende que este proyecto de Reglamento Sanitaria adquiera la condici6n que le falta para ser eficaz: ser adoptado y poderse aplicar cuanto antes. El tercero de los asuntos al que deseo referirme es el proyecto de presupuesto de la Organizaci6n. En los ultimos aiios los temas de salud han ido adquiriendo cada vez mayor relevancia, sobre todo desde que la salud se ha reconocido como un derecho humano basico y la protecci6n y el fomento de la salud se consideran un componente esencial de ese desarrollo humano. Acontecimientos recientes que estan en la mente de todos, como los terremotos y maremotos ocurridos en Asia el pasado diciembre, han puesto mas de relieve si cabe la necesidad de que existan mecanismos intemacionales de respuesta rapida ante situaciones extremas causadas por la naturaleza o por el hombre, mecanismos que han de incluir necesariamente un importante componente sanitaria. La Organizaci6n Mundial de la Salud es el organismo especializado de las Naciones Unidas en temas de salud. Tiene ya casi 60 aiios de historia, y en este tiempo ha atendido multiples demandas y ha afrontado una gran variedad de retos. Lo ha hecho y lo sigue haciendo unicamente con los medios que los Estados Miembros y otros contribuyentes voluntarios ponen a su disposici6n, y en el caso del tsunami, como en tantos otros, su actuaci6n ha sido ejemplar y eficiente. La Organizaci6n Mundial de la Salud es una organizaci6n que hace de la transparencia, la rendici6n de cuentas y el establecimiento de alianzas sus normas basicas de actuaci6n. Podriamos decir que es una organizaci6n que ha puesto en practica los principios del «buen gobiemo corporativo» antes incluso de que empezaramos a hablar de este concepto. El equipo dirigido por el Dr. Lee ha continuado y fortalecido ese estilo de gobiemo en esta Organizaci6n, pero en los ultimos 12 aiios la Organizaci6n ha visto c6mo su presupuesto ordinaria se elaboraba siguiendo el estricto criterio de crecimiento nominal cero, lo cual, bienio a bienio, se ha traducido en una reducci6n de su presupuesto en terminos reales. No cabe duda de que, de mantenerse indefinidamente, ese crecimiento nominal cero podria con toda seguridad acabar comprometiendo tanto la independencia como la propia capacidad de obrar de la Organizaci6n, y por eso ante esta Asamblea se presenta un proyecto de presupuesto para el bienio 2006-2007 que por primera vez desde hace 12 aiios modifica esta situaci6n. Espero que nuestros debates sobre este tema sean fructiferos y que enviemos todos a la comunidad intemacional una clara seiial de que la sa1ud nos importa y de que en consecuencia debemos contar con los recursos necesarios para mejorar los instrumentos que se encargan de protegerla y fomentarla, y entre esos instrumentos la Organizaci6n Mundial de la Salud es sin ninguna duda el instrumento mas valioso en el piano intemacional. Esta Asamblea es un foro donde expresamos la grand diversidad de nuestro mundo y tambien expresamos los deseos, los logros, los anhelos y las preocupaciones de los ciudadanos que lo habitamos. Hoy mas que nunca nuestro mundo es un mundo global, un solo mundo. Y si hay un ambito donde esa afirmaci6n resulta evidente es en el ambito de la salud. El mundo necesita mas que nunca puentes que unan los paises; grandes a1ianzas a favor de la vida, de la convivencia entre civilizaciones y entre culturas; foros donde el debate sea franco y constructivo, de soluciones compartidas. A58NR/2 page 16

Esta Asamblea es sin duda alguna uno de esos foros. Durante el afio transcurrido desde el final de la 57a Asamblea Mundial de la Salud, el Director General y todo su equipo han estado trabajando para que la que hoy comenzamos sea un exito. Este esfuerzo va a facilitar sin duda alguna nuestros trabajos, y ademas el concurso de los interpretes y del resto del personal de apoyo va a permitir que la Asamblea sea fructifera, y por ello quiero darles a todos las gracias anticipadamente. Estoy segura de que los debates que vamos a tener los proximos dias y las resoluciones que adoptemos nos van a permitir avanzar en la direccion de conseguir una mejor salud para todos, y tengamos todos la seguridad de que al hacerlo estamos tambien contribuyendo a construir un mundo no solo mas sano sino mas justo, mas vivible. Muchas gracias.

2. ADOPTION OF THE AGENDA AND ALLOCATION OF ITEMS TO THE MAIN COMMITTEES ADOPTION DE L'ORDRE DU JOUR ET REP ARTITION DES POINTS ENTRE LES COMMISSIONS PRINCIP ALES

La PRESIDENT A:

El primer punto que vamos a abordar esta tarde es el punto 1.4 «Adopcion del orden del dia y distribucion de su contenido entre las comisiones principales». Este punto ha sido examinado por la Mesa de la Asamblea en su primera sesion del dia de hoy. La Mesa de la Asamblea ha examinado el orden del dia provisional ( documento A58/1 ), preparado por el Consejo Ejecutivo y enviado a todos los Estados Miembros. Quisiera referirme en primer lugar al orden del dia provisional que figura en el documento A58/1. La Mesa de la Asamblea ha recomendado que se supriman dos puntos del orden del dia provisional, ya que no hay ninglin asunto que tratar en relacion con ellos. Son los siguientes: punto 5, «Admision de nuevos Miembros y Miembros Asociados (Articulo 6 de la Constitucion y articulo 115 del Reglamento Interior de la Asamblea)». Se nos ha informado de que no se ha recibido ninguna nueva solicitud. En coherencia con lo anterior, supresion asimismo del punto 17.5 «Contribucion de nuevos Miembros y Miembros Asociados» t,Hay acuerdo en que se supriman estos dos puntos? Puesto que no hay objeciones, asi queda acordado. La Mesa de la Asamblea ha recomendado asimismo que dos temas del subpunto 13.19, a saber «Expansion del tratamiento y la atencion en el marco de una respuesta coordinada e integral al VIH/SIDA» y «Migracion intemacional del personal sanitario: un reto para los sistemas de salud de los paises en desarrollo», se examinen como subpuntos especificos del orden del dia, dentro del punto 13. t,Desea la Asamblea aprobar esa recomendacion? Puesto que no hay objeciones, asi queda acordado. Los dos nuevos subpuntos se denominaran, respectivamente, 13.20, el que se refiere al VIH/SIDA, el punto 13.21, el que se refiere a la migracion intemacional del personal sanitario, y seran examinados en la Comision A. La Mesa de la Asamblea se mostro de acuerdo con la propuesta de que debido al retraso en la publicacion de los documentos el subpunto 13.2, «Consecucion de los Objetivos de Desarrollo del Milenio relacionados con la salud», este se examine al final de las deliberaciones sobre el punto 13. Esta recomendacion se sefialara a la atencion de la Comision A. La Mesa de la Asamblea examino tambien la propuesta de que se afiadieran dos puntos suplementarios al orden del dia. La primera propuesta consistia en inscribir en el orden del dia un punto suplementario «Aplicacion de resoluciones, Convenio Marco de la OMS para el Control del Tabaco». La Mesa decidio recomendar a la Asamblea de la Salud que incluyera ese punto en el orden del dia. t,Esta de acuerdo la Asamblea con esa recomendacion de la Mesa de incluir este punto como punto suplementario del orden del dia? Puesto que no hay objeciones, asi queda acordado. La Mesa de la Asamblea examino tambien la propuesta de incluir un segundo punto suplementario en el orden del dia «Invitacion a Taiwan a participar en la Asamblea Mundial de la A58/VR/2 page 17

Salud en calidad de observador». La Mesa ha adoptado la misma postcton que en Asambleas anteriores cuando se present6 la misma propuesta y, por lo tanto, recomend6 no incluir este punto en el orden del dia. Cuando en anteriores Asambleas se trat6 este propuesta, hicieron uso de la palabra dos oradores a favor de la inclusion del punto suplementario en el orden del dia y dos oradores en contra de esa inclusion. Propongo, para facilitar nuestro trabajo en una Asamblea con asuntos tan importantes que tratar, que sigamos esa misma pnictica. En consecuencia concedo la palabra al Chad.

Mme BAROUD (Tchad) :

Merci, Madame la Pn!sidente. Monsieur le Directeur general de !'Organisation mondiale de la Sante, Mesdames et Messieurs les chefs de delegation, Mesdames et Messieurs les Ministres, distingues delegues, Mesdames et Messieurs, permettez-moi tout d'abord de vous feliciter, Madame la Presidente, pour votre brillante election et d'exprimer egalement ma fierte en tant que femme pour votre election. Je voudrais egalement saisir cette opportunite pour saluer les differentes declarations que nous avons suivies depuis ce matin avec un grand inten~t. Toutes ont pose les questions cruciales de l'acces de toutes les populations aux services de sante face aux multitudes de maladies auxquelles nous sommes confrontes et a la problematique de la sante matemelle et infantile. Le Gouvemement de mon pays est convaincu que des decisions importantes pourront etre prises sur ces differents sujets pour le benefice de toutes les populations. C'est pourquoi notre Assemblee doit prendre aujourd'hui une decision d'une importance morale et professionnelle capitale. Allons-nous enfin accepter de discuter de la participation de Taiwan a l'OMS durant cette session? Ou allons-nous continuer a fermer les yeux et a toumer le dos a 23 millions d'hommes et de femmes que constitue le peuple de Taiwan. Il s'agit la d'un test pour notre conscience morale et pour notre jugement intellectuel. La position du Gouvemement de mon pays est sans equivoque sur cette question. L' Assemblee doit inclure ce point supplementaire dans son ordre du jour afin de permettre une discussion serieuse sur les conditions de participation de Taiwan a notre Assemblee. Notre Organisation dont le mandat est de promouvoir et de proteger la sante de toutes les populations aura a rendre compte a l'histoire de la realisation de ses nobles objectifs. En effet, depuis la fondation de cette institution, il a ete soutenu par ses plus hautes autorites, plus particulierement les differents Directeurs generaux qui se sont succedes, que la mobilisation contre les maladies necessite la participation et I' engagement de toutes les communautes de la planete. Permettez-moi d'adresser mes sinceres felicitations a la Direction generale de !'Organisation mondiale de la Sante pour la finalisation du projet de Reglement sanitaire international dont !'application devrait s'etendre a !'ensemble des peuples de la planete. Ainsi, une petite fenetre pourrait s 'ouvrir pour les peuples qui attendent depuis des annees devant les partes closes de notre institution. Sur la carte mondiale, il y a un trou noir et ce trou est le resultat de !'alienation de Taiwan dans nos activites. Il s'agit ici d'une menace pour le systeme de sante au niveau mondial et nous en sommes tous conscients. Le theme de la Joumee mondiale de la Sante le 7 avril demier et du debat general de la presente session a laquelle nous avons le privilege de prendre part- et je souligne le mot privilege­ met l'accent sur la sante de la mere et de !'enfant, et je cite« Donnons sa chance a chaque mere et a chaque enfant». Le Directeur general, le Dr Lee Jong-wook, dans sa declaration au cours de cette joumee du 7 avril, a mis un accent particulier sur cette question en ajoutant que chaque mere et chaque enfant comptent du fait que nous valorisons chaque vie humaine et qu'il est evident que des femmes et des enfants en bonne sante constituent le socle des communautes et des nations prosperes. Aussi nous devons nous demander pourquoi les meres et les enfants de Taiwan ne comptent pas. Ce que le Directeur general a dit ce jour la ne doit pas etre considere comme une simple declaration, mais reflete la les defis auxquels nous devons faire face en traduisant ces paroles en actions concretes. Nul n'est besoin de revenir sur le role crucial que joue Taiwan dans la reglementation du transport et du fret maritime aerien en Asie du Sud-Est avec la multitude de travailleurs venant de toutes parts que cela engendre. Aussi les defis de nouvelles maladies comme la grippe aviaire et le SRAS nous interpellent car, dans le contexte d'isolement de Taiwan en matiere sanitaire, nous mettons en peril la sante du monde. Il est done necessaire d' ouvrir le debat sur cette question et de trouver un moyen d' ecouter les 23 millions de voix qui ne demandent qu'a etre entendues sur leurs problemes sanitaires. A58NR/2 page 18

Un autre point sur lequel je me permets de faire appel concerne la Constitution de !'Organisation qui n'exclut pas la participation en tant qu'observateur de groupes ou d'entites au-dela de leur statut politique. Des exemples existent. Ce que nous reclamons aujourd'hui pour le peuple de Ta"iwan est qu'une solution soit envisagee afin de permettre a 23 millions de personnes de faire partie integrante de la carte sanitaire mondiale. Quoi de plus juste et de plus noble que d'offrir l'opportunite a une partie de la population mondiale d'entrer dans ses droits, ceux universellement reconnus a chaque individu de la planete, dans un monde ou le lien entre les droits de l'homme et le droit a la sante devient de plus en plus indissociable. Permettez-moi de conclure en rappelant encore le terme sur lequel, un a un, taus les orateurs depuis ce matin sont revenus: la sante de chaque mere et la sante de chaque enfant comptent. Faisons done en sorte que la sante de la mere et de l'enfant ta"iwainais puisse compter en acceptant seulement de debattre du sujet en l'incluant dans notre ordre du jour. Je vous remercie.

Mr M. KHAN (Pakistan):

Madam President, we congratulate you on your assumption of the office of the President of the Fifty-eighth World Health Assembly. Pakistan looks forward to working with you under your able stewardship. Madam President, my delegation has already delivered a statement in the General Committee, stating its position on the request of the Taiwanese authorities to be admitted to this session of the World Health Assembly as an observer. This question should have been settled in the General Committee rather than brought once again to the plenary of the Health Assembly. This only diverts our attention from the more pressing issues at hand. Pakistan strongly believes in the "one China" policy and regards Taiwan as an indivisible part and a province of the mainland. We hope that it will return to the mainland soon. We regret that extremely precious time at this Health Assembly is being taken up by a non-issue rather than by pressing, health-related matters. For the eighth consecutive year, the World Health Assembly has been asked to debate an issue which has no relevance to this Organization and which was decided over thirty years ago, not only by the World Health Organization itself but also by the United Nations General Assembly. For the eighth consecutive year this proposition will be rejected by this august Health Assembly. Should this issue, then, ever be brought to this house again? The answer is "No". Why? Because the proposal to invite Taiwan to the World Health Assembly as an observer is deficient in law and practice as well as being inconsistent with the established principles of inter-State relations; it also violates the Charter of the United Nations. My delegation fully supported the four-point proposal presented to the Fifty-seventh World Health Assembly by Ambassador Sha Zukang, China's Permanent Representative, suggesting ways and means to address the Taiwanese concerns for establishing contacts with the World Health Organization. We commend the Chinese Government's readiness and efforts to engage Taiwan in exploring ways to associate Taiwanese professionals with WHO and help to facilitate technical exchanges between Taiwan and WHO. In this regard, we welcome the signing of a Memorandum of Understanding between the Chinese Government and WHO to facilitate technical exchanges between Taiwan and WHO. This should bring the issue to a conclusion in purely substantive terms. Coming to the substance of the Taiwanese request, we would say that it should be rejected because it violates decisions of the United Nations General Assembly and WHO, the Constitution of WHO and international law. I will explain how. First, the issue of Taiwan's representation at the United Nations was settled conclusively by the United Nations over 30 years ago. United Nations General Assembly resolution 2758 (XXVI) of 25 October 1971 had decided to restore all rights to the People's Republic of China and to recognize the representative of the Chinese Government as the sole legitimate representation of China to the United Nations. This decision was endorsed by resolution WHA25.1, adopted in 1972. Second, though the Constitution of WHO allows territories or groups of territories not responsible for the conduct of their international relations to become Associate Members, Article 8 of the Constitution clearly stipulates that these territories "may be admitted as Associate Members by the Health Assembly upon application made on behalf of such territory or group of territories by the Member or other authority having responsibility for their international relations". It is evident that this consent is not forthcoming, thus the proposal to invite Taiwan as an observer to the Health Assembly is in contravention of the A58NR/2 page 19

Constitution of WHO. Third, state sovereignty and territorial integrity are fundamental principles of international law and a cornerstone of the Charter of the United Nations. Taiwan is a province and an integral part of China. The Government of the People's Republic of China has the sole responsibility for representing all its provinces and territorial units in the international forums. Extending an invitation to Taiwan or its health authorities as an observer in the meetings of WHO, which is a United Nations specialized agency, would be a direct violation of international law as well as the Charter of the United Nations. Madam President, my delegation believes that any proposal for inviting the Taiwanese health authorities as observers to the World Health Assembly is legally unacceptable and politically untenable. It also distracts us from the pressing issues at hand. We would, therefore, recommend that the Health Assembly should reject this proposal, clearly, decisively and definitively. Thank you.

Dr NT ABA (Malawi):

Madam President, Director-General, distinguished delegates, I wish first of all to congratulate you and your executive on your election to these very challenging positions. Malawi looks forward to working with you as you guide us through the deliberations of this august meeting. It is true that the General Committee rejected the request to place the question of Taiwan's participation as an observer in the Health Assembly during its meeting. The Malawi Government, however, feels very strongly that this is an important issue and that the Health Assembly should consider the merits and demerits of it. That is why we think it is not proper to have killed it at the Committee stage. It is true that the matter has been presented repeatedly to this august house and repeatedly rejected. On all those occasions the representations have been made by one side of the dispute only. At no time has WHO had an opportunity to listen to the other side of the argument. Each time the issue has been presented what has ensued is nothing but political arguments about keeping Taiwan out. At no time have we really heard about the political merits, the public health merits, from those that are refusing the participation of Taiwan. This is not quite in keeping with the well-known principles of natural justice. If you care to speak to the other side, find out what the issues are from Taiwan, you will find out that it is not the sovereignty of Taiwan or the membership of Taiwan in WHO that is at issue here. What is being asked for is observer status, participation in the World Health Organization - this for the purposes of meeting the public health needs of the island, the 21 million people there. What actually must not be forgotten is that after this resolution of 1971 of the United Nations, which has been repeatedly referred to, there ensued a dispute between Taiwan and China, China maintaining one side of the story but to a certain extent Taiwan presenting a different story. We must pay attention to both sides when we are looking after the health needs of the two populations. The participation of Taiwan in WHO touches the very existence and purpose of WHO. It is an ethical obligation of WHO to serve all human beings and protect their health without any fear, discrimination or intimidation by stronger Member States. The attainment of the highest possible level of health for all people is fundamental, as we all acknowledge. This of course is reflected in several articles of the Constitution of WHO. It is not true that the Constitution limits participation in WHO's work only to Member States, which must be sovereign States. In practice, we know that participation also extends to other groups of people, organizations, even single individuals, as long as they subscribe to the objectives of the Constitution of WHO. In the case where an observer organization comes from a sovereign State and has been granted participation in WHO as an observer, the question of two sovereign States in that situation has never arisen, so why should the granting of observer status to Taiwan raise fears of a "two-China" policy in this particular case? We would understand these sentiments if Taiwan were asking for Member status in this Organization; they are simply asking for observer status. If we examine the WHO's mandate, review principles of public health and leave politics aside, we find no professional, moral, ethical or other sound reasons for excluding Taiwan from WHO. In fact, the observer status of Taiwan in WHO, in our view, is not only a public health necessity; it is also a human rights imperative. We say this because the globalization of public health has created for us a global public health village where every stakeholder (whether a Member State or an observer, a health community or a nation) is a crucial public health partner. In order to respond to infectious disease threats, any health community - and I mean any health community, not just A58NR/2 page 20 sovereign States - must be able to identify infectious disease outbreaks and respond rapidly with international support. This fact, together with the Director-General's proclaimed "no-gap" policy in WHO's commitment to fight disease, only underscores why it is important that Taiwan should participate in WHO. The recent outbreaks of severe acute respiratory syndrome and avian influenza in Taiwan are disturbing examples of the danger inherent in Taiwan's exclusion from the work of WHO. Taiwan repeatedly asked for assistance from WHO and was denied that assistance. Where was China at that time? Taiwan has also requested to participate in other WHO activities and has been denied: a clear indication that the expectations we have that the public health requirements of Taiwan can be met through an arrangement between Taiwan and China are simply not workable. The negative consequences for both Taiwan and WHO here cannot be overemphasized. Taiwan, to our displeasure, has also been excluded from WHO's Global Outbreak Alert and Response Network, a situation which makes no public health sense whatsoever. I wonder if WHO is behaving with a clear, professional and moral conscience when it makes these decisions. I know that Taiwan is being denied its participation in WHO because of the sentiments and objections from the Member States led by the People's Republic of China. The arguments are under the "one China" policy, or the claim that China looks after Taiwan's health interests, and also the claim that Taiwan participates in the arrangements in WHO through the arrangements with China. There is also the assertion that the observer status, as I have said, of Taiwan would impinge on the territorial integrity, legal and sovereignty status of Taiwan. These are political arguments. None of these arguments are raising public health issues and I believe that it is not right or fair for WHO to keep on listening to this one-sided story and make decisions when we have no chance to be courageous enough to call the other side and hear their side of the story. This is the kind of debate that really is political and should not belong in WHO. This is why we are saying that in the interests of natural justice, when we hear from Taiwan we will find out that it is actually the public health issues that we should be taking care of, that we should be concerning ourselves with. In any case, we have never seen any evidence of the claim that arrangements are being made or have been made to look after the public health requirements of 23 million people who have actually come and asked for that assistance. It is a clear indication in our view that the "one China" policy (which we do not want to dispute and have never argued against) is not serving the public health needs of Taiwan. The answer therefore is not working. We believe that some of these problems that Taiwan is meeting occur because it is so small compared to the big rival, China. We find that perhaps most of the people who argue against this, find it much easier to support the stronger of the two rival factions. However, we would like to state that, with a population of 23 million, Taiwan is a larger community than 80% of the Member States represented in WHO. We therefore feel WHO is in danger of losing its moral authority and institutional credibility if it readily marginalizes the small and weak under political pressures from the big and strong Members. Many reputable organizations have resisted such political pressures and have made purely professional decisions and have recommended Taiwan's participation in WHO. These entities include reputable organizations like the World Medical Association, which only yesterday reaffirmed its support for Taiwan's participation in WHO, the World Health Professions Alliance (including the International Pharmaceutical Federation and the International Council of Nurses), The International Pediatric Association, the British Medical Association and many more. These are purely professional organizations: they talk of technical issues; there are no politics in their debate. They clearly see the need for WHO to include Taiwan or to allow it to participate as an observer. The other very august institutions that have similar recommendations arising from their debates (such as the United States Congress, the European Parliament, the Canadian Parliament, the Belgian Chamber of Representatives, the Italian Chamber of Deputies and similar bodies) clearly believe in and advocate the inclusion of Taiwan as an observer in the work of WHO. WTO has gone even further. In that Organization I understand that both Taiwan and China are members. They clearly see the need to work together. Why do we fail to see that in WHO? Finally, Madam President, regarding the Memorandum of Understanding between China and WHO, my Government finds this a rather strange development and, to a certain extent, unprocedural. We believe that the issue is Taiwan's request for observer status; but this has been answered through a Memorandum of Understanding negotiated between China and WHO and we are aware that there were no consultations whatsoever with Taiwan. How can a problem affecting Taiwan be resolved by negotiations between WHO and China without the involvement of Taiwan itself? Understandably, A58NR/2 page 21

Taiwan has firmly rejected this Memorandum of Understanding. Can WHO really be so naive and expect that this formula will work and will get us to resolve the public health problems of Taiwan? I do not think so. This attempt to resolve the issues would have made sense and would have been much more respectable if the aggrieved party, Taiwan in this case, had participated. Otherwise, in our view, the exercise raises more questions than answers. It is quite obvious to us that Taiwan needs to be present as an observer if WHO is not to be hypocritical in regard to its universal principles and "no­ gap" policy. We therefore recommend strongly that the Health Assembly seriously looks at representation of Taiwan as an observer. Thank you.

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La PRESIDENT A:

Hemos escuchado cuatro amplias intervenciones sobre este asunto. Una vez escuchadas wuedo concluir que la Asamblea esta de acuerdo con la recomeridacion de la Mesa de no incluir este punto como punto suplementario del orden del dia? Puesto que no hay observaciones, entiendo que la Asamblea ha decidido no incluir este punto como punto suplementario del orden del dia. Por lo tanto, entiendo que la Asamblea esta de acuerdo en adoptar e1 orden del dia provisional en su forma enmendada, a saber, con la supresion de los dos puntos mencionados al comienzo de la sesion y la inclusion de un unico punto suplementario: «Aplicacion de resoluciones Convenio Marco de la OMS para el Control del Tabaco». Asi queda acordado. Maiiana por la maiiana les distribuiremos el documento A5811 Rev.l en el que se recogeran los cambios mencionados. A continuacion vamos a tratar la distribucion del contenido del orden del dia entre las comisiones principales. El orden del dia provisional de la Asamblea fue preparado por el Consejo Ejecutivo reflejando una propuesta de distribucion de su contenido entre las Comisiones Ay B. No obstante, y considerando la carga de trabajo de la Comision A, la Mesa de la Asamblea ha decidido recomendar a la Asamblea de la Salud que transfiera algunos puntos de la Comision A a la Comision B. Esos puntos serian los siguientes: 13.12 «Prevencion y control del cancer»; 13.13 «Discapacidad, incluidos la prevencion, el tratamiento y la rehabilitacion»; 13.14 «Problemas de salud publica causados por el uso nocivo del alcohol»; 13.15 «Plan de A cc ion Intemacional sobre el Envejecimiento: informe sobre su ejecucion». Dado que la Asamblea acaba de aprobar la inclusion de un punto suplementario en e1 orden del dia aquel, que se refiere al Convenio Marco de la OMS para el Control del Tabaco, informe sobre los progresos realizados, proponemos que este punto se asigne a la Comision A y se examine dentro del pun to 13.19. Se entiende que, mas avanzados los trabajos, puede ser necesario hacer otras transferencias de asuntos de una comision a otra, dependiendo de la carga de trabajo de cada una de las comisiones principales. Por ello, la Mesa de la Asamblea volvera a reunirse el miercoles 18 de mayo y e1 viemes 20 de mayo, para proceder a los ajustes que sean necesarios respecto de la distribucion de los puntos entre las comisiones o del calendario. (,Esta de acuerdo la Asamblea con esas propuestas de distribucion de los puntos entre las Comisiones Ay B? No habiendo objeciones, asi queda acordado.

3. ANNOUNCEMENTS COMMUNICATIONS

La PRESIDENTA:

El programa de trabajo para el martes 17 de mayo sera el siguiente: de las 9.00 a las 12.30 horas, en la tercera sesion plenaria, continuara el debate general sobre el punto 3, y al mismo tiempo, de manera paralela, la Comision A celebrara su primera sesion. De las 13.00 alas 14.30 horas tendra lugar en la sala XII una reunion de informacion tecnica sobre la Cumbre Ministerial sobre Investigacion en Salud celebrada en Mexico. A continuacion, alas 15.00 horas, en la cuarta sesion plenaria proseguira el debate general sobre el punto 3, y al mismo tiempo y de manera paralela la Comision A celebrara su segunda sesion, al tiempo que se reunira la Comision de Credenciales. V olviendo a las sesiones plenarias, para facilitar la organizacion de la semana quisiera proponer un procedimiento que ya se ha seguido en otras ocasiones para que se respete escrupulosamente la lista de oradores en e1 debate relativo al punto 3 del orden del dia, asi como el orden de inscripcion de nuevos oradores en la lista. Las inscripciones deberan entregarse al Ayudante del Secretario de la Asamblea, o durante la plenaria, al funcionario encargado de la lista de oradores, en la tribuna. Propongo que la lista de oradores se cierre maiiana alas 12.00 horas. Entiendo que estas propuestas son aceptables para todos los delegados presentes. Quisiera recordar que aquellos pocos delegados A58NR/2 page 25 que no han presentado todavia sus credenciales oficiales, deben presentarlas a la secretaria de la Comisi6n de Credenciales, en el despacho A 667 de este mismo edificio, antes de las 11 horas del dia de mafiana.

4. REPORTS OF THE EXECUTIVE BOARD ON ITS 114TH AND 115TH SESSIONS RAPPORTS DU CONSEIL EXECUTIF SUR SES CENT QUATORZIEME ET CENT QUINZIEME SESSIONS

La PRESIDENT A:

Pasamos ahora al punto 2 «Informes del Consejo Ejecutivo sobre sus 1143 y 115a reuniones». Como saben, el Consejo Ejecutivo tiene una importantisima funci6n que cumplir en relaci6n con Ios asuntos de la Asamblea de la Salud. El Consejo, conforme a la Constituci6n de la Organizaci6n Mundial de la Salud, debe dar efecto a las decisiones y politicas de la Asamblea de la Salud; debe actuar como su 6rgano ejecutivo y debe asesorar a la Asamblea sobre las cuestiones que se le someten, con independencia de que tambien el Consejo puede presentar propuestas por iniciativa propia. En consecuencia, el Consejo nombra cuatro miembros para que lo representen en la Asamblea de la Salud. La funci6n de esos representantes es exponer en la Asamblea, en nombre del Consejo, el fundamento y el canicter de las recomendaciones formuladas por el Consejo Ejecutivo para su examen por la Asamblea. Por lo tanto, las declaraciones de Ios representantes del Consejo Ejecutivo, cuando hablan como miembros del Consejo designados para presentar las opiniones del Consejo, se deben distinguir de las opiniones de los delegados cuando expresan el punto de vista de sus gobiemos. Me complace ahora dar la palabra al representante del Consejo Ejecutivo, el Sr. David Gunnarsson, Presidente del Consejo.

Mr GUNNARSSON (Chairman of the Executive Board):

Madam President, Director-General, distinguished delegates, ladies and gentlemen; first of all, I would like to congratulate you, Madam President, and the other office-bearers on your election, and wish you every success in chairing what promises to be a very full agenda. Delegates, when my name was first put forward as Chairman of the Executive Board, I was very hesitant; but after having served on the Board for one year, I must admit that it has never been a burden, it has always been a pleasure. I am sure that in a week's time, when a new Chairman is elected, I am going to miss the work as Chairman of the Executive Board. I have come to believe, also, that we really live in a much better world than you would believe, listening to the news all around us. I have sensed so much goodwill between nations and between individuals on the Board. I would now like to focus briefly on the highlights of the work of the Executive Board over the past year, at its 114th and 115th sessions (a more detailed report is contained in document A58/2). At its 114th session, the Board adopted three resolutions on technical issues: sustainable financing for tuberculosis prevention and control; cancer prevention and control; and disability, including prevention, management and rehabilitation. In addition, the Board welcomed the Secretariat's work on avian influenza. In their discussions, Members emphasized the importance of preparedness against potential influenza pandemics -an issue that will be taken up by this Health Assembly. The Board also considered reports on human resources in health and manufacture of antiretrovirals in developing countries. The Board took note of progress in the implementation of multilingualism in WHO, and some members emphasized the need for more work on this issue. As part of the review of its working methods, the Board decided to merge its three committees- the Administration, Budget and Finance Committee, the Programme Development Committee and the Audit Committee - into a single Programme, Budget and Administration Committee, which was established through resolution EB114.R4. The I 15th session of the Board was held just three weeks after the tragic tsunami in the Indian Ocean, and an extensive debate was held on the first day on responding to health aspects of A58NR/2 page 26 humanitarian crises, which was dominated by discussion of the devastating effects on the countries and peoples affected. Under technical and health matters, several resolutions were put forward by the January session of the Board for your consideration at this Health Assembly, on topics such as infant and young child nutrition; social health insurance; the establishment of an annual World Blood Donor Day; malaria; public health problems caused by harmful use of alcohol; eHealth; rational use of medicines; the implementation of the International Plan of Action on Ageing; influenza pandemic preparedness and response; and responding to the health aspects of crises. On other technical matters, the Board accepted the proposal for an expanded global smallpox vaccine reserve, and took note of the Secretariat's reports on the draft global immunization strategy and the eradication of poliomyelitis. In addition, the Chair of the Intergovernmental Working Group on the Revision of the International Health Regulations was able to brief the Board on progress made. The Board accepted the new Programme, Budget and Administration Committee's recommendation that the consultative process on strategic resource allocation should continue, with new draft guiding principles to be submitted to the Board at its ll6th Session. With regard to the Proposed programme budget for 2006-2007, the Board also took note of the Committee's concern regarding the increasingly high proportion of the total budget made up by voluntary contributions. The Board agreed that the Director-General would engage in further consultations before submitting the proposed budget, revised in the light of members' comments, to the Health Assembly. The continuing consultative process for the Eleventh General Programme of Work 2006-2015 and the draft outline for that Programme were also noted. The Executive Board appointed Dr Luis Games Samba as Regional Director for Africa, and expressed its appreciation to the retiring Regional Director, Dr Ebrahim M. Samba. Dr Marc Danzon was reappointed as Regional Director for Europe. In December, the Government of Iceland was pleased to host a two-day seminar of Executive Board members in Reykjavik, Iceland. Members were able to have a frank and interesting exchange of views with the Director-General and his senior staff on future scenarios in global public health. Between meetings of the Executive Board, I have in my role as Chairman, participated in a few WHO meetings. In November last year, in Mexico: the Ministerial Summit on Health Research; in March in Chile: the first meeting of the Commission on Social Determinants of Health; and last week in Phuket, Thailand: a meeting on the tsunami where experts from the Secretariat, the private sector, other United Nations organizations and the military and nongovemmental organizations tried to analyse what had happened, what went wrong, what was well done, what could be learnt. Visiting Phuket now leaves no one untouched. I want to leave a few thoughts with you. First, coming from a country where we have to live with, and be prepared for, all sorts of crises that nature visits upon us, I must be frank and admit that I did not hear at the meeting any new technical innovations for preventing disasters or rescuing people; secondly, the question is, how could 300 000 people die when we know so much about disaster prevention and rescue? There is no simple answer. Around our globe, the national warning systems are usually dimensioned for smaller episodes. An enormous earthquake in the middle of the ocean could only be measured either by faraway seismic instruments or, in the case of the tsunami, by satellites. We did not have communications systems able to send information from the seismic instruments or satellites to the places at risk. If it had been possible to send out a warning, people would have had two to four hours to move to safety. We need early warning systems not only for diseases and the weather, but also for other natural disasters. Two of these warning systems for weather and natural disasters do not come under the mandate of WHO. But the consequences of the lack of warning systems certainly do. Thirdly, in some of the worst-hit places, much of the rescue was done by the military. Some 20 countries had military forces on the scene. One such place was Aceh in North Sumatra. The aircraft carrier USS Abraham Lincoln played an important role in that rescue. Yet it took more than ten days before they could start operating. It took some days to arrive, some days to set up the communication systems and some days to go through all the formalities to enable the military to do rescue work on foreign soil. You need to spend a lot of time on paperwork. One of the suggestions proposed in Phuket was that maybe the time has come when the international society, the United Nations or others should negotiate an international agreement that makes it easier and faster for any country to offer military assistance and also easier for countries to accept such offers from others. Fourthly, catastrophes and diseases are deadly but they also ruin our economies. This was evident when we visited the hospitable coastline resorts around Phuket: they A58/VR/2 page 27 were almost totally empty of tourists. First, the people are badly hurt with physical and mental injuries and then their livelihood is taken away from them. The environment is badly damaged. According to what the geologists tell us there is no more chance of the next big catastrophe hitting the Indian Ocean than the coasts of Iceland or any other country. So let us all go and have our holidays in some of the many beautiful places around the Indian Ocean. We could start by attending the Sixth Global Conference on Health Promotion in Thailand and, in such a way, show solidarity with that part of the world. I also participated in the Ministerial Summit on Health Research in Mexico. During that meeting it became very obvious to me that we are faced with what we can call the dilemma of "the ethics of ethics". In the developed countries, we spend millions upon millions on clinical research to minimize all the possible side effects of drugs and medical procedures, and by doing that we multiply the cost of drugs. At the same time people in the underdeveloped parts of the world are getting few or even no drugs or receiving no medical treatment. As somebody from that part of the world put it in Mexico: we do not need research that decreases the risks of complications by 5%, we need cheap drugs and medical procedures that can save tens of millions of lives now; even if that means that the drugs and procedures involve some risk. We need funds for research to help us build health systems and infrastructure that can organize human resources to distribute and deliver drugs and treatments to millions of people. This dilemma is not easy. What is not considered good enough in a rich country may save millions of lives in a poor country. That is why I call it "the ethics of ethics", because double standards are unacceptable. How are we going to face and deal with that ethical question? I do not know! The Mexico Summit suggested we should increase health systems research. Finally, a few words about the meeting in Chile, which was also very important indeed. How do social determinants influence our health? I think it was Sir Michael Marmot, the Chairman of the Commission, who said in Reykjavik last December, with slight editorial liberties by me: "If you want to be healthy choose rich parents; and if you miss out on that, you should at least marry rich if you want to stay healthy". In other words, those who are well off are usually much healthier than those that are poor. Iceland, my country, two or three generations back, was one of the poorest countries in Europe and in the whole world. The health of our people was also very poor. We have only a few natural resources apart from the fish in the ocean, powerful rivers, geothermal energy in the ground and the education of our people. We have had to learn to use those resources to their utmost. Let me give you an example of how we learned to increase the value of our fish products. When the President of Iceland invited the Members of the Executive Board for dinner in Iceland last December, he served the participants with the meat from the back of the neck of cod. This is a part of the fish that, when I was living at home with my parents (more years ago than I care to remember), was considered useless waste. If my mother had even suggested it as food, I would have rebelled and left home. In those days, it was simply thrown away. Today it is sold per kilo for almost the price of silver. The fact that we have a very productive fishing industry, with good quality fish that sells well in the international market, has made us one of the highest per capita income countries on our globe. The health status of my nation has also increased enormously. The transition in Iceland from a poor to a rich country took, I believe, 70 to 100 years. It was not always easy and it is still very dependent on mother nature. I sincerely hope that the Commission on Social Determinants of Health can come up with ideas that will help more countries to move fast from poverty to prosperity. This is probably the most important task we are faced with today. This concludes the report of the Chairman of the Executive Board. Let us remember that health is involved in most things we do. If we behave rationally, act responsibly and use common sense, we all have a good chance to enjoy good health in the future. Finally, Madam President, my colleagues and I, would like to reassure you that we will be available during the discussions in the committees of the Health Assembly. We stand ready to lend you our full support and provide information as needed on how the Board dealt with certain items under consideration by this Health Assembly. A58NR/2 page 28

La PRESIDENT A:

Muchas gracias, sefior Gunnarsson, por su excelente informe. Quiero aprovechar esta oportunidad para rendir un homenaje a la labor del Consejo Ejecutivo, y en particular, expresar nuestro reconocimiento y nuestro sincero agradecimiento a todos los miembros salientes que han contribuido tan activamente al trabajo del Consejo. Tengo el placer de dar la bienvenida en nombre de la Asamblea a su Excelencia sefior Maumoon Abdul Gayoom, Presidente de la Republica de Maldivas, al sefior Bill Gates, cofundador de la Fundaci6n Bill y Melinda Gates, y a la senora Ann Veneman, nombrada Directora Ejecutiva del UNICEF.

5. ADDRESS BY THE DIRECTOR-GENERAL ALLOCUTION DU DIRECTEUR GENERAL

La PRESIDENT A:

Doy la palabra al doctor Lee Jong-wook, Director General.

Le DIRECTEUR GENERAL :

Monsieur Gayoom, President de la Republique des Maldives, Monsieur Bill Gates, Madame la Presidente, Mesdames et Messieurs les Ministres, Mesdames et Messieurs les delegues, Mesdames et Messieurs, il y a soixante ans, les dirigeants mondiaux etaient engages dans un vif debat sur la maniere d'assurer le bien-etre de l'humanite apres la Deuxieme Guerre mondiale. C'etait pour eux !'occasion d'appliquer les connaissances qu'ils avaient acquises au prix des luttes devastatrices des annees precedentes. Leurs efforts ont debouche notamment sur le systeme des Nations Unies. A notre tour, nous sommes reunis ici cette semaine pour tirer les le<;:ons du passe et mettre ce savoir en pratique. La situation mondiale a continue de changer et nos institutions ont continue de s'adapter. L'ordre dujour en cette Cinquante-Huitieme Assemblee mondiale de la Sante rend compte de cette evolution tout en temoignant de !'importance constante et essentielle de la lutte contre les maladies et de !'amelioration de la sante pour une societe mondiale viable.

(L'orateur poursuit en anglais.) (The speaker continued in English.)

Well, I think that bad French is better than no French! I would like to thank the Vienna Philharmonic Orchestra for becoming our Goodwill Ambassador this morning. By playing for us this morning they have already provided an excellent summary of WHO's message to the world. It is that effective health work is, as our founders rightly put it, "basic to the happiness, harmonious relations and security of all peoples". This Health Assembly gives us a unique opportunity to ensure that our action is well-informed, and our knowledge is well-used. Health work teaches us with great rigour that action without knowledge is wasted effort, just as knowledge without action is a wasted resource. The most inclusive recent expression of the will of governments around the world is the Millennium Development Goals, and they place health at their centre. Yet the translation of those Goals into reality is still very far from completion, and progress towards them is not reassuring. Unless we succeed in bringing about the major changes we are working for in the very near future, the targets for reducing child mortality will not be achieved by 2015. This is a simple clear fact. Although the coverage rates for some health interventions have risen as planned, we have not yet seen the necessary improvement in health indicators. In some areas, death rates have actually risen as a result of extreme poverty and epidemics. A58NR/2 page 29

The technical and practical know-how exists for achieving what is necessary for global health, but we have not yet found ways to apply it on a large enough scale. The most encouraging trend so far has been the rise in funding for health development. Although it is still only a small fraction of what is needed, it has risen steeply. This means we have at least begun to overcome one of the biggest obstacles to progress on the Millennium targets, which is lack of resources. This intensifies the need to make the best use possible of the means we do have at our disposal. You will be discussing our Proposed programme budget for 2006-2007 early this week. It is aimed at reinforcing the positive trend by improving results in countries. To do so, the budget shows increases in the areas of epidemic alert and response, maternal and child health, noncommunicable diseases, tobacco control, and response to emergencies. It reflects our commitment to increased efficiency in our actions through results-based budgeting, and increased responsibility at the point of delivery of health care. Negotiation is a powerful means of ensuring that knowledge leads to action. The Framework Convention on Tobacco Control is a shining example of what can happen when creative dialogue combines the efforts of many partners. The Convention has now entered into force and has 64 Contracting Parties. Our goal is for the greatest possible number of Member States to become Contracting Parties, so as to maximize the impact of the Convention and fulfil its potential for saving lives. This success in reaching agreement and moving without delay to ratification is the proof that patient negotiation can get results. Tomorrow, we will be considering the outcome of discussions that potentially have even more far-reaching implications for global health. The revision of the International Health Regulations has received intense attention during the last few months and, as many here will attest, during the last few nights and days. In fact, to be very precise, it ended on Friday morning at 04:30. Agreement on these Regulations will be a landmark event for public health, but its significance will only be fully realized when the Regulations are in place and are being observed and implemented. Implementation will require very strong national capacities for detection, verification and response to disease outbreaks and other events. Achieving this will be a major undertaking in the immediate future. Global coordination has acquired a valuable asset with the Strategic Health Operations Centre, which was constructed and came into operation last year. It serves as the nerve centre for bringing together the logistics and health information needed to respond to public health emergencies. With headquarters, regions and countries, there are now more than 60 offices included in the Emergency Network. It provides an environment of instant communication between Member States and technical partners. Following the tsunami in south Asia, our Health action in crises unit used it to its maximum advantage to coordinate responses. At present it is enabling local, national and international health workers to contain the outbreak of Marburg haemorrhagic fever in Angola. In Thailand, at the tsunami conference earlier this month, a journalist asked me about WHO's concern over health risks during the first days of devastation. We had issued strong warnings of cholera, malnutrition and potential epidemics due to poor sanitary conditions, and the question now was whether those had been false alarms. My answer was: definitely not. We and our partners took rapid action to ensure the safety of water, the adequacy of nutrition, and the reliability of disease surveillance. That is how the escalation of the disaster was averted. All types of organizations were involved in this unprecedented effort of collaboration - government, nongovernmental and private sector. It has given us a welcome demonstration of what is possible. In that case action was effective because it was based on knowledge. The participants in the conference also highlighted many areas in which action was ineffective or even counterproductive for lack of knowledge and coordination. In emergencies it is particularly clear that action without knowledge is just as wasted as knowledge without action. We are working with our partners to achieve a better balance in future crises. Overall, the rapid and effective response to the tsunami was achieved thanks to the outstanding efforts of colleagues in the affected countries and elsewhere around the world. When prevention efforts are successful they are liable to go unnoticed. I would like to take this opportunity therefore to acknowledge the tremendous effort made by the many health and relief workers who worked day and night for many weeks to limit the devastating effects of this disaster. The capacity to respond to health threats quickly with well-coordinated action is indispensable for public health in the twenty-first century; that capacity is growing rapidly. WHO started the Global Outbreak Alert and Response Network five years ago. With the technical institutions of Member A58NR/2 page 30

States and the WHO collaborating centres, the Network has responded to more than 50 major disease outbreaks. There are now 130 institutions in the Network, with more and more from developing countries. Major demands placed on it include those of avian influenza, Ebola, Marburg, meningitis, myocarditis and plague. The Network is also involved in setting up the early warning systems being established following the tsunami disaster. The success of our global effort to maintain and increase security depends on reliable information that is available and clear to all who need it. We have to be able to see with clarity and precision the health needs confronting us, and the means at our disposal for meeting them. The Health Metrics Network will provide extremely valuable support for this effort. This is a new partnership for strengthening national health information systems, benefiting from generous support from the Bill and Melinda Gates Foundation and hosted by WHO. Progress on this core information function for all our activities is also highlighted this year by a new publication, World health statistics, which provides national, regional and global information on 50 health indicators. Clear communication, mutual understanding and agreement are also essential in all areas of disease control. Where the reasons for actions are not known, the actions are liable to fail. This was made painfully clear in the early stages of controlling Marburg in Angola, when villagers were more afraid of the health workers than of the disease the latter had come to control. We have not only to increase and use the expertise that is available, but also to make its purpose and value understood. Research has always been a high priority, and it is arguably more important for our work now than ever before. The need for new diagnostics, vaccines and treatments is urgent, and so is the need for new ways to deploy the technologies that already exist. The Ministerial Summit on Health Research in Mexico in November of last year stressed this need. It called for research policy to be made an integral part of the effort to strengthen national health systems. Following a series of consensus-building meetings, we are now ready to move forward with an international clinical trial registry. This will do much to strengthen the research process and its ability to win public trust. With great and well-founded expectation, we launched the Commission on Social Determinants of Health in Santiago, in March. Leading practitioners from all six of our regions are contributing their outstanding abilities to this effort; devising initiatives to make health systems work effectively and fairly is their immediate task. They are doing this in the context of defining and confronting major underlying causes of ill-health in the twenty-first century. Meanwhile, the Commission on Intellectual Property Rights, Innovation and Public Health will be drawing its findings together and presenting them to the Health Assembly one year from now. Its work will lead to more effective modes of cooperation on the drugs and vaccines that are essential for disease prevention and control. Partnership is the mark of all our major activities. That is especially clear this year with our focus in The world health report and World Health Day on the health of mothers, the newborn and children. All the organizations concerned with these areas of health must join forces and the areas of care themselves, for mothers, the newborn and children, must be combined. Many people in many countries and organizations have been working hard to make this year, 2005, mark a decisive shift towards a decline in mother and child mortality. Our key partner in this effort is the United Nations Children's Fund (UNICEF). As a mark of the solidarity between our two agencies I would like to introduce the new Executive Director of UNICEF, Ann Veneman. She began her time in office two weeks ago. I asked her to come and say a few words to us today about her plans for UNICEF and our common mission. With your permission, Madam President, I would like to invite her to do that now.

Ms VENEMAN (Executive Director, UNICEF):

Good afternoon, Dr Lee Jong-wook, excellencies, distinguished colleagues, thank you very much for the warm welcome. Dr Lee, thank you very much for your kind invitation. I am pleased to share the stage with President Gayoom and Mr Gates. Your partnership and commitment to public health, especially among the most vulnerable, are essential to our ultimate success. Twenty-five years ago, one of my predecessors at UNICEF and one ofDr Lee's predecessors at WHO provided leadership in what was known as the first "child survival revolution". They envisioned a world where oral rehydration salts were widely available, and 80% of children received basic immunization. To a large degree, their vision was fulfilled. But in some places, it was not sustained, and in others progress reached a plateau and stagnated. Today we have our own vision to realize. The A58NR/2 page 31

Millennium Development Goals provide a strategic plan, but it is up to us to ensure success. There are still nearly 11 million children who die every year of preventable causes. Almost always they are the poorest and most marginalized. In the two weeks I have been at UNICEF, I have heard lots of numbers, but that one -11 million- stands out. So do two others: the first is "10"- because 10 is how many years we have to fulfil the promise of the Millennium Declaration and the Millennium Development Goals. The second is "1 million" because in relatively short order we can start saving 1 million children every single year from dying before age five, and that is in sub-Saharan Africa alone. The task before us is daunting, but I come here today to say that remarkable results can be achieved. They can be achieved by starting with sound science, and using an integrated approach to target the most effective interventions. I would return to sub-Saharan Africa as an example, because we simply cannot achieve the Millennium Development Goals without making substantial progress there. In the case of the fourth Millennium Goal - child survival - sub-Saharan Africa faces the greatest challenges. There have been some notable successes at country level, but over the past 15 years, this region on average has lost ground in keeping children alive and healthy. In fact, while sub-Saharan Africa has only about 12% of the world's population, the region accounts for 42% of all deaths under age five around the world. The health threats to children are much like a dam where we plug one leak only to find that another one springs up. We must address the entire structure of this dam. A few years ago, the Government of Canada came to UNICEF with a challenge: for US$ 30 million, design a project in several African nations that will reduce child mortality by at least 15%, at a cost ofless than US$ 1000 per life saved. With those goals in mind, UNICEF developed and piloted an accelerated approach to saving children's lives in 11 African countries, including Benin, Burkina Faso, Cameroon, Chad, Gambia, Ghana, Guinea, Guinea-Bissau, Mali, Niger and Senegal. The programme relied on three specific packages of high-impact interventions and three different delivery methods. The first package involved Integrated Management of Childhood Illness, a joint strategy with WHO. Integrated Management of Childhood Illness addresses the most common life­ threatening conditions, such as diarrhoea, acute respiratory infections and malaria, through prevention and early treatment. The second package involved antenatal care for mothers, and includes measures such as tetanus immunization and presumptive treatment against malaria. And the third was an immunization-plus package that includes triple dose diphtheria-tetanus-pertussis vaccine and measles, as well as distribution of vitamin A. These interventions were delivered in three settings: at health centres, where the integrated management of child illnesses and immunization were conducted; through community outreach services, linking immunization with other interventions such as distribution of bednets and vitamin A supplements; and through the improvement of parenting practices at the household level, which included teaching health skills - such as how to rehydrate children with diarrhoea - exclusive breastfeeding, and the management of pneumonia and malaria in community settings. What really contributed to the success of the project was its implementation. The strategy included performance contracts that were negotiated at the local level with all the key players, and which were based on the accountability of each player delivering specific results. Partners at community level conducted rolling monitoring of so-called "tracer interventions", such as distribution and treatment of bednets and immunization coverage. This helped to identify bottlenecks such as inadequate access, low demand or insufficient compliance, so that we could determine what was working and where to target improvements. The early results of this initiative, finalized last week after months of review, are very encouraging. In fact, they exceed the benchmarks that were established at the outset of the project. We can report that in just three years, the dramatically increased coverage of these high-impact interventions is estimated to reduce child deaths by 20% across a range of countries and settings. The sound science contained in the recent Lancet papers predicts the effectiveness of this type of integrated approach. This programme, which now covers a population of 17 million children and women and is estimated to save nearly 18 000 child lives per year, shows us how it can work on the ground. By integrating and bundling a limited range of high impact interventions over a compact period we can get important results very quickly. The total additional cost of this effort amounted to about US$ 500 per life saved. So for a relatively modest investment, the return in terms of human potential can be vast. Importantly, this approach has now been adopted by countries like Ghana and A58NR/2 page 32

Mali as a major pillar of their national health strategies. We offer our gratitude and thanks to the Government of Canada for its vision, leadership and support for this programme, and to the countries in western and central Africa whose commitment has made these results possible. Countries around the world are demonstrating that progress in reducing child mortality is all about such leadership. In Cambodia, India, Madagascar and many other countries, leadership is making the difference between lives lost and lives saved. One striking lesson of the western Africa initiative is that it was implemented precisely in districts that were the hardest to reach, often with the highest rates of mortality. Perhaps even more importantly, the programme has been easily expanded and replicated, meaning it is not just another pilot, but a start to something bigger. We believe that we can reach 60% of children across sub-Saharan Africa by 2009 with these integrated community-based interventions. It is estimated that doing so would save the lives of an additional 1 million children every year, in that region alone. It will cost an additional US$ 500 million per year, or about US$ 1 per capita across the region. And if we add other breakthrough tools, such as inexpensive antibiotics, we can save even more lives in a region where HIV/AIDS is a major factor in child survival. At a cost of just 3 US cents a day, one particular antibiotic has been shown to reduce mortality in HIV -infected children by as much as 43%. These are the fundamental measures that we know will improve child survival. I personally believe that alongside this basic package of interventions, we can do much more in the next 10 years to expand access to safe water and provide better nutrition. Every day, 4000 children die of water-related diseases - diseases that are preventable. And malnutrition shares the blame for about half of the nearly 11 million children who die needlessly every year. Through the tireless work of organizations like the Bill & Melinda Gates Foundation and others, we are finding creative and innovative approaches and the resources needed to achieve results. Mr Gates, we are all grateful for your enormous support.

(Applause/Applaudissements)

UNICEF applauds the commitment of all of those involved in child survival, including the WHO, governments, nongovernmental organizations, private partners and health experts. Your enthusiasm and your focus not only on threats but on solutions makes this an exciting time. There are just 10 years left in which to achieve the ambitious promise of the Millennium Declaration and the Millennium Development Goals. When it comes to child survival and public health, we have seen what it takes to make progress. We have seen the interventions in action; and we have seen a growing focus on these issues around the world. Our aim must be to ensure that children are not just surviving, but thriving. We can see success, just ahead of us; our task now is to reach out and grasp it. Thank you again, Dr Lee, for including me today.

(Applause/Applaudissements)

The DIRECTOR-GENERAL:

Thank you, Executive Director of UNICEF, I look forward to working very closely with you. Madam President, I would like to end by drawing attention to the most serious known health threat the world is facing today, which is avian influenza. The timing cannot be predicted, but rapid international spread is certain once the pandemic virus appears. This is a grave danger for all people in all countries. We can get some idea of its magnitude from the Spanish influenza pandemic in 1918, which killed between 20 and 50 million people. At that time, public health and medical scientists had very little idea of what was happening until it was too late. By good fortune we have had time - and still have time - to prepare for the next global pandemic, because the conditions for it have appeared before the outbreak itself. We must do everything in our power to maximize that preparedness. When this event occurs, our response has got to be immediate, comprehensive and effective. For all the major health problems before us now, the solutions are available, but we have to put them into practice. Our task here this week and next is to decide on the ways to do this. The energy A58NR/2 page 33 and goodwill available in the world today are more than sufficient to meet all the challenges before us, but they have to be well-informed. The knowledge and skills are available, but they have to be put into practice. Let us make full use of the historic opportunity we have now to meet this double need. Thank you.

(Applause/Applaudissements)

La PRESIDENT A:

Muchas gracias, senora Veneman, muchas gracias doctor Lee por sus palabras. El texto de la declaraci6n del Director General se distribuini mas tarde, pero quiero aprovechar esta ocasi6n para expresarle los mejores sentimientos de afecto personal y de respeto profesional, y estoy segura de que esos sentimientos son compartidos por todos ustedes. Gracias doctor Lee por sus elocuentes palabras.

6. INVITED SPEAKERS INTERVENANTS INVITES

La PRESIDENT A:

Suspendemos el examen del punto 3 para pasar al punto 4 del orden del dia «Orador invitado». Es para mi un gran horror dar la bienvenida en nombre de esta Asamblea al Excelentisimo Sr. Maumoon Abdul Gayoom, Presidente de la Republica de Maldivas, que ha aceptado gentilmente dirigirse a esta Asamblea. Invito, pues, con verdadero placer a su Excelencia el Sr. Maumoon Abdul Gayoom a subir .a la tribuna. El Excelentisimo Sr. Maumoon Abdul Gayoom, Presidente de Maldivas, esta cumpliendo actualmente su sexto mandato y su vigesimo septimo aiio como Presidente. Su carrera en la administraci6n publica de Maldivas comenz6 en el aiio 1971 y ocup6 entre otros cargos el de Subsecretario Especial en la Oficina del Primer Ministro, asi como el de Ministro de Transporte. Ha sido tambien Embajador Adjunto de Maldivas en Sri Lanka y Representante Permanente de su pais ante las Naciones Unidas. Excelencia, tiene usted la palabra.

Mr MAUMOON ABDUL GAYOOM (President of the Republic ofMaldives):

Bismillah ar-rahman arrahim. Madam President, Director-General, Dr Lee Jong-wook, distinguished delegates, ladies and gentlemen. I would like first of all to congratulate you, Madam President, on your election to preside over the Fifty-eighth World Health Assembly, and to wish you success in your important assignment. I would like also to thank the Director-General of WHO, Dr Lee, for inviting me to address this session of the Health Assembly. It is indeed a great privilege, which I deeply appreciate. I had the pleasure of receiving Dr Lee in Male last year. His commitment and dedication to the aims and goals of WHO is indeed praiseworthy. Before I proceed further, I note with pleasure that Mr Bill Gates is scheduled to speak after me. I understand that his Foundation has committed more than US$ 4 000 million in global health grants to organizations across the world, including WHO. I am sure that I am echoing the sentiments of all of you and those of the Executive Director of UNICEF who spoke just before me, in expressing our deep appreciation to Mr Gates and to his Foundation for their great contribution to the cause of providing better health care worldwide. I want to speak to you on some matters of deep concern to my country, Maldives, and to the world. Sitting in this palatial meeting hall situated in the centre of this historic city of Geneva, surrounded by such a breathtaking panorama of natural beauty, it may be difficult for us to visualize the enormity and magnitude of natural disasters and other overwhelming problems that millions of people have to cope with in many parts of the world. Imagine a bright sunny day, on a small tropical island that rises no more than one metre from the mean sea level. Children are playing on the beaches enjoying their school holidays. Most of the able-bodied are out at sea fishing, or at work somewhere A58NR/2 page 34 on the island. All of a sudden, and without warning, the sea swells to some four metres, and crashes through the whole island. Within a matter of minutes, the waters recede as the tsunami rips through the Indian Ocean. In its wake, loved ones go missing, never to be seen alive again; the whole island is turned into rubble, and the entire community is left in shock. That was what happened to many islands in Maldives on 26 December 2004. One third of our people were directly affected, many of whom lost their livelihoods, and some 5% of the population was internally displaced. Nearly two decades of development and some 62% of the gross domestic product were washed away in a few hours. An economy that was expected to grow at around 7% will now barely attain 1% growth. Many governments and donor agencies have committed substantial funds for our recovery and reconstruction. We are extremely grateful to all of them, but our fear is that the promised assistance might take too long to materialise. We are also particularly concerned about the fact that the donor community has been very slow to react in providing assistance for the important task of reconstructing the damaged water and sewerage infrastructure. Equally urgent is cleaning up debris, garbage and waste piled up in the wake of the tsunami, in order to avert public health risks. However, the huge financing gap in this area, too, has meant that progress in addressing this concern has been slow. I share Mr Gunnarsson' s concerns about earthquakes and tsunamis and the damage and destruction they bring, and I agree with him that an early warning system is a "must". But I would like to add further that, for countries like Maldives that rise barely one metre above sea level and which consist of very small islands, an early warning system - in itself- can do nothing to save our people. They tell us, when the warning is there, to go three or four miles away from the sea front, or to go up about one hundred feet; nowhere in Maldives is three miles away from the sea and nowhere in Maldives is one hundred feet up. So having an early warning system, although in itself it is an important step, will not be enough. We have to develop a strategy whereby people in Mal dives and other low-lying nations can find refuge once the alert has been sounded. Turning to the various public health problems that the world is facing, I shudder to think of the millions who die daily from preventable diseases. Thousands of people all over the world are also dying from HIV I AIDS, drug-resistant strains of tuberculosis, and other communicable diseases. No epidemic has probably ever posed as severe a challenge to humankind as that now posed by HIV I AIDS. The world today has become very small. Globalization, fast air travel and trade have increased the opportunities for partnerships and socioeconomic integration. But these have also opened windows for the rapid spread of infectious diseases from one part of the world to another, within a matter of days. While communicable diseases like malaria, tuberculosis and cholera continue to be major public health challenges in several countries, concerns about the emergence of new pathogens have become equally worrying. Severe acute respiratory syndrome was the most recent and significant among these new infections. Of no less concern to all of us is avian influenza, which is being reported from a number of Asian countries even now. It is believed to have the potential to transform itself into a new pandemic strain, against which the human population would have little or no immunity. According to the scientific community, such a global pandemic could kill over 100 million people. While pandemics could threaten to kill millions of people worldwide, there can also be localized health hazards that could have equally, if not more, devastating health impacts on affected communities. A health issue of great concern to Maldives is that of thalassaemia. Nationally, one in five persons is a thalassaemia carrier and one in every 120 newborns suffers from this genetic disease. The only permanent cure is bone marrow transplantation - a treatment not available in Maldives and prohibitively expensive overseas. If preventive steps are not taken to reduce the incidence of thalassaemia in Maldives, informed projections show that in 50 years' time, the cost of treatment could consume over 40% of per capita health expenditure. The need to build capacity has been well illustrated by the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has made available billions of dollars for health. However, with ill-equipped and understaffed health systems, few developing countries are in a position to make full use of this unprecedented opportunity for health development. I feel WHO can play a crucial role in overcoming this obstacle, and can support countries in making use of this opportunity to build their health systems. There is much that is said these days about global warming, but not nearly enough about the health impacts of climate change. Agenda 21, the blueprint for sustainable development in the twenty- A58NR/2 page 35 first century, stressed as its foremost principle the protection of human health, and emphasized the close nexus between health and the environment. One might belong to a rural village or a bustling city; live in a slum or in a mansion; work on a farm or in a factory; or dwell in a mud hut on a delta or in a hamlet on a hilltop; the state of the global environment has a profound effect on each and every person's health wherever they are. According to WHO's statistics, over five million children die every year from illnesses and other conditions caused by the environment in which they live, learn and play. Acute respiratory infections aggravated by air pollution, diarrhoea from contaminated food and water, and malaria are the leading causes of death of children in the developing world. Climate change is the most pervasive result of environmental degradation, which is already affecting human health in a variety of ways. Today we know for certain that mankind's activities are changing the world's climate. Under the United Nations Framework Convention on Climate Change of 1992, national governments have a responsibility to carry out formal assessments of the risk to their population's health posed by global climate change. Let us today reaffirm our commitment to honour this important responsibility. For a country like Maldives, the environment poses particular health-related challenges. Our islands are typically small, with porous sand and a thin lens of potable water. The population is dispersed over 200 islands in generally very small communities. The cost of health care is high, with no economies of scale. Even so, considerable progress in the health status of the population has been attained over the past two decades, not only through significant gains in reducing infant, child and maternal mortality and in extending life expectancy, but also in stabilizing population growth. However, water and sanitation and waste management remain problems that require urgent attention. Indeed, in our quest to achieve our stated Millennium Development Goals, the most important challenges are those related to water and sanitation, and nutrition. Not only does our environment affect morbidity, but it also threatens the very survival of the nation. The most serious form of degradation of the environment is of course global warming, where the rising temperatures could kill the coral which forms the basis of our habitat. We would indeed suffer economic ruin if corals die, but such an event would also starve the nation of essential supplies of fish, which forms part of the staple diet. Moreover, global warming would also alter the epidemiological pattern, with an increase in vector-borne diseases and the emergence of more virulent forms of tropical diseases. And perhaps what is worse, as the seas rise, the water aquifers and the soil are likely to be poisoned by excess salination. In its latest report, the Intergovernmental Panel on Climate Change predicts significant rises in global temperatures in the coming years and decades. This would result in sea-level rise and greater frequency and intensity of extreme weather events. The links between the environment and health show that addressing the challenges in both areas calls for a global partnership, where everyone becomes part of the solution and no one is a problem. I firmly believe humanity is like the human body: what ails one part of the body affects the whole person. More than others, those who work in the health sector know how it feels to put a smile back on the face of a child, and to bring someone back from the brink of death. But at the end of the day, prevention is still better than cure. Let that be our goal in promoting environmental health. Thank you.

La PRESIDENT A:

Despues de haber escuchado estas palabras tan elocuentes y tan emotivas por parte del Excelentisimo Sr. Gayoom, me complace dar la bienvenida en nombre de la Asamblea de la Salud al Sr. William Gates, fundador de la Fundaci6n Bill y Melinda Gates, que ha aceptado muy amablemente dirigirse a esta Asamblea. Invito al Sr. Gates a subir a la tribuna. El Sr. Bill Gates naci6 en 1955 en Seattle; es presidente de Microsoft Corporation. Emprendi6 sus importantes actividades filantr6picas en 1994, afio en que cre6 la Fundaci6n William H. Gates, una fundaci6n centrada en la salud del mundo. Tres afios mas tarde cre6, junto con Melinda, la Gates Library Foundation, una instituci6n que trabaj6 para dotar a las bib1iotecas publicas de los Estados Unidos de ordenadores de acceso publico provistos de conexi6n a Internet. Estos dos grupos se fusionaron en el afio 2000 para constituir la Fundaci6n Bill y Melinda Gates. Junto con su esposa y cofundadora, Melinda, Bill Gates facilita orientaci6n estrategica a la fundaci6n, promueve las cuestiones fundamentales que esta ha asumido y supervisa sus importantes donaciones. Y sin ninguna A58NR/2 page 36 duda, la Fundaci6n Bill y Melinda Gates se ha constituido en un actor importante en el terreno de la cooperaci6n en salud. Tiene la palabra, sefior Gates.

Mr GATES (Co-founder of the Bill & Melinda Gates Foundation):

Thank you, Madam President, for that kind introduction. I was very honoured to have the Director-General invite me to speak here at the World Health Assembly; and I have been very impressed by the remarks of everyone this afternoon and their commitment to world health. It is a special privilege to talk to the ministers of health - particularly ministers from nations that face a staggering disease burden, unknown in the rich world. My wife Melinda and I have been fortunate enough to travel to many of your countries, and we have seen some of the heroic health work under way there. But even heroic efforts are not enough when disease is rampant and resources are scarce. I can hardly imagine what it is like for you to go into your ministries every morning, knowing that millions of people are seeking your life-saving assistance, and you can meet only a small fraction of that need. In my view - and there is no diplomatic way to put this - the world is failing billions of people. Rich governments are not fighting some of the world's most deadly diseases because rich countries do not have them. The private sector is not developing vaccines and medicines for these diseases, because developing countries cannot buy them. And many developing countries are not doing nearly enough to improve the health of their own people. Let us be frank about this: if these epidemics were raging in the developed world, people with resources would see the suffering and insist that we stop it. But sometimes it seems that the rich world cannot even see the developing world. We rarely make eye contact with the people who are suffering, so we act sometimes as if the people do not exist and the suffering is not happening. All of these factors together have created a tragic inequity between the health of the people in the developed world and the health of those in the rest of the world. I am here today to talk about how the world, working in a concerted manner, can dramatically reduce this inequity. I first learned about these tragic health inequities some years ago when I was reading an article about diseases in the developing world. It showed that more than half a million children die every year from rotavirus. I thought, "Rotavirus? I've never even heard of it. How could I never have heard of something that kills half a million children every year?!" I read further and learned that millions of children were dying from diseases that had essentially been eliminated in the United States. Melinda and I had assumed that if there were vaccines and treatments that could save lives, governments would be doing everything they could to get them to the people who needed them. But they were not. We couldn't escape the brutal conclusion that in our world today, some lives are seen as worth saving and others are not. We said to ourselves, "This can't be true. But if it is true, it deserves to be the priority of our giving". Today, in malaria; AIDS; tuberculosis; malnutrition; maternal, newborn, and child illness and so many other health problems, the world is not doing enough to deliver the solutions we do have, and we are not spending enough to find the solutions we do not have. As a result, millions of people die every year. This does not tell a flattering story; but the story is not over. In fact, the story is starting to change. I believe we are on the verge of taking historic steps to reduce disease in the developing world. What will make it possible to do something in the twenty-first century that we have never done before? Science and technology. Never before have we had anything close to the tools we have today both to spread awareness of the problems and to discover and deliver solutions. Global communications technology today can show us the suffering of human beings a world away. As the world becomes smaller, this technology will make it harder for us to ignore our neighbours, and harder for us to ignore the call of conscience to act. We are seeing the power of conscience in efforts such as the United States' Emergency Plan for AIDS Relief, the United Kingdom's Commission for Africa, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. But the desire to help means nothing without the capacity to help and our capacity to help is increasing through the miracles of science. Again and again, over and over, scientists have made the impossible possible. Recent advances in basic research, particularly the sequencing of the genome, give us a foundation for much better progress against all disease. If we match these accelerating capacities of science with the emerging moral awareness of global health A58/VR/2 page 37 inequities, we have an historic chance to build a world where all people - no matter where they are born- can have the preventive care, vaccines, and treatments they need to live a healthy life. To build this world, I see four priorities. First, governments in both developed and developing countries must dramatically increase their efforts to fight disease. The wealthy world's governments must not be content to merely increase their commitment every year. They need to match their commitment to the scale of the crisis. Yet this will not happen unless we see a dramatic increase in the efforts of developing countries to fight the diseases that affect their people. Countries in sub-Saharan Africa spend a smaller percentage of their gross domestic product on health than any other region of the world. A stronger commitment from developing countries will inspire a stronger commitment from the rest of the world. Priority number two: the world needs to direct more scientific research to health issues that can save the greatest number of lives, which means diseases that disproportionately affect the developing world. In the early 1900s, Nobel prizes were awarded for discoveries about the causes of both tuberculosis and malaria. Yet, more than a hundred years later, we do not have effective vaccines for either one. It is not because the problem is unsolvable; it is because we have not applied our scientific intelligence to this task. The world can change this - for malaria, tuberculosis, and many other diseases. In order to get the world's top scientific minds to take on the world's deadliest diseases, in 2003 our Foundation launched the Grand Challenges in Global Health initiative. We asked top researchers to tell us which breakthroughs could help solve the most critical health problems in the developing world. Scientists from more than 80 countries sent in thousands of pages of ideas, which led to 14 specific Grand Challenges in Global Health. Once we published these Challenges, more than 10 000 scientists submitted proposals for research. They included ideas such as vaccines that do not need refrigeration, hand-held microdevices that health workers can use with minimal training to detect life-threatening fevers, and drugs that can attack diseases that hide from the immune system. The quality of the ideas and the volume of the response showed us that when scientists are given a chance to study questions that could save millions of lives, they flock to it. We were so taken with the response that today we are announcing an increase of our commitment to these Grand Challenges from US$ 200 million to US$ 450 million. I am optimistic. I am convinced that we will see more groundbreaking scientific advances for health in the developing world in the next 10 years than we have seen in the last 50. We are already seeing exciting advances: we are seeing today a new, safe, cheap drug for visceral leishmaniasis, a disease that kills more than a quarter of a million people a year; we have seen a demonstration this past year that we could have a single vaccine for pneumonia that would reduce all deaths in Africa by 15%; we are seeing older malaria drugs make way for new more effective drugs, including new drug combinations that are extremely effective with only three days of treatment. We saw a malaria vaccine in trials last year that showed promise of preventing severe malaria. This year, there will be the biggest malaria-vaccine field study ever. This is the first solid scientific evidence in history that a malaria vaccine for young people is possible. We have also made progress this year towards the first new drug for sleeping sickness in 50 years, a new oral drug that was 100% effective and showed no toxicity in Phase 11 trials. Of course, one of the most daunting challenges is to create an effective vaccine to prevent RN/AIDS. Some of the world's top scientific minds are working on this challenge, but many of the researchers are isolated, under pressure for immediate results, and unaware of their colleagues' discoveries. Fortunately, over the past two years, the global scientific community has come together under the Global HNI AIDS Vaccine Enterprise to coordinate AIDS research under one strategy to help eliminate duplication, identify gaps, and maximize the synergy from so many brilliant minds. There is new energy around this Global HIV/AIDS Vaccine Enterprise, and our Foundation has recently announced US$ 400 million in funds to implement critical parts of this plan. It is time that the energy and commitment to find an HN vaccine matched the magnitude of the pandemic. We are confident that we will ultimately find a vaccine. In the meantime, we are equally confident that the world will see other technologies, such as a pill or a microbicide, that will block the transmission of HN. So I am very enthusiastic about the health discoveries that will come in the near future. But not everyone shares this enthusiasm. We have been criticized for emphasizing research into big health breakthroughs. Some point to the better health in the developed world and say that we can only improve health when we eliminate poverty; and A58NRJ2 page 38 eliminating poverty is an important goal, but the world did not have to eliminate poverty in order to eliminate smallpox; and we do not have to eliminate poverty before we reduce malaria. We do need to produce and deliver a vaccine; and the vaccine will save lives, improve health and reduce poverty. Improving health improves education; it expands productivity; it results in people having smaller families, so resources go further. When health improves, life improves by every measure. That is why we will continue to invest a significant percentage of our resources in searching for low-cost, life­ saving breakthroughs, especially through vaccine research, and we encourage wealthy governments to do the same. Priority number three: the world has to devote more thinking and funding to delivering interventions, not just discovering them. Imagine that one day there is worldwide rejoicing over the discovery of an effective AIDS vaccine. But imagine this too: we discover the vaccine, but do not distribute it; and millions continue to die. Well, what a horrifying thought! Most people would say, "We'd never let that happen". But, in a sense, we already are. That is what the world has been doing for decades in the case of diseases like measles, diphtheria, tetanus, and hepatitis B. In the past five years, more than 30 million children every year have gone unvaccinated with the basic vaccines that are widely used in the industrialized world. As a result, more than a million children die from vaccine­ preventable diseases each year. Getting the intervention to the people who need it should never be an afterthought; it should be built into the design of the new discovery. We need a new emphasis on "breakthroughs you can use" or what we like to call "deliverable technology", which means getting it to the people who need it. At the very outset, researchers should be seeking interventions that are not only effective, but also inexpensive to produce, easy to distribute, and simple to administer. As recently as a few years ago, the best AIDS treatment came in 20-pill cocktails that were notoriously difficult to deliver. Since then, we have seen AIDS treatment go to three pills a day. Discovery can make delivery easier: if we can go from 20 pills a day to three pills a day, why can we not go from three pills a day to a once-a-month treatment? Today, we have tuberculosis drugs that you have to take for nine months. Why can we not find one that works in three days? My background, of course, is information technology, and I know that is very different from global health. But I believe it does give a useful lesson: early in the computer age, computers were very large and costly, which limited the number of people who could use them; the continuous process of discovering new designs helped make the technology smaller and cheaper so that someone like me could declare the goal of a computer in every home and on every desk. Millions more people can get the benefit of new discoveries if you make delivery a priority, and if delivery shapes the design. Finally, priority number four: to find new discoveries and deliver them, we need to make political and market forces work better for the world's poorest people. Political systems in rich countries work well to fuel research and fund health-care delivery, but only for their own citizens. The market works well in driving the private sector to conduct research and deliver interventions, but only for people who can pay. Unfortunately, the political and market conditions that drive high quality health care in the developed world are almost entirely absent in the rest of the world. We have to make these forces work better for the world's poorest people. We have a model, I believe, in the Global Alliance for Vaccines and Immunization, an effort launched in 2000 to address the tragedy of millions of children dying every year from vaccine-preventable diseases. When the project began, vaccines were sitting on the shelf as kids were dying from those very diseases. Other necessary vaccines were not being manufactured at all. The market was not working to bring people what they needed because there was not enough money to create a demand and guarantee a supply. Since 2000, 11 governments have provided hundreds of millions of dollars for vaccine purchase and distribution. This has given companies a market incentive to manufacture these vaccines. As a result, in five short years, four million additional children have been immunized with basic vaccines, 42 million with hepatitis B, five million with Haemophilus influenza type b, and over three million with yellow fever - saving more than 700 000 lives. We hope even more funding will be made available through the proposed International Finance Facility for Immunization. Proposed by the United Kingdom, with support pledged by France, Germany, Italy and Sweden this initiative would provide developing countries with the reliable funding they need, year after year, to buy vaccines, which gives the private sector the market incentives to make them and deliver them. Market forces will work for poor people only if governments put up the funds to create a market. A58NR/2 page 39

Governments will put up the funds when the people in the developed world who now say, "I will not accept malaria, tuberculosis, and AIDS epidemics in my country", decide instead to say, "I will not accept malaria, tuberculosis and AIDS epidemics in my worlcf'. I believe that if we act on these four priorities, we can build a world where all people, no matter where they are born, can have the preventive care, vaccines, and treatments they need to lead a healthy life. We can do this, but everyone has to play a role. Governments in developed countries should match their financial commitments to the scale of the crisis, and make sure their efforts get results. Governments in developing countries should make health a priority by dramatically increasing the percentage of their budgets they commit to health, particularly in their efforts to build health systems that can adopt and deliver low-cost interventions. All governments should increase their research in areas where it can make the biggest impact - which means diseases that take the most lives - even if they do not have these diseases in their own countries. Scientists around the world should design the interventions with delivery in mind. That means designing interventions that are inexpensive to produce, easy to distribute, and simple to administer. Citizens around the world should petition their governments to put up money to make market forces work better for the world's poorest people. It is one thing to define the goals and design the tasks; it is quite another to get them done. An important duty falls to the health ministers in this room. You occupy a crucial position between the people who make funding decisions and the people suffering from disease. You can make an immense difference by urging the world to make eye contact with the people who are suffering. You can also show the world that there are solutions that work. One key to this is the new Health Metrics Network, which will be announced tomorrow and which we are proud to support. This Network will work to strengthen health information systems in countries so that health efforts are based on evidence, not speculation. If countries join this Network to help show that investments in health can be effective, funders around the world will have every reason to act. Change won't happen without you. I ask you to make the most of your opportunities to move our world in the right direction. I especially look forward to working even more closely with the ministers from the developing world, who are such crucial partners in this undertaking. There is no bigger test for humanity than the crisis of global health. Solving it will require the full commitment of our hearts and minds. We need both. Without compassion, we will not do anything; without science, we cannot do anything. So far, we have not applied all we have of either. I am optimistic that in the next decade, people's thinking will evolve on the question of health inequity. People will finally accept that the death of a child in the developing world is just as tragic as the death of a child in the developed world, and the expanding capacities of science will give us the power to act on that conviction. When we do, we have a chance to make sure that all people, no matter what country they live in, will have the preventive care, vaccines, and treatments they need to live a healthy life. I believe we can do this; and if we do, it will be the best thing humanity has ever done. Thank you.

7. ANNOUNCEMENTS COMMUNICATIONS

La PRESIDENT A:

Quisiera hacer ahora una importante invitaci6n relativa a la elecci6n de Miembros facultados para designar una persona que forme parte del Consejo Ejecutivo. El articulo 101 del Reglamento Interior de la Asamblea de la Salud dice lo siguiente: «Al comienzo de cada reunion ordinaria de la Asamblea de la Salud, el Presidente invitara a los Miembros a comunicar a la Mesa de la Asamblea cuantas propuestas deseen presentar sobre la elecci6n anual de los Miembros facultados para designar una persona que forme parte del Consejo. Esas propuestas deberim hallarse en poder del Presidente de la Mesa en el plazo maximo de veinticuatro horas a contar desde que el Presidente, en aplicaci6n del presente articulo, haya formulado la invitaci6n». En consecuencia, invito a los delegados que deseen presentar propuestas relativas a esta elecci6n a que las comuniquen al Ayudante del Secretario de la A58NR/2 page 40

Asamblea antes de las 16.00 horas del martes 17 de mayo, para que la Mesa de la Asamblea pueda reunirse y formular sus recomendaciones a la Asamblea respecto de esta e1eccion.

8. ADDRESS BY THE DIRECTOR-GENERAL (resumed) ALLOCUTION DU DIRECTEUR GENERAL (reprise)

La PRESIDENT A:

Quiero sefialar, antes de comenzar el examen del punto 3, la recomendacion del Consejo Ejecutivo de que en sus intervenciones atribuyan una atencion especial al tema de esta Asamblea, a saber, la salud de la madre y el nifio. Los de1egados que deseen dar cuenta de aspectos destacados de la actividad sanitaria de su propio pais pueden presentar por escrito su informe para que consten en acta, de acuerdo con la resolucion WHA20.2; tambien deseo sefia1ar a su atencion la resolucion WHA50.18 en la que se recomienda a los delegados que limiten sus intervenciones a cinco minutos. Para recordar a los oradores esa recomendacion, se ha insta1ado un sistema de luces que ven ustedes aqui: la luz verde pasan1 al amarillo cuando hayan transcurrido cuatro minutos y finalmente al rojo en el quinto minuto. Si alg{.tn delegado desea presentar una declaracion para su inclusion in extenso en las aetas literales, o si tiene una version escrita del discurso que va a pronunciar, deben1 facilitar capias al funcionario encargado de la lista de oradores para agilizar la interpretacion y la transcripcion de las aetas. Este procedimiento se aplican'l tambien a los delegados que tengan que abandonar Ginebra y no puedan pronunciar su discurso en relacion con este punto del orden del dia antes de retirarse. Pueden pedir que el texto integro se publique en las aetas de la Asamblea. Queda abierto el debate sabre el punto 3. Los dos primeros oradores de la lista del dia del boy son el delegado del Japon y el delegado de Egipto que hablan1 en calidad de representante de Estados miembros de la Liga de Estados Arabes, y por lo tanto representani a 22 paises. Les invito a ambos a que suban a la tribuna. Tiene la palabra el delegado del Japon.

Dr FUJII (Japan):

Madam President, Director-General, distinguished delegates, ladies and gentlemen, on behalf of the Government of Japan I would like to express my appreciation for this opportunity to present our position on international health issues. As globalization progresses, health issues become globally shared. With the threat of new and re-emerging infectious diseases on the rise, and the shortening of life expectancy through the spread of AIDS, we face the menace of one country's health crisis directly affecting another, or of one disease undermining the socioeconomic foundation of an entire nation. Now is the time for all Member States to treat health threats as a common problem, and work together in international solidarity to ensure the safety of our populations. One important step in this direction is international consensus on achieving the Millennium Development Goals. At present, one quarter of the world's population is living in poverty. The realization of global cooperation towards alleviating poverty is a significant achievement, but in order to truly secure world-wide good health, above all else, we must strengthen our efforts and intensify our health measures for the world's poor. Since his inauguration, Dr Lee Jong-wook has energetically tackled a wide range of issues, and Japan greatly commends his endeavours. The first I must mention is the rapid response to the tsunami disaster that hit the Indian Ocean rim in December last year. WHO dispatched surveillance and response experts to the affected sites through the Global Outbreak Alert and Response Network. Thanks to their rapid assessments, WHO succeeded in containing an anticipated outbreak of infectious diseases. It was only through WHO that this kind of prompt response mechanism could be realized. In parallel, Japan immediately provided emergency funding to the affected countries. The second undertaking I should like to mention involves Dr Lee's efforts to conclude the Framework Convention A58/VR/2 page 41

on Tobacco Control. Japan ratified the Convention at the earliest possible date in June last year. We are counting on Dr Lee's further leadership for the effective functioning of this important Convention. Third is his response to HIV/AIDS. Through WHO's leadership, the "3 by 5" initiative has clearly shown the effectiveness of antiretroviral treatment, and enabled 700 000 people to receive it by the end of 2004. Japan has long been committed to HIV/AIDS response, and has appealed for a comprehensive support package to provide not only prevention, but also cure and care. We are confident that WHO will lead the way in this direction. Through our recent experiences with SARS and avian influenza, all of us have become aware of the importance of a cross-border public health network without any geographical gaps, as well as the importance of the universality of WHO. What is vital is that the international community responds quickly to new risks to public health. A complete overhaul of the International Health Regulations has long been under discussion. We hope this Health Assembly will adopt the revised Regulations, and that preparedness and response action will be further strengthened through WHO. Japan wishes to offer its positive cooperation in this endeavour. The newly issued World health report takes maternal and child health as its theme. We fully welcome the report, which states the need for continuous care for mother and child, as well as the importance of good health systems that support such programmes. In order to maintain the successes of each programme, including maternal and child health, we must integrate essential medicines, health facilities, health information systems and other elements into cohesive and sustainable public health systems, with particular emphasis on human resources development. Public health networks, as well, can only function on this basis. We believe that development partners should provide comprehensive support from this standpoint. Many challenging health issues are ahead of us. Japan, as a member of the international health community, will extend its support until people all over the world can enjoy good health, which, we believe, is the mission of WHO. Thank you very much for your kind attention.

La PRESIDENT A:

Muchas gracias. Tiene ahora la palabra el delegado de Egipto que hablani en calidad de representante de Estados miembros de la Liga de Estados Arabes. Puesto que hablani en nombre de 22 paises, tendra a su disposici6n 10 minutos en vez de cinco. Despues de Egipto hablara el representante de los Estados Unidos de America.

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Mr LEAVITT (United States of America):

Madam President, Dr Lee Jong-wook, I am pleased to attend the World Health Assembly, and honoured to represent the United States of America. On behalf of President George W. Bush, I reaffirm America's strong commitment to WHO. I am committed to improving the health and well­ bei~g of people. wherever I can, and committed to making health a priority in United States foreign pohcy. Health diplomacy makes good neighbours, and extends America's spirit of compassion around the world. Americans will continue to promote a culture of life and human dignity. We will reach out to reduce suffering, to promote understanding, and to inspire compassionate action to care for the truly needy and foster self-reliance. Working together, we can help improve the human condition around the world. We strongly commend the Director-General, Dr Lee, for his leadership. We applaud his A58NRJ2 page 44 initiative to place maternal and child health at the top of the WHO agenda. When women are healthy, when children and families are healthy, their communities thrive. One of our most pressing global health priorities is fighting AIDS. We in the United States have marshalled our resources to combat this scourge. President Bush's five-year, US$ 15 000 million Emergency Plan for AIDS Relief is the largest commitment ever made by any government towards international health initiatives. The initial data from the field suggest that the President will meet his goal of treating more than 200 000 people in the 15 focus countries by next month, which will be the end of the first year of full implementation of the Plan's programme. We must be vigilant in fighting other global infectious diseases as well. That is why we support WHO's efforts to revise the International Health Regulations. These Regulations will benefit and protect all people around the globe. Adoption of the revised Regulations will be an effective tool in our efforts to respond to the challenges posed by biological, chemical or radiological threats to public health, whether naturally occurring, deliberate, or accidental. These are serious threats, but there is another threat that may affect more people in more regions than any one event, no matter how major. I am referring to the grave and growing threat of an influenza pandemic. We have seen the damage avian influenza has already caused to the economy and people of south-east Asia. In the age of globalization, avian influenza could spread quickly to even more countries and regions, putting millions of lives at risk. In fact, I believe that the world is closer to a potential influenza pandemic now than at any time in decades. The best defence against such a catastrophic event is preparedness and early warning disease surveillance. Every day of warning will save lives. That is why the United States launched an initiative to train researchers and epidemiologists to improve management and surveillance, to foster communications among health experts and to improve laboratory capabilities. There is a time in the life of every problem when it is big enough for us to see but small enough for us to solve. For influenza preparedness, that time is right now. There is one medicine that helps stem the tide of every disease, old or new, easily treated or drug-resistant. That medicine is cooperation; cooperation helped us stop the Marburg virus. We commend WHO for its efforts: we sent infectious disease specialists from our Centers for Disease Control and Prevention to support and complement those that WHO has extended. Cooperation is helping us to eradicate poliomyelitis: we stand, as a world, at the brink of a victory won by WHO, UNICEF, the United States, Rotary International, and many others, although many challenges remain. Cooperation helped tsunami survivors as well. The United States was sending help to many of these locations before the tsunami struck, and we remain committed to helping those affected by this terrible disaster. Doctors, hospitals, consumers, and insurers in my country are poised to cooperate on the adoption of interoperable health information technology. Once we can transmit medical data electronically with common standards while protecting our privacy, we will benefit from fewer medical mistakes, lower costs, less hassle, and better health. And I encourage you to foster this process in your home countries. Fellow Ministers, let us never forget that concern for health transcends governments, it transcends cultures, language and political divisions. We must continue to work together to improve the well-being of people everywhere. We can accomplish so much more by working together to reward results and look for neighbourhood solutions. I look forward to working with all of you. Thank you very much.

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La PRESIDENT A:

Hemos terminado la lista de oradores del dia de boy. Permitanme recordarles el programa de maiiana: comenzaremos alas 9.00 horas con la tercera sesi6n plenaria y al mismo tiempo se celebrara la primera sesi6n de la Comisi6n A en la sala XVIII. A las 13.00 horas tendni lugar, en la sala XII, una reunion de informaci6n tecnica sobre la Cumbre Ministerial sobre Investigaci6n en Salud celebrada en Mexico. Por la tarde, alas 15.00 horas, proseguira en la cuarta sesi6n plenaria el examen del punto 3, al tiempo que se celebrani la segunda sesi6n de la Comisi6n A en la sala XVIII, y se reunini en la sala VII la Comisi6n de Credenciales. Se levanta la sesi6n.

The meeting rose at 19:10. La seance est levee a 19h10. A58NR/3 page 49

THIRD PLENARY MEETING

Tuesday, 17 May 2005, at 09:15

President: Ms E. SALGADO (Spain)

TROISIEME SEANCE PLENIERE

Mardi 17 mai 2005, 9h15

President: Mme E. SALGADO (Espagne)

ADDRESS BY THE DIRECTOR-GENERAL (continued) ALLOCUTION DU DIRECTEUR GENERAL (suite)

La PRESIDENT A:

Se declara abierta la Asamblea. Buenos dias, senoras y senores. Espero que hayan podido disfrutar de unas horas de merecido descanso; vamos entonces a continuar nuestro trabajo. Esta manana la Asamblea va a continuar el debate sabre el punto 3 del orden del dia que iniciamos ayer. Los dos primeros oradores incluidos en la lista son Sudcifrica y Nueva Zelandia. Les invito a subir a la tribuna. Day la palabra al delegado de Sudcifrica.

Dr TSHABALALA-MSIMANG (South Africa):

Madam President, Director-General, honourable mm1sters, distinguished guests, ladies and gentlemen. Let me begin by congratulating you, Madam President, and your deputies, on your election. I wish to also extend congratulatory remarks to our invited guests, His Excellency Mr Maumoon Abdul Gayoom, the President of the Republic of Maldives, and Mr Bill Gates for such inspiring addresses. I congratulate the Vienna Philharmonic Orchestra on its appointment as WHO Goodwill Ambassador and I thank the musicians for a wonderful performance. I also congratulate the new Executive Director of UNICEF. I note with satisfaction the good work that UNICEF is undertaking, and welcome the commitment of the new Executive Director to continue to intensify efforts that will determine the health of our future generations. I wish to turn my attention now to the report of the Director-General, Dr Lee Jong-wook. Dr Lee, thank you very much for a comprehensive report. This week and next week, we shall be considering various health issues that will have a significant impact on global health. The level of our success in making a positive impact on global health will largely be determined by the extent to which the outcome of our deliberations in this Health Assembly can be implemented. This, in turn, is dependent upon the resources that this collective is prepared to make available within the programme budget. It is for this reason that the Proposed programme budget 2006-2007 is one of the critical dimensions that the Health Assembly must address. South Africa stands firmly behind the proposed increase in the programme budget. We shall, however, at the appropriate time, offer comments on ASSNR/3 page 50 specific areas of this proposed programme budget. It is our view that the modest increase proposed in this budget will enable countries to address some of the challenges and implement programmes that will change the lives of millions of ordinary people around the world. One such challenge is that of human resources for health. The adoption of the resolution on international migration of health personnel by the Fifty­ seventh World Health Assembly was not only long overdue but was a very clear statement by honourable ministers of their commitment to addressing challenges faced by developing countries. This commitment must be translated into action. As we shall proceed later to consider the Director­ General's progress report in this regard, we shall indeed be looking for clear signs of this commitment. South Africa has effectively and innovatively implemented the Commonwealth Code of Practice for the International Recruitment of Health Workers. An agreement has been reached with the United Kingdom on the reciprocal exchange of health professionals. We are already starting to see anecdotal evidence of this strategy working. It may be a good idea, therefore, to use this experience, and others, as a case study within the context of the implementation of this resolution. We are delighted to note that The world health report 2006 will be dedicated to human resources for health. We trust that the Director-General has already begun the all-important work of developing the report. It is impossible to overemphasize the deep significance of this report for developing countries, and particularly those in Africa. This, in our view, calls for the constitution of an informed reference group, with particular knowledge of the situation in developing countries, and we hereby request the Director-General to constitute such a group as soon as possible. That said, South Africa stands ready and willing to participate in the process of developing this report. We are certain that, based on our experience over the last decade, we have a significant contribution to make. Later this year, in September, our Heads of State and Government will be meeting at the United Nations General Assembly to consider progress in achieving targets with respect to the Millennium Development Goals. We are concerned about the observation that if current trends continue, most poor countries will not meet the health-related Millennium Development Goals. It is disturbing also that no region in the developing world is on track to meet the child mortality target. We also note with concern the slow progress towards meeting targets related to maternal mortality. We therefore request the Director-General to ensure that adequate resources are allocated to this area of work, and to provide technical support to countries. We also urge Member States to intensify efforts to meet these challenges. We welcome the focus that WHO is placing on women and children. In particular, we welcome The world health report 2005 on the theme "Make every mother and child count" as well as the dedication of the World Health Day on 7 April 2005 to this important issue. It is of vital importance, however, that as we examine this issue, we focus not only on HIV/AIDS and other communicable diseases but also on noncommunicable diseases such as diabetes, hypertension, cardiac diseases, asthma and trauma-related violence, which have devastating consequences for the health of women and children. Furthermore, we need to focus on the areas of women, children and tobacco control, as well as on healthy lifestyles. We wish to underscore the importance of nutrition as a basis for good health. Good nutrition increases energy levels, boosts immunity and is a critical component of a comprehensive response to disease. Nutrition prolongs good health and serves a solid foundation that often determines the success of other medical interventions. At the same time, the importance of physical activity in promoting health lifestyles cannot be overemphasized. We are also delighted that the Health Assembly will begin to consider the issue of alcohol abuse. With regard to tobacco control, South Africa welcomes the fact that the WHO Framework Convention on Tobacco Control has entered into force. We firmly congratulate all countries that have ratified the Convention. We are delighted to be among that group, having ourselves ratified the Convention on 19 April2005. We encourage those that have not ratified it to do so speedily to ensure that the health of all nations is protected. The real challenge of implementing international tobacco-control measures lies ahead of us all. We wish to underscore the need for technical and financial support in the implementation of the Framework Convention. This matter is very close to our hearts and was raised consistently by developing countries during the negotiations. We trust that WHO and other relevant institutions and development partners will ensure that the developing countries are A58NRJ3 page 51 indeed fully supported and empowered to discharge their responsibilities. We look forward eagerly to the first meeting of the Conference of the Parties, which is scheduled for February 2006. The extent to which we will succeed in making every mother and child count is inextricably linked to the accessibility and affordability of essential medicines and pharmaceutical products. Distinguished delegates will recall that the Health Assembly established a commission to produce an analysis of intellectual property rights, innovation and public health. Last week, we had an opportunity of hosting this commission in South Africa. We appreciate the opportunity to be able to contribute to the work of this commission. We firmly believe that the outcome of the commission's work will greatly promote accessibility and affordability of drugs and other pharmaceutical products, and the safety, quality and efficacy of traditional medicines. We congratulate the Director-General on the establishment of the Commission on Social Determinants of Health, which was recently launched in Chile. We wish to stress that we already know the social determinants of health; what we need now is action, action and more action! We need to see the impact of programmes put in place. We trust that the Commission will deliver these results to us. In conclusion, allow me to extend South Africa's sincere condolences and deepest sympathy to the survivors of the tsunami disaster and earthquakes as well as other disasters around the world. We commend the enormous international humanitarian response provided to victims of the tsunami in south Asia, and we are privileged to have been part of that exercise. As we respond to these disasters, we must not forget that Africa is disproportionately experiencing a disaster of one kind or another on a daily basis. We urge development partners to ensure that while responding to disasters in other parts of the world, Africa does not fall off the radar screen. We sincerely hope that from the lessons learnt in responding to these disasters, nations across the globe will unite to ensure that better early-warning systems, risk reduction and preventative measures are in place. South Africa remains committed to supporting any global initiative aimed at disaster preparedness, risk reduction and humanitarian response, both nationally and internationally. It is precisely for this reason that South Africa participated actively in the recently concluded intergovernmental negotiations towards a revised set of International Health Regulations. We participated not only as an individual Member State but also as one of the 46 Member States of the African Region. We are proud to say that our Region was able to reach a consensus on all issues, and in particular on those that, in our view, are of particular relevance or significance to Africa. As a result of extensive work done by the members of the African Region negotiating team, we were able to speak at the negotiations with one voice. It is impossible to overestimate the significance of this for ensuring that our issues were considered seriously and addressed appropriately. We are satisfied with the outcome. The final draft of the revised International Health Regulations is a document of significant compromise; a delicate balance has been achieved. In our view, in the process at this Health Assembly - which will hopefully result in the adoption of the Regulations - all care should now be taken not to interfere with or upset this delicate balance. The effectiveness of the revised International Health Regulations will now depend upon our ability to build and maintain all the necessary structures and systems to support their application. It is of critical importance to ensure that wherever a public health emergency of international concern occurs, there is capacity for surveillance, preparedness and response. South Africa reaffirms its commitment to being a credible partner in this process. As we make this commitment, we emphasize the need to pay special attention to capacity-building within the individual countries of the African Region, and we ask for the considered support, where needed, of WHO and all Member States, to enable us to meet all our obligations under these regulations.

Ms KING (New Zealand):

New Zealand strongly affirms WHO's contention that nations must ensure that every mother and child counts. We also strongly believe that making every mother and child count means far more than simply providing health services for mothers and children. We support the "continuum of care" concept, which takes account of the many factors affecting the lives of women and children; but we believe that it is not possible to develop health policy and make decisions based on guesswork, prejudice or hunches: resources, both financial and human, are far too scarce for that. We must base A58NR/3 page 52 policy and decisions on information and evidence. As Bill Gates said yesterday, "evidence, not speculation". There is an old saying: "You cannot manage if you cannot control. And you cannot control if you cannot measure". Collection of information allows us to track and measure women and children as they pass through the life cycles of pregnancy, birth, childhood and adolescence, ensuring that they actually do access the services provided. Information allows us to ensure that they stay on our health radar as their health needs change, and as they change their health providers. Collection and monitoring of information helps us to know what we are doing right, what we could do better, and where our priorities should be. Today, I want to give a few brief practical examples of how we are using information and evidence to make every mother and child count. New Zealand made a strong start in this respect in 1977 by creating a National Health Index number as a unique identifier for each person accessing health and disability services in New Zealand. This number and the database provide the means, among other things, to transfer clinical information between agencies, and to link data in national databases for planning, monitoring, funding, research and reporting purposes, all without the need for patient-identifying details. New Zealand has traditionally provided universal free access to maternity services, and has fostered a patient-centred approach. It ensures that one carer has accountability for ensuring the well-being of pregnant mothers. This continuum of care in pregnancy is followed through after the birth with services for the child. All women who are pregnant or give birth in New Zealand are counted. The Maternal and Newborn Information Service contains information on the availability and utilization of maternity services, and the outcomes for all women who give birth in New Zealand. This information is useful for planning and assessing the population's health needs, and is used by health professionals, policy-makers and academics. We have already learnt from this service that New Zealand caesarean section rates are higher than is recommended by WHO and higher than in other countries. This information now needs to be interpreted so that the implication of the higher rates for New Zealand can be understood. The National Immunization Register, to be fully established by the end of 2005, is an important step in implementing our Child Health Information Strategy and keeping count of children's interactions with the health services. The Register allows automatic notification of children who are missing out on services, so they can be followed up. It will also enable health professionals to find out quickly and easily, for example, what vaccines a child has been given and help to make sure immunizations are given at the right time. It will also provide a more accurate record of regional and national immunization coverage rates, enabling better planning to target populations with the lowest rates, to protect both individuals and communities. New Zealand is also a strong believer in health research and although our health research sector is small by international standards, leading New Zealand health researchers are internationally recognized. One of the foremost "longitudinal" studies in the world is the Dunedin Multidisciplinary Health and Development Study, which has followed the health and development of 1000 people born in Dunedin from birth through to their current age of 32 years. The Study has provided a wealth of information for policy-makers and academics alike. New Zealand is also conducting important research on nutrition. The first National Children's Nutrition Survey, carried out in 2002, sampled more than 3250 children aged from 5 to 14 years. Information was collected on food intake, physical activity, dental health and body measurements. With the rise in obesity and its resultant problems, this information is invaluable. For example, the Survey showed us that younger children have a better food intake than older children and are less likely to be overweight or obese, and that New Zealand, European and other children have a more nutritious food intake and are less likely to be overweight and obese than children of local and ethnic groups. Two other important sources of information will help ensure that every mother and child counts in New Zealand. We have established a Child and Youth Mortality Review Committee to help understand and reduce infant, child, and youth death rates, and to indicate where health, education, social or environmental systems are not functioning to protect children and young people. A Perinatal and Maternal Mortality Review Committee is being established with a view to further reducing the number of perinatal and maternal deaths. We believe we are not only making progress toward improved health for every mother and child, but that by keeping count of our progress we are learning what we are doing well and what we can do better in the continuum of care. It is our belief that there is A58NR/3 page 53 no stronger investment that we can make in the health of our nation than committing to making every mother and child count.

Dr KECHRID (Tunisia):

La PRESIDENT A:

Muchas gracias al representante de Tunez. Tiene la palabra el delegado de Luxemburgo, que hablani en representaci6n de la Union Europea. A58NR/3 page 54

M. DI BARTOLOMEO (Luxembourg):

Madame la Presidente, Mesdames et Messieurs, c' est pour moi un honneur de pouvoir m'adresser a vous au nom de l'Union europeenne. La Bulgarie et la Roumanie, pays adherents, la Turquie et la Croatie, pays candidats, ainsi que l'Albanie, la Bosnie-Herzegovine, l'ex-Republique yougoslave de Macedoine et la Serbie-et-Montenegro, pays du processus de stabilisation et d'association et candidats potentiels, se rallient a cette intervention. A vous-meme et a tous ceux qui occuperont des postes de responsabilite au cours de cette Cinquante-Huitieme Assemblee mondiale de la Sante, j 'adresse d' emblee nos vives felicitations pour leur election. Permettez-moi egalement de remercier le Dr Lee pour son expose fort engage et son esprit de cooperation que j 'ai pu apprecier des le 1er janvier de cette annee dans le cadre de notre action concertee en faveur des victimes du tsunami. L'Union europeenne salue !'initiative de concentrer notre debat general sur le theme meme du Rapport mondial de la sante, 2005, a savoir la sante de la mere et de I' enfant. La sante de la mere et de l'enfant est essentielle pour l'avenir de l'humanite entiere et le Rapport mondial de la sante, 2005 souligne combien il reste a faire pour (( dormer sa chance a chaque mere et a chaque enfant )) et pour leur assurer le niveau de sante le plus eleve possible. Toutes les minutes, une femme meurt de complications liees a la grossesse ou a l'accouchement. Chaque annee nous comptons plus de 3,3 millions de mortinaissances ; 4 millions de nouveau-nes meurent dans les 28 jours suivant leur mise au monde et 6,6 millions d'autres enfants en has age disparaissent avant leur cinquieme anniversaire. Face a ces 9 millions de morts par an, nous devons faire notre !'exigence de notre Directeur general qui nous exhorte «a faire de la dispensation de soins a la mere et a I' enfant un imperatif absolu ». Cette focalisation thematique ne se veut nullement en opposition avec !'attention toute particuliere et soutenue a accorder aux autres sujets a l'ordre du jour de l'Assemblee, qui connaissent un lien direct avec la sante de la mere et de I' enfant, tels le VIH/SIDA, le paludisme et les objectifs du Millenaire pour le developpement. Priver la mere et l'enfant des soins de sante qui leur reviennent equivaut a une inacceptable discrimination et est un obstacle de taille a la realisation des objectifs du Millenaire pour le developpement. Assurer une sante matemelle, neonatale et infanto­ juvenile adequate facilitera 1' eel os ion de systemes de sante durables meme la ou les structures de sante restent aujourd'hui menacees. Dans les pays en developpement, les complications survenant au cours de la grossesse et de 1' accouchement demeurent la principale cause de mortalite des femmes en age de procreer. La mortalite lors de l'accouchement n'y a pas diminue au cours des dix demieres annees. Nombre de ces deces sont provoques par des avortements pratiques dans des conditions dangereuses. Le programme d'action du Caire a reconnu le droit a la sante sexuelle et genesique ainsi que l'autonomisation des femmes et 1' egalite des sexes comme etant des elements capitaux de 1' effort global vis ant a favoriser le developpement et a reduire la pauvrete. Un meilleur acces aux services de sante genesique et aux informations y relatives est essentiel a la mise en oeuvre du programme d'action du Caire et des objectifs du Millenaire, notamment ceux relatifs a la sante matemelle, a la reduction de la mortalite infantile, a la promotion de 1' egalite des sexes, a la lutte contre le VIH/SIDA et a ceux lies a !'eradication de la pauvrete. L'Union europeenne veillera des lors a voir cet acces dument repris parmi les objectifs du Millenaire pour le developpement et assorti d'indicateurs de suivi. L'annee 2005 doit consacrer une attention particuliere au VIH/SIDA, dont la force meurtriere annuelle correspond a 15 tsunamis. Les statistiques nous rappellent avec une constemante constance sa propagation dans le monde et notamment dans la population feminine et chez les enfants. Apporter une reponse appropriee a cette pandemie reellement existante requiert la reconnaissance de la particuliere vulnerabilite de la femme face a cette maladie devastatrice. La lutte contre le VIH/SIDA exige de la part de la communaute intemationale un effort coherent et concerte s 'appuyant sur les «trois principes ». Aux yeux de l'Union europeenne, l'OMS a un role moteur a jouer dans cet effort. Des solutions nouvelles et innovantes sont necessaires. Elles doivent preserver un bon equilibre entre la prevention sans prealable et l'acces aux soins dont un acces durable a des medicaments proposes a des prix abordables. L'Union europeenne place beaucoup d'espoir dans !'initiative « 3 millions d'ici 2005 » de l'OMS que nous soutenons pleinement et dont nous sommes impatients de connaitre les demiers progres. Parler de la sante de l'enfant m'oblige a aborder aussi le sujet du paludisme qui contribue de maniere substantielle au taux de mortalite infantile. En effet, 8 % des deces des enfants A58NR/3 page 55 de moins de cinq ans sont dus au paludisme, alors qu'il est possible a la fois de le prevenir et de le guerir. Nous encourageons des lors l'OMS a renforcer ses efforts afin de realiser le controle de cette maladie mortelle. Au-dela des moustiquaires impregnees et des antipaludeens efficaces telles les associations medicamenteuses a base d'artemisinine, il importera de garantir aux femmes enceintes vivant dans des regions d'endemie l'acces au traitement antipaludique preventif intermittent. L'Union europeenne a pris une part active dans la creation, le financement et la promotion de l'efficacite du Fonds mondial de lutte contre le VIH/SIDA, la tuberculose et le paludisme. Par ailleurs, le plan d'action adopte par la Commission europeenne le 27 avril dernier propose une serie d'actions concretes et cherche - en collaboration avec ses partenaires mondiaux tels que l'OMS et l'ONUSIDA- a developper les reseaux regionaux pour promouvoir l'acces a des medicaments surs et d'un prix abordable, pour renforcer les capacites de reglementation des pays partenaires et pour soutenir de nouveaux travaux de recherche. Pour cela comme pour la realisation des objectifs du Millenaire y relatifs, des ressources supplementaires seront necessaires. De meme, tous les acteurs engages dans le renforcement des systemes de sante - y compris les organisations internationales - doivent eviter la duplication de leurs strategies et de leurs actions et miser sur le partage du travail. 11 importe en effet de faire un usage plus efficace des forces et des competences de chacun et d'en degager un benefice maximal pour la sante publique au niveau mondial. Les membres de l'Union europeenne continueront a souligner !'importance des synergies et de la complementarite entre leurs programmes de sante publique et d'aide au developpement et ceux de l'OMS. Je m'en voudrais de ne pas feliciter l'OMS pour son action dans les situations de crise. Suite a la catastrophe du raz-de-maree en Asie, !'Organisation a demontre qu'elle dispose de la capacite institutionnelle de mobiliser, de centraliser et d'agir dans de telles situations. En debut d'annee nous etions d'accord pour souligner trois points d'importance dans le contexte du tsunami. 11 revient a l'OMS d'assurer dans des situations de crise une surveillance epidemiologique. 11 est d'autre part essentiel de se pencher sur les moyens de prevenir les consequences dramatiques des catastrophes naturelles, y compris les consequences sanitaires, car leur impact est le plus devastateur dans les pays les plus demunis ayant un moindre niveau de sante. Finalement, le tsunami ne doit pas faire perdre de vue les autres besoins humanitaires existants de par le monde. L'Union europeenne soutient les activites d'evaluation, de coordination et de prevention que l'OMS y deploie. Face a la menace d'une pandemie de grippe, l'OMS a un role essentiel a assurer en matiere de prevention et de capacite d'action. L'Union europeenne apprecie l'excellente collaboration avec l'OMS en cette matiere. Pour sa part, l'Union europeenne a travaille au renforcement de ses plans d'actions nationaux et communautaires, a I' acceleration de la production des vaccins et a !'identification d'autres procedures d'urgence. L'Union europeenne espere etendre sa bonne collaboration avec l'OMS aux travaux du Centre europeen de prevention et de controle des maladies qui s'ouvriront a Stockholm le 27 mai prochain ; ce Centre a pour mission de deceler, d' evaluer et de faire connaitre les menaces que des maladies transmissibles peuvent representer pour la sante. Pour terminer, je souhaiterais tout d'abord vous faire part de la satisfaction de l'Union europeenne pour le travail accompli dans la finalisation du Reglement sanitaire international. Nous exprimons I' espoir que no us saurons saisir la chance de le voir adopte par 1' Assemblee mondiale de la Sante. Laissez-moi finalement vous assurer de la determination et de !'ambition de l'Union europeenne de continuer son etroite collaboration avec !'Organisation mondiale de la Sante dans l'interet de la meilleure sante possible pour tous. Je vous remercie.

Mr GABRIELSEN (Norway):

Madam President, Dr Lee Jong-wook, excellencies, ladies and gentlemen, health has to be considered in a gender perspective, otherwise women will keep losing. We must change health policies, and include gender as a perspective in health. Central to Norway's national strategy for public health is the strengthening of research on gender differences. Girls and women have the right to participate fully, at all levels of society. Society cannot afford less. To educate a girl is the best investment in health any society can make. Moreover, access to education is the central pillar of human development and poverty reduction. All children have the right to receive primary education - A58NR/3 page 56 girls no less than boys. Our loyalties as ministers of health are first and foremost to the marginalized and the invisible. In our society, children with mental problems are one such group. To correct inequalities in health care, we must set targets. Half a million healthy young women die every year of complications related to pregnancy and childbirth; most of these deaths are preventable. The numbers regarding children are even more appalling: 10 million children under 5 die each year. Most of these deaths could be avoided with simple means. Norway wishes to emphasize the need for a comprehensive health-systems approach. At country level, WHO should focus on system-wide issues and comprehensive approaches rather than doing disease-specific work, using vertical approaches. WHO needs, both at global and at country level, to play a much more active part in United Nations reform issues. By getting more involved in United Nations reforms, WHO will ensure that both the United Nations system in general, and WHO itself, becomes more relevant and effective. Furthermore, we welcome the emphasis that has been placed on the urgent need to address the health personnel crisis. Norway strongly believes that it will be impossible to meet the Millennium Development Goals without a proper solution to this global challenge. This issue requires our urgent attention and political commitment, in order to find a solution to ensure that the global resources of qualified health personnel are distributed more fairly. All of us have a responsibility to act on our prior commitments in the area of reproductive health. There is a need for increased awareness, political commitment and - last but not least - action with regard to reproductive health. Norway would like to see universal access to reproductive health services included as an added target in the Millennium Development Goal to "Improve maternal health". We also need to bridge the gap between sexual and reproductive health and HIV/AIDS prevention. Reproductive health services are an important starting point for HIV/AIDS prevention and awareness. The worrying feminization of the AIDS epidemic means that we also need to have a gender-based approach, targeting both men and women. All governments should support the development of drugs and vaccines against HIVI AIDS. Domestic violence against women and children as a result of harmful drinking is an increasing problem throughout the world. A vast number of children experience neglect owing to alcohol-use disorders. There is also a growing professional concern that women should abstain from the use of alcohol during pregnancy. I strongly urge Member States to adopt the resolution on public health problems and alcohol during this Health Assembly. The targets relating to poverty reduction, gender and health in general have been set. They can- and must- be reached. For that, let us hold each other accountable.

Mr NAVEH (Israel):

Madam President, Dr Lee J ong-wook, distinguished ministers of health, dear delegates, "Make every mother and child count" is the slogan for World Health Day 2005. An ancient Jewish proverb says: "One who saves a single soul has saved the whole world". My people cannot forget how we lost a third of our mothers and children in a terrible holocaust only 60 years ago. But each mother had a name and each child was a flower, whose lost innocence lives on in every one of our children today. My generation in Israel has been equally responsible for both its parents and its children. I have an equal obligation to my mother, who survived a concentration camp, and to my three children, to ensure they never know the horrors of deprivation, sickness and annihilation. This is why Israel has invested every shekel it can in our modernized health system, open to providing emergency treatment to people from all over the world. Much thought has gone into the services designed to assist mothers from the moment of giving birth, through the challenging process of raising their children. We call this network "A drop of milk" and all mothers, Jewish, Moslem, and Christian alike, benefit from its guidance, medical care, and feeling of security. As Minister of Health, I face daily the arduous task of priority decision-making. The goals of "Health for All" have become a moral issue. Noncommunicable diseases are high on our list. But how can we finance the high costs of the medicine required for cancer, heart disease, diabetes, and so on, when every group of patients demands the best possible treatment and preventive care? Israel like other countries has initiated reforms, such as free-to-all national health care, privatization of hospitals, and community-based services, with patient safety given top priority. Just this week, I inaugurated a A58NR/3 page 57 telephone service to supply immediate psychological counselling for young people in distress. One way to deal with soaring medical costs is through programmes encouraging healthy lifestyles - combating smoking, obesity, and alcohol and drugs. At the same time, we must educate people in healthy eating habits and promote healthy ageing. "Make every mother and child count." Indeed, every mother must be reassured that her child is safe from the horrendous effects of drugs. This disastrous medical threat to children in the modem world must be a war we do not lose. Indeed, every child should know that its mother will find a hospital bed if needed, will find a doctor on call, and will find an old age home when necessary. Our historically justified anxiety for our mothers and children is the reason why Israel is among the first to offer aid in world disasters- be it the terrible tsunami in south Asia, an earthquake in Turkey, or an epidemic in Africa. After four and a half terrible years, these days are days of hope for an era of reconciliation and peace in the Middle East. During the last four and half years almost 1000 Israelis, many of them children and babies, have lost their lives in vicious Palestinian terrorist attacks against us. Palestinian children and teenagers have been cruelly and cynically exploited by terrorist organizations and in many cases have been encouraged to carry out suicide bombings against the Israeli civilian population. Israeli hospitals have been overstretched in treating terrorist victims. The hospitals in Israel have to be constantly prepared for the possibility of terrorist attacks. In spite of the terrorism, Israel has not changed its humanitarian approach: it continues to provide Palestinian patients with hospital services, and ambulatory medical care in Israeli hospitals. Magen David Adorn provides emergency medical assistance to whoever requires it. Furthermore, we provide training programmes for physicians and facilitate the transfer of medical donations and medical equipment to the Palestinian territories. Unfortunately, as part of the vicious Palestinian attack campaign against us, they have halted projects of cooperation with us, and we urgently call on them to resume their participation in our medical courses and epidemic prevention campaigns, for the sake of their mothers and children, as much as ours. I call here upon all the ministers of health in our region to resume our dialogues, in the interest of all our peoples. May the embracing arms of a mother and the smile of her child guide us all to a better, healthier world for ourselves and future generations.

Mr LJUBICIC (Croatia):

Madam President, distinguished excellencies, dear colleagues, ladies and gentlemen, as a Minister of Health, it is my great pleasure and honour to address you here today on behalf of the Government of the Republic of Croatia. I would like to join my congratulations to those of previous speakers to you, Madam President, and other members of the Bureau on your election. I would also like to use this opportunity to express my country's appreciation to WHO for focusing the plenary debate of the Fifty-eighth World Health Assembly on maternal, newborn and child health care since there are many extraordinary long-term benefits of investing in these areas and because we all want our children to grow up to their fullest potential. My country, a signatory to the Millennium Development Goals and the Convention on the Rights of the Child, places a high value on reducing maternal death and child mortality and, consequently, aims at saving the life of each and every child, of each and every mother. By attempting to preserve every human life, one attempts to ensure a better future for the generations to come. Therefore, it seems obvious today that every country should introduce and firmly support, at national and regional level, integrated health programmes for providing a continuum of care for mothers and children which spans from timely intervention and administration of skilled care, through pregnancy and childbirth to childhood. Over half a million women die every year in pregnancy and childbirth worldwide, and almost 11 million children die under the age of five. We are all witnessing, to a greater or lesser extent, these disturbing figures in our respective countries. Since 1991, Croatia has seen a negative population trend, joining the countries having a high share of elderly people - aged 65 or more - and a decreased share of young people, which is a strong reason for committing oneself to improving - and investing in - maternal, newborn and child care and services. However, maternal mortality concerns only sporadic cases in Croatia, therefore following the A58NR/3 page 58 trends of the developed countries. The perinatal mortality rate for 2004 was 5.7 per thousand children born. The infant mortality rate of 6.3 per thousand live born, due especially to pregnancy complications with premature delivery and consequent immaturity, is decreasing gradually but is still slightly higher than the European Union average of five per thousand. No significant change has been observed in the past 20 years in the fetal mortality rate, which is around 4%. Consequently, prioritized measures for safe motherhood in Croatia are related to the prevention, control and early detection of complications in pregnancy. The Republic of Croatia- engaged in the integration process to the European Union and aspiring to the highest European standards - seeks to harmonize its legislation with European Union standards, including in the field of maternal, newborn and child health care. In line with this, the Croatian Government recognizes the importance of improving maternal and child care and aims to establish a three-level regional organization for perinatal care to provide skilled care for pregnant mothers, childbearing mothers and children, as well as for high-risk pregnancies; to develop specialized services, such as neonatal services; and to evaluate and monitor health care provision for the mother and child at all levels. This system will also feature cross-sectoral cooperation in regulatory decision-making concerning the promotion of the right to the protection of maternal and child health. Furthermore, Croatia is investing considerable effort in order to improve concretely the country's prenatal policy and has already begun to prepare a perinatal strategy for achieving this goal through the following actions: improving prevention and treatment of maternal and child diseases and introducing obligatory medical examinations for pregnant women - providing at least six examinations and two ultrasound scans; introducing the alternative birth setting; setting up joint mother-baby units in all hospitals to ensure stronger maternal-infant bonding; establishing several cytogenetic laboratories; providing maternity-leave allowance for unemployed women; providing a three-year maternity leave for women with two or more children; creating perinatal centres of excellence; and organizing continuing education for paediatricians and gynaecologists. I wish to take the opportunity, to quote the Director-General, who reminded us in his personal invitation to celebrate this year's World Health Day. He said that "healthy mothers and children are the bedrock of prosperous communities and nations". I wish to assure you that we are committed to dedicating all our efforts to address the various tasks which have been outlined and in pursuing higher standards for maternal, newborn and child health care. Finally, Madam President, ladies and gentlemen, I would like to conclude my statement with a plea to all of my colleagues who are here today: please give mothers a chance to improve their health and survive and their children, in turn, a chance to grow and develop in a safe world in order to become healthy parents themselves.

Mr KIM Guen-tae (Republic of Korea):

Madam President, Director-General, honourable ministers, distinguished delegates, last year, outbreaks of emerging diseases, such as avian influenza, and natural disasters left many people exposed to serious health risks. As there are no borders in disease, our efforts to bring good health for all should have no borders. This highlights the need for close international collaboration in disease surveillance and preparedness. Our country is now waging war against smoking. The Government of the Republic of Korea has already raised tobacco levies and we will continue to enforce this policy. Increased fiscal revenues from the levies will be used to provide funding for public health programmes, such as smoking­ cessation and health promotion initiatives. "Make every mother and child count" is the slogan of WHO this year. Good health of mothers and children is essential for the future of our society. Therefore, our projects for better health of mothers and children are important and necessary investments in the future and keys to sustainable development. Investing in children would be the most effective means to break the cycle of poverty and provide a critical element of the social safety net. Globalization is widening the gap between the rich and poor, as well as fostering a "health divide". Without resolving the global burden of disease, we cannot achieve sustainable development and social integration. In this regard, the right to health is one of the most important human rights. We can call a society fully democratic only when it guarantees health for its people. A58NR/3 page 59

The Republic of Korea has committed US$ 45 million to aid recovery efforts over the next three years in the countries affected by the tsunami disaster. We are more than willing to play an active role to boost the regional and global cooperation that will be critical in tackling health threats such as avian influenza. We also have the intention to support anti-smoking programmes in other developing countries. We intend to provide international fellowship programmes for the capacity-building of policy-makers in these countries. The Republic of Korea suggests that the north-east Asian countries create a collaborative system in the near future. No one in this world should be ignored or left behind in our efforts to build a healthy future. Let us work together for a healthy society for all.

Dr CHUA SOl LEK (Malaysia):

Madam President, excellencies, distinguished delegates, it gives me great pleasure to say something about Malaysia's efforts in maternal and child health. Indeed, we are proud to note that Malaysia's success story in reducing maternal mortality is depicted in this year's World health report. I hope that this is an inspiration to other developing countries to invest in maternal and child health. A major driving force in our success is political commitment, a commitment that is translated into policy, services and resources. We have always given priority to vulnerable and disadvantaged groups in the population. Hence, women of reproductive age and children have always been given the best care possible, both at the primary health-care level and at hospitals and institutions. In case it is assumed that Malaysia has succeeded because of its comparative wealth, I must make it known here that the financial allocations towards this have never been exorbitant, but that it is the prudent use of resources and knowing where to prioritize that have helped us. I would like to list our success factors at three levels. The first is the overall socioeconomic development that Malaysia has achieved in the past three decades. After all, health - and especially maternal and child health - is determined to a large extent by secular factors not within the health sector's purview, such as food supply, housing, education and income. I must state that efforts on poverty alleviation by the Malaysian Government have had a positive impact on health in general, and on maternal and child health in particular. I take this opportunity to congratulate international agencies under the United Nations banner for their call for poverty eradication, which is the first of the eight Millennium Development Goals. The second is the improvement of general health and health services in the country, which includes the development of facilities and manpower. There have been no compromises in the provision of facilities for safe delivery and our investments have paid dividends. In Malaysia, 89% of the population now live within 5 km of a health facility and 98% of our deliveries are safe deliveries. The third concerns the specific initiatives for maternal and child health, which include emergency obstetric services, maternal as well as infant and child nutrition, strong primary health care with a good, reliable referral system to hospitals, continuous quality improvement, a neonatal retrieval system, the high-risk approach for pregnant mothers and a detailed auditing of every maternal death. We had a successful and visible launching of World Health Day last month, graced by the First Lady, the wife of the Prime Minister of Malaysia. This is a clear manifestation of political will at the highest level. Of course, Malaysia has to remain vigilant about the challenges ahead. For us to further reduce the already low rates of maternal and child mortality is going to be a difficult task, so we have to do all we can to sustain these successes. We have to be very specific and we are entering the difficult stage of preventing causes of death such as extreme prematurity and genetic disorders. We also have to do more to embrace the broader concept of sexual and reproductive health, to go beyond mere biology and encompass social determinants, such as the influence of gender equality, the role of men in reproductive health and the issue of human rights. Globalization, with its inherent advantages and disadvantages, will have an impact on health. As an example, we have already made much progress in ensuring the availability of antiretroviral drugs for AIDS sufferers. Indeed, it is with regard to the sixth Millennium Development Goal and the target of halting and reversing HIVI AIDS that Malaysia has some real concerns. Lastly, if and when Malaysia decides to undertake a major reform of the health system, there will be a need for us to protect maternal and child health so that is not compromised by, for instance, a A58NR/3 page 60 new financing scheme or a restructured health system. We are committed to making "every mother and child count".

Dr PEZESHKIAN (Islamic Republic oflran):

Bismillah ar-rahman arrahim. Madam President, Director-General, excellencies, ladies and gentlemen, it is indeed a privilege and an honour for me to address the Fifty-eighth World Health Assembly. It also gives me pleasure to congratulate you, Madam President, on your election as the President of this eminent body. My congratulations also go to the distinguished officers to whom I wish every success in their important work. We thank the Director-General for devoting World Health Day and The world health report 2005 to the critical issue of maternal, newborn and child health. This year's slogan, "Make every mother and child count", reflects the reality that, today, both governments and the international community need to make the health of women and children a higher priority. Too many mothers and children in the world are dying or suffering from the effects of ill-health, poor nutrition and inadequate health care. In this perspective, each one of us has a role to play. There is a need to strengthen political and technical leadership and allocate more financial and human resources to this important priority area. In Iran, life in the twenty-first century will continue to be influenced by a variety of factors, including epidemiological, demographic, socioeconomic, political, technological, environmental and global developments. One of our main tasks in this century is to develop efficient and effective health­ care services, responsive to the emerging health needs of our communities. As a result, we launched a health sector reform initiative in 2002. In this connection, a more organized effort was undertaken recently by selecting four provinces to pilot a set of interventions before their countrywide implementation. These interventions are aimed at the following: designing and testing a universal basic package and a strengthened patient referral system, ensuring better-quality services that are responsive to the needs of communities; ensuring stewardship and good governance in the public sector, guaranteeing pro-poor policies; improving health planning and management, including decentralization in the health sector, by delegating administrative and financial authority; reviewing existing health-financing options in order to introduce measures to ensure fair financing, eliminating inefficiencies and bringing equity; and making organizational arrangements for the conceptualization, formulation and implementation of health sector reforms. According to WHO, each year more than half a million mothers die during pregnancy and in childbirth. At the same time, 10.6 million children under the age of five die from a handful of preventable and treatable conditions. It is against this background, that we have developed our maternal and child health services in the context of the national primary health-care system. Further to the successful implementation of several innovative programmes, such as those for the integrated management of childhood illness, control of iodine deficiency disorder, together with "Healthy child" and "Baby-friendly hospital" initiatives, in the past two decades, we have been able to reduce the infant and child mortality rates from 93 and 135 to 28.6 and 36 per thousand, respectively. According to the most recent studies, 88% of deliveries take place in hospitals and maternity centres, while 90% of deliveries are attended by trained personnel. Despite these achievements, we still have a long way to go. As you are well aware, nearly all maternal and child deaths occur in low- and middle-income countries. In establishing the Millennium Development Goals, the international community made a commitment to reduce maternal deaths by three quarters, and child mortality by two thirds, by the year 2015. To my understanding, the health needs of populations cannot be met without ensuring an appropriate level of socioeconomic development. To this end, we should move towards identifying the actual socioeconomic determinants of health in different settings, and find proper solutions applicable to different environments. Furthermore, we must work together to tackle the poverty-ill-health cycle through an innovative, multisectoral approach that ensures access to health care, healthy living conditions and safe working environments, and access to food and education for marginalized and poor people. Some of Iran's experiences and achievements in this regard include the following: the establishment of a High Council for Health under the Cabinet and the President, consisting of 20 ministers and heads of organizations; and the granting of parliamentary approval for increasing the A58NR/3 page 61 public share of health from 5.6% to 7% of GDP, increasing the fair financial contribution index from 0.83 to 0.9 and decreasing the percentage of families faced with catastrophic health expenditures from 3.3% to 1% in the next national five-year plan. I cannot conclude my speech without remembering Palestinian mothers and children, who are suffering from occupation by the Zionist regime. I see no need to respond to something that is so obvious in the reports of the Director-General to this body this year and in previous years- reports of state terrorism and its effects on the Palestinian people and of the killing and suffering of this nation at the hands of the occupier. In conclusion, we know how to deal effectively with the major causes of death and disability. If we truly want to reach the goal of ensuring health for all, we must continue to form global partnerships, to strengthen global systems, to harness global communications and, above all, to commit ourselves to tackling the root causes of disease and disability, namely, poverty, illiteracy, inequity, insecurity and violence. Thank you.

El Sr. COSTA (Brasil):

Senora Presidenta, senor Director General: Como todos los anos, la Asamblea Mundial de la Salud es una oportunidad para examinar de manera conjunta algunas de las mas urgentes cuestiones de salud y proponer medidas que conduzcan a posibles soluciones de consenso. Este ano, el tema del Dia Mundial de la Salud senala a la atenci6n la necesidad de garantizar la salud a los ninos y las mujeres. Todavia existe un amplio espacio para reducir las muertes de ninos y de madres con medidas simples y de gran eficacia, que necesitan ser universalizadas con urgencia. En Brasil, continuamos desarrollando estrategias para la ampliaci6n del acceso a la atenci6n primaria, con vistas a su universalizaci6n, al mismo tiempo que se promueve la calificaci6n de la atenci6n hospitalaria para reducir las muertes de recien nacidos y de madres. Otro tema relevante es el nuevo texto del Reglamento Sanitaria Internacional, que deberemos aprobar en esta ocasi6n, que culmina 10 anos de intensa labor. El proceso constructivo, que reuni6 a todos Ios Estados, concluye con un instrumento adecuado para hacer frente a los desafios que hacen posible la propagaci6n internacional de enfermedades. El tema relativo al uso nocivo del alcohol nos pone delante de la necesidad de desarrollar politicas publicas capaces de hacer frente al creciente riesgo para la salud publica, al mismo tiempo que tratamos de proteger a los segmentos mas vulnerables de la sociedad. En Brasil, el Ministerio de Salud esta implantando una red de unidades especializadas en la atenci6n a los usuarios del alcohol y otras drogas. Lideramos un grupo de trabajo interministerial, integrado, entre otros, por el Gabinete de la Presidencia, los Ministerios de Justicia, de Hacienda y de Educaci6n, con vistas a elaborar una amplia politica de reducci6n de riesgos asociados al uso nocivo del alcohol. Ese grupo presentara pr6ximamente al Presidente de la Republica el resultado de su labor. Tenemos la seguridad de que esa politica sera una de las marcas fundamentales del Gobierno en el sector salud. Ademas de esos temas, es necesario que los Miembros de esta Organizaci6n revisen y perfeccionen sus respuestas a la pandemia de SIDA. Para ello es necesario que las medidas de prevenci6n sean adoptadas sobre la base de evidencias cientificas, evitando asi la defensa inconsistente de posiciones intolerantes y llenas de prejuicios. Pero, ademas de ello, es necesario que seamos mas eficaces para asegurar el acceso a los antirretrovirales. Las restricciones econ6micas ponen trabas al acceso a estos medicamentos de las personas que mas los necesitan en los paises en desarrollo, aun cuando se trata de medicamentos de primera generaci6n. La meta de tres millones de tratamientos hasta el ano 2005 necesita ser actualizada, pues necesitamos ver en otra luz las estrategias adoptadas para que consigamos veneer el tremendo desafio de procurar salvar las vidas que se pierden sin sentido. En Brasil, nuestra politica de garantizar el acceso universal a los medicamentos antirretrovirales afronta diversos riesgos. Por un lado, los precios cobrados por esos medicamentos crean verdaderas barreras de acceso. Por otro lado, el uso creciente de nuevos medicamentos, en sustituci6n de los mas antiguos, producidos localmente, crea presiones insoportables en el presupuesto del ministerio. Este ano, para continuar atendiendo a los 156 000 pacientes que reciben tratamiento con antirretrovirales tuvimos que aumentar el presupuesto del ministerio en un 50% con relaci6n al presupuesto de 2004. A58NR/3 page 62

Del conjunto de 17 medicamentos que componen el tratamiento del SIDA en Brasil, nueve son importados y representan un 80% del presupuesto. En el mes de marzo, teniendo en cuenta nuestra determinaci6n politica de continuar manteniendo y ampliar el tratamiento con antirretrovirales, remiti solicitaciones de concesi6n de licencia voluntaria a tres laboratorios, que representan casi dos tercios de la demanda de antirretrovirales importados. En este momento estamos en plena proceso de negociaci6n para obtener las licencias voluntarias para la producci6n local de esos medicamentos, que van a representar una economia estimada del orden del 50%. Estamos dispuestos a utilizar todas las flexibilidades del Acuerdo sabre los Aspectos de los Derechos de Propiedad Intelectual relacionados con el Comercio, incluso la licencia obligatoria si es ese el unico camino para garantizar el mantenimiento de nuestro Programa de SIDA, que alcanz6 indudablemente el reconocimiento internacional. Como esa cuesti6n interesa a todos los paises, tengo la seguridad de que a todos nos interesa construir un ambiente de reglas econ6micas estables, pero subordinadas al prop6sito de evitar que el escenario catastr6fico del SIDA siga multiplicandose. Coma Miembros de esta Organizaci6n volcada en la salud publica, tenemos la obligaci6n moral de garantizar a todas las personas el acceso a tecnologias que puedan salvar o mejorar la vida. Muchas gracias.

Mme GOSSELIN (Canada) :

Madame la Presidente, Monsieur le Directeur general, Mesdames et Messieurs les Ministres, chers delegues, le Canada reconnait que cette tribune et nos interventions multilaterales sont essentielles pour }'amelioration de la sante partout dans le monde. Le Canada a recemment souligne !'importance de la sante pour la securite dans son enonce de politique internationale : «La sante est devenue une question internationale cruciale ayant des incidences dans les domaines de l'economie, de la science et de la securite. La fievre aviaire, la pandemie de VIH/SIDA et les efforts deployes pour circonscrire les poussees epidemiques de nouvelles maladies, tout cela exige une action multilaterale v1goureuse. » Aujourd'hui, j'aimerais me concentrer brievement sur quatre grandes questions d'importance: les preparatifs et la capacite d'intervention en cas de pandemie de grippe; le Reglement sanitaire international ; le fardeau demesure des maladies liees a la pauvrete ; et enfin, la sante de la mere et de l'enfant. Selon les experts, le risque d'une pandemie mondiale de grippe est plus eleve aujourd'hui qu'il ne l'ajamais ete depuis pres de quarante ans. Les preparatifs a l'echelle nationale et internationale sont done essentiels. Au Canada, nous sommes intervenus activement pour ameliorer les mesures d'urgence. Nos activites consistent a maintenir a jour le Plan canadien de lutte contre une pandemie d'influenza, a s'assurer d'un approvisionnement suffisant en vaccin, a maintenir un systeme d'alerte en temps reel pour les maladies respiratoires graves, et a etablir un systeme de surveillance efficace dans les hOpitaux. Soucieux de proteger la sante de la population partout dans le monde, le Canada travaille avec ses partenaires internationaux pour mieux nous preparer tous en cas de pandemie d'influenza. Ces dernieres annees, nous avons partage notre expertise avec plusieurs pays afin de les appuyer dans leurs interventions pour combattre des flambees de grippe aviaire et nous avons !'intention de continuer nos efforts. Nous avons tous travaille ensemble a reviser le Reglement sanitaire international parce que nous savons que le monde doit avoir une methode transparente et rigoureuse pour pouvoir intervenir face aux urgences de sante publique deportee internationale. Nous devons savoir a priori qui fait quoi pour pouvoir reagir efficacement et ensemble. Nous crayons que le Reglement revise se situe au centre de la protection de la sante publique a l'echelle de la planete. Le Canada appuie entierement son adoption. L'atteinte des objectifs du Millenaire en matiere de sante continue de presenter de multiples defis auxquels nous pouvons faire face. Le fardeau des maladies liees a la pauvrete, comme le VIH/SIDA et le paludisme, reste encore demesure. Nous savons ce qui fonctionne pour combattre ces maladies ; nous devons maintenant accroitre nos efforts et promouvoir des interventions plus efficaces. Le Canada a appuye les efforts de l'OMS pour dispenser des soins a ceux qui en ont besoin. Grace notamment a !'initiative « 3 millions d'ici 2005 », 700 000 habitants de pays en developpement re<;oivent aujourd'hui des traitements antiretroviraux. Nous sommes encore A58NR/3 page 63 loin de l'objectif fixe, et pour y arriver, des investissements de taille sont en cours pour renforcer la capacite des systemes de sante et mieux soutenir les intervenants dans ce domaine. Chaque annee, a travers le monde, un demi million de femmes meurent suite a une grossesse et 11 millions d' enfants ne vivent pas jusqu'a cinq ans. La plupart de ces deces sont causes par des maladies a la fois evitables et souvent facilement traitables, pres du cinquieme du fardeau mondial de la maladie est attribuable a une sante sexuelle et reproductive mediocre. Le Canada est un ardent defenseur du droit des femmes et des jeunes filles de decider par elles-memes de leur sante sexuelle et reproductive et d'avoir un acces equitable a de bons services de sante. Le Canada a annonce dernierement l'octroi d'une aide financiere importante aux programmes de sante des meres et des enfants dans les pays en developpement. Plus de la moitie de ces fonds seront consacres a la promotion de la sante des enfants en Afrique. En terminant, j'aimerais parler du budget propose par le Directeur general de l'OMS. Pour etre pleinement efficace, l'OMS ne peut accepter qu'a l'echelle mondiale des fonctions aussi cruciales que la surveillance des maladies misent de fa<;:on excessive sur des contributions volontaires et imprevisibles. C' est pourquoi le Gouvernement du Canada appuie lui aussi le budget propose. Comme tous, nous croyons dans une discipline budgetaire. Toutefois, dans l'interet de l'efficacite, nous devons nous assurer que l'OMS ales ressources necessaires pour remplir le mandat que lui conferent ses Etats Membres. J'aimerais enfin souligner que le Canada, conscient de ses obligations mondiales, est determine a renforcer l'OMS et a oeuvrer avec l'ensemble de ses Etats Membres pour ameliorer la sante de tous. Merci.

Mr M.N. KHAN (Pakistan):

Bismillah ar-rahman arrahim. First of all, let me congratulate you, Madam President, on behalf of Pakistan's delegation, on your election as President of the Health Assembly. I would also like to congratulate all the Vice-Presidents and the Chairmen of the committees. We have a daunting task ahead of us. More than 10 million children die every year before reaching the age of five and more than half a million women die during pregnancy and childbirth; two thirds of these deaths are preventable by very simple and well-known health interventions. Five million adults die every year from inhaling the smoke of harmful, unnecessary products. Tuberculosis and malaria together continue to kill nearly three million people. Eight thousand are dying every day due to AIDS-related conditions; only 5% of the people in the advanced stages of the disease have access to antiretroviral therapy in the developing world, especially Africa. Great efforts are needed to promote mental health in view of the stress and conflicts that individuals and communities face. We as a community, as an international community, and as a family, have failed to reach several of the targets fixed in the Declaration of Alma-Ata in 1978, the Programme of Action of the International Conference on Population and Development in Cairo, the Declaration of Commitment of the United Nations General Assembly special session on HIV I AIDS, the Millennium Development Goals and many other international declarations and commitments. I think it is time that we all concentrate and complement and supplement each other to reach these targets. We have to work together. There is no one but us and this is critical if we have to reach these targets. In Pakistan, we are committed to providing health care to our people; the Government has taken several steps in this regard. Health reforms are in the offing; the national health policy provides an overall vision for health development, based on the health-for-all approach. This is founded on accessibility, affordability and acceptability of health services by the general population. The Pakistan Government has embarked on strengthening health services throughout by expanding key national preventive and promotional interventions. These include interventions for emergency health care (especially in reproductive health), essential curative services, prevention of communicable diseases, mother and child protection and women's health care. A comprehensive approach for nutrition programmes has also been filling the basic nutrition gaps in health, and nutrition education is being followed stringently. No mother has to die today of preventable causes. This is the year 2005: the mother is the central force; she is the nucleus of the family; she is the nucleus of the community and the nation. Hence, our focus on children and mothers is a tremendous tribute to all ofus here and to WHO. If we do simple things, I think they can be very cost-effective and very result-oriented. I always say if we A58NR/3 page 64 can control two things - water and blood - 70% of the diseases can be controlled because they are either water-borne or blood-borne diseases; and this will have a tremendous effect on the child and mother mortality rates. Hence, boil the water before it is consumed until we have all the protocols in; all blood products must be screened and all blood must be screened before transfusion. And the other thing is mothers' milk. It is critical that we focus on mothers' milk: this saves a lot of infection to the child and also gives it very important nutrition and antibodies to make the child strong to face up to all the diseases that it can. Spacing is another thing: childbirth is such a traumatic affair both for the mother and the child that spacing is critical; I cannot overemphasize this. I was just saying that if men had to give birth, there would be total population control because after one child they would never dream of having a child again. So it is important to focus on spacing. Pakistan's national programme for family planning and primary health care, which delivers basic health services to the doorstep, is a very successful programme called the "Lady Health Workers Programme". This is a huge link between the Government and the people - rather than a fortunate section of society - those in the rural areas, the poor. Wherever the lady health workers are present there has been a marked decrease in child and mother mortality rates, so there is a tremendous link here that if basic skills are provided we can really do something at the grass-roots level. We have to intercept the poliovirus in our country. We are working tremendously hard and we are focused and we do not want to be defocused from this. It is time that we consigned poliovirus to the text books and did something more for humanity. In Pakistan, we have a low prevalence of HIV/AIDS but we are a high-risk country with a population of 150 million people. This is the time to seize the opportunity and in Pakistan we have a very strong HIVI AIDS programme because we anticipated the risk that a problem might suddenly spring up with globalization. Pakistan has a great opportunity and I think we have to learn from our neighbours not to waste time but to seize the opportunity. We also have to control malaria; that is something that is also hitting our country, but also most of Africa. Tuberculosis control aims to control tuberculosis through directly observed treatment, short course (DOTS). In Pakistan, by next week 100% of the country will be covered by tuberculosis DOTS. Projects on health and mothers' health care, nutrition and control of noncommunicable diseases have been initiated by the Government. New programmes for the prevention of hepatitis in our country have been launched with the Prime Minister's Programme. It is a huge programme and will have a tremendous effect on both mother and child health in Pakistan. An intensive public health education campaign has been launched with other ministries. With the Ministry of Education and the Ministry of Information we are now working as intersectoral ministries. It is important for the ministries to work together. We also have a new drug policy being implemented in Pakistan to ensure quality drugs at reasonable prices. That is the key: the price of the drug has to be controlled, and it is important that we look at this very very seriously. The problems of better governance and management of health-care systems are being addressed. I think management of health care now is a science; it has to be developed to new levels and then the efficiencies will come in. During the last three to four years, there has been a tremendous increase in public health budget allocations and I was fortunate that the Finance Minister that I was working with is now the Prime Minister of Pakistan, and it helps to have friends in high places; so I have nearly doubled my budget in Pakistan. Political commitment is of paramount importance. I am glad to say that our President, President Musharraf, and the Prime Minister, are both leading from the front in the health sector with commitment and leadership. I would just like to take this opportunity to thank Dr Lee Jong-wook and Dr Gezairy for their last visit to Pakistan. It was a very fruitful trip and I just want to make a small reference to the Honourable Minister of Health of Israel, who mentioned how their mothers and children had suffered and that they really understand misery, pain, anguish and suffering. And with a very heavy heart, I would say that Israel should be the most compassionate nation in the world, understanding these sufferings because they have been through them. So we would request that everyone works and learns from the past to bring better things to the future. We must make a decision today, we must go forward. Do we want to destroy what we have or do we want to build on what we have? This decision is very critical. We cannot keep on building and keep on destroying. For example, in the Region of the Americas, nearly US$ 60 000 million worth of health care system has been destroyed. Now how do we go further? This is a decision that we have to make as a family. And nothing can work, as I always say, if one item is missing- and that is peace. A58NR/3 page 65

The endless killing of fellow human beings must stop. It has to stop, and in Pakistan, we are very glad that, together with my counterpart in India, we are working very hard to bring peace to our region. For too long, both Indian and Pakistani populations have suffered. It is time to bring sanity and I know that, if we work hard, we will do that. In fact, I was the first minister to go to India from Pakistan and talk about peace, and have been prevailing on my President and Prime Minister to talk about peace. Finally, I would request that, when they go back, all the health ministers that are here today should prevail on their Presidents and Prime Ministers to talk about peace, to talk about saving lives and not taking lives. Let peace prevail, and, in the end, I just want to say that wherever there is peace, there is God.

Professor SUCHAI CHAROENRATANAKUL (Thailand):

Madam President, Director-General, excellencies, ladies and gentlemen. First of all, I would like to congratulate you, Madam President, for being elected as President of the Fifty-eighth World Health Assembly. Under your leadership, I sincerely believe that the Health Assembly will come to a successful conclusion. My sincere congratulations and heartfelt appreciation also go to the Director­ General, Dr Lee Jong-wook, for his inspiration, his vision, action and hard work, as well as the leadership that has guided WHO from the start of his tenure. This year's World Health Day theme of "Make every mother and child count" is really relevant and challenging. In Thailand, the maternal and child health programme has long been the nation's top priority. There had been a sustained effort to reduce the maternal mortality rate long before we began to pursue the Millennium Development Goals. From 1970 to 1990, the maternal mortality rate in Thailand dropped from more than 200 to around 40 per 100 000 live births. The infant mortality rate was also reduced by half, from slightly more than 50 to less than 25 for 1000 live births. However, this number is not satisfactory; we know we can do better. Thailand is committed to meeting the Millennium Development Goals to reduce the number to the level of other developed nations; by doing so, we have to set our strategies to overcome these challenges. The first strategy is to improve the health information system. We are fully aware of the importance of the data on maternal and child health and its implications for the achievement of the Millennium Development Goals. But the problem facing us, like many other countries, is that the data are usually derived from many different sources, such as the national vital registration system, the safe motherhood and childhood programmes, and field surveys. The numbers have become very conflicting. Thailand is right now investing around US$ 1 million per year to improve the national health information system. We also welcome the Health Metrics Network initiative and are ready to cooperate with the international community to rectify this problem. The second strategy is to focus our efforts on the poor and on marginalized people. Despite our nationwide coverage of the health-care infrastructure, inequitable access to health care still exists. Our Prime Minister, Dr Thaksin Shinawatra, has started the policy of universal coverage of essential medical care, which in Thailand we call the "30 baht schemes". The coverage of health insurance in Thailand has increased from 70% in 2001 to 95% in 2005. Recently, the Prime Minister of Thailand approved a five-year investment plan of US$ 2500 million for rural health development infrastructures. These policies will greatly enhance and increase the access to quality care in the rural areas of Thailand. The Thai Government has also attached great importance to many maternal and child health programmes, such as the Safe Motherhood Initiative, child survival initiatives, breast-feeding campaigns and the parental school project. We are also committed to fulfilling the "3 by 5" initiative by implementing the programme on the prevention of HIV I AIDS mother-to-child transmission, which has proved to be very successful. The rate of transmission from mother to child has been greatly reduced, falling from 30% to 2% between 1990 and 2004. Thailand looks beyond the survival of its children. Another important strategy promotes the better development of Thai children. We pay serious attention to the proper development of healthy children with high intelligence and emotional quotients. The Thai Government has recently officially launched a US$ 20 million project, called "Brain-based Learning". The main objective is to find ways and means to develop learning skills and to promote the brain development of Thai children. The first A58NR/3 page 66 intervention involves providing a baby gift set to all newborns in Thailand. The set contains various toys, books, CDs, animated blankets and a guidebook for mothers to encourage the learning ability of the babies right from the beginning of their life. Finally, Madam President, I would like to thank the Director-General for deciding to hold the Sixth Global Conference on Health Promotion in Bangkok from 7 to 11 August this year. We have set up an exhibition in this Health Assembly to inform you of the progress of the event. I would also like to thank all of you who provided us with strong support during the recent tsunami crisis. The waves of global support have completely overridden the tsunami. I would sincerely appreciate your further support by coming to visit our beautiful country and culture. So I hope to see you this year for the Sixth Global Conference on Health Promotion in Bangkok. Thank you.

Dr SUPARI (Indonesia):

Your Excellency, Madam President, Director-General, Chairman of the Executive Board and honourable delegates. First of all, I wish to congratulate you, Madame Salgado, for your deserved election as President of this Health Assembly. I would like to take this opportunity to refer to progress and constraints, as well as prospects for global health development from my country's perspective. I understand that progress in achieving the health targets as set out in the Millennium Development Goals is far from being materialized in many countries. In this context, we note that many developing countries, including Indonesia, are still facing numerous challenges, so they need to further accelerate their health development. The debate of this Health Assembly, which focuses on maternal and child health as well as the theme of World Health Day 2005, "Make every mother and child count", is relevant to the challenges facing us in health development. Indonesia has been making great efforts in its maternal and child health programmes in order to accelerate the reduction of the maternal mortality ratio through a strategy to make pregnancy safer. In the context of achieving maternal and child health targets in the Millennium Development Goals by 2015, I would like to underline one of the strategic directions, namely, strengthening an integrated approach to reproductive, maternal, newborn and child health within our health system. To reduce child mortality, immunization is still considered one of the most cost-effective public health interventions and Indonesia has been meeting universal child immunization targets since 1990. Vaccine used for the programme is produced domestically by the state-owned enterprise PT Bio Farma. I would like to take this opportunity to thank WHO for its support in providing assessments on vaccine production and technical support to improve the quality assurance and quality system of the said PT Bio Farma. At present, this state-owned company is making efforts to improve its quality management system; I sincerely hope that in the near future, PT Bio Farma vaccine will acquire WHO prequalification. I would also like to inform you that in mid-March 2005, a suspected poliomyelitis outbreak was identified in certain parts of West Java province. An outbreak response was conducted promptly and a wider mopping-up will be carried out this month. The Government has encouraged health services at the district level to step up their acute flaccid paralysis surveillance. In this regard, I appreciate that WHO headquarters and the Regional Office for South-East Asia have sent a team to assist Indonesia in the epidemiological investigation. Large-scale epidemics of re-emerging and newly emerging diseases such as avian influenza outbreaks have been reported to have occurred in Indonesia since August 2003. In fact, these epidemics and other potential health threats could seriously affect a large number ofpopulations as well as the economy of the country. The earthquake and tsunami disaster has caused tremendous destruction as well as a large-scale humanitarian catastrophe in Aceh and North Sumatra provinces: more than 128 000 people have been killed, while 93 000 people are still missing and 600 000 people are displaced. On behalf of the Government and the people of Indonesia, allow me to take this opportunity to express my sincere gratitude and appreciation to WHO, UNICEF, other international organizations, as well as Member countries, nongovemmental organizations, and others for their humanitarian aid and the immediate responses they have provided. The disasters that occurred in Indonesia and other affected countries have taught us the importance of disaster preparedness and solidarity as well as cooperation among countries. In the same vein, it is evident that global preparedness for countering outbreaks or disasters, A58NR/3 page 67 and the response network, can be enhanced. I take this opportunity to urge WHO to strengthen this response network and allocate more resources and technical assistance for better capacity building, capacity strengthening and performance improvement. The future initiatives of our global health development, especially in relation to principles and implementation of primary health care and health promotion, form part of an essential strategy for achieving health targets in the Millennium Development Goals. We are informed that the principles of primary health care continue to be supported by Member States and the entire international community. I observe that the central issue of health development is the existence of a strong health care system and the empowerment of the people themselves in health development. However, in general I would like to state that many programmes on health promotion and healthy lifestyles have not yet been as successful as we expected. Therefore, in this context, I would like to propose that the Director-General should give health promotion the highest priority, in order for Member States to be able to address major health risk factors in a more effective manner. From what we know, if the trend observed during the 1990s continues, many poorer countries will not meet the health-related Millennium Development Goals. This rather slow progress can only be overcome with a serious and massive scale-up of existing health programmes. In this context, I agree with key strategic directions for achieving the Millennium Development Goals as discussed by the Executive Board and WHO Secretariat a few months ago. Based on our experiences, health needs should be addressed with a broad development framework that prioritizes growth with equity and empowerment, as well as social protection of the poor. Therefore health strategies should be firmly rooted in overall accountable public policies, and their implementation should be aimed at reducing poverty. Hence greater investment in public health and strengthening health systems is needed. It is hoped that WHO will lay greater emphasis on these strategic directions in its workplans and budget to accelerate efforts to reach the Millennium Development Goals. Thank you.

Mr QUASHIGAH (Ghana):

Madam President, Director-General, honourable mm1sters, distinguished delegates, invited guests, ladies and gentlemen, I wish to join other delegates in congratulating you on your election as President of the Fifty-eighth World Health Assembly, and you, Dr Lee Jong-wook, for your dynamic leadership. Ghana fully associates itself with the statement to be delivered by Eritrea on behalf of the African group. However, I wish to draw attention to other issues of importance to Ghana. Ghana is pleased to be part of the global movement to ensure sustained focus on maternal and child health. We therefore find the theme of this year's Health Assembly, which is "Make every mother and child count", very timely and relevant. Indeed, Ghana joined the global community to celebrate this year's World Health Day on 7 April. Countries and the global community need to do more to improve maternal health and ensure child survival and development. We can no longer sit by while so many women die from pregnancy-related complications and so many children die before their fifth birthday. One in 15 children born alive in Ghana today does not live to see its first birthday and one in nine children born today will die before it is five years old. The tragedy is that most maternal and childhood deaths are preventable. Indeed, the global community has for some time now, been aware of what is killing our mothers and children. The levels of poverty, malnutrition and HIV I AIDS are still too high in our countries; access to health services including essential obstetrics care is too low; and many families still have unmet needs for family planning. Ghana strongly recommends that nutrition to boost the immune system should be included in the programme for rehabilitating HIV patients. We therefore welcome the renewed global commitment to urgently addressing these challenges as part of efforts to achieve the Millennium Development Goals. However, Ghana wishes to call the attention of the global community to three areas that require urgent action if we are to make every mother and child count in our countries and communities. The first is to make pregnancy safer. The Government of Ghana welcomes the focus on a continuum of care and a lifespan approach to maternal and child health. Nevertheless, countries need to increase access to family planning and essential obstetric care services. To that end, Ghana was pleased to host an international conference on repositioning of family planning for the western African region in February this year. Ghana is also currently implementing several strategies to increase coverage of interventions for improving safe motherhood. The Government adopted a "close-to-client" approach to A58NR/3 page 68 services delivery, involving the establishment of a community-based health planning system. We are also implementing a policy of free antenatal care and delivery services in the country. In line with this commitment, Ghana continues to allocate funds from the national budget to support these policies. We have also introduced a national health insurance programme, with the objective of eliminating the financial barriers arising from user fees. The second area to which we wish to draw attention is malaria control. Malaria is still a major cause of high infant, child and maternal morbidity and mortality in our countries. We therefore welcome the Roll Back Malaria initiative and wish to call on the global community to adopt comprehensive and integrated measures for the control of malaria. We in Ghana welcome the focus on case management using artemisinin combination therapy and the renewed efforts to promote the use of insecticide-treated nets. Nevertheless, we think these measures do not go far enough. We need a renewed emphasis on vector-control measures, including indoor residual spraying and environmental sanitation. We also call for intensified research into the sterile-insect technique that we believe is environmentally safe and can be applied to wide areas. In anticipation ofMr Bill Gates' challenge to research scientists, my Ministry is collaborating with the Ghana Atomic Energy Commission, a research institution, to explore the use of the sterile-insect technique to sterilize mosquitoes as a malaria-control intervention. Our message is that we should sustain the current measures of case management and use of insecticide-treated nets, but we need new interventions for vector control. The third area concerns the human resource crisis facing our health systems. We in Ghana have a human resource crisis characterized by the migration of doctors and nurses to developed countries. The remaining health workers are inadequate, inequitably distributed, and poorly motivated. We therefore urge this Health Assembly to ensure follow-up action on resolution WHA57.19 on the international migration of health personnel. Let me conclude by saying that making every mother and child count in our countries will require political commitment. I therefore wish to call on fellow ministers to ensure that this issue is discussed at the highest political levels in our individual countries. We also need to engage our ministers of finance so that they understand that investment in health is an important and necessary growth and poverty-reduction strategy. Finally, because health requires multisectoral collaboration and action, we need to mobilize all aspects of our society, including the international community, civil society, nongovemmental organizations and the media, to support this endeavour. Thank you.

La PRESIDENT A:

Muchas gracias al delegado de Ghana. Tiene la palabra el delegado de Eritrea, que hablani en nombre del Grupo de Africa.

Mr MEKY (Eritrea):

Madam President, Director-General, honourable ministers, distinguished ladies and gentlemen, on behalf of the African group, I wish to join others in congratulating you, Madam President, on your election. We also welcome the address by the Director-General as well as by the invited guests, His Excellency the President ofMaldives, the Executive Director of UNICEF and Mr Bill Gates. The choice of the theme for the general debate of this Health Assembly, "Make every mother and child count", is most opportune because the issues that affect the health of our mothers and children need to take the centre stage. Women and children constitute the majority of the population of every country, yet they remain marginalized in every aspect ofhuman endeavour. We in Africa realize that if progress is to be made towards achieving the Millennium Development Goals, then we need healthier communities, strong economies and sustainable development. All these benchmarks require the full participation of women and children in decisions that affect their health. In this regard, a functional health system will be complete when all people - including women and children - have accessible, acceptable and affordable quality health care. It is a fact that maternal mortality and infant mortality rates in Africa are among the highest in the world. If this problem is not attended to, over the next 10 years there will be at least 2.5 million maternal deaths and 49 million maternal disabilities, resulting in at least 7.5 million child deaths and a loss of productivity of US$ 45 000 million. There A58NR/3 page 69 are various reasons why Africa has been unable significantly to reduce maternal and unfair deaths. In Africa, access to sexual and reproductive health remains very limited and unequal. In addition, social, economic, political and educational inequities constitute great challenges. Other important challenges include: inadequate financial resources and allocation; lack of access to and availability of quality skilled care during pregnancy, childbirth and the immediate postnatal period. Moreover, poorly functioning health systems, especially for obstetric and neonatal emergencies, poor logistics for the management of drugs, growing poverty, particularly among women, and harmful sociocultural beliefs and practices associated with low status of women also contribute to Africa's inability to reduce maternal and infant mortality significantly. Healthy women are empowered women. We need significant reductions in the maternal and child mortality rate now and not in the long run. Governments have a key responsibility to ensure the continuous and sustainable improvement of health care, first and foremost for the most vulnerable members of society - women and children. Provision of a continuum of care, better health infrastructure, and greater rights for women will obviously contribute to the creation of an enabling environment at all levels, which is critical to the attainment of the highest standard of health for women and children. In addition, programmes need to be developed to include access to information on reproductive health rights as well as family planning services. Priority should also be placed on improving the nutritional and health status of mothers through education and information, as part of maternal health and safe motherhood programmes. Poor nutrition remains the biggest risk factor contributing to the global burden of disease, and malnutrition is a direct or indirect cause of over half of child deaths. It increases the fatality rate from communicable diseases and increases the risk of progression of HIV to AIDS. The importance of poor nutrition also extends beyond its relationship with infection and death. For instance, iodine- and iron­ deficient children are slower to learn and develop intellectually and thus this deficiency reduces their capacity to achieve their full human potential and contribute to societal development. Improving nutritional well-being to reduce the mortality rate will require approaches that redress the underlying inequities through broad-based programmes that improve household food security. Additionally, interventions such as promoting breastfeeding, providing children and women with vitamin A, iron and folate supplements, and ensuring availability of iodized salt for populations are among the most cost-effective approaches for improving quality of life. There is also the challenge of conflict. Sub-Saharan Africa has had more than its share of armed conflicts. Conflict has indirect and direct effects on health: indirectly, it diverts resources away from the sector; directly, it prevents services from reaching displaced populations in disputed territories and destroys health infrastructure. Although no one is spared, sadly women and children are the usual victims of the adverse effects of conflicts. It is rightly said that men's social and sexual behaviour directly affect women's reproductive health. Therefore, while catering for the specific needs of women, attention will also have to be paid to the roles and responsibilities of men and the need for them to assume greater responsibility for their sexual and reproductive behaviour, as well as their social and family roles. Educational programmes have to be embarked upon to engage men's support for maternal health, and safe motherhood strategies should be devised to ensure that men share responsibility for sexual and reproductive health, including family planning, and for preventing and controlling sexually transmitted diseases, including HIV/AIDS. As has already been stated, women play a pivotal role in the social and economic development of their respective countries. It is therefore of concern that, in Africa, women and children form the greater number of people infected with HIV/AIDS. The majority of our mothers, sisters and children do not fully enjoy their rights, especially to education and the attainment of the highest standard of physical and mental health and social security. These inequalities make our mothers more vulnerable in the area of sexual and reproductive health, thus increasing their vulnerability to HIV infection. Furthermore, poverty, as well as negative and harmful traditional and cultural practices that make women inferior, also renders them vulnerable to HIV I AIDS. Neonatal, child and maternal morbidity and mortality rates remain high in Africa. However, most of the deaths are preventable. Our children suffer from diarrhoea and acute respiratory infections, vaccine­ preventable diseases, and neonatal and perinatal crises, which are aggravated by malnutrition. This is why, for us in Africa, the Integrated Management of Childhood Illness strategy is welcome news. Another area that is of paramount importance is vaccination and immunization services which target A581VR/3 page 70 children and women of childbearing age. Widespread immunization contributes to a reduction in child mortality and maternal mortality. In conclusion, we in Africa have adopted a road map that aims to accelerate the attainment of the Millennium Development Goals related to maternal and newborn health by improving the provision of, and access to, quality maternal and newborn health care, among others. We believe that the training of appropriately skilled cadres for emergency obstetric care is one of the most important actions for improving access to quality care at all levels. As we prepare for the United Nations General Assembly to be held in September this year at the level of the African Union Heads of State and Government to assess the progress made in achieving the Millennium Development Goals, we recommit ourselves to working together with other international partners in meeting the targets set for the Millennium Development Goals. We invite and encourage our development partners to walk this road with us and continue to support us in this regard. Thank you.

Mr STORACE (Italy) (interpretation from the Italian): 1

Madam President, Director-General, distinguished colleagues, ladies and gentlemen, it is a privilege for me to address this Health Assembly, in my capacity as Minister of Health of Italy. First of all, I wish to express my appreciation for the theme proposed for this year's general discussions: the protection of maternal and child health affects the well-being of families and, in more general terms, of society as a whole. The world scenario in relation to maternal and child health is still highly differentiated; most industrialized countries, such as Italy, are witnessing a progressive ageing of the population, along with a constant reduction in the number of births, while in most of the developing countries the demographic trend is increasing and problems arising from the right to health of mothers and children remain unsolved. Figures and data of The world health report 2005 are so dire that they cause us great concern: each year, more than half a million women die during pregnancy or childbirth and more than 10 million children die before their fifth birthday. This tragedy must be stopped by adopting urgent initiatives to favour access to primary care and assistance during childbirth; and to encourage planning and implementation of evidence-based preventive measures and strategies in order to reduce maternal and child mortality significantly (by at least 60%). Our civilization is at stake if we do not guarantee the right to motherhood and the right to life. Italy will offer its active contribution, both in terms of experience and resources, to the following: adopting an integrated approach to the reproductive health of the mother, the newborn and the child, avoiding separation and fragmentation of interventions by different specialized health sectors, thus guaranteeing an harmonious approach to both expressed and unexpressed needs; recognizing that there is not a single model that can be effective in all situations and, as a result, giving priority to the development of local strategies, more suited to specific national and regional circumstances; developing high-quality information systems, to streamline interventions assessment and health-care planning; and fighting unjust differences in terms of access to health-care services. In Italy, as well as in many other industrialized countries, women have their first pregnancy and childbirth at an increasingly older age, with more related health-care problems; yet, a constant decrease in children's mortality rate, down to a minimum level, has also been observed and this is hardly likely to be bettered. In the field of international collaboration, to improve maternal and child health, I wish to underline the commitment of the Italian Cooperation for development which, through its many multilateral and bilateral contributions to the United Nations' specialized agencies, such as WHO, UNICEF and UNFPA has offered its participation, with the common aim of reaching the Millennium Development Goals, in particular those related to maternal and child health. Since 2004, Italy has also been a member of the Child Survival Partnership, jointly launched by WHO and UNICEF. Almost all the most relevant themes to be discussed at this Health Assembly have at their core, the subject of maternal and child health; in particular, I wish to mention the fight against malaria, tuberculosis and HIV I AIDS, as well as the immunization strategy adopted worldwide to eradicate

1 In accordance with Rule 89 of the Rules of Procedure of the World Health Assembly. A58NR/3 page 71 poliomyelitis. However, to be able to face the growing needs of numerous countries and the requests of health care addressed to WHO, renewed and intensified international efforts are necessary. We are therefore in favour of the well-grounded proposal to increase the WHO regular budget for the biennium 2006-2007. We should, and can, do more. World Health Day 2005 has been devoted to maternal and child health, with the slogan "Make every mother and child count". In The world health report 2005 it is stated that the health of mothers and children is "at the core of the struggle against poverty and inequality". It is now up to us to make these statements come true.

Professor AKDAG (Turkey):

Madam President, distinguished colleagues, Director-General, ladies and gentlemen, I am very pleased to address the Fifty-eighth World Health Assembly. At the outset, I would like to congratulate you, Madam President, on your election as President of this distinguished Health Assembly, as well as all other elected officials, and wish success to all participants. Also as a paediatrician, I find the theme selected for World Health Day - "Make every mother and child count" - a very timely and appropriate choice. However, since a safe motherhood approach and basic newborn care are the two main components of Millennium Development Goals, we have to acknowledge that we are still far behind achieving these targets. We have to focus on reducing prenatal mortality rates. The awareness of parents should be raised even before pregnancy, as it is very important for prenatal and neonatal health; we should also continue to provide our people with widespread pre-pregnancy counselling support. Moreover, responding to the needs that might arise, we should provide more accessible genetic counselling services to increase the prospects of having healthy children. Another widely known factor concerns nutritional deficiencies, which constitute a vicious circle with chronic diseases. Therefore the monitoring of early childhood development becomes an important concept in healthy beginnings to life. Furthermore, the value ofbreastfeeding is unquestionable for newborn babies. Now I would like to give some brief information on what we have recently achieved in Turkey on the aforementioned issues. Underlining men's role in reproductive health, we have been carrying out a training programme covering 450 000 young men during their military service. Our comprehensive scanning programmes for genetic diseases, such as thalassemia and phenylketonuria, continue with great success. Our training programme for health personnel to improve neonatal resuscitation skills has reached up to 95% of our hospitals. The rate of exclusive breastfeeding within the first six months of life has increased by almost 20%. Our programme for providing free iron and vitamin D supplement to all babies is under way. Within the last year, almost 600 000 people on lower incomes have received conditional cash support for regular health controls of pregnant women and children. With regard to the eradication of measles, the campaign to immunize almost 20 million children will be completed within two days and will be the largest in scale within the WHO European Region. I would like to draw your attention to the fact that the world community is witnessing a setback in the fight against poliomyelitis. The recent outbreaks have once again proven that no country is immune to poliomyelitis. Therefore combined efforts and extraordinary actions, not only at regional, but also at global level are required. Only in this way could poliomyelitis be the first disease to be eradicated in the twenty-first century. Also we must carry on our efforts to stem the loss of our babies due to other vaccine-preventable diseases, such as neonatal tetanus and measles. Taking this opportunity, I would like to reiterate the full support of my Government for the revision process of the International Health Regulations which will finally be adopted by the Health Assembly. I believe that it will play an important role in preventing the spread of diseases constituting threats to international public health. In concluding, let me underline that we consider our mothers and children as invaluable assets and we endeavour to do our best to fulfil our obligations to them, using all means within our capacity. I would like to invite all Member States to work closely together to make sure that every mother and child counts. Thank you. A58NR/3 page 72

Ms RAUCH-KALLAT (Austria):

Dear ministers, distinguished delegates, ladies and gentlemen. Madam President, let me first of all congratulate you on your election as President of the Fifty-eighth World Health Assembly and you, Director-General, for your ambitious and dynamic work during the past two years. As a former Minister for Youth and Family and now as Minister of Health and Women of the Republic of Austria, I am very grateful to WHO for taking the motto "Make every mother and child count" as the theme for World Health Day 2005 and the general discussion today, which gives us the opportunity to highlight this issue of major worldwide importance from different perspectives. Within the Austrian Government I am responsible for health and women, so Millennium Development Goal 5 on maternal health is particularly close to my heart. Women's health requires a rights-based approach of entitlements to essential health services that should be available, accessible and affordable. At the same time, a gender perspective needs to be integrated into the review of all the Millennium Development Goals. From the international perspective, medical care and treatment for pregnant women, mothers and children differ worldwide considerably. That applies also to the framework conditions which are essential for the maintenance and promotion of health as well as peace, social justice, good living conditions, education and a healthy environment. There is a great need for action, especially in developing countries. On World Health Day 2005, I presented the second Austrian women's health report 2005, which aims at giving a full picture of the health situation of women in Austria. The report concentrates especially on changes in women's health data during the past 10 years on the basis of the first Austrian women's health report, published in 1995 as one of the first national women's health reports, as well as on gender-specific measures for prevention and health strategies, and actions to be taken. This report will be the basis for Austria's European Union presidency in the first half of 2006, the main topics being women's health and gender-specific medicine, as well as diabetes as our special priority. Under Austria's European Union presidency, we are planning to discuss in this context gender-specific data and statistics, new patterns of disease involving stress and smoking; and heart attacks caused by women's changing lifestyles, as well as results from other national women's health reports. The issues of the reproductive and sexual health of women are considered in an important chapter in the Austrian women's health report. The focus lies on primary health care for pregnant women, mothers and their children. Unlike the international data showing a high maternal mortality rate, the maternal and infant death rates in Europe have considerably decreased as a result of the improvement in primary health care and living conditions. In Austria, a very successful maternal and infant health programme has existed since 1974 and has had an extremely positive effect on infant mortality by decreasing the rate from 20 per thousand in the year 1974 to 4.2 per thousand in the year 2004. The maternal mortality rate, which developed in the same positive way, is about 2.6 per 100 000 livebom children. For the early detection of diseases during pregnancy and in the first years of life, regular medical consultations are required. Every pregnant woman is provided with a mother and child pass. Women have to undergo at least six clinical examinations and some special blood tests during pregnancy. In a similar way, children have to undergo 12 examinations before the end of their fifth year of life. These examinations are carried out by general practitioners or appropriate specialists such as gynaecologists and paediatricians. Most pregnant women and children undergo these examinations, which are free of charge. These medical examinations are necessary for the continuation of child care benefit paid on a monthly basis, which is an essential incentive. During this programme, the infant mortality rate has decreased dramatically, as I have already mentioned. The Austrian women's health report also shows that the issues associated with reproductive health in my country are different to those in developing countries. The decrease in the birth rate, the medicalization of pregnancy and birth and the negative consequences of an unhealthy lifestyle, including nicotine and alcohol abuse or an unbalanced diet, imply unfavourable effects for mothers and children. The increase in the risk of a premature birth, a stillbirth or an abortion is closely linked to an unfavourable lifestyle. Physical, sexual and psychological violence against women is another problem in our society and a very important topic affecting women's health. The long-term impact of unseen damage like psychological harm and physiological injuries creates serious disturbances. To combat domestic A58NR/3 page 73 violence, Austria adopted the Protection Against Violence Act allowing police to expel a perpetrator from the family home and to issue a barring order, and enabling civil law courts to issue interim injunctions. My Ministry, together with the Ministry of the Interior, is funding intervention centres against violence in the family that actively contact the victim and offer legal counselling and sociopsychological services. Women's health is intrinsically linked to safeguarding the fundamental legal rights of women. Austria, like other European Union countries, has experience of young migrant women being confronted with harmful traditional practices such as forced marriage, female genital mutilation and honour crimes. Many of the home countries are taking a whole range of actions to overcome such practices. Austria would like to join these efforts and is planning to organize a conference on possible action to be taken at a European level during our European Union presidency in 2006. We really do hope that many countries outside the European Union will join this initiative, because we must never forget that women's rights are human rights. Thank you.

Ms HALTON (Australia):

Madam President, I also extend Australia's congratulations on your election. The health of the world's people is dependent on many factors. In the current era, one of those is protection from potentially devastating new diseases that can spread very quickly like severe acute respiratory syndrome, and avian influenza. It is imperative for all of us who can contribute to disease control, to work even closer together to prevent pandemics. Australia strongly supports adoption of the revised International Health Regulations and their new global cooperation regime. We commend the Intergovernmental Working Group on Revision of the International Health Regulations, and extend our gratitude to its Chair, Ambassador Mary Whelan, and to the Director-General and the Secretariat for their support for the process. Only the universal application of these revised Regulations will ensure protection for all. We therefore urge Member States and all others who will participate in the new administrative mechanisms to act quickly and with the same spirit of cooperation that has marked the negotiations for the International Health Regulations. Australia also welcomes WHO's renewed focus on mothers and children, as a key to achieving the Millennium Development Goals by 2015. Ensuring the health and safety of mothers and their babies is one of the most fundamental duties of any society; but for too many women, the miracle of birth ends in tragedy. This year's World health report shows that no significant progress has been made over the last decade in reducing the terrible death toll among mothers and babies. This year, we need to focus on poor water and sanitation, malnutrition and communicable diseases, which are responsible for many child deaths; but pregnancy and childbirth are still the leading causes of death and disability among women of reproductive age in developing nations, mainly due to lack of skilled health care. Another factor, especially in Africa, is the AIDS epidemic. By the end of 2004, according to WHO, 19.2 million women were living with or dying from HIV I AIDS worldwide; many of them were doomed to pass on the disease to their children before or after birth. As a global community, we have the knowledge, skills and resources to prevent many of these tragedies. As The world health report has identified, we need to build these skills into health systems that are sustainable and accessible and can be provided without high cost to those who need help. This is not easy, but better health for mothers and babies means better health, social and economic outcomes for communities. Australia is fortunate to be able to ensure safe birthing for most women and babies. I am delighted that the latest figures show our infant mortality rate has dropped by 50% in the past two decades to 4.8% per 1000 in 2003, with similar improvements in mortality for children aged one to 14 years. But we strive to do better. We are developing the National Agenda for Early Childhood, to ensure a healthy start in life for every child. In particular, more must be done for our indigenous women and children. The "Healthy for Life" package announced in the Australian budget this month will provide a sound start in life for all indigenous babies and reduce their vulnerability to chronic disease. In our region, maternal and child health is a priority for Australia's international health assistance, totalling$ 242 million this year, or 12% of our total international aid budget. It is the major focus of Australian health assistance to Indonesia. Australian-funded projects have provided training for midwives and the community and have helped to strengthen local health facilities. So far, more A58NR/3 page 74 than one million women of reproductive age and 260 000 newborns in Indonesia have benefited from this assistance. In China, we have funded a rural health project in Sichuan province, which was awarded the 2004 Global Health Council/White Ribbon Alliance for Safe Motherhood Award for its successful safe motherhood public information campaign. In the Western Pacific, about 3000 children under the age of five die every day. More than 40% are babies who die within a month of birth, and maternal and child health is a critical feature of our assistance to Papua New Guinea, the Solomon Islands, Vanuatu and Fiji. We have also made a voluntary contribution of $ 1.24 million to WHO's Asia-Pacific initiatives. In this context, education is a crucial element for health professionals, and importantly, for the community. We also need to build the capacity of health systems, not just in terms of skills and facilities, but in terms of financing. We welcome WHO's creation of the Department of health systems financing to support countries in developing better health systems. The fact that maternal deaths are actually rising in some countries shows us that ad hoc solutions, however well meaning, are not good enough. We must get the fundamentals right - for every mother and every child.

Dr SINGA Y (Bhutan):

Madam President, Director-General, Vice-Presidents, your excellencies, honourable health ministers, distinguished delegates, ladies and gentlemen, may I have the honour and privilege to convey to this gathering warm greetings from the people of the Kingdom of Bhutan. Allow me, Madam President, to congratulate you on your election to this very important and prestigious office. I am confident that under your wise and able leadership the deliberations of this Health Assembly will come to a successful conclusion. In equal measure, I would like to congratulate all the newly elected office bearers and Bureau of the Fifty-eighth World Health Assembly. We would like to commend the Director-General Dr Lee Jong-wook and his able staff for the many initiatives that have been taken to improve the health and well-being of the global community. More than ever, we are compelled to deal with global health emergencies such as severe acute respiratory syndrome, avian influenza and the tsunami tragedy. Bhutan commends the critical role WHO has played in such crisis preparedness, response and recovery. Further, Bhutan welcomes the revision of the International Health Regulations, which will benefit the global community by enabling it to respond to the need to ensure public health security. This year's theme for World Health Day, "Make every mother and child count", is very appropriate; it is timely to focus on the health of mothers and children. Bhutan would like to commend WHO not only for prioritizing the health of mothers and children but also for emphasizing the health of neonates and thus promoting maternal, neonatal and child health instead of only maternal and child health as in the past. Bhutan stands fully committed to achieving the Millennium Development Goals - particularly those concerning the reduction of infant, child and maternal mortality - by providing universal coverage and access to a continuum of services and by making skilled services available at the point of need. We are confident that through close cooperation and collaboration with WHO and other health development partners, we will be able to achieve the health-related Millennium Development Goals. HIV I AIDS is a serious threat and Bhutan's efforts to reverse the situation have been under way since well before the United Nations Millennium Declaration. For the people living with HIV/AIDS, and in accordance with WHO's "3 by 5" initiative, we have introduced comprehensive antiretroviral treatment with effect from 2004. Bhutan has made notable progress in fulfilling the objectives of the WHO Framework Convention on Tobacco Control. The National Assembly ratified the WHO Framework Convention on Tobacco Control in 2004 and banned the sale of tobacco and tobacco-related products. Many public places and institutes in Bhutan have been declared smoke-free areas. We are gathered here to enhance collectively our efforts to deal with the urgent health issues that plague the world today. WHO has the experience and mandate to face these challenges and we must acknowledge the need for additional resources to match the scale of health problems. In line with this, Bhutan supports the proposal of the Director-General to enhance WHO's resources through an increase in assessed contributions. In conclusion, I would like to reaffirm Bhutan's strong commitment to working closely with Member States in order to move towards achievement of the Millennium A58NR/3 page 75

Development Goals and beyond. We firmly believe that in so doing, we will help to ensure a healthier and safer world. Thank you and Tashi Delek!

Dr HOSSAIN (Bangladesh):

Madam President, honourable health m1msters, Director-General, excellencies, ladies and gentlemen, good afternoon. I congratulate you, Madam President, on your election as the President of the Fifty-eighth World Health Assembly, which will benefit from your wisdom and experience. I also congratulate the other members of the Bureau. It is an honour and a pleasure to participate in this Health Assembly. I was particularly impressed by the statement of the Director-General yesterday. I thank Dr Lee for his determination to act and his excellent speech. Before proceeding to the major theme of my statement, I wish to inform the Health Assembly of our progress in implementing the WHO Framework Convention on Tobacco Control, which was approved at the Fifty-sixth World Health Assembly when I was the President. We were proud to be among the first countries to sign the Framework Convention in 2003. Immediately thereafter, we ratified the Convention. Effective from 26 March this year, an anti-tobacco law is in place, which severely limits smoking in public places and prohibits advertising. We continue to educate the public on the dangers of smoking. With a view to achieving Millennium Development Goals 4 and 5, the theme of World Health Day this year, "Make every mother and child count", is appropriate and timely. On 9 April, this year, ministers and delegates from 11 countries, as well as representatives from civil society and intergovernmental organizations, met and agreed on the Delhi Declaration on Maternal, Newborn and Child Health. Improving the well-being of mothers and children not only increases the health of society, it also decreases inequality and poverty. In Bangladesh, we have established 191 emergency obstetric care centres (equipped with modem treatment and operating-theatre facilities) in addition to the existing State maternal health-care facilities; these centres are staffed by trained health-care providers. In addition, we have trained family welfare attendants and female-health assistants as community skilled birth attendants working in the rural areas. As a part of the demand-side financing, we have introduced a maternal health voucher scheme for poor, pregnant women. Improvement of maternal and child health is one of our priorities. Child health programmes are providing comprehensive services to children under five years. The accessibility of Expanded Programme on Immunization services improved to 96%, and it was possible to prevent an estimated two million child deaths between 1987 to 2000. The Expanded Programme on Immunization continues to prevent 200 000 deaths each year. A new vaccine against hepatitis B has been added since April 2003 with the technical and financial support of the Global Alliance for Vaccines and Immunization. The hepatitis B vaccine programme will be expanded to cover the country by 2005. Bangladesh achieved poliomyelitis-free status more than four years ago. It is a milestone in the history of our public health sector. We must ensure that there is no poliomyelitis invasion. The number of deaths from acute respiratory infection has come down to nearly 85 000 in the year 2004, yet it remains the single largest killer among children under five years. The programme to control diarrhoea! diseases is one of the most successful in Bangladesh. We have adopted an integrated management of childhood illness strategy as a new way forward to reduce childhood mortality and morbidity. The success of our policies can be measured by a single yardstick: over the last 33 years, the average life expectancy in Bangladesh has gone up from 43 years to 62 years. We are proud of this achievement, but are committed to striving to do even better. To achieve the Millennium Development Goals, let us work together to improve health and the overall status of women and children. It is recognized that, for a developing country, resource constraints pose a serious obstacle to achieving the Millennium Development Goals. WHO should explore the possibility of creating a fund for Goals 4 and 5 to help overcome these obstacles. The Global Fund to Fight AIDS, Tuberculosis and Malaria and the Global Alliance for Vaccines and Immunization are excellent examples that could be emulated. At the Fifty-sixth World Health Assembly, I had suggested that a global TV channel on health should be introduced under the auspices of WHO. As time passes, I am ever more convinced of the need for such a channel. Apart from informing people on health issues, this can be invaluable in times of emergency. I strongly recommend that this matter be given greater attention. A58NR/3 page 76

In conclusion, I wish to reiterate that we are ready to work with WHO for the benefit of humanity. I am confident that under the capable leadership of Dr Lee, WHO will receive new impetus in health improvement programmes, and also address the challenges of the Millennium Development Goals. Thank you, ladies and gentlemen.

La PRESIDENT A:

Ahora tiene la palabra el delegado de Antigua y Barbuda quien hablan1 en nombre de los miembros de la Comunidad del Caribe: Bahamas, Barbados, Dominica, Granada, Haiti, Jamaica, Saint Kitts y Nevis, Santa Lucia, San Vicente y las Granadinas, Suriname, y Trinidad y Tabago, y en nombre de su propio pais.

Mr MAGINLEY (Antigua and Barbuda):

Madam President, I wish first of all to congratulate you on your election as President of the Fifty-eighth World Health Assembly. I also wish to thank the Director-General, Dr Lee Jong-wook, for his detailed report and to note the presentation yesterday by Mr Bill Gates. Colleague ministers, heads of delegations and delegates, as Minister of Health of Antigua and Barbuda, I have the honour and privilege of addressing the Fifty-eighth World Health Assembly, on behalf of the Caribbean countries that are organized in the Caribbean community (CARICOM). I would also like to bring greetings on behalf of the Prime Minister of Antigua and Barbuda, the Honourable Baldwin Spencer, and to state his continued appreciation and recognition of the work of WHO. The world health report has highlighted the need to address the major concerns related to maternal and child health cases in an integrated and coordinated manner. The CARICOM states also recognize the need to harmonize best practices and promote greater efficiencies in maternal and child health services through improved regional and subregional integration and cooperation. We consider that technical cooperation between countries, both North-South and South-South, can be beneficial to our region, specifically with regard to HN I AIDS, which continues to adversely affect many of our women and children. The Caribbean is well known internationally as a quality tourist destination. CARICOM member states are geographically dispersed with diverse economies of scale and peoples. In addition to offering quality entertainment and cultural diversity, visitors generally have a glamorous impression of the Caribbean. However, our region still has challenges of poverty, significant health needs and regularly faces the disastrous effects of hurricanes and other forces of nature. For example, in the past year we have been adversely affected by Hurricane Ivan and severe flooding that caused mass destruction in the Caribbean. Grenada suffered a severe setback as a result of this devastating hurricane in September of 2004 and it is estimated that 90% of the island's buildings were damaged. Hurricane Ivan also caused terrible destruction in the Bahamas, the Cayman Islands, and Jamaica, damaging homes and the health infrastructure and placing many people at risk from disease, contaminated water and food shortages. In Guyana early this year, heavy rainfall caused severe flooding in its densely populated low-lying coastal areas. An estimated 40% of Guyana's population was affected and thousands were forced to flee their homes; this left approximately 15% of the population homeless. The flooding also resulted in an outbreak of leptospirosis. We need to thank Canada, the United States of America, WHO, PAHO and the European Union, for the immediate support that they provided in response to these disasters. However, we must seize this opportunity to restate the point that vulnerability to natural disasters must be factored into the development assessment equation. Against the backdrop of the disturbing frequency of hurricanes, and the real threats of seismic and volcanic activity and coastal flooding, CARICOM continues to take serious issue with traditional measurements of economic status, such as per capita income and life expectancy. Experience teaches that years of investment in education, health care and economic infrastructure can be erased within a few hours by nature's fury. In our vulnerable and small land masses, a hurricane affects the entire socioeconomic fabric. Additionally, mothers and children suffer the most in these circumstances as disasters can negatively affect transportation and health services. These damaging events have a huge negative impact on our people and economies and time after time we have had to A58NR/3 page 77 rebuild our nations, health systems and health facilities. We have to rise to this challenge as our region's principal source of income is derived from tourism, which accommodates approximately 26 million overnight visitors each year. We would welcome increased efforts from WHO and P AHO to increase their support to our region to develop effective preparedness, response and recovery strategies and programmes. The Caribbean is a region of high mobility that demands a close surveillance system for communicable diseases. This high mobility also requires that residents attain a high immunization status, which helps to ensure that not only residents remain disease-free but also that the many visitors to our shores remain healthy as well. The elimination of measles and congenital rubella syndrome are just two examples of why our Expanded Programme on Immunization can be used as a model internationally. Effective immunization has indeed improved child health in our region and we are pleased to join the fight with other nations in the prevention of the spread of poliomyelitis, since a single case in the world means that we are all at risk. Our existing capacity to respond to international health threats is limited and we need the support of PAHO and WHO in this area. The Caribbean, through the Caribbean Epidemiology Centre, has been doing rather well in surveillance particularly for communicable diseases. Although we welcome the improvements in the revised International Health Regulations, we realize that the proposed new Regulations will require further investment for implementation. Preliminary estimates indicate that millions of dollars will be needed over the next three years in our region in order to respond adequately to the requirements of these new Regulations. We in the Caribbean are faced with challenges in financing, and specifically health-care financing. Additionally, many of the Caribbean countries are making a big sacrifice with the new budget distribution from PAHO, which will cause the budget of the PAHO offices in several of our countries to be reduced. This budget reduction in the region will further constrain the already limited health budgets of countries and put our health achievements of recent years, such as the high level of immunization, under significant pressure. The region has an HIV prevalence of 2.6%, second only to sub-Saharan Africa. UNAIDS estimates that between 1. 9% and 3.1% of Caribbean adults of reproductive age, were living with HIV during 2003. Although we consider WHO's "3 by 5" initiative very useful for increasing the number of people living with HIV and AIDS who are in therapy, the necessary supporting services such as laboratory services and monitoring and evaluation, should accompany therapy. In fact, we are of the opinion that therapy will be most effective in an environment of strengthened health systems. We need to thank PAHO and WHO for the support that they have provided for the Caribbean Commission on Health and Development, modelled on the Commission on Macroeconomics and Health and chaired by Sir George Alleyne, former Director of PAHO. Several studies from this Commission have provided the evidence to establish national and regional health promotion strategies and to guide policy decisions for our countries and for the region. Maternal and child health programmes also continue to be a priority. In addition to the worrying status and impact of the HIV I AIDS epidemic, the impact of chronic noncommunicable diseases and related risk factors is of specific concern. The Caribbean countries realize that behavioural change is the single most important cross-cutting element in addressing lifestyle diseases such as HIV I AIDS and noncommunicable diseases (including diabetes, hypertension, violence and accidents). Obesity, now considered a disease in its own right, represents an escalating epidemic in our region. We note, as well, that obesity affects women disproportionately and has a negative effect on maternal health. These diseases are all preventable with a change in behaviour. We believe that more needs to be done to address the risk factors for these diseases, such as tobacco use, alcohol abuse, risky sexual behaviour and reduced physical activity. In addition to the resolutions on the Global Strategy on Diet, Physical Activity and Health and the WHO Framework Convention on Tobacco Control, we would like to urge WHO to develop a global framework and approach to behavioural change. If we improve the chronic conditions that predate pregnancy, we may be able to achieve better outcomes for women and children. Premature maternal deaths occur as a result of cancer of the cervix, which is extremely high in our region. We ask WHO to address this preventable disease, which kills many of our women in early adult life. We need access not only to appropriate treatment programmes but also to effective screening techniques for cervical cancer prevention and control. A58NR/3 page 78

A lack of resources continues to challenge the delivery of health services in our region, particularly with respect to maternal and child health. The recruitment of trained health professionals by more developed countries compromises our ability to deliver adequate services. Director-General, we appeal to you to assist us with the issue of the migration of our health-care professionals. We thank you for all your good work in the region but we wish to emphasize that much of this work is threatened by that migration. Additionally, this drain on our human resources also threatens our ability to achieve the Millennium Development Goals, particularly Goals 4 and 5 that relate to maternal and child health. We would not be here today if our mothers had not had safe births. We all therefore have an obligation to ensure that not only mothers but that all women are given the opportunity to live fully productive lives. This can be achieved if we continue to work together in an integrated and coordinated manner against diseases and other factors that negatively affect women and children. Thank you very much.

M. COUCHEPIN (Suisse):

Madame la Pn':sidente, Monsieur le Directeur general, Mesdames et Messieurs, dans un monde interdependant dans tous les domaines, la Suisse attache une grande importance au renforcement des mecanismes internationaux de surveillance et de controle des maladies infectieuses. Les questions de gouvernance touchant l'OMS comme le systeme des Nations Unies sont aussi essentielles. En ce qui concerne la surveillance des maladies transmissibles, le Gouvernement suisse a mene, en janvier dernier, un exercice de crise fictif simulant !'apparition soudaine d'une grave epidemie de grippe. Cet essai a demontre !'importance, mais aussi les defis, d'une coordination internationale efficace dans la phase initiale de la crise. En effet, seules des decisions prises au niveau international, peu de temps apres la decouverte d'un risque, s'averent efficaces. La revision du Reglement sanitaire international est particulierement necessaire, notamment a la suite des flambees de SRAS et, plus recemment, de grippe aviaire. La Suisse se felicite que les travaux de revision du Reglement aient pu etre acheves a temps et ceci grace a l'excellente presidence de 1' Ambassadeur Mary Whelan d'Irlande. Avec la revision soumise a la presente Assemblee de la Sante, le Reglement sanitaire international est en passe d'evoluer d'un outil purement technique vers un instrument applicable a tous les evenements a risque pour la sante publique. La Suisse espere que la resolution relative au Reglement revise puisse etre adoptee lors de cette Assemblee. Dans son rapport sur la rHorme de l'ONU, le Secretaire general de ]'Organisation des Nations Unies a aussi souligne !'importance pour la securite mondiale d'une meilleure surveillance des epidemies. La revision du Reglement s'inscrit parfaitement dans un cadre securitaire global. La Suisse soutient pleinement le processus de reforme des Nations Unies lance par le Secretaire general. Dans ce contexte, nous pensons que l'OMS doit imperativement inscrire ses activites de cooperation au developpement et d'assistance technique dans un cadre programmatique et coordonne. De plus, dans le cadre de l'agenda international d'harmonisation de l'aide, l'OMS doit contribuer activement aux efforts visant a reduire les couts de transaction de l'aide internationale et a en ameliorer l'impact. Nous encourageons l'OMS a mettre en oeuvre les recommandations formulees dans la resolution 59/250 de l'Assemblee generale consacree a l'examen triennal complet des activites operationnelles de developpement du systeme des Nations Unies. Les exemples de l'efficacite des approches concertees ne manquent pas. L'action en faveur de la sante maternelle et infantile, sujet du Rapport sur la sante dans le monde de cette annee, en est un. Elle exige une etroite cooperation entre les organisations du systeme des Nations Unies. L'action en sante maternelle et infantile a elle-meme des liens etroits avec la sante sexuelle et reproductive et avec les droits qui y sont rattaches. Son importance a ete rappelee l'an passe a l'occasion du dixieme anniversaire de la Conference du Caire. Toujours dans le cadre de la bonne gouvernance, la Suisse attache une grande importance au financement durable de la sante egalement dans les pays avances. La Suisse a demande a l'OMS et a l'OCDE d'analyser conjointement son systeme de sante afin d'identifier ses forces et ses faiblesses. Le but d'une telle analyse est d'examiner les differentes options de reforme qui permettraient d'enrayer l'escalade des couts tout en maintenant un acces a des soins de qualite. Cela devrait aussi permettre de profiter des synergies decoulant de la collaboration entre l'OMS et l'OCDE. A58NRJ3 page 79

Enfin, en conclusion, permettez-moi de vous remercier vivement, Monsieur le Directeur general, et avec vous, tout le personnel de l'OMS. Malgre les differentes contraintes, vous accomplissez un travail remarquable au service des Etats Membres et de leurs citoyens. Je vous remercte.

La PRESIDENT A:

Estimados delegados, es hora ya de levantar la sesi6n de esta mafiana. Quisiera hacerles unos anuncios de programa: Esta tarde, a las 13.00 horas, tendni lugar en la sala XII una sesi6n de informaci6n tecnica sobre la Cumbre Ministerial de Mexico sobre Investigaci6n en Salud. Seguidamente, alas 15.00 horas tendni lugar la segunda sesi6n de la Comisi6n Ay se reunini tambien la Comisi6n de Credenciales, esta ultima en la sala VII. Y a esas mismas 15.00 horas tendni lugar la sesi6n plenaria para retomar el punto 3; tengo el honor de anunciarles que esa sesi6n seni presidida por el Vicepresidente primero de la Asamblea, el Sr. Meky. Se levanta la sesi6n.

The meeting rose at 12:35. La seance est levee a 12h35. A58NR/4 page 80

FOURTH PLENARY MEETING

Tuesday, 17 May 2005, at 15:10

President: Mr S. MEKY (Eritrea)

QUATRIEME SEANCE PLENIERE

Mardi 17 mai 2005, 15h10

President: M. S. MEKY (Erythree)

ADDRESS BY THE DIRECTOR-GENERAL (continued) ALLOCUTION DU DIRECTEUR GENERAL (suite)

The PRESIDENT:

The Health Assembly is called to order. Please be seated. Good afternoon, ladies and gentlemen. This afternoon, the Health Assembly will resume its consideration of item 3 of the agenda. The first two speakers on my list are Malawi and Algeria. May I invite them to come to the rostrum. I give the floor to the delegate of Malawi, who will speak on behalf of the Southern African Development Community: Angola, Botswana, Democratic Republic of the Congo, Lesotho, Mauritius, Mozambique, Namibia, South Africa, Swaziland, United Republic of Tanzania, Zambia, Zimbabwe and his own country.

DrNTABA (Malawi):

Mr President, Director-General, honourable m1msters, distinguished delegates, ladies and gentlemen, it is indeed an honour and privilege for the Republic of Malawi to address the Fifty-eighth World Health Assembly and present this statement on behalf of all the Member States of the Southern African Development Community (SADC). At the very outset, SADC wishes to congratulate you, Madam President, and you, Mr Vice-President, together with all your colleagues, on your election to these very high offices and the Director-General for his report, and to commend WHO for having judiciously selected the theme "Make every mother and child count" for this year's Health Assembly. Indeed, the highlights in The world health report 2005 refer to the daunting health problems still faced by mothers and children, particularly when only a decade is left to achieve the United Nations Millennium Development Goals. This is a laudable initiative fully supported by SADC Member States. SADC notes with great concern that 10 million children and half a million mothers still die worldwide each year from preventable causes. We accordingly endorse the policy briefs and recommendations of The world health report 2005, which aim at preventing millions of premature deaths of mothers and children around the world. The SADC region has not been spared from this tragedy. The health indicators in the region continue to be clouded by high maternal and child mortality rates. In some Member States, the infant mortality rate is above 150 per 1000 live births and A58NR/4 page 81 the maternal mortality rate is above 1000 per 100 000 live deliveries. Life expectancy in the region averages about 57 years. Communicable diseases (including HIV/AIDS), noncommunicable diseases and trauma contribute to the high burden of maternal deaths. It is felt that poverty and the concomitant factors of inadequate health education - particularly of women - and lack of access to health services need to be addressed, in addition to medical interventions. We highlight the importance of strengthening health systems to drive health improvements, and we draw attention to the SADC Protocol on Health, which aims to drive our action towards achieving the Millennium Development Goals. The epidemics of HIV, malaria and tuberculosis continue to account for high rates of mortality among women and children in the region; tuberculosis has become one of the leading causes of death among AIDS patients. The estimated incidence of tuberculosis in the region is around 300 cases per 100 000 population. Malaria is currently one of the biggest killers, despite being a preventable and treatable illness. In the SADC region, there are about 13 million reported cases of malaria annually and this disease kills over 250 000 people every year, of whom the majority are mothers and children. However, one ofthe greatest challenges facing SADC's Member States is HIV/AIDS. In fact, SADC is the worst-affected region in the world. The combined population of SADC's Member States amounts to about 3.5% of the global population, yet it accounts for more than 37% of people living with HIV I AIDS in the world. The number of children orphaned as a result of the pandemic is indeed alarming. In addition, HIV represents another challenge for safe motherhood: it is estimated that more than two million HIV -positive mothers give birth to children worldwide every year. These mothers are more likely to have complications during pregnancy and delivery or abortion; a large number of maternal deaths are attributable to HIV/AIDS infection. Another subject of great concern is the magnitude of noncommunicable diseases in the region. The incidence of noncommunicable diseases is currently increasing rapidly, adding to the burden of communicable diseases. It is estimated that noncommunicable diseases and injuries cause 28% of morbidity and 35% of mortality in sub-Saharan Africa. The WHO Regional Office for Africa has projected that if nothing is done to deal with this particular scourge, 50% of morbidity and mortality in Africa, including SADC's Member States, will be caused by noncommunicable diseases in 2020. Here, too, women seem to be the most vulnerable. We are indeed pleased that WHO has placed noncommunicable diseases high on its agenda. SADC believes that the main health problems in the region are exacerbated by poverty, very low per capita income, fragile health systems and other socioeconomic factors. The three pertinent barriers identified in the region that prevent Member States from improving maternal and child health are: lack of human capital and the capacity to develop adequate pools of human resources; inadequate access to health care and the related lack of capacity of existing health-care systems to deliver adequate health services; and limited access to information on the health rights of mother and child and medical attitudes that view health issues as separate from their social and cultural context. These three interrelated barriers must be eliminated. The loss of highly trained health professionals to developed countries has worsened the situation regarding the availability of adequately trained and qualified health personnel. This is further exacerbated by the death of many health professionals throughout southern Africa from AIDS. As a result, there are fewer personnel in the region to provide care to patients, most of whom are women and children. With regard to access to modem health care, it should be noted that for most citizens it is tied up directly with their socioeconomic status. Access to comprehensive health-care services by the poor remains another major problem in the region. For this reason, about 80% of the people in the WHO African Region, mostly women, seek health-care services from indigenous practitioners or traditional healers. There is, therefore, an urgent need - particularly for the benefit of mothers and children - to promote and integrate the use of affordable, modem health technology with traditional health-care services. SADC Member States commend WHO's initiative of advocating the integration of the use of traditional medicine into primary health care services. It is unfortunate that appropriate health information is not reaching all stakeholders and often tends to remain the monopoly of health workers. Mothers and their children still encounter difficulties accessing basic health services, adequate food and shelter, and remain vulnerable to physical abuse. SADC considers that investing in the health of mothers and children and providing them with the required health information is not an option, but a necessity. There is a need to strengthen information systems and resource capacity, and ASSNR/4 page 82 to ensure that in matters of health, the principles of equity, accessibility and affordability predominate. SADC' s Member States have shown their firm commitment to improving the health of their peoples with the coming into force in August 2004 of the SADC Protocol on Health, whose main objectives include: development of strategies and harmonization of policies and standards for health-care provision in the region; capacity building for effective health-care delivery and efficient use of available resources; and finally, reduction of the burden of major communicable and noncommunicable diseases affecting the region. An implementation plan for the Protocol is currently being developed that addresses the priorities of SADC and the African Region, as well as international declarations and commitments, such as the Millennium Development Goals, the Declaration of Commitment on HIV/AIDS of the the United Nations General Assembly special session on HIV/AIDS, as well as the Abuja Declaration on Roll Back Malaria in Africa and that on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases. As a region, the Community remains optimistic. We hope that through the implementation of this plan, SADC will be able to make significant strides to improve life expectancy and enhance the quality of life of the people of the SADC region in general, and of those of mothers and children, in particular. To achieve the targets as set out in the implementation plan, SADC makes an earnest appeal to WHO, other United Nations agencies, donor communities and developed nations to support its Member States with adequate financial and technical assistance. The United Republic of Tanzania will propose a draft resolution entitled "Working towards universal coverage of maternal, newborn and child health interventions" and we appeal to the Health Assembly to support it. On this note, Mr Vice-President, I wish the Fifty-eighth World Health Assembly fruitful deliberations, particularly in respect of forthcoming resolutions aiming at reducing maternal and child mortality worldwide and at improving the quality of life of the world population, with an emphasis on making every mother and child count. Thank you.

M. JAZAiRY (Algerie):

Monsieur le President de seance, Excellences, Mesdames et Messieurs, S. E. Amar TOU, Ministre de la Sante, de la Population et de la Reforme hospitaliere, m' a charge de presenter a Mme la Presidente de notre Assemblee et aux membres du Bureau nos felicitations pour leur election. Monsieur le President de seance, nous tenons aussi a nous associer a la declaration que vous avez faite ce matin en tant que Ministre de la Sante de l'Erythree au nom de la Region africaine de l'OMS. L' Assemblee generale des Nations Unies, en l'an 2000, a consacre deux de ses huit objectifs du Millenaire pour le developpement a la sante maternelle et infantile. Cinq annees apres le Sommet du Millenaire, force est de constater que l'objectif de reduction de la mortalite maternelle et infantile reste hors de portee dans de nombreuses regions du monde. Depuis !'accession de 1' Algerie a l'independance, l'acces pour tous aux soins de sante est non seulement un droit garanti par l'Etat, mais egalement un imperatif moral et politique. Pays emergent a revenu intermediaire, 1' Algerie est aujourd'hui dans une phase de transition demographique avec une baisse de la mortalite et une baisse notable des naissances. Le taux algerien de mortalite infantile a considerablement baisse. 11 a ete ramene a 30 deces pour 1000 naissances vivantes en 2004 alors qu'il etait encore de 180 deces pour 1000 naissances vivantes en 1962. Cette baisse porte essentiellement sur la mortalite postneonatale due aux maladies nutritionnelles et infectieuses. Ces maladies ont pu etre enrayees grace a !'amelioration des conditions de vie, a une meilleure education sanitaire des parents et a une meilleure couverture sanitaire. Un probleme qui persiste est celui de la mortalite neonatale. La prematurite, a elle seule, est responsable de 10 % des deces neonatals. Comparee a la lutte contre la mortalite infantile qui cependant a remporte dans }'ensemble d'importants succes, la lutte contre la mortalite maternelle requiert des efforts supplementaires. Les ratios de mortalite maternelle dans le monde oscillent entre 5 pour 100 000 naissances dans les pays industrialises et 1500 pour 100 000 naissances dans les pays les plus demunis. L'Algerie, avec un taux de 99 deces pour 100 000 naissances vivantes, se situe parmi les pays de niveau intermediaire. En effet, et malgre les efforts consentis par le pays en matiere de sante publique, et plus particulierement de sante maternelle, la mortalite maternelle reste encore trop elevee. Au demeurant, nombre de deces neonatals sont la consequence directe d'une mauvaise prise en charge de la grossesse et de l'accouchement. D'ou le tout nouveau programme de perinatalite, A58NR/4 page 83 adopte par decret le 6 avril dernier, qui vient couronner les efforts menes par 1' Algerie pour ameliorer de fa~ton sensible la sante maternelle et infantile. Parler de la chance a donner a chaque mere et a chaque enfant, c'est aussi evoquer le fait que des enfants, des femmes et des hommes n'ont toujours pas acces a des services sanitaires de base. Les raisons en sont certes la pauvrete, mais aussi les catastrophes humanitaires non seulement naturelles, mais egalement celles induites par les conflits armes. On songe a l'Iraq et aux territoires arabes occupes ou la situation sanitaire est des plus preoccupantes et necessite une reponse concertee de la communaute des nations. Parler de la chance a donner a chaque mere et a chaque enfant, c' est aussi evoquer les problemes d'acces aux medicaments. 11 y a urgence a se conformer a cet autre objectif du Millenaire pour le developpement en rendant les medicaments essentiels disponibles et abordables dans les pays en developpement au profit des plus pauvres. Le necessaire respect de la propriete intellectuelle ne devrait pas en effet aboutir a un deni du droit a la sante et a la vie pour ceux-ci. Je vous remercie.

Ms HARNEY (Ireland):

Ambassadors, delegates, it is a great pleasure for me, as the Minister for Health and Children in Ireland, to address this Health Assembly for the first time. Since we began our deliberations this morning, 300 people in Africa have died from AIDS, 900 have died from malaria and 1500 from tuberculosis. That is over 2700 people. In my part of the world, they talk about health being your wealth - and it certainly is; and yet we know that if we are to combat the diseases that are rampant in so many parts of the world, the creative solidarity that the Director-General spoke about yesterday - and which is one of the eight Millennium Development Goals - will have to be put into effect. It is the people in this room, who number about one third of those who have died in Africa alone in the last six hours, who will help to solve the health problems that confront our globe. The world of business deals every day with globalization and its effects. Globalization acknowledges global interdependence and nowhere is that more obvious than in the area of health care; nevertheless, we have yet to deal with health care issues taking account of the reality of globalization. The Health Assembly and WHO have a crucial role to play in ensuring that we have focused responses to the most immediate needs that affect the public in this world. I learnt only this morning, for example, that with a very focused approach, around five main illnesses that affect children - including acute respiratory illness, diarrhoea, measles and malaria - could be halved in five years. If we applied the focus that we had in the aftermath of the tsunami, when this world proudly showed creative solidarity, and worked together to combat some of the biggest illnesses affecting many regions of this world, just think of the positive effect that would have over a few short years. We have to acknowledge the huge progress that has been made, as the Director-General said yesterday: the reactivated immunization programme in Nigeria is halving the incidence of poliomyelitis there; it is almost on the verge of eradication in India and Pakistan. So focused, targeted responses work and therefore, in the context of this Health Assembly, we have to examine how, together, we can approach these issues with the same sense of determination and focus that the Director-General spoke about. The revised International Health Regulations will certainly give us the capacity to deal with new and emerging threats, and obviously one of the biggest emerging threats is the avian influenza pandemic. We do not know when it is going to happen, but experts say it will happen. Clearly, we need to have responses that are immediate, effective, comprehensive and, above all else, we have to work together, recognizing that diseases cannot always be contained in this small world of ours. In Ireland, we are stockpiling the antiviral drugs because a vaccine is going to take a considerable length of time to develop, arriving six or nine months -maybe a year- after the strain has been identified. Another important issue on the agenda of WHO is the issue of patient safety, and I had the pleasure this morning of listening to a lecture by Sir Liam Donaldson, the British Chief Medical Officer, who is heading up the World Alliance for Patient Safety. Again, when we realize that, in the United States of America, you have a one-in-three-million chance of dying in an aircraft accident, but a one-in-three-hundred chance of dying as a result of a medical error in a hospital, we cannot take this issue for granted, and I am delighted that we are going to pool our expertise. In the developing world, A58NR/4 page 84 it is an issue of clean water and clean needles; in the developed world, it is an issue of putting in place appropriate risk assessment systems to make sure that patient safety comes higher on the agenda. In conclusion, can I say that all of us here face challenges. For all of us, there is the challenge of finding more resources to deal effectively with health; but for some there is also the challenge of dealing with rampant diseases that in the developed world have long since been eliminated, and I think it is only by working together, sharing experiences, sharing expertise and having that commitment to creative solidarity that we can help to make this - from a health perspective - a safer, more dynamic world.

Ms JOHANSSON (Sweden):

Mr President, distinguished delegates, Sweden supports the statement made by Luxembourg on behalf of the European Union. The terrible tsunami in the Indian Ocean on 26 December 2004 had a global impact. The loss of hundreds of thousands of human lives in a single day in several Asian countries is a great tragedy. Sweden is one of the countries most affected outside the region. Since then, the international community - including WHO, governments and other actors - has shown solidarity and sympathy and has assumed responsibility for the situation, not only by sending its condolences, but also by supporting the most affected areas financially and technically. Local populations, governments and nongovemmental organizations have made heroic efforts in the light of this disaster. WHO has started to work on a new General Programme of Work, covering the period 2006 to 2015. I would like to congratulate the Director-General for launching a broad consultation process. This will definitely contribute to WHO taking the lead in meeting future global health challenges. Sweden also supports the proposed budget increase for the years 2006 and 2007 and hopes that all Member States will endorse it. We particularly welcome the approach based on a more transparent, results-oriented budget. Voluntary contributions have become fundamental for WHO; Sweden is concerned both that they are increasing as a proportion of the total budget, and by the fact that they are earmarked. It hampers WHO's ability to act in line with the priorities set by the governing bodies. We would favour a steady increase in the regular budget and less earmarking of our voluntary contributions. Sweden therefore strongly supports the efforts of WHO to harmonize voluntary contributions. This year's theme covers maternal health and the health of children. According to the latest reports, only minor progress has been made in achieving the health-related United Nations Millennium Development Goals, including those on maternal and child health and HIV/AIDS. To change this, sexual and reproductive health and rights must receive greater attention. We underlined all this in the Health Assembly last year, when we adopted the strategy on reproductive health. This issue is among the top priorities on our development agenda and we will continue to encourage greater investment in this field. We will also work to ensure that sexual and reproductive health and rights are well reflected in the high-level plenary to review the outcome ofthe Millennium Summit to be held in New York, in September 2005. Sweden also supports the proposal to use the goal of universal access to sexual and reproductive health - from the International Conference on Population and Development, in Cairo - as a target for Millennium Development Goal 5 on improving maternal health. The recognition of sexual and reproductive health and rights is of course very closely linked to gender equality. As pointed out very clearly yesterday by the President of the Health Assembly- the Minister of Health and Consumer Affairs of Spain, Mrs Elena Salgado- women's empowerment must be at the core of the development agenda. Women must have the same opportunities as men in all aspects of life, including access to health services. This is not the case today, and addressing this inequality must be at the core of our efforts to improve the health of all human beings. Another major global health challenge in this context is the strengthening of health systems. There is a growing consensus that weak and fragmented health systems are stopping us from achieving the Millennium Development Goals. Robust health systems play an essential role in combating diseases and eliminating poverty. In addition, such systems must cover everyone and health care must be provided based on need, not on ability to pay. Access to health services is, or at least should be, a human right! The promotion of healthy living conditions and lifestyles is yet another very important A58NR/4 page 85 global health challenge; we therefore applaud the launch of the WHO Commission on Social Determinants of Health. This initiative is well in line with Swedish public health policy, namely, building on the importance of social determinants when striving for health equity in the general population. Differences in health must be narrowed, not only between countries and regions but also between groups of people. Of course, we have great expectations of the upcoming Sixth Global Conference on Health Promotion in Thailand, in August 2005. One factor that has an immediate effect on health is alcohol. Harmful alcohol consumption is a major cause of illness and mortality in many countries; that is why the Nordic countries have introduced a resolution on alcohol for adoption at this Health Assembly. Another matter of critical importance for the global health situation is antimicrobial resistance. Such resistance poses a serious threat to our ability to practise modern medicine. Therefore, the Nordic countries have also put forward a resolution on this issue. I strongly urge this Health Assembly to adopt these two resolutions dealing with matters that are so significant for the health and well-being of our citizens. In conclusion, let me once again repeat Sweden's support for the crucial work of WHO and our strong belief in the Organization's key role as global health authority. Let me join with other speakers in hoping that this Health Assembly will adopt the revision of the International Health Regulations. Thank you.

Professor KY A W MYINT (Myanmar):

Mr President, excellencies, distinguished delegates, ladies and gentlemen, may I congratulate you, Mr Vice-President, on your election to the post of Vice-President of the Fifty-eighth World Health Assembly, and the other Vice-Presidents and Chairmen of the main Committees, and other officials who have been elected to lead the Health Assembly. Women and children are a country's most vulnerable assets and in Myanmar they constitute 67% of the total population. It is deemed appropriate that the Millennium Development Goals call for a two-thirds reduction in child mortality and a 75% reduction in maternal mortality by 2015. World Health Day 2005 reaffirmed our commitment to "Make every mother and child count". Myanmar has identified protein energy malnutrition and micronutrient deficiencies as its major nutritional problems. Growth monitoring and promotion for children under three, iron supplementation for pregnant women, children under five and adolescent schoolgirls, together with universal salt iodization for sustained elimination of iodine deficiency disorders and biannual supplementation of high-potency vitamin A capsules, form the major nutritional interventions. In 1998, the Integrated Management of Childhood Illnesses strategy was adopted and introduced as the Integrated Management of Maternal and Childhood Illnesses strategy. From 2000 onwards, in line with the innovative life-cycle approach, a women and childhood development project was also launched by the Department of Health. These strategies have helped to reduce under-five mortality. This achievement was largely attributed to improved access to primary health care services and better coverage of the Expanded Programme on Immunization: 5.4 million children from nine months to under five years were immunized against measles in three phases from 2002 to 2004, achieving over 80% coverage during all phases. Immunization against vaccine-preventable diseases has led to a decrease in the under-five mortality rate and the programme has now reached all325 townships in Myanmar. Among the leading causes of under-five mortality are diarrhoea and acute respiratory infections. Access to a safe water supply and environmental sanitation are priority areas of concern. According to the latest Multiple Indicator Cluster Survey, carried out in 2003, 79% of the population have access to safe drinking-water and 76% are living with sanitary means of excreta disposal. The maternal mortality ratio significantly declined in the last decade. Regarding the proportion of births attended by skilled health personnel, it was reported by the health-management information system as standing at 40.1% in 2001 and 60% in 2004. Currently, a midwife has to cover four to eight villages, involving a population of 5000 to 10 000. Thus, a category of voluntary health worker- the auxiliary midwife­ has been trained with the objective of improving maternal and newborn health in the rural community. At present, the ratio of midwifery-skilled providers to a village is 1 :2 and we are striving to achieve the national target of at least one midwifery-skilled person to every village. Institutional delivery has A58NR/4 page 86 also been encouraged through upgrading and promoting rural health centres and subcentres with the development of labour rooms. The five-year reproductive health strategic plan for 2004-2008 was developed and implemented at national level. Screening for antenatal syphilis and detection of anaemia for every pregnant mother, as well as the active management of the third stage of labour and the use of magnesium sulphate in the management of severe eclampsia has been introduced at appropriate operational levels. Community­ oriented reproductive health care, with the participation and involvement of volunteers, national nongovernmental organizations (such as the Myanmar Maternal and Child Welfare Association), international nongovernmental organizations, and partners of the United Nations system, has been emphasized for effective reduction of maternal deaths. I would like to reaffirm our commitment to meeting the Millennium Development Goals; we are also trying to include WHO's "3 by 5" initiative. In conclusion, I would like to express my sincere appreciation to WHO and all our partners in health development for their valuable support to our country. I would like to assure you that, as far as Myanmar is concerned, no effort will be spared to contribute towards achieving WHO's objective of making every mother and child count. Thank you, Mr President.

PEHIN DATO ABU BAKAR APONG (Brunei Darussalam):

Mr President, excellencies, ladies and gentlemen, first of all, I would like to take this opportunity to join my colleagues here in congratulating Madam President on her election as the President of the Fifty-eighth World Health Assembly and also the Vice-Presidents and other office­ bearers. I am confident that this august Health Assembly will make good progress under your stewardship. We are living in a world that has undergone many changes. We have witnessed how globalization, through information technology, has revolutionized our way of life; at the same time, we are witnessing the same phenomenon in health: advances in health technology and medicines bring more benefits but also mean higher costs for many- especially developing countries. We also notice that new challenges arise: new emerging diseases, like severe acute respiratory syndrome (SARS) and avian influenza, have regional and global implications. The developing countries are still struggling with the problems of communicable diseases; they also face those posed by increasingly prevalent chronic noncommunicable diseases, which contribute to the "double burden of disease" syndrome. This year's theme for World Health Day, "Make every mother and child count", is very appropriate and timely as mothers and children are the most vulnerable groups these days. Therefore, the promotion of their health and well-being is of the utmost importance to their security. Within this context, Brunei Darussalam supports our Director-General's call for a new momentum to address and improve maternal, neonatal and child health. We also endorse his suggestions, made in The world health report 2005, for reducing mortality among mothers and children through wider use of key interventions and an approach involving a continuum of care. Brunei Darussalam has adopted a policy in the past few decades that provides comprehensive health-care services to mothers and children from primary to tertiary level. The initiatives we have successfully implemented include child health screening, developmental surveillance and immunization, birth spacing, antenatal and postnatal care, and well-woman screening. We also realize that coverage alone would not be sufficient without a well-trained workforce. The Government of His Majesty the Sultan and Yang Di-Pertuan of Brunei Darussalam - through the ministries of health and education - has, over the years, recruited and trained a health workforce to meet increasing demands; its skills are continuously upgraded through training, both domestically and overseas. The Government of His Majesty the Sultan and Yang Di-Pertuan of Brunei Darussalam also realizes the importance of non-health aspects of maternal and child well-being. Therefore, other basic necessities, such as clean water, good sanitation and education are made accessible and readily available nationwide. All this has helped us to meet most of WHO's indicators for health. According to our health statistics for the year 2003, only two maternal deaths were reported, while the infant mortality rate stands at 9.5 per 1000 live births. This figure is in stark contrast to the one reported back in the 1960s and 1970s, when the average infant mortality rate was high, standing at 38 per 1000 live A58NR/4 page 87 births. In general, Brunei Darussalam is happy to be able to meet the aspirations of the Millennium Development Goals. However, with the new challenges confronting us, there is no room for complacency. We remain committed to improving the well-being of our people, especially women and children; we realize that the Government alone would not be able to sustain this and we have enlisted the cooperation, participation and contribution of business, as well as the public sector. The private­ public partnership is alive and well in our country. As I said earlier, newly emerging and re-emerging communicable diseases have provided us with new challenges. We commend WHO on its leadership in handling and monitoring the development of SARS. The bitter experience of SARS in our region has taught us one valuable lesson, that is, not to drop our guard too soon. With this in mind, we still need to increase our vigilance and efforts to monitor potential dangers continuously at our borders and airport. In this respect, we are thankful for the close collaboration among health officials in ASEAN, Asia-Pacific Economic Cooperation and WHO. An early warning provided through information exchanges would give us lead time to respond appropriately should an outbreak happen. The unfortunate tsunami incident that befell our region in December 2004 has also taught us a lesson on the importance of preparedness, as well as information sharing, which could have saved thousands of lives. Finally, in joining others in celebrating World Health Day 2005, we hope for a brighter and healthier future for all of us, especially mothers and children. We believe this can be achieved if we think and act together. Thank you.

Professor CORREIA DE CAMPOS (Portugal):

Mr President, first, I would like to congratulate the Director-General on his excellent report, describing the immense work done by WHO in cooperation with its Member States. We have been special partners since the origins of the Organization and we are particularly committed to promoting health in Europe and the rest of the world, being active participants both bilaterally and within the framework of the European Union. As a Member of the European Union, Portugal fully agrees with the views of the Luxembourg presidency, as expressed today in this Fifty-eighth World Health Assembly by my colleague, the Minister of Health. Portugal has benefited from the valuable help of WHO -and, in particular, of the WHO Regional Office for Europe- in formulating its new health strategy, the National Health Plan; the Regional Director and his staff were personally involved in the process. We strongly approve of the theme chosen for World Health Day 2005, which is the central issue of the debate in this Health Assembly. This is also our success story: in fact, it has been possible to improve mother and child health considerably in Portugal in recent years. Indeed, this improvement is clearly reflected in our maternal, perinatal and infant mortality rates; the latter rate decreased in the last 40 years from 77 to 5 per 1000 live births. Consequently, the gains in health correspond to an increase in life expectancy of 12.5 years during this period. Nevertheless, there are still problems in adult health and other emergent issues resulting from new demographic and social dynamics. We are facing many challenges concerning a number of key areas and indicators: poverty, unemployment, school dropout rates and low literacy levels. All of these have been exacerbated by Portugal's rapid transition from being a traditional country of emigrants to being a country of immigrants, which has generated situations of social exclusion and inequality in health that need to be combated. The promotion of health in general, and public health in particular, is now at the top of our political agenda. I would like to refer briefly to three aims of the Government's programme: growing old healthily; fighting substance addiction and HIV I AIDS; and reforming the health system to make it fair, efficient and flexible. HIV I AIDS still constitutes a serious health problem in Portugal, with almost 1000 deaths annually and high incidence rates. This requires urgent action to prevent and fight the disease, with a particular focus on information and awareness campaigns designed to change behaviour. Campaigns against excessive smoking and alcohol consumption, especially by young people and in public places, are being organized. It is our priority to articulate the fight against drug abuse, with the reduction of alcohol consumption and smoking and the prevention of HIV I AIDS. The reform of the health system in Portugal will foster accessibility, quality and equality, while seeking to A58NR/4 page 88 ensure medium- and long-term sustainability. Primary health care will, of course, be the focus of this reform. Portugal has sought to play an active role in the technical and political approach to acute problems of great importance. Let me emphasize our participation in the revision of the International Health Regulations, within the European Union, and in the meetings of the Intergovernmental Working Group on the Revision of the International Health Regulations organized by WHO, which I hope will be successful at this Health Assembly. Portugal has also participated in the process leading up to the adoption by the Fifty-sixth World Health Assembly of the Framework Convention on Tobacco Control. I would like to emphasize the Portuguese Government's commitment to the immediate ratification of the Framework Convention, which Portugal signed in January 2004. We are also maintaining a state of preparedness to be able to respond quickly to other countries, as demonstrated during the recent health problems in Angola and Sao Tome and Principe, when Portugal provided prompt cooperation. We would also like to increase our multilateral cooperation with WHO's African Region and Region of the Americas. It has been our policy to meet the requests from WHO and Portuguese-speaking countries to have essential world health strategy documents translated into Portuguese. WHO belongs to us all. Although its effectiveness depends on the way in which its resources are managed, it is also affected by the political will of its Member States, who should give the required support. This is our wish. Thank you.

Sir LIAM DONALDSON (United Kingdom of Great Britain and Northern Ireland):

Thank you, Mr President. The United Kingdom supports the statement made earlier by the Minister of Health from Luxembourg about European Union actions and European Union support for the key role of WHO. During our European Union presidency, from July 2005, the United Kingdom will take forward the work of previous presidencies and will focus on two big themes: health inequalities and patient safety. We will also support the European Union's work on responding strongly to the spread of HIV/AIDS. We face a challenging agenda, in Europe and globally, and we will continue the emphasis in our presidency on the need for close collaboration between the European Union and WHO to tackle it. For example, in November 2005, we will host an international summit on patient safety. Besides advancing work to help improve the safety of patients in the countries of the European Union, this will also facilitate the development of a European regional strategy for patient safety. It will be led by the WHO Regional Office for Europe and will be part of a wider initiative now being undertaken by the WHO World Alliance for Patient Safety, including the development of strategies under the excellent leadership of WHO's other regional directors. We will also host a major conference on health inequality, exploring the contribution that all parts of government (not just health ministries) can make to health. We have high hopes of the Commission on Social Determinants of Health that WHO has established and we think that it will make a significant contribution to this agenda. The United Kingdom has therefore given over US$ 1 million to help the Commission in its important work. This year, the United Kingdom also has the presidency of the G8 Summit and we are focusing our attention on the special needs of Africa and on the impact on our lives of climate change. Progress here will contribute to the achievement of the Millennium Development Goals and to securing international unity and improving people's lives. We aim to develop a comprehensive plan of specific actions to address the complex and interlinked problems experienced in Africa. This must complement existing United Nations processes and we are seeking G8 agreement in advance of the high-level pienary to review the outcome of the Millennium Summit, this coming September. We want to increase resources for Africa through more and better-targeted aid, debt relief and improved effectiveness in line with commitments made at the High-Level Forum on Aid Effectiveness in Paris. Our aim is to support better governance, help build peace and create security, thereby improving opportunities for good health and education and tackling the AIDS crisis. The United Kingdom is currently revising the major report we published three years ago on the health effects of climate change. In general, we want to focus on the likely health and economic cost of not facing up to the problems of climate change. We need a shared willingness to introduce more energy-efficient technology in the short term, matched by a longer-term commitment to undertake A58NR/4 page 89 research and develop new technologies. We must reduce greenhouse gas emissions and create new sustainable energy infrastructures. Maternal and child deaths are - tragically - not rare events. We know that nearly 11 million children under five die each year - four million of them in the first month of life. About 600 000 women die each year from maternity-related causes. Poor women and children bear the greatest burden: women in the poorest countries are 100 times more likely to die from maternal causes than women in rich countries; and children in the poorest countries are 20 times more likely to die before they reach five than children in rich countries. HIV I AIDS is spreading rapidly in many regions. Despite these alarming figures, success is possible; cost-effective interventions are available and have been shown to work in poor-country settings. Strengthened health systems are vital for the better delivery of effective interventions; we need a coherent architecture for aid in support of health systems. The Secretary-General of the United Nations, in his 2005 report "In larger freedom: towards development, security and human rights for all" urges concerted action against the range of threats to international peace and security, emphasizing that these threats, which include deadly infectious disease, are interlinked. We support this approach. The United Kingdom also supports the agenda of Mexico's Ministerial Summit on Health Research as a route to improving services and systems. Dr Lee rightly said that neither knowledge without action, nor action without knowledge, will deliver health improvements. Research is crucial to making the bridge between knowledge and action. So policy development, both national and international, must be based on evidence, and policy impact must be evaluated, leading to a virtuous circle of improvement. In support of these imperatives, we must promote both the registration of all clinical trials and access to data; and we must find a way to encourage more of the brightest and most talented young graduates around the world to make their careers in health systems and public health research, and to make such research careers an attractive alternative to those in the biological and molecular sciences. We should perhaps also encourage the idea of a Nobel Prize in the field. The Nobel categories were last renewed in 1968, ironically the last year of a pandemic-influenza outbreak. Perhaps we should, therefore, look to those individuals who are exceptionally talented and who- through their discovery, innovation and leadership- transform the lives of millions of people around the world, and consider a heath category for the Nobel Prize structure. One of the greatest threats is, of course, the risk of pandemic influenza. We have heard a lot about that in the past year and the current avian influenza situation in south-east Asia is of increasing concern internationally. We need to be as prepared as we can to mount a rapid and flexible response. The United Kingdom supports WHO in its role of preparing for pandemic influenza. There are three immediate issues for successful global collaboration: communication in key areas, such as research and development and surveillance and response, must be of the highest quality; we must share ideas on planning and learning from best practice; and we need to make rapid progress, in particular to increase global vaccine-manufacturing capacity. For all these reasons, we need an effective WHO. We in the United Kingdom certainly support that and we would like to commend the Director-General's leadership in forging ahead with this challenging agenda.

El Dr. ESTEVEZ TORRES (Cuba):

Excelentisimas Autoridades que presiden esta seston plenaria, distinguidos delegados, observadores y demas participantes en esta 58a Asamblea Mundial de la Salud. Coma es de todos conocido, el Director General nos ha solicitado que las intervenciones en esta plenaria se refieran a «Cada madre y cada nifio contaran», por considerar que este asunto requiere de analisis y las consecuentes acciones si queremos mejorar la calidad de vida de madres y nifios y si, tal coma nos comprometimos, pensamos cumplir los Objetivos de Desarrollo del Milenio. A continuaci6n me permitire expresar algunas ideas y datos que repercuten sabre la salud maternoinfantil, la mayoria de los cuales se tomaron del «lnforme mundial sabre el conocimiento orientado a mejorar la salud», publicado por la OMS en 2004, y el informe sabre el «Estado Mundial de la Infancia 2004» que publica el UNICEF. A58NR/4 page 90

Tal como expresa el informe de la OMS, el estado actual de la salud global se caracteriza por notables logros, pero con desigualdades persistentes, lo que es tambien aplicable a la salud de la madre y del nifio, y estimo puede ser atribuible a la aplicaci6n de recetas neoliberales en muchos paises a escala mundial. Dentro de las desigualdades persistentes se pueden sefialar las siguientes: mientras una quinta parte de la poblaci6n mundial disfruta de una esperanza de vida de unos ochenta afios, dos tercios de la poblaci6n mundial que vive en Ios paises menos acomodados de Africa, Asia y America latina sufren el peso mundial de la enfermedad y muerte prematura, lo que ha conducido a que la esperanza de vida haya bajado a menos de 40 afios en algunos paises africanos. En cuanto a la salud matemoinfantil, el Informe sobre el estado mundial de la infancia, del UNICEF, sefiala que la tasa de mortalidad en menores de 5 afios fue de 82 en el 2002; sin embargo el informe de la OMS antes citado plantea que 6 millones de muertes infantiles del mundo en vias de desarrollo pueden evitarse aplicando sencillas intervenciones efectivas. En relacion a la mortalidad derivada de la matemidad, el informe del UNICEF antes citado sefiala que en el 2000 la tasa fue de 400 por 100 000, y el informe de la OMS sefiala como cifra interesante que en Kenya la tasa fue de 1000 por 100 000 y solo el 41% de Ios partos fueron atendidos por personal formado, mientras que en el Japon la tasa fue de 8 por 100 000 y el 100% de Ios partos fueron atendidos por el personal formado adecuadamente. En lo que se refiere a mi pais, puedo sefialar que no tenemos esas desigualdades, pues nuestro Sistema Nacional de Salud es universal, gratuito y accesible a todos, sin discriminacion de ning{m tipo, y ademas la sociedad cubana presta especial atencion a la proteccion de la salud matemoinfantil, poniendo enfasis en que las vidas de madres y nifios se desarrolle en un medio seguro y sano. El Sistema de Salud en Cuba ha implantado estrategias para perfeccionar Ios programas desde una perspectiva integral, multidisciplinaria e intersectorial con el objetivo de promover el cuidado de la mujer, Ios jovenes, el nifio y la nifia en las diferentes instancias, identificando factores de riesgo, y acciones de promoci6n y prevencion de la salud que adquieren su maxima expresi6n en el Sistema del medico y enfermera de la familia. Como resultado del accionar en la salud de la madre y Ios nifios y nifias se pueden sefialar Ios siguientes indicadores alcanzados en 2004: la tasa de mortalidad en nifios menores de 5 afios fue de 7,7 por 1000 nacidos vivos; la tasa de mortalidad infantil fue de 5,8 por 1000 nacidos vivos; el porcentaje de nifios de menos de 1 afio vacunados contra el sarampion fue de 100%; se aplican en el programa de inmunizaci6n del pais 10 vacunas que protegen contra 13 enfermedades, y la cobertura en todos Ios casos sobrepasa el 95%; 7 de esas vacunas se producen en el pais. En el afio 2002 se inicia el desarrollo de Ios Programas de la Revolucion en Salud, conceptualizado como las profundas y esenciales transformaciones que debe desarrollar en el sistema de salud para continuar elevando la calidad de la atencion a la poblacion, lograr la participaci6n comprometida de todos nuestros trabajadores en la transformacion de nuestro sistema de salud, asi como de cualquier mision que se nos asigne en cualquier lugar del mundo, y alcanzar la excelencia en Ios servicios. Como expresion de la profunda transformacion de la atencion primaria que esta ocurriendo en el pais se puede sefialar: el fortalecimiento de la capacidad resolutiva de Ios policlinicos, como eje fundamental de este nivel de atencion; la creacion de servicios en Ios policlinicos que eran exclusivos de Ios hospitales, y el desarrollo de un importante programa de preparacion y perfeccionamiento del capital humano tan necesario para el desarrollo de la salud. Mas de 25 afios despues de Alma-Ata, Cuba muestra modestamente al mundo sus resultados y se propone continuar disminuyendo la mortalidad infantil y materna, mejorando la calidad de vida e incrementando la expectativa de vida de su poblacion. Ante esta Asamblea ratificamos nuestro compromiso no solo de mejorar la salud de la madre y el nifio y la nifia en nuestro pais sino de mejorar la de todos nuestros ciudadanos y continuar contribuyendo a la de Ios pueblos que necesitan en el resto del mundo, pues tenemos la convicci6n de que un mundo mejor es posible. Muchas gracias. A58NR/4 page 91

Mr GUNNARSSON (Iceland):

Mr President, ladies and gentlemen, in this plenary address, Iceland will focus on the theme of World Health Day 2005, "Make every mother and child count". Like all other nations in the world, Iceland wants to improve the health and well-being of mothers and children worldwide. Let me again remind you that, only two to three generations ago, Iceland was indeed a very poor country; the health situation of the population was very bad and child mortality was very high. It is therefore very much on our mind that our former situation is still to be found in many parts of the world. It is tragic that half a million mothers die in childbirth every year, and that 11 million children die in the first five years of their life. By sharing knowledge and experience, Iceland is willing to contribute to making this situation better. Today, Iceland enjoys prosperity and this has enabled us to tackle many of the factors that determine health. Poverty is relatively low, for example; we have plenty of good water; our family bonds are strong; and, owing to good health services, we have in the last decades been among the nations with the lowest maternal and perinatal death rates. This does not mean that we do not have problems: our modem society has its share of the consequences of our present lifestyles, such as obesity, cardiovascular disease and, not least, problems of psychosocial origin. Women in Iceland are well educated and in our universities there are more female than male students. They are ambitious and the work participation rate of women in Iceland is as high as 90%. The fertility rate is rather high compared with other western societies. This means that women in Iceland are under pressure to be both productive citizens and good mothers; sometimes this can result in stress-related syndromes that affect the health and well-being of both mothers and children. Examples of such symptoms are anxiety, depression and abuse of alcohol and drugs by women; among children, obesity and behavioural and mental disorders are a growing health problem. Our current main focus on making every mother and child count is, therefore, on the psychosocial problems that threaten their health and well-being. This cannot be accomplished unless responsibility is shared among the different sectors of society. In this context, Iceland emphasizes the role of the health services to remain in the forefront and advocate for the better health and well-being of mothers and children. Yesterday, we listened with great interest to Bill Gates when he put forward his idea that economic prosperity and a high level of education are the result of good health, but not the other way around. Iceland is perhaps an example of this. We have always believed that good health and prosperity are like sisters that go hand in hand. It must be admitted, however, that Bill Gates' idea is more appropriate to the budget debate. I therefore expect that we will use it on the next such occasion. Thank you.

Mrs KALUKI NGILU (Kenya):

Mr President, your excellencies, Kenya is pleased to take the floor. Madam President, on behalf of the Kenyan delegation, I would like to congratulate you on your election as President of the Fifty­ eighth World Health Assembly. May I also take this opportunity to thank the Director-General for the support which WHO has given to my country and for his comprehensive report to this Health Assembly. Kenya has made progress in many aspects of health over the last year, while also consolidating the gains from previous years. Nevertheless, we have experienced new challenges that call for new solutions. In line with this year's theme of"Make every mother and child count", the Kenyan Government recognizes that the survival and well-being of mothers and children are not only important in their own right, but are also central to solving much broader economic, social and developmental challenges. In Kenya, the maternal mortality rate is estimated at 414 per 100 000 live births; this means that approximately 3000 to 6000 women die yearly from pregnancy-related complications. Childbearing­ related events contribute to 27% of the deaths among women aged 15-49 years. Additionally, for every maternal death, there are 30 women who suffer chronic illnesses and disabilities, such as obstetric fistula. The reasons for these deaths include delivery by unskilled persons, delay in seeking A58NR/4 page 92 care, delay in accessing care, and delay in receiving care. Poverty and sociocultural, economic and gender issues further contribute to the above factors. In response to this situation, Kenya is committed to the attainment of the Millennium Development Goals and has put in place measures targeting the improvement of maternal and neonatal health, including the following: a strategic plan for the health sector with an emphasis on maternal and child health; safe motherhood and newborn health programme guidelines; a national reproductive health strategy; capacity building for service providers; recruitment of health personnel; strengthening of health facilities countrywide; and the factoring of interventions for the prevention of mother-to­ child transmission of HIV I AIDS into maternal and newborn health programmes. In addition, maternal death reviews have been instituted in health facilities, maternal death has been made a notifiable condition and there is community mobilization to motivate women to seek safe motherhood services. On the issue of child survival in my country, the under-five mortality rate increased from 110 to 115 deaths per 1000 live births between 1998 and 2003. The major causes of morbidity and mortality in children under five in Kenya include malaria, acute respiratory tract infection, pneumonia, diarrhoea and malnutrition; all are exacerbated by HIV I AIDS. In response, the Ministry of Health has adopted a strategy for the integrated management of childhood illnesses; our immunization services have also been strengthened. Concerning HIVIAIDS, I wish to express our gratitude for the support my country has received from development partners and global initiatives. HIVIAIDS remains the most serious health and development problem in Kenya. The Government of Kenya continues to make HIV I AIDS control a top priority and has increased its financial commitment towards HIV I AIDS activities. As a result, HIV prevalence rates dropped from 10% in the year 2000 to 7% in the year 2003. As a result of advocacy strategies, demand for voluntary counselling and testing has increased; there is also a trend towards behaviour change, with a decline in sexually transmitted infections and increased condom use. We currently have 38 000 patients on antiretroviral therapy and expect to put 95 000 patients on antiretrovirals by the end of this year. Kenya will then have met its contribution to the global target of the "3 by 5" initiative. Continuing challenges include the shortage of skilled health workers, the unsustainable supply of essential commodities and overstretched health systems. In my country, we have complied with the "Three Ones" principle in our fight against HIVIAIDS. We have one national plan, a robust and inclusive coordinating mechanism and a single, comprehensive, monitoring and evaluation framework. We expect our partners to support this without imposing difficult parallel systems that have so far inhibited flow of resources to the people in need. Malaria continues to claim between 26 000 and 30 000 lives every year in my country, mostly among children and pregnant women. Our prevention and treatment strategies are challenged by difficulties in controlling mosquitoes and the resistance of the malarial parasite to drugs. We have responded to these by emphasizing indoor residual spraying, use of long-lasting insecticide-treated nets, integrated vector management and change of first-line treatment to artemisinin-based combination therapy. These strategies are unsustainable in the long run, hence our appeal to the international community for sustained support. In pursuance of universal access to quality health care, Kenya is establishing a national social health insurance scheme to improve access to care and mitigate the poverty imposed on households by the high cost of health care. To improve health financing, our Government has increased the allocation for health from 5% of the total Government budget in the year 2000 to 10% in this financial year. May I now recognize the important step WHO has taken in establishing the Commission on Social Determinants of Health. Recognition that social factors are powerful determinants of health is a big move towards the delivery of universal health care with a view to achieving the Millennium Development Goals. The true guardians and victims of social determinants are women and children. The empowerment of women is a strategy for improving the health of communities that the world must pursue with renewed vigour and commitment. Finally, the sizeable gap between research work and the application of research findings in the interest of health improvement is a matter of great concern. Highly trained scientists spend long hours and large sums of money on research and their findings are not promptly utilized, if at all. We must apply research findings in order to improve the health of our people and to strengthen health systems in particular. Maternal and newborn outcomes are the most sensitive indicator of a functioning health A58NR/4 page 93 care system. So let us work together to improve health systems and make every mother and child count. Together we can make a difference and all of us have a role to play.

Mr MERITON (Seychelles):

Mr President, distinguished colleagues, ladies and gentlemen, in the past few months, we have heard much about the threat of a new influenza pandemic. It is not so long ago that we experienced the outbreak of severe acute respiratory syndrome, with its negative impact on human health and economic activities. A worldwide pandemic is not a new phenomenon: in 1919, the epidemic of influenza reached Seychelles and our population suffered the most serious public health disaster since the smallpox outbreak some three decades before. In 1919, my country was an isolated, virtually unknown and forgotten colony, lost in the middle of a vast ocean of no political or economic importance. Yet the virus reached us. Today, my country, though tiny in size and population, is a well­ known destination for visitors and we find ourselves in an ocean of great political interest and economic potential. Our vulnerability to disease agents, whether viruses or tobacco, has increased dramatically. This illustrates the global challenges that face WHO and all its Member States. Today, more than ever, we need a stronger and more responsive WHO and international solidarity. Today, I renew my pledge to this solidarity for global health, which we have demonstrated by being the first African country to ratify the WHO Framework Convention on Tobacco Control. The health challenges that we face in my country are no different from those that many other ministers have already talked about, and which are constantly on the world health agenda. Seychelles faces the challenges of noncommunicable diseases arising from changes in lifestyle and the influence of modem trends in consumption of food, alcohol and tobacco, in addition to communicable diseases such as HIV I AIDS and the threat of new infections coming from outside our borders. With the ease and frequency of travel between my country and Europe, Africa and Asia, we are constantly aware of our common vulnerability to existing and emerging diseases that could flare up into the next worldwide pandemic. We face diverse challenges, such as ensuring that every citizen has access to a high standard of health care and managing a heavy burden of both noncommunicable and communicable diseases; we need to maintain vigilance against new health risks. All these require resources that a small country with a population of 80 000 and limited natural resources has to work very hard to mobilize. In spite of our many difficulties, we continue to make progress in improving people's lives, reducing mortality and increasing life expectancy. While we struggle to regain and maintain a sustainable economy, despite the disadvantages that burden a small isolated population, we are nevertheless reassured that our people enjoy good health and therefore a brighter future. We believe that investment in people and in their health - with the greatest emphasis on our children, whom we see as national treasures and the architects of our future- is the number one priority of my country. As we discuss this year's theme, dedicated to mothers and children, we rejoice in the fact that Seychelles has come a long way in improving maternal and child health: we have the lowest maternal and infant mortality rates in our region, as well as universal health and immunization coverage and quality antenatal and perinatal care. We also acknowledge, however, that there is much more for us to do to pursue "health for all" and "health by all". We do not underestimate the difficulties that are inherent in maintaining a consistently high level of health care services and we know that there are many other challenges ahead. Our challenges and difficulties are not unique. Many small island States face similar situations. We can learn much from each other and I urge WHO to launch a global small island States health initiative. Island States share many common health and developmental issues, which are often related to our isolation, limited human resource base, small and vulnerable economies and environment. Most of us are also experiencing rapid economic and social changes. While these bring many benefits, we also face many cultural and lifestyle influences that impact negatively on health. Through such an initiative, we can learn from and assist each other. Finally, I salute Dr Lee, our Director-General, and Dr Luis Gomez Sambo, our new Regional Director for Africa, for their hard work. I assure them of the continuing support and commitment of the Government of Seychelles to the ideals of our Organization. A58NR/4 page 94

El Dr. GONZALEZ GARCIA (Argentina):

Senor Presidente, senores delegados, senores Ministros, amigas y amigos: Tengo el honor por cuarto ano de participar en esta honorable Asamblea como Ministro de Salud y Ambiente de la Republica Argentina. Muchos cambios han ocurrido en Ios ultimos anos en mi pais. Tengo la conviccion de que si perseveramos en la senda trazada por el Presidente Kirchner, en un futuro cercano estaremos observando que estos cambios fueron el comienzo de tiempos mas saludables, y ambientes mas confortables. Lo estamos hacienda capitalizando nuestros logros, pero tambien aprendiendo de nuestros errores. En muy pocos anos hemos conseguido revertir las consecuencias de la crisis mas grave de nuestra historia. Estamos hacienda lo que debe hacer el Estado en salud. Hemos dejado de hablar de reformas y empezamos a disenar y ejecutar verdaderas politicas de Estado. En el ano 2004 lanzamos el Plan Federal de Salud, bajo cuyos lineamientos se consolidaron diferentes estrategias de promocion de la atencion primaria y de fortalecimiento del primer nivel de atencion. En ese sentido se destaca el Programa Remediar, que prescribe y entrega gratuitamente medicamentos en mas de 5000 centros de salud ubicados en todo el territorio del pais, dando acceso gratuito a 15 millones de argentinos. La politica nacional de medicamentos se completa con la prescripcion de medicamentos por su nombre generico, que ya ha superado el 70% de las recetas emitidas. Esto contribuyo a que Ios laboratorios bajen Ios precios de venta en las farmacias. Argentina es hoy uno de Ios paises con mayor porcentaje de prescripcion por nombre generico en el mundo. Tambien comenzamos a ejecutar el Programa Nacional de Medicos Comunitarios, que refuerza la presencia y reorienta las practicas de profesionales en el primer nivel de atencion. A traves de este programa se esta realizando un posgrado en servicio en salud social y comunitaria, con la participacion de 17 universidades en todo el pais. Otro hito reciente es el inicio del Plan Nacer, un viejo sueno de muchos sanitaristas en la Argentina. Este Plan protege a todas las mujeres embarazadas y a todos Ios ninos. Con este Plan queremos terminar, y espero que para siempre, con el abandono de miles de mujeres, que no tienen cuidado ni contencion durante el embarazo y el parto. A partir de este Plan, podemos decir que en la Argentina «Cada madre y cada nino contaran». Estamos profundizando el Programa Nacional de Salud Sexual y Procreacion Responsable, asegurando informacion, capacitacion, anticonceptivos y condones en forma totalmente gratuita destinados a toda persona en edad fertil que lo desee. Estas acciones implican una politica de Estado orientada a mejorar la salud de los argentinos. Gracias a ellas, ya comenzamos a verificar logros: no solo comenzaron a disminuir los casos de embarazo de las adolescentes, sino que ademas la mortalidad infantil se redujo en un 12% en dos anos. En el ultimo ano logramos que murieran mil ninos menos que el ano anterior. Este es el mayor descenso de los ultimos 20 anos. No obstante, aun se siguen verificando grandes diferencias a nivel regional. En 2004 tuve el honor de contarles del exito que logramos en la negociacion regional de precios para medicamentos antirretrovirales para el SIDA que hicimos en Lima en el ano 2003. Estoy seguro que la proxima reunion regional de precios de antirretrovirales que realizaremos en Buenos Aires el proximo agosto nos permitira obtener menores precios y por lo tanto mayor acceso a los tratamientos. Nuestro pais sigue cubriendo con medicacion y todo tipo de cuidados a todos los enfermos. Asimismo, nos vemos acechados, al igual que otros paises del mundo, por las reglas economicas que no tienen en cuenta Ios derechos de los pacientes a recibir sus tratamientos con continuidad. Argentina tiene en su lucha contra la pandemia del SIDA una politica de Estado que mantendra con toda firmeza teniendo en cuenta que cualquiera que sea la regla intemacional, los enfermos siguen siendo nacionales. La mejor forma de mejorar la salud es modificar Ios estilos de vida. Pero cuando estos estan determinados por la pobreza, no son estilos sino destinos de vida. Iniciamos esta reforma para enfrentamos a ellos, porque no nos resignamos a verlos como fatalidades. Pero definir politicas en salud y ambiente es tambien decidir que rol se asigna al Estado. A58NR/4 page 95

La crisis de 2001 nos dejo dos ensefianzas. La primera es que la experiencia argentina es la mejor manera de desmentir el modelo de los organismos de credito que postulan que la pobreza se puede reducir solamente con crecimiento y sin politicas redistributivas. La pobreza, ya sabemos los argentinos, no solo es resultado de problemas sociales de larga data; a veces es causa directa de modelos impuestos dogmaticamente por organismos internacionales. La segunda ensefianza dice que de la crisis se sale con una firme voluntad politica, generando consensos con los diversos actores sociales. Hoy, gracias a este impulso, el Gobierno y toda la sociedad argentina aspiran a protagonizar la mayor transformacion sanitaria de las ultimas decadas. Desde esta perspectiva, el Ministerio de Salud y Ambiente trabaja en la ejecucion de estrategias para cumplir con los Objetivos de Desarrollo del Milenio. En este sentido, hemos planificado una reunion con todos los Ministros de Salud y Ambiente de las Americas en junio, en Argentina, para identificar lecciones aprendidas sobre los Objetivos del Milenio y acordar acciones comunes que nos permitan llegar alas metas de 2015. Sabemos que la pobreza es causa fundamental de las dificultades para acceder a los servicios de salud. Pero tambien estas dificultades se encuentran indudablemente asociadas a la reproduccion de las condiciones de pobreza en las familias. No solo enfrentamos la pobreza material de millones de familias. Tambien nos oponemos a la pobreza de ideas, que es la peor de todas las pobrezas. Por eso, en Argentina, la salud no solo es vista como un resultado del crecimiento economico, sino que se la concibe como un pilar fundamental que impulsa el desarrollo nacional. Nuestra responsabilidad principal no es paliar los efectos de la pobreza, sino ayudar a que las personas puedan tener vidas mas saludables para que puedan dejar de ser pobres. Este debe ser el objetivo de todos, yen pos de eso debemos trabajar para lograr un mundo mas sano y mas saludable. Muchas gracias.

El Sr. CARRERO CUBEROS (Republica Bolivariana de Venezuela):

Seiior Vicepresidente: en nombre de la Republica Bolivariana de Venezuela quiero felicitar a la senora Elena Salgado y al resto de los miembros de la mesa por su designacion para dirigir esta Asamblea, que seguramente llegara a conclusiones y acuerdos favorables para los pueblos del mundo. A partir de 1999, Venezuela inicia la Revolucion Bolivariana que, entre otros objetivos, revierte el proceso neoliberal de privatizacion de los servicios de salud y bienestar social que habia sido iniciado en 1990. La inequidad de este proceso afecto particularmente a las madres y a los nifios del mundo. Venezuela se ha enfrentado al reto de eliminar die has desigualdades y para ell os se han elaborado estrategias y programas llamados «Misiones» de caracter social en las areas de salud, educacion, alimentacion, empleo, reconocimiento de la identidad cultural y desarrollo endogeno que han dado como resultado la disminucion de las injusticias y la reparacion de Ios dafios producidos durante los cuarenta afios precedentes. El Gobiemo Nacional ha invertido mas de US$ 5000 millones implementando las misiones sociales durante los ultimos dos afios. La Constitucion Bolivariana de 1999 consagra la salud como derecho social fundamental, regida por los principios de equidad, gratuidad y universalidad. La «Mision Barrio Adentro», en el campo de la salud, ha generado un hito en las politicas sociales en tiempo record. En cuanto a la salud infantil, diversas estrategias han reducido la mortalidad de una tasa promedio superior a 23 por 1000 nacidos vivos en el quinquenio 1994-1998, a 17 por 1000 nacidos vivos, en el siguiente quinquenio. Venezuela (pais con 25 mill ones de habitantes) tambien ha dado un gran sal to adelante en el campo de las inmunizaciones. El Plan Nacional de Vacunacion 2004 permitio aplicar cerea de 25 millones de dosis de las diversas vacunas, principalmente a los nifios. Tambien se incorporaron nuevas vacunas y se redujeron las desigualdades con una mayor cobertura; por ejemplo, en vacuna triple bacteriana, de un total de 336 Municipios, 100 tenian una cobertura de vacunacion inferior al 50%, y para el afio 2004, solo habia 19 Municipios en esta condicion. Este afio se estima reducir aun mas esta cifra. De otra parte, nuestro pais da acceso gratuito y universal a los antirretrovirales, y ademas garantiza la distribucion sin costo alguno de mas de 100 tipos de medicamentos esenciales. En Venezuela, cada madre, principalmente las de los sectores tradicionalmente excluidos, y gracias al incremento de la cobertura de atencion en el primer nivel, pueden contar y contaran con los A58NR/4 page 96 cuidados prenatales basicos que incluyen, entre otras medidas, la distribucion gratuita de suplementos alimentarios y nutricionales. Asimismo, con las nuevas normas de salud sexual y reproductiva se descongestionaran los hospitales y maternidades, fortaleciendo la atencion de partos de bajo riesgo en centros de menor complejidad. Esto impactara significativamente en la disminucion de la mortalidad infantil. Con la Mision Barrio Adentro Venezuela ha incrementado la cobertura en atencion primaria, pasando de 4000 a 18 000 medicos en las comunidades mas desfavorecidas, con el amplio apoyo del servicio de salud de la Republica de Cuba en este aspecto. Tan solo en el afio 2004 se realizaron 70 millones de consultas de atencion primaria, en contraste con las 60 millones de consultas realizadas en el quinquenio 1994-1998. La Organizacion Panamericana de la Salud ha reconocido los avances en salud, motivado al incremento de la cobertura en la atencion primaria. Actualmente, con la Mision Barrio Adentro II se esta ampliando la red secundaria y el acceso de la poblacion a todo tipo de examenes y servicios de diagnosticos, a la atencion ambulatoria especializada y a la atencion de emergencia, que en los ultimos 30 afios se habian privatizado casi totalmente, negandole su utilizacion tanto a los grupos excluidos, como a la clase media. Con los indicadores utilizados internacionalmente no ha sido posible medir en toda su dimension el efecto de estas politicas sociales, por cuanto enfatizan los criterios de caracter economico, como por ejemplo el PIB per capita, pero no reflejan los avances en el disfrute de los derechos humanos y en el derecho al desarrollo social. Aspiramos a que la OMS amplie la elaboracion de indicadores que permitan medir la disminucion de las brechas e inequidades sociales. Con la Revolucion Bolivariana que lidera el Presidente Hugo Chavez, boy podemos decir que no solo cada nifio y cada madre cuentan, sino que cada venezolano y venezolana comienzan a ser verdaderos ciudadanos en una sociedad democratica de derecho y justicia social, como lo establece nuestra Constitucion Bolivariana. Muchas gracias.

Dr FATIMIE (Afghanistan):

Mr President, excellencies, distinguished colleagues, ladies and gentlemen, assalamu alaikum. It is my pleasure to thank the Secretariat of the Fifty-eighth World Health Assembly for giving me such a great opportunity to share information concerning Afghanistan's post-conflict health sector reconstruction in general, and the world health theme of the year in particular. Indeed, today's world health theme of healthy mothers and children has reminded Afghanistan of the challenge it is facing. It has drawn its attention to the appalling health status of Afghan mothers and children and it has stimulated our nation to redouble its efforts aimed at increasing access to a health care system that is responsive to the situation and, especially, to those in greatest need. Afghanistan is in transition, moving from decades of conflict to a long-lasting peace, and from a protracted state of anarchy to a democratically elected Government. Afghanistan is fully aware that it is well known for experiencing some of the worst health indicators and it is also aware that it ranks second among those with the highest maternal and child mortality in the world. The Afghan Government has made maternal and child health a top national health priority and has urged bilateral and multilateral partners to assist it in investing in strategic programmes targeting the basic needs of maternal and child health. To ensure higher political commitment, the Government has appointed a deputy health minister, whose primary responsibility is focused entirely on maternal and child health and family planning. There are many factors that contribute to maternal death in Afghanistan. One of the causes is tuberculosis infection; women account for 70% of all cases of tuberculosis, again increasing maiernal mortality. Given the high morbidity and mortality that children face, child health remains a priority in Afghanistan. The good news in Afghanistan is that poliomyelitis is on the verge of eradication; and immunization coverage of childhood diseases has increased from 28% in 2002 to the current figure of 67%. However, keeping up the momentum requires sustained efforts and a flow of external assistance in particular. The needs of the health sector in this war-devastated country are massive. Nevertheless, the Government is determined to move on with identified priorities. In short, the country is in urgent need of a health care system that responds to increasing health care needs. However, it is critical that the system should take into account the modalities of external assistance, appropriate health interventions A58NR/4 page 97 and the sustainability of the reconstruction process. Taking specific areas, the availability of essential obstetric care, for example, is a priority in most provinces. Without such interventions, Afghan mothers and families will continue to face misery and what I call the "silent tsunami health crisis". Again, concerning the health situation, Afghanistan has some of the worst mortality indicators in the world: one in five children die before their fifth birthday, while one woman dies every 20 minutes due to complications in childbirth and pregnancy; nearly 700 children under the age of five die every day in Afghanistan, along with more than 70 expectant mothers. These health indicators clearly show that mothers and children in Afghanistan have been suffering in a silent emergency. At this Fifty-eighth World Health Assembly, I would like to remind you that diseases have no borders, yet we certainly know that the fruits of science never cross these borders. Afghanistan strongly believes that collaboration between neighbouring countries is vital and should always be upheld and strengthened. To this end, I take this opportunity to kindly invite my fellow ministers of health from China, India, Iran, Pakistan, Tajikistan, Turkey, Turkmenistan and Uzbekistan to Afghanistan for a regional collaboration forum. I would like to add to my remarks and share with the Health Assembly the view that poor health does not only impede development and limit the achievement of full individual potential and productivity; it also creates insecurity and instability - a serious issue for Afghanistan and certainly for the entire region and world. The health system in Afghanistan was not destroyed by doctors, nurses and health administrators, but it is we who are too often left alone to rebuild it, brick by brick and service by service. Afghanistan cannot therefore rapidly and dramatically reduce its globally high levels of maternal and child morbidity and mortality in isolation from necessary improvements in other health or social development programmes, whether in Afghanistan, the region or the world. We need the collaboration and cooperation of all other ministries, of local institutions, of international partners and, most importantly, of the people of Afghanistan and the region. We need to transform "health for all" into "health by all", where everyone shares responsibility and the same commitment to raising the health status of their global neighbours and ignores irresponsible impulses towards violence, detrimental health practices or environmental degradation. Towards the objective of global harmony, improved health status and the elimination of violence, the Ministry of Public Health of Afghanistan calls upon my colleagues within the Health Assembly to meet at a conference in Kabul in late April or early May 2006, to outline the principles, goals and activities that can lead us to achievement of the Millennium Development Goals and "health for all", in particular the acceleration of improvements in maternal and child health. To conclude, Afghanistan appreciates the support of the international community and it strongly acknowledges the need for the continuous collaboration and assistance of WHO and its Member States. Once again, I would like to bring to the attention of international donors and our Member States the importance of sharing experience, knowledge and assistance in order to help Afghanistan in its struggle to fight against violence, poverty, ignorance and disease and to strengthen our efforts to join other nations in their journey towards achieving the Millennium Development Goals by the year 2015, with the subsequent achievement of health for all.

Dr RAMADOSS (India):

Mr President, on behalf of the Government of India and myself, I extend my heartiest congratulations to the President and Vice-Presidents of the Fifty-eighth World Health Assembly. For more than a decade now, starting with the United Nations Conference on Environment and Development (held in Rio de Janeiro, Brazil), health has increasingly been occupying the central place in the development plans of many countries. This is clearly illustrated in the Millennium Development Goals, three of the eight goals of which are directly related to health, the rest having a significant bearing upon it. I am happy to note the increasing awareness of the importance of providing for the resource base for achieving the Millennium Development Goals. It is pertinent to mention here the leadership and vision shown by WHO in encouraging countries to establish national commissions on macroeconomics and health, eo-chaired by finance and health ministers. My Prime Minister, Dr Manmohan Singh, was also a distinguished member of the Commission on Macroeconomics and Health set up by WHO. We have constituted in India a national commission with a clear mandate to A58NRI4 page 98 produce evidence-based arguments for investing in health by underscoring the centrality of health to the process of development and poverty alleviation. The Government of India is trying to bring health to the centre of the political discourse in our country. Under the National Common Minimum Programme of our Government, we have committed ourselves to increasing public investment in health substantially. We also believe that increased expenditure has to be accompanied by innovations in the management of delivery systems: we must get our primary health infrastructure to function properly; a committed cadre of health workers in rural areas, particularly accountable to local communities, has to be built up; effective systems of health insurance need to be put in place; and key programmes like those for immunization, sanitation, hygiene and nutrition have to be integrated into the mainstream of all the health delivery systems. Our Government last month launched one of the largest health initiatives incorporating a radically new approach called the "National Rural Health Mission". It aims at providing effective health care to the entire rural population of India, with a special focus on 18 states with weak public health indicators. The Health Mission will initially cover about 250 000 villages in rural India. Each village will have "Accredited Social Health Activists (ASHA): a new ray of hope for villages", to act as a link between the health centres and the last villagers, in the remotest village. The core of our Health Mission is our commitment to the well-being of mothers and children. We need a comprehensive approach to deal with the painfully high levels of maternal and child mortality still prevalent in our country. We are in the process of launching the second phase of the Reproductive and Child Health Programme. This Programme takes a sector-wide approach with a flexible funding pool, greater ownership by the states and decentralized planning, programme implementation and institutional strengthening at different levels for achieving our health goals. The focus of the Programme is on promoting institutional deliveries, skilled attendance at birth and emergency obstetrics care with a greater focus on families below the poverty line, especially in rural areas. I am happy to inform you that India is conscious of injection-safety issues; all immunization programmes are being undertaken from this year with auto-disable syringes only. The integrated management of neonatal and childhood illness is being implemented throughout the country in a phased manner through enhancing the skills of all categories of health workers and by promoting breastfeeding and nutrition. I am happy to inform you that our national efforts in the sphere of maternal and child health received a boost with the global launch of The world health report 2005 in New Delhi by the Director­ General of WHO on World Health Day this year. The event was marked by the adoption of the Delhi Declaration on Maternal, Newborn and Child Health on 9 April 2005, which makes an appeal for the highest national and international political commitment to maternal, newborn and child health. I urge all countries and institutions to abide by the honest goals of this Declaration, particularly with regard to the need for additional resources. India, a large country of one thousand million people, presents huge diversities. While in some parts of the country communicable diseases like malaria and tuberculosis continue to be the leading causes of death, in others there is a rapid increase in noncommunicable diseases like diabetes, cardiovascular diseases and cancer. We also have the spectre of HIV I AIDS, which has the potential to cast a very heavy burden of human suffering upon us if not effectively contained. This dual burden of infectious and communicable diseases alongside lifestyle diseases is indeed a cause for concern. However, past investments in the design and launching of sound strategies for reducing tuberculosis, malaria, leprosy and HIV I AIDS, are beginning to pay off; complex programmes like the tuberculosis programme have shown extremely encouraging results with the doubling of cure rates to 85% under the directly observed treatment short-course programme. We are also confident of eliminating leprosy and eradicating poliomyelitis by 2005. The entry into force of the WHO Framework Convention on Tobacco Control this year will help us in our efforts in dealing with noncommunicable diseases. A massive prevention programme to check the spread of HIV I AIDS has been combined with antiretroviral treatment for people living with HIVIAIDS. We aim to integrate an HIVIAIDS containment programme with primary care for wider coverage. I would like to say a few words about the tsunami disaster that struck India and some of the countries in our region last year. The Government of India not only responded to its own crisis-struck population, but also rushed health supplies to strengthen technical and voluntary efforts for relief and A58NR/4 page 99 rehabilitation in neighbouring Member States, namely, Indonesia, Maldives and Sri Lanka. I also take this opportunity to place on record our appreciation of the efforts of WHO in giving support to the Member States in relief and rehabilitation activities. I particularly wish to place on record our appreciation of the visit by the Director-General to the tsunami-affected areas of my country. India appreciates the accelerated decentralization process of resource allocation and results­ based budgeting initiated by the Director-General. India believes that there is a need to increase financial resources at regional and country level to improve technical and managerial performance, ensure greater accountability and improve the delivery of programmes. The guiding principles for resource allocation in WHO should be the health needs of countries and regions, based on objective and internationally accepted indicators of the burden of diseases, like the Millennium Development Goal health indicators, poverty, education and population levels and access to essential health-care services. We strongly believe that it is imperative for a meaningful health-care delivery system that life­ saving essential medicines continue to be available at affordable prices. With this objective in mind, India has recently amended its Patents Act, 1970. The Patents (Amendment) Act, 2005 of India incorporates all the flexibilities provided under the Agreement on Trade-Related Aspects of Intellectual Property Rights and the subsequent WTO Ministerial Conference in Doha pertaining to the granting of compulsory licensing and other mechanisms for effective availability. The Act will enable India, with its strength in the field of production of cost-effective quality generics, to address the needs of those countries which have an insufficient manufacturing capacity in pharmaceuticals. Organizations such as WHO have the role of monitoring the dynamics of the impact of new patent laws worldwide and of alerting us all about the possible fallouts in relation to prices and the availability of essential drugs. The impact of globalization has also been felt in another area- that of traditional systems of medicine providing cost-effective alternatives to expensive modern drugs. Traditional Indian systems of medicine like Ayurveda, Siddha, Unani, yoga and naturopathy are now being systematically promoted to provide a wider choice to patients. With a view to standardizing these efforts, steps have been taken to publish formularies and pharmacopoeias. Traditional knowledge on these systems has been digitized and published for easy access by all countries. It is my privilege to be here in this august Health Assembly and share with you all the vision that India's leadership has adopted to promote a healthy society that will be able to access the fruits of development in the most equitable manner. Before concluding, I wish you all success and assure you of our constructive cooperation in steering this Health Assembly. I thank you all for your attention.

Mrs GANDI (Mongolia) (interpretation from the Khalkha Mongolian): 1

Mr President, Mr Director-General, distinguished delegates, ladies and gentlemen, it is a distinct honour and privilege for me and my delegation to attend the Fifty-eighth World Health Assembly and I am confident that under your capable leadership, Mr President, the Health Assembly will be able to contribute a great deal to the strengthening of the global health system which is ultimately intended to ease the health protection of the populations of its Member States, based on the principles of justice and equality. Taking this opportunity, on behalf of my delegation, I would like to commend the Director­ General and his team for their excellent work towards the betterment of health practices and policies globally, which serves as a hidden engine for the development of countries. It was rightly stated by Dr Lee that improvements in health are essential if progress is to be made with the other Millennium Development Goals. The focus of World Health Day this year on the theme of maternal and child health, and the insight gained into these issues during the Health Assembly, will undoubtedly lead to greater progress towards achieving these Goals. In conformity with the commitments of the global community, the Government of Mongolia has identified its objectives as seeking the achievement of the Millennium Development Goals through the reduction of child mortality to 29.2 per 1000 live births, and maternal mortality to 50 per 100 000 live births, by 2015. As a result of persistent

1 In accordance with Rule 89 of the Rules of Procedure of the World Health Assembly. A58NR/4 page 100 endeavours, coupled with the friendly assistance of international partners, the maternal mortality ratio has been reduced to 98.8 per 100 000 live births or two times lower in 2004 than in 1992, when the registration of maternal mortality in accordance with WHO guidelines began. Upon successful implementation of the Maternal Mortality Reduction Strategy for 2001-2004, a new Strategy for 2005-2010 has been adopted with a greater focus on the organization and management of health care services for mothers and children, the introduction of evidence-based interventions, and the improvement of access to reproductive health services and safe motherhood, specifically for those living in remote rural areas and for the poor. In terms of child health, child mortality decreased twofold between 1990-2000, and in 2004 under-five mortality declined to 29.2. These positive outcomes were largely due to intensive public-health interventions such as an Expanded Programme of Immunization, Integrated Management of Childhood Illness and breastfeeding. However, Mongolia still remains one of the countries in the Western Pacific Region with relatively high maternal and child mortality and health improvements that are not distributed equitably. Among the threats to global health, HIV I AIDS is causing devastation throughout the world. Mongolia is affected by that as well, although it is still considered to be a country with a low HIV I AIDS prevalence. However, the rate of increase in the number of confirmed cases of HIV I AIDS has been growing rapidly during the past year- a 125% rise in the first quarter of 2005 compared to the first quarter of 2004. This is an alarming fact that has captured the attention of the entire nation and the Government. Mongolia has a number of risk factors, making it extremely vulnerable to a widespread epidemic: poverty; a high prevalence of sexually transmitted infections; a growing number of sex workers; and the increasing mobility of the population, with rapidly escalating HIV I AIDS epidemics in both neighbouring countries. The Government, with the support of international partners, has initiated different interventions to prevent HIV I AIDS from spreading. In spite of all of our efforts, rates of sexually transmitted infections remain exceedingly high among the general population and its vulnerable groups, as well as among the low-risk population. In our view, the international community also needs to pay greater attention to countries with low HIV I AIDS prevalence. We believe in the virtue of public health interventions, and the benefits of such interventions, understandably, will be more evident from the timely actions taken in countries with low HIV I AIDS prevalence. Mr President, rapid globalization leads, in turn, to the greater vulnerability of nations to emerging and re-emerging infectious diseases and new diseases. Therefore, we welcomed the revision of the International Health Regulations and supported the underlying principles of the revision process as we believe in the necessity of setting up efficient mechanisms and in a regulatory system for timely and appropriate response to public health emergencies of international concern. We also look forward to mobilizing our efforts and commitment to strengthening global health actions in relation to crises and disasters. Finally, I would like once more to convey our strong commitment to global efforts in protecting and improving the health of humanity. Thank you very much for your attention.

Le Dr Ponmek DALALOY (Republique democratique populaire lao) :

Monsieur le President de seance, Excellences, honorables delegues, Mesdames et Messieurs, nous faisons face a taut de defis, en particulier a ceux nouvellement surgis a la fin du siecle dernier et depuis le debut du XXI" siecle, mettant en cause l'accomplissement des objectifs du Millenaire et les efforts pour nous sortir de la pauvrete, consequence de la guerre, qui est en fait la cause reelle et profonde de toutes les difficultes, de tous les obstacles qui vont a l'encontre du slogan de la Journee mondiale de la Saute « Donnons sa chance a chaque mere et a chaque enfant». Au nom de la delegation de la Republique democratique populaire lao, c'est aujourd'hui un grand honneur pour moi de pouvoir saluer chaleureusement la Cinquante-Huitieme Assemblee mondiale de la Saute. Nous voudrions saisir cette occasion pour feliciter la Presidente, les Vice-Presidents pour leur election a leur poste de haute responsabilite. Nous sommes certains que sous leur sage direction notre Cinquante­ Huitieme Assemblee mondiale de la Saute sera couronnee de succes. A 1'occasion de cette auguste Assemblee, permettez-moi egalement d'exprimer notre haute appreciation au Directeur general, le Dr Lee Jong-wook, pour ses efforts soutenus et cibles en faveur de !'amelioration de la saute a travers le monde, notamment celle de la mere et de 1' enfant. ASSNR/4 page 101

La sante de la mere et de !'enfant revet la plus grande importance. C'est dans cet esprit que dans notre pays le Gouvemement lui accorde la premiere priorite car elle est tres etroitement liee a la pauvrete et au sous-developpement. Pour l'ameliorer, le Gouvemement reaffirme sa volonte politique, son engagement, ses actions pour la faire sortir de sa crise invisible. Cette volonte politique, cet engagement, ces actions sont fortement refletes dans le texte et !'esprit de la constitution, des lois et des reglements s'y rapportant. Dans cet esprit, une commission nationale pour la mere et !'enfant a ete creee en 1992, et en 1994 un centre pour la mere et I' enfant a ete constitue pour coordonner les efforts avec nos partenaires locaux et exterieurs. En septembre 2000, notre Gouvemement a approuve la Declaration du Millenaire qui constitue la base pour fixer les objectifs. Pour accomplir ces objectifs, notre Gouvemement consacre tous ses efforts a travers !'execution de la strategie nationale pour le developpement et la reduction de la pauvrete a !'horizon 2020. Pour y parvenir le Ministere de la Sante a elabore un ensemble de regles concretes pour servir de guide. De plus, apres la Joumee mondiale de la Sante cette annee, consacree a la sante de la mere et de !'enfant, un haut commandement charge notamment de la coordination a ete ajoute au systeme existant pour rendre plus efficaces encore les taches primordiales. Malgre les progres tres appreciables obtenus, 1' etat de sante de notre population, notamment celle de la mere et de !'enfant, reste precaire. Par exemple, en l'an 2000 la mortalite matemelle a ete de 530 pour 100 000, la mortalite des enfants de mains d'un an de 82 pour 1000, celle des enfants de mains de 5 ans de 106 pour 1000. Nous attendons actuellement les resultats du recensement effectue en mars de cette annee pour savoir si nous avons pu les rabaisser a 350, 60 et 80 respectivement. La malnutrition plafonne a 40 %, les soins prenatals a 35 %, ajoutes a cela le bas niveau d'education, surtout parmi les femmes des groupes ethniques, et la frequence des naissances a domicile, nous enregistrons un taux eleve de naissances et de marts. Tout cela constitue de grands defis pour la Republique democratique populaire lao. Pour faire face a ces defis, comme nous avons a notre disposition !'ensemble des actions entrant dans le cadre de la celebration de la Joumee mondiale de la Sante, en cooperation avec l'OMS et l'UNICEF, une campagne de mobilisation de haut niveau a ete entreprise, a laquelle ont pris part taus les partenaires. L'objectif de la campagne consiste a revoir la situation et a revitaliser et renverser l'elan des campagnes de vaccination qui a tendance a baisser, et a mettre taus les problemes au premier plan de nos actions. Nous et taus nos partenaires sommes d'accord pour considerer que la priorite donnee a la mere et a !'enfant est etroitement liee a la realisation des objectifs du Millenaire pour le developpement. En consequence, nous avons decide, pour ce qui est de la priorite de la mere et de I' enfant, de considerer la vaccination comme la colonne vertebrate de notre action, tout en reconciliant les differents reseaux. Etant donne !'importance et la dimension des defis lies a la sante de la mere et de 1'enfant dans notre pays, no us lanc;:ons un appel pour une approche sectorielle mettant ensemble, d'une fac;:on coordonnee, taus les efforts interieurs et exterieurs visant le meme but. Dans ce sens, nous pensons que nous pourrons realiser les buts du slogan. Au nom de la delegation de la Republique democratique populaire lao, permettez-moi d'exprimer nos sinceres remerciements a l'OMS et aux autres organisations pour leur soutien continu. Dans cet esprit no us souhaitons voir accroitre notre cooperation. L 'eradication de la poliomyelite dans notre pays en l'an 2000 a demontre que nous avons les capacites d'agir et que nous pouvons agir. Enfin, permettez-moi de souhaiter a notre Cinquante-Huitieme Assemblee mondiale de la Sante plein succes. Merci.

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Professor MILOSAVLJEVIC (Serbia and Montenegro ):

Mr President, distinguished delegates, excellencies, ladies and gentlemen, I am greatly honoured to speak before this Health Assembly on behalf of the state union of Serbia and Montenegro today. First of all, I would like to express my sincere appreciation and gratitude to WHO for its activities in Serbia and Montenegro, for the assistance it has been and is providing and for the very fruitful cooperation with its offices in Belgrade and Podgorica at a time when we are passing through transition and reforming our health care systems. Mr President, I congratulate you and Madam President on your election to preside over this Health Assembly, and to the members of the Bureau. I am also pleased to voice my personal satisfaction that I am addressing delegates of the Health Assembly from all over the world, confident that its work will be successful. This is also a valuable opportunity for me to point out the role of Director-General Dr Lee Jong-wook, his hard work and many achievements, wishing him every success in the future. My delegation aligned itself with the statement of the European Union presidency delivered by the distinguished Minister of Health of Luxembourg. My address will, therefore, focus on some national priority issues. WHO has always addressed the challenges and health problems all over the world in a timely and forceful manner, supporting its Members in their efforts to provide good health to their citizens. True to its commitments, The world health report and theme for this year, "Make every mother and child count" were launched on World Health Day and the event was marked in many countries, as in our country as well. In fact, throughout the year, promotion of mother and child health care will be one of our priorities in Serbia and Montenegro. Our relevant indicators for the mother and child health situation are basically satisfactory. Nevertheless, we will continue to work on their improvement. We in the state union of Serbia and Montenegro have had our share of problems and have addressed them to the best of our abilities, with invaluable assistance from the international community. The cumulative effects of critical events during the last decade of the twentieth century have affected the health status of our population. The country has entered into a new epidemiological transition and more than half of the population suffer from cardiovascular diseases. The second major problem is malignant diseases. Like many countries of south-east Europe undergoing socioeconomic transition, Serbia and Montenegro is facing an increased burden of noncommunicable diseases related to high-risk behaviours such as abuse of tobacco, alcohol and narcotic drugs, inadequate nutrition and physical inactivity. We are now in the process of preparing our national strategy for noncommunicable diseases, based on WHO recommendations. After signing the WHO Framework Convention on Tobacco Control in June last year we are now preparing for its ratification; a draft national tobacco control strategy is also ready for public discussion and adoption. Among communicable diseases, the major threats to the country due to present risk factors are HIV/AIDS and tuberculosis. With the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the first results have been achieved: vertical transmission of HIV has slowed down and - through the education of health professionals -knowledge about this disease and behaviours affecting it has improved. Bearing in mind the numerous and different problems we faced during transition, I would like to emphasize the following key challenges and issues for heath-care system reform in our country: developing a realistic health reform strategy with solutions that match the actual problems in Serbia and Montenegro and that are achievable within realistic expenditure limits; making the health system financially sustainable, while reducing high out-of-pocket payments; strengthening and unifying leadership, capacity, accountability and transparency in the ministries of health and health insurance funds; restructuring and upgrading health facilities to increase efficiency and quality, and modernizing management, standards and medical practice; implementing European Union-oriented medicines regulation and reforming pricing and reimbursement policies for drugs to improve safety, access and expenditure control; reforming public health institutes and training to reduce low-value activities and increase the focus on health promotion and prevention of noncommunicable diseases. In the pursuit of a professional and credible health policy, it is our intention to turn plans into actions and enable our population to receive quality health services in accordance with generally accepted standards. Before I conclude, let me express once again my great appreciation and most profound gratitude to WHO and convey our wishes and hopes that our cooperation will continue successfully in the future. Thank you. A58NR/4 page 104

M. GIANNOPOULOS (Gn!ce):

Monsieur le President de seance, permettez-moi tout d'abord de vous feliciter vivement pour votre election. Il va de soi que ces felicitations sont extensibles a tous ceux qui occuperont des postes a responsabilite pendant la Cinquante-Huitieme Assemblee mondiale de la Saute; de remercier le Dr Lee Jong-wook pour son expose ainsi que pour le travail accompli par l'OMS sous sa direction; et finalement de feliciter 1' Ambassadeur d'Irlande, Mme Mary Whelan, ainsi que tous ceux qui ont contribue a un accord sur la revision du Reglement sanitaire international. Le Ministre du Grand-Ducbe du Luxembourg, en sa capacite de President de l'Union europeenne, dans son intervention a laquelle la Grece souscrit pleinement, a trace les grandes lignes qui a notre avis doivent guider nos travaux. Permettez-moi cependant de vous adresser a mon tour quelques mots sur le theme principal de notre debat et qui me tiennent a coeur. Je suis heureux que le theme de cette Cinquante-Huitieme Assemblee mondiale de la Saute souligne 1' attention particuliere et necessaire que nous devons porter a chaque mere et a chaque enfant du monde. Ce sujet nous impose de regarder de plus pres les problemes specifiques de ce couple fondateur de l'humanite: la mere et l'enfant. L'importance de ces liens, remontant aux origines de l'humanite, a ete magnifiee par le mythe des anciens grecs qui mettait en exergue le lien entre Demeter, deesse de la terre et de !'agriculture, et sa fille Persephone. Ce lien determinait les saisons et par consequent le cycle de la production et de la nutrition. Les problemes qui affectent le lien sacre entre la mere et 1' enfant, bien que tres differents selon les pays, le milieu economique, social et culturel, exigent une solution immediate et concertee, au niveau mondial. Le role de la mere est d'une importance capitate non seulement dans la protection et !'education des enfants mais aussi pour !'existence propre a ces demiers. Les plus grands problemes qu 'une mere puis se affronter pour son enfant sont ceux de la nutrition, de la vaccination, de la prevention des maladies et du soutien psychologique. Dans les pays en developpement, des millions d'enfants meurent chaque jour a cause du manque d'eau potable et de nourriture. Chaque annee egalement plus de trois millions et demi d'enfants meurent dans ces memes pays faute de vaccination alors que les maladies comme le tetanos, la poliomyelite et le paludisme ont ete totalement eradiquees dans les pays developpes. Le fleau du SIDA, qui constitue un probleme grave tant pour les meres que pour leurs enfants, est une preoccupation majeure a laquelle la societe intemationale accorde une grande priorite. La Grece, consciente de la gravite du probleme, a intensifie son action dans ce domaine. Beaucoup trop d'enfants connaissent belas d'autres problemes terribles comme les abus sexuels qui les traumatisent a vie. Et bien souvent dans ces cas-la leur seule protection demeure celle de leur mere. Des etudes scientifiques prouvent que nombre d'enfants qui n'ont pas reyu d'affection presenteront de graves problemes psychologiques plus tard et auront une tendance a se refugier dans la drogue et dans la violence. L'Organisation mondiale de la Saute, l'UNICEF et d'autres organisations intemationales oeuvrent dans le bon sens et s' efforcent de procurer nourriture et vaccins necessaires aux plus demunis, de secourir les meres et les enfants dont les droits fondamentaux doivent par ailleurs etre proteges par tousles Etats. En Grece qui, ces demieres decennies, est devenue un pays d'immigration, le Gouvemement s'est efforce de soutenir le lien entre la mere et l'enfant au moyen de mesures legislatives concretes comme l'octroi d'allocations de maternite aux meres qui, pour diverses raisons, ne sont pas couvertes par le regime de la securite sociale, de programmes d'aides specifiques a la petite enfance, et de mesures de protection a 1' egard des enfants qui en sont depourvus et specialement ceux de la rue. Il est a noter que toutes les meres et tous les enfants refugies en Grece beneficient d'un controle et d'une protection sanitaires immediats. L'aptitude qu'aura !'Organisation mondiale de la Saute a soutenir le couple fondamental que constituent la mere et l'enfant sera un des criteres cles de reussite de cette institution. Je ne doute pas du succes de la presente Assemblee de la Saute si nous nous engageons pleinement dans ce combat. Les catastrophes recentes provoquees par le tsunami ont montre que !'engagement est un facteur crucial pour faire face meme a des situations qui nous paraissent insurmontables de prime abord. Je vous remercie de votre attention. A58NR/4 page 105

El Dr. FERNANDEZ GALEANO (Uruguay):

Senor Vicepresidente, senoras y senores delegados: El gobiemo de mi pais, recientemente insta1ado, me ha hecho e1 honor de designarme como delegado ante esta historica y siempre relevante Asamblea. Reciban el saludo del Gobiemo uruguayo, que aspira a contribuir en forma decidida con la OMS a la construccion colectiva entre todas las naciones, pueblos y estados del mundo con plena vigencia de los derechos humanos, el estricto cumplimiento del derecho intemacional y el abordaje de los grandes desafios que enfrenta la humanidad, basado en el dialogo, la cooperacion y la solidaridad. Entendemos la salud como un derecho humano esencial, un bien social y una responsabilidad del Estado. Como un derecho impostergable de las y los ciudadanos, y consideramos un imperativo etico garantizar el acceso universal y equitativo a la atencion a la salud continua, oportuna, humana y de calidad. Esta nueva etapa la enfrentamos con esperanza y decision. Historicamente, en mi pais, como casi toda America Latina, los aspectos programaticos y de atencion estuvieron referidos a lo «matemoinfantil». Las mujeres y los ninos fueron considerados dentro de la relacion madre-hijo, atendiendo solamente a los aspectos referidos a una dependencia mutua, a las mujeres en su condicion exclusiva de madres y a los ninos como recien nacidos o lactantes. Considerando la perspectiva de genera como un nuevo paradigma transformador de la cultura y de la relacion entre los hombres y las mujeres, nuestro Gobiemo resolvio crear, a nivel nacional, un area programatica de Salud de la Mujer y Genera. En forma simultanea se impulso un Programa de Atencion Integral al Nino abarcativo de todo el periodo de vida que ella conlleva, promoviendo la atencion y normalizando las acciones de salud dedicadas a ninos y ninas en un momento especial de deterioro nacional. El 60% de los ninos y ninas menores de 5 anos en Uruguay nacen y viven en hogares que estan por debajo de la linea de pobreza. El Uruguay se reproduce dramaticamente en el tercio mas pobre de su poblacion. Casi el 30% de los partos, de los hospitales publicos fueron de mujeres menores de 19 anos, y mas del 80% de estas madres adolescentes no completaron la ensenanza secundaria, y de ellas el 80% no estan integradas a la actividad economica. El peso mayor en la reproduccion biologica, social e intergeneracional de la sociedad se concentra en los sectores con menos recursos economicos, contribuyendo a la reproduccion e infantilizacion de la pobreza, con los consiguientes riesgos de morbimortalidad infantil y materna que estos procesos acarrean. El sistema educativo formal no ha incorporado hasta hoy la educacion sexual como parte de la curricula en ninguno de los niveles del sistema educativo. La incorporacion a la curricula definitiva continua siendo un tema sensible en la agenda del debate politico y social. Un gran avance en la consolidacion de las politicas de salud sexual y reproductiva fue la Comision Intergubemamental para Promover una Politica Integrada de Salud Sexual y Reproductiva en la Region del Mercosur, apoyada por la Organizacion Panamericana de la Salud. La educacion sexual es aun una asignatura pendiente en la salud y en la educacion. La misma se encarara coordinadamente desde la perspectiva de derechos de ciudadania y siguiendo los principios que sustenta la Constitucion y la Sociedad Uruguaya. Frente a la realidad nacional, hemos definido acciones para atender a ninas, ninos y mujeres en los centros publicos como eje de trabajo prioritario orientado a sectores en situacion de exclusion social. Estos objetivos se empiezan a implementar en el marco del cambio de modelo de atencion, gestion y financiamiento con una fuerte jerarquizacion del primer nivel de atencion en el marco de la estrategia de atencion primaria de salud. En el contexto de los Objetivos de Desarrollo del Milenio, priorizar la salud de ninas, ninos y mujeres es una parte integral e insustituible de las metas de reduccion de la pobreza, pero es tambien un deber etico y moral. Frente a la convocatoria de «Cada madre y cada nino contaran», nuestro Gobiemo se propane, por lo tanto, crear un area programatica de salud de la mujer y genero y consolidar la atencion integral al nino a traves de a1gunas acciones: creacion del Comite de Auditoria de Mortalidad Infantil y de menores de 5 anos; formacion de Comites de Muertes Matemas de Mujeres por Causa de Embarazo, ASSNR/4 page 106

Parto y Aborto, con participacion de equipos tecnicos y con una participacion decidida de la sociedad civil; inicio del dialogo con el Ministerio de Cultura a fin de que a todos los niveles se implemente la educacion sexual basada en una perspectiva de derechos; y potenciacion del Servicio Nacional de Banco de Leche Humana del Area de Recien Nacidos del Centro Hospitalario Pereira Rossell. En Uruguay, rincon pequeiio de America Latina, ya comenzamos a construir un lugar elegido y deseado para nacer y vivir. Muchas gracias.

El Dr. FRENK (Mexico):

Seiior Vicepresidente de la Asamblea, Sr. Director General de la OMS, colegas: deseo expresar el beneplacito del Gobiemo de Mexico por la eleccion de la Sra. Ministra de Sanidad y Consumo de Espaiia, Doiia Elena Salgado, a la Presidencia de esta Asamblea y del Sr. Saley Meky a la primera Vicepresidencia, asi como de los otros vicepresidentes. Es aqui, en el maximo foro de la salud mundial, donde mejor se expresa la voluntad de movilizar la accion colectiva de todas las naciones para impulsar el valor universal de la salud. Tambien deseo agradecer al Director General de la Organizacion Mundial de la Salud, y a su excelente equipo de colaboradores, por haber designado a Mexico como sede de la Cumbre Ministerial de Investigacion en Salud, llevada a cabo en noviembre pasado. Esta reunion congrego al mayor numero de ministros de salud en la historia para discutir el tema de la investigacion. La interaccion entre Ios encargados de la produccion, el financiamiento y la utilizacion de la investigacion resulto fructifera. La Declaracion de Mexico es un llamado a fortalecer la investigacion en salud como elemento esencial para alcanzar los Objetivos de Desarrollo del Milenio. En particular, la investigacion en sistemas de salud genera conocimiento esencial para diseiiar, implantar y evaluar las reformas requeridas. Sobre esta base, Mexico esta llevando a cabo una profunda reforma estructural sustentada en dos pilares, la calidad y la proteccion financiera, con el fin de promover la equidad y contribuir a un desarrollo justo e incluyente. En nuestra reforma, la calidad esta concebida de manera integral para proteger el derecho de la poblacion a recibir servicios que garanticen la seguridad de los pacientes, la efectividad de las intervenciones y el trato digno hacia los usuarios y sus familiares. Por su parte la proteccion financiera es la aplicacion de mecanismos eficientes, solidarios y justos para eliminar las barreras economicas que impiden el acceso a los servicios o que empobrecen a las familias por el pago de la atencion y Ios medicamentos. El 1 de enero de 2004 entro en vigor una reforma legal que establece en Mexico el Sistema de Proteccion Social en Salud, cuyo objetivo es lograr el aseguramiento publico universal. Desde entonces, y por los proximos cinco aiios, el financiamiento publico de la salud esta creciendo en una proporcion sin precedente. Gracias a ese esfuerzo, se ha establecido el nuevo Seguro Popular de Salud para cubrir a los 50 millones de personas, entre ellas las mas pobres, que habian quedado excluidas de la seguridad social tradicional. En Mexico, las mujeres y los niiios representan un grupo de poblacion especialmente vulnerable a las barreras financieras y sus consecuencias. Es por ello que el Seguro Popular se ha convertido en el mas valioso instrumento de las politicas publicas de salud para alcanzar los Objetivos de Desarrollo del Milenio en materia de salud materna e infantil. Para Mexico la salud de cada mujer y de cada niiio es una tarea de primer orden en la agenda gubemamental y un derecho consagrado en su Constitucion Politica. Celebramos, por ello, que el Informe sabre la salud en el mundo 2005 haya sido dedicado a este componente vital del desarrollo y prosperidad de las naciones. Hoy mas que nunca debemos llevar a cabo reformas sustentadas en una base tecnica producto de la investigacion cientifica, inspiradas en una deliberacion etica que promueva la justicia y la inclusion social e impulsadas por un compromiso politico para hacer de la salud el motor de un desarrollo equitativo en e1 mundo entero. Muchas gracias. A58NR/4 page 107

The PRESIDENT:

I thank the delegate of Mexico. I now give the floor to the delegate of the Marshall Islands who will speak on behalf of the Pacific island countries: Cook Islands, Fiji, Kiribati, Micronesia, Nauru, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu and on behalf of his own country.

Mr JACKLICK (Marshall Islands):

Mr President, Director-General, honourable mm1sters, distinguished delegates, ladies and gentlemen, it is indeed an honour and a humble privilege to address this important Health Assembly today, on behalf of the Pacific island countries. We extend to you all our warm greetings and compliments. Mr President, we congratulate you and Madam President on your new appointments and wish to reaffirm our unwavering support for and cooperation with you in your work. We are confident that you will provide the appropriate direction, guidance and leadership for this Health Assembly through dynamic, productive deliberations, constructive recommendations and fruitful outputs and conclusions. Our Pacific islands are spread out in the Pacific Ocean. They are small islands separated by vast distances of sea, with populations ranging from 1500 to 5 million. Pacific island countries have a relatively young population; nearly 45% of the total population is under the age of 14 years. Mothers and children are of great value to our communities and this is a strong tradition and custom of the Pacific islands. Joined with other world leaders, Pacific island leaders committed themselves to the achievement of the Millennium Development Goals stated in the United Nations Millennium Declaration during the Millennium Summit in September 2000, including improvement of mothers' and children's health. Maternal and child health status in the Pacific region has improved significantly as a consequence of health programmes focusing on maternal and child health. However, the under­ fives still face some mortality, especially in two of the Pacific countries, that is higher than the average for countries in eastern Asia. Mother and child health remains a serious concern across the region. The theme of this year's World Health Day and The world health report, "Make every mother and child count", continues to mean a lot to us. We want to pay special attention to every case, as every additional mortality has a proportionately greater impact in our small population. It has been recognized that the primary requirement for achieving a further reduction in maternal mortality lies in improving access to quality obstetric care, including emergency services. Universal access to appropriate and effective antenatal, maternal, newborn and child health care is essential, although it is a challenge for Pacific islands considering the isolated locations of people, particularly on outer islands that are very difficult to access. A continuing emphasis is needed on basic health care, including the provision of immunization, as well as more effective education and preventative health measures related to nutrition. Immunization programmes in the Pacific are at a critical and important period of their development, and many Pacific island countries require renewed attention and support. With the focus on transition from the previous regional goal of poliomyelitis elimination (which was achieved in 2000) to the "two new pillars" of measles elimination and hepatitis B control, it is vital that the previous programme gains are sustained for future generations of Pacific children, while the new targets are addressed. Despite our previous success, it is important that we do not become complacent and lose sight of the continued benefits that further expansion of the Expanded Programme on Immunization can provide. With regard to service availability, although there has been some improvement, there is still more ground to cover. For example, there is a need to focus on improving the quality of services, improving coordination of the referral system and strengthening the health system in general; health information systems to assist with planning also need to be improved. There is a need for such things as estimations of the size of populations at risk, and monitoring and evaluation need to be in place in order to assess mother and child health conditions. In general, relevant data from all sectors should be utilized and definitions and indicators must be standardized across agencies and organizations. With all these in place, better planning and monitoring can be done which will lead to more appropriate and effective health services. A58NR/4 page 108

The improvement of mother and child health will also require progress in addressing communicable and noncommunicable diseases, such as malaria, diarrhoea! diseases and child obesity, which have a high incidence across the region. Thanks to WHO's support for the introduction of the Safe Motherhood Initiative, antenatal care packages and increased activities under the Integrated Management of Childhood Illness provide support to Pacific island countries in mobilizing resources to target action to those mothers and children in greatest need. The Pacific island countries continue to experience many paradoxes of geography and history: while we are isolated physically from the continental land masses we float, relatively powerless, in the tides of globalization; while we have apparently low rates of many old infections, we are vulnerable to devastation by new ones as they emerge; while we have a history of active and frugal lifestyles, having even been accustomed to hardship, our current health burdens are dominated by diseases caused by overconsumption and physical inactivity; while our health workers are scarce and expensive to develop, our human resources shortages arise not from lack of production but from loss of these workers to more developed countries. Ten years ago, Pacific island countries' ministers of health had their first meeting to discuss specific health issues for Pacific islands. After that meeting, the Pacific island countries began a journey towards the attainment of "healthy islands" status. The healthy island theme defined the idea of attaining a state where children are nurtured in body and mind; where environments invite learning and leisure; where people work and age with dignity; and where ecological balance is a source of pride. The Pacific island countries have made much progress in this past decade of work. After five previous meetings of ministers of health of Pacific island countries, my fellow ministers of health met again at Apia, in March of this year. At this meeting, we reviewed past achievements and reaffirmed the priority given to healthy lifestyles and supportive environments; to tackling communicable diseases, including the threat of new and emerging infections; and to the challenges surrounding human resources for health. The burden of noncommunicable diseases in Pacific island countries continues to increase. It is predominant in most of the Pacific island countries and involves the adoption of unhealthy lifestyles within environments that facilitate unhealthy choices. There is thus a considerable double challenge of reducing risk, and of caring for existing cases of noncommunicable diseases. Infectious diseases threaten life in the Pacific island countries in two ways. First, the communities continue to have significant health problems; two of the most significant communicable diseases are HIV I AIDS and dengue fever. Although HIVIAIDS prevalence is relatively low in most of the Pacific island countries, the vulnerability of these small countries and the impact of the disease on them are relatively high. The endorsement of a regional strategy on HIV I AIDS by the Pacific island countries has given the work on HIV I AIDS a high profile. Second, there is a continuing threat that new and emerging communicable diseases, such as avian influenza will devastate the health of Pacific island populations. Here is another double challenge - that of preventing or eliminating infections where possible, while remaining vigilant for new threats and responding rapidly to them. We are aware that the Pacific island countries face considerable human resources constraints. Human resources are slow and expensive to develop and yet only too easily and rapidly lost due to the migration of workers. Pacific islands face the common challenge of continually developing their health workers to a level where they can provide quality health services. Factors beyond the control of ministries of health and governments include the basic human right to freedom of movement. Thus the need for effective human resources management through partnership and collaborative approaches at national and regional levels has become more imperative. Greater emphasis needs to be given to societal needs and public health requirements, while continuing to respect the freedom of individuals. In the development of human resources, it is further recognized that there are capacity constraints in the Pacific. One innovative solution is distance education through the Pacific Open Learning Health Net. The geographical separation of Pacific island countries by a huge ocean isolates us. However, this fact does not in any way limit our contribution to efforts to improve global and regional health. Although we are geographically fragmented, we are demonstrating unity of vision and purpose; we are deeply rooted in a common Pacific culture and identity. Individually we may need external technical and financial support; collectively we have shown the capacity to produce models and templates for A58NR/4 page 109 action that are globally at the cutting edge. Our populations may be small but the variety of our experiences and the aggregate of our data and experiences are proving to be an invaluable resource to public health progress. Finally, on behalf of the Pacific island countries, I would like to express our sincere thanks and acknowledgement of our regional and global partners, who have rendered invaluable assistance to our health efforts. Thank you for your attention.

Dr SAD AS IV AN (Singapore):

Mr President, honourable ministers, distinguished delegates, ladies and gentlemen, I would first like to congratulate you, Mr President, and your colleagues on your election to your posts. We are very glad that the Fifty-eighth World Health Assembly has taken the theme "Make every mother and child count". This has been Singapore's philosophy since our independence 40 years ago. We are a small island nation that has benefited tremendously from subscribing to this philosophy. We understand the challenges developing countries face. At the time of our independence, we were a developing country with a limited budget for health care. Population growth rates were high; in fact, the KK Maternity Hospital in Singapore set a record in 1966 with 39 835 deliveries, which earned it a place in the Guinness book of records for 10 years as the hospital with the highest number of deliveries in a year. In 1965, the Government was acutely aware that the country had to make do with precious few natural resources. Our only abundant resource was our people; we had to invest in human capital if our fledgling nation was going to survive. Priorities had to be set and maternal and child health was accorded a top priority in the belief that healthy mothers bring up healthy children. Singapore set up a nationwide primary health-care system that was both accessible and affordable; a national childhood immunization programme was introduced to protect children against nine important infectious diseases; health screening, growth and development screening, dental care, immunization and health promotion were also delivered universally to students through school-based services. Singapore is a multi-racial society comprised mainly of Chinese, Malays and Indians, so linguistic, cultural and religious barriers to access had to be overcome by building trust in the community. This effort involved health education campaigns and community outreach visits by primary health care workers. Resistance to vaccination and western medication had to be overcome bit by bit. These efforts have made a difference: our maternal mortality ratio fell from 45 per 100 000 in 1960 to 5 per 100 000 in 2004; the infant mortality rate likewise declined from 35 per 1000 live births in 1960 to 1.9 per 1000 live births in 2004. This is one of the lowest rates in the world. Singapore has experienced the benefits of a policy that strongly supports maternal and child health and so we strongly support WHO's efforts towards giving mothers, babies and children the care that they deserve. In order to make a difference, we must join forces in making maternal and child health care a top priority. We must bring all stakeholders together with solutions that work. This will make the difference that counts. Thank you.

Dr VIT (Czech Republic):

Mr President, ladies and gentlemen, allow me, first of all, to align myself with the statement made by the presidency of the European Union. We all know that, in many countries, universal access to the health care to which all women and children are entitled is far from a reality. Ten million children and half a million mothers die every year, mostly from avoidable causes. We have to recognize the importance of improving the health of mothers and children for the future of our world. Women and children are often excluded from health care, particularly due to social inequity, which is the key constraint to progress. The low status of women, gender-based violence and marginalization have to be tackled by social, political and legal means. However, social inequity is not the only problem; humanitarian crises, poverty and the HIV I AIDS epidemic are also factors that should be recalled. There is a need to improve health programmes for pregnancy and childbirth as well as childhood, and to strengthen health systems: every woman has the right to access skilled and responsive care, at and after birth. We need also to develop effective ways of organizing continuity of care during the first weeks after birth for women and their babies; and we need to develop programmes to tackle vaccine-preventable diseases. A58NR/4 page 110

I am happy to be able to say that the Czech Republic pays particular attention to mother and child care. A programme of immunization based on the vaccination calendar has been established in line with WHO standards. Through vaccination, it has been possible almost to eliminate diphtheria, infectious poliomyelitis, and measles in the Czech Republic and to reduce significantly the morbidity due to whooping cough, tetanus and other diseases. Consistent and coordinated efforts in the field of perinatal care have contributed to a significant decrease in newborn mortality, especially within the first six days. The Czech Republic also has a long tradition of preventive child care that starts as early as the antenatal or perinatal period and is provided in cooperation with obstetricians, geneticists and paediatricians. The Czech Republic has achieved very good results in the provision of health services to mothers and children and is prepared improve these results further and promote them not only within the framework of international cooperation but also within the framework ofhumanitarian aid. Individual countries as well as the international community will need to focus further on ensuring the highest level of health to mothers and children. The future health of our societies depends on it. Thank you for your attention.

The meeting rose at 18:10. La seance est levee a 18h10. A58/VR/5 page 111

FIFTH PLENARY MEETING

Wednesday, 18 May 2005, at 09:15

President: Ms E. SALGADO (Spain)

CINQUIEME SEANCE PLENIERE

Mercredi 18 mai 2005, 9h15

President: Mme E. SALGADO (Espagne)

1. FIRST REPORT OF THE COMMITTEE ON CREDENTIALS1 PREMIER RAPPORT DE LA COMMISSION DE VERIFICATION DES POUVOIRS1

La PRESIDENT A:

Se abre la sesion. Examinaremos el primer informe de la Comision de Credenciales, que se reunio ayer bajo la presidencia del Dr. Kienene de Kiribati. El informe figura en el documento A58/50 que se les ha entregado a ustedes. (,Desea la Asamblea formular alguna observacion sobre el informe? No hay observaciones. (,Desea la Asamblea aprobar el informe? Puesto que no hay ninguna objecion, se aprueba el informe. Ademas de este informe, la Secretaria me ha comunicado que desde la reunion de ayer se ban recibido las credenciales oficiales de Brunei Darussalam, Iraq, Panama, Sierra Leona y el Uruguay, es decir, Ios Estados Miembros que habian presentado credenciales provisionales, como se indica en el informe de la Comision. No ha sido posible convocar a la Mesa para que las examinara pero, conforme con la practica habitual de esta Asamblea, he examinado las credenciales oficiales de Ios cinco Estados Miembros y he constatado que cumplen con el Reglamento Interior. Por lo tanto, recomendaria a la Asamblea que aceptara como oficiales las credenciales presentadas por Brunei Darussalam, Iraq, Panama, Sierra Leona y el Uruguay. (.Esta de acuerdo la Asamblea con la propuesta de que se aprueben las credenciales? Puesto que no hay objeciones, queda decidido. La Comision A no ha podido terminar todavia sus trabajos sobre el subpunto 13.1 «Revision del Reglamento Sanitario Internacional» a pesar de todos Ios esfuerzos dedicados hasta ahora. Por consiguiente, no podremos examinar su informe dentro del punto 8 del orden del dia. La resolucion que se examinara dentro del subpunto 13.1 figurara en un informe posterior de la Comision A, que les anunciaremos oportunamente.

1 See reports of committees m document WHA58/2005/REC/3. 1 Voir les rapports des commissions dans le document WHA58/2005/REC/3. A58NR15 page 112

Quiero anunciarles que la Comisi6n A va a celebrar su tercera sesi6n en la sala XVIII. Por lo tanto, reanudamos ahora el debate sobre el punto 3.

2. ADDRESS BY THE DIRECTOR-GENERAL (continued) ALLOCUTION DU DIRECTEUR GENERAL (suite)

Los dos primeros oradores de mi lista son Belarus y Finlandia. Invito a Belarus y Finlandia a subir a la tribuna; la delegada de Belarus tiene la palabra.

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Ms HYSSALA (Finland):

Let me start by congratulating you, Madam President, on your election and by wishing you every success in your challenging task. I also want to emphasize that Finland associates itself with the European Union statement. Finland also wishes to thank the Director-General for The world health report 2005, which provides topical information on mothers', newborns' and children's health and on access to care for families. The majority of maternal and perinatal deaths are preventable. Five years ago, the United Nations set its Millennium Development Goals. Six of the eight Goals concern mothers' and children's health, including reducing poverty, enabling access to education and promoting gender equality. Ill-health is both a determinant and a consequence of poverty. It weakens the ability to work and reduces productivity and income. Poor people seldom have access to health-care services and they do not have enough knowledge and resources to improve the income and welfare of their families. In most cases, a high number of children in a family puts a strain on the family and weakens its standard of living. A high fertility rate is a factor that increases poverty; and gender inequality is a factor that maintains poverty. The health of poor women is often weaker than that of poor men. These women are less educated and have fewer opportunities to take part in societal decision-making. They are often victims of sexual violence and/or abuse, and this in turn, exposes them to venereal diseases, unwanted pregnancies, and HIV/AIDS. Lack of care during pregnancy and childbirth also often causes women long-term and/or permanent damage that reduces the well-being of the family. High-quality and accessible sexual and reproductive health services within primary health care are still one of the most effective ways of improving the health of women and girls and thus maternity and child health. In meeting the requirements of the Millennium Development Goals, the role of national policies cannot be overlooked. Each and every country has a primary responsibility for its own development, and expertise on its own development needs; that is why the implementation of the health-related Millennium Development Goals is our prime responsibility as ministers of health. Finland believes that WHO has to play its role in achieving the Millenium Development Goals, by providing the Member States with concrete policy advice. I welcome WHO's initiatives focusing on countries where maternal and perinatal mortality rates are high. It is my pleasure to bring to this Health Assembly greetings from the global Network of Women Ministers of Health. As Chair of the Network, I should like to read a sentence from the statement agreed upon by the Network yesterday: In order to address the persistent inequalities women experience in obtaining the best possible health, we call upon the international public health community, in particular WHO and its Member States, to redouble their efforts to address gender inequalities in developing health policies and programmes. A58NR/5 page 114

Mme NEBOUT ADJOBI (Cote d'Ivoire):

Madame la Presidente de la Cinquante-Huitieme Assemblee mondiale de la Sante, Mesdames et Messieurs les Ministres de la Sante etchers delegues, Monsieur le Directeur general de !'Organisation mondiale de la Sante, Mesdames et Messieurs, avant tout propos, qu'il me soit perrnis de vous feliciter, Madame la Presidente, pour votre brillante election ainsi que tous les membres du Bureau de la Cinquante-Huitieme Assemblee mondiale de la Sante. Je voudrais rendre un hommage appuye a M. Muhammad Nasir Khan du Pakistan qui a dirige avec beaucoup de dexterite les travaux de la Cinquante-Septieme Assemblee mondiale de la Sante. Je voudrais egalement adresser mes felicitations et exprimer toute ma gratitude au Directeur general de !'Organisation mondiale de la Sante pour les appuis considerables dont a beneficie la Cote d'lvoire. Comme aux sessions precedentes en 2003 et 2004, je me fais le devoir d'exprimer enfin mes remerciements les plus chaleureux aux pays amis et aux organisations intemationales pour leur assistance a la Cote d'Ivoire qui connait une crise sans precedent depuis pres de trois ans. Grace a leurs interventions, aussi efficaces que variees, mon pays fait face aux problemes qui l'assaillent. Et c'est peu dire ! La Cote d'Ivoire, qui vit les consequences et les effets collateraux d'un pays en conflit, se rejouit de ce que l'OMS ait retenu comme theme pour cette Cinquante-Huitieme Assemblee mondiale de la Sante, la sante de la mere et de I' enfant. En effet, nul n'ignore que cette frange de la population est la plus fragilisee lors des crises politico-socio-economiques comme celles que traverse mon pays. Ces crises exposent les femmes et les enfants aux sevices sexuels avec tous les risques connus tels que la contamination par le VIR. De nombreux enfants ne peuvent plus beneficier de la vaccination de routine, ce qui les rend fortement vulnerables face aux maladies a potentiel epidemique. Le taux de mortalite matemelle, qui etait de 597 deces matemels pour 100 000 naissances en 1994 est aujourd'hui de 800 deces matemels pour 100 000 naissances. Le taux de mortalite infantile, qui etait deja de 112 deces d'enfants de mains d'un an pour 1000 naissances en 2002, a empire du fait de la crise que traverse la Cote d'Ivoire. Trente pour cent seulement, soit le tiers des structures sanitaires de l'Etat, peuvent pratiquer la planification familiale. Enfin, la couverture en soins obstetricaux d'urgence est de 42 % en Cote d'Ivoire. Depuis le 19 septembre 2002, la Cote d'lvoire, du fait de la crise militaro-politique, est coupee en deux parties separees par une zone de confiance. Cette partition du pays a entraine une repartition inegale de 1'Administration generale et sanitaire sur 1'ensemble du territoire national. Par ailleurs, on constate des problemes sanitaires graves, notamment la non-fonctionnalite d'un nombre eleve de districts sanitaires tenus par des benevoles a defaut de la presence d' organisations intemationales non gouvemementales. Cette non-fonctionnalite est en rapport avec le deplacement des populations et des personnels de sante, l'absence des moyens logistiques, la ferrneture des infrastructures sanitaires, la difficulte de mettre en oeuvre certains programmes de sante, dont le programme de vaccination, et la mauvaise surveillance des maladies a potentiel epidemique. Tout ceci a pour consequences majeures d'accroitre l'inaccessibilite des populations aux soins, la recrudescence de certaines affections (VIH/SIDA, tuberculose, poliomyelite, paludisme et ulcere de Buruli) et des epidemies de rougeole, de fievre jaune, d'infections respiratoires aigues et de maladies diarrheiques. Ace niveau de mon propos, je voudrais remercier le Fonds mondial et le Fonds americain pour l'appui qu'ils ont accorde a mon pays lui perrnettant ainsi de poursuivre efficacement la lutte contre le VIH/SIDA et la tuberculose. La Cote d'lvoire, qui est le seul pays en Afrique de l'Ouest a n'avoir pas encore beneficie de !'assistance du Fonds mondial dans le domaine de la lutte contre le paludisme, espere en l'acceptation de sa proposition a 1' occasion du prochain round. J' exprime a us si la reconnaissance de mon pays aux responsables et aux acteurs de toutes les organisations non gouvemementales intemationales qui agissent, parfois au peril de leur vie, pour eviter une catastrophe humanitaire a la Cote d'Ivoire. Je voudrais toutefois exprimer la necessite d'une coordination plus accrue des activites des organisations non gouvemementales et d'une mobilisation exceptionnelle des ressources destinees aux interventions humanitaires en periode de conflit. Je n'oublie pas les cooperations bilaterales et multilaterales pour leur soutien sans faille. La Cote d'lvoire fonde un grand espoir sur cette Cinquante-Huitieme Assemblee mondiale de la Sante dont les themes se rapportent directement a la situation qu'elle connait. Je vous remercie. A58NR/5 page 115

El Dr. LAMATA COTANDA (Espana):

Senora Presidenta, senor Director General, senoras y senores delegados: Race 400 anos, Cervantes, por boca de Don Quijote, decia que «no hay cosa que m

El Dr. COSENTINO (Peru):

Senora Presidenta, distinguidos miembros de la Asamblea: Quisiera en primer lugar y en nombre de la delegacion del Peru, facilitar a usted y a Ios distinguidos miembros de la Mesa que la acompanan por su eleccion para dirigir Ios trabajos de la presente Asamblea. Asimismo felicitar al Ministro del Pakistan por el importante trabajo realizado durante el ano pasado, y por supuesto, por su intermedio, senora Presidenta, el reconocimiento al Director General por su reconocido liderazgo en las importantes iniciativas que ha fomentado. Senora Presidenta: No cabe duda que la salud constituye una de las prioridades mas importantes de la agenda global del desarrollo, de conformidad con lo establecido en la Declaracion del Milenio y los ocho Objetivos de Desarrollo del Milenio, tres de ellos directamente relacionados con la salud, y de ellos, dos con la salud de la madre y del nino. Lograrlos significa un desafio pendiente para el mundo y en especial para Ios paises en vias de desarrollo como el Peru, donde las brechas e inequidades sociales impiden que Ios logros y avances que hemos alcanzado en estos ultimos anos, sobre todo en indicadores de salud maternoinfantil sean homogeneos en todo nuestro territorio. Creemos que en el Peru se ban obtenido algunos avances importantes en estos temas y que estamos en la senda correcta. Contamos, por ejemplo, con un Seguro Integral de Salud que financia atenciones de la madres y ninos de Ios sectores mas pobres y que desde que se implemento a la fecha ha logrado afiliar a mas de nueve millones de personas. Sin embargo, en nuestro caso, la barrera economica no ha sido el unico obstaculo que hemos tenido que enfrentar. Quizas mas dificil es la barrera cultural que existe entre los que brindamos servicios de salud y la poblacion mas pobre y excluida. AI respecto, hemos fortalecido campanas de salud preventivo-promocionales e implementado condiciones para que el trabajo de parto de las mujeres peruanas se realice respetando sus costumbres y su cultura, pero asistidas por personal de salud, de modo que el parto sea seguro. Parte de esta estrategia ha consistido en la implementacion de Casas de Espera que permiten que las mujeres gestantes en las ultimas semanas permanezcan en un ambiente contiguo al servicio de salud, hasta que llegue e1 momento del parto, y puedan ser atendidas por personal capacitado y en mejores condiciones, tanto para la madre como para el recien nacido. Quizas por ello los reportes preliminares de las Encuestas Nacionales han mostrado que la mortalidad infantil se ha reducido en un 30% en Ios ultimos cinco anos y que los partos institucionales se incrementen de manera sostenida, lo cual impacta, evidentemente, en una importante reduccion de la morbi-mortalidad materna. Senora Presidenta: Lo anterior implica un esfuerzo conjunto de toda nuestra region de las Americas, pues aun se requieren mayores acciones. Sin embargo, los recursos necesarios para lograrlo son siempre escasos. Por eso exhortamos a que se cumpla con los acuerdos de la Conferencia Intemacional para el Financiamiento del Desarrollo llevado a cabo en Monterrey, donde se exhorto a los paises mas desarrollados a duplicar los recursos destinados a la asistencia oficial para el desarrollo yen especial aquellos destinados a cumplir con los Objetivos del Milenio. Solo una accion conjunta permitira logros sostenidos en la mejora de las condiciones de vida de la poblacion y de su estado de salud. La salud es un derecho basico y fundamental, y por tanto una responsabilidad de todos. Cada muerte materna o infantil que ocurra es un llamado de atencion a nuestras conciencias. La globalizacion no solo debe expresarse en un mayor intercambio de capitales, bienes y servicios sino en una responsabilidad compartida de los males publicos globales como son la pobreza, la contaminaci6n ambiental, las epidemias, etc. Los paises en vias de desarrollo no pueden financiar solos la soluci6n de estos males publicos, que son globales y que determinan en gran medida la situaci6n de salud de nuestra poblaci6n. Basta recordar que la magnitud de recursos destinados a financiar las guerras en el mundo y las medidas de seguridad de los paises mas desarrollados superan con creces aquellos recursos destinados a la asistencia oficial para el desarrollo para lograr los Objetivos del Milenio. Por ello, en este foro y con el compromiso de la Organizaci6n Mundial de la Salud, estamos obligados a proponer medidas concretas de cooperaci6n para poder asi salvar los obstaculos que con esfuerzos conjuntos pueden y deben ser resueltos para el beneficia de la poblaci6n mundial. Muchas gracias. A58NR/5 page 117

Mr DEV ACOT A (Nepal):

Madam President, Director-General, your excellencies, distinguished delegates, ladies and gentlemen. At the outset, let me, on behalf of my delegation and on my own behalf, congratulate you, Madam President, on your well-deserved election; I congratulate other office-bearers as well. We repose our full trust and confidence in you, Madam President, and in your colleagues, and remain confident that you will guide the deliberations of this Health Assembly to a successful conclusion. May I also take this opportunity to record our sincere appreciation to President Maumoon Abdul Gayoom of the Republic of Maldives, and to Mr Bill Gates for their insightful and inspiring speeches. Whether it be in the preventive, curative or promotive aspects of health-related issues, or in the development of standards, norms or best practices, WHO has always been there to advocate for us, to guide us and to help us. WHO's achievements in the past six decades have certainly been remarkable; yet for all that, the challenges ahead are no less forbidding. In Dr Lee Jong-wook we have a Director­ General who is as dynamic and committed as he is insightful. We wish him every success in his efforts to make WHO more responsive to the challenges in the area of global public health. Despite the severe constraints under which we initiated our march towards socioeconomic development, I am pleased to share with this distinguished gathering news that some of our achievements in the health sector have been highly encouraging. For example, life expectancy has significantly improved, and so have total fertility rates and contraceptive prevalence rates. We have been working towards the eradication of poliomyelitis through immunization, and the Vitamin A distribution programme has been exemplary in its success. Despite some limited successes, our efforts to reduce maternal mortality and improve neonatal and child health have not borne the desired results as yet. With a view to improving access to quality essential health-care services, particularly for poor and vulnerable groups, we have embarked upon implementation of the health sector reform programme 2004-2009 from this year. The major thrusts of the programme, if I may add, are reducing maternal mortality, encouraging family planning practices and improving child health. We have already taken a number of measures specifically designed to address some of the major causes of maternal mortality, and we remain firm in our belief that these measures will reduce the mortality rate among mothers significantly and within a short period of time. The present Government in Nepal has been constituted to restore peace and stability and provide effective governance. As such, ensuring quality health services to all remains one of the major priorities of the Government. In line with this commitment we recently completed our immunization campaign against measles with success and we will continue to focus our efforts on all public health issues, especially those relating to increasing access and enhancing quality of services. Similarly, our commitment to the Millennium Development Goals remains unwavering; in order to attain them within the stipulated time frame, however, our national efforts need to be substantially complemented by international cooperation. The globalized world of today requires a cooperative endeavour of the highest order among nations and international institutions. Such cooperation should be based on unity of purpose, a high level of commitment and a profound sense of solidarity; all the more so as public health challenges become ever more complex and daunting in countries with limited resources and capabilities. When faced with challenges, WHO has done well in the past. As we all share a common destiny, we are confident that this Health Assembly will rise to the occasion once again and guide the Organization to bring about a perceptible change in the lives of millions of needy people around the world. They deserve better and they should not be disappointed. We have the means and capacity to do so; we need to summon the necessary will and channel our efforts towards these ends. To conclude, Madam President, yes, Nepal fully shares the vision of making every mother and child count; but this can only be turned into reality if all of us try to outgrow our prejudices and preferences, our inhibitions and our indifference, and join hands with a sincerity of purpose. Thank you, Madam President, for your kind indulgence. A58NR/5 page 118

Mr DE SILV A (Sri Lanka):

Madam President, let me congratulate you and the Vice-Presidents most sincerely on your election to this prestigious Health Assembly. Madam President, Director-General, distinguished colleagues, 2005 was a year of unprecedented challenges for the Ministry of Health in Sri Lanka owing to the tsunami that struck on 26 December - the worst natural disaster that has struck our country in recent history. The tragic consequences of the tsunami on Sri Lanka destroyed over 75% of the island's coastline, taking around 38 000 lives and displacing nearly a million people. The health sector as a whole was put under immense pressure; we lost 89 medical institutions, including a large maternity hospital. Responding swiftly, the Government of Sri Lanka joined forces with both local and international agencies to ensure that the best solutions were found quickly for the immediate problems created. This is the opportune moment for me to place on record the invaluable support we received from WHO, the Director-General, our Regional Director, other United Nations and donor agencies, and governments. I wish to express my sincere gratitude to all of these for the prompt response shown at a time of grief. With their assistance the Government and people of Sri Lanka have undertaken the difficult task of rebuilding the infrastructure and health services of affected areas. We are proud and happy to emphasize that we were able to contain and control the occurrence of the communicable diseases usually seen after a disaster of this nature and were able to recover without much delay, as we already had a vibrant health system in place. Madam President, you are aware that Sri Lanka has recorded impressive achievements in the health sector, with relatively low levels of public expenditure on health, as a result of free education and free health services afforded to its people. Current life expectancy is 73 years, compared with the regional average of around 60 years. Infant mortality is around 12.2 per 100 000 live births and fertility is near replacement level. The population growth rate is around 1.2%, and the maternal mortality rate, at 56 deaths per 100 000 live births, is well below that of countries with similar levels of per capita income. However, we have major challenges ahead of us in the aftermath of the tsunami disaster. The current year's WHO theme, "Make every mother and child count", has already been adopted and put into effect by Sri Lanka in its national programmes. Maternity leave has been increased, breastfeeding breaks have been introduced, and day-care centres in workplaces have been established. A national child protection authority has been established to ensure children's rights and to protect them from child abuse. Sri Lanka is classified as a low-prevalence country for HIV and AIDS, but many of the risk factors already exist in our country, which could bring about an epidemic. Therefore we cannot be complacent; we have to take precautions to prevent a possible spread and to mitigate the effects on those who are already HIV -positive. My Government has launched a vibrant awareness programme coupled with improved service delivery, including free antiretroviral treatment to all those infected. Sri Lanka is a country that has seen the adverse effects of the health sector "brain drain", and we still witness many of our talented, best-qualified doctors and nurses taking wing to the developed world. I would like to propose to this august Health Assembly that we develop collectively a set of guiding principles for the management of migration of health personnel and the introduction of compensatory payments for developing countries. Director-General, I would recommend this for your kind consideration as a useful and practical project for next year's WHO theme of human resources development. After a long and protracted conflict we are now enjoying a period of tranquility in Sri Lanka, and the Government has taken this opportunity to further strengthen health facilities in the conflict-affected areas. In conclusion, let me state that my Government and the people of Sri Lanka are committed to ensuring that we maintain our impressive health achievements despite the tsunami disaster, and continue our progress towards achieving the Millennium Development Goals. Thank you. A58NR/5 page 119

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El Dr. GARCIA (Chile):

Senora Presidenta, senoras m1mstras y senores ministros, senoras delegadas y senores delegados: Me es muy grato poder asistir a esta reunion. Senora Presidenta, me es grato extender mis felicitaciones por su eleccion como Presidenta de nuestra Asamblea y desearle los mayores exitos bajo su experimentada conduccion. Senora Presidenta: Desde la creacion del Servicio Nacional de Salud en 1952, Chile viene enfrentando el desafio de dar mejor salud a su poblacion en forma organizada y como una prioridad nacional. La decada de los sesenta y principios de los setenta, se enfocaron a una exitosa expansion de cobertura nacional y al desarrollo de programas de atencion matemoinfantil que impactaron positivamente en la mortalidad de la madre y el niiio. En Ios ochenta el sistema de salud chileno vio estancado su desarrollo, en un periodo coincidente con la ruptura de la democracia en mi pais A partir de la llegada de la democracia a Chile, a comienzos de Ios noventa, se retorno la exitosa tradicion de salud publica del pais. Se reforzo y revitalizo el sistema publico, fuertemente debilitado en la decada anterior, y se establecio una mayor regulacion de Ios seguros privados de salud, con el objetivo de mejorar su eficiencia y equidad. Senora Presidenta: Los gobiemos democniticos en mi pais ban tornado un fuerte compromiso con el desarrollo de la salud publica, expresado en un fuerte apoyo al proceso de reforma del sector salud. En los noventa se ejecuto un singular esfuerzo tecnico y financiero para rehabilitar el sistema de salud publico. En forma mas importante aun a partir del aiio 2000, bajo el Gobiemo del Presidente Ricardo Lagos, se ha promovido y concluido recientemente, el mas amplio proceso de reforma del sector salud en Ios ultimos 50 alios de historia en mi pais, que ha sido aprobado definitivamente por una amplia mayoria politica y ciudadana, asegurando su viabilidad futura como politica de Estado. Este proceso de reforma se hacia imperativo, dado Ios avances sanitarios resultado de politicas publicas mantenidas por aiios, pese a las diversas visiones de la sociedad, lo que ha producido una transicion demografica y epidemiologica de creciente magnitud. Programas de vacunaci6n masiva y de alimentacion complementaria, acceso amplio a agua potable, manejo de residuos solidos, y sobre todo acceso universal a programas matemoinfantiles, ban cambiado el perfil de salud de Chile y han obligado a redefinir objetivos sanitarios y por ende la organizacion de todo el sistema de salud. Los exitosos resultados de mortalidad materna e infantil alcanzados por Chile se contraponen a una fuerte irrupcion de daiios producto de enfermedades cronicas como la hipertension arterial, A58NR/5 page 122 diabetes y cancer. Tambien impactan fuertemente aquellas enfermedades producto de cambios en los estilos de vida, como accidentes y violencias, obesidad y trastomos de salud mental. Este tipo de enfermedades agravan potenciales y reales inequidades que deben ser resueltas. He aqui algunos de nuestros actuales desafios. Senora Presidenta: Bajo los principios de una mayor equidad, eficiencia y respeto de los derechos de las personas se ban promovido un conjunto de iniciativas legales y financieras orientadas a mejorar sustantivamente el desempeno y resultados dd sistema de salud chileno. La nueva Ley de Autoridad Sanitaria cambio la organizacion del sector salud, introduciendo una efectiva separacion de funciones de regulacion sanitaria, financiamiento y provision de servicios de salud. Las nuevas autoridades sanitarias regionales de salud, tanto publicas como privadas, siendo los 28 servicios de salud los responsables de ejecutar las politicas de salud a ese nivel. Nuevos hospitales autogestionados en red tendnin una gestion mas flexible, que permitira una mayor eficiencia en su accionar. A su vez, la atencion primaria con poblacion asignada, financiamiento capitado, y basada en el modelo de salud familiar, se ha constituido en la herramienta basica de la reforma para incorporar mayor eficiencia y equidad en este nivel. Senora Presidenta: Chile ha tornado una decision trascendental en su reforma, al reconocer los derechos de salud de mis compatriotas como nunca antes se habia hecho. Al establecer un regimen de garantias en salud, bajo la denominacion de AUGE, con el caracter de ley que reconoce a todos los chilenos igual derecho de acceso a la salud en terminos de oportunidad, calidad de servicios y proteccion financiera, tanto en el sistema publico como privado, estamos comprometiendo nuestro mayor esfuerzo como pais en este sentido. De esta forma, cualquier chileno independientemente de su genero, ingreso, seguro de salud, o lugar de residencia podra exigir una atencion ajustada a protocolos de atencion sustentados en evidencia cientifica y a niveles conocidos de proteccion financiera como nunca antes. Para esto se ban seleccionado las patologias que representan una mayor carga de enfermedad para el pais. Especial enfasis se ha dado a la condicion de salud de las mujeres y los ninos. Se ha priorizado, entre otros, los canceres de mama y cervicouterino, el manejo integral de la prematurez, de las malformaciones congenitas como la fisura palatina y las cardiopatias congenitas, ademas del tratamiento del VIH/SIDA con triterapia para todos los enfermos. Tambien hemos comprometido nuestros esfuerzos en una mejor regulacion de los seguros publico y privados, aplicando el AUGE de manera integral a sus beneficiarios y creando una nueva entidad reguladora, la Superintendencia de Salud, que bajo principios de calidad y equidad asegurara los derechos de los chilenos. Nada de esto seria posible sin el aprendizaje y los conocimientos que Chile ha alcanzado como pais en vias de desarrollo en la aplicacion de politicas sociales. Por esta razon hemos comprometido fuertemente nuestra participacion como pais en la Comision sobre Determinantes Sociales de Salud, recientemente lanzada por la Organizacion Mundial de la Salud en Santiago de Chile, como una forma de compartir los logros y experiencias del pais en esta materia, asi como para aprender de otros en el hermoso desafio de lograr mas y mejor salud para nuestros paises. Sobre el particular, vayan nuestras felicitaciones y apoyo a nuestro Director General, el Dr. Lee y su equipo, por esta valiosa y trascendente iniciativa. Solo mediante la cooperacion, colaboracion y coordinacion entre los distintos paises aqui presentes podremos dar cuenta de los desafios sanitarios que enfrentamos, y para poder aprender de nuestros aciertos y desaciertos. Chile esta desde ya disponible para esta importante tarea. Muchas gracias.

El Dr. KONTOROVSKY (Nicaragua):

Senora Presidenta: En mi delegacion, nos sentimos honrados de su bien merecida eleccion; somos conocedores de su trayectoria, de su capacidad profesional y especialmente de su calidad humanitaria. Honorables senoras y senores: Quiero dejar patente el reconocimiento de mi delegacion por e1 extraordinario trabajo realizado en la revision del Reglamento Sanitario lntemacional, dirigido magistralmente por la Presidenta Embajadora Wheelan. Asimismo, quiero expresar mi esperanza de A58NR/5 page 123 que esta maxima Organizaci6n Mundial de la Salud conserve y refuerce su espiritu humanitario, que es la esencia y raz6n de ser de ella misma; se desprende por tanto que el mas grande y substancial objetivo es la salud de todos los habitantes de la tierra y entonces podemos deducir que la implementaci6n de la universalidad de todos los articulos del RSI en beneficio de la ya mencionada humanidad, entendida esta como el conjunto de todas las personas, de todos los paises, de todos los territorios, de todos los entes, de todas la etnias y grupos de poblaci6n. Si la OMS no actua en concordancia y coherencia con su enunciado de Organizaci6n Mundial de la Salud, estaria permitiendo el regreso al pasado, a la epoca de Torquemada y por tanto estariamos creando nuevos «apartheid en salud», nuevos guetos en salud y por que no decirlo, estariamos condenando a territorios y grupos de personas a un nuevo holocausto en salud y esta vez con mayor alevosia. Esta 58a Asamblea Mundial de la Salud [sic] tiene como lema central «Cada madre y cada nino contaran». Quiero recordar que tanto en mi pais, Nicaragua, como en los paises de Centroamerica y demas paises en desarrollo, el objetivo principal de las politicas de salud esta alrededor de la disminuci6n de la mortalidad materna, perinatal e infantil; diferentes y variadas estrategias, diversos e intensos esfuerzos de recursos humanos y econ6micos se hacen para lograrlo. Pero, senora Presidenta, hay una magna ironia, cuando sabemos que hay madres y ninos que no cuentan. Porque nos preguntamos (.En d6nde cuentan las madres y ninos de la Republica de Taiwan? (.D6nde estan los derechos humanos de las madres y ninos de Taiwan? Senora Presidenta: Considero que nuestra Organizaci6n debe excluir los intereses econ6micos y politicos y quedarnos con la sinceridad y transparencia altruista unicamente con el tema de la salud, que incluya las nuevas agresiones individuales y colectivas, sus causas, sus origenes y sus efectos directos e indirectos. Quisiera hacer un llamado a la reflexi6n a todos nuestros hermanos de la OMS: «Juntemonos en un solo coraz6n alrededor de la salud incluyendo a todos los seres humanos sin distingo de ideologias politicas, religiosas, o de estrato social, etnografico, territorial o grupal». Senora Presidenta: Quiero manifestar nuestra solidaridad con todo aquel pais o territorio, rico o pobre, grande o pequeno, indefenso o protegido, a fin de que toda enfermedad que perturbe su tranquilidad, detenga su desarrollo econ6mico y diezme su poblaci6n, ya sea por el VIH/SIDA, malaria, SRAS, tuberculosis, dengue, c6lera, efectos de emanaciones radionucleares, quimicas o biol6gicos, etc. para que prevalezca sobre todo derecho, por muy internacional que sea, el derecho mas inherente a la libertad, al desarrollo, a la paz, a la felicidad, como es el derecho humano, porque ahi esta implicito el derecho a la vida; don de Dios para la humanidad. Que Dios nos bendiga a todos y a la Organizaci6n Mundial de la Salud. Muchas gracias.

Mr KIRA TA (Kiribati):

Madam President, your excellencies, m1msters and heads of delegations, Director-General, distinguished ladies and gentlemen, kam na bane ni mauri! Madam President, first I would like to congratulate you on your election. You have my full support and my delegation has every confidence in your ability to steer this meeting to a fruitful and successful conclusion. I thank the Director­ General for his comprehensive address, which touched on a number of key health issues that are relevant both at the global and national levels. The clear message that the Director-General projected to us on WHO/UNICEF partnership is encouraging, and should prepare us to revisit mother and child health issues in a better light and with a view to a brighter future. This ties in well with this year's health theme, "Make every mother and child count". The message also alluded to the fact that while we are in the midst of increasing health problems from noncommunicable diseases, the global picture tells us that we simply cannot leave communicable diseases behind, let alone forget about them completely. We are forever being reminded of the lurking danger and the potential for devastation that rapidly spreading disease could bring to our community and to global health. The work of the Intergovernmental Working Group on Revision of the International Health Regulations is commendable. We should offer our thanks to the Director-General, the Secretariat and the Chair of the Working Group, and to those Member States that have been actively involved and that have worked very hard. The revision of the International Health Regulations comes at an appropriate time, especially when new and re-emerging diseases are posing new threats that are evidently more challenging to public health. I am referring here to severe acute respiratory syndrome and to the more A58NRJ5 page 124 recent outbreak of avian influenza in a number of countries in the Asian region. From what we have heard, the avian influenza virus has the potential to develop into strains that are far more sinister, destructive and deadly. However, the Director-General pointed out in his speech yesterday that we are now in a better position and more prepared than ever before to deal with this challenge. But how do we deal with it? The spread of communicable diseases has a way of its own that has no regard and no respect for borders and boundaries. As such, concerted global efforts must be in place to deal successfully with these public health problems. As the Director-General quite correctly stated in his address at the last Health Assembly, we cannot afford any gaps in our global efforts and our response network. Having said that, the principle of universality in implementation of the International Health Regulations naturally must come next. For the successful application of the International Health Regulations, all Member States and territories must be considered part of this universality. No one must be left behind if we are to leave no gaps, and the entire international community must move forward as one. Even though the International Health Regulations are still being discussed in Committee A, and are yet to be presented to this plenary, the proposed resolution as it now stands urges Member States to take all appropriate actions to facilitate its universal application. It further requests WHO to continue to provide international leadership in the area of alert and response to public health events, including the timely dissemination of information to the international community. And it is within the context of that universality and international community that countries like Taiwan and other territories with sole authority over their health services should be given the opportunity to contribute to global health surveillance according to these revised International Health Regulations. Each Member State, each territory and each entity has either a role to play or a benefit to derive from that participation, and must not be denied that opportunity. WHO's core function is to promote health in the context of universality. I reiterate my delegation's support for universality as a medium for the successful implementation of the revised International Health Regulations or of any WHO-sponsored health initiative. Thank you for this opportunity. I foresee many positive results of this meeting under your able stewardship. Thank you, Madam President.

Professor LAMBO (Nigeria):

Madam President, I wish to congratulate you most sincerely on your election as the President of the Fifty-eighth World Health Assembly. I also wish to congratulate the Director-General for hosting this year's Health Assembly. Fellow ministers, ladies and gentlemen, I bring you warm greetings from Chief Olusegun Obasanjo the President of the Federal Republic of Nigeria and the Chairman of the African Union. I am pleased to inform the Health Assembly that Nigeria hosted a High-Level Forum on the Health Millennium Development Goals on 2 and 3 December 2004 in Abuja. We believe the outcome of the meeting will significantly sensitize all stakeholders to further provide the necessary support for attaining the Millennium Development Goals. My country has also developed a strategic plan for accelerating the achievement of the health-related Millennium Development Goals and we have also costed it. The document has been presented to our partners and stakeholders for support, especially in areas where there are resource gaps. We trust that WHO will continue to take the lead in providing the necessary support for the implementation of the health-related Millennium Development Goals strategic plan in my country. This year's theme of "Make every mother and child count" is apt for Nigeria, bearing in mind our unacceptably high matemal, neonatal and child mortality and morbidity. We acknowledge the contributions of WHO in the area of maternal and child health in Nigeria, through many demonstrable evidence-based interventions, for example the integrated management of childhood illness and making pregnancy safer. A great challenge that we have, is to scale up these interventions within the currently available, weak national health system. Our experience has shown that without strengthening the health system, any attempt to alleviate the health problems of our children and women through the implementation of already known cost-effective interventions will only amount to a half measure. The operations undertaken on cost in order to make pregnancy safer at district level in Nigeria have already indicated the amount of resources that will be needed to implement cost-effective interventions. In A58NR/5 page 125 addressing the challenge of financing, we are introducing a national health insurance scheme to incorporate maternal and child health services as part of the package of benefits and this will be launched on 29 May, 2005. We would like to implore WHO to support us in this process through partnership and appropriate resource mobilization for scaling up the implementation of interventions and best practices in maternal and child health. Specifically, we are seeking the establishment of a global fund targeted at maternal and child health, similar to the Global Fund to Fight AIDS, Tuberculosis and Malaria. This will make additional resources available to implement the activities to reduce morbidity and mortality from maternal and child-related diseases globally. In another development, I appreciate that Nigeria is one of the six remaining endemic countries with wild-type poliovirus transmission but I would like to assure all members of this Health Assembly that Nigeria will meet the target of stopping wild-type poliovirus transmission by December 2005. In collaboration with our partners at the lnteragency Coordinating Committee, and in states, local government areas and wards, we have continued to implement clear and simple innovations to our strategies, which involve all stakeholders- especially the communities. In particular, the mapping of settlements within the wards to ensure full coverage of all those eligible, from 0 to 59 months, is being strengthened. Consequently, to achieve our target the Federal Government of Nigeria has continued to allocate financial resources to support our country's prior efforts; this has significantly complemented international support to our country. However, in the realization of the challenges ahead and the action points arising therefrom, we need to mobilize additional funds to meet the existing funding gaps for the remaining planned Global Polio Eradication Initiative activities for this year. The prevalence ofHIV/AIDS in our country remains a major threat to the health and well-being of our people. In the last year, a substantial sum of money has been invested in our country programmes to increase access to antiretroviral treatments, improve preventive services and thereby prevent new infections. These efforts are being supported by the Federal Government ofNigeria, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief. Over the past six months, the number of people living with AIDS on antiretroviral therapy has doubled and it now stands at approximately 30 000 people. The challenges for this programme currently include securing access to sustainable and affordable antiretroviral therapies, ensuring affordable consumer CD4 kits and other clinical laboratory tests, monitoring patients to ensure adherence to regimes, and tracking drug-resistant cases. The support of WHO is therefore required in these areas as part of the Organization's "3 by 5" initiative. By way of information, I wish to use this opportunity to let this distinguished gathering know that the 14th International Conference on HIV I AIDS and Sexually Transmitted Infections in Africa, with the theme "HIV/AIDS and the family", will be held in Abuja between 4 and 9 December 2005. The timing of this Conference is quite appropriate considering the role of the family in the production of health; all Member States are hereby kindly invited to this all-important conference. However, I am worried about the preparedness of my country to respond to any of the global epidemics threatening our planet. For one, we do not have the elaborated capacity to diagnose any of these viral diseases and we do not know the burden of disease in Nigeria. I therefore request WHO to invest more in Africa to build the necessary capacity in our countries to diagnose these diseases and respond to any outbreak that occurs. Finally, Madam President, our health systems as we have mentioned several times require strengthening; until and unless this is done, all our prevention, control and eradication efforts will be futile. This must be tackled head-on so that the implementation of our health programmes will have greatest impact. I thank you all.

Dr KAMUGISHA (Uganda):

Madam President, Vice-Presidents, Director-General, honourable mm1sters and heads of delegation, distinguished participants, ladies and gentlemen, I would like to join others in congratulating you on being elected to this high office and to pledge Uganda's support as you provide us with the necessary leadership. Let me also, at this juncture, convey to you warm greetings from the President, Government and people of Uganda and appreciation of the good work you have been doing to promote the health of the people. May I also congratulate the Director-General, Dr Lee Jong-wook, for hosting the Fifty-eighth World Health Assembly and for completing two years in office. Over this A58NR/5 page 126 period, Member States, and especially those in sub-Saharan Africa, have made strides in a number of areas, particularly in expansion of antiretroviral treatment. During the last Health Assembly, Dr Lee announced the introduction of the "3 by 5" strategy of expansion of access to antiretroviral treatment. Since then, many advances have been made in antiretroviral treatment service delivery. There could not have been a better choice of theme for this year's Health Assembly than "Make every mother and child count". Maternal, neonatal and child health indicators are poor in most developing countries. The situation is no different in Uganda, where the infant mortality rate is now 83 per 1000 live births, the maternal mortality rate is 506 per 100 000 live births, and the under-fives mortality rate is 147 per 1000 children. Moreover, women have not been spared by the HIV/AIDS pandemic. The preliminary results of the recently concluded Uganda HIV/AIDS Sera-Behavioural Survey show that while 7% of adult women and men aged 15 to 59 are infected with HIV, women aged 30 to 34 have the highest HIV prevalence, about 12%. The results further show that the HIV prevalence among young women is three times higher than that of their male counterparts. Additionally, the results show that the contraceptive prevalence rate is low. If the above situation continues unabated, then the future of the country will be grim. To tackle the above problems, Uganda has adopted a holistic approach. A health sector strategic plan has been developed with a clearly-defined minimum health-care package. The package is composed of cost-effective health interventions that address over 80% of health conditions. The components of the package include control of communicable diseases such as malaria and tuberculosis and sexual and reproductive health. In the area of sexual and reproductive health, activities are being implemented to reduce the maternal mortality ratio over a period of five years from 506 to 354 per 100 000 live births; to increase the contraceptive prevalence rate from 15% to 30%; and to increase deliveries supervised by skilled health workers from 38% to 50%. Furthermore, we are providing services for the prevention of mother-to-child transmission of HIV as well as antiretroviral treatment. To reduce morbidity and mortality due to malaria, measures are being taken to increase the proportion of children under five and women who sleep under insecticide-treated nets. Currently the proportion is 25%, which is far below the desired level. In the area of antiretroviral treatment, many successes have been achieved. Over the last year, many more needy AIDS patients in Uganda have gained access to antiretroviral treatment, with the resultant improvement in their quality of life and avoidance of premature deaths. Through public-private partnership, Uganda has had tremendous success in rolling out the antiretrovira1 treatment expansion plan. Support received from different partners has been used for the training of health-care providers on antiretroviral treatment, the improvement of health infrastructure, and the procurement of the required laboratory equipment as well as antiretroviral drugs. To date, close to 55 000 AIDS patients in Uganda are on antiretroviral drugs. Furthermore, we anticipate that by the end of December 2005, well over 60 000 AIDS patients will have access to antiretroviral drugs, thus surpassing the "3 by 5" target of 60 000 patients by the end of 2005. The targets for December 2006 and December 2007 are 90 000 and 120 000 respectively. Of the 55 000 patients who are currently on antiretroviral drugs, some are sourcing the drugs through their own financing mechanisms, while a good number are receiving the drugs free of cost. Free antiretroviral drugs are being distributed under the Government's antiretroviral treatment programme, which has enabled many AIDS patients who would otherwise not have gained access to such drugs to do so. Women and orphaned children are amongst the top beneficiaries. We believe that this programme will lead to the achievement of some of the Millennium Development Goals. I would like to end by underscoring the importance of strong political leadership and commitment, partnership, and strong health-care system leadership. We thank all our development partners- including WHO and funding agencies- for supporting us in our quest to meet our targets. We shall work together to meet these indicators to improve maternal, neonatal and child health. I thank you, Madam President.

Dr SOK TOUCH (Cambodia):

Madam President, Director-General, distinguished delegates, ladies and gentlemen, in establishing the Millennium Development Goals more than four years ago, the international A58NR/5 page 127 community made a commitment to reduce maternal deaths by three quarters and child mortality by two thirds by 2015. The Royal Government of Cambodia has translated these global targets into national targets, and is committed to reducing maternal mortality from 437 deaths per 100 000 live births in 2000 to 140, and to reducing infant and under-five mortality rates from 95 and 124, respectively, per 1000 live births to 50 and 65, by 2015. Globally, more than half a million women and 10.6 million children - and in Cambodia more than 60 000 children - will continue to die each year unless essential and affordable intervention is made available. This is despite the fact that a small set of preventive and curative interventions, such as vaccines and appropriate home care, could save more than six million children each year. Affordable and effective means to prevent death and suffering are available, but many have yet to reach every mother and child. Too many mothers and children are dying or suffering from the effects of ill-health, poor nutrition and inadequate health care. More than 70% of all maternal deaths are caused by just five leading factors: haemorrhage, infection, unsafe abortion, high blood pressure and obstructed labour. Neonatal causes, pneumonia, post-neonatal diarrhoea, malaria, measles and HIV I AIDS are treatable conditions that account for more than 70% of all child deaths. The Integrated Management of Childhood Illness strategy was adopted in Cambodia in 1998, and has been implemented at district level since 2001. Child survival is high on the Ministry of Health's policy agenda, and there is full political commitment to reducing child mortality as an integral part of the Health Sector Strategic Plan 2003-2007, which was reconfirmed at a high-level consultation on child survival in June 2004. However, coverage of key elements for child survival, such as oral rehydration, antibiotics for pneumonia, skilled birth attendance and exclusive breastfeeding remains insufficient. The main concern remains insufficient access to basic curative care, particularly in rural areas. Between 1994 and 2003, the consultation rates in public facilities for children under five only increased from 0.39 to 0.56 per child per year, which is still only 28% of the expected rate. Priority for health-care system delivery in Cambodia is given to comprehensive provision of essential health-care services in rural areas and for the urban poor. Promising ways to overcome access barriers to appropriate care, such as equity funds and community-based heath insurance schemes, are to be institutionalized on a large scale; new approaches, including bringing services closer to communities, should also be explored. International and national goals to reduce maternal and child death by 2015 will not be met at the current pace unless rapid and well-coordinated action is taken now; only rapid and concerted action will bring down the number of mother and infant deaths. The Ministry of Health of Cambodia is committed, through joint efforts with WHO and relevant stakeholders and development partners at national and global levels, to reorienting national and subnational development plans and budgets so as to achieve fully the maternal and child Millennium Development Goals by the set date. The Ministry also fully supports the creation of a momentum that will compel governments, the international community, civil society and individuals to take action to improve mother and child health and well-being. In this regard, WHO's assistance in mobilizing more resources for mother and child health interventions is highly appreciated. Thank you.

Le Dr BIJOU (Ha"iti) :

Madame la Presidente de l 'Assemblee, la delegation hai"tienne a l 'honneur de vous presenter ses chaleureuses felicitations pour avoir accede a cette position qui vous confere la lourde responsabilite de diriger la Cinquante-Huitieme Assemblee mondiale de la Sante. Monsieur le Directeur general de !'Organisation mondiale de la Sante, au nom du Gouvernement d'Hai"ti, je vous adresse les plus vifs compliments pour la maitrise avec laquelle vous conduisez les destinees de cette prestigieuse Organisation. Mesdames, Messieurs les Ministres, distingues membres des differentes delegations a la Cinquante-Septieme Assemblee mondiale de la Sante, c'est avec la desolation dans l'ame que j'avais brosse la situation alarmante de mon pays apres quinze ans de commotions socio-politiques qui avaient culmine par le demantelement du systeme de sante. Des actions positives, le texte n'en contenait pas, sinon que des engagements qui avaient ete pris dans un contexte encore charge d'incertitude. Un an apres, dans les memes circonstances, c'est avec le plus grand plaisir que je prends la parole pour exprimer la fierte de la delegation ha"itienne et faire le point sur quelques actions A58NR/5 page 128 entreprises par le Gouvemement de transition en faveur des meres et des enfants ha'itiens, en accord avec les objectifs du Milh~naire pour le developpement. La Republique d'Ha'iti accuse le plus haut ratio de mortalite matemelle et infantile dans la region des Ameriques et des Caraibes, soit respectivement 523 pour 100 000 naissances vivantes et 80,3 pour 1000 naissances vivantes. Alarme par ces statistiques et stimule par le souci de respecter les engagements pris au Caire, a Beijing et a 1' Assemblee generale des Nations Unies, le Gouvemement interimaire, sans se laisser effrayer par le poids du deti a relever, s'est decide fermement a diligenter toutes interventions visant a rabattre les indicateurs de 10 % annuellement, en vue de les ramener au tiers d'ici 2015. Pour atteindre cet objectif, les actions se circonscrivent autour de deux principaux axes strategiques : le renforcement institutionnel et l' extension de la couverture sanitaire, dispositions qui commencent a se concretiser par la rehabilitation des matemites et pediatries des principaux hopitaux du pays, incluant leur equipement et !'affectation d'un personnel apte a satisfaire leurs besoins au double point de vue quantitatif et qualitatif. Environ 500 techniciens de toutes categories ont ete recrutes et mis en service a travers les differentes institutions du pays. 11 convient de signaler ici que toutes les matemites disposent maintenant d'une equipe d'infirmieres sages-femmes. Sur le plan de la formation, 47 bourses d'etudes ont ete octroyees en vue d'ameliorer le niveau de gestion et de prestation des soins. De plus, pour compenser la devaluation de la monnaie nationale et stimuler le personnel de sante, ce demier a beneficie au cours de la periode d'une indexation de salaire de l'ordre de 45%. Mesdames, Messieurs, la satisfaction dont nous ont comble ces accomplissements s'etait malheureusement effritee par les consequences effroyables de deux grandes catastrophes qui ont fait plus de 4000 morts et des dizaines de milliers de families sans abri : un lourd tribut pour le Gouvemement qui luttait deja contre le marasme economique que lui ont legue les autorites precedentes. A ce compte, n'est-ce pas !'occasion de faire remarquer que si de fa<;on ponctuelle certaines valeurs ont ete attribuees au secteur de la sante par la communaute intemationale, l'aide au developpement promise tarde encore a venir. La population s'impatiente, d'ou une montee de la violence avec toutes les consequences negatives sur la sante des groupes les plus fragiles, en particulier les femmes et les enfants. Nous renouvelons notre appel a tous les amis du peuple hai"tien et nous demandons a l'OMS de mettre son poids dans la balance. Ainsi, le Gouvemement de transition peut s'enorgueillir d'avoir a son actifl'augmentation de ses reserves, grace a un plan de restriction des depenses publiques professionnellement applique, qui a permis le demarrage de certains travaux d' infrastructure. La situation tout a fait imprevisible que je viens de vous decrire brievement n'avait pas brise, ni meme attenue, la volonte de resoudre la problematique de la sante matemelle et de la sante infantile. Tous les efforts deja tentes nous ont au contraire encourages dans cette direction; nous etions meme conscients de leur insuffisance pour garantir 1' equite en matiere de sante, si chere au Gouvemement. C'est ce qui justifie d'ailleurs la mise en oeuvre de plusieurs actions a caractere communautaire. En collaboration avec nos partenaires, no us avons decrete deux semaines pour la sante des enfants en juin et en novembre. Au cours de ces deux semaines, les enfants sont vaccines et re<;oivent de la vitamine A et un traitement contre les parasites intestinaux. Les enfants des rues beneficient aussi de ces memes attentions. Cette annee, la celebration de la Joumee mondiale de la Sante a honore la femme dans le cadre du theme choisi. Le Ministere de la Sante publique et de la Population a profite de la circonstance pour annoncer la gratuite des soins prenatals comprenant la consultation prenatale, la vaccination et les examens de laboratoire. De meme, le projet de creation d'un centre d'excellence pour les femmes est devenu une realite. Il constitue le point de depart du reseau de matemite sans nsque. Poursuivre notre objectif dans un cadre d'actions eparses, d'activites ponctuelles nous aurait impregnes d'un sentiment d'insatisfaction profonde. Nous avions ainsi estime qu'une orientation vers la reforme du secteur sante est indispensable. Dans cette optique, la structure du Ministere de la Sante publique a ete reconsideree dans un cadre legal appuye par un projet de loi organique elabore avec l'appui technique de !'Organisation panamericaine de la Sante. On y releve la volonte de moderniser ce Ministere avec la creation de deux nouvelles directions : la direction d'epidemiologie et de la recherche, et la direction de promotion de la sante et de protection de 1' environnement, des actions qui A58NR/5 page 129 se trouvent renforcees par la finalisation du plan strategique 2005-2010. Voila en quelques mots le tableau de la situation actuelle de la sante de la mere et de I' enfant. Pour finir, je profite de cette tribune pour exprimer la gratitude du peuple hai:tien envers tous les pays amis qui lui ont temoigne leur sympathie au cours de l'annee 2004 a }'occasion des differentes catastrophes. Je vous remercie.

Dr FORTES (Angola):

Thank you Madam President for giving me the floor. We would like to congratulate you for your election as President of the Fifty-eighth World Health Assembly. Honourable ministers, distinguished delegates, excellencies, Angola, located in the southern African region, is now facing an epidemic of haemorrhagic fever caused by the Marburg virus. As you are aware, this pathogenic agent is not well known to the international scientific community, and is characterized by its high virulence and mortality rate. The outbreak is caused by a virus with an unknown reservoir, and there is no vaccine or specific treatment. The crisis has resulted in about 300 deaths, including health workers and increasing suffering and poverty of the exposed populations. The epidemic situation is confined to the Uige province, and soon we hope to be able to declare the end of the epidemic. Meanwhile, we consider that the lack of basic needs, the weakness and the vulnerability of the health-care systems in our region do not allow a prompt, adequate response to epidemics in order to reduce loss of life. At this point, I would like to emphasize the shortage of trained national staff, who would be crucial for allowing a prompt response, and for facilitating communication and mutual understanding between health personnel and the community. In this regard, we request the improvement of the national expertise capacity for crisis preparedness, response and recovery. On behalf of the Government of Angola, I would like to take this opportunity to thank the international community for the immediate support provided to my country, mainly by WHO, UNICEF, nongovemmental organizations, Centers for Disease Control and Prevention (Atlanta, Georgia) and all the donor countries. Thank you for your attention.

Dr SHEIKH YUSUF (Somalia):

Madam President, your excellencies, Vice-Presidents and the Chairmen of the main committees, Director-General, Regional Directors, distinguished delegates, I am greatly honoured and pleased to address this august Health Assembly for the first time as the Minister of Health of the Transitional Federal Government of Somalia. Madam President, allow me first and foremost to express my wholehearted congratulations to you, the five Vice-Presidents and other elected members. May I also convey to you best greetings of my President, His Excellency, Mr Abdullahi Yusuf Ahmed. Most of you are well aware of the current situation of Somalia, the devastation of the health­ care infrastructure, the absence of an organized public health delivery system and the limited human and financial resources that have made Somalia one of the most disadvantaged countries with regard to health status of the population. The Ministry of Health of the Transitional Federal Government of Somalia is currently in the process of relocating to Somalia and is making sincere efforts to coordinate health-care delivery support to all the regions of the country. The health initiative of the Ministry of Health is aimed also at promoting peace and reconciliation among the Somali population and its diverse communities in such a way that health will be a bridge to peace. The Minister of Health and the Transitional Federal Government of Somalia are very much aware of the unfailing health and humanitarian assistance that WHO, as an organization, and its Member States have provided to the people of Somalia, despite the very difficult and insecure situation prevailing in the country. We are now looking forward with confidence and hope to further and extended support from our Organization and its Member States in all aspects of health-care delivery (whether it is preventive, curative or rehabilitative). In this connection, the vision of the Ministry of Health of the Transitional Federal Government of Somalia is to provide high-quality, equitable, affordable and sustainable health-care services to all communities in Somalia, through effective partnership with local authorities, communities, the private sector and international organizations and donors. Our mission is to provide A58NR/5 page 130 adequate technical support and resource assistance to regions, districts and communities to develop a standard, basic health-care delivery system that serves all the people. Considering our problems as briefly outlined, we would greatly appreciate receiving a technical as well as an advocacy contribution to formulate coherent policy and strategy to ensure credible and effective planning and implementation of public health programmes in the country. In this regard, we are ready to engage fully with WHO in joint planning and policy formulation exercises with the aim of producing feasible policies and plans that could be readily and effectively implemented towards the achievement of the health-related Millennium Development Goals. Finally, on behalf of the Transitional Federal Government of Somalia and the Ministry of Health, I wish to record our appreciation, gratitude and thanks to WHO which has assisted and supported health-sector services in Somalia under very difficult and extreme conditions during all those years since the collapse of the central government and the disintegration of the health-care delivery system. Madam President, thank you very much for giving me the opportunity to address this august Health Assembly. Thank you all.

Le Dr JEAN LOUIS (Madagascar):

Madame la Presidente, Mesdames, Messieurs les membres du Bureau de 1' Assemblee mondiale de la Sante, honorables Ministres, honorables membres des delegations, c'est un grand honneur et un reel plaisir pour moi de prendre la parole en cette occasion et de vous presenter mes chaleureuses salutations. Permettez-moi tout d'abord de vous presenter Madagascar. Madagascar est une grande ile qui se trouve au sud-ouest de 1' ocean indien ; sa superficie est de 590 000 km2 et elle compte 17 millions d'habitants. Il y a en tout et dans taus les niveaux 3600 centres de sante a Madagascar. La sante de la mere et de l'enfant garantit le bien-etre de taus les membres de la famille et de toute la societe, permettant de participer activement au developpement socio-economique du pays. Ainsi a Madagascar, dans le cadre de la mise en oeuvre du document de strategie de reduction de la pauvrete, plusieurs activites ont ete entreprises, notamment amelioration de la qualite des services avec respect des normes dans les hopitaux et les centres de sante, amelioration de l'acces des femmes aux soins prenatals et a l'accouchement assiste, vulgarisation de la planification familiale, dotation en ambulances des hopitaux de district, renforcement des competences des agents de sante a taus les niveaux, approvisionnement regulier des formations sanitaires en medicaments essentiels, y compris en medicaments pour les soins obstetricaux et neonatals d'urgence de base et complets, et generalisation du programme de prise en charge integree des maladies de l'enfant. De plus, afin d'ameliorer l'accessibilite geographique, plus de 5000 km de routes ont ete rehabilitees ou construites. Quelque 41 centres hospitaliers de district niveau 1 ont ete transformes en centres hospitaliers de district niveau 2 pour la prise en charge des soins obstetricaux et neonatals d'urgence complets. Le developpement des reseaux de communication par la radio en bande laterale unique et la telemedecine ont permis de renforcer le systeme et d'ameliorer la prise en charge des cas compliques. Les efforts entrepris ont commence a porter leurs fruits comme en temoignent la reduction du taux de mortalite matemelle qui est passe de 488 pour 100 000 naissances vivantes a 469 pour 100 000 naissances vivantes, et la reduction du taux de mortalite des enfants de mains de cinq ans qui, lui, est passe de 159 pour 1000 a 94 pour 1000. Afin de poursuivre les efforts et d'accelerer les initiatives pour atteindre les objectifs du Millenaire, nous avons elabore une feuille de route en collaboration avec tous les partenaires. Pour relever le defi de reduction de la mortalite matemelle et infantile et de donner sa chance a chaque mere et a chaque enfant, Madagascar intervient suivant des cadres strategiques qui s'articulent autour de la decentralisation, de !'integration des services de matemite sans risque, de la planification familiale, de la prise en charge integree des maladies de l'enfant dans le paquet minimum d'activites des centres de sante de base, de la disponibilite des services de qualite, de !'implication permanente de la communaute dans la gestion et la promotion de la sante, du developpement du partenariat national et international, ainsi que du partenariat public-prive, et, enfin, autour de la valorisation du statut de la femme dont l'objectif est de reduire les disparites sexospecifiques au profit du developpement equitable entre les femmes et les hommes. A58NR/5 page 131

Les orientations futures mettront l'accent sur les formes du systeme de sante a tous les niveaux, integrant les reformes hospitalieres avec le concours des partenaires pour le developpement a travers }'amelioration de la qualite de service et de la disponibilite des soins, l'accroissement de la demande de la population, le renforcement de la gestion du programme sante de reproduction, notamment la matemite sans risque, et, en demier lieu, }'amelioration de l'accessibilite aux services. Au total, l'etat de sante de la mere et de I' enfant s'est nettement ameliore a Madagascar comme l'attestent les resultats de l'enquete demographique et de sante de 2004, mais il reste precaire; beaucoup reste a faire si nous voulons etre au rendez-vous de la realisation des objectifs du Millenaire pour le developpement d'ici 2015. L'appropriation nationale, conjuguee a une volonte politique de haut niveau appuyee par un partenariat public-prive efficace et effectif, nous permettra de faire des avancees majeures et contribuera favorablement a }'amelioration de l'etat de sante de la mere et de l'enfant a Madagascar. Je vous remercie de votre attention.

Le Professeur BONGELI (Republique democratique du Congo) :

Madame la Presidente, Monsieur le Directeur general, Mesdames et Messieurs les Ministres, Mesdames et Messieurs les membres des delegations des Etats Membres de l'OMS, Mesdames et Messieurs, distingues invites, je saisis }'occasion qui m' est offerte pour feliciter Mme la Presidente et la rassurer que la delegation de la Republique democratique du Congo reaffirme son engagement pour atteindre les objectifs des assises de la Cinquante-Huitieme Assemblee mondiale de la Sante. Je confirme en meme temps a M. le Directeur general que la delegation de mon pays partage les elements de son rapport et s'inscrit dans les priorites globales qui y sont contenues. La Republique democratique du Congo se trouve classee en sixieme position parmi les pays qui contribuent a la charge excessive de la mortalite et de la morbidite infantiles et matemelles dans le monde. En effet, le taux de mortalite infantile est de 127 pour 1000 naissances vivantes et celui de la mortalite matemelle est de 1296 deces matemels pour 100 000 naissances vivantes. Nous sommes conscients de l'impact negatif de l'etat de sante precaire des enfants et des femmes dans notre pays. C'est pourquoi, malgre la crise chronique que le pays traverse depuis une quinzaine d'annees, le Gouvemement congolais a adopte les differentes resolutions et recommandations de l'OMS pour realiser quelques performances en ce qui conceme certains programmes de sante prioritaires. 11 s'agit de la realisation des joumees nationales de vaccination pendant la periode de guerre et d'insecurite ; de la couverture vaccinate qui atteint 60 % pour la vaccination de routine par 1' anti gene DTC3 dans le cadre du Programme elargi de vaccination, chiffre confirme par 1' audit de la qualite des donnees effectue recemment par 1' Alliance mondiale pour les vaccins et la vaccination; de }'admission de notre pays a }'introduction de nouveaux vaccins; des performances acceptables en ce qui conceme le taux de detection de la tuberculose de 65 % contre 70 % attendu, tandis que le taux de succes au traitement est de 79 % contre 85 % attendu ; de la stabilisation de la seroprevalence du VIH/SIDA, a 5 % bien que certaines indications montrent des variations importantes le long de la ligne de front comme consequence de la guerre ; de la revision de la politique therapeutique contre le paludisme par }'adoption de la combinaison artesunate-amodiaquine; des bonnes performances obtenues dans le cadre de la lutte contre la trypanosomiase et de notre precieuse contribution dans les etudes qui ont permis de confirmer l'innocuite de la nouvelle molecule dont a parle M. Bill Gates; enfin, des efforts notables dans le cadre de 1'elimination de la lepre comme probleme de sante qui ont produit des resultats encourageants. Bien que nous ayons cette prevalence stable du VIH/SIDA en general, nous devons denoncer devant cette auguste Assemblee les sequelles et consequences qui accompagnent les violences de tout ordre faites aux femmes et aux enfants en Republique democratique du Congo pendant la guerre, surtout pour la transmission du VIH/SIDA et les traumatismes qui ont entraine des handicaps chez de nombreuses femmes. Et j'en profite pour solliciter une resolution ferme et corrective a l'endroit des personnes qui sont responsables de ces crimes odieux. En effet, les violences sexuelles faites aux femmes et aux enfants en Republique democratique du Congo sont souvent couplees aux mutilations des parties genitales feminines, pratiques perverses couramment utilisees comme armes de guerre d'intimidation par differentes factions armees locales et surtout etrangeres. C'est en Republique A58NR/5 page 132 democratique du Congo, plus particulierement dans sa partie orientale, que l'on trouve des femmes triplement aneanties : psychologiquement humiliees parce que violees souvent devant epoux et enfants, physiquement traumatisees parce que violentees dans leurs parties intimes au point de necessiter une prise en charge chirurgicale et, dans 50% des cas, contaminees par le VIH/SIDA, et, enfin, socialement rejetees par les leurs pour une faute qu'elles n'ont pas commise ! Ces femmes mortes vivantes existent bel et bien en Republique democratique du Congo et, pour la plupart, elles sont abandonnees a elles-memes. Cependant, ce tableau sombre ne condamne pas le pays au desespoir. D'admirables efforts sont deployes par le Gouvemement de transition avec l'appui tres apprecie et determinant de la communaute intemationale que la delegation remercie particulierement. La Republique democratique du Congo beneficie d'un atout de taille: elle dispose de medecins et autres professionnels de la sante tres bien formes qui operent des miracles dans des conditions de travail difficiles. Aujourd'hui, beaucoup de ces braves medecins et infirmiers sont predisposes a la fuite, suite a de nombreux ecueils qui entravent la bonne pratique de 1'art de guerir. Des equipements medicaux meme elementaires rendraient ces professionnels de la sante stables et performants. En ce qui conceme l'approvisionnement en medicaments essentiels, l'anarchie post-conflit fait que la Republique democratique du Congo constitue un marche propice aux medicaments contrefaits de qualite douteuse. Des efforts entrepris par le Gouvemement pour mettre un terme a cette anarchic ont besoin d'etre appuyes par l'OMS pour reviser notre reglementation pharmaceutique et installer un laboratoire de controle d'assurance de la qualite. En matiere de VIH/SIDA, si des efforts sont deployes pour en contenir I' expansion, il y a lieu de noter que la prise en charge des malades est encore faible: 5000 personnes vivant avec le VIH/SIDA seulement sont prises en charge, dont 3000 risquent d'arreter leur traitement faute de pouvoir en supporter les couts. Le Gouvemement vient de decider la gratuite des antiretroviraux et compte sur les partenaires habituels pour rendre 1'espoir de vivre a ces personnes actives, rendues passives par la maladie. Les resultats positifs precites ont ete possibles grace a !'engagement au haut sommet de l'Etat du chef d'Etat Joseph Kabila, a l'autodetermination de notre peuple qui tient a l'unite de notre pays, au soutien de l'OMS et de nos differents partenaires, ainsi qu'a la conviction du personnel de sante qui pourtant travaille dans des conditions precaires. Voila pourquoi nous tenons a rendre notre partenariat plus efficace, par la restructuration de nos organes de coordination a tous les niveaux de notre systeme de sante de maniere a disposer des informations en temps reel et d'aligner les investissements sur nos priorites pour des actions concertees plus efficaces. Si nous avons realise quelques progres, notre systeme d'alerte precoce et de riposte accuse encore plusieurs deficiences. Par exemple, nous avons detecte l'annee demiere l'epidemie de fievre typho'ide et nous venons d'etre surpris par une epidemic de rougeole. Ces epidemics de rougeole sont devenues rares dans les quatre provinces ou nous avons eu a organiser des campagnes supplementaires de lutte contre la rougeole. La Republique democratique du Congo soutient fermement la mise en oeuvre du Reglement sanitaire international revise et fait appel au Directeur regional pour continuer a nous appuyer pour son application a la Region africaine. Pour relever le deft de la reduction de cet exces de mortalite infantile et matemelle, nos services de sante doivent etre rehabilites et renforces par du materiel et des equipements medicaux, l'approvisionnement regulier en medicaments essentiels generiques et en produits de laboratoire, une meilleure integration des interventions a impact rapide dans les services de sante et au niveau communautaire, ainsi que par le renforcement des capacites du personnel de sante et des communautes. Une contrainte majeure a surmonter reste l'instabilite du personnel de sante a cause de la degradation continue des conditions de travail. Il nous faudrait accelerer !'acquisition des intrants pour recuperer le retard accumule dans la mise en oeuvre des interventions financees par le Ponds mondial et le Reseau collegial pour la surveillance de la situation et des tendances de la pandemic de VIH/SIDA (MAP). Pour ce qui est des pathologies qui tuent le plus nos populations, notamment le paludisme, les diarrhees, les infections respiratoires aigues, la malnutrition, la tuberculose et le VIH/SIDA, la Republique democratique du Congo attend instamment l'aide de la communaute intemationale en matiere d'hygiene, d'assainissement du milieu et de potabilisation de l'eau destinee a la consommation humaine. Je vous remercie de votre aimable attention. A58NR/5 page 133

Mr DIMITROV (Kyrgyzstan): ,l],-p ,Il,HMHTPOB (Kbiprb13CTaH):

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La PRESIDENT A:

Antes de dar la palabra al representante de Santa Tome y Principe, qmero poner en su conocimiento que se ha mencionado dos veces la cuesti6n de Taiwan. Recomendaria que ello no se volviera a producir. Muchas gracias.

Le Dr de LIMA (Sao Tome-et-Principe) :

Madame la Presidente, Monsieur le Directeur general, distingues delegues, Mesdames, Messieurs, au nom de la Republique democratique de Sao Tome-et-Principe et de la delegation que j'ai l'honneur de diriger, permettez-moi, Madame la Presidente, de vous feliciter a !'occasion de votre election a la presidence de la Cinquante-Huitieme Assemblee mondiale de la Sante ; je felicite aussi les Vice-Presidents et les Presidents des Commissions A et B. Qu'il me soit egalement permis de saisir cette sublime occasion pour saluer les distingues chefs de delegation et les delegues ici presents. Le fait d'avoir choisi comme theme du debat general un sujet lie a la sante de la mere et de l'enfant traduit la grande preoccupation de l'OMS a l'egard du lourd fardeau de la morbidite et de la mortalite que les meres et les enfants dans beaucoup de pays du monde doivent toujours supporter. Le rapport « Donnons sa chance a chaque mere et a chaque enfant )) est un cri d' alarme lance non seulement aux gouvernements et a la societe des pays ou l'on observe encore des deces inacceptables chez les nourrissons, les enfants et les femmes, mais aussi a la communaute internationale. La situation est alarmante en raison de l'inegalite d'acces aux soins de sante des meres et des enfants malgre les possibilites qui s'offrent a la communaute internationale de les rendre universels; c'est sans aucun doute egalement un defi pour taus car nous savons qu'il existe des connaissances techniques et des strategies qui, dument mises en oeuvre, pourraient soulager la souffrance et empecher la mort de millions d'enfants et de milliers de femmes par des causes qui sont bien connues et evitables. 11 ressort clairement du rapport que la creation de systemes durables de sante capables de fournir la continuite et l'integralite des soins aux meres et aux enfants et capables aussi d'etablir un enchainement etroit avec les communautes et les families est une condition sine qua non pour repondre de maniere adequate aux problemes critiques qui affectent la sante et la survie de milliers de meres et de millions d' enfants. 11 existe dans nombre de pays des facteurs tels que les guerres, l'instabilite politique et la pandemie du VIH/SIDA qui destabilisent les faibles systemes de sante nationaux et qui ne facilitent pas l'acces des meres et des enfants aux soins essentiels. Cependant, il est vrai que dans la majorite de nos pays ou la situation de la sante de la mere et de l'enfant devient critique, le manque de ressources financieres s'est accentue de telle fa<;:on qu'il ne permet pas un financement durable des projets de developpement sanitaire. L'investissement de 52,4 milliards de dollars, somme qu'on estime necessaire pour reduire la mortalite chez les enfants dans 75 pays, additionne a l'investissement A58NR/5 page 135 necessaire pour reduire la mortalite maternelle, est un effort que beaucoup d'entre eux ne sont pas en mesure de garantir. La communaute internationale doit done jouer un role important qui ne peut pas et ne doit pas se limiter au soutien technique et financier aux pays les moins avances. Il est capital que la question des echanges commerciaux entre les pays du Nord et les pays du Sud soit reglee de sorte que les pays pauvres disposent des ressources financieres appropriees pour garantir la perennite des soins de qualite aux meres et aux enfants. Merci, Madame la Presidente.

Dr MBOWE (Gambia):

Madam President, Director-General, honourable ministers, distinguished delegates, ladies and gentlemen, I would like to avail myself of this opportunity on behalf of the Government and people of Gambia to commend WHO for coordinating international health in such a technically competent manner. Today, more than ever before, our world is realizing phenomenal changes and innovations that transcend international boundaries, thanks to the intricacies of globalization. Consequently, there have been great increases in cross-border flows of people, goods and services, which have also facilitated the spread of infectious diseases. WHO's mechanism that ensures a globalized outbreak alert and response platform to curb outbreaks that threaten global health has offered great opportunities to the international community, and particularly to developing countries, whether big or small. In order to achieve its goal of "the attainment by all peoples of the highest possible level of health", WHO must remain informed about the entire world health situation and be able to obtain and disseminate the relevant data, technology, and other resources needed to prevent, monitor, and respond to epidemic, endemic and other diseases as boldly and fairly stated in the Constitution. Any loophole in this global health network presents a danger for the global community. The Government of Gambia recognizes public health both as an investment good and as a central, long-term driver of economic growth. Therefore, the Government remains committed to the realization of the goals and objectives articulated in the country's poverty reduction strategy paper, which remains the Government's strategic blueprint for development, as well as for attaining the objectives of the Millennium Development Goals. An assessment of the possibility of the Gambia attaining the Millennium Development Goals revealed that the country is likely to meet the health goals - for example, reduction of under-five mortality by two thirds, reduction of maternal mortality by three quarters, and reversing the spread of diseases, (especially HIV/AIDS and malaria)- through sustained commitment and effort at the national level as well as collaboration with other stakeholders in the global health arena at the international level. In this regard, the Government of Gambia looks more to its bilateral and allied donors who have the special experience, resources and achievements and are willing to put these at the disposal of the people of the Gambia. The Republic of China (Taiwan) - which has been successful in eradicating infectious diseases such as the plague, smallpox, rabies and malaria - has offered considerable technical and financial assistance towards the Government of Gambia's efforts in the attainment of its health objectives.

The PRESIDENT:

Mr Delegate, we have to apply articles 58 and 59. China has the floor.

Dr DENG Hongmei (China):

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La PRESIDENT A:

Muchas gracias, sefiora delegada. Seguramente ha podido usted escuchar mi recomendaci6n previa, que hubiera debido ser seguida por los oradores. Rogaria al delegado que retomara la palabra tratando de terminar de la forma mas breve posible, y recomendaria que no hiciera otra menci6n al asunto del que hemos hablado.

Dr MBOWE (Gambia):

Admittedly, despite the gains being realized in the health sector, communicable diseases still pose a formidable threat to the health of Gambians. Malaria is still the leading cause of illness and death; it is also the leading cause of workdays lost due to illness. Malaria-related maternal deaths continue to pose a critical challenge to the Government's efforts. High mortality levels are often observed in infants and children; the national estimates of neonatal and perinatal mortality rates are 31.2 per 1000 live births and 54.9 per 1000 total births, respectively. However, through the interventions of WHO and UNICEF, which have been our conventional partners in the Roll Back Malaria initiative and the Accelerated Child Survival and Development programme respectively, some gains have been made in the fight against malaria. With the recent acquisition of two small aircraft, our vector-control efforts will be significantly enhanced. At this juncture, I would like to inform this august gathering that my Department of State is at an advanced stage in its preparations for conducting its first demographic and health survey. The Government of Gambia, like all others, is mindful of the scourge of the HIV I AIDS pandemic, which is threatening the survival and well-being of mankind. In the Gambian context, the prevalence of HIV-1 and HIV-2 stood at 2.1% and 0.8% respectively in 2004; as part of the first demographic and health survey, a larger sample of the population will be tested to determine national prevalence in late 2005 and early 2006. A national treatment manual for antiretrovirals has been developed; antiretroviral treatment and patient-care technology services are currently being provided in four public and two private health facilities. Two support groups of people living with HIV I AIDS are actively involved in a national response initiative. One of the main strategies used to contain and reduce the spread of HIV I AIDS infections is the promotion of accurate knowledge of how HIV I AIDS is transmitted, and how to prevent transmission. In the country, the United Nations system's response has been the setting up of a thematic group and the UNAIDS Technical Working Group. On 25 August 2004, Gambia signed a grant agreement with the Global Fund to Fight HIV I AIDS, Tuberculosis and Malaria. For the initial two years, US$ 5.66 million has been approved. The fight against malaria and HIV I AIDS has thus been intensified on the home front.

The emergence of infectious and noncommunicable diseases also exerts additional problems on an already overstretched national health budget. Diseases such as diabetes and cardiovascular disorders are increasing rapidly. The chronic nature of such diseases requires life-long medication, which is difficult to sustain. Gambia has recently recorded some sporadic cases of cholera; however, thanks to an epidemiology surveillance and control mechanism, and through rapid interventions from WHO and UNICEF, and the Republic of China (Taiwan), the cases were adequately managed and controlled.

Dr DENG Hongmei (China):

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La PRESIDENT A:

Senora delegada, esta presidencia dirige los debates. Creo que hemos intentado hacerlo de la mejor manera posible. Espero con esto haber mostrado mi conformidad con lo expresado. Muchas grac1as.

Monsenor LOZANO-BARRAGAN (Santa Sede):

Senora Presidenta, distinguidos delegados: Me es muy grato traer a la Organizacion Mundial de la Salud los cordiales saludos del nuevo Papa, Benedicto XVI. Su Santidad se ha mostrado muy preocupado por los problemas de salud en el mundo, y ofrece todo su apoyo y ayuda al esfuerzo mundial para lograr la salud para todos, especialmente la salud de los mas desprotegidos, privilegiando los temas que ahora nos preocupan, en particular la salud maternoinfantil. Por desgracia, las enfermedades, en singular las infecciosas, se presentan mas virulentas en los paises mas pobres, que precisamente por su pobreza no tienen recursos para poder obtener las medicinas, que gracias al progreso tecnico actual, facilmente podrian tener alg(ln remedio. De hecho, cada ano las enfermedades infecciosas son responsables de la muerte de 17 millones de personas, de las cuales e1 90% viven en los paises en vias de desarrollo. Por ejemplo, el 95% de enfermos de SIDA no tienen dinero para pagar los antirretrovirales. En la actualidad no se encuentran ni siquiera en el mercado de algunos de estos paises las medicinas para curar las llamadas «enfermedades de pobres», como por ejemplo la tuberculosis, el paludismo, la viruela, el dengue hemorragico, la leishmaniasis, algunas formas de meningitis, la enfermedad del sueno, etc. En el pasado reciente de fines de siglo XX, de 1223 medicinas nuevas introducidas en el mercado entre 1975 y 1997, en 22 anos, solo se introdujeron 13 para el tratamiento de enfermedades infecciosas tropicales. El presupuesto total para medicinas en el mundo se estima entre US$ 50 000 y US$ 60 000 millones por ano, y de este presupuesto solo el 0,2% se dedica a enfermedades respiratorias, tuberculosis y enfermedades diarreicas: Estas enfermedades se estima que sean las causantes dellS% de muertes en el mundo. Junto con estos problemas de salud, refiriendonos en especial a la salud maternoinfantil, es terrible constatar que de 211 millones de nuevos seres humanos que son concebidos, se tienen 46 millones de abortos inducidos, 32 millones entre los que mueren prematuros o mueren al nacer y solo 133 millones 11egan a nacer y vivir. Senor Presidente, conscientes en la Santa Sede de estas y similares problematicas, el Papa Juan Pablo II establecio una Fundacion, cuyo nombre es «El Buen Samaritano», para ayudar a los enfermos mas necesitados del mundo. El nuevo Papa, Benedicto XVI, con gusto ha ratificado dicha Fundacion. El objetivo inicial de esta Fundacion lo concretamos en comprar medicinas para los mas necesitados, y a la fecha ya hemos podido prestar alguna ayuda a enfermos de 11 paises de Africa, uno de Asia y otro de America Latina en los 3 meses que lleva operando la Fundacion. El 26,7% de los Centros de atencion a los enfermos de VIH/SIDA en el mundo son atendidos por la Iglesia Catolica. Queremos asi cooperar de alguna manera a la gran labor que desempena la OMS y sumar nuestros esfuerzos para ayudar en este renglon de la salud especialmente a los mas pobres y necesitados. Muchas gracias.

Mr GAW ANAS (African Union):

Madam President, Director-General, honourable mm1sters, your exce11encies, ladies and gentlemen, I bring you all greetings from Professor Alpha Oumar Konare, Chairperson of the African Union Commission. I wish to take this opportunity to join the previous speakers in congratulating the Minister of Health of Spain for becoming one of the few women to be elected President of the Health Assembly. I also wish to commend the honourable ministers of health under the wise leadership of the outgoing President, the Minister of Health ofPakistan, as we11 as WHO, under the dynamic leadership ofDr Lee Jong-wook, for their co11ective and untiring efforts to improve global health. Africa, which carries the heaviest burden of disease, recognizes what this entails and is aware that it cannot go far without the support of other countries and partners. African leaders have poverty reduction and improvement of the health status of African populations high on their agenda, laying A58NR/5 page 138 emphasis on vulnerable groups - especially women and children. The related strategies that we have adopted in the African Union include early warning systems for emergency preparedness and response, promotion of timely access to information, prevention and control of communicable diseases, provision of affordable drugs, integrated and functioning health systems, health financing and development of human resources in health. There is evidence that African leaders have increased their commitment to ensuring the realization of their pledges, particularly those aimed at tackling the major causes of morbidity and mortality, which include HN/AIDS, tuberculosis, malaria, other infectious diseases and poverty, as well as malnutrition. The African Union Commission has become a member of the global Task Force on HN/AIDS Coordination and is also in the process of finalizing its HN/AIDS Strategy 2005-2007 to address what we regard as an exceptional continental emergency. The AIDS Watch Africa programme, which is an advocacy and resource mobilization strategy at Heads of State level, is in place. With respect to malaria and tuberculosis, an African Union malaria task force is being established and recently the African Union Commission endorsed a Stop TB Partnership roadmap. We continue to participate in various forums, including the high-level meeting on maternal, newborn and child health that was recently held in New Delhi. We will continue to participate and provide political support and leadership and ensure that the voice of Africa is heard everywhere. At the January 2005 Assembly of the Heads of State and Government of the African Union, they requested the African Union Commission to work with partners to take stock of the progress made in the implementation of the Millennium Development Goals and to prepare an African common position on their mid-term review. It will be recalled that almost all the Goals are health related. It is my hope that during the debate that will take place at the next summit, we will highlight the issue of child survival. The preliminary indications, as we all know, are that more has to be done if Africa as a continent is to attain these Goals. I recall the words of the United Nations Secretary-General: "What is needed is not more technical or feasibility studies." What we need is for the commitments that were made to be effectively implemented. Hence, I believe that health ministers, WHO, and other partners need to play a revitalized leadership role to ensure access to basic health services for all. The agenda and outcome of the Fifty-eighth World Health Assembly is therefore of particular interest to the African Union. The African Union Commission will cooperate with all stakeholders in the implementation of the outcome of this Health Assembly and all other endeavours aimed at promoting global health. At this juncture, let me draw the attention of this Health Assembly to the problem of refugees and displaced persons in Africa, especially health in the Dafur region in Sudan. While the support of WHO and many other partners thus far is commendable, the magnitude of the problem requires much more collaboration and efforts. The African Union appreciates the progress made on the revision of the International Health Regulations and it is our hope that the present Health Assembly will reach an agreement on these Regulations. I would like to take this opportunity to commend the African Group in Geneva for their efforts in coordinating and harmonizing views and opinions of African countries, enabling them to speak about important health issues with one voice. Finally, I would like to welcome the new Regional Director for Africa, Dr Samba. The African Union Commission will accord him all the necessary support, as we did with his predecessor. I thank you for giving the African Union Commission, and hence Africa, an opportunity to be part of the Fifty-eighth World Health Assembly.

Dr ESHAYA-CHAUVIN (International Federation of Red Cross and Red Crescent Societies):

Madam President, Director-General, excellencies, distinguished colleagues, the International Federation of Red Cross and Red Crescent Societies welcomes the opportunity to inform you of the experiences of millions of volunteers working around the world to improve the health of vulnerable people. The contribution of the Red Cross and Red Crescent Societies to health objectives is very well known, both nationally and internationally. It is, however, important to bring this understanding to a new level so that cooperation opportunities can be maximized, for the benefit of vulnerable people everywhere in the world. This is one of the main reasons for the decision by WHO and the International Federation that we should lay a new institutional base for our work together. That base is A58NR/5 page 139 the joint Letter of Collaboration signed on 11 May 2005 by the Secretary-General of the International Federation and the Director-General of WHO. The letter will be brought to the attention of all National Red Cross and Red Crescent Societies, and all ministries of health. I will not describe its operational content now, but do wish to underline its message that: The basis of cooperation between the International Federation and WHO is their complementary approach to vulnerability to disease as a major cause of poverty, just as poverty itself is a major contributor to vulnerability to disease. Threats to public health compromise the productivity and productive potential of individuals, communities and entire nations. The International Federation and WHO will work together towards achieving the Millennium Development Goals. We are pleased that there is more and more acknowledgement from governments and international organizations of the importance of mobilizing civil society and the communities around it. We recognize that we as the International Federation have a responsibility to assist through the willing support of our Red Cross and Red Crescent Societies. It is our hope that the joint Letter will make this a more efficient and better-directed contribution to mobilization efforts. Our National Societies - with their commitment to community mobilization, and their place as auxiliaries to the public authorities in the humanitarian field - have much to offer, especially in terms of their large volunteer network, the respect enjoyed by their emblems, and most importantly their proven ability to mobilize the power of humanity and bring additional resources to the community level. The International Federation congratulates WHO for making maternal and child health the focus of the last World Health Day on 7 April 2005, and for The world health report- also dedicated to maternal and child health. Both highlighted an invisible health crisis. In developing countries, pregnancy- and childbirth-related complications are among the leading causes of death for women of reproductive age, and one child in 12 does not reach his or her fifth birthday. Yet the fate of these women and children is too often overlooked or ignored. In April 2005, the International Federation's Health and Community Services Commission endorsed maternal and child health guidance notes for National Societies so that they can better contribute to the global health agenda and the Millennium Development Goals. We see our work together as likely to expand considerably in the future, especially as ministries of health and National Societies expand their own collaboration. That, together with the active partnering which will be further enhanced by our joint letter, suggests that our organizations are at the beginning of a new era in collaboration, for the benefit of human dignity in some of its most basic senses. Madam President, Director-General, thank you for your kind attention.

M. KESSEDJIAN (France) :1

Madame la Presidente, des progres en matiere de sante maternelle et infantile sont indispensables pour la realisation des objectifs du Millenaire pour le developpement. Reduire la pauvrete, lutter efficacement contre le VIH et chercher a atteindre les objectifs du Millenaire pour le developpement necessitent d'investir davantage dans les systemes de sante et les services d'education destines aux femmes. Nous sommes convaincus que la mise en oeuvre integrale du programme d'action du Caire contribuera a la reduction de la pauvrete, a I'egalite des sexes, a !'amelioration du statut de la femme et a la lutte contre le VIH/SIDA. C'est pourquoi nous souscrivons pleinement aux elements developpes par la Presidence de l'Union europeenne sur les liens de la question du VIH/SIDA avec la sante sexuelle et genesique et les droits qui s'y rapportent. La Cinquante-Septieme Assemblee mondiale de la Sante a adopte une strategic en matiere de sante genesique qui porte sur cinq aspects prioritaires a nos yeux : le developpement des soins prenatals lors de l'accouchement et post-partum, les soins aux nouveau-nes, l'offre de soins de qualite pour la planification familiale, }'elimination de l'avortement clandestin, la lutte contre les maladies sexuellement transmissibles, les infections de l'appareil reproductif et du col de l'uterus, et la protection de la sante sexuelle. Sur tous ces points, des efforts doivent etre poursuivis et nous nous y

1 Le texte qui suit a ete remis par la delegation de la France pour insertion dans le compte rendu, conformement a la resolutton WHA20.2. A58NR/5 page 140 employons au niveau national comme dans nos engagements au niveau international. Notre pays qui connait encore une mortalite maternelle trop elevee s'est dote d'un plan perinatalite. Notre objectif prioritaire est de ne plus avoir a enregistrer de morts qui auraient pu etre evitees. Nous considerons qu'il reste encore des progres a accomplir en matiere de cesarienne afin de reduire le nombre de celles qui ne sont pas medicalement indispensables. Nous avons pu eliminer la mortalite resultant des avortements clandestins en depenalisant l'avortement il y a maintenant 30 ans, mais nous devons constater que les interruptions de grossesse rendent compte des difficultes des femmes dans la gestion quotidienne des techniques contraceptives. Le nombre d'interruptions volontaires de grossesse (IVG) a diminue ces dernieres annees, mais compte tenu de la proportion croissante des grossesses chez les mineures nous avons resolu de renforcer !'information sur la contraception et l'IVG. Une loi votee en 2001 a allonge le delai legal de l'IVG de 10 a 12 semaines et etabli le recours a l'IVG medicamenteuse: aujourd'hui, celle-ci represente 35% de la proportion des IVG pratiquees et a double depuis 1990. Nous menons des actions de prevention portant sur la lutte contre les cancers du sein, de l'ovaire et de l'uterus. Nous sommes attentifs aux maladies rares de l'enfant qui ont beneficie d'un plan qui vise a ameliorer le depistage et l'acces aux soins, le carnet de sante de l'enfant a ete refait pour integrer les tests pour la prise en charge des problemes de developpement moteur et des messages d'information aux parents, notamment sur la nutrition, l'allaitement, la mort subite, les accidents domestiques. Un des axes du Plan violence et sante que nous avons con<;:u concerne les enfants et les adolescents, les accidents de la vie courante, les maltraitances. Suite a !'adoption de la strategie mondiale pour l'alimentation, l'exercice physique et la sante et pour laquelle la Cinquante-Neuvieme Assemblee mondiale de la Sante examinera un rapport de mise en oeuvre, nous sommes tres soucieux de la prevention de l'obesite chez l'enfant. La maniere de se nourrir a fortement evolue en un siecle. Nous veillons, en particulier dans le cadre de notre Plan national nutrition et sante, a suivre avec attention !'evolution de la courbe de poids, a prevenir le developpement d'une obesite chez l'enfant par la lutte contre la sedentarite, a exercer un controle rigoureux des messages publicitaires sur les produits alimentaires a forte charge calorique, et a adapter au mieux la supplementation des laits «premier age» en acides gras essentiels afin qu'ils se rapprochent de la composition du lait maternel. Madame la Presidente, en juin prochain, lorsque 1' Assemblee generale des Nations Unies procedera a son examen des progres accomplis dans la realisation des objectifs fixes lors de sa session extraordinaire, puis, en septembre, a 1' occasion du sommet qui se deroulera lors de la soixantieme session de 1' Assemblee generale et qui sera consacree aux suites donnees au Sommet du Millenaire, il nous faudra reconnaitre explicitement !'importance des questions relatives a la sante sexuelle et genesique et aux droits qui s'y rapportent et souligner leur correlation avec le VIH/SIDA. La sante et les droits de la femme en matiere de sexualite et de procreation sont prioritaires a nos yeux pour la lutte contre la propagation du SIDA. L'autonomisation des femmes implique la faculte pour celles-ci de maitriser leur sexualite et leur reproduction. Nous avons peu de chances de realiser des progres en matiere de prevention du VIH si les droits de la femme ne sont pas reconnus et respectes. SIDA et pauvrete sont a la fois cause et consequence l'un de l'autre. Pour contribuer a enrayer ce cercle vicieux, la France agit autant dans le cadre de ses politiques nationales de sante publique qu'a travers sa cooperation bilaterale et multilaterale. Nous estimons que le combat contre le VIH/SIDA ne peut etre gagne sans un acces universe! a des services de qualite en matiere de sante genesique. Pour cela des ressources doivent etre degagees a la fois pour garantir l'acces universe! aux soins de sante genesique et sexuelle et pour combattre le VIH et le SIDA. Les bailleurs de fonds doivent tenir leurs engagements en termes de financement de ces services. Les services prenatals et de sante genesique, que les femmes sont nombreuses a frequenter, constituent par consequent des points de contact essentiels pour maximiser les resultats des actions de prevention du VIH/SIDA et pour garantir le respect integral des droits de la femme. Intensifier la lutte contre le SIDA signifie egalement intensifier les actions menees dans le domaine de la sante genesique et sexuelle. Le soutien aux programmes de recherche dans ce domaine est indispensable pour trouver des moyens plus efficaces de lutte contre la transmission sexuelle et la transmission mere-enfant du VIH. Au-dela de cette meilleure coordination des diverses strategies ( « trois principes »), la France estime que des progres determinants ne seront pas obtenus sans un veritable changement d'echelle A58NR/5 page 141 dans le financement de 1utte contre le VIH/SIDA. Deja deuxieme contributeur bilateral au Fonds mondial de lutte contre le SIDA, la tuberculose et le paludisme, notre pays veut doter cet original mecanisme de gouvemance intemationale de ressources plus perennes pour avancer significativement vers l'objectif des« 3 millions d'ici 2005 ». Elle propose cette fois une operation pilote fondee sur une source innovante de financement : une taxe intemationale sur les billets d'avion ou le kerosene, qui pourrait permettre de relever les defis existants. Face au defi de la stabilite des programmes therapeutiques et de la remise a niveau des systemes de saute, !'augmentation de l'aide publique traditionnelle ne suffira pas. A moyen terme, c'est done une etape autrement plus importante que la communaute intemationale devra franchir, dont les differentes reflexions en cours sur les biens publics mondiaux ont montre la direction (Commission Macroeconomie et Saute de l'OMS, groupe franco­ suedois, groupe «quadripartite», sommets franco-allemands). Sans remettre en cause la souverainete des Etats, seuls des mecanismes innovants de financement (facilites financieres ou prelevements de solidarite intemationaux), couples a un veritable renforcement de la cooperation intergouvemementale, permettront de briser le cercle vicieux du SIDA et de la pauvrete.

M. RI TCHEUL (Republique populaire democratique de Coree) :1

Madame la Presidente, Mesdames et Messieurs, permettez-moi, tout d'abord, de presenter mes sinceres felicitations a Mme la Presidente et aux Vice-Presidents pour avoir ete elus a cette Assemblee. J'aimerais aussi exprimer ma ferme conviction que cette Assemblee obtiendra des resultats fructueux. De meme, je voudrais affirmer que je tiens en haute estime les propositions faites par le Directeur general concemant les menaces et les degats a surmonter dans les pays de 1' Asie du Sud-Est et a l' echelle mondial e. Dans son rapport, le Directeur general a bien souligne la necessite de coherence des efforts au niveau mondial pour faire face aux dangers du SIDA, de la tuberculose, du SRAS, de la grippe aviaire et des maladies infectieuses et non transmissibles, ainsi que la proposition d' augmentation du budget de l'OMS pour 2006-2007 et encore d'autres mesures importantes. Nous sommes stirs que la proposition du Directeur general visera a ameliorer considerablement la situation sanitaire actuelle et done nous lui accordons notre appui. Comme vous le savez, a cause des catastrophes naturelles et des conflits, et d' autres facteurs de maladies, beaucoup de personnes continuent de perdre la vie sans beneficier des soins necessaires. La realite, telle qu'elle est, exige que tout le monde s'entraide avec determination afin d'eliminer le plus vite possible les facteurs menac;;ant toujours l'humanite a l'echelle mondiale. A cet egard, conformement aux situations d'urgence ou l'on voit apparaitre et se diffuser de nouvelles maladies transmissibles, ma delegation s'attend a ce que l'OMS s'occupe des secteurs de toute premiere priorite, etablisse les justes strategies planifiees et concentre tous les efforts necessaires. Mais la cooperation de !'Organisation ne sera pas le moyen fondamental pour ameliorer la situation sanitaire des Etats Membres. Pour que la cooperation offerte par l'OMS soit a la fois efficace et prospective, nous pensons qu'il faudrait renforcer les assistances techniques et materielles conformement aux differentes realites et aux differents niveaux sanitaires de chaque pays. Par consequent, ma delegation propose que l'OMS porte une attention particuliere au fait d'assurer la cooperation en vue d'augmenter les capacites intemes des Etats Membres a repondre aux besoins en medicaments et en specialistes medicaux necessaires. A l'heure actuelle, sous la direction clairvoyante du camarade respecte Kim Jong 11, notre Gouvemement fait tous ses efforts pour ameliorer la saute et le bien-etre du peuple conformement aux idees du Juche son lesquelles 1'homme est le bien le plus precieux du monde. La troisieme session de la Onzieme Assemblee populaire supreme, qui s'est tenue tout recemment dans notre pays, a decide d'augmenter de 110,3% la subvention pour le domaine de la saute, y compris le traitement medical gratuit, dans le budget etatique de cette annee. Ce budget contribuera encore plus a ameliorer la sante

1 Le texte qui suit a ete remis par la delegation de la Republique populaire democratJque de Coree pour insertion dans le compte rendu, conformement a la resolution WHA20.2. A58NR/5 page 142 publique de notre pays, permettant d'etablir des institutions modemes de traitement preventif et d'accroitre la production des medicaments. Dorenavant, bien que nous soyons confrontes a certains obstacles, nous continuerons d'appliquer invariablement la politique populaire superieure de medecine preventive, y compris le traitement gratuit, et de faire le maximum pour renforcer la capacite sanitaire du pays attache a !'amelioration et au developpement de la sante populaire a l'aide de la cooperation etroite de l'OMS et du Bureau regional. Durant ces demieres annees, conformement a son noble devoir humanitaire, l'OMS nous a fourni beaucoup de medicaments, surtout des installations et des appareils medicaux destines au renforcement des hopitaux de province avec l'aide de la formation des experts medicaux. En profitant de cette occasion, notre delegation tient a exprimer ses remerciements sinceres a l'OMS, au Bureau regional, a l'UNICEF, au dispositif mondial pour l'approvisionnement en medicaments et aux pays donateurs qui nous ont accorde leur aide et leur appui sinceres. Merci.

La PRESIDENT A:

Muchas gracias a los oradores. Muchas gracias tambien por haberse autodisciplinado en el uso del tiempo. Cumplimos asi el debate sobre el punto 3 del orden del dia. A las 13.00 horas, en la sala XII, se celebrani una sesi6n de informaci6n tecnica sobre el fortalecimiento de la preparaci6n y respuesta ante una pandemia de gripe; alas 15.00 horas se reunini la Comisi6n A, alas 18.00 horas la Mesa celebrani su segunda sesi6n en la sala XII para formular recomendaciones a la Asamblea de la Salud respecto de la elecci6n anual de los Miembros facultados para designar una persona que forme parte del Consejo Ejecutivo. La Mesa de la Asamblea examinani tambien los avances de nuestro programa de trabajo. Se levanta la sesi6n.

The meeting rose at 12:25. La seance est levee a 12h25. A58NR/6 page 143

SIXTH PLENARY MEETING

Thursday, 19 May 2005, at 17:10

President: Ms E. SALGADO (Spain)

SIXIEME SEANCE PLENIERE

Jeudi 19 mai 2005, 17h10

President: Mme E. SALGADO (Espagne)

AWARDS DISTINCTIONS

La PRESIDENT A:

Se abre la sesi6n. A continuaci6n examinaremos el punto 7 - Premios. Excelencias, distinguidos delegados, senoras y senores. Nos hemos reunido hoy aqui para hacer entrega de los premios otorgados por la Fundaci6n Leon Bemard, la Fundaci6n Conmemorativa Sasakawa para la Salud y la Fundaci6n de Ios Emiratos Arabes Unidos para la Salud. Me complace enormemente dar la mas cordial bienvenida a Ios distinguidos ganadores de estos prestigiosos premios. Me complace tambien poder saludar al senor Y ohei Sasakawa, Presidente de la Fundaci6n Nippon, como representante de la Fundaci6n Conmemorativa Sasakawa para la Salud, y al Excelentisimo senor Mohamed Al-Shaali, Embajador de Ios Emiratos Arabes Unidos, que representa al Fundador de la Fundaci6n de Ios Emiratos Arabes Unidos para la Salud.

Presentation of the Leon Bernard Foundation Prize Remise du Prix de la Fondation Leon Bernard

Vamos a comenzar con la entrega del Premio de la Fundaci6n Leon Bemard. Este premio se concede a una persona que haya realizado una labor destacada en el campo de la medicina social; este ano el premio se ha otorgado al Profesor T. Sharmanov, de Kazajstan. El Profesor Sharmanov, que se encuentra con nosotros acompanado de su hijo, el Dr. Shamam, contribuy6 en su pais, como Ministro de Salud, a organizar la conferencia intemacional sobre la adopci6n de la Declaraci6n de Alma-Ata. Ha contribuido asimismo a hacer realidad muchos programas de gran escala de relevancia social sobre la nutrici6n racional y la prevenci6n de las enfermedades no transmisibles relacionadas con la alimentaci6n. Por iniciativa suya, Kazajstan ha adoptado por primera vez una politica nacional en materia de nutrici6n, cuyo objetivo es prevenir la carencia de micronutrientes, fomentar una alimentaci6n saludable y asegurar el control de la calidad y la inocuidad de los alimentos. Y por todo ello tengo el gran privilegio de entregar el Premio de la Fundaci6n Leon Bemard al Profesor T. Sharmanov, de Kazajstan. ASSNR/6 page 144

Amid applause, the President handed the Leon Bernard Foundation Prize to Professor Sharmanov. Le President remet au Professeur Sharmanov le Prix de la Fondation Leon Bernard. (Applaudissements)

Professor SHARMANOV:

Madam President, Director-General and delegates of the Health Assembly. I am extremely touched and grateful to the Executive Board of WHO and its Director-General, the much-respected Dr Lee Jong-wook, for the fact that I am receiving the Leon Bemard Foundation Prize at the Health Assembly under the roof of the majestic Palais des Nations. I am infinitely proud and delighted that the triumphant victory of the International Conference on Primary Health Care (in Alma-Ata, in 1978) has made my beloved city well recognized across the world. The fact that you have awarded to me, a citizen of Kazakhstan, the highest world health-care prize, promotes my country's prestige in the world arena. The ideas and principles of the Alma-Ata Declaration radically changed the course of the world's health care. Its recommendations, regarding provision for health as paramount among life's values, received absolute recognition in all of the world's nations and are present today in the constitutions of all countries. I take particular pleasure in the fact that the ideology present in the principles of the Alma-Ata Declaration have found fertile ground in the country that was the fatherland of this truly great Conference. Thanks to the far-sighted policies and attachment of President Nazarbayev of Kazakhstan, practical conditions for acceleration of health-care reforms, mobilization of resources for disease prevention and strengthening of the population's health were created. Today, Kazakhstan has become a more attractive country in terms of the main social development indicators. It has gracefully and confidently entered the world community, with a reputation as a country with a stable market economy, an image of good international relations and balanced democratic processes. Today, the issues of primary health care that have been passed on through the principles of the Alma-Ata Declaration have acquired global significance - having shifted from the area of technical expertise into the sphere of politics, entering the agenda of the United Nations - while the issue of health care has been given a central place within the development of human society. I wish the delegations of the Health Assembly fruitful work under such fine WHO leadership, in order to achieve the noble goals of health for all and increase the life expectancy of thousands of millions of people on the planet. Thank you for your attention.

Presentation of the Sasakawa Health Prize Remise du Prix Sasakawa pour la Saute

La PRESIDENT A:

Distinguidos delegados, senoras y senores, paso a continuaci6n a hacer entrega del premia Sasakawa para la Salud. Este premia se otorga cada ano a personas o instituciones en reconocimiento de una labor destacada e innovadora en el campo del desarrollo sanitaria, y con el prop6sito de fomentar el ulterior desarrollo de tallabor. Tengo el placer de anunciarles que el Premia Sasakawa para la Salud del ano 2005 ha sido otorgado al Centra de Capacitaci6n y Educaci6n en Ecologia y Salud para los Campesinos, de Mexico. El Centra proporciona atenci6n primaria mediante un sistema de atenci6n de salud creado para los refugiados y los habitantes locales, basado en la participaci6n activa de las comunidades y de agentes de salud comunitarios voluntarios. Este Centra promueve los servicios de salud en zonas de conflicto mediante la promoci6n de la neutralidad medica y analiza los efectos de los conflictos armadas en los problemas de salud. El Centra ha construido un consultorio y casas de salud para las mujeres, y ha creado ademas un centra de apoyo a los ninos con discapacidades fisicas y mentales. Invito ahora al senor Yohei Sasakawa a que se dirija a la Asamblea en nombre de la Fundaci6n Conmemorativa Sasakawa para la Salud. A58NR/6 page 145

Mr SASAKA W A (Sasakawa Memorial Health Foundation):

Madam President, Dr Lee, excellencies, distinguished guests, ladies and gentlemen, I am delighted to introduce this year's winner of the Sasakawa Health Prize: the Centre for Training and Education in Ecology and Health for Peasants (Mexico). The Centre has done remarkable work, improving the health and nutrition of the disadvantaged indigenous population in Mexico. The Centre collaborates in the creation of conditions for a better exercise of the economic, social and cultural rights of indigenous peoples. It takes a holistic approach and its work includes creation of health-care systems, enhancement of health education and mobilization of volunteer community health workers and even ranges as far as generating agro-ecology programmes. The Centre has successfully realized the ideals of health for all in all of the communities it serves. It is thus a great pleasure to honour the Centre's accomplishment and present the Sasakawa Health Prize. Article 25 of the Universal Declaration of Human Rights states: Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. Looking at the world as a whole, however, this shared goal is still far from being realized. Many people still have no ready access to health services; there are even those who are discriminated against because of the disease from which they suffer. The latter is an issue I am personally fighting, as the WHO Goodwill Ambassador for Leprosy Elimination. Leprosy is one of the oldest diseases known to mankind. Only very recently has a cure become widely available. However, since multidrug therapy was introduced on a global scale in 1985, more than 14 million people worldwide have been cured. Over the same period, global prevalence of the disease has fallen by almost 90%. In 1985, leprosy was a public health problem in 122 countries. Today, only nine remain. WHO's target date for leprosy elimination as a public health problem in every country of the world is December of this year. I have visited the endemic countries to meet with political leaders, health authorities and front-line health workers to encourage them in their efforts to achieve elimination. I also appeal to the media and those in the non-leprosy community to spread the three messages that "Leprosy is curable", "Treatment is free" and "Social discrimination has no place". The Director-General, Dr Lee, began his career in leprosy research. Dr Lee has maintained his strong interest in leprosy elimination and vigorously supports our activities. In every endemic country, the WHO office works tirelessly for elimination in cooperation with governments and nongovemmental organizations. As you can see, much work is being done towards the elimination of the disease. However, the problem of discrimination remains. Last August at the fifty-sixth session of the United Nations Sub-Commission on the Promotion and Protection of Human Rights, a resolution was unanimously adopted to further investigate the state of discrimination against people affected by leprosy. Responding to this, numerous cured persons have stood up and started to make their voices heard. At last, leprosy is being tackled simultaneously on two fronts: as a medical disease, and as a social issue involving discrimination. Health for all must include the right not only to enjoy a healthy life but also the right not to be the object of unreasonable social discrimination because of illness. I am committed to fighting leprosy as well as the social discrimination it engenders, and I take this opportunity to ask for your kind understanding and support. As I conclude, I would like to once more congratulate the Centre for Training and Education in Ecology and Health for Peasants. The Centre is a shining example of good health care in action. It is also showing us how important dignity is to health. It is my deepest wish that this honour will advance the Centre's activities, further contributing to the health and happiness of Mexico's indigenous population. Thank you. A58NR/6 page 146

La PRESIDENT A:

Muchas gracias, senor Sasakawa. A continuaci6n, tengo el honor de entregar el Premio Sasakawa para la Salud al Director del Centro de Capacitaci6n y Educaci6n en Ecologia y Salud para los Campesinos de Mexico, el Dr. Arana.

Amid applause, the President handed the Sasakawa Health Prize to Dr Arana. Le President remet le Prix Sasakawa pour la Sante au Dr Arana. (Applaudissements)

El Dr. ARANA:

Quiero expresar mi agradecimiento al Consejo Ejecutivo de la Organizaci6n Mundial de la Salud, y al Comite de Selecci6n del Premio Sasakawa por el reconocimiento otorgado a nuestro centro. El trabajo que el Centro de Capacitaci6n y Educaci6n en Ecologia y Salud para Campesinos ha de-sarrollado en Chiapas, en el sureste de Mexico, durante mas de 20 afios, se inspir6 desde sus inicios en la Declaraci6n de Alma-Ata de 1978 cuyo espiritu se mantiene vivo en muchas organizaciones del mundo que, como la nuestra, siguen dedicando su trabajo al desarrollo de las capacidades locales para enfrentar los problemas de salud. Las acciones que desarrollamos con refugiados guatemaltecos durante varios afios nos mostraron las consecuencias devastadoras que tienen los conflictos armados en la poblaci6n civil, hecho que nos impuls6 a promover activamente los principios de la autoridad medica y el derecho humanitario internacional durante el conflicto armado tambien en Mexico en 1994. Hemos sido testigos de la manera en que las divisiones comunitarias ocasionadas por los conflictos destruyen el tejido social y afectan a la salud fisica y mental de sus habitantes. Sin embargo, tambien hemos podido atestiguar el poder creativo y transformador de las poblaciones cuando estas se deciden a trabajar unidas como actores activos en la lucha por la salud. Por eso creemos que las condiciones de salud de una poblaci6n son el resultado de su capacidad de ejercicio de sus derechos econ6micos, sociales, culturales y ambientales. Desarrollamos una propuesta de educaci6n para la formaci6n de individuos y sociedades sensibles y conscientes de los derechos propios y ajenos como la base para alcanzar mejores condiciones de salud. La perspectiva de los derechos fortalece la dignidad, la cual es el rasgo mas distintivo del humano, el cual debe ser protegido y fortalecido en cada acci6n de salud. Quisiera expresar mi reconocimiento a los cientos de promotores y promotoras de salud, en su gran mayoria campesinos indigenas mexicanos y guatemaltecos, los cuales, a pesar de tener poco acceso a la educaci6n formal, han dedicado afios de su vida a capacitarse para desempefiar actividades de atenci6n primaria en beneficio de sus comunidades. De ellos y de ellas hemos recibido valiosas lecciones de solidaridad y compromiso, tambien de amor. Una de las actividades sobresalientes de nuestro trabajo ha sido el disefio de modelos de educaci6n orientados a la prevenci6n de la desnutrici6n y a la promoci6n de la salud reproductiva en contextos interculturales. Los contenidos de estas propuestas han sido en gran medida nutridos y fortalecidos por las importantes resoluciones de la Asamblea de la Salud para la protecci6n y la promoci6n de la lactancia materna. Desde su formaci6n, nuestro centro tambien se ha hermanado con organizaciones de muchos otros paises, de la International Baby Food Action Network, para promover el cumplimiento del C6digo Internacional para la Comercializaci6n de Sucedaneos de la Leche Materna. Desde su creaci6n, el Centro de Capacitaci6n y Educaci6n en Ecologia y Salud para Campesinos ha contado con el respaldo del Instituto Nacional de Ciencias Medicas y Nutrici6n Salvador Soubiran, prestigiosa instituci6n mexicana, y este hecho constituye un ejemplo de articulaci6n entre las instituciones de investigaci6n y la academia con los esfuerzos organizados de la poblaci6n mas necesitada para contribuir a la resoluci6n de problemas de salud concretos.

(The speaker continued in English.) (L'orateur poursuit en anglais.) A58NR/6 page 147

Environmental destruction and social inequity are the major threats to peace, life and health in this globalized world. To fight them, we must, now more than ever, avoid depending on technology alone. Sustainable change can only be achieved by strengthening the capacity of countries, individuals and their communities with the aim of creating the conditions for the exercise of all human rights for all. The best way partnership can be constructed for a better world is with people and their communities.

(The speaker continued in Spanish.) (L'orateur poursuit en espagnol.)

En nombre de Ios integrantes de nuestro Centro quisiera agradecer nuevamente esta distinci6n no sin antes subrayar que esta constituye un compromiso para continuar y profundizar el trabajo que realizamos con las poblaciones indfgenas de Chiapas. Muchas gracias.

Presentation of the United Arab Emirates Health Foundation Prize Remise du Prix de la Fondation des Emirats arabes unis pour la Sante

La PRESIDENT A:

A continuaci6n haremos entrega del Premio de la Fundaci6n de Ios Emiratos Arabes Unidos para la Salud. Este ano, el premio ha sido otorgado a Su Majestad la Reina Rania Al-Abdullah de Jordania, por su destacada contribuci6n al desarrollo sanitario. Su Majestad la Reina Rania Al­ Abdullah apoya el desarrollo sanitario de muchas maneras y patrocina numerosas causas, asistiendo a diversas conferencias intemacionales, regionales y locales y a programas relacionados con la salud. Ademas, Su Majestad ha prestado apoyo en Jordania a una campana destinada a destacar el problema de la violencia familiar y la necesidad de proteger a Ios ninos, una campana que es la primera en su genero en Jordania. Su Majestad esta al frente de numerosas organizaciones nacionales e intemacionales relacionadas con la salud, entre ellas la Fundaci6n Intemacional de la Osteoporosis, el Fondo para Vacunas, la Asociaci6n Jordana para la Donaci6n de 6rganos, asi como la Asociaci6n Jordana contra el Cancer, el Equipo Nacional para la Seguridad de la Familia y el Equipo Nacional para el Desarrollo de la Primera Infancia. Tambien me gustaria anunciar a la Asamblea de la Salud que Su Majestad la Reina Rania de Jordania ha sido nombrada Patrocinadora de la OMS para la prevenci6n de la violencia en la Region del Mediterraneo Oriental. Desafortunadamente, Su Majestad la Reina Rania de Jordania no nos puede acompanar hoy, debido a importantes compromisos previos. Por consiguiente, sera el Excelentfsimo Senor Darwazah, Ministro de Salud de Jordania, quien reciba el premio en nombre de Su Majestad. Pero antes de hacer entrega del premio al Senor Ministro, tengo el placer de invitar al Excelentfsimo Senor Embajador Mohamed Al-Shaali, que representa la Fundaci6n de los Emiratos Arabes Unidos para la Salud, a dirigirse a esta Asamblea de la Salud. Senor Embajador, tiene usted la pal abra.

Mr AL SHAALI (United Arab Emirates Health Foundation):

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La PRESIDENTA:

Muchas gracias, senor Embajador. Tengo el horror entonces de hacer entrega del Premio de la Fundaci6n de Ios Emiratos Arabes Unidos para la Salud al Excelentisimo Senor Darwazah, Ministro de Salud de Jordania, quien lo recibe en nombre de Su Majestad la Reina Rania.

Amid applause, the President handed the United Arab Emirates Health Foundation Prize to Mr Darwazah. Le President remet le Prix de la Fondation des Emirats arabes unis pour la Sante a M. Darwazah. (Applaudissements) A58NR/6 page 149

Mr DARWAZAH (Jordan):

La PRESIDENTA:

Muchas gracias, senor Ministro. A58NR/6 page 150

Francesco Pocchiari Fellowship Bourse Francesco Pocchiari

La PRESIDENT A:

Es para mi un placer anunciar a la Asamblea de la Salud que la beca Francesco Pocchiari 2005 ha sido concedida a la Profesora Gonlil Dine, de Turquia. Nacida en el afi.o 1967, la Dra. Dine se licencio por las Facultades de Medicina de Izmir y Antalya, de Turquia. Sus actuales trabajos se centran en la investigacion de los servicios de salud y en la manera de entender ese concepto como la investigacion de todos los aspectos de las tecnologias de la salud y la prestacion de atencion sanitaria. Esta beca va a permitir a la Dra. Dine profundizar en el terreno del amilisis decisional y la evaluacion de nuevos modelos de atencion primaria. Quisiera sefi.alar a la atencion de la Asamblea de la Salud el documento A58/42, que presenta las enmiendas introducidas en los Estatutos de la Fundacion lhsan Dogramaci para la Salud de la Familia, seglin lo aprobado en la ll5a reunion del Consejo Ejecutivo. Con esta nota y dando una vez mas mi felicitacion a los premiados, concluimos el punto 7 del orden del dia, y con ello esta sesion plenaria de la Asamblea de la Salud. Para su informacion, les indico que la proxima sesion plenaria se celebrara el viemes 20 de mayo de 2005, alas 9.00 horas. Se levanta la sesion.

The meeting rose at 17:50. La seance est levee a 17h50. A58NR/7 page 151

SEVENTH PLENARY MEETING

Friday, 20 May 2005, at 09:10

President: Ms E. SALGADO (Spain)

SEPTIEME SEANCE PLENIERE

Vendredi 20 mai 2005, 9hl0

President: Mme E. SALGADO (Espagne)

1. ANNOUNCEMENT COMMUNICATION

La PRESIDENT A:

Se abre la sesi6n. Cuando se reuni6 el miercoles 18 de mayo la Mesa de la Asamblea elabor6 la lista para la elecci6n anual de los Miembros facultados para designar una persona que forme parte del Consejo Ejecutivo y tambien examin6 el programa de trabajo de la Asamblea. La Mesa se reunini hoy de nuevo alas 14.30 horas para determinar los progresos realizados. Tras considerar los progresos que se habian realizado por las comisiones principales, la Mesa recomend6 que el plena se reuniera esta mafiana alas 9.00 horas para examinar el punto 6 «Consejo Ejecutivo: elecci6m>, y el punto 8 «lnformes de las comisiones principales». De acuerdo con el programa de trabajo que elabor6 la Mesa, la Comisi6n Ay la Comisi6n B se reuninin inmediatamente despues de que se levante la sesi6n plenaria.

2. EXECUTIVE BOARD: ELECTION CONSEIL EXECUTIF: ELECTION

La PRESIDENT A:

Podemos pasar a examinar ahora el punto 6 «Consejo Ejecutivo: elecci6n». Sefialo a su atenci6n la lista de 10 miembros que figura en el documento A58/51, elaborado por la Mesa de conformidad con el articulo 102 del Reglamento Interior. En opinion de la Mesa, si resultan elegidos esos 10 Miembros, se garantizara una composici6n de conjunto equilibrada en el Consejo. Por orden alfabetico ingles, los Miembros en cuesti6n son los siguientes: Azerbaiyan, Bhutan, Iraq, Jap6n, Liberia, Madagascar, Mexico, Namibia, Portugal y Rwanda. De conformidad con lo dispuesto en el articulo 80 del Reglamento Interior, (.desea la Asamblea elegir esos 10 Miembros que propane la Mesa? Puesto que no hay ninguna objeci6n, declaro elegidos a esos 10 Miembros. Esta elecci6n quedara pues debidamente registrada en las aetas de la Asamblea. ASSNR/7 page 152

Deseo aprovechar esta oportunidad para invitar a los Miembros a prestar la debida atenci6n a las disposiciones del Articulo 24 de la Constituci6n a la hora de designar una persona que forme parte del Consejo Ejecutivo.

3. REPORTS OF THE MAIN COMMITTEES1 RAPPORTS DES COMMISSIONS PRINCIP ALES 1

La PRESIDENT A:

A continuaci6n abordaremos el punto 8 del orden del dia «lnformes de las comisiones princi­ pales».

First report of Committee A Premier rapport de la Commission A

En primer lugar, vamos a examinar el primer informe de la Comisi6n A que se encuentra en el documento A58/49.

Mr BURCI (Legal Counsel):

Thank you, Madam President. The Secretariat would like to make an observation on the title of the draft resolution contained in document A58/49, the first report of Committee A. On the basis of consultations among a number of Member States, it was proposed to delete from the title of the draft resolution the words "south Asian" so the title would read: "Health action in relation to crises and disasters, with particular emphasis on the earthquakes and tsunamis of 26 December 2004". Madam President, you may wish to ask the Health Assembly whether there is any objection to this amendment to the title of the draft resolution. Thank you, Madam President.

La PRESIDENT A:

Hay alguna observaci6n en relaci6n con la modificaci6n que se ha propuesto? Puesto que no hay observaciones L,esta dispuesta la Asamblea, de conformidad con lo dispuesto en el Reglamento a adoptar esta resoluci6n con la enmienda propuesta por la Secretaria? No habiendo ninguna objeci6n, se adopta la resoluci6n en su forma enmendada y por consiguiente se aprueba el primer informe de la Comisi6n A.

The meeting rose at 09:20. La seance est levee a 9h20.

1 See reports of committees in document WHA58/2005/REC/3. 1 Voir Ies rapports des commissions dans le document WHA58/2005/REC/3. A58NR/8 page 153

EIGHTH PLENARY MEETING

Monday, 23 May 2005, at 09:15

President: Ms E. SALGADO (Spain)

HUITIEME SEANCE PLENIERE

Lundi 23 mai 2005, 9hl5

President: Mme E. SALGADO (Espagne)

1. SECOND REPORT OF THE COMMITTEE ON CREDENTIALS1 DEUXIEME RAPPORT DE LA COMMISSION DE VERIFICATION DES POUVOIRS1

La PRESIDENT A:

Se abre la sesi6n. La Asamblea examinan1 hoy el segundo informe de la Comisi6n de Credenciales, que se reuni6 el 19 de mayo de 2005. El informe figura en el documento A58/52 que todos ustedes han recibido. (,Desean formular observaciones acerca del informe? No hay observaciones. (,Desea la Asamblea aprobar este informe? Puesto que no hay objeciones, se aprueba el informe.

2. REPORTS OF THE MAIN COMMITTEES1 (continued) RAPPORTS DES COMMISSIONS PRINCIPALES1 (suite)

Second report of Committee A Deuxieme rapport de la Commission A

La PRESIDENT A:

Examinaremos ahora el segundo informe de la Comisi6n A, que figura en el docurnento A58/54. Hagan caso omiso de la palabra «proyecto» puesto que la Comisi6n ha adoptado el informe sin ninglin cambio. El informe contiene una resoluci6n, titulada «Control del paludismo». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay ninguna objeci6n, se adopta la resoluci6n y por consiguiente se aprueba el segundo informe de la Comisi6n A.

1 See reports of committees in document WHA58/2005/REC/3. 1 Voir les rapports des commissions dans le document WHA58/2005/REC/3. A58NR/8 page 154

Third report of Committee A Troisieme rapport de la Commission A

La PRESIDENT A:

Examinaremos ahora el tercer informe de la Comisi6n A, que figura en el documento A58/55. El informe contiene la resoluci6n titulada «Revision del Reglamento Sanitario Internacional». (.Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n y por consiguiente, se aprueba el tercer informe de la Comisi6n A. Quisiera felicitar a todos y a todas por la adopci6n del Reglamento Sanitario Internacional y reconocer muy en particular la contribuci6n de la Presidenta del Grupo de Trabajo Intergubernamental, la Embajadora Mary Whelan, de Irlanda, que nos acompafia en la Mesa. Si alguna delegaci6n desea intervenir sobre este punto, con mucho gusto le dare la palabra. La Arabia Saudita tiene la palabra.

Dr AL-MANEA (Saudi Arabia): . ,~)lo~ll_p o.L.J.l:o. ~ 4...i..:....lll J \..i..Jc w....:.:. = ~ .wi ~~ \..l;Ul\ · Wl -=-- '-11 11 r, t...;,"j\ .hi! u..:l i - 0 - 0 I.,? - ~ J f' lY' C"" ~ !$', ..) • ..) .4..billl o~ ~ ~t.J )I e:a 0'11 r-..:li....\1 r-th::l' e:a ~ _; r-1 .~)lo~ll_p

Doy ahora la palabra al Asesor Juridico.

Mr BURCI (Legal Counsel):

Thank you, Madam President. The status of Annex 9 was discussed in the Intergovernmental Working Group as well as in the drafting group that worked on the resolution. The text that appears in Annex 9 is the current Health Part of the Aircraft General Declaration as adopted by ICAO. Since the Intergovernmental Working Group had a number of changes to recommend to the document, and since the document is not a WHO document, but an ICAO document, it was agreed to submit those recommended changes to ICAO. In the future, when ICAO revises the Aircraft General Declaration, if it also revises the Health Part, hopefully it will take into account our comments and our recommendations. At that point, the new text will be inserted into Annex 9 next time with the changes that ICAO has approved. Once again, the text that appears in Annex 9 is the current Health Part of the Aircraft General Declaration, and the document currently in force and applied in international civil aviation practice. Thank you very much.

Ms LAMBERT (South Africa):

Madam President, once again at the Health Assembly we are making international history. Two years ago in May 2003, the Health Assembly adopted the Framework Convention on Tobacco Control, the world's first public health treaty. The Framework Convention on Tobacco Control was the result of a lengthy process of careful negotiation and subtle compromise. In the two short years since we adopted the Framework Convention on Tobacco Control, it has achieved the requisite number of ratifications and has now come into force. In another two years' time, as the result of yet another lengthy process of careful negotiation and subtle compromise, which was eventually concluded in the early hours of the morning, the 2005 version of the International Health Regulations will enter into force. This will be another public health milestone just like the Framework Convention on Tobacco Control. These new International Health Regulations are a great deal more than a mere revision of the 1969 Regulations. Those Regulations, as important as they were and, indeed, still are, amount to little A58NR/8 page 155 more than an international health directive based on a few diseases like yellow fever. The new International Health Regulations are much more like an international convention or treaty. They are comprehensive, detailed and applicable between and among all Member States ofWHO that choose to be bound by them wholly or in part through the reservations mechanism. The new International Health Regulations are deliberately intended to be universally applicable. They have been designed consciously to protect the health and well-being of all the people of the world. The purpose and scope of the new International Health Regulations are wide-ranging but still within the mandate of WHO. The revised International Health Regulations aim to prevent, control and provide a public health response to the international spread of disease and to situations where there is a public health emergency of international concern. South Africa is particularly satisfied to see that the implementation of the new International Health Regulations will be done with full respect for the dignity, human rights and fundamental freedoms of all people. This principle, which echoes the sacrosanct principles enshrined in the South African Constitution, is of paramount importance to us, and we congratulate the negotiators for paying particular attention to human rights. The second principle that is of deep significance to South Africa is that of state sovereignty. While we fully comprehend that, particularly in present times, we have to yield some sovereignty in order to ensure universal human safety, well-being and health, we nevertheless believe that no international legal instrument should automatically deprive nations of what should be inalienable aspects of their sovereignty. We are, therefore, also satisfied that the negotiators have carefully attended to this principle in the new International Health Regulations. On historic occasions such as this, expressions of gratitude and appreciation are entirely appropriate and so, on behalf of the South African Government, we would like to reiterate the sentiments that we expressed on Tuesday morning in Committee A. We would like to start by thanking the Director-General, Dr Lee, for his leadership in promoting an urgent revision of the International Health Regulations. We highly commend Dr Hardiman and his colleagues for the hours of research, thought and hard work that went into the compilation of the original proposed text of the Regulations, and the Secretariat, under the able leadership of Dr Kean and his extraordinary team of people - too many to name here, but who are known to us nonetheless. The South African Government would like to express its heartfelt thanks. You not only made the negotiations possible, you made them pleasant and seamless as well. To Mr Burci and his able team of lawyers, all of whom were indispensable in the negotiating process, we owe a special debt of gratitude. We salute Ireland's Ambassador, Mrs Mary Whelan, the strong, skilful and gracious Chair of the process, whom we hold in high esteem. We also pay tribute to all the negotiators from more than 150 Member States: your patience, skill, determination and flexibility have provided us with a document that as a collective we can be proud of. And, finally, we would like to pay a very special and heartfelt tribute to the negotiators from the WHO Regional Office for Africa. We have no words to tell you how proud we are of all your efforts, your dedication and commitment to Africa and to the spirit and letter of the African renaissance. They shine through in every piece of work that you undertake for us. We congratulate and salute you. Thank you, Madam President and colleagues.

Mr HOHMAN (United States of America):

Madam President, first of all I would like to associate my delegation with the remarks just made by the distinguished representative of South Africa, when she thanked the many colleagues who have been involved in the process leading up to the adoption of the International Health Regulations. I will not repeat all the names, but I do want to single out Ambassador Whelan, in particular, for her effective leadership of the Working Group and for her good humour, which played an important part in enabling it to reach this conclusion. I also want to congratulate the Director-General and everyone in the Secretariat who made an important contribution. The United States agrees with other Member States that the current International Health Regulations are inadequate to deal with current high levels of international migration, emerging infections and threats of terrorism. Accordingly, the United States has participated actively in the Working Group and in subregional and regional meetings. The United States believes that the revised Regulations will provide an effective mechanism for responding to new global public health threats in a manner that is consistent with the principles embodied in Article 3. A58NR/8 page 156

We attach particular importance to the universal application of the Regulations for the protection of all people of the world from the international spread of disease. The United States is pleased with the Working Group's achievements and the cooperation and flexibility of the negotiating partners, and fully supports the adoption of the text of the International Health Regulations as approved by the Working Group on 14 May 2005, and which we have adopted this morning. However, the United States has several concerns regarding the final text of the revised Regulations and will submit formal understandings and a reservation in relation to these concerns at the appropriate time. Throughout the revision process of the International Health Regulations, the United States has taken the position that the new Regulations must reflect the real threats to international public health in the twenty-first century. Among the most serious of those threats is the accidental or deliberate release of biological, chemical and radiological materials. One of the reasons given by WHO for revising the International Health Regulations was to address these new threats to public health. The United States is pleased that all States Parties to the revised Regulations will be obligated to report events that involve the naturally occurring, accidental or deliberate release of biological, chemical and radiological materials that may have the potential to cause public health emergencies of international concern, and that the Director-General may declare public health emergencies of international concern regardless of the source or origin of the event. We note that Article 7 of the revised Regulations specifically requires a State Party to provide WHO with any evidence it has of an unexpected or unusual public health event within its territory, irrespective of origin or source, which may constitute a public health emergency of international concern. The deliberate or accidental release of biological, chemical and radiological materials within the territory of a State Party would certainly constitute an unexpected or unusual event, irrespective of origin or source. Moreover, the Health Assembly has explicitly acknowledged a role for WHO in this area, most notably in resolution WHA55.16 on global public health response to natural occurrence, accidental release or deliberate use of biological and chemical agents or radionuclear material that affect health, which was adopted by consensus in 2002. Thus, the United States will apply the revised Regulations with the understanding that they apply to all such health threats, namely, chemical, biological and radiological, and all causes and modes of events, regardless of whether they are naturally occurring, accidental or deliberate, and we expect all other WHO Member States to do the same. The United States expects to submit a formal understanding to this effect at the appropriate time. The United States sought a provision within the International Health Regulations that would have explicitly allowed States Parties, in rare cases, to take into account national security requirements as they apply the International Health Regulations to their armed forces. Although the Working Group did not adopt this explicit provision, the United States understands that the Regulations - a public health instrument - are not intended to compromise the national security of States Parties. Therefore, we will implement these Regulations as they apply to armed forces on that understanding. The United States expects to submit a formal understanding to that effect at the appropriate time. Finally, and for the record, the United States sought a provision that would explicitly recognize the right of federal states to implement the Regulations in a manner that is consistent with the division of rights and responsibilities existing in their constitutionally mandated systems of government. Unfortunately, the Working Group did not accept this straightforward request. Accordingly, the United States will submit a narrowly tailored reservation, in accordance with Article 62 of the International Health Regulations, that will clarify that the United States will implement the Regulations in a manner that is consistent with our federal system of government. The United States also states for the record of this meeting that the United States Federal Government will implement the Regulations to the extent that it exercises jurisdiction over the matters covered therein. Otherwise, our state and local governments will implement them. To the extent that state and local governments in the United States exercise jurisdiction over these matters, the Federal Government will take measures appropriate to our federal system to facilitate the implementation of these Regulations. Thank you.

Mr SHA Zukang (China):

Madam President, the Chinese delegation is happy that the revised International Health Regulations have been finally adopted today. We believe that the revised International Health A58NR/8 page 157

Regulations, as an international legal instrument, will play an important role in building up the world health system and taking care of people's health and life in the world. Thanks to our cooperation, flexibility and a "give and take" spirit, we eventually concluded the revised International Health Regulations as scheduled. My delegation appreciates the efforts made by all parties in the whole process of the revision work, especially the Chair of the Intergovernmental Working Group, Ambassador Mary Whelan. China also appreciates the hard work done by the coordinators of the resolution drafting group and the Chairman of Committee A; last but not least, our appreciation goes to the Director-General, Dr Lee, and his excellent team for their longstanding support for our work. As all have agreed, there are four principles in the revised International Health Regulations, namely: respecting human rights; respecting the sovereignty of Member States; abiding by the United Nations Charter and the Constitution of the World Health Organization; and universal application. People may have preferences, but China believes that the four principles are of equal importance and are interrelated. The revised International Health Regulations have provided explicit obligations for Member States and responsibility for the WHO Director-General. It is our view that all parties concerned shall perform their respective functions as provided by the revised International Health Regulations and cooperate with each other for their comprehensive and effective implementation. Thank you, Madam President.

Dr PEZESHKIAN (Islamic Republic oflran):

Madam President, Director-General, excellencies, distinguished delegates, on behalf of the WHO Eastern Mediterranean Region Member States, I wish to express my felicitations to all for this achievement. It became possible only through great determination and remarkable endeavour. Let me take this opportunity to sincerely thank Ambassador Mary Whelan, the distinguished Permanent Representative of Ireland, for her hard work. Our appreciation also goes to the Director-General and his capable staff for all their tireless efforts. The agreement we have just reached is the final outcome of a multilateral process, indeed a difficult and complex one; we nevertheless managed to finish the work. The most pressing issue for the Eastern Mediterranean Region was to undertake, with resolve and good faith, the finalization and adoption of the revised International Health Regulations. The Eastern Mediterranean Region was serious in pursuing its interests and concerns and equally well disposed to work in concert with others towards the finalization of the International Health Regulations. The Region tried its best to ensure that a broader scope of the revised International Health Regulations would not lead WHO to get involved in areas and activities already being covered by other competent specialized agencies, leading to overlapping of their functions, focus and competencies. For WHO Member States, the aim was to make sure that they would not be overburdened by duplicative obligations. The Eastern Mediterranean Region also wanted to ensure that an expanded scope would not result in redundancy, ending up with a diversion of resources of which the developing States are in dire need. We tried to guarantee that a broader scope would not go beyond WHO's purview as a humanitarian specialized agency, as its humanitarian mission and function should not be disturbed through unwarranted interference on non-health issues. The resolution to which the revised International Health Regulations are attached is understood to be only a procedural vehicle to carry the Regulations to their destination. It is my delegation's understanding, and I believe it is also the understanding of most other delegations, that internationally binding instruments are to be implemented by those party to them, regardless of their individually tailored understandings. To conclude, I should like to express my gratitude to the Member States of the Eastern Mediterranean Region for their excellent work, support and cooperation throughout the process. It was only through the solidarity of the group that the achievements could be reached. I thank you, Madam President. A58NRJ8 page 158

El Dr. ESTEVEZ TORRES (Cuba):

Nos sumamos a los agradecimientos expresados por todos los que ban intervenido anteriormente en relacion a los esfuerzos que se realizaron para la aprobacion del nuevo Reglamento Sanitaria Internacional, y en especial agradecemos la labor realizada por la Representante Permanente de Irlanda, Sra. Whelan, que ha presidido el Grupo de Trabajo Intergubernamental que negocio la revision del Reglamento Sanitaria Internacional. El Reglamento Sanitaria Internacional debe ser un instrumento que fortalezca la capacidad de la comunidad internacional no solo para dar respuesta a la propagacion de enfermedades sino tambien para prevenirlas. Para cumplir con ese objetivo sera muy importante la capacidad que posean todos los Estados Partes en el Reglamento para responder adecuadamente ante los eventos que se contemplaran en ese instrumento. Todos aqui somas conscientes de que existe una brecha entre paises ricos y pobres en cuanto a las capacidades logisticas para responder o enfrentar eventos relacionados con el Reglamento. No todos los paises en desarrollo cuentan con los medicamentos, medias de diagnostico de enfermedades y equipos medicos para cumplir adecuadamente con los objetivos del Reglamento. En consecuencia, el exito de su aplicacion dependera en gran medida de la forma en que los Estados Partes cooperen entre si y se abstengan de adoptar medidas unilaterales que obstaculicen el desarrollo de las capacidades nacionales de cualquier otro Estado Parte. El bloqueo economico y financiero que el Gobierno de los Estados Unidos de America aplica contra Cuba es un serio obstaculo que impacta en toda la sociedad cubana, y por supuesto afectara la manera en que Cuba pudiera responder en correspondencia con las disposiciones del nuevo Reglamento Sanitaria Internacional. Asimismo, Cuba reconoce la importancia que posee un Reglamento Sanitaria Internacional de la OMS para la proteccion de la salud de la poblacion mundial, y no se nos escapa el hecho de que el reglamento que esta vigente (de 1969) ya resulta insuficiente y por tanto la revision del mismo constituye un paso de avance. Habida cuenta de todo lo expresado anteriormente, Cuba se sumo al consenso de la Asamblea Mundial de la Salud que acaba de adoptar el nuevo Reglamento Sanitaria Internacional, pero hara una reevaluacion del mismo a la luz de las preocupaciones que mi delegacion ha planteado. Muchas gracias.

La PRESIDENT A:

Muchas gracias. Para finalizar este turno de intervenciones sabre este punto tienen la palabra el Canada y Luxemburgo.

Ms GILDERS (Canada):

Madam President, Canada would like to acknowledge, as our South African colleague put it, the historic nature of what we have achieved today. At times progress can seem difficult or slow when we tackle issues of major global significance. But on a morning like this, we can be truly proud of the consensus that can be achieved when Member States undertake negotiations with good faith, commitment and flexibility. Canada wishes to join others in congratulating the Director-General and the Secretariat on their unrelenting support and hard work in bringing us to this consensus. We also pay tribute to the skills and good humour of Ambassador Whelan, whose chairmanship also helped to bring us to this consensus. For Canada, there were several matters of prime importance: the need for a clear, transparent process; a scientifically based assessment and review process for determining potential public-health emergencies of international concern; the universal application of rules; and clear roles for all players, including communication with national focal points. These were key driving factors for us and we are very pleased with the results. We join others in thanking all fellow delegates for their commitment to making the world a much safer place, with a clear set of international health regulations for dealing with the very real threat of the international spread of disease. Thank you very much, Madam Chair. A58NR/8 page 159

Le Dr HANSEN-KOENIG (Luxembourg) :

Madame la Presidente, je parle au nom de l'Union europeenne, de ses 25 Etats Membres, des pays adherents, Roumanie et Bulgarie, et des pays candidats, Croatie et Turquie. Je serai tres breve, mais je ne peux pas ne pas parler. Nous vivons aujourd'hui un moment historique et je tiens a exprimer nos plus sinceres remerciements et nos felicitations a taus ceux qui y ant contribue. D'abord, notre gratitude a Madame 1'Ambassadeur Mary Whelan pour son engagement exemplaire durant tout ce processus ; mes sinceres remerciements vont aussi a taus les Etats Membres qui se sont montres engages, souples, taus guides par un meme but, celui de mieux proteger la sante publique, notre sante commune. Mais cette revision n'aurait pas abouti sans le long travail de preparation engage avant meme la reunion du groupe intergouvernemental. Plus largement, l'Union europeenne tient a feliciter l'OMS pour un succes qui viendra durablement renforcer la credibilite et la pertinence de !'Organisation. Ces felicitations s'adressent done aussi a vous Monsieur le Directeur general, a vos predecesseurs, comme aux hommes et aux femmes de vos services, dont le devouement a la cause du Reglement sanitaire international ne s'est jamais relache. Le monde a aujourd'hui franchi un pas important sur le difficile chemin menant vers !'assurance du meilleur niveau de sante possible pour to us.

La PRESIDENT A:

Muchas gracias, muchas gracias a todos par sus palabras de felicitaci6n que quiero hacer mias para el equipo que ha dirigido los trabajos.

Fourth report of Committee A Quatrieme rapport de la Commission A

La PRESIDENT A:

Pasemos ahora, si les parece, a otro punto del orden del dia. Examinamos el cuarto informe de la Comisi6n A, que figura en el documento A58/56; aqui tambien pueden hacer caso omiso de la palabra proyecto, puesto que la Comisi6n ha adoptado el informe sin realizar ninglin cambio. El informe contiene dos resoluciones. La primera se titula «Resoluci6n de Apertura de Creditos para el ejercicio financiero 2006-2007». Tiene la palabra el delegado de los Estados Unidos de America.

Mr HOHMAN (United States of America):

Thank you, Madam President. During the discussion on the Proposed programme budget for 2006-2007 in Committee A, my delegation expressed some concern about one of the indicators in one area of work. We were assured by the Secretariat that a corrigendum would be issued to correct that error. We have not yet seen that corrigendum, and therefore my delegation is not in a position to adopt the appropriations resolution until we have some information about our request.

Mr AITKEN (Office of the Director-General):

Just to confirm that that corrigendum will be issued this week, as was mentioned by the appropriate Assistant Director-General in Committee A.

Mr HOHMAN (United States of America):

Thank you for the information provided by the Secretariat. However, I would want to see that corrigendum issued by tomorrow, if that is possible. A58NR/8 page 160

Dr NORDSTROM (Assistant Director-General):

Yes, it will be possible to have that issued as discussed in the Committee and in accordance with the United States' request. In addition to that, we will also issue a new document which is the approved programme budget, incorporating this change plus two more changes that were suggested during the Committee: one relating to essential medicine, a new paragraph 14, incorporating also the corrigendum containing some of the figures that were issued before the discussion at the Board, plus we will incorporate the appropriation resolution itself in the revised document, which is actually going to be the approved programme budget document. Thank you.

La PRESIDENT A:

(,Esta dispuesta la Asamblea a adoptar esta resoluci6n de Apertura de Creditos para el ejercicio financiero 2006-2007, en su forma enmendada? Puesto que no hay objeciones, se adopta la resoluci6n en la forma enmendada. La segunda resoluci6n se titula Fortalecimiento de la preparaci6n y respuesta ante una pandemia de gripe. (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n y por consiguiente se aprueba el cuarto informe de la Comisi6n A.

First report of Committee B Premier rapport de la Commission B

La PRESIDENTA:

Examinaremos a continuaci6n el primer informe de la Comisi6n B que figura en el documento A58/53. La Comisi6n adopta el informe sin cambio alguno. Este informe contiene ocho resoluciones y una decision. La primera resoluci6n se titula «Condiciones de salud en el territorio palestino ocupado, incluidos Jerusalen oriental y el Golan sirio ocupado. (,Desea la Asamblea adoptar esta resoluci6n? Tiene la palabra el delegado de los Estados Unidos de America.

Mr HOHMAN: (United States of America):

Madam President, my delegation would like the official records of this plenary meeting to reflect that this resolution was adopted in Committee B by a recorded vote and is not a consensus resolution. Thank you.

La PRESIDENT A:

Muchas gracias. Asi figurara en las aetas. (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluc16n. La segunda resoluci6n se titula «Miembros con atrasos de contribuciones de importancia bastante para que este justificado aplicar el Articulo 7 de la Constituci6n». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n. La tercera resoluci6n se titula «Atrasos en el pago de contribuciones: Georgia». (,Desea la Asamblea adoptar esta resoluci6n? No hay objeciones, se adopta la resoluci6n. La cuarta resoluci6n se titula «Atrasos en el pago de las contribuciones: Iraq». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n. La quinta resoluci6n se titula «Atrasos en el pago de las contribuciones: Republica de Moldova». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n. La sexta resoluci6n se titula «Atrasos en el pago de las contribuciones: Tayikistam>. (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n. A58NR/8 page 161

La septima resolucion se titula «Sueldos de los titulares de puestos sin clasificar y del Director General». t,Desea la Asamblea adoptar esta resolucion? Puesto que no hay objeciones, se adopta la resolucion. La octava resolucion se titula «Seguridad de la sangre: propuesta para el establecimiento del Dia Mundial del Donante de Sangre». t,Desea la Asamblea adoptar esta resolucion? Puesto que no hay objeciones, se adopta la resolucion. Dentro del subpunto 19.5 del orden del dia, la Comision estuvo de acuerdo con una decision titulada «Nombramiento de representantes en el Comite de la Caja de Pensiones del Personal de la Organizacion Mundial de la Salud». t,Esta de acuerdo la Asamblea con esta decision? Puesto que no hay objeciones, asi queda decidido y por consiguiente se apmeba el primer informe de la Comision B.

The meeting rose at 10:00. La seance est levee a 10 heures. A58NRJ9 page 162

NINTH PLENARY MEETING

Wednesday, 25 May 2005, at 11:00

President: Ms E. SALGADO (Spain)

NEUVIEME SEANCE PLENIERE

Mercredi 25 mai 2005, 11 heures

President: Mme E. SALGADO (Espagne)

1. REPORTS OF THE MAIN COMMITTEES1 (continued) RAPPORTS DES COMMISSIONS PRINCIPALES1 (suite)

La PRESIDENT A:

Esta mafiana vamos a abordar el punto 8 del orden del dia «lnforrnes de las comlSlones principales».

Fifth report of Committee A Cinquieme rapport de la Commission A

Vamos a comenzar examinando el quinto inforrne de la Comisi6n A, que se encuentra en el documento A58/57. La Comisi6n ha adoptado el inforrne sin ninglin cambio, por lo que pueden ustedes hacer caso omiso de la palabra «proyecto». El inforrne contiene dos resoluciones. La primera se titula «Financiaci6n sostenible de la prevenci6n y el control de la tuberculosis». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay ninguna objeci6n, se adopta la resoluci6n. La segunda resoluci6n se titula «Proyecto de estrategia mundial de inrnunizaci6n». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay ninguna objeci6n, se adopta la resoluci6n y por consiguiente se aprueba el quinto inforrne de la Comisi6n A.

Le Professeur KINDE-GAZARD (Benin) :

Madame, je souhaite intervenir au nom du Groupe africain et vous prier de donner la parole a notre collegue du Zimbabwe qui pourra lire notre declaration. Je vous remercie.

1 See reports of committees in document WHA58/2005/REC/3. 1 Voir les rapports des commissions dans le document WHA58/2005/REC/3. A58NRI9 page 163

Dr PARIRENYATW A (Zimbabwe):

Thank you, Madam President. My delegation takes the floor on behalf of the 46 Member States of the WHO African Region to express our unequivocal support for the global immunization strategy as reflected in document A58!12. We also wish to place on record our understanding that this Fifty-eighth World Health Assembly has expressed its full approval of this strategy through the adoption of the resolution on global immunization strategy as contained in document A58/57. We are confident that the international community, our development partners and other relevant partners will embrace this strategy and work together with the Director-General to provide the much needed support to Member States, especially those in greatest need, in the implementation of this strategy. I wish to thank you, Madam President.

La PRESIDENTA:

Muchas gracias. Tiene la palabra la delegaci6n de Sudafrica.

Ms MAFUBELU (South Africa):

Madam President, thank you for having given me the floor. The delegation of South Africa would like to support in full the statement read by the Honourable Minister of Zimbabwe on behalf of the 46 Member States of the African group. We wish to express our appreciation to the Member States for approving the global immunization strategy. We are confident that the Director-General will get all the support he needs to implement this. We stand ready and willing to give our support also where it is required. Thank you.

Second report of Committee B Deuxieme rapport de la Commission B

La PRESIDENTA:

A continuaci6n examinaremos el segundo informe de la Comisi6n B que se encuentra en el documento A58/58. La Comisi6n ha adoptado este informe sin ninglin cambio. El informe contiene dos resoluciones. La primera se titula «Promoci6n de un envejecimiento activo y saludable». ~Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n. La segunda resoluci6n se titula «Migraci6n intemacional del personal sanitario, un reto para los sistemas de salud de los paises en desarrollo». ~Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n y por consiguiente se aprueba el segundo informe de la Comisi6n B.

Third report of Committee B Troisieme rapport de la Commission B

La PRESIDENTA:

A continuaci6n examinaremos el tercer informe de la Comisi6n B, que se encuentra en el documento A58/59, yen el documento A58/59 Corr.l, publicado solo en ingles. Este informe se ha adoptado tambien sin cambios y contiene seis resoluciones.

La primera resoluci6n se titula «Informe financiero interino no comprobado sobre las cuentas de la Organizaci6n Mundial de la Salud en el afio 2004». ~Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta esta resoluci6n. A58NR/9 page 164

La segunda resoluci6n se titula «Contribuciones para 2006-2007», el texto en ingles de esta resoluci6n se encuentra en el documento A58/59 Corr.l. (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta esta resoluci6n. La tercera resoluci6n se denomina «Modificaciones del Reglamento Financiero y de las Normas de Gesti6n Financiera». (,Desea la Asamblea adoptar esta resoluci6n Puesto que no hay objeciones, se adopta esta resoluci6n? La cuarta resoluci6n se titula «Fondo para la Gesti6n de Bienes Inmuebles». (,Desea la Asamblea adoptar esta resoluci6n? No habiendo objeciones, se adopta la resoluci6n. La quinta resoluci6n se titula «Prevenci6n y control del cancer». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta esta resoluci6n. La sexta y ultima resoluci6n de este informe se titula «Discapacidad, incluidos la prevenci6n, el tratamiento y la rehabilitaci6n». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta esta resoluci6n y por consiguiente se aprueba e1 tercer informe de la Comisi6n B.

Sixth report of Committee A Sixieme rapport de la Commission A

La PRESIDENT A:

A continuaci6n examinaremos el sexto informe de la Comisi6n A que se encuentra en el documento A58/60; pueden tambien aqui hacer caso omiso de la palabra «proyecto», puesto que la Comisi6n ha adoptado el informe sin ninglin cambio. El informe contiene una resoluci6n, titulada «Sostenimiento de la eliminaci6n de los trastomos por carencia de yodo». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n y por consiguiente se aprueba e1 sexto informe de la Comisi6n A.

Fourth report of Committee B Quatrieme rapport de la Commission B

La PRESIDENT A:

A continuaci6n examinaremos el cuarto informe de la Comisi6n B, que figura en el documento A58/61. La Comisi6n ha adoptado el informe sin ninguna modificaci6n. En este informe figuran dos resoluciones. La primera se titula «El proceso de reforma de las Naciones Unidas y el papel de la Organizaci6n Mundial de la Salud en la armonizaci6n de las actividades operacionales para el desarrollo en los paises» (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta esta resoluci6n. La segunda resoluci6n se titula «Problemas de salud publica causados por el uso nocivo del alcohol». (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta la resoluci6n y de este modo se aprueba el cuarto informe de la Comisi6n B. Tiene la palabra la delegaci6n de Islandia.

Mr GUNNARSSON (Iceland):

Thank you, Madam. I take the floor on behalf of the five Nordic countries: Denmark, Finland, Sweden, Norway and Iceland. But first, let me say that I want to applaud you and the Chairmen of the Committees and indeed all Member States for the excellent manner in which this Health Assembly has been conducted; then I shall speak about the resolution on alcohol. I said to the Director-General before the beginning of this meeting that I had attended 10 sessions of the Health Assembly here and I thought this was the best one. He looked at me and said, "David, it isn't true. It is only your memory that is failing; they have all been good." And I think that A58NR/9 page 165 is true and it proves to me that, when we meet in this distinguished hall, we show that we have a good possibility to resolve our disputes in peace. The approval by this Health Assembly of the resolution on alcohol is indeed a landmark decision. We, the Nordic countries, have no doubt that the Work ahead of us- for the WHO Secretariat as well as for Member States - will be as interesting and challenging as the process we have been through to agree on this resolution. In this regard, it is important that the resolution sets clear terms of reference for the work the Secretariat will undertake, including for the involvement of stakeholders. We also attach great importance to the fact that WHO's regulations for expert groups will apply. Thank you, Madam President.

La PRESIDENT A:

Muchas gracias, sefior delegado, por sus palabras y permitame tambien felicitarle a mi vez por el trabajo que usted ha realizado durante toda esta Asamblea. Tiene la palabra la delegaci6n de Nueva Zelandia.

Dr MATHESON (New Zealand):

Thank you, Madam President. The New Zealand delegation strongly supports the sentiments just expressed by the delegate of Iceland. We also would like to note that the resolution draws attention to the involvement of stakeholders, especially in operative paragraphs 2(8) and 2(9). The New Zealand interpretation of this reference is that we need to be sure that all stakeholders are given a voice in the work that WHO undertakes on this important topic. The resolution recognizes the significant role of industry and that there are other important voices that need to be heard: for example, those of children, youth and families who are directly affected by the harmful use of alcohol. New Zealand attaches great importance to the involvement of all these stakeholder groups. Thank you, Madam President.

Seventh report of Committee A Septieme rapport de la Commission A

La PRESIDENT A:

Examinaremos a continuaci6n el septimo informe de la Comisi6n A, que figura en el documento A58/62. En este informe figuran tres resoluciones. La primera se denomina «Mejora de la contenci6n de la resistencia a los antimicrobianos» (,Desea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta esta resoluci6n. La segunda resoluci6n se titula «Cibersalud». En este caso, la Comisi6n ha aprobado el proyecto de resoluci6n con algunas modificaciones, y por ello concedere la palabra al Sr. Aitken, quien dani lectura de los cambios que se han introducido. Sefior Aitken tiene usted la palabra.

Mr AITKEN (Office of the Director-General):

Thank you, Madam President. The Committee adopted this report with one correction to the resolution: it was the omission of a footnote that defined e-leaming. That footnote would come at the end of operative paragraph 2(6) and would read as follows: "eLeaming is understood in this context to mean use of any electronic technology and media in support of learning." Thank you, Madam President.

La PRESIDENT A:

Muchas gracias (,Desea la Asamblea adoptar esta resoluci6n en su forma enmendada, de acuerdo con la lectura del Sr. Aitken? Puesto que no veo ninguna objeci6n, se adopta la resoluci6n en su forma enmendada. A58NR/9 page 166

La tercera resoluci6n se denomina «Reforzamiento de la bioseguridad en ellaboratorio». (,De­ sea la Asamblea adoptar esta resoluci6n? Puesto que no hay objeciones, se adopta esta resoluci6n y por consiguiente se aprueba el septimo informe de la Comisi6n A en su forma enmendada.

Fifth report of Committee B Cinquieme rapport de la Commission B

La PRESIDENT A:

Seguidamente examinaremos el quinto informe de la Comisi6n B. Este informe apareceni como documento A58/63. La Comisi6n B celebr6 su decima sesi6n el 25 de mayo de este aiio 2005 bajo la presidencia del Profesor Jose Pereira Miguel (Portugal). Se decidi6 recomendar a la 58a Asamblea Mundial de la Salud que adoptara dos resoluciones relativas al punto 13 del orden del dia «Asuntos tecnicos y sanitarios» y el subpunto 13.2 «Consecuci6n de los Objetivos de Desarrollo del Milenio relacionados con la salud». La primera resoluci6n se titula «Acelerar la consecuci6n de los objetivos de desarrollo relacionados con la salud acordados internacionalmente, incluidos los que figuran en la Declaraci6n del Milenio», se encuentra en el documento A58/B/Conf.Paper N° 6. Dado que la Comisi6n ha aprobado este proyecto de resoluci6n con modificaciones, concedere la palabra al Sr. Aitken para que de lectura de los cambios que se han introducido. Senor Aitken, tiene usted la palabra.

Mr AITKEN (Office of the Director-General):

Thank you, Madam President. There was only one change, which was in the penultimate preambular paragraph, to add the words "including nongovemmental organizations". The phrase would now read: "Noting that many countries have cooperation and partnership mechanisms with civil society, including nongovernmental organizations, ... " and then we continue on as in the text. Thank you, Madam President.

La PRESIDENT A:

(,Desea la Asamblea adoptar esta resoluci6n en esta forma enmendada de acuerdo con la modificaci6n leida por el Sr. Aitken? Puesto que no hay ninguna objeci6n, se adopta la resoluci6n en esta forma enmendada. La segunda resoluci6n se titula «Hacia la cobertura universal en las intervenciones de salud materna, del recien nacido y del nifim> y se encuentra en el documento A58/ A/Conf.Paper. No 7 Rev.l. En este caso tambien la Comisi6n ha aprobado el proyecto de resoluci6n con modificaciones y en consecuencia concedere la palabra al Sr. Aitken para que de lectura de los cambios que se han introducido. Senor Aitken, tiene usted la palabra.

Mr AITKEN (Office of the Director General):

Thank you, Madam President. There were two changes introduced this morning in the Committee; the first was in the third last preambular paragraph, simply to add the words "General Assembly" so that the last wording would read: " ... and the United Nations General Assembly special session on children (New York, 2002);". The second change was a correction in operative paragraph 1, subparagraph 2, to remove the word "care" which is in the last line so that it would read " ... health by 2015;". Thank you, Madam President.

La PRESIDENT A: Muchas gracias. t,Desea la Asamblea adoptar esta resoluci6n con esos cambios que ha leido el Sr. Aitken? Puesto que no hay ninguna objeci6n, se adopta esta resoluci6n en su forma enmendada y por consiguiente se aprueba el quinto informe de la Comisi6n B con las modificaciones que se han mencionado. A58NR/9 page 167

Eighth report of Committee A Huitieme rapport de la Commission A

La PRESIDENT A:

A continuacion examinaremos el octavo informe de la Comision A. El informe aparecen1 como documento A58/64. La Comision A celebro su sesion el 25 de mayo de 2005 bajo la presidencia del Dr. Bijan Sadrizadeh (Republica Islamica del Iran). Se decidio recomendar a la 58 3 Asamblea Mundial de la Salud que adoptara tres resoluciones relativas a Ios siguientes puntos del orden del dia: 13.11 «Nutricion del lactante y del nino pequeno», 13.16 «Seguro social de enfermedad» y 13.18 «Cumbre Ministerial sobre lnvestigacion en Salud». La primera resolucion se titula: «Nutricion del lactante y del nino pequeno» y se encuentra en el documento A58/A/Conf.Paper No 11 Rev.l. (.Desea la Asamblea adoptar esta resolucion? Puesto que no hay ninguna objecion, se adopta la resolucion. La segunda resolucion se titula «Financiacion sostenible de la salud, cobertura universal y seguro social de enfermedad» y se encuentra en el documento A58/A/Conf.Paper No 15. l,Desea la Asamblea adoptar esta resolucion? Puesto que no hay objeciones, se adopta esta resolucion. La tercera resolucion se titula «Cumbre Ministerial sobre lnvestigacion en Salud». Se encuentra en el documento A58/A/Conf.Paper No 14 y, dado que la Comision ha aprobado este proyecto de resolucion con modificaciones, concedo la palabra al Sr. Aitken, para que de lectura de Ios cambios que se han introducido. Senor Aitken tiene usted la palabra.

Mr AITKEN (Office of the Director-General):

Thank you, Madam President. This morning, the Committee approved this draft resolution with two changes, both to operative paragraph 4. The first was in subparagraph 5, where wording at the end was agreed as follows: " ... and to consider convening the next ministerial-level meeting on health research in 2008;". Then in subparagraph 6, to remove the square brackets and add the words "on health research" after the words "Member States", so the opening would read: "to ensure that meetings open to all Member States on health research ... " and then would continue as shown. Thank you.

La PRESIDENT A:

Muchas gracias senor Aitken. l,Desea la Asamblea adoptar esta resolucion con Ios cambios mencionados? Puesto que no hay objeciones, se adopta la resolucion con esos cambios y por consiguiente se aprueba el octavo informe de la Comision A en su forma enmendada. Concluye con eso nuestro examen del punto 8 del orden del dia «lnformes de las comisiones principales».

2. SELECTION OF THE COUNTRY OR REGION IN WHICH THE FIFTY -NINTH WORLD HEALTH ASSEMBLY WILL BE HELD CHOIX DU PAYS OU DE LA REGION OU SE TIENDRA LA CINQUANTE­ NEUVIEME ASSEMBLEE MONDIALE DE LA SANTE

La PRESIDENT A:

Deseo senalar a la atencion de la Asamblea de la Salud que, de conformidad con lo dispuesto en el Articulo 14 de la Constitucion, la Asamblea de la Salud en cada reunion anual debeni designar el pais o region en el que se celebrara la siguiente reunion anual, y posteriormente el Consejo Ejecutivo fijara el lugar exacto y la fecha. En este punto, quisiera recordar que la 38 3 Asamblea Mundial de la Salud llego a la conclusion de que en interes de todos Ios Estados Miembros las Asambleas de la Salud debian celebrarse en la sede de la Organizacion. A58NR/9 page 168

Por consiguiente, debo entender que la Asamblea decide que la 59a Asamblea Mundial de la Salud se celebre en Suiza. (,Esta de acuerdo la Asamblea con esta decision? Puesto que no hay objeciones, asi queda acordado. (,Desea alguna delegaci6n tomar la palabra antes de levantar la sesi6n? Dado que nadie desea tomar la palabra levantare la sesi6n durante unos breves minutos antes de proceder a la sesi6n de clausura. Les ruego que permanezcan en sus asientos. Se levanta la sesi6n.

The meeting rose at 11:35. La seance est levee a llh35. A58NRJ10 page 169

TENTH PLENARY MEETING

Wednesday, 25 May 2005, at 11:40

President: Ms E. SALGADO (Spain)

DIXIEME SEANCE PLENIERE

Mercredi 25 mai 2005, llh40

President: Mme E. SALGADO (Espagne)

CLOSURE OF THE SESSION CLOTURE DE LA SESSION

La PRESIDENT A:

Se abre la sesi6n. Hemos llegado al ultimo punto del orden del dia: punto 9. Clausura de la Asamblea. Invito al Dr. Sadrizadeh (Republica Ishimica del Inin), Presidente de la Comisi6n A, a subir a la tribuna para resumir ante la Asamblea el extraordinario trabajo realizado por la Comisi6n A. Sefior Sadrizadeh, tiene usted la palabra.

Dr SADRIZADEH (Islamic Republic oflran) (Chairman of Committee A):

Madam President, Director-General, honourable ministers, distinguished delegates, ladies and gentlemen, as in the past, Committee A dealt with a very heavy agenda of extremely pressing and challenging public-health issues. The focus of our discussions ranged from ancient health risks to the most up-to-date technology. The Committee began its substantive deliberations by discussing the revision of the International Health Regulations. Her Excellency, Ambassador Mary Whelan of Ireland, Chair of the Intergovernmental Working Group on Revision of the International Health Regulations, reviewed for us the complex but stimulating process of revision. All our attention then turned to the related draft resolution on which the deliberations continued in four sessions of a working group. Delegations demonstrated the flexibility, spirit of cooperation and willingness to compromise that came to characterize the work of the Committee. The full Committee approved by consensus the amended draft resolution entitled "Revision of the International Health Regulations", bringing to a successful conclusion the long process of review. The spirit of harmony, respect and mutual support with which we began, prevailed until the completion of our work. All the resolutions of Committee A were approved by consensus. These included the resolutions, "Health action in relation to crises and disasters, with particular emphasis on the earthquakes and tsunamis of 26 December 2004"; "Malaria control"; "Strengthening pandemic-influenza preparedness and response"; "Sustainable financing for tuberculosis prevention and control"; "Global immunization strategy"; and "eHealth". A58NR/10 page 170

Our agenda included the Proposed programme budget 2006-2007 which we discussed after dividing the areas of work into six groups. The related appropriation resolution for the financial period 2006-2007 was approved by consensus. We transferred six agenda subitems to Committee B. Throughout this Health Assembly, working groups materially assisted the Committee. This was certainly true in the case of the revision of the International Health Regulations, as I have mentioned. It was also valid for the resolutions on improving the containment of antimicrobial resistance; sustainable health financing, universal coverage and social health insurance; enhancement of laboratory biosafety; and infant and young-child nutrition. The Committee noted the Secretariat's report on poliomyelitis. The Committee also took note of the progress reports on implementation of resolutions. These were: "Prevention and control of iodine deficiency disorders"; "Traditional medicine"; "Implementing the recommendations of the World report on violence and health"; "Strategic approach to international chemicals management"; "Promotion of healthy lifestyles"; "WHO Framework Convention on Tobacco Control"; and "Scaling up treatment and care within a coordinated and comprehensive response to HIV/AIDS". The resolution entitled "Sustaining the elimination of iodine deficiency disorders" was approved as amended. In short, ours was a very demanding but absorbing agenda. This brief account fails to do justice to the richness of scientific content and earnest humanity reflected in the interventions of all delegations. It was a privilege to have chaired Committee A. I would like to express my admiration for the patience, dedication and spirit of international solidarity shown by the distinguished delegates and my gratitude for their cooperation. Although opinions differed on certain issues, no voting was required; the Committee reached agreement on every item. Delegates debated vigorously and fairly but, in the end, were able to put aside national considerations in favour of perceived benefit to global public health. In conclusion, Madam President, I would thank the Vice-Chainnen, Dr Ntaba of Malawi and Pehin Dato Abu Bakar Apong of Brunei Darussalam, and the Rapporteur, Dr Busuttil of Malta for their willing assistance. I particularly want to thank Dr Islam and Dr Zupan, the Secretary and Co-Secretary of Committee A and all the rest of the staff of the Committee, without whose steady support my task would scarcely have been possible. I am also very grateful to the dozens of other Secretariat staff who contributed to the smooth running of the Committee's daily work. It has been an honour, for me personally and for my country the Islamic Republic of Iran, to have chaired this Committee. Thank you, Madam President and distinguished delegates.

La PRESIDENT A:

Muchas gracias. Quisiera felicitarle muy cordialmente por su excelente presentaci6n, asi como por el acierto con el que ha presidido la Comisi6n. En ausencia del Dr. Walcott, Presidente de la Comisi6n B, invito al Vicepresidente de la Comisi6n B, Profesor Pereira Miguel (Portugal), a subir a la tribuna para informar sobre los trabajos de la Comisi6n B. Tiene la palabra, seiior Pereira.

Professor PEREIRA MIGUEL (Portugal) (Vice-Chairman of Committee B):

Madam President, distinguished delegates, Dr Lee Jong-wook, ladies and gentleman, it is a great pleasure for me to present to you this report on behalf of Dr Jerome Walcott, Chairman, Dr M. Abdur Rahman Khan, Vice-Chairman, and Mr Yee Ping Yi, Rapporteur, my colleague officers of Committee B during this year's Health Assembly. I will concentrate my comments on a few of the landmark achievements of Committee B since you have all been informed about the daily work of the Committee through its reports. This year the work of the Committee included six subitems under "Technical and health matters", which were transferred from Committee A, in addition to its mandated items: "Report of the Internal Auditor"; "Financial matters"; "Real Estate Fund"; "Staffing matters"; "Proposal for establishment of World Blood Donor Day"; "Implementation of multilingualism in WHO"; and "Collaboration within the United Nations system and with other intergovernmental organizations". A58NR/10 page 171

The Committee also took up discussions on the health conditions of, and assistance to, the Arab population in the occupied Arab territories, including Palestine. All the discussions in Committee B were very intensive and productive, whether they pertained to technical and health matters or to administration or other matters. The exchanges took place in an impressive spirit of consensus-building and solidarity. Twenty resolutions and one decision were approved. The Committee started its work with the discussion on health conditions of, and assistance to, the Arab population in the occupied Arab territories, including Palestine. Over 40 delegations took the floor. In accordance with Rule 74 of the Rules of Procedure, a roll-call vote was taken. The draft resolution entitled "Health conditions in the occupied Palestinian territory, including East Jerusalem, and in the occupied Syrian Golan" was approved, with 103 Members voting - 95 votes in favour, eight votes against - and 11 abstentions. The agenda item, "Financial matters: Status of collection of assessed contributions, including Member States in arrears in the payment of their contributions to an extent that would justify invoking Article 7 of the Constitution" was considered. Five resolutions were approved in this respect. Two other resolutions were approved following discussions on the unaudited interim financial report on the accounts of WHO for 2004, and on the assessments for 2006-2007, both of which were introduced by Dr Y oosuf, Chairman of the Programme, Budget and Administration Committee of the Executive Board. Within the agenda item on staffing matters, the subitem, "Amendments to the Staff Regulations and Staff Rules" in respect of salaries of staff in ungraded posts and of the Director-General was considered and one resolution approved. A decision was also approved regarding the appointment of representatives to the WHO Staff Pension Committee. An important aspect of the discussions under "Collaboration within the United Nations system and with other intergovernmental organizations" was the submission and approval of a resolution on the United Nations reform process and WHO's role in harmonization of operational development activities at country level. Discussions on the issue of a proposal for establishment of World Blood Donor Day resulted in the approval of a resolution. The six subitems under "Technical and health matters" transferred from Committee A were the following: "Achievement of health-related Millennium Development Goals"; "Cancer prevention and control"; "Disability, including prevention, management and rehabilitation"; "Public health problems caused by harmful use of alcohol"; "International Plan of Action on Ageing: report on implementation"; and "International migration of health personnel: a challenge for health systems in developing countries". Discussions on all these subitems were intense and enlightening but I would like to highlight and salute the very conciliatory efforts made by many delegations towards reaching consensus, especially in relation to the resolutions on public health problems caused by harmful use of alcohol and the achievement of health-related Millennium Development Goals. No less than 40 interventions on public health problems caused by harmful use of alcohol and the establishment of a working group for the Millennium Development Goals were necessary to work through some of the contentious issues, over a two-day period, in order to reach agreement. These efforts have been particularly rewarding because they have resulted in the approval of two pioneering resolutions: "Public-health problems caused by harmful use of alcohol" and "Accelerating achievement of the internationally agreed health-related development goals, including those contained in the Millennium Declaration". Please allow me also to pay tribute to the technical and administrative staff throughout the Organization who have ably supported and facilitated the work of the delegations so that advances could be made rapidly. It has been an honour and privilege for me and my country to chair Committee B during the last two days. As I have just mentioned, we have been able to settle some important technical and management issues within a short space of time and in a spirit of conciliation and solidarity. I should like to thank warmly all the delegations who contributed to this impressive settling of differences. Of course, all this was only possible because of the tremendous support and professional assistance my colleagues and I received from the Secretariat of Committee B to make sure that the Health Assembly could proceed smoothly and productively. I would like expressly to extend my gratitude to the Secretary of Committee B, Dr Y ounes. I thank you, Madam President, for your leadership which has been instrumental in achieving the objectives of this Health Assembly. I would also like to thank the Vice-Presidents for their support in making this Health Assembly as successful as it has been. And to you, Director-General, on behalf of us all, I would like to extend our warm thanks for your generous A58NR/10 page 172 support throughout the Health Assembly. We know that we can count on your unfailing support beyond the confines of the Health Assembly. I should like to take this opportunity to wish all the officers and delegates safe travel, good health and peace. Adios y buen viaje, or, as we say m Portuguese, Adeus e boa viagem.

La PRESIDENT A:

Quisiera darle las gracias por su informe, y elogiar la manera en que el Presidente y los dos vicepresidentes han dirigido los trabajos de la Comisi6n B. Dado que las comisiones principales han finalizado sus trabajos, incluido el examen de los informes del Consejo Ejecutivo, podemos ya tomar nota oficialmente de dichos informes. A juzgar por las observaciones que he escuchado, entiendo que la Asamblea desea felicitar al Consejo por el trabajo realizado y expresar su agradecimiento por la dedicaci6n con que ha llevado a cabo las tareas que se les han encomendado. t,Estan ustedes de acuerdo, espero, en esta felicitaci6n colectiva? (Applause/Applaudissements)

La PRESIDENT A:

Puesto que no hay observaciones, asi queda acordado. El Director General desea dirigirles unas palabras. Doctor Lee, tiene usted la palabra.

The DIRECTOR-GENERAL:

Madam President, honourable ministers, distinguished delegates, first of all, I would like to thank you for adopting the resolution on my salary without voting. I would like to thank all the delegates for the energy and commitment they have demonstrated over the last 10 days; in particular, I wish to thank you, Madam President, for presiding so graciously and so successfully over these discussions with the excellent support of the Vice-Presidents of the Health Assembly and Chairmen of Committee A and Committee B. I would also like to add my thanks to Ambassador Whelan who chaired the Intergovernmental Working Group on Revision of the International Health Regulations. The adoption of the resolutions and the Regulations reflects a consensus that has great strength and clarity. Yet adoption of these Regulations is only a beginning; I will immediately take action on the steps required in the resolution, including strengthening our capacity to provide support to countries for detection, assessment and response to public health emergencies and the establishment of an International Health Regulations roster of experts. We may have little time to prepare for the next influenza pandemic. I urge all Member States and partners to meet the requirements for preparedness, surveillance and response and we will ensure that the Secretariat moves quickly to assist you all in these efforts. The adoption of the Programme budget for 2006-2007 gives clear direction to the work of the Organization in the next biennium and also reflects the trust of Member States in the work of the Secretariat. I thank you very much. The Health Assembly has adopted many resolutions concerning issues of profound significance for global health, and the Secretariat will work quickly to implement the actions required by these resolutions. Thank you all for the hard work and the many accomplishments of the past 10 days. Thank you very much.

(Applause/Applaudissements)

LA PRESIDENT A:

Doctor Lee, Director General de la Organizaci6n Mundial de la Salud, honorables ministros, excelencias, distinguidos delegados e invitados, senoras y senores, amigos y amigas: Permitanme, en primer lugar, felicitar a la Asamblea por la exitosa conclusion de los trabajos derivados de una agenda tan completa como la que hemos tenido. El merito principal sin ninguna duda corresponde a los A58NR/10 page 173 mmtstros y al resto de los miembros de las delegaciones, por su activa participacion y por su capacidad para construir consensos para llegar a acuerdos. Una parte muy importante del merito corresponde al Dr. Lee y a su equipo. Durante esta semana y media de trabajo conjunto he podido comprobar' su gran dedicacion y su notable capacidad de liderazgo. Para mi ha sido un placer trabajar conjuntamente y, desde luego, me ofrezco a seguirlo haciendo con el mismo espiritu de colaboracion durante el resto de la presidencia. Quiero agradecer tambien a los cinco Vicepresidentes de la Asamblea, y a los Presidentes y Vicepresidentes de las Comisiones A y B, sus largas horas de esfuerzo. Su sabiduria y tambien su paciencia han permitido presentar ante este plenario importantes proyectos de resolucion que despues han sido adoptados. La Asamblea tiene, tambien, una deuda con el personal de apoyo de la Secretaria, con los traductores y con los interpretes, y con todos aquellos cuyo trabajo constante y callado permite que un gran acontecimiento como este se pueda desarrollar fluidamente y concluir con exito. Honorables ministros, distinguidos delegados: durante los ultimos 10 dias hem os escuchado a oradores y a expertos de gran nivel que, como todos nosotros, comparten un decidido compromiso con la salud de la gente. Hemos escuchado al Sr. Maumoon Abdul Gayoom, Presidente de la Republica de Maldivas, relatamos lo que para un pais pequefio situado en el Oceano indico significo - y todavia significa - la tragedia causada por el tsunami del pasado diciembre. Oyendole, hemos aprendido lo importante que resulta estar preparados, lo importante que resulta actuar con anticipacion para, en la medida de lo posible, prevenir este tipo de situaciones. Hemos aprendido tambien que es vital actuar de forma nipida y efectiva, y contar con un buen liderazgo, y, tambien, que el esfuerzo de reconstruccion posterior requiere ser sostenido en el tiempo. Y a todo ello se refiere la resolucion que la Asamblea ha adoptado sobre este tema. Hemos escuchado, asimismo, al Sr. Bill Gates en su calidad de cofundador de la Fundacion Bill y Melinda Gates. El Sr. Gates planteo cuatro grandes prioridades para que la ciencia y la conciencia moral actuenjuntas en la construccion de un mundo mas sano y mas justo: intensificar la lucha contra las enfermedades; investigar mas sobre aquellos problemas que mas vidas se cobran; dedicar mas recursos a que las soluciones lleguen a quienes mas las necesitan; y conseguir que las fuerzas politicas y el mercado operen en beneficia de los mas pobres. Y creo hablar en nombre de toda la Asamblea si digo que todos compartimos esas prioridades. Hemos escuchado tambien al Director General en un excelente discurso del que formaron parte las palabras de la Sra. Venneman, Directora Ejecutiva recientemente nombrada del UNICEF. El hecho mismo de que se haya dirigido a la Asamblea Mundial de la Salud a las dos semanas de ocupar su cargo pone de manifiesto la importancia que tanto el UNICEF como la OMS otorgan al trabajo conjunto. Y este es un enfoque que debe ser reforzado en beneficia de la salud de todos los nifios del mundo. De lo que hemos escuchado a los distintos oradores saco tres conclusiones. La primera es que, mas que nunca, vivimos en un solo mundo. La segunda es que los retos de la salud publica mundial son formidables. Y la tercera, que cada vez disponemos de mas y mejores medios para hacer frente a esos retos. Conseguir los resultados depende, por lo tanto, de nosotros mismos, de nuestra capacidad de movilizacion, de nuestra inteligencia y nuestra conciencia para definir objetivos, para aprender de la experiencia, para trabajar y para sostener el esfuerzo, y tambien de nuestro sentido de solidaridad para at ender a quienes mas lo necesitan. Y debo decir que he vis to mucho de todo esto en los 10 dias de esta Asamblea. Por ejemplo, con ocaswn de los debates para la aprobacion del Reglamento Sanitaria Intemacional, y creo poder decir, sin temor a equivocarme, que esta ss• Asamblea Mundial de la Salud va a ser recordada como la Asamblea que aprobo el nuevo Reglamento Sanitaria Intemacional. Un Reglamento a la altura de los retos de comienzos del siglo XXI. Un instrumento que da confianza y seguridad a los Estados y alas personas, porque cuando hace 10 afios, la 48• Asamblea Mundial de la Salud tomo la decision de revisar el Reglamento Sanitaria Intemacional del afio 1969, sus Miembros sofiaron con ver este momento. Y este momento ha llegado a1 fin, y por eso creo que todos debemos felicitamos. Esta Asamblea ha adoptado tambien otras resoluciones muy importantes. Quisiera solo mencionar algunas: el control del paludismo; el fortalecimiento de los preparativos para hacer frente a A58NR/10 page 174 una eventual pandemia de gripe; la situaci6n sanitaria en los territorios de Palestina; el financiamiento de la prevenci6n y el control de la tuberculosis; la estrategia mundial de inmunizaci6n; la estrategia de envejecimiento activo y saludable; la migraci6n del personal de salud; la nutrici6n de Ios nifios. Y por ultimo, y no es lo menos importante, tambien hemos aprobado el presupuesto de la OMS para el bienio 2006-2007. Este presupuesto marca una tendencia ascendente que, aunque modesta, va a permitir que la Organizaci6n haga frente a nuevos retos sabre la base de la transparencia, la eficacia y el fortalecimiento de las acciones regionales y de pais, y tambien sabre la rendici6n de cuentas. Todo esto, se realiza ya por parte de esta modelica Organizaci6n. Distinguidos delegados: Ios retos de la salud en el nuevo siglo requieren un compromiso renovado y el esfuerzo de todos. De las autoridades nacionales, de Ios agentes sociales, de Ios profesionales de la salud, de Ios organismos internacionales, de los ciudadanos tambien. Y en particular, requieren una OMS prestigiosa y fortalecida. Me parece que la 58a Asamblea Mundial de la Salud que ahora concluimos ha cumplido sus objetivos y, de nuevo, les doy las gracias por ello. Y confio, tambien, en que sepan perdonar Ios errores o defectos en que como Presidenta haya podido incurrir. Cuando el Director de la Oficina Regional para Europa me dijo que iba a proponer mi nombre, senti que era un gran honor para mi y para mi pais y quiero decides que ademas ha sido un gran placer. Quisiera por ello aprovechar esta ocasi6n para expresarles mis mejores deseos de paz y de prosperidad a ustedes y a los paises que representan. A vanzar en la direcci6n de las resoluciones que hemos tornado es una tarea grande y noble. Porque grande y noble es trabajar por la salud de la gente. Y el afio que viene vamos a tener la oportunidad de volver a reunirnos para proseguir el esfuerzo. Rasta entonces, les deseo a todos ustedes un buen viaje de regreso para todos aquellos que se hayan desplazado y a todos ustedes good luck, mes felicitations, au revoir et excusez-moi de ne pas par/er franr;ais, arabe, chinois ou russe. Merci a taus, gracias a todos y hasta el afio que viene. Muchas gracias a todos.

(Applause/Applaudissements)

El momento final ha llegado, con pena para todos, pero hemos terminado con exito nuestros trabajos y, por lo tanto, declaro oficialmente clausurada la 583 Asamblea Mundial de la Salud.

The session closed at 12:15. La session est close a 12h15. A58NR page 175 MEMBERSHIP OF THE HEALTH ASSEMBLY COMPOSITION DE L' ASSEMBLEE DE LA SANTE

LIST OF DELEGATES AND OTHER PARTICIPANTS LISTE DES DELEGUES ET AUTRES PARTICIPANTS

DELEGATIONS OF MEMBER STATES DELEGATIONS DES ETATS MEMBRES

AFGHANISTAN-AFGHANISTAN MrE. Nina Second Secretary, Permanent Mission, Geneva Chief delegate - Chef de delegation ALGERIA- ALGERIE Dr S.M.A. Fatimie Ministre de la Sante publique Chief delegate - Chef de delegation (Chief delegate from 16 to 18 May 2005) (Chef de delegation du 16 au 18 mai 2005) M. I. Jaza'iry Ambassadeur, Representant permanent, DrF. Kakar Geneve Vice-Ministre, Planification et Prevention, Ministere de la Sante publique Delegate(s)- Delegue(s) (Chief delegate from 19 to 25 May 2005) (Chef de delegation du 19 au 25 mai 2005) Professeur F. Belateche Directrice de la Prevention, Ministere de la Delegate(s)- Delegue(s) Sante, de la Population et de la Reforme hospitaliere Dr A. Omer Ambassadeur, Representant permanent, Dr A. Guennar Geneve Charge d'etudes et de syntbese, Conseiller en Relations intemationales, Ministere de la M. A.K. Nasri Sante, de la Population et de la Reforme Premier Secretaire, Mission permanente, hospitaliere Geneve Alternate(s)- Suppleant(s) Alternate(s)- Suppleant(s) M. D. Lebane M. G.S. Rasuli Charge d'etudes et de synthese, Ministere de la Deuxieme Secretaire, Mission permanente, Sante, de la Population et de la Reforme Geneve hospitaliere

ALBANIA- ALBANIE Dr A. Boudiba Sous-Directeur de la Pharmacie et des Chief delegate - Chef de delegation Equipements, Ministere de la Sante, de la Population et de la Reforme hospitaliere Mr V. Thanati Ambassador, Permanent Representative, Dr D. Fourar Geneva Sous-Directeur de la Prevention, Ministere de la Sante, de la Population et de la Reforme Delegate(s)- Delegue(s) hospitaliere

Mrs P. Goxhi M. M. Bessedik First Secretary, Permanent Mission, Geneva Ministre Conseiller, Mission permanente, Geneve A58NR page 176

Mlle D. Soltani Dr S. N eto de Miranda Secretaire diplomatique, Mission permanente, Assistant for Health, Permanent Mission, Geneve Geneva

ANDORRA- ANDORRE ANTIGUA AND BARBUDA­ ANTIGUA-ET-BARBUDA Chief delegate - Chef de delegation Chief delegate - Chef de delegation Mrs M. Coll Armangue Head, Promotion, Protection and Health Mr H.J. Maginley Planning Unit, Ministry ofHealth and Welfare Minister ofHealth, Sports and Youth Affairs

Delegate(s)- Delegue(s) Delegate(s)- Delegue(s)

Mr F. Bonet Casas Dr R. Sealey-Thomas Ambassador, Permanent Representative, ChiefMedical Officer, Ministry of Health Geneva ARGENTINA- ARGENTINE Mr X. Trota Bollo Third Secretary, Permanent Mission, Geneva Chief delegate - Chef de delegation

ANGOLA- ANGOLA Dr. G. Gonzalez Garcia Ministro de Salud y Ambiente Chief delegate- Chef de delegation Delegate(s)- Delegue(s) Dr S.F. Veloso Minister of Health Sr. A.J. Dumont Embajador, Representante Permanente, Delegate(s)- Delegue(s) Ginebra

Dr F.J. Fortes Alternate(s)- Suppleant(s) Director, Endemics Department, Ministry of Health Sra. M. Oviedo Senadora Nacional Dr A.M. Rosa Neto Director, International Cooperation, Ministry Sra. S.E. Gallego of Health Senadora Nacional

Alternate(s)- Suppleant(s) Sr. 0. Gonzalez Diputado Nacional, Presidente de la Comisi6n Dr J.A. Artur de Salud de la Honorable Camara de Director, Legal Affairs, Ministry of Health Diputados

Mr A. Chipilica Sr. H. Cettour Deputy Director, Cabinet of the Minister of Diputado Nacional Health Sr. D. Vitale Dr J .A. Mangueira Diputado Nacional Minister Counsellor, Charge d'affaires a.i., Permanent Mission, Geneva Dr. C. Vizzotti Subsecretario de Relaciones Sanitarias e Dr E. Neto Sangueve Investigaci6n en Salud, Ministerio de Salud y First Secretary, Permanent Mission, Geneva Ambiente A58NR page 177

Dra. C. Madies Ms C. Halbert Subsecretaria de Politicas, Regulaci6n y Assistant Secretary, Policy and International Fiscalizaci6n, Ministerio de Salud y Ambiente Branch, Department of Health and Ageing

Sra. A. de Hoz Alternate(s)- Suppleant(s) Ministro, Misi6n Permanente, Ginebra Ms L. Podesta Sr. E.A. Varela Assistant Secretary, Biosecurity and Disease Consejero, Misi6n Permanente, Ginebra Control Branch, Department of Health and Ageing Sr. L. Bonelli Ministerio de Salud y Ambiente Mr B. Eckhardt Director, International Policy and Sra. S. Mercado Communications Section, Department of Asesora de Prensa del Senor Ministro de Salud Health and Ageing y Ambiente MrM. Sawers Sra. M. Rosen First Secretary, Permanent Mission, Geneva Asesora del Senor Ministro de Salud y Ambiente Mrs C. Patterson Minister Counsellor (Health), Permanent ARMENIA- ARMENIE Mission, Geneva

Chief delegate - Chef de delegation MrM. Palu Director, Coherence and Strategic Issues Mr Z. Mnatsakanyan Group, AusAID Permanent Representative, Geneva Mr G. Adlide Delegate(s)- Delegue(s) Counsellor (Development Cooperation), Permanent Mission, Geneva Mr A. Apitonian Counsellor, Permanent Mission, Geneva AUSTRIA- AUTRICHE

Ms M. Ayvazyan Chief delegate - Chef de delegation First Secretary, Permanent Mission, Geneva Ms M. Rauch-Kallat Alternate(s)- Suppleant(s) Federal Minister of Health and Women

Mr L. Minasyan Deputy chief delegate- Chef adjoint de la Third Secretary, Permanent Mission, Geneva delegation

AUSTRALIA- AUSTRALIE Professor R. Schlogel Deputy Director General of Public Health, Chief delegate - Chef de delegation Head, Subdivision for Medical and Pharmaceutical Affairs, Federal Ministry of Ms J. Halton Health and Women Secretary, Department of Health and Ageing Delegate(s)- Delegue(s) Delegate(s)- Detegue(s) Dr W. Petritsch Professor J. Horvath Ambassador, Permanent Representative, Chief Medical Officer, Department of Health Geneva and Ageing A58NR page 178

Alternate(s)- Suppleant(s) Alternate(s)- Suppleant(s)

Dr C. Kokkinakis Mr E. Mammadov Minister, Deputy Permanent Representative, Third Secretary, Permanent Mission, Geneva Geneva BAHAMAS- BAHAMAS Dr C. Lassmann Minister, Federal Ministry of Foreign Affairs Chief delegate - Chef de delegation

Dr V. Gregorich-Schega DrM. Bethel Head, International Health Relations, Federal Minister of Health Ministry of Health and Women Deputy chief delegate- Chef adjoint de la Ms E. Strohmayer delegation Deputy Head, International Health Relations, Federal Ministry of Health and Women Dr M. Dahl-Regis ChiefMedical Officer, Ministry of Health Dr R. Strauss Assistant Manager, Federal Ministry of Health Delegate(s)- Delegue(s) and Women OrB. Carey Dr J.-P. Klein Director of Public Health, Ministry of Health Federal Ministry of Health and Women BAHRAIN- BAHREIN Mr F. Pressl Cabinet of the Federal Minister, Federal Chief delegate - Chef de delegation Ministry of Health and Women Dr N .A. Haffadh Ms A. Punzet Minister of Health International Health Relations, Federal Ministry of Health and Women Delegate(s)- Delegue(s)

Dr W. Aulitzky Mr S.M. Al-Faihani Ambassador, Permanent Representative, Dr D. Zimper Geneva International Health Relations, Federal Ministry of Health and Women Dr A.W.M. Abdul Wahab Assistant Under-Secretary for Primary Care AZERBAIJAN- AZERBAIDJAN and Public Health, Ministry of Health

Chief delegate- Chef de delegation Alternate(s)- Suppleant(s)

Dr A. Insanov DrF.A. Amin Minister of Health Assistant Under-Secretary for Training and Planning, Ministry of Health Delegate(s)- Delegue(s) Dr S.A. Khalfan Mr E. Amirbayov Director of Public Health, Ministry of Health Ambassador, Permanent Representative, Geneva Dr H.E. Al-Mehza Chief, International Relations, Ministry of Dr A. Urnnyashkin Health Head, International Relations Department, Ministry of Health A58NR page 179

Mrs S.A. Al-Rashid Mr M.A. Baten Chief, Primary Health Care Nursing Services, Ministry of Health Mr J. Alam

Mrs RE. Bu-Hindi Mr M. Hossain Director, Office of the Minister of Health Mr N .U. Ahammed BANGLADESH -BANGLADESH Mr A. Ali Chief delegate- Chef de delegation BARBADOS-BARBADE Dr K.M. Hossain Minister of Health and Family Welfare Chief delegate - Chef de delegation

Deputy chief delegate - Chef ad joint de la Dr J. Walcott delegation Minister of Health

Dr T. Ali Delegate(s)- Delegue(s) Ambassador, Permanent Representative, Geneva Mrs A. W illiams Permanent Secretary (ag.), Ministry of Health Delegate(s)- Delegue(s) Dr J. St. John Dr M.A. Rahman Khan ChiefMedical Officer, Ministry of Health Director General, Directorate of Health Services Alternate(s)- Suppleant(s)

Alternate(s)- Suppleant(s) Mr T. Clarke Ambassador, Permanent Representative, Mr M.-U. Zaman Geneva Minister, Permanent Mission, Geneva Ms S. Rudder Mr M.D. Islam Deputy Permanent Representative, Geneva First Secretary, Permanent Mission, Geneva Ms N. Clarke MrN.U. Ahmed Counsellor, Permanent Mission, Geneva Third Secretary, Permanent Mission, Geneva MrM. Wilson Professor M.M. Rahman First Secretary, Permanent Mission, Geneva Past Director General, Directorate of Health Services Ms N. Burke First Secretary, Permanent Mission, Geneva Adviser(s)- Conseiller(s) BELARUS-BELARUS Mr N.A. Shaheen Chief delegate - Chef de delegation Mr M.O.H. Bhuiyan Mme L. Postoyalko Mr K.M.I. Khalil Ministre de la Sante

MrM.S. Alam Delegate(s)- Delegue(s)

Mr M.H. Bhuiyan M. S. Aleinik Representant permanent, Geneve A58NR page 180

M. A. Molchan M. J. Bosteels Conseiller, Mission permanente, Geneve Attache, Mission permanente, Geneve

BELGIUM- BELGIQUE Or P. Demoulin Directeur general, Ministere de la Chief delegate - Chef de delegation Communaute franc;aise

Or 0. Cuypers M. D. Maenaut President du Comite de Direction, SPF Sante Delegue de la Communaute flamande de publique, Securite de la Chaine alimentaire et Belgique, Mission permanente, Geneve Environnement Mme M.-H. Timmermans Deputy chief delegate - Chef adjoint de la Delegue de la Communaute franc;aise de delegation Belgique, Mission permanente, Geneve

M. F. Roux Mme M. Wauters Ambassadeur, Representant permanent, Conseiller, Ministere de la Sante de la Geneve Communaute flamande de Belgique

Delegate(s)- Delegue(s) M. B. Gryseels Directeur, Institut de Medecine tropicale, Or G. Thiers Anvers Directeur, Institut scientifique de la Sante publique M. D. Van de Roost Coordonnateur, Institut de Medecine tropicale, Alternate(s)- Suppleant(s) Anvers

Mme F. Gustin BELIZE- BELIZE Conseiller, Mission permanente, Geneve Chief delegate - Chef de delegation M. A. Delie Conseiller, Mission permanente, Geneve Ms A. Hunt Charge d'affaires, Permanent Mission, Geneva Mme L. Meulenbergs Conseiller, Service des Relations Delegate(s)- Delegue(s) intemationales, SPF Sante publique, Securite de la Chaine alimentaire et Environnement Mr M. Tamasko Permanent Mission, Geneva Or J. Laruelle Conseiller, Direction generale de la Mr T. Tichy Cooperation au Developpement BENIN - BENIN M. D. Angelet Premier Secretaire, SPF Affaires etrangeres Chief delegate - Chef de delegation

M. J. Depreter Professeur D.A. Kinde-Gazard Premier Secretaire, Mission permanente, Ministre de la Sante publique Geneve Delegate(s)- Detegue(s) Or 0. Reynders Administration des Soins de sante primaires, Or B.H. Falhun SPF Sante publique, Securite de la Chaine Secretaire general, Ministere de la Sante alimentaire et Environnement publique Or D. Yevide A58NR page 181

Directrice nationale de la Protection sanitaire Delegate(s)- Delegue(s)

Alternate(s)- Suppleant(s) Dra. V. de Urioste Blanco Directora, Medicamentos y Tecnologia en M. S. Amehou Salud, Ministerio de Salud y Deportes Ambassadeur, Representant permanent, Geneve Dr. F. Antezana Aranibar Asesor, Ministerio de Salud y Deportes M. Y. Amoussou Premier Conseiller, Mission permanente, Alternate(s)- Suppleant(s) Geneve Sr. G. Poggi Borda BHUTAN- BHOUTAN Consejero, Misi6n Permanente, Ginebra

Chief delegate - Chef de delegation Dr. F. Arandia Castel16n Presidente, Colegio Medica de Bolivia Dr Jigmi Singay Minister of Health Sra. E. Olivera Choque Presidenta, Colegio de Enfermeras de Bolivia Delegate(s)- Delegue(s) Sr. J. Gonzales Mr S.T. Rabgye Secretario Ejecutivo, Confederaci6n Sindical Ambassador, Permanent Representative, de Trabajadores en Salud Geneva Dr. 0. Lanza Ms K.C. Namgyel Director, Acci6n Intemacional en Salud Deputy Permanent Representative, Geneva Sr. A. Calvo Alternate(s)- Suppleant(s) Consultor, Organizaci6n Panamericana de la Salud Dr D. Wangchuk Director, Department of Medical Services, Dr. E. Ayll6n Ministry of Health Representante de Control Social

Mr P. Wangchuk BOSNIA AND HERZEGOVINA­ Deputy Secretary, Policy and Planning BOSNIE-HERZEGOVINE Division, Ministry ofHealth Chief delegate - Chef de delegation Ms T. Pemo Nursing Superintendent, Jigme Dorji Dr S. Godinjak W angchuck Hospital Head, Department for Health and Social Welfare, Ministry of Civil Affairs of Bosnia Mr C. Tenzin and Herzegovina First Secretary, Permanent Mission, Geneva Delegate(s)- Delegue(s) BOLIVIA- BOLIVIE Ms J. Kalmeta Chief delegate - Chef de delegation Ambassador, Permanent Representative, Geneva Dra. R. Quiroga Morales Ministra de Salud y Deportes Professor A. Smajkic Director, Institute for Public Health A58NR page 182

Alternate(s)- Suppleant(s) Mr G. Pitso First Secretary, Permanent Mission, Geneva Dr A. Kapetanovic Senior Expert for Health and Development, Mr T. Mogotsi Ministry of Health of the Federation ofBosnia Second Secretary, Permanent Mission, Geneva and Herzegovina Ms 0. Sekape Dr S. Jovic Second Secretary, Permanent Mission, Geneva Assistant Minister, Ministry of Health and Social Welfare of the Republic of Srpska BRAZIL- BRESIL

Ms D. Kremenovic-Kusmuk Chief delegate - Chef de delegation First Secretary, Permanent Mission, Geneva MrH. Costa MrS. Fadzan Minister of Health Minister Counsellor, Permanent Mission, Geneva Deputy chief delegate- Chef adjoint de la delegation BOTSWANA- BOTSWANA Mr L.F. de Seixas Correa Chief delegate - Chef de delegation Ambassador, Permanent Representative, Geneva Professor S.D. Tlou Minister of Health Delegate(s)- Delegue(s)

Delegate(s)- Delegue(s) Mr P. Buss President, Oswaldo Cruz Foundation Mr C.T. Ntwaagae Ambassador, Permanent Representative, Alternate(s)- Suppleant(s) Geneva Mr J. Barbosa da Silva Jr. Mrs B.E. Tafa Secretary, Health Surveillance, Ministry of Permanent Secretary, Ministry of Health Health

Alternate(s)- Suppleant(s) Mr A.C. do Nascimento Pedro Minister Counsellor, Permanent Mission, Dr T.L. Moeti Geneva Deputy Permanent Secretary, Ministry of Health Dr J. Gomes Temporao President, National Institute of Cancer Mr T.M. Lekuni Minister Counsellor, Deputy Permanent Mr S.L. Bento Alcazar Representative, Geneva Head, Department of International Affairs, Ministry of Health Mrs M. Balosang Chief Health Officer, Ministry of Health Mr L. Portela Delgado Special Adviser, Ministry of Health Mr S.S. Mokgweetsinyana Chief Health Officer, Ministry of Health Mr P.M. de Castro Saldanha Second Secretary, Permanent Mission, Geneva Mrs M. Matlho Counsellor, Permanent Mission, Geneva Mr C.H. Spezia Technical Adviser, Ministry of Health A58NR page 183

Ms M. Simao Ms Farida Hairani Dr Hisham Director, Division of International Second Secretary, Permanent Mission, Geneva Cooperation, STD/AIDS Programme, Ministry of Health Dr Zainal Ariffin Haji Yahya Acting Deputy Director, Human Resources Mr D. Lins Menucci Development, Ministry of Health Technical Adviser, National Agency of Health Surveillance, Ministry of Health Mr Sabri Haji Anuar Senior Therapist, Ministry of Health Mr E. Rage Carmo National Coordinator, Communicable Ms Dk Suzylawati PL WP Dr Haji Ismail Diseases, Ministry of Health Legal Adviser, Ministry ofHealth

Mr P. Chequer BULGARIA- BULGARIE Director, National Programme for STD/AIDS Chief delegate - Chef de delegation Ms M. F erreira Rea Technical Expert, Health Institute, Health MrS. Bogoev Department, State of Sao Paulo Minister of Health

BRUNEI DARUSSALAM- BRUNEI Delegate(s)- Delegue(s) DARUSSALAM Mr D. Tzantchev Chief delegate - Chef de delegation Ambassador, Permanent Representative, Geneva Pehin Dato Abu Bakar Apong Minister of Health MrT. Churov Director, Directorate for Human Rights and Deputy chief delegate- Chef adjoint de la International Humanitarian Organizations, delegation Ministry ofForeign Affairs

Dato Paduka Mahadi Haji Wash Alternate(s)- Suppleant(s) Ambassador, Permanent Representative, Geneva Mrs V. lvanova Head, Cabinet of the Minister of Health Delegate(s)- Delegue(s) Professor L. lvanov Mr Serbini Ali Director, National Centre ofPublic Health Permanent Secretary, Ministry ofHealth Protection

Alternate(s)- Suppleant(s) Mr B. Mladenov Head, Department of International Datin Paduka Dr Hjh Intan Haji Salleh Humanitarian Organizations, Ministry of Director-General of Health Services, Ministry Foreign Affairs of Health Ms R. Toshkova Dr Hjh Kalsom Abdul Latif Senior State Expert, Directorate of Director of Health Services, Ministry of Health International Cooperation and European Integration, Ministry of Health Mrs Hjh Norsiah Haji Johari Deputy Director of International Affairs, Ms D. Mehandjiyska Ministry of Health Third Secretary, Permanent Mission, Geneva A58NR page 184

BURKINA FASO- BURKINA FASO Delegate(s)- Delegue(s)

Chief delegate- Chef de delegation M. Z. Gahutu Anibassadeur, Representant permanent, DrB.A. Yoda Geneve Ministre de la Sante Dr L. Mboneko Delegate(s)- Delegue(s) Inspecteur general de la Sante publique

Dr B.K.M. Sombie Alternate(s)- Suppleant(s) Conseiller technique du Ministre, Ministere de la Sante Dr G. Nsengiyumva Directeur general de la Sante publique Dr S.D. Zombre Directeur general de la Sante, Ministere de la M. N. Nkundwanabake Santc Premier Conseiller, Mission permanente, Geneve Alternate(s)- Suppleant(s) Mme A. Nyiramajyambere Dr G. Conombo-Kafondo Responsable du Centre de Medecine Directrice, Sante de la Famille, Ministere de la communautaire et du Centre pilote de la prise Sante en charge de la transmission du VIH/SIDA de la mere a 1' enfant Mme E. Kabre-Yameogo Direction regionale de la Sante du Centre, Dr RP. Manariyo Ministere de la Sante Hopitaux universitaires de Geneve

M. M.B. Nebie CAMBODIA- CAMBODGE Charge d'affaires, Mission permanente, Geneve Chief delegate - Chef de delegation

Mme L.J. Ilboudo Zerbo Dr Nuth Sokhom Attache, Mission permanente, Geneve Minister of Health

Mme A. Kansole Nebie Delegate(s)- Delegue(s) Attache, Mission permanente, Geneve Mr Chheang Vun Adviser(s)- Conseiller(s) Ambassador, Permanent Representative, Geneva Dr A.J. Tiendrebeogo Secretaire permanent, Conseil national de Dr Keo Pheak Kdey Lutte contre le SIDA/IST, Presidence du Faso Charge d'affaires a.i., Permanent Mission, Geneva BURUNDI- BURUNDI Alternate(s)- Suppleant(s) Chief delegate - Chef de delegation Mr Chou Yin Sim DrJ. Kamana Acting Director General for Health Ministre de la Sante publique Dr Sok Touch Director, Communicable Disease Control Department A58NR page 185

Professor San Chan Soeung M. B. Kollo Program Manager, National Immunization Chef, Division de la Cooperation, Ministere de Program la Sante publique

Dr Lo V easna Kiry M. M. Fezeu Director, Planning and Health Information Secretaire permanent, Groupe technique Department central, Comite national de Lutte contre le SIDA, Ministere de la Sante publique MrPhan Peuv Second Secretary, Permanent Mission, Geneva Mme J. Folabit Chef, Service des Professions medico­ Mr Heng Sileng sanitaires et paramedicales, Ministere de la Office of the Minister of Health Sante publique

CAMEROON-CAMEROUN Mme A.J. Ndoumba Ngono Direction des Nations Unies et de la Chief delegate - Chef de delegation Cooperation non gouvemementale, Ministere des Relations exterieures M. U. Olanguena Awono Ministre de la Sante publique M. F. Ngantcha Ministre Conseiller, Mission permanente, Delegate(s)- Delegue(s) Geneve

M. J.S. Ndjemba Endezoumou M. L.M. Zoua Ambassadeur, Representant permanent, Premier Conseiller, Mission permanente, Geneve Geneve

M. A. Abana Elongo CANADA- CANADA Charge de mission a la Presidence de la Republique du Cameroun Chief delegate - Chef de delegation

Alternate(s)- Suppleant(s) Ms H. Gosselin Associate Deputy Minister, Health Canada M. B. Yaou Inspecteur general des Services administratifs, Delegate(s)- Delegue(s) Ministere de la Sante publique Mr I. Shugart Mme L.F. Bella Assumpta Senior Assistant Deputy Minister, Health Directeur de la Lutte contre la Maladie, Policy Branch, Health Canada Ministere de la Sante publique Mr I. F erguson M. J. Rollin Ndo Minister, Acting Permanent Representative, Directeur de la Pharmacie et du Medicament, Geneva Ministere de la Sante publique Alternate(s)- Suppleant(s) Mme M. Baye Lukong Conseiller technique, Ministere de la Sante Ms C. Gilders publique Director General, International Affairs Directorate, Health Policy Branch, Health M. 0. Taousse Canada Directeur, Centrale nationale d' Approvisionnement en Medicaments Dr P. Gully essentiels, Ministere de la Sante publique Deputy Chief Public Health Officer, Public Health Agency of Canada A58NR page 186

MrD. MacPhee CAPE VERDE- CAP-VERT Counsellor, Permanent Mission, Geneva Chief delegate - Chef de delegation Ms M. Rappolt Associate Deputy Minister, Health and Long M. B.M. Ramos Term Care, Government of Ontario Ministre de l'Etat et de la Sante

Dr R. Masse Delegate(s)- Detegue(s) President-Directeur general, Institut national de sante publique du Quebec M. I.A. de Sousa Carvalho Cadre superieur, Cabinet des Etudes et de la Ms E.E. Wilson Cooperation, Ministere de la Sante Chief Executive Officer, Canadian Public Health Association M. B. Monteiro Silva Charge d'affaires a.i., Mission permanente, Adviser(s)- Conseiller(s) Geneve

MrN. Singh CENTRAL AFRICAN REPUBLIC - Director General, Governance and Social REPUBLIQUE CENTRAFRICAINE Development, Canadian International Development Agency Chief delegate - Chef de delegation

Mr G. Wieringa M. N.M. Nali Senior Program Officer, United Nations and Ministre de la Sante publique et de la Commonwealth Program, Canadian Population International Development Agency Delegate(s)- Delegue(s) Ms L. Holt Acting Director, Social Development Policies, Dr F. Mamadou-Yaya Canadian International Development Agency Directeur de la Sante familiale et de la Population, Ministere de la Sante publique et Mr G. Aslanyan de la Population Senior Health Advisor, Social Development Policies, Canadian International Development M. S. Walser Agency V ice-Consul, Consulat de la Republique centrafricaine aupres de la Principaute du Mr J. Vellinga Liechtenstein Acting Director, International Affairs Directorate, Health Canada CHAD-TCHAD

Ms G. Wiseman Chief delegate - Chef de delegation Senior Adviser, International Affairs Directorate, Health Canada Mme A. Baroud Ministre de la Sante publique Mr D. Strawczynski Adviser, International Affairs Directorate, Delegate(s)- Delegue(s) Health Canada M. M. Bamanga Abbas MrT. Fetz Ambassadeur, Representant permanent, Second Secretary, Permanent Mission, Geneva Geneve

Dr J. Lariviere Dr H. Mahamat Hassan Health Canada Adviser Secretaire general, Ministere de la Sante publique A58NR page 187

Alternate(s)- Suppleant(s) CHINA- CHINE

Dr E. Mbaiong Malloum Chief delegate - Chef de delegation Conseiller du Ministre, Ministere de la Sante publique MrGao Qiang Minister, Ministry of Health M. 0. Ouadjon Directeur de la Planification, Ministere de la Delegate(s)- Delegue(s) Sante publique Mr Sha Zukang Dr S. Garba Tchang Ambassador, Permanent Representative, Responsable du Programme elargi de Geneva vaccination Dr Yin Li CHILE - CHILl Director General, Department of International Cooperation, Ministry of Health Chief delegate - Chef de delegation Alternate(s)- Suppleant(s) Dr. P. Garcia Ministro de Salud DrYorkChow Secretary for Health, Welfare and Food, Hong Delegate(s)- Delegue(s) Kong Special Administrative Region

Sr. J. Martabit Mr Koi Kuok Ieng Embajador, Representante Permanente, Director, Department of Health, Macao Special Ginebra Administrative Region

Sr. J.E. Eguiguren Mr Li Shouxin Ministro Consejero, Misi6n Permanente, Director General, Department of Social Ginebra Development, State Development and Reform Commission Alternate(s)- Suppleant(s) Dr Chen Xianyi Dr. R. Tapia Director General, Office of Health Emergency Jefe, Oficina de Cooperaci6n y Asuntos Response (Center for Public Health Internacionales, Ministerio de Salud Emergency), Ministry of Health

Dra. X. Aguilera DrP.Y. Lam Jefa, Division de Planificaci6n Sanitaria, Director of Health, Department of Health, Subsecretaria de Salud Publica, Ministerio de Hong Kong Special Administrative Region Salud Dr Chen J uemin Sr. B. del Pic6 Director General, Yunnan Provincial Segundo Secretario, Misi6n Permanente, Department of Health Ginebra Dr Mao Qun'an Dra. P. Frenz Deputy Director General, Department of Asesora, Ministerio de Salud General Administration, Ministry of Health

Dr Xiao Donglong Deputy Director General, Department of Disease Control, Ministry of Health A58NR page 188

Dr Ren Minghui Ms HuMeiqi Deputy Director General, Department of Consultant, Division of International International Cooperation, Ministry of Health Organizations, Department of International Cooperation, Ministry of Health Dr Lei Chin Ion Deputy Director, Department of Health, Macao Dr Cao Bin Special Administrative Region Assistant Consultant, Department of Maternal and Community Health, Ministry of Health Dr Qi Qingdong Assistant Director General, Department of MrWuHaiwen International Cooperation, Ministry of Health Third Secretary, Division VII, Department of International Treaty and Law, Ministry of Dr Cindy KL Lai Foreign Affairs Assistant Director (Special Health Services), Department of Health, Hong Kong Special Adviser(s)- Conseiller(s) Administrative Region Mr Andy Chan MrTan Jian Assistant to Secretary for Health, Welfare and Counsellor, Permanent Mission, Geneva Food, Hong Kong Special Administrative Region MrLa Yifan Counsellor, Permanent Mission, Geneva Ms Zhao Y angling First Secretary, Permanent Mission, Geneva Mr Zhou Jian Counsellor, Permanent Mission, Geneva Mr Y ang Xiaokun Second Secretary, Permanent Mission, Geneva Ms Luo Yi Senior Adviser, International Health Exchange Ms LanMei and Cooperation Center, Ministry of Health Second Secretary, Permanent Mission, Geneva

Dr Deng Hongmei Ms Han Jianli Counsellor, Permanent Mission, Geneva Programme Officer, Department of International Cooperation, Ministry of Health Mr Wang Mingjian Adviser, International Health Exchange and Mr Lu Haitian Cooperation Center, Ministry of Health Third Secretary, Permanent Mission, Geneva

MrLuFuquan MrXu Jian Secretary, Department of General Programme Officer, Division oflnternational Administration, Ministry of Health Organizations, Department of International Cooperation, Ministry of Health Mr Wang Chuan Deputy Director, Division V, Department of Ms Vong Wai Han International Organizations and Conferences, Consultant, Department of Social Culture, Ministry ofForeign Affairs Macao Special Administrative Region

Mr Chen Haiping MrKelly So Deputy Division Director, Ministry of Foreign Office of the Secretary for Health, Welfare and Affairs Food, Hong Kong Special Administrative Region Dr Yan Jun Deputy Division Director, Department of Disease Control, Ministry of Health A58NR page 189

Mr Ding Baoguo CONGO- CONGO Programme Officer, Division of International Organizations, Department of International Chief delegate - Chef de delegation Cooperation, Ministry of Health Dr A. Gando Dr AnNi Ministre de la Sante et de la Population Programme Officer, Division of International Organizations, Department of International Delegate(s)- Detegue(s) Cooperation, Ministry of Health M. J. Biabaroh-Iboro Mr ZhangZe Ministre Conseiller, Charge d'affaires a.i., Attache, Permanent Mission, Geneva Mission permanente, Geneve

Mr Zhang Yi Dr D. Bodzongo Attache, Permanent Mission, Geneva Directeur general de la Sante

COLOMBIA- COLOMBIE Alternate(s)- Suppleant(s)

Chief delegate - Chef de delegation Mme Y.Y. Voumbo-Matoumona Conseillere a la Sante Sra. C. Forero Ucros Embajadora, Representante Permanente, M.A.M.Etongo Ginebra Directeur des Etudes et de la Planification

Delegate(s)- Detegue(s) Mme D. Bikouta Premier Conseiller, Mission permanente, Sra. L.S. Arango de Buitrago Geneve Ministra Consejera, Misi6n Permanente, Ginebra M. S. Baret Bokwango Charge du protocole, Mission permanente, Sr. J.C. Lozano Herrera Geneve Misi6n Permanente, Ginebra COOK ISLANDS- ILES COOK COMOROS- COMORES Chief delegate- Chef de delegation Chief delegate - Chef de delegation Mr V. V aevae Pare M. M. Caabi Elyachroutu Minister of Health Vice-President de l'Union des Comores, Ministere de la Solidarite, de la Sante, de la Delegate(s)- Delegue(s) Population, de la Protection sociale, de l'Emploi et de la Reforme de l'Etat Mr V. Teokotai Secretary of Health Deputy chief delegate - Chef ad joint de la delegation COSTA RICA- COSTA RICA

Dr A. Msa Mliva Chief delegate - Chef de delegation Directeur national de la Sante publique Sr. L. V are la Quir6s Delegate(s)- Delegue(s) Embajador, Representante Permanente, Ginebra M. A. Chaibou Bedja Conseiller technique en Sante A58NR page 190

Deputy chief delegate - Chef adjoint de la Dr M. Tanoh Adjoba delegation Directeur adjoint, Cabinet du Ministre de la Saute et de la Population Dr. C. Gamboa Peiiaranda Director General de Salud, Ministerio de Salud Dr K.C. Konan Charge d'etudes, Cabinet du Ministre de la Delegate(s)- Delegue(s) Saute et de la Population

Sr. A. Solano Ortiz Dr F. Bledi Trouin Ministro Consejero, Misi6n Permanente, Directeur general de la Saute et de la Ginebra Population, Ministere de la Saute et de la Population Alternate(s)- Suppleant(s) M. G. Ble Dr. F. Oviedo Chef de Service de la Cooperation Direcci6n de Servicios de Salud, Ministerio de intemationale, Ministere de la Saute et de la Salud Population

COTE D'IVOIRE- COTE D'IVOIRE DrN. Kouame Directeur-coordonnateur, Programme national Chief delegate - Chef de delegation de Lutte contre le Tabac, Ministere de la Saute et de la Population Dr A.M. Toikeusse Ministre d'Etat, Ministre de la Saute et de la Dr A. M'Bengue Population Directeur-coordonnateur, Programme national de Nutrition, Ministere de la Saute et de la Deputy chief delegate - Chef adjoint de la Population delegation Dr S.D. Memain Mme C. Nebout Adjobi Directeur-coordonnateur, Programme national Ministre de la Lutte contre le SIDA de Lutte contre le Paludisme, Ministere de la Saute et de la Population Delegate(s)- Delegue(s) DrAM. Seya M. C. Beke Dassys Directeur-coordonnateur, Programme elargi de Ambassadeur, Representant permanent, vaccination, Ministere de la Saute et de la Geneve Population

Alternate(s)- Suppleant(s) DrG. Adja Directeur-coordonnateur, Programme national Professeur K.P. Odehouri de Prise en charge des Personnes vivant avec Directeur, Institut national d'Hygiene publique le VIH/SIDA, Ministere de la Saute et de la Population Professeur E.D. Sess Directeur, Institut national de la Saute publique DrK. San Directeur-coordonnateur, Programme national DrK. Zamble de Lutte contre la Tuberculose, Ministere de la Inspecteur general, Ministere de la Lutte contre Saute et de la Population le SIDA Dr E. Zotoua Professeur D. Djeha Directeur-coordonnateur, Programme national Chef de Service du STP/Plan national de de Lutte contre la Lepre, Ministere de la Saute Developpement de la Saute, Ministere de la et de la Population Saute et de la Population A58NR page 191

Dr J. Anzi Alternate(s)- Suppleant(s) Directeur-coordonnateur, Programme de la Medecine traditionnelle, Ministere de la Sante Ms M. Adamic et de la Population First Secretary, Permanent Mission, Geneva

Dr R. Assi Gbonon Mrs S. Zabica Directeur de la Pharmacie et du Medicament, Counsellor, Department for International Ministere de la Sante et de la Population Cooperation, Ministry of Health and Social Welfare Dr S. Konate Directeur, Centre national de transfusion CUBA-CUBA sangume Chief delegate - Chef de delegation DrD. Souare Directeur, Pharmacie de la sante publique, Dr. G. Estevez Torres Ministere de la Sante et de la Population Viceministro de Salud Publica

M. J.K. Weya Deputy chief delegate - Chef ad joint de la Premier Conseiller, Mission permanente, delegation Geneve Sr. J .I. Mora Godoy Dr M. Capri-Traore Embajador, Representante Permanente, Chargee d'etudes, Service juridique, Ginebra Pharmacie de la sante publique, Ministere de la Sante et de la Population Delegate(s)- Delegue(s)

Dr A.R. Duncan Dr. A. Gonzalez F ernandez Sous-Directeur, Laboratoire Galenique, Jefe, Departamento de Organismos Ministere de la Sante et de la Population Internacionales, Ministerio de Salud Publica

M. G.M. Danhoue Alternate(s)- Suppleant(s) Charge de mission, Ministere de la Sante et de la Population Sr. J. F errer Rodriguez Funcionario, Direcci6n de Asuntos CROATIA- CROATIE Multilaterales, Ministerio de Relaciones Exteriores Chief delegate - Chef de delegation Sra. M.C. Herrera Mr N. LjubiCic Consejera, Misi6n Permanente, Ginebra Minister of Health and Social W efare Sr. 0. Le6n Gonzalez Delegate(s)- Delegue(s) Segundo Secretario, Misi6n Permanente, Ginebra Mr G. Markotic Ambassador, Permanent Representative, Sr. M. Sanchez Oliva Geneva Tercer Secretario, Misi6n Permanente, Ginebra

Mr C. Grbesa CYPRUS-CHYPRE Head, Department for International Cooperation, Ministry of Health and Social Chief delegate- Chef de delegation Welfare Mr A. Gavrielides Minister of Health A58NR page 192

Deputy chief delegate- Chef adjoint de la MrV. Hejduk delegation Development Cooperation and Humanitarian Aid Department, Ministry of Foreign Affairs Mr J.C. Droushiotis Ambassador, Permanent Representative, MsJ.Pexova Geneva International Relations Department, Ministry of Health Delegate(s)- Delegue(s) Ms K. Moravcova Mr P. Papadopoulos Czech Nurses Association and Head Hurse, Deputy Permanent Representative, Geneva Department of Internal Medicine, General University Hospital, Prague Alternate(s)- Suppleant(s) DEMOCRATIC PEOPLE'S REPUBLIC Ms H. Mina OF KOREA- REPUBLIQUE First Secretary, Permanent Mission, Geneva POPULAIRE DEMOCRATIQUE DE COREE Dr C. Kaisis Senior Medical Officer, Department of Chief delegate - Chef de delegation Medical and Public Health Services Mr Ri Tcheul Dr A. Demetriou Ambassador, Permanent Representative, Representative of the Cyprus Medical Geneva Association, Department of Medical and Public Health Services Delegate(s)- Delegue(s)

Mr C. Andreou Mr Kye Chun Yong Nursing Officer, Representative of the Deputy Permanent Representative, Geneva Pancyprian Nursing Association, Department of Medical and Public Health Services Mr Pak J ong Min Director, Department of External Affairs, CZECH REPUBLIC- REPUBLIQUE Ministry of Public Health TCHEQUE Alternate(s)- Suppleant(s) Chief delegate - Chef de delegation Mr Choe Il DrM.Vit Researcher, Department of International Deputy Minister of Health, Chief Medical Organizations, Ministry ofForeign Affairs Officer Mr Jang Il Hun Delegate(s)- Delegue(s) Counsellor, Permanent Mission, Geneva

Mr A. Slaby DEMOCRATIC REPUBLIC OF THE Ambassador, Permanent Representative, CONGO- REPUBLIQUE Geneva DEMOCRATIQUE DU CONGO

Professor B. Fiser Chief delegate - Chef de delegation Head, Physiology Institute, Masaryk University, Brno Professeur E. Bongeli Y eikelo Y a A to Ministre de la Sante Alternate(s)- Suppleant(s)

MrM. Boucek Deputy Pemanent Representative, Geneva A58NR page 193

Delegate(s)- Delegue(s) Dr E. Smith Medecin-chef et Directeur, Administration de Dr C. Miaka Mia Bilenge la Sante publique Secretaire general a la Sante Mme M. Kristensen Dr J.-M. Mbuya Mbayo Consultant, Administration de la Sante Directeur, Programme elargi de vaccination publique

Alternate(s)- Suppleant(s) MmeK. Worm Chef de Section, Ministere de l'Interieur et de Dr P. Lokadi Lopetha la Sante Directeur du Cabinet du Ministre de la Sante Mme J. Michelsen Dr J. Kokolomami Conseiller, Mission permanente, Geneve Directeur, Programme national de Lutte contre le SIDA Mme M. Hessel Secretaire d' Ambassade, Mission permanente, Mme C. Nsenga Mikani Geneve Directeur, Services generaux et Ressources humaines M. S. Bolus Attache, Mission permanente, Geneve Mme P. Toloko Chargee de mission, Cabinet du Ministre de la M. P. Larsen Sante Attache, Mission permanente, Geneve

M. S. Mutomb Mujing Adviser(s)- Conseiller(s) Deuxieme Conseiller, Mission permanente, Geneve M. J. Krogh Bureau du Ministre de l'Interieur et de la Sante DENMARK-DANEMARK Mme L. Bmndum J ensen Chief delegate - Chef de delegation Bureau du Ministre de l'Interieur et de la Sante

M. L.L. Rasmw;sen DJIBOUTI- DJIBOUTI Ministre de l'Interieur et de la Sante Chief delegate - Chef de delegation Delegate(s)- Delegue(s) Dr S.B. Tourab M. I. Valsborg Secretaire general, Ministere de la Sante Secretaire general, Ministere de l'Interieur et de la Sante Delegate(s)- Deiegue(s)

Dr J.K. Getrik M. O.A. Isma'il Directeur general de la Sante publique Secretaire executif, Comite intersectoriel de lutte contre le SIDA, le paludisme et la Alternate(s)- Suppleant(s) tuberculose

M. H.R. lversen Ambassadeur, Representant permanent, Geneve

M. M. Jergensen Directeur, Ministere de l'lnterieur et de la Sante A58NR page 194

DOMINICAN REPUBLIC­ Delegate(s)- Delegue(s) REPUBLIQUE DOMINICAINE Mrs N. Gabr Chief delegate - Chef de delegation Ambassador, Permanent Representative, Geneva Sr. S. Baez Secretario de Estado de Salud y Asistencia Dr H.A.A. Zaher Social First Under-Secretary, Ministry of Health and Population Deputy chief delegate- Chef adjoint de la delegation Alternate(s)- Suppleant(s)

Sra. C. Hernandez Bona Mr A. Meleika Embajadora, Representante Permanente Deputy Permanent Representative, Geneva Alterna, Ginebra Dr M.N. El Tayeb Delegate(s)- Delegue(s) Adviser to the Minister of Health and Population Dra. M. Bello de Kemper Consejero, Misi6n Permanente, Ginebra Mr T. Khallaf Third Secretary, Permanent Mission, Geneva Alternate(s)- Suppleant(s) EL SALVADOR-EL SALVADOR Dr. R. Peguero G6mez Asesor Tecnico, Secretaria de Estado de Salud Chief delegate- Chef de delegation y Asistencia Social Dr. J.E. Navarro Marin Sra. M. Brito Vice-ministro de Salud Publica y Asistencia Social ECUADOR-EQUATEUR Delegate(s)- Delegue(s) Chief delegate- Chef de delegation Sr. B.F. Larios L6pez Sr. H. Escudero Martinez Embajador, Representante Permanente, Embajador, Representante Permanente, Ginebra Ginebra Sr. R. Recinos Trejo Delegate(s)- Delegue(s) Ministro Consejero, Misi6n Permanente, Ginebra Sr. R. Paredes Proafio Representante Permanente Adjunto, Ginebra EQUATORIAL GUINEA- GUINEE EQUATORIALE Srta. L. Baquerizo Tercer Secretario, Misi6n Permanente, Ginebra Chief delegate- Chef de delegation

EGYPT- EGYPTE Sr. P. Abaga Esono Vice-Ministro de Sanidad, Encargado de los Chief delegate - Chef de delegation Servicios Sanitarios e lnfraestructuras Hospitalarias Dr M.A.A. Tag-El-Din Minister of Health and Population A58NR page 195

Delegate(s)- Detegue(s) Second Secretary, Permanent Mission, Geneva

Sra. J. Nzang Nkara ETHIOPIA- ETHIOPIE Directora General de Salud Publica y Planificaci6n Chief delegate - Chef de delegation

Sr. G. Gori Momolu Dr K. Tadesse Jefe de Gabinete Tecnico Minister, Ministry of Health

ERITREA- ERYTHREE Delegate(s)- Delegue(s)

Chief delegate - Chef de delegation MrF. Yimer Ambassador, Permanent Representative, MrS. Meky Geneva Minister of Health DrG. Azene Delegate(s)- Detegue(s) Head, Department of Planning and Programming, Ministry of Health Mr B. Woldeyohannes Charge d'affaires, Permanent Mission, Geneva Alternate(s)- Suppleant(s)

Dr G. Tesfasellasie Mrs H. Mengistu Head, International Cooperation, Ministry of Senior Expert on Maternal and Child Health, Health Department of Family Health, Ministry of Health Alternate(s)- Suppleant(s) Ms S. Amin Oumer Sister M. Kelete Third Secretary, Permanent Mission, Geneva Primary Health Care Coordinator, Zoba Debub, Ministry of Health FIJI -FIDJI

ESTONIA- ESTONIE Chief delegate - Chef de delegation

Chief delegate - Chef de delegation Mr S. Naivalu Minister for Health MrP. Laasik Assistant Minister, Ministry of Social Affairs Delegate(s)- Delegue(s)

Delegate(s)- Delegue(s) Mrs R. Nadakuitavuki Director, Nursing and Health System Mr T. Nirk Standards, Ministry of Health Ambassador, Permanent Representative, Geneva Dr A. Chandra Director, Northern Health Service Ms A. Taal Head, Public Health Department, Ministry of FINLAND- FINLANDE Social Affairs Chief delegate - Chef de delegation Alternate(s)- Suppleant(s) Ms L. Hyss~ila Ms T. Habicht Minister of Health and Social Services, Head, Health Policy, Public Health Ministry of Social Affairs and Health Department, Ministry of Social Affairs Ms H. Leht A58NR page 196

Deputy chief delegate- Chef adjoint de la Adviser(s)- Conseiller(s) delegation Professor P. Ruutu MrK. Leppo Surveillance and Epidemiologic Investigations Director General, Health Department, Ministry Unit, National Public Health Institute of Social Affairs and Health Mr P. Anttila Delegate(s)- Delegue(s) President, Finnish Medical Association

Mr V. Himanen Ms G. Blumenthal Ambassador, Permanent Representative, Health and Population Adviser, Unit for Geneva Sectoral Policy, Ministry for Foreign Affairs

Alternate(s)- Suppleant(s) FRANCE-FRANCE

Ms L. Ollila Chief delegate - Chef de delegation Ministerial Adviser, Head of Section, International Affairs Unit, Ministry of Social M. B. Kessedjian Affairs and Health Ambassadeur, Representant permanent, Geneve Ms S. Mattila Minister Counsellor, Permanent Mission, Delegate(s)- Delegue(s) Geneva Professeur D. Houssin Mr M. Jaskari Directeur general de la Sante, Ministere des Counsellor, Unit for Economic and Social Solidarites, de la Sante et de la Famille Development, Ministry for Foreign Affairs M. M. Giacomini Ms S. Sammalkivi Representant permanent adjoint, Mission Second Secretary, Permanent Mission, Geneva permanente, Geneve

Ms M. Tallavaara Alternate(s)- Suppleant(s) Special Adviser to the Minister of Health and Social Services M. L. Contini Sous-Directeur des Affaires economiques, M5 M. Saarinen Ministere des Affaires etrangeres Medical Counsellor, Health Department, Ministry of Social Affairs and Health Dr I.-B. Bmnet Chef, Cellule des Affaires europeennes et Mr R. Pomoell internationales, Direction generale de la Sante, Ministerial Counsellor, Head of Medical Ministere des Solidarites, de la Sante et de la Affairs, Ministry of Social Affairs and Health Famille

Ms M. Vallimies-Patomaki Dr F. Goyet Senior Officer, Health Department, Ministry of Chef, Bureau sante, Direction du Social Affairs and Health Developpement et de la Cooperation technique, Ministere des Affaires etrangeres Ms H. Tanhua Senior Officer, International Affairs Unit, Mme F. Auer Ministry of Social Affairs and Health Conseiller, Mission permanente, Geneve A58NR page 197

M. G. Delvallee Mme N. Mathieu Direction des Nations Unies et Organisations Mission permanente, Geneve internationales, Ministere des Affaires etrangeres GABON- GABON

Mme I. Virem Chief delegate - Chef de delegation Cellule des Affaires europeennes et internationales, Direction generate de la Sante, Mme P. Missambo Ministere des Solidarites, de la Sante et de la Ministre d'Etat, Ministre de la Sante publique Famille Deputy chief delegate- Chef adjoint de la Mlle E. Sicard delegation Delegation aux Affaires europeennes et internationales, Ministere des Solidarites, de la M. D. Ndiaye Sante et de la Famille Charge d'affaires a.i., Mission permanente, Geneve Dr S. Diallo Direction du Developpement et de la Delegate(s)- Delegue(s) Cooperation technique, Ministere des Affaires etrangeres Professeur P.A. Kombila Koumba Directeur general de la Sante Dr C. Boulais Direction du Developpement et de la Alternate(s)- Suppleant(s) Cooperation technique, Ministere des Affaires etrangeres Dr A.R. Nlome Nze Conseiller technique du Ministre d'Etat, Dr P. Bouscharain Ministre de la Sante publique Direction du Developpement et de la Cooperation technique, Ministere des Affaires Mme E.P. Fayette etrangeres Conseiller technique du Ministre d'Etat, Ministre de la Sante publique M. H. d'Oriano Direction du Developpement et de la Mme M. Angone-Abena Cooperation technique, Ministere des Affaires Conseiller, Mission permanente, Geneve etrangeres M. H. Lombat Dr F.-M. Lahaye Attache de Cabinet du Ministre d'Etat, Direction du Developpement et de la Ministre de la Sante publique Cooperation technique, Ministere des Affaires etrangeres GAMBIA- GAMBlE

M. F. Leger Chief delegate - Chef de delegation Premier Secretaire, Mission permanente, Geneve DrT. Mbowe Secretary of State for Health and Social Mme A. Le Guevel Welfare Deuxieme Secretaire, Mission permanente, Geneve Delegate(s)- Delegue(s)

M. I.-F. Trogrlic Ms I. Iallow Executive Director, National Nutrition Agency M. I.-F. Connan Mission permanente, Geneve A58NR page 198

GEORGIA- GEORGIE Mr U. Scholten Director, International Health and Social Chief delegate - Chef de delegation Policy, Federal Ministry of Health and Social Security, Berlin Dr N. Pruidze Deputy Minister of Labour, Health and Social Ms M. Taprogge Affairs Office of the Federal Minister of Health and Social Security Delegate(s)- Delegue(s) DrP. Pompe Mr A. Chikvaidze Head of Division, Executive Group "Protocol, Ambassador, Permanent Representative, International Visitor's Service, Relations with Geneva the Embassies", Federal Ministry of Health and Social Security, Berlin Mr K. Gedevanishvili First Counsellor, Permanent Mission, Geneva Mr R. Schroer Adviser, Federal Foreign Office, Berlin Alternate(s)- Suppleant(s) MrM. Debrus Mr K. Edilashvili Head of Division, Multilateral Co-operation in First Secretary, Permanent Mission, Geneva the Field of Health, Federal Ministry of Health and Social Security, Bonn GERMANY- ALLEMAGNE Dr I. von Voss Chief delegate - Chef de delegation Counsellor, Permanent Mission, Geneva

Mrs U. Schmidt Dr F. Niggemeier Federal Minister of Health and Social Security, Permanent Representation to the European Bonn Union, Brussels

Deputy chief delegate - Chef adjoint de la Mr T. Hofmann delegation Deputy Head of Division, Federal Ministry of Health and Social Security, Bonn Mr M. Steiner Ambassador, Permanent Representative, DrW. Traub Geneva Bundesrat/Ministry for Social Affairs Baden­ Wuerttemberg Delegate(s)- Detegue(s) Dr C. Luetkens Mrs S. Weber-Mosdorf Ministry for Social Affairs Hessen Director-General, European and International Health and Social Policy, Federal Ministry of Mrs H. Reemann Health and Social Security, Bonn Federal Centre for Health Education, Cologne

Alternate(s)- Suppleant(s) DrR. Krech Division for Health, Education and Social Mr K. Metscher Protection, German Agency for Technical Minister, Permanent Mission, Geneva Co-operation

Mr H. VoigtHi.nder Dr A. Brandrup-Lukanow Expert, Federal Ministry of Health Director, Division for Health, Education and Social Protection, German Agency for Technical Co-operation A58NR page 199

Mr F. Stierle Professor K. Frimpong Boateng Head of Section, Division for Health, Chief Administrator, Korle Bu Teaching Education and Social Protection, German Hospital Agency for Technical Co-operation Dr H. Odoi-Agyarko Ms A. Klein Head, Maternal and Child Health, Ministry of Interpreter, Federal Ministry of Health and Health Social Security Miss M. Sumani MrD. Kranen ChiefNursing Officer, Ministry of Health Counsellor, Permanent Mission, Geneva Dr E. Addai MrS. Dorr Acting Director, Policy Planning, Monitoring Second Secretary, Permanent Mission, Geneva and Evaluation, Ministry of Health

MrS. Preuss MrR. Azumah Attache, Permanent Mission, Geneva Deputy Director, Administration, Ministry of Health Ms F. Jerosch Attache, Permanent Mission, Geneva Mrs G. Alarbi Regulatory Officer, Food and Drugs Board Professor R. Korte Expert, German Agency for Technical Miss M. Alomatu Co-operation First Secretary, Permanent Mission, Geneva

Ms J. Knoess GREECE- GRECE German Agency for Technical Co-operation Chief delegate - Chef de delegation GHANA- GHANA Mr A. Giannopoulos Chief delegate - Chef de delegation Deputy Minister of Health and Social Solidarity Mr C.E.K. Quashigah Minister of Health Deputy chief delegate- Chef adjoint de la delegation Deputy chief delegate- Chef adjoint de la delegation Mr T. Kriekoukis Ambassador, Permanent Representative, Dr K. Bawuah-Edusei Geneva Ambassador, Permanent Representative, Geneva Delegate(s)- Delegue(s)

Delegate(s)- Delegue(s) Dr M. Violaki-Paraskeva Honorary Director-General, Ministry of Health Professor A.B. Akosa and Social Solidarity Director-General, Ghana Health Service Alternate(s)- Suppleant(s) Alternate(s)- Suppleant(s) Mr A. Cambitsis Mr P. Aryene Minister Counsellor, Permanent Mission, Minister, Deputy Permanent Representative, Geneva Geneva Mr N. Plexidas Counsellor, Permanent Mission, Geneva A58NR page 200

Ms F. Raidou Srta. S. Urruela Director for International Relations, Ministry Segundo Secretario, Misi6n Permanente, ofHealth and Social Solidarity Ginebra

Ms A. Kyrlesi GUINEA- GUINEE Director for Public Health, Ministry of Health and Social Solidarity Chief delegate - Chef de delegation

Ms M. Manola Professeur A. Cisse Director for Financial Services, Ministry of Ministre de la Sante publique Health and Social Solidarity Delegate(s)- Delegue(s) Ms A. Papadia Director for the Development of Health Units, M. B. Diallo Ministry of Health and Social Solidarity Ambassadeur, Representant permanent, Geneve Ms S. Kyriakou Attache, Permanent Mission, Geneva DrM. Camara Secretaire general, Ministere de la Sante Ms G. Ricco-Kakalioura publique Ministry of Health and Social Solidarity Alternate(s)- Suppleant(s) Ms M. Liodaki Division for International Relations, Ministry Dr J.L. Austin of Health and Social Solidarity Conseiller charge de la cooperation

Mr L. Giannopoulos M. A.K. Kaba Adviser, Ministry of Health and Social Conseiller (Affaires politiques), Mission Solidarity permanente, Geneve

GUATEMALA- GUATEMALA GUINEA-BISSAU- GUINEE-BISSAU

Chief delegate - Chef de delt~gation Chief delegate - Chef de delegation

Dr. J. G6mez Son Dr M.O. da Costa Semedo Viceministro de Salud Publica y Asistencia Ministre de la Sante Social Delegate(s)- Delegue(s) Delegate(s)- Delegue(s) Dr A.P.J. da Silva Sr. L. Pira Directeur general de la Planification et de la Embajador, Representante Permanente, Cooperation, Ministere de la Sante Ginebra Dr E.M. da Costa Dr. E. Mendez Directeur, Centre de medicaments essentiels Jefe, Departamento de Regulaci6n de los Programas de Atenci6n a las Personas, GUY ANA- GUYANA Ministerio de Salud Publica y Asistencia Social Chief delegate - Chef de delegation

Alternate(s)- Suppleant(s) Dr L. Ramsammy Minister of Health Srta. S. Hochstetter Consejero, Misi6n Permanente, Ginebra A58NR page 201

Delegate(s)- Deh~gue(s) Deputy chief delegate- Chef adjoint de la delegation DrR. Brohim Program Manager, Health Sector Sr. J.B. Zapata Development, Caribbean Community Embajador, Representante Permanente, (CARICOM) Ginebra

HAITI - HAITI Delegate(s)- Delegue(s)

Chief delegate - Chef de delegation Sra. G. Bu Figueroa Consejero, Misi6n Permanente, Ginebra Dr J. Bijou Ministre de la Sante publique et de la Alternate(s)- Suppleant(s) Population Sra. C. Duarte Delegate(s)- Delegue(s) Asistente Tecnico, Secretaria de Salud Publica

M. J.-C. Pierre Sr. M. Perez Ministre Conseiller, Charge d'affaires, a. i., Segundo Secretario, Misi6n Permanente, Mission permanente, Geneve Ginebra

Dr R. Raphael HUNGARY- HONGRIE Directeur, Departement sanitaire du Centre Chief delegate - Chef de delegation Alternate(s)- Suppleant(s) Dr G. Kap6cs M. J. Theodore Honorary State Secretary, Ministry of Health Delegue de 1' Association de Sante publique (Chief delegate from 16 to 17 May 2005) d'Hai"ti (Chef de delegation du 16 au 17 mai 2005)

M. J .B. Alexandre Mr T. T6th Ministre Conseiller, Mission permanente, Ambassador, Permanent Representative, Geneve Geneva (Chief delegate from 18 to 25 May 2005) Dr L. Belotte (Chef de delegation du 18 au 25 mai 2005) Directrice, Sante de la Famille Delegate(s)- Delegue(s) Dr M. Pamphile Membre du Cabinet particulier du Ministre de Ms K. Novak la Sante publique et de la Population Director-General, Ministry of Health

HONDURAS-HONDURAS Mr D. Horvath Deputy Permanent Representative, Geneva Chief delegate - Chef de delegation Alternate(s)- Suppleant(s) Dra. F. Mejia Subsecretaria de Estado, Despacho de Salud DrM. Kokeny Publica Special Representative of the Government of the Republic of Hungary to the Standing Committee of the WHO Regional Committee for Europe A58NR page 202

Dr A.F. Kovacs Mrs S. Gudmundsd6ttir Deputy ChiefMedical Officer, National Public Head of Division, Ministry ofHealth and Health Service Social Security

MrB. Ratkai Mrs H. Ottosd6ttir Third Secretary, Permanent Mission, Geneva Head of Division, Ministry of Health and Social Security Ms A. Ajan Adviser, Permanent Mission, Geneva Ms A. Knutsd6ttir Attache, Permanent Mission, Geneva ICELAND- ISLANDE INDIA-INDE Chief delegate - Chef de delegation Chief delegate - Chef de delegation Mr J. Kristjansson Minister for Health and Social Security Dr A. Ramadoss (Chief delegate from 19 to 21 May 2005) Minister of Health and Family Welfare (Chef de delegation du 19 au 21 mai 2005) Delegate(s)- Deiegue(s) Mr D.A. Gunnarsson Permanent Secretary, Ministry of Health and Mrs P. Lakshmi Social Security Minister of State for Health and Family (Chief delegate from 16 to 18 May and from Welfare 23 to 25 May 2005) (Chef de delegation du 16 au 18 et du 23 au 25 Mr P. Rota mai 2005) Secretary, Ministry of Health and Family Welfare Delegate(s)- Delegue(s) Alternate(s)- Suppleant(s) Mr S.H. J6hannesson Ambassador, Permanent Representative, Dr S.P. Agarwal Geneva Director General of Health Services, Ministry of Health and Family Welfare Mrs S. Stefansd6ttir Adviser to the Minister MrH.S. Puri Ambassador, Permanent Representative, Alternate(s)- Suppleant(s) Geneva

Mr I. Einarsson Dr J. Singh Director of Department, Ministry of Health Assistant Director General (International and Social Security Health and Public Health), Ministry of Health and Family Welfare Mrs V. Ing6lfsd6ttir ChiefNursing Officer, Directorate of Health MrD. Saha Deputy Permanent Representative, Geneva Dr S. Magnusson Director of Department, Ministry ofHealth Mr B.P. Sharma and Social Security Joint Secretary (International Health), Ministry of Health and Family Welfare DrH. Briem State Epidemiologist, Directorate of Health Mr A.K. Chatterjee First Secretary, Permanent Mission, Geneva A58NR page 203

Mr K. Dhanavel Dr I.N. Kandun Office of the Minister of Health and Family Special Adviser to the Minister on Welfare Environmental Health and Epidemiology, Ministry of Health INDONESIA- INDONESIE Dr M. Djamaluddin Chief delegate - Chef de delegation Primary Secretary, National Agency for Drugs and Food Control Dr S.F. Supari Minister of Health Dr G. Setiadi Head, Planning and Budget Bureau, Ministry Deputy chief delegate - Chef adjoint de la of Health delegation Dr Abdurrahman Dr M. Wibisono Head, Center of Analysis for Health Ambassador, Permanent Representative, Development, Ministry of Health Geneva Dr S. Hermiyanti Delegate(s)- Delegue(s) Director, Family Health, Ministry of Health

Professor A. Azwar Dr N. Bahaudin Director General of Community Health, Directorate General of Pharmaceutical Ministry ofHealth Services, Ministry of Health

Alternate(s)- Suppleant(s) Dr M. Kustantinah Director, Surveillance of Therapeutic Products, Mr E. Hariyadhi National Agency for Drugs and Food Control Ambassador, Deputy Permanent Representative, Geneva Dr R. Day Director, Eradication of Animal-Borne Disease Professor U .F. Achmadi Affecting Humans, Ministry of Health Director General of Communicable Disease Control and Environmental Health, Ministry of Dr D. Yusharmen Health Director, Epidemiology and Surveillance, Ministry of Health Dr S.A. Suparmanto Director General for Medical Services, Dr M.A. Hasjmi Ministry of Health Head, Centre of Crisis and Health Emergency Response, Ministry of Health Dr S.S. Astuti Director General ofMedical Care, Ministry of Dr B. Hartono Health Head, Health Promotion Centre, Ministry of Health Dr K.S. Latief Head, National Institute ofHealth Research Dr S. Soeroso and Development, Ministry of Health Director, Sulianti Saroso Infectious Diseases Hospital Dr Muharso Head, Board of Human Resources for Health Dr E. Tresnaningsih Development, Ministry of Health Head, Centre for Research and Development on Disease Eradication, Ministry of Health Dr Sampumo Head, National Agency for Drugs and Food Control A58NR page 204

Dr H.T.A. Rubiana Alternate(s)- Suppleant(s) Director, Usage of Rational Medicine, Ministry of Health Mr S.M.K. Sajjadpour Ambassador, Deputy Permanent Mr H. Budiarto Representative, Geneva Counsellor, Permanent Mission, Geneva Mr M. G. Haji Iri Mr S.M. Soemamo Member, Islamic Consultation Assembly Counsellor, Permanent Mission, Geneva Dr B. Delavar MrS. Raja Director General, Family Health and Planning Counsellor, Deputy Director for Human Department, Ministry of Health and Medical Rights, Humanitarian, Social and Cultural Education Affairs, Ministry of Foreign Affairs Dr B. Sadrizadeh Mr A.P. Sarwono Senior Adviser to the Minister of Health and First Secretary, Permanent Mission, Geneva Medical Education

Dr T. Sihombing Dr M.H. Niknam Head, Division of Program and Information, Director General, International Affairs Ministry of Health Department, Ministry of Health and Medical Education Dr L.S. Wahyuni Head, Division of Protocol and Secretariat, Mr S.M.H. Mohammadi Ministry of Health Officer-in-Charge, Liaison with WHO, Ministry of Foreign Affairs Dr Asyik Ministry of Health Mr R. Bayat Mokhtari Counsellor, Permanent Mission, Geneva Mr B. Panjaitan Ministry of Health MrP. Seadat Senior Expert, Ministry of Foreign Affairs Mr A.C. Sumirat Third Secretaf), Permanent Mission, Geneva IRAQ-IRAQ

Ms D.E.S. Sutikno Chief delegate - Chef de delegation Third Secretary, Permanent Mission, Geneva Dr AM. Ali Mohammed IRAN (ISLAMIC REPUBLIC OF)­ Minister of Health IRAN (REPUBLIQUE ISLAMIQUE D') Delegate(s)- Delegue(s) Chief delegate - Chef de deli~gation Mr B. Al-Shibib Dr M. Pezeshkian Ambassador, Permanent Representative, Minister of Health and Medical Education Geneva

Delegate(s)- Detegue(s) MrN.S. Abid Ministry of Health Mr M.R. Alborzi Ambassador, Permanent Representative, Alternate(s)- Suppleant(s) Geneva Miss M.A Y ass Dr M.E. Akbari First Secretary, Permanent Mission, Geneva Deputy Minister for Health A58NR page 205

Mr A.R. Khrnob Mr P. Synnott Ministry of Health Assistant Principal Officer, International Unit, Department of Health and Children Mr A.H. Salman Ministry of Health Ms S. Barnes Assistant Principal Officer, Department of IRELAND- IRLANDE Health and Children

Chief delegate - Chef de delegation Ms G. McGrane Higher Executive Officer, International Unit, Ms M. Harney Department of Health and Children Tanaiste and Minister for Health and Children Ms G. Coyle Delegate(s)- Delegue(s) Higher Executive Officer, International Unit, Department of Health and Children Mrs M. Whelan Ambassador, Permanent Representative, Dr E. Connolly Geneva Deputy Chief Medical Officer, Department of Health and Children Dr J. Kiely ChiefMedical Officer, Department of Health Mr D. Cunningham and Children Press Officer, Department of Health and Children Alternate(s)- Suppleant(s) Ms S. Kelly Mr M. Scanlan Assistant Principal Officer, Department of Secretary General, Department of Health and Health and Children Children ISRAEL- ISRAEL MrB. Phelan Principal Officer, International Unit, Chief delegate - Chef de delegation Department of Health and Children Mr D. Naveh Mr P. Flanagan Minister of Health Department of Health and Children Deputy chief delegate- Chef adjoint de la Ms P. Ryan delegation Adviser, Department of Health and Children Mr I. Levanon Ms M. Godfrey Ambassador, Permanent Representative, Nursing Adviser, Department of Health and Geneva Children Delegate(s)- Delegue(s) Mr J. O'Toole Health Counsellor, Permanent Representation, Professor A. Israeli Brussels Director General, Ministry of Health

Mr B. Cahalane Alternate(s)- Suppleant(s) First Secretary, Permanent Mission, Geneva MrY. Amikam Ms 0. Keane Deputy Director General, Information and Second Secretary, Permanent Mission, Geneva International Relations, Ministry of Health A58NR page 206

DrY. Sever M. V. Simonetti Director, Department of International Ministre Conseiller, Representant permanent Relations, Ministry of Health adjoint, Geneve

Dr A. Leventhal Alternate(s)- Suppleant(s) Director, Public Health Services, Ministry of Health M. R. Bettarini Ministre plenipotentiaire, Conseiller Mr T. Shalev Schlosser diplomatique du Ministre de la Sante Deputy Permanent Representative, Geneva M. N. Accame MsN. Furman Chef, Bureau de Presse, Ministere de la Sante Counsellor, Permanent Mission, Geneva Professeur V. Silano Adviser(s)- Conseiller(s) Chef, Departement de 1'Innovation, Ministere de la Sante Mr I. Elgar Director, Ministry of Foreign Affairs Mme M.P. Di Martino Directeur general, Rapports avec 1'Union Mr E. Ben-Tura europeenne et Rapports intemationaux, Deputy Director, Ministry of Foreign Affairs Ministere de la Sante

MrO. Zohar M. D. Greco Senior Adviser to the Minister of Health Directeur general, Promotion de la Sante, Ministere de la Sante Ms E. Gouldman-Zarka Permanent Mission, Geneva Professeur E. Garaci President, Institut superieur de la Sante Ms T. Guluma Permanent Mission, Geneva Mme L. Fiori Premier Conseiller, Mission permanente, Professor R. Rahamimoff Geneve Chief Scientist, Ministry of Health Dr F. Cicogna Dr Y. Blachar Bureau des Rapports intemationaux, Ministere Chairman, Israel Medical Association de la Sante

Dr L. W appner Professeur F. Aiuti Director General, Israel Medical Association Expert, Ministere de la Sante

ITALY -ITALIE Dr M.T. De Rose Rapports avec 1'Union europeenne et Rapports Chief delegate - Chef de delt~gation intemationaux, Ministere de la Sante

M. F. Storace Dr S. Moriconi Ministre de la Sante Rapports avec l'Union europeenne et Rapports intemationaux, Ministere de la Sante Delegate(s)- Delegue(s) M. A. Maiella M. P. Bruni Ministere de la Sante Ambassadeur, Representant permanent, Geneve Professeur G. Majori Directeur, Laboratoire de Parasitologie, Institut superieur de la Sante A58NR page 207

Mme M.P. Rizzo JAPAN - JAPON Ministere des Affaires etrangeres Chief delegate - Chef de delegation Dr L. Pecoraro Institut d'Hygiene et de Sante publique Dr M. Fujii Parliamentary Secretary for Health, Labour Mme M.-A. Militello and Welfare Ministere de la Sante Delegate(s)- Delegue(s) M. F. Colombo Premier Secretaire, Mission permanente, Mr I. Fujisaki Geneve Ambassador, Permanent Representative, Geneva M. E. Di Palo Ministere de la Sante Dr Y. Matsutani Assistant Minister for Technical Affairs, M. C. Allegrucci Minister's Secretariat, Ministry of Health, Ministere de la Sante Labour and Welfare

M. D. Mariotti Bianchi Alternate(s)- Suppleant(s)

JAMAICA- JAMAIQUE MrS. Endo Ambassador, Deputy Permanent Chief delegate - Chef de delegation Representative, Geneva

Mr J. Junor Mr H. Sobashima Minister of Health Minister, Permanent Mission, Geneva

Delegate(s)- Deiegue(s) MrK. Nakazawa Director, International Affairs Planning Office, MrR. Smith Minister's Secretariat, Ministry of Health, Ambassador, Permanent Representative, Labour and Welfare Geneva Dr Y. Iwasaki Mrs G.A. Young Director, International Cooperation Office, Permanent Secretary, Ministry of Health Minister's Secretariat, Ministry of Health, Labour and Welfare Alternate(s)- Suppleant(s) Mr H. Horie Dr B. Wint Counsellor, Permanent Mission, Geneva ChiefMedical Officer, Ministry of Health Adviser(s)- Conseiller(s) Ms C. Spencer Minister Counsellor, Permanent Mission, Mr T. Hatsugai Geneva Deputy Director, Liquor Tax and Industry Division, National Tax Agency Ms S. Betton First Secretary, Permanent Mission, Geneva Dr H. Inoue Deputy Director, International Affairs Division, Minister's Secretariat, Ministry of Health, Labour and Welfare

MrY. Arai First Secretary, Permanent Mission, Geneva A58NR page 208

Ms T. Tsujisaka Dr S. Mizushima First Secretary, Permanent Mission, Geneva Director, Department of Human Resources Development, National Institute of Public MrS. Nakagawa Health First Secretary, Permanent Mission, Geneva Dr K. N akashima Mr T. Y amaguchi Senior Researcher, Infectious Disease First Secretary, Permanent Mission, Geneva Surveillance Center, National Institute of Infectious Diseases DrT. Enami Deputy Director, General Affairs Division, DrH. Akashi Health Service Bureau, Ministry of Health, Expert Service Division, Bureau of Labour and Welfare International Cooperation, International Medical Center of Japan Ms M. Imai Deputy Director, International Affairs DrY. Tada Division, Minister's Secretariat, Ministry of Expert Service Division, Bureau of Health, Labour and Welfare International Cooperation, International Medical Center of Japan DrY. Egami Deputy Director, International Affairs Ms M. Suzuki Division, Minister's Secretariat, Ministry of Permanent Mission, Geneva Health, Labour and Welfare JORDAN- JORDANIE Dr K. Nabae Assistant Director for International Chief delegate - Chef de deh~gation Organizations, International Affairs Division, Minister's Secretariat, Ministry of Health, MrS. Darwazah Labour and Welfare Minister of Health

MrS. Mizoguchi Delegate(s)- Delegue(s) Office of the Parliamentary Secretary for Health, Labour and Welfare Dr S. Al Kharabseh Secretary-General, Ministry of Health Mr T. Hitakatsu Chief of Planning Section, Liquor Tax and Dr M. Burayzat Industry Division, National Tax Agency Ambassador, Permanent Representative, Geneva DrY. Nishijima Section Chief, International Affairs Division, Alteruate(s)- Suppleant(s) Minister's Secretariat, Ministry of Health, Labour and Welfare Dr A. Belbeisi Director, Public Health, Ministry of Health Dr M. Hasegawa Technical Officer, Vital and Health Statistics MrM. Qasem Division, Minister's Secretariat, Ministry of Director, International and Public Relations, Health, Labour and Welfare Ministry of Health

Dr A. Sato Mr H. Al Husseini Technical Officer, Tuberculosis and Infectious First Secretary, Permanent Mission, Geneva Diseases Control Division, Health Service Bureau, Ministry of Health, Labour and Welfare A58NR page 209

KAZAKHSTAN- KAZAKHSTAN Dr M. A. Hassan Chief Executive Officer, National Health Chief delegate - Chef de delegation Insurance Fund

Mr Y. Dossayev Mr A.K. Langat Minister of Health Care Chief Public Health Officer

Deputy chief delegate- Chef adjoint de la Mrs J.M. Wanyoike delegation Deputy Chief Nursing Officer

Mr K. Abusseitov Mrs L. Nyambu Ambassador, Permanent Representative, First Secretary, Permanent Mission, Geneva Geneva KIRIBATI - KIRIBATI Delegate(s)- Delegue(s) Chief delegate - Chef de delegation Mr A. Akhmetov Minister Counsellor, Permanent Mission, MrN. Kirata Geneva Minister of Health and Medical Services

Mr M. Zhagiparov Delegate(s)- Delegue(s) Third Secretary, Permanent Mission, Geneva Dr T. Kienene KENYA- KENYA Permanent Secretary for Health and Medical Services Chief delegate - Chef de delegation KUWAIT- KOWEIT Mrs C. Kaluki Ngilu Minister for Health Chief delegate - Chef de delegation

Delegate(s)- Delegue(s) Mr D.A.R. Razzooqi Ambassador, Permanent Representative, Ms A.C. Mohamed Geneva Ambassador, Permanent Representative, Geneva Delegate(s)- Delegue(s)

Mr P.R.O. Owade Dr A.Y. Al-Saif Ambassador, Deputy Permanent Assistant Under-Secretary, Public Health Representative, Geneva Affairs

Alternate(s)- Suppleant(s) Dr Y.A. Al-Nesef Assistant Under-Secretary, Medical Support Dr J.W. Nyikal Services Director of Medical Services Alternate(s)- Suppleant(s) Dr A. Misore Deputy Director of Medical Services, Ministry Dr Y.A. Al-Sharrah of Health Assistant Secretary General, Arabization Centers for Medical Science Dr M. Solomon Assistant Director of Medical Services Mr N. Al-Bader First Secretary, Permanent Mission, Geneva A58NR page 210

Dr G.M. Al-Salem LATVIA- LETTONIE Director, Physical Medicine and Rehabilitation Hospital Chief delegate - Chef de delegation

Dr M.I. Al-Saleh Mr R. Mucivs Head, Disease Control Unit Deputy State Secretary, Ministry of Health

Dr A. Al-Awadi Deputy chief delegate - Chef adjoint de la Director-General, Regional Organization for delegation the Protection of Marine Environment Ms L. Sema Ms J. Al-Sabah Director, Department of Strategical Planning, Attache, Permanent Mission, Geneva Ministry of Health

KYRGYZSTAN - KIRGHIZISTAN Delegate(s)- Delegue(s)

Chief delegate - Chef de delegation Mr J. Karklivs Ambassador, Permanent Representative, Mr M. Mamytov Geneva Minister for Health Care Alternate(s)- Suppleant(s) Delegate(s)- Delegue(s) Ms G. VItola Mr M. Jumaliev Third Secretary, Permanent Mission, Geneva Ambassador, Permanent Representative, Geneva LEBANON- LIBAN

Mr B. Dimitrov Chief delegate - Chef de delegation Head, Department of External Affairs, Ministry for Health Care Dr M.J. Khaleefa Minister of Public Health Alternate(s)- Suppleant(s) Delegate(s)- Delegue(s) Mr A. Erkin First Secretary, Permanent Mission, Geneva DrW. Ammar Director-General, Ministry of Public Health LAO PEOPLE'S DEMOCRATIC REPUBLIC- REPUBLIQUE DrW. Faraj DEMOCRATIQUE POPULAIRE LAO Adviser to the Minister of Public Health

Chief delegate - Chef de delegation Adviser(s)- Conseiller(s)

Dr Ponmek Dalaloy Mr H. Hoteit Minister of Public Health Head, Supplies and Equipment Department, Ministry of Public Health Delegate(s)- Delegue(s) LESOTHO- LESOTHO Professor B. Boupha Director, National Institute of Public Health Chief delegate - Chef de delegation

DrN. Boutta DrM. Phooko Deputy Director of Cabinet, Ministry ofPublic Minister of Health and Social Welfare Health A58NR page 211

Delegate(s)- Detegue(s) Delegate(s)- Delegue(s)

Mr T.J. Ramotsoari Dr M.S.A. Mostofa Nuaje Principal Secretary, Ministry of Health and Head of Health in the Canton of Caltuna Social Welfare Batnan

DrN. Letsie Dr S. Awenat Ministry of Health and Social Welfare General People's Committee ofHealth

Alternate(s)- Suppleant(s) Alternate(s)- Suppleant(s)

Mrs K. Mafike Mr A. Benomran Ministry of Health and Social Welfare Minister, Permanent Mission, Geneva

Mrs M. Pheko DrM.N. Smau Minister Counsellor, Permanent Mission, General People's Committee ofHealth Geneva LITHUANIA- LITUANIE Miss T. Tsekoa First Secretary, Permanent Mission, Geneva Chief delegate - Chef de delegation

Adviser(s)- Conseiller(s) Mr Z. Padaiga Minister of Health MrN. Masuku Permanent Mission, Geneva Delegate(s)- Delegue(s)

LIBERIA - LIBERIA Ms R. Baranauskiene Under-Secretary, Ministry of Health Chief delegate - Chef de delegation Mr V. Grabauskas Dr P.S. Coleman Chancellor, Kaunas University of Medicine Minister, Ministry of Health and Social Welfare Alternate(s)- Suppleant(s)

Delegate(s)- Delegue(s) Mr A. ZananaviCius Charge d'affaires a. i., Minister Counsellor, Dr N.S. Bartee Permanent Mission, Geneva Deputy Minister, Planning, Research and Human Resource Development, Ministry of Ms R. Kazragiene Health and Social Welfare Counsellor, Permanent Mission, Geneva

Professor S.B. Barh MrV. Meizis Chief Medical Officer Head, International Relations and European Integration Division, Ministry of Health LIBYAN ARAB JAMAHIRIYA­ JAMAHIRIY A ARABE LIBYENNE LUXEMBOURG-LUXEMBOURG

Chief delegate - Chef de delegation Chief delegate - Chef de delegation

Ms N. Al-Hajjaji M. M. Di Bartolomeo Ambassador, Permanent Representative, Ministre de la Sante Geneva (Chief delegate from 16 to 17 May 2005) (Chef de delegation les 16 et 17 mai 2005) A58NR page 212

Delegate(s)- Delegue(s) Alternate(s)- Suppleant(s)

M. A. Bems Dr M.P. Rahantanirina Ambassadeur, Representant permanent, Directeur de la Sante de la Famille, Ministere Geneve de la Sante et du Planning familial

Dr D. Hansen-Koenig DrM. Mosa Directeur de la Sante, Direction de la Sante Directeur des Urgences et de la Lutte contre (Deputy ChiefDelegate from 18 to 25 May) les Maladies transmissibles, Ministere de la (Chef adjoint de delegation du 18 au 25 mai) Sante et du Planning familial

Alternate(s)- Suppleant(s) M. J.M. Rasolonjatovo Premier Conseiller, Mission permanente, Mme A. Schleder-Leuck Geneve Conseiller de Direction, Ministere de la Sante M. R. Rakotonarivo Dr C. Kapp-Joel Conseiller, Mission permanente, Geneve Charge de mission, Mission permanente, Geneve MALAWI- MALAWI

MmeD. Gregr Chief delegate - Chef de delegation Charge de mission, Mission permanente, Geneve DrH. Ntaba Minister of Health M. S. Tack Attache Sante, Representation permanente du Deputy chief delegate- Chef adjoint de la Luxembourg aupres de l'Union europeenne, delegation Bruxelles Dr W.O.O. Sangala M. C.J.R. Lilliehook Acting Principal Secretary, Ministry of Health Conseiller, Bureau de liaison du Conseil de l'Union europeenne a Geneve Delegate(s)- Delegue(s)

Mme E. Fischer Dr A. Phoya Mission permanente, Geneve Director ofNursing Services, Ministry of Health M. F. Lecuit Alternate(s)- Suppleant(s) MADAGASCAR- MADAGASCAR Dr S.C.C. Chen Chief delegate - Chef de delegation Health Technical Adviser, Mzuzu Central Hospital Dr R.R. Jean Louis Ministre de la Sante et du Planning familial DrB. Mwale Executive Director, National AIDS Delegate(s)- Delegue(s) Commission

M. A. Rambeloson MALAYSIA- MALAISIE Ambassadeur, Representant permanent, Geneve Chief delegate - Chef de delegation

M. F. Ratsimanetrimanana Dr Chua Soi Lek Conseiller, Secretaire executif du Comite Minister of Health national de Lutte contre le SIDA A58NR page 213

Deputy chief delegate- Chef adjoint de la Delegate(s)- Delegue(s) delegation Dr S. Moosa Dr Shafie Ooyub Deputy Director of Health Services, Ministry Deputy Director General (Public Health), of Health Ministry of Health Mr A. Afaal Delegate(s)- Delegue(s) Assistant Director, Ministry of Health

Mrs Hsu King Bee MALI-MALI Ambassador, Permanent Representative, Geneva Chief delegate - Chef de delegation

Alternate(s)- Suppleant(s) Mme M.Z.M. Y ouba Ministre de la Sante Dr Pratapha Senan Director, Perak State Health Department, Delegate(s)- Deiegue(s) Ministry of Health M. L.M.J. Bastide Dr Marzukhi Md. Isa Ambassadeur, Representant permanent, Deputy Director (Vector Borne Diseases), Geneve Disease Control Division, Ministry of Health Dr S. Diallo Dr Azmi bin Abdul Rahim Conseiller technique Principal Assistant Director (International Health Unit), Disease Control Division, Alternate(s)- Suppleant(s) Ministry of Health M. I. Sangho Mr Amran Mohamed Zin Charge de mission Deputy Permanent Representative, Geneva Dr M.S. Traore Mr Bala Chandran Tharman Directeur national de la Sante Counsellor, Permanent Mission, Geneva DrN. Kone Ms Ngoo Yee Jin Chef, Section Immunisation, Programme elargi Office of the Minister of Health de vaccination

Mr Wan Zulkfli Wan Setapa M. S. Kasse Attache (Labour), Permanent Mission, Geneva Premier Conseiller, Mission permanente, Geneve Mr Ruslin Jusoh First Secretary, Permanent Mission, Geneva Mme F. Diacounba M'Bo Technicienne superieure de la sante MALDIVES - MALDIVES MALTA-MALTE Chief delegate - Chef de delegation Chief delegate - Chef de delegation Dr A. A. Y oosuf Director-General of Health Services, Ministry Mr S.F. Borg of Health Ambassador, Permanent Representative, Geneva A58NR page 214

Deputy chief delegate- Chef adjoint de la Professeur Ba M. Lemine delegation Conseiller technique du Ministre de la Sante et des Affaires sociales Dr R. Busuttil Director General of Health, Ministry of Health, Alternate(s)- Suppleant(s) the Elderly and Community Care Dr I. Ould Mohamed V all Delegate(s)- Delegue(s) Directeur de la Protection sanitaire, Ministere de la Sante et des Affaires sociales Dr T. Firman Senior Medical Officer, Office of the Director Dr M.T. Mint Ahmedou General of Health, Ministry of Health, the Directrice de la Pharmacie et des Laboratoires, Elderly and Community Care Ministere de la Sante et des Affaires sociales

Alternate(s)- Suppleant(s) M. M. Ould Magha Premier Conseiller, Mission permanente, Mr R. Sarsero Geneve Counsellor, Permanent Mission, Geneva Dr S.M.O.M. Lemine El Mehdy Mr J. Busuttil Directeur general, Central d' Achat de First Secretary, Permanent Mission, Geneva Medicaments et Consommables

Mr T. Bonnici MAURITIUS- MAURICE Second Secretary, Permanent Mission, Geneva Chief delegate - Chef de delegation MARSHALL ISLANDS- ILES MARS HALL Mrs R. V eerapen Permanent Secretary, Ministry of Health and Chief delegate - Chef de delegation Quality of Life

Mr A.T. Jacklick Delegate(s)- Delegue(s) Minister of Health Dr R.S. Sungkur Deputy chief delegate- Chef adjoint de la ChiefMedical Officer, Ministry of Health and delegation Quality of Life

Mr R. Edwards Alternate(s)- Suppleant(s) Assistant Secretary for Primary Health-Care, Ministry of Health Mr M.I. Latona Minister Counsellor, Permanent Mission, MAURITANIA- MAURITANIE Geneva

Chief delegate- Chef de delegation Mr U.K. Sookmanee Second Secretary, Permanent Mission, Geneva M. M.L. Ould Selmane Ministre de la Sante et des Affaires sociales Ms R. Wilfrid-Rene Second Secretary, Permanent Mission, Geneva Delegate(s)- Delegue(s) MEXICO- MEXIQUE M. M.S. Ould Mohamed Lemine Ambassadeur, Representant permanent, Chief delegate - Chef de delegation Geneve Dr. J. Frenk Secretario de Salud A58NR page 215

Delegate(s)- Delegue(s) MICRONESIA (FEDERATED STATES OF)- MICRONESIE (ETATS FEDERES Dr. R. Tapia DE) Subsecretario de Prevenci6n y Promoci6n de la Salud, Secretaria de Salud Delegate(s)- Delegue(s)

Sr. P. Macedo MrM. Samo Embajador, Representante Permanente Assistant Secretary for Health, Department of Alterno, Ginebra Health, Education and Social Affairs

Alternate(s)- Suppleant(s) MONACO- MONACO

Dr. J. Sepulveda Chief delegate - Chef de delegation Coordinator General de los Institutos Nacionales de Salud, Secretaria de Salud M. P. Blanchi Ambassadeur, Representant permanent, Dr. C. Ruiz Geneve Coordinador de Asesores del Subsecretario de Prevenci6n y Promoci6n de Salud, Secretaria Delegate(s)- Delegue(s) de Salud MmeA. Negre Sr. M. Bail6n Directeur, Direction de 1' Action sanitaire et Director General de Relaciones sociale Internacionales, Secretaria de Salud Mlle C. Lanteri Dr. R. Lozano Ascencio Premier Secretaire, Mission permanente, Director General de Informaci6n en Salud, Geneve Secretaria de Salud Alternate(s)- Suppleant(s) Sra. D.M. Valle Consejero, Misi6n Permanente, Ginebra M. A. Jahlan Troisieme Secretaire, Mission permanente, Sra. S. Hernc'mdez Geneve Directora de Asuntos Multilaterales, Direcci6n General de Relaciones Internacionales, MONGOLIA- MONGOLIE Secretaria de Salud Chief delegate - Chef de delegation Dr. F. Antiga Presidente, Sociedad Mexicana de Salud Mrs T. Gandi Publica, Secretaria de Salud Minister for Health

Sra. J. Jimenez Delegate(s)- Delegue(s) Directora de Enfermeria, Direcci6n General de Calidad y Educaci6n en Salud, Secretaria de Mr K. Bekhbat Salud Ambassador, Permanent Representative, Geneva Sra. C. Garcia Tercer Secretario, Misi6n Permanente, Ginebra Mrs T. Bolormoo Director, International Cooperation Sra. A.L. Calder6n Department, Ministry of Health Jefe del Departamento de Enlace con la OMS y la ONU, Direcci6n General de Relaciones Internacionales, Secretaria de Salud A58NR page 216

Alternate(s)- Suppleant(s) Mme R. Fadil Vice-Presidente, Association marocaine des Ms D. Gerelmaa Sciences infirmieres et Techniques sanitaires Third Secretary, Permanent Mission, Geneva MOZAMBIQUE- MOZAMBIQUE MOROCCO- MAROC Chief delegate - Chef de delegation Chief delegate - Chef de delegation Dr P.I. Garrido M. M. Cheikh Biadillah Minister of Health Ministre de la Saute Delegate(s)- Delegue(s) Delegate(s)- Delegue(s) Mr A.C. Zandamela M. 0. Hilale Ambassador, Permanent Representative, Ambassadeur, Representant permanent, Geneva Geneve Dr G. Mac ha tine DrF. Hamadi Director, Planning and Cooperation, Ministry Secretaire general, Ministere de la Saute of Health

Alternate(s)- Suppleant(s) Alternate(s)- Suppleant(s)

Dr M. El Ismaili Alaoui DrJ. Tomo Inspecteur general, Ministere de la Saute Director, Human Resources, Ministry of Health DrM. Tyane Directeur de la Population, Ministere de la Dr M. Saide Saute Head, Department ofNational Programme on HIV/AIDS, Ministry of Health Dr N. Chaouki Directeur a.i. de l'Epidemiologie et de la Lutte Ms B.X. Dos Santos contre les Maladies, Ministere de la Saute Nurse for Maternal and Infancy Health, Maputo Central Hospital Mme S. Bouassa Ministre plenipotentiaire, Mission permanente, MrM. Carlos Geneve Second Secretary, Permanent Mission, Geneva

Dr M. Hamouiyi MYANMAR- MY ANMAR Chef, Division des Urgences et Secours, Direction des Hopitaux et des Soins Chief delegate - Chef de delegation ambulatoires, Ministere de la Saute Professor Kyaw Myint Dr H. Khattabi Minister for Health Chef, Service des Maladies sexuellement transmissibles SIDA, Direction de Deputy chief delegate- Chef adjoint de la l'Epidemiologie et de la Lutte contre les delegation Maladies, Ministere de la Saute Mr Nyunt Maung Shein Mme S. Ayouche Ambassador, Permanent Representative, Conseiller, Cabinet du Ministre de la Saute Geneva A58NR page 217

Delegate(s)- Delegue(s) Deputy chief delegate - Chef adjoint de la delegation Dr AungMon Rector, University ofPharmacy, Yangon Dr K. Shangula Permanent Secretary, Ministry of Health and Alternate(s)- Suppleant(s) Social Services

Dr Kyaw Nyunt Sein Delegate(s)- Detegue(s) Director (Disease Control), Department of Health Ms M. Nghatanga Director, Primary Health Care Services Mrs Aye Aye Mu Counsellor, Permanent Mission, Geneva Adviser(s)- Conseiller(s)

Mr Tha Aung Nyun Ms M. Zauana Counsellor, Permanent Mission, Geneva Researcher

Dr Soe Lwin Nyein NAURU- NAURU Deputy Director (Epidemiology), Department of Health Chief delegate - Chef de delegation

MrThet Lwin DrK. Keke Deputy Director (International Health), Minister for Health Department of Health Delegate(s)- Delegue(s) MrMyintThu First Secretary, Permanent Mission, Geneva Mrs C. Scatty Secretary for Health and Medical Services MrBaHlaAye First Secretary, Permanent Mission, Geneva NEPAL- NEPAL

Mr Kyaw Thu Nyein Chief delegate - Chef de delegation Second Secretary, Permanent Mission, Geneva Mr L.K. Devacota Mrs Khin Oo Hliang Secretary, Ministry of Health and Population Second Secretary, Permanent Mission, Geneva Delegate(s)- Detegue(s) Mr SoeAung Third Secretary, Permanent Mission, Geneva Mr G.C. Acharya Ambassador, Permanent Representative, Mrs Flora Saito Geneva Attache, Permanent Mission, Geneva Dr H.N. Acharya Mrs Siang Tial Chief, Policy, Planning and International Attache, Permanent Mission, Geneva Cooperation Division, Ministry of Health and Population NAMIBIA- NAMIBIE Alternate(s)- Suppleant(s) Chief delegate - Chef de delegation Mr G .B. Thapa MrR. Kamwi Minister Counsellor, Permanent Mission, Minister of Health and Social Services Geneva A58NR page 218

Adviser(s)- Conseiller(s) MrP. Hartog Senior Policy Adviser, International Affairs, Professor P.S. Shrestha Ministry ofHealth, Welfare and Sport Institute of Medicine Ms G. Vrielink NETHERLANDS- PAYS-BAS Senior Policy Adviser, Ministry of Foreign Affairs Chief delegate - Chef de delt~gation Adviser(s)- Conseiller(s) Mr H. Hoogervorst Minister of Health, Welfare and Sport MrB. Kuik Department of Communication, Ministry of Delegate(s)- Detegue(s) Health, Welfare and Sport

Mr H. de Goeij MrT. vanUum Director -General, Ministry of Health, Welfare Director, Department of Economic Affairs and and Sport Labour Market Policy, Ministry of Health, Welfare and Sport Mr I. de Jong Ambassador, Permanent Representative, Mrs L. Kootstra Geneva Director, Public Health Department, Ministry of Health, Welfare and Sport Alternate(s)- Suppleant(s) Mr P. van Dalen Mr M. Sprenger Senior Policy Adviser, Public Health Director-General, National Institute for Public Department Health and the Environment Mrs M. Peters Ms A. van Bolhuis Senior Adviser, Ministry of Foreign Affairs Director, International Affairs, Ministry of Health, Welfare and Sport Mrs E. Leemhuis Senior Adviser, Ministry of Foreign Affairs Mr P. Sciarone Deputy Permanent Representative, Geneva NEW ZEALAND- NOUVELLE­ ZELANDE Ms M. Middelhoff First Secretary, Permanent Mission, Geneva Chief delegate - Chef de delegation

Mr L. van Ommen Ms A. King Senior Desk Officer, Social and Institutional Minister of Health Development Division, Ministry of Foreign Delegate(s)- Detegue(s) Affairs Dr K. Poutasi Mr H. van der Hoeven Director-General of Health, Ministry of Health Desk Officer, United Nations and International Financial Institutions Department, Ministry of Dr D. Matheson Foreign Affairs Deputy Director-General of Public Health, Ministry of Health Mr L. van der Heiden Coordinator, Global Public Health, Alternate(s)- Suppleant(s) International Affairs, Ministry of Health, Welfare and Sport Mr S. McKernan District Health Board NZ A58NR page 219

Dr D. Campbell M. I.A. Lamine Principal Adviser (Public Health), New Directeur de la Legislation et du Contentieux Zealand Food Safety Authority Alternate(s)- Suppleant(s) MrR. Lind DrB. Samba Mr J. Harvey Directeur de la Sante Office of the Minister of Health NIGERIA- NIGERIA Dr A. Bloomfield Chief Adviser, Public Health, Ministry of Chief delegate - Chef de delegation Health Professor E. Lambo MrN. Kiddle Minister of Health Deputy Permanent Representative, Geneva Delegate(s)- Delegue(s) Ms R. McLean Policy Support Officer, Permanent Mission, Dr S. Sule Geneva Director, Health Planning and Research

Mr D. Anderson Dr E. Abebe Policy Support Officer, Permanent Mission, Director, Public Health Geneva Alternate(s)- Suppleant(s) NICARAGUA- NICARAGUA Dr A. Adeyemi Chief delegate- Chef de delegation Director, Community Development and Population Activities Dr. I. Kontorovsky Viceministro de Salud Dr D. Awosika National Coordinator and Chief Executive, Delegate(s)- Delegue(s) National Programme on Immunization

Sr. E. Castillo Pereira Dr T. Fakeye Representante Altemo, Encargado de Deputy Director, International Health Negocios, a.i., Ginebra Mr B.B. Olowodola Sra. P. Campbell Special Assistant to the Minister of Health Primer Secretario, Misi6n Permanente, Ginebra DrM. Odeku Assistant Director, Community Development NIGER- NIGER and Population Activities

Chief delegate - Chef de delegation Dr M.M. Lecky Executive Secretary, National Health M. A. lbrahim Insurance Scheme Ministre de la Sante publique et de la Lutte contre les Endemies Dr O.A. Sorungbe Executive Chairman, National Primary Health Delegate(s)- Delegue(s) Care Development Agency Mrs T.I. Koleoso-Adelekan DrD. Magagi Director, Health Systems Development, Conseiller technique National Primary Health Care Development Agency A58NR page 220

Professor B. Osotimehin Ms H.C. Sundrehagen Chairman, National Action Committee on Director-General, Ministry of Health and Care AIDS Ms B. Bull Professor K. Soyinka Senior Adviser, Ministry of Local Government National Action Committee on AIDS and and Regional Development President, ICASA 2005 Dr T. Hetland Mr P. Abah Senior Adviser, Ministry of Health and Care Assistant Director, National Action Committee on AIDS Ms T. Kongsvik Counsellor, Permanent Mission, Geneva Ms M. Makanjuola Head, Health Desk, Nigerian Television Authority Mr S.I. Nesvag Adviser, Ministry of Foreign Affairs Mr M. Adamu Mohammed Nigerian Television Authority Dr S. M0gedal Senior Adviser, The Norwegian Agency for Ms C. Ogbonna Development Cooperation Technical Assistant, National Programme on Immunization Ms A.H. Rimestad Deputy Director-General, Norwegian Dr A.O.K. Dipeolu Directorate of Health and Social Welfare Minister, Permanent Mission, Geneva Ms E. R0ine Dr S.M. Baba Adviser, Norwegian Directorate of Health and Senior Counsellor, Permanent Mission, Social Welfare Geneva MrS. R0ren Dr A. Nasidi Adviser, Ministry of Health and Care National Coordinator, Global Fund

NORWAY- NORVEGE Ms K. Gasser Attache, Permanent Mission, Geneva Chief delegate - Chef de delegation OMAN-OMAN Mr A. Gabrielsen Chief delegate - Chef de delegation Minister of Health and Care Dr A.M. Moussa Delegate(s)- Delegue(s) Minister of Health

Mr W.C. Stmmmen Delegate(s)- Delegue(s) Ambassador, Permanent Representative, Geneva Mr A.M.M. Al-Riyami Ambassador, Permanent Representative, Ms E. Aspaker Geneva State Secretary, Ministry of Health and Care Dr A.A. Al-Ghassani Alternate(s)- Suppleant(s) Under-Secretary for Health, Ministry of Health

Dr B.-I. Larsen Alternate(s)- Suppleant(s) Director-General, Norwegian Directorate of Health and Social Welfare Dr A.J. Mohammad Director-General of Health, Ministry of Health A58NR page 221

Dr J.A. Jawad Al-Lawati Mr A.A. Khokher Director, Noncommunicable Disease First Secretary, Permanent Mission, Geneva Surveillance and Control, Ministry of Health Mr R.S. Sheikh Dr S.T. Al-Oweidi First Secretary, Permanent Mission, Geneva Communicable Diseases Prevention and Control, Ministry of Health Mr F.N. Tirmizi

Mrs H.S. Al-Sabiri PALAU -PALAOS Head of Nursing, Sahar Hospital Delegate(s)- Delegue(s) Mr A.A. Al-Qassimi First Secretary, Permanent Mission, Geneva Dr C.T. Otto Senator, Chairman of Health and Education Mrs F. Al-Ghazali Committee, Palau National Congress Counsellor, Permanent Mission, Geneva PANAMA- PANAMA PAKISTAN-PAKISTAN Chief delegate - Chef de delegation Chief delegate - Chef de delegation Sr. J.A. Castillero MrM.N. Khan Embajador, Representante Permanente, Minister for Health Ginebra

Deputy chief delegate - Chef adjoint de la Delegate(s)- Delegue(s) delegation Sra. U. Alfu de Reyes MrM. Khan Embajadora, Representante Permanente Ambassador, Permanent Representative, Adjunta, Ginebra Geneva Dr. W.S. Lum Chong Delegate(s)- Delegue(s) Subdirector General de Salud Publica, Ministerio de Salud Mr R.K. Bharu:;ha Chairperson, Senate Standing Committee Alternate(s)- Suppleant(s)

Alternate(s)- Suppleant(s) Sra. I. Pusztai Directora Nacional de Asuntos Intemacionales, Dr H.R. Aziz Ministerio de Salud Chairperson, National Assembly's Standing Committee Sr. J .F. Corrales Ms T. Janjua Consejero, Misi6n Permanente, Ginebra Deputy Permanent Representative, Geneva PAPUA NEW GUINEA­ Dr A. Ahmed PAPOUASIE-NOUVELLE-GUINEE Deputy Director-General (Health) Chief delegate - Chef de delegation Professor A.J. Khan Principal, Frontier Medical College MrM. Pep Minister for Health DrU.A. Khan President, Pakistan Medical Association A58NR page 222

Deputy chief delegate - Chef adjoint de la Delegate(s)- Delegue(s) delegation Sra. E. Astete Rodriguez Dr T. Pyakalyia Embajadora, Representante Permanente, Deputy Secretary, Technical Health Services Ginebra Division, Department of Health Sr. J.L. Salinas Delegate(s)- Delegue(s) Representante Permanente Altemo, Ginebra

Mr P. Kase Alternate(s)- Suppleant(s) Director, Policy, Projects and Legal Services, Department of Health Sr. J.P. Vegas Consejero, Misi6n Permanente, Ginebra Alternate(s)- Suppleant(s) Srta. E. Beraun Escudero Mr P. Waranka Primera Secretaria, Misi6n Permanente, Governor, East Sepik Province Ginebra

MrK. Konga Dr. E. Prettel Second Secretary, Ministry of Health Coordinador Regional para America, Consejo Intemacional para el Control de Ios des6rdenes PARAGUAY-PARAGUAY por deficiencia de Y odo

Chief delegate- Chef de delegation Dr. C. Cosentino Director General, Oficina de Cooperaci6n Sr. R. Gauto Vielman Intemacional, Ministerio de Salud Embajador, Representante Permanente, Ginebra Dr. L. Manrique Asesor del Despacho de la Ministra de Salud Delegate(s)- Delegue(s) Sr. R. Patifio Dr. L. Ligier Rios Misi6n Permanente, Ginebra Director General, Unidad Tecnica de Relaciones Intemacionales, Ministerio de PHILIPPINES - PHILIPPINES Salud Publica y Bienestar Social Chief delegate - Chef de delegation Sr. F. Barreiro Perrota Consejero, Misi6n Permanente, Ginebra Dr M.M. Dayrit Secretary, Department of Health Alternate(s)- Suppleant(s) Deputy chief delegate - Chef adjoint de la Sra. E. Laterza de Ios Rios delegation Primera Secretaria, Misi6n Permanente, Ginebra MrE. Manalo Ambassador, Permanent Representative, PERU-PEROU Geneva

Chief delegate - Chef de delegation Delegate(s)- Delegue(s)

Dra. P. Mazzetti Mr R.L. Tejada Ministra de Salud Second Secretary, Permanent Mission, Geneva A58NR page 223

Alternate(s)- Suppleant(s) PORTUGAL-PORTUGAL

Or M.C. Villaverde Chief delegate - Chef de delegation Director IV, Bureau of Health and Policy Development and Planning, Department of Professeur A. Correia de Campos Health Ministre de la Sante

POLAND- POLOGNE Delegate(s)- Delegue(s)

Chief delegate - Chef de delegation M. J.C. da Costa Pereira Ambassadeur, Representant permanent, Mr P. Sztwiertnia Geneve Under-Secretary of State, Ministry of Health Professeur J. Pereira Miguel Delegate(s)- Delegue(s) Directeur general de la Sante

Mr Z. Rapacki Alternate(s)- Suppleant(s) Ambassador, Permanent Representative, Geneva Professeur J. Torgal Institut d'Hygiene et de Medecine tropicale Mr D. Adamczewski Director, Health Policy Department, Ministry M. F. George of Health Sous-Directeur general de la Sante

Alternate(s)- Suppleant(s) Adviser(s)- Conseiller(s)

Ms M. Krowiak Mme T. Oleiro Chief Adviser, Ministry of Health Chef de Cabinet du Ministre de la Sante

Mr J. Strejczek M. M. Vieira Counsellor, Department of the United Nations Adjoint du Ministre de la Sante System and Global Affairs, Ministry of Foreign Affairs M. J. Sousa Fialho Conseiller, Mission permanente, Geneve Ms R. Lemieszewska Counsellor, Permanent Mission, Geneva Mme T. Norton Dos Reis Expert Adviser(s)- Conseiller(s) QATAR-QATAR Professor S. Radowicki National Consultant for Gynaecology and Chief delegate - Chef de delegation Obstetrics Or K.J. Al-Thani Ms A. Gesiarz-Krasucka Deputy Chairperson, National Health Legal Adviser, Department of Analyses and Authority Healthcare Reimbursement Systems, Ministry of Health Delegate(s)- Delegue(s)

Ms S. Lyson Mr N.R. Al Nuaimi Chief Expert, Department for European Ambassador, Permanent Representative, Integration and International Co-operation, Geneva Ministry of Health Dr M. G. Al-Ali Member, National Health Authority Board A58NR page 224

Alternate(s)- Suppleant(s) Mr Choi Hee-joo Director, Health Insurance Policy Division, Mr J.A. Al Boainain Ministry of Health and Welfare Minister Plenipotentiary, Permanent Mission, Geneva Dr Park Ki-dong Director, Infectious Disease Control Division, Mr M.A. Al-Duhaimi Korea Center for Disease Control and First Secretary, Permanent Mission, Geneva Prevention

Mr H.M. Al-Hatmi Mr Ryu Jeong-hyun Director, Office of the Minister of Public First Secretary, Permanent Mission, Geneva Health Mr Kang Dae-sung REPUBLIC OF KOREA- REPUBLIQUE Deputy Director, Human Rights and Social DECOREE Affairs Division, Ministry of Foreign Affairs and Trade Chief delegate - Chef de delegation Mr Cho Choong-hyun Mr Kim Geun-tae Deputy Director, International Cooperation Minister of Health and Welfare Division, Ministry of Health and Welfare

Deputy chief delegate- Chef adjoint de la Mr Park Jae-man delegation Office of the Minister, Ministry of Health and Welfare Mr Choi Hyuck Ambassador, Permanent Representative, Ms Park Eun-young Geneva Ministry of Health and Welfare

Delegate(s)- Delegue(s) Adviser(s)- Conseiller(s)

Dr Kim Chung-sook Dr Lee Tae-soo Commissioner, Korea Food and Drug President, Korea Human Resource Administration Development Institute for Health and Welfare

Alternate(s)- Suppleant(s) DrKong Gu Scientific Adviser to the Commissioner, Korea Mr Moon Chang-jin Food and Drug Administration Deputy Minister for Social Welfare Policy, Ministry of Health and Welfare REPUBLIC OF MOLDOVA­ REPUBLIQUE DE MOLDOVA Mr Cho Tae-yul Ambassador, Deputy Permanent Chief delegate - Chef de delegation Representative, Geneva

Mr Ahn Hyo-hwan Dr V. Revenco Counsellor, Permanent Mission, Geneva Minister of Health and Social Protection Ms Paik Ji-ah Counsellor, Permanent Mission, Geneva Delegate(s)- Detegue(s)

Mr Lee Suk-kyu Mr D. Croitor Director, International Cooperation Division, Ambassador, Permanent Representative, Ministry of Health and Welfare Geneva A58NR page 225

ROMANIA- ROUMANIE Alternate(s)- Suppleant(s)

Chief delegate- Chef de delegation Mr A.V. Pirogov Deputy Permanent Representative, Geneva Professor M. Cinteza Minister of Health Mr V.M. Zimjanin Principal Counsellor, Department of Delegate(s)- Delegue(s) International Organizations, Ministry of Foreign Affairs Mr P. Dumitriu Charge d'affaires a.i., Permanent Mission, Mr V.K. Ryazantsev Geneva Deputy Chief, Department of International Cooperation, Ministry of Health and Social Mrs D. Iordache Development First Secretary, Permanent Mission, Geneva Professor A.V. Karaulov Alternate(s)- Suppleant(s) Adviser to the Deputy Minister of Health and Social Development Mrs C. Angheluta Deputy Director General, Directorate for Mr A.A. Pankin European Integration and Foreign Affairs Senior Counsellor, Permanent Mission, Geneva Mrs R. Costinea Director, Public Health Directorate, Ministry Mr N.V. Lozinskiy of Health Senior Counsellor, Permanent Mission, Geneva Mr F. Popovici Deputy Director General, Public Health Adviser(s)- Conseiller(s) Directorate, Ministry ofHealth Professor S.M. Furgal Mr L. Gheorghe Adviser to the Head of the Federal Supervisory Counsellor to the Minister of Health Service for Consumer Rights Protection and Human Welfare RUSSIAN FEDERATION- FEDERATION DE RUSSIE Dr M.P. Shevyryova Chief, Unit of Human Welfare, Ministry of Chief delegate - Chef de delegation Health and Social Development

Mr V.I. Starodubov Dr A.V. Pavlov Deputy Minister of Health and Social Counsellor, Permanent Mission, Geneva Development MrN.N. Sikachev Delegate(s)- Delegue(s) Counsellor, Permanent Mission, Geneva

Mr A.E. Granovskiy Mr A.V. Markov Director, Department of International Second Secretary, Permanent Mission, Geneva Organizations, Ministry of Foreign Affairs Mr D.A. Khudov Mr L.A. Skotnikov Attache, Permanent Mission, Geneva Ambassador, Permanent Representative, Geneva Mr M.M. Kochetkov Attache, Permanent Mission, Geneva A58NR page 226

RWANDA- RWANDA Delegate(s)- Delegue(s)

Chief delegate - Chef de delegation Ms Palanitina Toelupe Chief Executive Officer, Ministry of Health Dr J.D. Ntawukuliryayo Ministre de la Sante Alternate(s)- Suppleant(s) (from 23 to 25 May 2005) ( du 23 au 25 mai 2005) Mrs Tufi Mulitalo

M. H. Inyarubuga SAN MARINO- SAINT-MARIN (from 16 to 21 May 2005) (du 16 au 21 mai 2005) Chief delegate - Chef de delegation

Delegate(s)- Delegue(s) Dr M.R. Rossini Ministre de la Sante et de la Securite sociale, Mme V. Rugwabiza de la Prevoyance, des Affaires sociales et de Ambassadeur, Representant permanent, l'Egalite des Chances Geneve Delegate(s)- Delegue(s) Alternate(s)- Suppleant(s) Mme F. Bigi M. G. Kavaruganda Ambassadeur, Representant permanent, Conseiller, Mission permanente, Geneve Geneve

SAINT KITTS AND NEVIS­ Dr M. Fiorini SAINT-KITTS-ET-NEVIS Autorite pour 1' Autorisation, 1'Accreditation et la Qualite des Services sanitaires, Delegate(s)- Delegue(s) sociosanitaires et socio-educatifs

Mrs S. Ross-Chaderton Alternate(s)- Suppleant(s) First Secretary, Embassy of the Eastern Caribbean States, Brussels Mme S. Zonzini Bureau du Ministre de la Sante et de la SAINT VINCENT AND THE Securite sociale, de la Prevoyance, des GRENADINES- SAINT-VINCENT-ET­ Affaires sociales et de l'Egalite des Chances LES-GRENADINES SAO TOME AND PRINCIPE­ Chief delegate- Chef de delegation SAO TOME-ET-PRINCIPE

MrC. Lewis Chief delegate - Chef de delegation High Commissioner of Saint Vincent and the Grenadines to the United Kingdom, London Dr A.M. dos Santos Ministre de la Sante Delegate(s)- Delegue(s) Delegate(s)- Delegue(s) Ms I. Maurer Dr J.M. de Carvalho SAMOA- SAMOA Directeur, Soins de Sante

Chief delegate - Chef de delegation Dr Cheng Hua Wu Conseiller du Ministre de la Sante Mr Mulitalo Siafausa Minister of Health A58NR page 227

Alternate(s)- Suppleant(s) M. AL. Dieng Directeur, Cabinet du Ministre de la Sante et Dr A.S.M. de Lima de la Prevention medicale Conseiller du Ministre de la Sante Alternate(s)- Suppleant(s) Mr F.A. de Sousa Pontes Infirmier M. D.M. Sene Ministre Conseiller, Mission permanente, SAUDI ARABIA- ARABlE SAOUDITE Geneve

Chief delegate - Chef de delegation DrB. Drame Directeur de la Sante Dr H.A. Al-Manea Minister of Health Dr P.C. Faye Directeur de la Prevention medicale Delegate(s)- Delegue(s) Dr M.K. Badiane Dr A. Attar Directeur de la Pharmacie et des Laboratoires Ambassador, Permanent Representative, Geneva M. A. Basse Premier Secretaire, Mission permanente, Dr M.N. Al-Howasi Geneve

Alternate(s)- Suppleant(s) Mme C.C. Wone Chargee de programme, Conseil national de Dr Y.Y. Al-Mazrou Lutte contre le SIDA

Dr K. bin Al-Hussein Mme M. Fall Presidente, Association nationale des Sages­ Dr AI. Al-Sharif Femmes d'Etat

Mr A.H. Zawawi SERBIA AND MONTENEGRO­ SERBIE ET MONTENEGRO Mrs M.H. Al-Oseymi Chief delegate- Chef de delegation Dr S.N. Felemban Professor T. Milosavljevic Mr M.I. Al-Agail Minister of Health, Republic of Serbia

SENEGAL- SENEGAL Delegate(s)- Delegue(s)

Chief delegate - Chef de delegation Mr D. Sahovic Ambassador, Permanent Representative, Dr I.M. Samb Geneva Ministre de la Sante et de la Prevention medicale ProfessorS. Simic Assistant Minister of Health of the Republic of Delegate(s)- Deiegue(s) Serbia Alternate(s)- Suppleant(s) M. 0. Camara Ambassadeur, Representant permanent, Ms S. Krivokapic Geneve Assistant Minister of Health of the Republic of Montenegro A58NR page 228

Mr M. Begovic SINGAPORE - SINGAPOUR Minister, Deputy Permanent Representative, Geneva Chief delegate - Chef de delegation

Mr V. Lazovic Dr B. Sadasivan Second Secretary, Permanent Mission, Geneva Senior Minister of State (Health)

Mrs V. Radonjic-Rakic Deputy chief delegate - Chef adjoint de la Third Secretary, Permanent Mission, Geneva delegation

SEYCHELLES-SEYCHELLES Mr B. Gafoor Ambassador, Permanent Representative, Chief delegate - Chef de delegation Geneva

Mr V. Meriton Delegate(s)- Delegue(s) Minister of Health and Social Services Professor K. Satku Delegate(s)- Delegue(s) Director of Medical Services, Ministry of Health Dr J. Gedeon Director General, Community Health Alternate(s)- Suppleant(s)

Miss M.-A. Hoareau Dr Chew Suok Kai Vice-Chairperson, Nurses Association of Deputy Director of Medical Services Seychelles (Epidemiology and Disease Control), Ministry of Health Alternate(s)- Suppleant(s) Mr Yee Ping Yi Dr C. Shamlaye Director (Planning and Development), Special Adviser Ministry of Health

SIERRA LEONE- SIERRA LEONE Dr Ooi Peng Lim Deputy Director (Disease Control), Ministry of Chief delegate - Chef de delegation Health

Mrs A. Thomas MrS. Maniar Minister of Health Deputy Permanent Representative, Geneva

Delegate(s)- Deiegue(s) Mr K. Lim Boon Hwa First Secretary, Permanent Mission, Geneva DrN. Conteh Director General, Medical Services, Ministry Mr Ong Soo Chuan of Health First Secretary, Permanent Mission, Geneva

Mr E. Luy MrM. Basha Counsellor, Consulate of the Republic of First Secretary, Permanent Mission, Geneva Sierra Leone, Geneva Ms Koong Pai Ching First Secretary, Permanent Mission, Geneva

Mr D. Song Kheng Leong Office of the Senior Minister of State (Health) A58NR page 229

SLOV AKIA- SLOV AQUIE Adviser(s)- Conseiller(s)

Chief delegate - Chef de delegation Ms I. Lah Adviser, Ministry of Health Mr P. Ottinger State Secretary, Ministry of Health Ms D. Petric Adviser, Ministry of Health Deputy chief delegate- Chef adjoint de la delegation SOLOMON ISLANDS- ILES SALOMON

Mr K. Petocz Chief delegate- Chef de delegation Ambassador, Permanent Representative, Geneva MrB. Una Minister of Health and Medical Services Delegate(s)- Delegue(s) Delegate(s)- Delegue(s) Mrs K. Frecerova Director-General, International Relations Dr G. Malefoasi Section, Ministry of Health Under-Secretary Health Improvement, Ministry of Health and Medical Services Alternate(s)- Suppleant(s) SOMALIA- SOMALIE Mr S. Hlavacka Director, Health Insurance Company Chief delegate - Chef de delegation

Mrs Z. Cervena Dr A. Sheik Yusuf Department of International Relations, Minister of Health of the Transitional Federal Ministry ofHealth Government

Mrs N. Septakova Delegate(s)- Delegue(s) First Secretary, Permanent Mission, Geneva Dr M.H. Duale SLOVENIA- SLOVENIE Acting Permanent Secretary, Ministry of Health Chief delegate - Chef de delegation Mr M.O. Dubad Mr A. Brucan Minister Counsellor, Charge d'affaires a.i., Minister of Health Permanent Mission, Geneva

Delegate(s)- Delegue(s) Alternate(s)- Suppleant(s)

Mr A. Gosnar Mr A.A. Issa Ambassador, Permanent Representative, Counsellor, Permanent Mission, Geneva Geneva SOUTH AFRICA- AFRIQUE DU SUD Ms V.-K. Petric Under-Secretary, Ministry of Health Chief delegate - Chef de delegation

Alternate(s)- Suppleant(s) Dr M.E. Tshabalala-Msimang Minister of Health Mr I. Jukic First Secretary, Permanent Mission, Geneva Delegate(s)- Delegue(s) Dr K.S. Chetty Deputy Director-General A58NR page 230

Dr L. Makubalo Desk Official, International Health Liaison Cluster Manager, Monitoring and Evaluation Mr M. Msimang Alternate(s)- Supplt!ant(s) Mr G.L. Motaung Mr V .R. Mabope Special Adviser to the Minister SPAIN- ESP AGNE Ms P. Lambert Chief delegate - Chef de delt!gation Legal Adviser to the Minister

Ms D. Mafubelu Sra. E. Salgado Health Attache, Permanent Mission, Geneva Ministra de Sanidad y Consumo

Adviser(s)- Conseiller(s) Deputy chief delegate- Chef adjoint de la delegation Ms P.N. Nkonyeni Member of the Executive Council for Health, Dr. F. Lamata Cotanda Kwazulu-Natal Secretario General de Sanidad, Ministerio de Sanidad y Consumo MrS. Belot Member of the Executive Council for Health, Delegate(s)- Delegue(s) Free State Sr. J.A. March Pujol MsN. Dube Embajador, Representante Permanente, South African Local Government Association Ginebra DrU. Sankar Alternate(s)- Suppleant(s) South African Local Government Association

Ms N. Mayathula-Khoza Sr. M. Oiiorbe de Torre South African Local Government Association Director General de Salud Publica, Ministerio de Sanidad y Consumo Mr S.S. Kotane Charge d'affaires, Permanent Mission, Geneva Sra. M. Neira Presidenta, Agencia Espaiiola de Seguridad Ms C. Kotzenberg Alimentaria, Ministerio de Sanidad y Consumo Cluster Manager, Non-Communicable Diseases Sra. M. Tena Directora del Gabinete de la Ministra de Ms T.L. Moeng Sanidad y Consumo Director, Nutrition Sr. J.M. Bosch Bessa Mr L. S. Mngadi Representante Permanente Adjunto, Ginebra Media Liaison Officer for the Minister of Health Sr. E. Yturriaga Saldanha Subdirector General, Organismos MrB. Bench Internacionales Tecnicos, Ministerio de Protocol Officer, International Health Liaison Asuntos Exteriores y de Cooperaci6n MrM. Masuku Office of the Minister Sr. G. L6pez Mac-Lellan Consejero, Misi6n Permanente, Ginebra Mrs N. Mnconywa Office of the Member of the Executive Council for Health, Kwazulu-Natal Ms N.N. Mtsila A58NR page 231

Sr. I. Arranz Sra. E. Rodriguez Machado Director Ejecutivo, Agencia Espafiola de Jefa de Servicio, Subdirecci6n General de Seguridad Alimentaria, Ministerio de Sanidad Relaciones Internacionales, Ministerio de y Consumo Sanidad y Consumo

Sr. A. Infante Campos Sra. I. Saiz Martinez Acitores Asesor de la Ministra de Sanidad y Consumo Jefa de Secci6n, Subdirecci6n General de Promoci6n de la Salud y Epidemiologia, Sra. J. Gonzalez Alonso Ministerio de Sanidad y Consumo Subdirectora General, Promoci6n de la Salud y Epidemiogia, Ministerio de Sanidad y Adviser(s)- Conseiller(s) Consumo Sra. C. Perez Canto Sr. P.A. Garcia Gonzalez Directora de Communicaci6n, Ministerio de Subdirector General, Sanidad Exterior, Sanidad y Consumo Ministerio de Sanidad y Consumo Sra. R. Moreno Castillo Sr. J. Perez Lazaro Asesora de la Ministra de Sanidad y Consumo Subdirector General, Relaciones Internacionales, Ministerio de Sanidad y Sr. R. Rodriguez Andres Consumo Adjunto a la Directora de Comunicaci6n, Ministerio de Sanidad y Consumo Sra. L. Chamorro Secretaria del Plan Nacional para el SIDA, Sra. M. Mufioz Alcafiiz Ministerio de Sanidad y Consumo Gabinete de la Ministra (Protocolo ), Ministerio de Sanidad y Consumo Sra. 0. Tello Anchuela Directora, Centro de Epidemiologia, Sra. M.L. Frutos L6pez Ministerio de Sanidad y Consumo Gabinete de la Ministra (Protocolo ), Ministerio de Sanidad y Consumo Sr. A. Rodriguez Alvarez Vocal Asesor, Direcci6n General de Farmacia SRI LANKA- SRI LANKA y Productos Sanitarios, Ministerio de Sanidad y Consumo Chief delegate - Chef de dell~gation

Sra. C. Amela Heras Mr N.S. de Silva Consejera Tecnica, Subdirecci6n General de Minister of Health care, Nutrition and Uva Promoci6n de la Salud y Epidemiologia, W ellassa Development Ministerio de Sanidad y Consumo Delegate(s)- Delegue(s) Sr. 0. Gutierrez de Solana Consejero Tecnico, Direcci6n General de Mrs S. F ernando Salud Publica, Ministerio de Sanidad y Ambassador, Permanent Representative, Consumo Geneva

Sr. M. Minguez Gonzalo Mr Y.D.N. Jayathilake Jefe de Servicio, Subdirecci6n General de Additional Secretary (Medical Services), Sanidad Exterior, Ministerio de Sanidad y Ministry of Healthcare, Nutrition and Uva Consumo W ellassa Development

Sra. M.L. Garcia Tufion Jefe de Servicio, Subdirecci6n General de Relaciones Internacionales, Ministerio de Sanidad y Consumo A58NR page 232

Alternate(s)- Suppleant(s) SWEDEN- SUEDE

Dr H.S.B. Tennakoon Chief delegate - Chef de delegation Deputy Director General (Planning), Ministry ofHealthcare, Nutrition and Uva Wellassa Ms Y. Johansson Development Minister for Health and Elderly Care

Mr S. Pathirana Deputy chief delegate- Chef adjoint de la Second Secretary, Permanent Mission, Geneva delegation

MrS. Dissanayake Mr M. Johansson Second Secretary, Permanent Mission, Geneva Minister for Public Health and Social Services

SUDAN- SOUDAN Delegate(s)- Delegue(s)

Chief delegate - Chef de delegation Mr K. Asplund Director-General, National Board of Health DrAB. Osman and Welfare Federal Minister of Health Alternate(s)- Suppleant(s) Delegate(s)- Delegue(s) Ms M. Horn afRantzien Dr I.E.M. Abdulla Charge d'affaires a.i. and Deputy Permanent Representative, Geneva Dr I.A. El Bashir Ms E. Persson-Goransson Alternate(s)- Suppleant(s) State Secretary, Ministry ofHealth and Social Affairs Dr E.A. Elsayid Ms E. Bjorling Dr S. Mandil Member of Parliament

Mrs 1.1. Elamin Ms H. Pedersen Permanent Mission, Geneva First Secretary, Permanent Mission, Geneva

SWAZILAND- SWAZILAND Ms A. Blomberg First Secretary, Permanent Mission, Geneva Chief delegate - Chef de delegation Ms D. Alopaeus-Stahl Mr S. Shongwe Director, Ministry for Foreign Affairs Minister for Health and Social Welfare Mr F. Lennartsson Delegate(s)- Delegue(s) Director, Ministry of Health and Social Affairs

Dr J. Kunene MrS. Karlsson Deputy Director, Ministry of Health and Social Mrs G. Mavuso Affairs

Alternate(s)- Suppleant(s) Mr A. Hilmerson Desk Officer, Ministry of Health and Social Mrs B. Shongwe Affairs

Mrs P. Kisanga A58NR page 233

Ms K. Nilsson-Kelly Deputy chief delegate- Chef adjoint de la Desk Officer, Ministry of Health and Social delegation Affairs Professeur T. Zeltner Ms U. Komell Secretaire d'Etat, Directeur de l'Office federal Desk Officer, Ministry of Health and Social de la Sante publique, Departement federal de Affairs l'Interieur

Ms K. Jansson Delegate(s)- Delegue(s) Desk Officer, Ministry of Health and Social Affairs M. B. Godet Ambassadeur, Representant permanent, Mr B. Pettersson Geneve Deputy Director General, National Institute for Public Health Alternate(s)- Suppleant(s)

Ms A. Gardulf M. G. Silberschmidt Government Chief Nurse, National Board of Vice-directeur, Chef de la Division des affaires Health and Welfare intemationales, Office federal de la Sante publique, Departement federal de l'Interieur Ms B. Schmidt Administrative Director, National Board of M. J. Martin Health and Welfare Conseiller (Developpement), Mission permanente, Geneve Ms B. Nordstrom Senior Programme Officer, Swedish M. D. Mausezahl International Development Cooperation Conseiller principal sante, Section du Agency developpement social, Direction du developpement et de la cooperation, Professor 0. Cars Departement federal des Affaires etrangeres Swedish Institute for Infectious Disease Control M. G. Kessler Chef, Section organisations intemationales, Ms J. Aktander Office federal de la Sante publique, Political Adviser Departement federal de l'Interieur

Ms A. Blomberg M. A. V on Kessel First Secretary, Permanent Mission, Geneva Chef suppleant, Section organisations intemationales, Office federal de la Sante Adviser(s)- Conseiller(s) publique, Departement federal de l'Interieur

Ms E. Nilsson-Bagenholm M. P. Beyer Secretary General, Swedish Medical Affaires intemationales, Institut federal de la Association propriete intellectuelle, Departement federal de Justice et Police SWITZERLAND- SUISSE M. 0. Chave Chief delegate - Chef de delegation Chef, Division ONU/Developpement, Direction du developpement et de la M. P. Couchepin cooperation, Departement federal des Affaires Conseiller federal, Chef du Departement etrangeres federal de l'Interieur A58NR page 234

M. F. del Ponte Alternate(s)- Suppleant(s) Conseiller medical a l'aide humanitaire, Direction du developpement et de la Dr K. Baradi cooperation, Departement federal des Affaires Director, National Immunization Programme etrangeres Mrs S. Abbas Mme F. Freiburghaus Third Secretary, Permanent Mission, Geneva Section du developpement social, Direction du developpement et de la cooperation, Adviser(s)- Conseiller(s) Departement federal des Affaires etrangeres Dr A.A. Talas MmeA. Levy Director, Aleppo Health Cheffe de la section alcool, Office federal de la Sante publique, Departement federal de TAJIKISTAN- TADJIKISTAN 1' Interieur Chief delegate - Chef de delegation Mme E. Manfrina Division ONU/Developpement, Direction du Dr A. Temurov developpement et de la cooperation, First Deputy Minister of Health Departement federal des Affaires etrangeres Delegate(s)- Delegue(s) Mme A. Ochieng Pemet Section questions thematiques intemationales, Mr S. Dzobirov Office federal de la Sante publique, Director-General, Centre for Immunization, Departement federal de l'Interieur Ministry of Health

Mme B. Schaer Bourbeau THAILAND- THAILANDE Deuxieme Secretaire, Mission permanente, Geneve Chief delegate - Chef de delegation

Mme S. Zobrist Professor Suchai Charoenratanakul Cheffe suppleante de la section questions Minister of Public Health thematiques intemationales, Office federal de la Sante publique, Departement federal de Delegate(s)- Delegue(s) l'Interieur Mr Chaiyong Satjipanon SYRIAN ARAB REPUBLIC - Ambassador, Permanent Representative, REPUBLIQUE ARABE SYRIENNE Geneva

Chief delegate - Chef de delegation Dr Natskhol Pawanawichien Adviser to the Minister of Public Health, Dr M. Al-Housami Office of the Minister, Ministry ofPublic Minister of Health Health

Delegate(s)- Delegue(s) Alternate(s)- Suppleant(s)

Dr M. Al Koutayni Dr Vichai Tienthavom Deputy Minister of Health Permanent Secretary, Ministry of Public Health Dr B. Ja' Afari Ambassador, Permanent Representative, Dr Supachai Kunaratanapruk Geneva Deputy Permanent Secretary, Ministry of Public Health A58NR page 235

Dr Narongsakdi Aungkasuvapala Dr Chumrurtai Kanchanachitra Deputy Permanent Secretary, Ministry of Director, Institute for Population and Social Public Health Research, Mahidol University

Dr Thawat Suntrajarn Dr Thaksaphon Thamarangsi Director-General, Department of Disease Medical Officer, International Health Policy Control Program, Ministry of Public Health

Dr Suvaj Siasiriwattana Dr Supakorn Buasai Director, Bureau of Policy and Strategy, Director, Thai Health Promotion Foundation Ministry of Public Health Dr Y ot T eerawattananon Dr Somyos Charoensak Medical Officer, International Health Policy Director-General, Department ofHealth, Program, Ministry of Public Health Ministry of Public Health Ms Pornpit Silkavute Dr Suwit Wibulpolprasert Research Manager, Health Systems Research Senior Adviser in Health Economics, Office of Institute the Permanent Secretary, Ministry of Public Health Mrs Walaiporn Patcharanarumol Pharmacist, International Health Policy Mrs Krisana Chandraprabha Program, Ministry of Public Health Minister, Deputy Permanent Representative, Geneva Mrs Areekul Puangsuwan Program and International Affairs Officer, Dr Viroj Tangcharoensathien Thai Health Promotion Foundation Senior Policy and Plan Analyst, Bureau of Policy and Strategy, Ministry of Public Health Dr Tassana Boontong President, Thailand Nursing Council Dr Kumnuan Ungchusak Director, Bureau of Epidemiology, Department Dr Jintana Yunibhand of Disease Control, Ministry of Public Health President, The Nurses' Association of Thailand Dr Sopida Chavanichkul Director, International Health Group, Ministry Dr Nyana Preaesrisakul of Public Health Director, The Information and Public Relations Office, Ministry of Public Health Mr Witchu Vejjajiva First Secretary, Permanent Mission, Geneva Ms Kesorn Chinda Public Relations Officer, Ministry of Public Ms Prangtip Chansomsak Health First Secretary, Permanent Mission, Geneva Mr Chanapahol Songserm Dr Siriwat Tiptaradol Local Administrative Officer, Office of the Director, Health Systems Research Institute, Minister, Ministry of Public Health Ministry of Public Health Ms Tarntip Karunsiri Dr Preecha Prempree Foreign Relations Officer, Bureau of Policy Medical Officer, Bureau of Epidemiology, and Strategy, Ministry ofPublic Health Department of Disease Control, Ministry of Public Health Ms Nawarat Liamthai Policy and Plan Analyst, Office of the Minister, Ministry ofPublic Health A58NR page 236

Mr Lam Plookphet Delegate(s)- Delegue(s) Policy and Plan Analyst, Office of the Minister, Ministry of Public Health Mr D. Ximenes Head, Department of Health Policy Ms N antakam Chalermrungroj Development, Ministry ofHealth The Information and Public Relations Office, Ministry of Public Health Mrs I.M. Games District Liaisons Officer, Ministry of Health Mr Sakchay Jiemkay The Information and Public Relations Office, Alternate(s)- Suppleant(s) Ministry of Public Health Mr A. Dick THE FORMER YUGOSLAV REPUBLIC Charge d'affaires a.i., Permanent Mission, OF MACEDONIA- EX-REPUBLIQUE Geneva YOUGOSLAVE DE MACEDOINE TOGO-TOGO Chief delegate - Chef de delegation Chief delegate - Chef de delegation DrY. Dimov Minister of Health Mme S. Aho Ministre de la Saute Delegate(s)- Delegue(s) Delegate(s)- Delegue(s) Mr G. Avramchev Ambassador, Permanent Representative, Dr P. Tchamdja Geneva Directeur general de la Saute

Ms S. Cicevalieva TONGA- TONGA Ministry of Health Delegate(s)- Delegue(s) Alternate(s)- Suppleant(s) Dr V.T. Tangi Ms D. Zafirovska Minister of Health Minister Counsellor, Permanent Mission, Geneva TUNISIA - TUNISIE

Mr N. Dzaferi Chief delegate - Chef de delegation Second Secretary, Permanent Mission, Geneva Dr R. Kechrid Mr G. Atanasov Ministre de la Saute publique Third Secretary, Permanent Mission, Geneva Delegate(s)- Delegue(s) Ms G. Majnova Ministry of Health M. S. Labidi Ambassadeur, Representant permanent, Ms G. Damjanovska Geneve Ministry of Health Dr H. Abdessalem TIMOR-LESTE- TIMOR-LESTE Directeur general, Unite de la Cooperation technique Chief delegate - Chef de delegation

Dr R. Maria de Araujo Minister for Health A58NR page 237

Alternate(s)- Suppleant(s) Dr F. Aydinli Deputy General Director, Primary Health Care, Dr H. Achouri Ministry of Health Directeur, Tutelle des Hopitaux Ms S. Tezel Aydin DrM. Nabli Deputy Head, Department ofForeign Affairs, Chef de Service, Direction des Soins de Sante Ministry of Health de Base Dr S. Mollahaliloglu M. H. Landoulsi Director, Public Health School, Ministry of Conseiller aux Affaires etrangeres, Mission Health permanente, Geneve Mr M. Lakadamyali TURKEY- TURQUIE First Secretary, Permanent Mission, Geneva

Chief delegate - Chef de delegation MrH. Ergani Second Secretary, Permanent Mission, Geneva Professor R. Akdag Minister of Health DrN. Yardim Public Health School, Ministry of Health Delegate(s)- Delegue(s) Mr H. Giingor Mr T. Kurttekin Assistant Expert, State Planning Organization Ambassador, Permanent Representative, Geneva TUVALU -TUVALU

Professor N. Dnuvar Delegate(s)- Deiegue(s) Under-Secretary, Ministry of Health Mr L. Faavae Alternate(s)- Suppleant(s) Permanent Secretary for Health

ProfessorS. Aydin UGANDA- OUGANDA Deputy Under-Secretary, Ministry of Health Chief delegate - Chef de delegation Dr R. Kose General Director, Mother and Child Health and Dr A. Kamugisha Family Planning, Ministry ofHealth Minister of State for Health (Primary Health Care) MrK. bzden Head, Department of Foreign Affairs, Ministry Delegate(s)- Deiegue(s) of Health Mr M.S. Kezaala MrM. Esenli Permanent Secretary, Ministry of Health Deputy Permanent Representative, Geneva Mr K. Ruhemba Mr H. Kivan<; Ambassador, Permanent Representative, Counsellor, Permanent Mission, Geneva Geneva

Dr S. bzceada Alternate(s)- Suppleant(s) Counsellor, Ministry of Health Professor F. Omaswa Mr C. Korkut Director General of Health Services, Ministry Counsellor, Permanent Mission, Geneva of Health A58NR page 238

Mr W.G. Naggaga Delegate(s)- Delegue(s) Ambassador, Deputy Permanent Representative, Geneva Mr M.H. Al Shaali Ambassador, Permanent Representative, Mrs F. Kamugisha Geneva Ministry of Health Mr H.A. Al Kim Ms M.M. Chota Under-Secretary, Ministry of Health Commissioner for Nursing Services, Ministry of Health Alternate(s)- Suppleant(s)

Dr A. Opio Dr M. Fikri Assistant Commissioner for National Disease Assistant Under-Secretary for Preventive Control, Ministry of Health Medicine, Ministry of Health

Mr E. Kamahungye Mr N .K. Al Budoor First Secretary, Permanent Mission, Geneva Assistant Under-Secretary for Foreign Relations and International Health, Ministry of UKRAINE- UKRAINE Health

Chief delegate - Chef de delegation Dr S.A. Al Darmaki Assistant Under-Secretary for Finance and Mr M. Polishchuk Administration Affairs, General Health Minister of Health Authority- Abu Dhabi

Delegate(s)- Delegue(s) Mr Q. Al Muroushid Director-General, Health and Medical Services Mr V. Bielashov Administration, Dubai Permanent Representative, Geneva Dr A. Al Khayat Mrs Z. Tsenilova Director, Al Wasl Hospital, Dubai Head, International Relations Department, Ministry of Health Dr M. Al Oulama Deputy Director-General for Technical Affairs, Alternate(s)- Suppleant(s) Health and Medical Services Administration, Dubai Mrs S. Homanovska Counsellor, Ministry of Foreign Affairs Dr A.A. Julfar Director, Primary Health Care, Health and Mrs K. Sotulenko Medical Services Administration, Dubai First Secretary, Permanent Mission, Geneva Dr A. Al Mutawaa UNITED ARAB EMIRATES­ Director, Health Education, Ministry of Health EMIRATS ARABES UNIS Mr A.S. Al Romaithi Chief delegate- Chef de delegation Director, Health Affairs Division, General Health Authority - Abu Dubai Mr H.A.R. Al Madfa Minister of Health Dr A. Abu Haliqa Manager, Health Care Development and Research, General Health Authority - Abu Dubai A58NR page 239

Mr K.J. Al Khaili Dr C. Presern Deputy Director, Al Mafraq Hospital, Abu Counsellor, Permanent Mission, Geneva Dubai Ms H. Nellthorp Mr A.H.S. Al Hamood First Secretary, Permanent Mission, Geneva Head, Foreign Relations Section, Ministry of Health Ms F. McConville Health Adviser, Department for International Mr O.M. Al Falasi Development Public Relations Officer, Information Section, Health and Medical Services Administration, Ms J. Bunting Dubai Statistics Adviser, Department for International Development UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND­ Mr B. David ROY AUME-UNI DE GRANDE- Health Adviser, Department for International BRETAGNE ET D'IRLANDE DU NORD Development

Chief delegate - Chef de delegation MrB. Green Team Leader, UN and Commonwealth Mrs P. Hewitt Department, Department for International Minister of State for Health Development

Delegate(s)- Delegue(s) Adviser(s)- Conseiller(s)

Sir Liam Donaldson MrN. Boyd Chief Medical Officer, Department ofHealth Head, International Affairs, Department of Health Dr D. Harper Director, Health Protection and International Professor C. Beasley Health, Department of Health ChiefNursing Officer, Department of Health

Alternate(s)- Suppleant(s) Professor A. Maslin International Officer for Nursing and Dr G. Scally Midwifery, Department of Health Regional Director of Public Health, Government Offices for the South West Professor S. Davies Director, Research and Development, Professor P. Johnstone Department of Health Regional Director of Public Health, Government Offices for Yorkshire and the Ms L. Demming Humber International Business Manager, Department of Health Mr T. Kingham Head, Global Health, Department of Health Miss A. Akinfolajimi Deputy International Business Manager, Dr S. Tyson Department of Health Head of Profession (Health), Human Development Group, Department for Dr D. Salisbury International Development Head, Immunisation and Communicable Diseases Team, Department of Health MrN. Thorne Ambassador, Permanent Representative, Geneva A58NR page 240

MrM. Ahmed Delegate(s)- Delegue(s) Director General (International), Department for International Development Mr C.K. Mutalemwa Ambassador, Permanent Representative, Ms A. Forder Geneva Health Adviser, Scaling up Services Team, Policy Division, Department for International Alternate(s)- Suppleant(s) Development Ms M.J. Mwafisi Mrs L. Reid Permanent Secretary, Ministry of Health Programme Officer, Department for International Development Dr U.M. Kisumku Deputy Principal Secretary, Ministry of Health MrS. Lee and Social Welfare, Zanzibar Team Leader, Scaling up Services Team, Policy Division, Department for International Dr G.L. Upunda Development Chief Medical Officer

Ms L. Lush Dr A.A. Mzige Senior Health and HIV Adviser, International Director, Preventive Services Divisions Advisory Department, Department for International Development Dr S.A. Muhsin Director, Preventive Services, Ministry of Ms S. Baldwin Health and Social Welfare, Zanzibar Acting Head, Specialised Agencies, Department for International Development Dr R.O. Swai Programme Manager, National AIDS Control Ms P. Tarif Programme Second Secretary, Permanent Mission, Geneva Mr C.P. Mpandana Ms H. Thomas Acting ChiefNursing Officer Attache, Permanent Mission, Geneva Mrs I.F. Kasyanju Ms H. F einstein Counsellor, Permanent Mission, Geneva Office of the Minister of State for Health UNITED STATES OF AMERICA­ Ms C. Pearson ETATS-UNIS D'AMERIQUE Office of the Chief Medical Officer, Department of Health Chief delegate - Chef de delegation

UNITED REPUBLIC OF TANZANIA­ Mr M.O. Leavitt REPUBLIQUE-UNIE DE TANZANIE Secretary of Health and Human Services

Chief delegate - Chef de delegation Deputy chief delegate- Chef adjoint de la delegation Mrs A.M. Abdallah Minister for Health Mr K.E. Moley Ambassador, Permanent Representative, Deputy chief delegate- Chef adjoint de la Geneva delegation

Mr S.J. Othman Minister for Health and Social Welfare, Zanzibar A58/VR page 241

Delegate(s)- Delegue(s) Dr D.A. Singer Senior Medical Policy Adviser, Office of Dr W.R. Steiger International Health Affairs, Department of Special Assistant to the Secretary for State International Affairs, Department of Health and Human Services Mr R.M. Trostle Senior Technical Adviser, Vaccines and Alternate(s)- Suppleant(s) Surveillance, United States Agency for International Development Ms A. Blackwood Director for Health Programs, Office of Ms E. Yuan Technical Specialized Agencies, Bureau of International Health Officer, Office of Global International Organization Affairs, Department Health Affairs, Office of the Secretary, of State Department of Health and Human Services

Dr J. Gerberding Dr B. Anderson Director, Centers for Disease Control and Chair and Director, The Breast Health Global Prevention, Department of Health and Human Initiative, Fred Hutchinson Cancer Research Services Center

MrD.E. Hohman Ms N. Brinker Health Attache, Permanent Mission, Geneva Founder, Susan G. Komen Breast Cancer Foundation Mr S. Simonson Assistant Secretary for Public Health Mr C. Hickey Emergency Preparedness, Office of Public International Health Policy Adviser, Office of Health Emergency Preparedness, Department Global Health Affairs, Office of the Secretary, of Health and Human Services Department of Health and Human Services

Ms M.L. Valdez Dr J.C. Nelson Deputy Director for Policy, Office of Global President, American Medical Association Health Afairs, Office of the Secretary, Department of Health and Human Services URUGUAY- URUGUAY

Adviser(s)- Conseiller(s) Chief delegate - Chef de delegation

MrM. Abdoo Dr. M. Fern{mdez Galeano Special Assistant to the Director, Office of Viceministro de Salud Publica Global Health Affairs, Office of the Secretary, Department of Health and Human Services Delegate(s)- Delegue(s)

Ms K. Kruglikova Sr. G. Valles International Resource Management Officer, Embajador, Representante Permanente, Permanent Mission, Geneva Ginebra

MrT.M. Peay Sr. R. Pollak Counsellor (Legal Affairs), Permanent Ministro, Misi6n Permanente, Ginebra Mission, Geneva Alternate(s)- Suppleant(s) Mr J. Santamauro Office of the United States Trade Sr. F. Lugris Representative, Permanent Mission, Geneva Primer Secretario, Misi6n Permanente, Ginebra A58NR page 242

Sra. A. De Bellis VENEZUELA (BOLIVARIAN REPUBLIC Primer Secretario, Misi6n Permanente, OF)-VENEZUELA(REPUBLIQUE Ginebra BOLIVARIENNE DU)

Sra. I. Amezaga Chief delegate- Chef de delegation Attache, Misi6n Permanente, Ginebra Sr. B. Carrero Cuberos UZBEKISTAN- OUZBEKISTAN Embajador, Representante Permanente, Ginebra Chief delegate - Chef de deh~gation Delegate(s)- Delegue(s) Mr F. N azirov Minister of Health Dr. J .R. Mendoza Viceministro de Salud y Desarrollo Social Delegate(s)- Delegue(s) Sra. R. Poitevien Cabral Mrs C. Y adgarova Embajadora, Representante Permanente Head, Directorate for Maternal and Child Altema, Ginebra Protection, Ministry of Health Alternate(s)- Suppleant(s) MrB. Obidov First Secretary, Charge d'affaires a.i., Sra. R. del V alle Mata Le6n Permanent Mission, Geneva Directora General, Cooperaci6n Tecnica y Relaciones Intemacionales, Ministerio de Alternate(s)- Suppleant(s) Salud y Desarrollo Social

Mr A. Sidikov Sr. R.E. Perdomo Director, Department of International Director General, Salud Ambiental y Cooperation, Ministry of Health Contraloria Sanitaria, Ministerio de Salud y Desarrollo Social Mr A. Mursaliyev Third Secretary (Economic Affairs and WTO), Dr. J.M. Garcia Permanent Mission, Geneva Director, Vigilancia Epidemiol6gica, Ministerio de Salud y Desarrollo Social VANUATU- VANUATU Sr. E. Bitetto Gavilanes Chief delegate - Chef de delegation Primer Secretario, Misi6n Permanente, Ginebra Mr M.S. Iatika Government Minister, Ministry of Health Sr. D. Ibarra Martinez Tercer Secretario, Misi6n Permanente, Ginebra Delegate(s)- Delegue(s) Adviser(s)- Conseiller(s) Mr G. Taleo Director a. i., Public Health Services Sr. F. Di Cera Misi6n Permanente, Ginebra

VIETNAM-VIETNAM

Chief delegate - Chef de delegation

Dr Nguyen Thi Xuyen Vice-Minister, Ministry of Health A58NR page 243

Delegate(s)- Dell~gue(s) Alternate(s)- Suppleant(s)

Mr Ngo Quang Xuan Mr K.A. Al-Sakkaf Ambassador, Permanent Representative, Adviser to the Minister of Public Health and Geneva Population on Bilateral Cooperation

Dr Tran Trong Hai Dr N.N. Al-Jaber Director, International Cooperation Member, Executive Bureau, Health Ministers' Department, Ministry of Health Council for Gulf Cooperation Council States

Alternate(s)- Suppleant(s) Mr N.A.Y. Abdel Wahab Director, Nutrition and Food Safety Mrs Le Thi Thu Ha Department Deputy Director, International Cooperation Department, Ministry of Health Dr I. Al-Mahbishi Attache, Permanent Mission, Geneva Dr Nguyen Hoang Long Deputy Director, Financial Planning ZAMBIA- ZAMBIE Department, Ministry of Health Chief delegate- Chef de delegation Mr Nguyen Huy Nga Deputy Director, General Department of Dr B. Chituwo Preventive Medicine and HIV I AIDS Minister of Health Prevention and Control, Ministry of Health Delegate(s)- Delegue(s) Mr Pham Hong Nga Counsellor, Permanent Mission, Geneva Mr L. Mtesa Ambassador, Permanent Representative, Dr Nguyen Tran Hien Geneva Director, National Institute of Hygiene and Epidemiology, Ministry of Health Dr S.K. Miti Permanent Secretary, Ministry ofHealth Mrs N guyen Thi Minh Chau Expert, International Cooperation Department, Alternate(s)- Suppleant(s) Ministry of Health Dr B.U. Chirwa YEMEN- YEMEN Director General, Central Board of Health

Chief delegate - Chef de delegation MrM. Daka Deputy Permanent Representative, Geneva Dr M.Y. Al-Naami Minister of Public Health and Population Dr P. Kalesha Ministry of Health Delegate(s)- Delegue(s) Dr V.C. Mtonga Dr F.S. bin Ghanem Ambassador, Permanent Representative, Mrs E. Sinjela Geneva Counsellor, Permanent Mission, Geneva

Dr A. Al-Rabi Mr A. Zulu Under-Secretary, Population Sector, Ministry First Secretary, Permanent Mission, Geneva of Public Health and Population A58NR page 244

ZIMBABWE- ZIMBABWE OBSERVERS FOR A NON-MEMBER STATE Chief delegate - Chef de dell~gation OBSERVATEURS D'UN ETAT Dr P.D. Parirenyatwa NONMEMBRE Minister of Health and Child Welfare HOLY SEE- SAINT-SIEGE Deputy chief delegate- Chef adjoint de la delegation Mgr J. Lozano-Barragan President, Conseil pontifical pour la Pastorale DrE. Xaba des Services de la Sante Secretary for Health and Child Welfare Mgr S.M. Tomasi Delegate(s)- Delegue(s) Nonce Apostolique, Observateur permanent, Geneve Mr C. Chipaziwa Ambas:;ador, Permanent Representative, Mgr F. Nwachukwu Geneva Conseiller, Mission permanente, Geneve

Alternate(s)- Suppleant(s) Mgr J.-M.M. Mpendawatu

Mrs M. Sibanda Dr G. Rizzardini Director, Finance Dr M. Evangelista Dr S.M. Midzi Deputy Director, Disease Prevention Pere R.J. Vitillo

Dr 0. Mugurungi OBSERVERS Coordinator, AIDS and Tuberculosis OBSERVATEURS Mrs R. C. Madzima Coordinator, Environmental Health ORDER OF MALTA- ORDRE DE MALTE MrN. Mawoyc Coordinator, Environmental Health M. P.-Y. Simonin Ambassadeur, Observateur permanent, Geneve Mr S.C. Mhango Deputy Permanent Representative, Geneva Mme M.-T. Pictet-Althann Ministre Conseiller, Observateur permanent Dr S.T. Mukanduri adjoint, Geneve Minister Counsellor, Permanent Mission, Geneva M. M. de Skowronski Ministre Conseiller, Obervateur permanent Mr R. Chibuwe adjoint, Geneve Minister Counsellor, Permanent Mission, Geneva Mme R. Saraceno-Persello Premier Secretaire, Mission permanente, MrNderere Geneve Pharmaceutical Industry A58NR page 245

INTERNATIONAL COMMITTEE OF Mr R. Mister THE RED CROSS Coordinator, UN-Interagency cooperation for COMITE INTERNATIONAL DE LA Indian Ocean Tsunami CROIX-ROUGE Dr M. Gunasekera Dr P. Perrin Senior Executive Director, Special Operations, Medecin Chef The Sri Lanka Red Cross Society

Dr H. Le Guillouzic DrG. Gizaw Chef, Unite des services de sante Senior Officer, Communicable Diseases

Dr C. Felix Ms H. Etemadi Adjoint au Chef, Unite des services de sante Senior Officer, Private Sector Relations

Dr E. Burnier INTER-PARLIAMENTARY UNION Expert, VIH/SIDA et tuberculose UNION INTERPARLEMENTAIRE

INTERNATIONAL FEDERATION OF Mr A.B. Johnsson RED CROSS AND RED CRESCENT Secretary-General SOCIETIES FEDERATION INTERNATIONALE DES Mr S. Tchelnokov SOCIETES DE LA CROIX-ROUGE ET Officer-in-Charge, Economic and Social DU CROISSANT-ROUGE Questions

Dr B. Eshaya-Chauvin OBSERVERS INVITED IN Head, Health and Care Department ACCORDANCE WITH RESOLUTION Mr B. Gardiner WHA27.37 Unit Manager, AIDS Global Programme OBSERVATEURS INVITES Dr F. Font Sierra CONFORMEMENT A LA Senior Health Officer for Americas Region RESOLUTION WHA27.37

Mr P. Carolan PALES TINE -PALESTINE Senior Officer, Blood Dr T. Al-Wuhaidi Dr A. Marschang Minister of Health Responsible Officer, Public Health in Emergencies Unit Dr M. Abu-Koash Ambassador, Permanent Observer, Geneva Ms J. Barbe Senior Assistant, Health and Care Department Dr A. Al-Masri Deputy Minister of Health Ms J. Muller International Representation Officer Dr I. Tarawiyeh Assistant Deputy Minister of Health MrC. Lamb Special Adviser, International Representation Mr W. Shaqura Director of International Cooperation, Ministry Dr E. Mbizvo of Health Senior Officer, Health and Care Department Mr T. Al-Adjouri Counsellor, Permanent Mission, Geneva A58NR page 246

Ms N. Hassassian Dr E. Hoekstra Counsellor, Permanent Mission, Geneva Senior Health Adviser, Geneva

REPRESENTATIVES OF THE Dr P. Salama UNITED NATIONS AND Chief, Immunization RELATED ORGANIZATIONS Dr K. Oyegbite REPRESENTANTS DE Senior Programme and Planning Officer, L'ORGANISATION DES Planning and Coordination, Health Section NATIONS UNIES ET DES INSTITUTIONS APP ARENTEES Mr S. Kianian-Firouzgar Deputy Regional Director, Geneva UNITED NATIONS- ORGANISATION DES NATIONS UNIES Dr S. Kumar Regional Programme Officer, Health and Mr F.J. Homann-Herimberg Nutrition, Geneva Special Adviser to the Emergency Relief Coordinator, Office for the Coordination of Mr A. Timmer Humanitarian Affairs, Geneva Project Officer, Nutrition, Geneva

Dr P. Millett Dr D. Popovic Associate Political Affairs Officer, United Project Officer, Immunization, Geneva Nations Department for Disarmament Affairs, Geneva Branch Mrs M. Calivis Regional Director, Geneva Mr D. Bertrand Inspector, Joint Inspection Unit Mr E. Stanislavov Regional Programme Officer, Geneva Mr E. Fontaine Ortiz Inspector, Joint Inspection Unit Mr A. Court Director, Programme Division Mr T. Inomata Inspector, Joint Inspection Unit UNITED NATIONS HUMAN SETTLEMENTS PROGRAMME MrW. Munch (UN-HABITAT)- Inspector, Joint Inspection Unit PROGRAMME DES NATIONS UNIES POUR LES ETABLISSEMENTS UNITED NATIONS CHILDREN'S HUMAINS FUND- FONDS DES NATIONS UNIES POUR Ms S. Lacroux L'ENFANCE Director, UN-HABITAT, Geneva Office

Ms A. Veneman Ms M. Mejia Executive Director Liaison Officer

Mr B. Nabors UNITED NATIONS POPULATION Assistant to the Executive Director FUND- FONDS DES NATIONS UNIES POUR LA Dr P. Villeneuve POPULATION Chief, Health Section MrK. Waki Dr K. Mukelabai Deputy Executive Director Senior Health Adviser, Health Section A58NR page 247

Ms S. Hamid MrM. Loftus External Relations Officer Head, Inter-Organization Desk

MrS. Bernstein UN AIDS - ONUSIDA Millenium Project Dr P. Piot Mr E. Palstra Executive Director Officer-in-Charge, Geneva Liaison Office Ms P. Mane Dr V. Fauveau Director, Social Mobilization and Information Senior Maternal Health Adviser, Geneva Department Liaison Office MrM. Sidibe Ms K. Nilsen Director, Country and Regional Support Junior Professional Officer, Geneva Liaison Department Office MrP.DeLay Ms M. Ali Director, Monitoring and Evaluation Assistant, Geneva Liaison Office Mr A. Dangor UNITED NATIONS RELIEF AND Director, Advocacy, Communication and WORKS AGENCY FOR PALESTINE Leadership REFUGEES IN THE NEAR EAST­ OFFICE DE SECOURS ET DE TRAVAUX Mr B. Plumley DES NATIONS UNIES POUR LES Chief of the Executive Office REFUGIES DE PALESTINE DANS LE PROCHE-ORIENT Ms S. Mehta Deputy Director, Country and Regional Mr M. Burchard Support Department Chief, UNRWA Liaison Office in Geneva Ms E. Timpo Ms V. Basso Associate Director, Country Programming and UNRW A Liaison Office in Geneva Liaison Division

OFFICE OF THE UNITED NATIONS Mr L. Loures HIGH COMMISSIONER FOR Associate Director, Global Initiative Division REFUGEES- HAUT COMMISSARIAT DES NATIONS MrE. Murphy UNIES POUR LES REFUGIES Associate Director, Governance and UN Relations MsN. Ezard Senior Public Health Officer, Technical Mr E. Haarman Support Section Chief, Finance and Administration

Ms F. Abdalla Ms J. Girard Senior Nutritionist, Technical Support Section Chief, Human Resources Management

Ms M. Schilperoord Ms C. Hankins Programme Officer, Technical Support Section Associate Director, Strategic Information

Mr P. Spiegel Mr J. Fleet Consultant, Technical Support Section Senior Adviser, Care and Public Policy A58NR page 248

MrG. Tembo INTERNATIONAL NARCOTICS Team Leader, UN Action at Regional and CONTROL BOARD- Country Levels ORGANE INTERNATIONAL DE CONTROLE DES STUPEFIANTS Ms T. Boonto Special Assistant to Executive Director Professor H. Ghodse President Mr J. Tyszko External Relations Officer, Governance and MrK. Kouame UN Relations Secretary of the Board

THE GLOBAL ALLIANCE FOR Ms B. Hammond VACCINES AND IMMUNIZATION­ Drug Control Officer ALLIANCE MONDIALE POUR LES VACCINS ET LA VACCINATION SPECIALIZED AGENCIES

Dr J. Lob-Levyt INSTITUTIONS SPECIALISEES Executive Secretary INTERNATIONAL LABOUR Mr B. Stenson ORGANIZATION- Principal Officer ORGANISATION INTERNATIONALE DU TRAVAIL DrM. Ahun Team Leader, Country Support Mr A. Diop Executive Director, Social Protection Sector Mr J.-P. Le Calvez Acting Team Leader, Communication Dr I. Herrell Senior Adviser in Health, Social Protection Ms L. Jacobs Sector Senior Officer MrM. Cichon Dr I. Rizzo Director, Social Security, Financial, Actuarial Senior Programme Officer, Country Support and Statistical Services, Social Protection Sector Dr A. Bchir Senior Programme Officer, Monitoring Dr B. Alli Director a. i., ILO Programme on HIVI AIDS Mr A. Palacios and the World of Work, Social Protection Team Leader, Fund-Raising Sector

Mr U. Cancellieri Dr S. Niu Team Leader, Operations In Focus Programme on Safety and Health at Work and the Environment, Social Protection Mr F. McKinnon Sector Senior Adviser Dr S. Beckmann Ms V. Laurent ILO Programme on HIVI AIDS and the World Fund-Raising Officer of Work, Social Protection Sector

Ms X. Scheil-Adlung Social Security Policy and Development Branch, Social Protection Sector A58NR page 249

Ms S. Maybud INTERNATIONAL Sectoral Activities Department, Social TELECOMMUNICATION UNION­ Dialogue Sector UNION INTERNATIONALE DES TELECOMMUNICATIONS Mr A. Dale Relations with Intergovernmental M. M.-H. Cadet Organizations, Bureau for External Relations Chef des Affaires exterieures and Partnerships WORLD METEOROLOGICAL FOOD AND AGRICULTURE ORGANIZATION- ORGANIZATION OF THE UNITED ORGANISATION METEOROLOGIQUE NATIONS- MONDIALE ORGANISATION DES NATIONS UNIES POUR L' ALIMENTATION ET M. P. Lefale L' AGRICULTURE Fonctionnaire scientifique, Departement du Programme climatologique mondial MrT.N. Masuku Director, FAO Liaison Office with the United WORLD INTELLECTUAL PROPERTY Nations in Geneva ORGANIZATION- ORGANISATION MONDIALE DE LA Mr P. Paredes-Portella PROPRIETEINTELLECTUELLE Liaison Officer, FAO Liaison Office with the United Nations in Geneva Mme K.L. Rata Relations exterieures et cooperation avec MrS. Jutzi certains pays d'Europe et d' Asie Director, Animal Production and Health Division INTERNATIONAL ATOMIC ENERGY AGENCY- UNITED NATIONS EDUCATIONAL, AGENCE INTERNATIONALE DE SCIENTIFIC AND CULTURAL L'ENERGIE ATOMIQUE ORGANIZATION- ORGANISATION DES NATIONS UNIES Mr W. Burkart POUR L'EDUCATION, LA SCIENCE ET Deputy Director General, Head of the LA CULTURE Department ofNuclear Sciences and Applications Ms I. Breines Director, UNESCO Liaison Office, Geneva Ms J. Rissannen External Relations Officer, IAEA Office at WORLD BANK- BANQUE MONDIALE Geneva

Mr J.K. Ingram MrM. Samiei Special Representative to Europe, Geneva Programme Manager, Programme of Action for Cancer Therapy INTERNATIONAL MONETARY FUND­ FONDS MONETAIRE INTERNATIONAL Ms A. Reidon IAEA Office at Geneva Mr J.-P. Chauffour IMF Representative to WTO, Geneva WORLD TRADE ORGANIZATION­ ORGANISATION MONDIALE DU COMMERCE

Mrs G. Stanton Senior Counsellor, Agriculture and Commodities Division A58NR page 250

Mrs J. Watal AFRICAN UNION- UNION AFRICAINE Counsellor, Intellectual Property Division Mr B.P. Gawanas MrR. Kampf Commissioner for Social Affairs Counsellor, Intellectual Property Division Mrs K.R. Masri Mr W. Meier-Ewert Ambassador, Permanent Observer, Geneva Legal Affairs Officer, Intellectual Property Division Dr G. Kalimugogo Head, AIDS Watch Africa REPRESENTATIVES OF OTHER INTERGOVERNMENTAL Mr T. Bisika ORGANIZATIONS Head, Health, Nutrition, HIVI AIDS and Population REPRESENTANTSD'AUTRES ORGANISATIONS Mr V. Wege Nzomwita INTERGOUVERNEMENTALES Minister Counsellor, Permanent Delegation, Geneva INTERNATIONAL COMMITTEE OF MILITARY MEDICINE- DrE. Buch COMITE INTERNATIONAL DE Health Adviser, NEPAD Secretariat, Pretoria MEDECINE MILITAIRE COMMONWEALTH SECRETARIAT­ Dr A. Pasture! SECRETARIAT DU COMMONWEALTH President, Conseil scientifique Ms A. Keeling LEAGUE OF ARAB STATES- LIGUE Director, Social Transformation Programmes DES ETATS ARABES Division

Mr S. Alfarargi Dr D. de Silva Ambassador, Permanent Observer, Geneva Deputy Director/Head of Health Section, Social Transformation Programmes Division Dr H. Hamouda Director, Department of Health and DrJ. Amuzu Environment, League of Arab States Adviser, Health Section Secretariat MrD. Walker Dr 0. El-Hajje Educational Specialist, Commonwealth of Permanent Delegation, Geneva Learning

MrS. Aeid Dr K.T. Joiner Permanent Delegation, Geneva Executive Director, West African Health Organisation Mr H. El-Roubi League of Arab States Secretariat Dr S.V. Shongwe Executive Secretary, East, Central and OFFICE INTERNATIONAL DES Southern African Health Community EPIZOOTIES - OFFICE INTERNATIONAL DES Mr A.B. Kibwika-Muyinda EPIZOOTIES Administration Manager, East, Central and Southern African Health Community Dr W. Droppers Charge de mission Mrs M.G. Shomari A58NR page 251

Professor B. Sandhu Mr K. McCarthy Secretary, Commonwealth Association of Directorate General for Research Paediatric Gastroenterology and Nutrition Mrs A. Karaoglou EUROPEAN COMMISSION - Directorate General for Research COMMISSION EUROPEENNE Mr C. Dufour Mr M. Kyprianou Permanent Delegation, Geneva European Union Commissioner for Health and Consumer Protection HEALTH MINISTERS' COUNCIL FOR GULF COOPERATION COUNCIL Mr C. Trojan STATES- Ambassador, Permanent Delegation, Geneva CONSEIL DES MINISTRES DE LA SANTE, CONSEIL DE COOPERATION Dr B. Merkel DES ETATS ARABES DU GOLFE Head of Unit, Directorate General for Health and Consumer Protection Dr T.A.M. Khoja Chairman, Executive Board of the Health Dr M. Rajala Ministers' Council Head of Unit, Directorate General for Health and Consumer Protection Mr R.l. Al-Mousa Member, Executive Board of the Health Dr T. Piha Ministers' Council Head of Unit, Directorate General for Health and Consumer Protection Dr M.S. Hussein Member, Executive Board of the Health Dr L. Fransen Ministers' Council Head of Unit, Directorate General for Development INTERNATIONAL ORGANIZATION FOR MIGRATION- MrT. Bechet ORGANISATION INTERNA TIONALE Minister Counsellor, Permanent Delegation, POUR LES MIGRATIONS Geneva Dr D. Grondin MrN. Fahy Director, Migration Health Department Deputy Head of Unit, Directorate General for Health and Consumer Protection Dr G. Grujovic Medical Information Specialist, Migration MrP. Brunet Health Services Deputy Head, Cabinet of the Commissioner Dr S. Gunaratne Mrs C. Thompson Coordinator, Health Programmes for the Directorate General for Health and Consumer South-Pacific, Migration Health Services Protection ORGANISATION INTERNATIONALE Mrs G.G. Kjaeserud DE LA FRANCOPHONIE­ Directorate General for Health and Consumer ORGANISATION INTERNATIONALE Protection DE LA FRANCOPHONIE

Dr K. Saluvere M. H. Cassan Directorate General for Health and Consumer Ambassadeur, Representant permanent, Protection Geneve A58NR page 252

Mme S. Coulibaly Leroy Ms C. Cepuch Representant permanent adjoint, Geneve Ms L. Chavez Mile M. Poirey Consultante Dr Z. Chowdhury

ORGANIZATION OF THE ISLAMIC Mr T. Davies CONFERENCE- ORGANISATION DE LA CONFERENCE Ms D. Davies ISLAMIQUE Ms P. De Agrella MrB. Ba Ambassador, Permanent Observer, Geneva Ms C. De Larvemette

Mr M.A. Jerrari Ms A.M. Doppenberg Minister Counsellor, Permanent Delegation, Geneva Ms J. Duchatel

REPRESENTATIVES OF Ms A. Eisenhoffer NON GOVERNMENTAL ORGANIZATIONS IN OFFICIAL Dr E. Espinoza RELATIONS WITH WHO Mr C. Fluckiger REPRESENTANTSDES ORGANISATIONS NON MrM. French GOUVERNEMENTALESEN RELATIONS OFFICIELLES Ms E. Gitta AVECL'OMS Dr M. Hamlin Zuniga African Medical and Research Foundation Fondation pour la Medecine et la Recherche MrD. Hathi en Afrique Ms K.M. Hennings DrH. Jeene Ms K. Herz CMC- Churches' Action for Health CMC- L' Action des Eglises pour la Saute MrP. Holley

Mr B.K. Adhikary Ms P. Hughes

Mr M. Ahnlund Dr G. J ourdan

Ms A. Ahnlund Mr B. Kadasia

Ms V. Bemard MrH. Khan

Ms A. Beutler Ms M.T. Klein

Mr H.P. Bollinger Ms J. Koch

Dr M. Carballo DrM. Kurian

Mr J. Cardosa Ms D. Lachavanne Ms L. Lhotska A58NR page 253

Ms A. Lindsay MrS. Satyanarayan

Mr W.P. Luedemann Dr R. Schneider

Mr C. McClure Dr A. Shukla

DrB. Menard Ms C. Starey

Ms M. Meurs Ms A. Stiickelberger

Ms P. Morton Dr B. Teper

MsM.O. Moya Mr P. Tibasiimwa

Mr P. Mubangizi Ms A. Tijstsma

Ms M. Mufioz Mr N.G. Udumalagala

MsM. Murry Dr J. Utrera

Dr R. Narayan Ms L. van Haren

Dr C. Nettleton Ms M. van Heemstra

Mr A.H.M. Nouman Dr M. Van Hoyweghen

MrS. Ochieng Ms E. V erheul

Dr A. Ojoo Dr 0. Vilchez

DrE. Ombaka Mr D. Wangechi

MrN. Perski Ms C. Wiskow

Ms C. Peter Mr H.M. Zobair

Mr A. Petersen Commonwealth Association for Mental Handicap and Developmental Disabilities Ms E. Petitat-Cote Association du Commonwealth pour les Handicaps mentaux et les Incapacitt~s liees Dr J. Prem au developpement

MsN. Que Dr V .R. Pandurangi

Dr A. Quizhpe Peralta Dr G. Supramaniam

Ms F. Rasolomanana Mr A.V. Pandurangi

Dr J. Richter Ms A. Vanigasooriyar

Ms H. Sackstein Dr M.S. Islam

Ms L. Salemo MrG. Hosur A58NR page 254

Dr S. Kanhere Ms E.'t Hoen

Ms G. Anusuya Bai Ms M.E. Dailly

Mr P. Praveen Singh Mr J. Love

Mr S. Chandra Mr T. Balasubramaniam

Commonwealth Pharmaceutical Association Mr D.W. Mwangi Association pharmaceutique du Commonwealth Corporate Accountability International Corporate Accountability International Mr J. Bell MsK. Mulvey Ms C. Bell Ms L. Wykle-Rosenberg Consumers International Consumers International Council for International Organizations of Medical Sciences Ms M. Childs Conseil des Organisations internationales des Sciences medicales MrO. Lanza Dr J.E. Idanpaiin-HeikkiHi Mr B. Misra Dr J. V enulet Mr S. Ochieng MrS. Floss Mr S.R. Khanna Council on Health Research for Ms A. Allain Development Conseil de la Recherche en Saute pour le Ms N. El Rassi Developpement

Dr A. Gupta Professor C. IJsselmuiden

Dr L. Lhotska Ms S. de Haan

Ms A. Linnecar Mr A. Kennedy

Mr A. Nikiema Ms C. Nieto

Ms Yeong Joo Kean FDI World Dental Federation Federation dentaire internationale Ms M. Woldetensaie Dr Heung-Ryul Yoon Dr Z. Chowdury Dr J.T. Bamard Dr K. Balasubramaniam Dr H. Benzian Dr R. Lopez Linares Dr R. Beaglehole Ms H.L. Luna Coelho Ms C. Nackstad

Ms S. Gombe MrM. Lack A58NR page 255

Professor S. Moss Ms K. Bendixen

Framework Convention Alliance on Mr D. Hayward Tobacco Control Framework Convention Alliance on Global Health Council Tobacco Control Conseil mondial de la Sante

Mr L. Huber Ms A. Roberts

Mr C. Bostic Ms S. Smith

MrS. John Mr Chuan C. Yaun

Mr P. Diethelm Dr N. Simelela

Mr Meng-Chih Lee Ms M. Hesla

Ms J. Myndiukova MrM.N. Mensah

German Pharma Health Fund e. V. Mr M. Franciosa German Pharma Health Fund e.V. Mr Santi Ram Pokhrel Dr C. Fink-Anthe Ms J.W. Sheffield Mr M. Schottler Ms A.M. Starrs Mrs K. Raabe Mr 0. Odumuye Global Forum for Health Research Global Forum for Health Research MrS. Yasiri

Dr R. Narayan Ms M. Lichtenberg

ProfessorS. Matlin Mr J. Harsh Dr A. de Francisco Mr L. Shangwa Ms M.A. Burke MsH. Lund Ms S. Olifson-Houriet Mr E.A. Friedman Dr A. Ghaffar DrN. Leydon Ms M. Haslegrave Ms N. Dhingra Ms S. Jupp Dr R. Mathai Ms C. Mauroux Mr A. Purohit Ms A. Pawlowska Ms D. Draghici MrM. Wagner Mr D. Spiegel Ms A. Sundaram MrM. Cabral Mr R. Walgate A58NR page 256

Mr J. Norris International College of Surgeons College international des Chirurgiens International Alliance of Women Alliance internationale des Femmes Professor P. Hahnloser

Mrs G. Haupter Professor N. Hakim

Mrs M. Pal Dr R. Dieter

Mrs H. Sackstein MrM. Downham

International Association for Maternal and Dr W.P. Chang Neonatal Health Association internationale pour la Sante de Mr S.M. Hou la Mere et du Nouveau-Ne Ms Ly Lai DrR. Kulier MrD. Liao International Association for the Study of Obesity MrM. Kau International Association for the Study of Obesity Mr C.J. Hung Professor P. J ames MrY.N. Hsu Ms K. Baillie MrS. Lin MrN. Rigby Professor J.M. Alvear International Association of Cancer Registries International Confederation of Midwives Association internationale des Registres Confederation internationale des Sages­ du Cancer Femmes Ms E. Rapiti Ms K. Herschder

Mr L. Verkooijen Ms R. Brauen

International Association of Logopedics and Ms J. Bonnet Phoniatrics Association internationale de Logopedie et International Council for Control of Iodine Phoniatrie Deficiency Disorders Conseil international pour la Lutte contre Dr A. Muller les Troubles dus a une Carence en lode

International Catholic Committee of Nurses Professor J.C. Ling and Medico-social Assistants Comite international catholique des Professor H. Burgi Infirmieres et Assistantes medico-sociales Dr M. Zimmerman Mrs I. Wilson Professor E. Pretell

MrD. Haxton A58NR page 257

International Council for Standardization International Federation of Business and in Haematology Professional Women Conseil international pour la Federation internationale des Femmes de Standardisation en Hematologie Carrieres liberales et commerciales

Dr S. Heller Ms M. Gerber

International Council of Nurses Ms G. Gonzenbach Conseil international des Infirmieres International Federation of Chemical, Mrs K. Stallknecht Energy, Mine and General Workers' Unions Dr T. Ghebrehiwet Federation internationale des Syndicats de Travailleurs de la Chimie, de l'Energie, des Mrs L. Carrier-Walker Mines et des Industries diverses

Ms J. Caughley Mr B. Erikson

Ms S. Wilburn Ms A. Biondi

Ms D. Turin Ms R. Gonzalez

Mr L. Chiriatti International Federation of Gynecology and Obstetrics Mrs C. Bosson Federation internationale de Gynecologie et d'Obstetrique Ms U. Grosse Dr R. Kulier Mrs B. Wienkamp-Weber International Federation of Health Records Mrs Chen Ching Min Organizations Federation internationale des Associations Mrs P. Caldwell du Dossier de Sante

International Council of Women Ms J.S. Clark Conseil international des Femmes Ms L. Nicholson Mrs A. Tan Ms M. Skurka Mrs C. Schenk Monfrini

International Diabetes Federation International Federation of Medical Federation internationale du Diabete Students Associations Federation internationale des Associations MrN. Rigby d'Etudiants en Medecine

International Federation for Medical and Mr A. Rudkjobing Biological Engineering Federation internationale du Genie medical Mr J.A. Afriye et biologique Ms S. Bottcher Professor J. Nagel Ms J. Myndiukova Professor R. Magjarevic Mr M. Singla Dr M. Nagel Mr A. Watabe A58NR page 258

Mr A. El Saify International Federation of Surgical Colleges MrH. Hamoda Federation internationale des Colleges de Chirurgie MrC. Brown Professor S.W.A. Gunn Ms S. Murugasen International Federation on Ageing Ms N. Matthaeas Federation internationale de la Vieillesse Mrs I. Hoskins Mr U. Nwadike International Hospital Federation Mr A. Ibrahim Federation internationale des Hopitaux

International Federation of Pharmaceutical Professor P.-G. Svensson Manufacturers Associations Federation internationale de l'Industrie du Miss S. Anazonwu Medicament Dr R. Masironi Dr H.E. Bale Jr Mrs L. Ciaffei Mr E. Noehrenberg International Lactation Consultant Dr K. Elemesova Association Association internationale de Conseil en Ms 0. Morin Lactation

Ms M. Gaj ewski Ms M. Arendt Lehners

Dr R. Krause International Medical Parliamentarians Organization MrT. Sano Organisation internationale des Parlementaires Medecins Ms A.-L. Boffi Dr N. Pirmoazen Ms S. Crowley International Organization for Mr A. Aumonier Standardization Organisation internationale de Ms P. Carlevaro Normalisation MrT. Hancox MrM. Ojanen International Pediatric Association Mr J. Pender Association internationale de Pediatrie

Ms L. Kroukamp Dr A. Grange

MrP. Hedger Dr J.G. Schaller

Mr J. McCarthy Dr Chan Chok-wan

Dr S.A. Cabral

Dr S.O. Lie A58NR page 259

Dr M. C. Rahimy International Society of Physical and Rehabilitation Medicine DrM. Moya International Society of Physical and Rehabilitation Medicine International Pharmaceutical Federation Federation internationale pharmaceutique Professor G. Stucki

Mr J. Parrot Dr J. Melvin

Mr A.J.M. Hoek International Society of Radiographers and Radiological Technologists DrV.P. Shah Association internationale des Techniciennes et Techniciens diplomes en Ms T. Alves Electro-Radiologie medicate

Mr 0. Bruce Dr A. Yule

Professor K.K. Midha Mrs A.F. Yule

Ms B. Fmkjaer International Special Dietary Foods Industries Mrs M. Torongo Federation internationale des Industries des Aliments dietetiques Dr A. Arancibia Dr A. Bronner Mr J. Ware Mr D. Hawkins Miss Chen Mei-Chuan Ms J. Keith Miss Wang Chao-Yi MrC. Burcky International Pharmaceutical Students' Mr H. Scholick Federation Federation internationale des Etudiants en Ms D. Malone Pharmacie

Ms T. Wuliji Ms M. Creedon

Mr S. Dalgliesh Ms K. Bolognese

MrS. Bell Ms H. Mouchly W eiss

International Planned Parenthood Ms C. Drotz Federation Federation internationale pour la Mr Thien Luong Van My Planification familiale Mr M. Miranda Dr N. Simelela International Stroke Society International Society for Preventive Societe internationale contre I'Accident Oncology vasculaire cerebral Association internationale pour la Prevention et le Depistage du Cancer Mr K. Asplund

Professor H.E. Nieburgs A58NR page 260

International Union against Cancer Mr E. Hammond Union internationale contre le Cancer Ms Lim Li Ching Mrs I. Mortara MrM. Khor Mr R. Israel Ms S. Shashikant Mrs S. Jones Rotary International Mr R. Cunningham Rotary International Mr B. Rosted Mr R. Homdler

Mr J.J. Divino MrG. Coutau

Mr P. Reamonn Soroptimist International Soroptimist International Mrs J. Blondcau Ms I.S. Nordback International Women's Health Coalition Coalition internationale pour la Sante des The Network: Towards Unity for Health (TUFH) Femmes The Network: Towards Unity for Health (TUFH) Ms Z. Woods Dr P. Kekki Italian Association of Friends of Raoul Follereau The Save the Children Fund Association italienne des Amis de Raoul The Save the Children Fund Follereau Ms R. Keith Dr E. Pupulin Ms C. Walker Ms G. Upham Ms S. Witter Ms A. Morot Ms G. McCullough La Leche League International Liguc internationale La Leche Ms T. Van Ommeren Ms H. Kuonen-Goetz Ms S. Lynch Medical Women's International Association Association internationale des Femmes MrP. Davis Medecins MrR. Samba Dr C. Bretscher Dutoit Ms A. Russell OXFAM OXFAM World Association of Societies of Pathology and Laboratory Medicine Mr M. Kamal-Smith Association mondiale des Societes de Pathologie et Biologie medicale Ms A. Baze DrU. Merten Ms J. Brant Dr R. Bacchus A58NR page 261

World Confederation for Physical Therapy World Federation of Hydrotherapy and Confederation mondiale de Physiotherapie Climatotherapy Federation mondiale du Thermalisme et du Ms B.J. Myers Climatisme

World Council of Optometry Professor N. Storozhenko World Council of Optometry Professor U. Solimene Professor D. Sheni ProfessorS. Serrano MrY. Gutman Dr E. Rocco World Federation for Medical Education Federation mondiale pour l'Enseignement Ms E. Minelli de la Medecine World Federation of Public Health Associations Professor L. Christensen Federation mondiale des Associations de la Saute publique Dr H. Karle DrW. Tsou World Federation for Mental Health Federation mondiale pour la Saute mentale Dr P. Orris

Mrs M. Lachenal Mr T. Louvet

Dr S. Flache Dr S.M. Asib Nasim

World Federation of Chiropractic Dr M. Goldbaum Federation mondiale de Chiropratique Dr P.E. Gadelha Vieira Dr A. Metcalfe Dr E. Wilson Dr E. Anrig Mr C. Rosene

Dr G. Auerbach Dr Wang Hexiang

Dr S. Borges Mr Cai Jiming

Dr M. Tetrault Professor Lu Rushan

Mr D. Chapman-Smith Mr F. Paredes

Mrs H. Anrig Dr D. Zeegers

Dr R. Baird Dr U. Laaser

MrD. O'Bryon Mr J. Theodore

Mr E. Leonard Dr J.-F. Vely Professor L. Nagymajtenyi

Dr B. Sadrizadeh

Dr A. Leventhal A58NR page 262

Dr T. N akahara World Medical Association Association medicale mondiale Dr Lee Seung W ook DrY. Blachar Dr L.F. Antiga Tinoco Ms L. Wapner

Mr H. Munoz Grande DrM. Borrow

Dr G. Keating Dr Wu Shuh-min

Dr G. Tellnes Dr S. Roy

Mr P. Madgwick Dr L. Mikhailov

Mr A. McCapra Dr J. Appleyard

Dr A. Demin DrY. Coble

Dr Shan N aidoo Dr E. Hill

Mr M. Kaufmann Dr J. Nelson

Professeur H. Pekcan Ms R. Menes

MrB. Metin DrD. Human

DrM. Vamam Dr R. Parsa-Parsi

Dr C. Ruiz Matus Dr S. Sveinsson

Ms M. Hilson Dr 0. Kloiber

Professor T. Abelin Dr A. Rowe

Dr A.K. Jones Ms E. Viaud

Ms S. Succop Mrs I. Borika

Ms J. Bell Davenport Dr B. Selebano

Dr M. Saidi Dr K. Letlape

Dr A. Chandra Dr P. Anttila

Mr J. N derere Dr Wu Yung Tung

World Heart Federation World Organization of Family Doctors Federation mondiale du Coeur Organisation mondiale des Medecins de Famille Mrs J. Vofite Dr I. Hellemann Mrs H. Alderson World Organization of the Scout Movement Mrs D. Grizeau-Clemens Organisation mondiale du Mouvement scout Ms C. Adler Dr E. Missoni

Mr Chalongkwan Tavarayuth

MrD. McAdam A58NR page 263

World Self-Medication Industry DrH. Cranz Industrie mondiale de I' Auto medication responsable World Vision International Vision mondiale internationale Dr D.E. Webber DrM. Amayun Ms S. Durand-Stamatiadis

REPRESENTATIVES OF THE EXECUTIVE BOARD

Mr D.A. Gunnarsson Dr A.B. Osman Dr Yiu Li Dr A. A. Y oosuf

REPRESENTANTS DU CONSEIL EXECUTIF

M. D.A Gunnarsson Dr A.B. Osman Dr Yiu Li Dr A. A. Y oosuf

OFFICE OF THE EXTERNAL AUDITOR BUREAU DU COMMISSAIRE AUX COMPTES

Mr K.S. Menon

A58NR page 265

INDEX OF NAMES

This index contains the names of speakers reported in the present volume.

INDEX DES NOMS DES ORATEURS

Cet index contient les noms des orateurs dont les interventions figurent dans le present volume.

AKDAG, R. (Turkey/Turquie), 71 DIRECTOR-GENERAL/DIRECTEUR AL SHAALI, M.H. (United Arab Emirates GENERAL, 28, 172 Health Foundation/Fondation des Emirats DONALDSON, L. (United Kingdom of arabes unis pour la Saute), 147 Great Britain and Northern AL-MANEA, H.A. (Saudi Arabia/Arabie Ireland/Royaume-Uni de Grande­ saoudite), 154 Bretagne et d'Irlande du Nord), 88 ARANA, M. (Sasakawa Health Prize/Prix Sasakawa pour la Sante), 146 ESHAYA-CHAUVIN, B. (International Federation of Red Cross and Red BAROUD, A. (Chad/Tchad), 17 Crescent Societies/Federation BIJOU, J. (Haiti/Hai'ti), 127 internationale des Societes de la Croix­ BONGELI, E. (Democratic Republic of the Rouge et du Croissant-Rouge), 138 Congo/Republique democratique du ESTEVEZ TORRES, G. (Cuba), 89, 158 Congo), 131 FATIMIE, S.M.A. (Afghanistan), 96 CARRERO CUBEROS, B. (Bolivarian FERNANDEZ GALEANO, M. (Uruguay), Republic of V enezuela/Republique Vice-Chairman of the Fifty-eighth bolivarienne du Venezuela), 95 World Health AssemblyNice­ CHUA SOl LEK (Malaysia/Malaisie ), 59 President de la Cinquante-Huitieme CORREIA DE CAMPOS, A. (Portugal), 87 Assemblee mondiale de la Sante, 105 COSENTINO, C. (Peru/Perou), 116 FORTES, F.J. (Angola), 129 COSTA, H. (Brazil/Bresil), 61 FRENK, J. (Mexico/Mexique), 106 COUCHEPIN, P. (Switzerland/Suisse), 78 FUJII, M. (Japan/Japon), 40

DARWAZAH, S. (United Arab Emirates GABRIELSEN, A. (Norway/Norvege), 55 Health Foundation Prize/Prix de la GANDI, T. (Mongolia/Mongolie), 99 Fondation des Emirats arabes unis pour GAO Qiang (China/Chine), 21,46 la Saute), 149 GARCIA, P. (Chile/Chili), 121 DE LIMA, A.S.M. (Sao Tome and GATES, B. (Bill & Melinda Gates Principe/Sao Tome-et-Principe ), 134 Foundation/Foundation Bill et Melinda DE SILVA, N.S. (Sri Lanka), 118 Gates), 36 DENG Hongmei (China/Chine), 135, 136 GA WANAS, B.P. (African Union/Union DEV ACOTA, L.K. (Nepal/Nepal), 117 africaine), 137 DI BARTOLOMEO, M. (Luxembourg), 54 GIANNOPOULOS, A. (Greece/Grece), 104 DIMITROV, B. (Kyrgyzstan!Kirghizistan), GILDERS, C. (Canada), 158 133 GONZALEZ GARCIA, G. (Argentina/Argentine), 94 A58NR page 266

GOSSELIN, H. (Canada), 62 KONTOROVSKY, I. (Nicaragua), 122 GUNN ARS SON, D .A. (Iceland/Islande) KY A W MYINT (Myanmar), 85 (Chairman ofthe Executive Board/President du Conseil executif), 25, LAMATA COTANDA, F. (Spain/Espagne), 91, 164 115 LAMBERT, P. (South Africa/Afrique du HALTON, J. (Australia/Australie), 73 Sud), 154 HANSEN-KOENIG, D. (Luxembourg), LAMBO, E. (Nigeria/Nigeria), 124 159 LEAVITT, M.O. (United States of HARNEY, M. (Ireland/Irlande), 83 America/Etats-Unis d 'Amerique ), 43 HELLSBERG, C. (President, Vienna LJUBICIC, N. (Croatia/Croatie), 57 Philharmonic/President, Philharmonique LOZANO-BARRAGAN, J. (Holy de Vienne), 8 See/Saint-Siege), 137 HOHMAN, D.E. (United States of America/Etats-Unis d' Amerique ), 155, MAFUBELU, D. (South Africa/Afrique du 159, 160 Sud), 163 HOSSAIN, K.M. (Bangladesh), 75 MAGINLEY, H.J. (Antigua and HYSSALA, L. (Finland/Finlande), 113 Barbuda/Antigua-et-Barbuda), 76 MATHESON, D. (New Zealand/Nouvelle­ INSANOV, A. (Azerbaijan/Azerba"idjan), Zelande ), 165 101 MAUMOON ABDUL GAYOOM (President, Republic of JACKLICK, AT. (Marshall Islands/Iles Maldives/President, Republique des Marshall), 107 Maldives ), 33 JAZAIRY, I. (Algeria/Algerie), 82 MBOWE, T. (Gambia/Gambie), 135, 136 JEAN LOUIS, R. (Madagascar), 130 MEKY, S. (Eritrea/Erythree), 68 JOHANSSON, Y. (Sweden/Suede), 84 MERITON, V. (Seychelles), 93 MILOSAVLJEVIC, T. (Serbia and KALUKI NGILU, C. (Kenya), 91 Montenegro/Serbie-et-Montenegro ), 103 KAMUGISHA, A. (Uganda/Ouganda), 125 KECHRID, R. (Tunisia/Tunisie), 53 NAVEH, D. (Israel/Israel), 56 KESSEDJIAN, B. (France), 139 NEBOUT ADJOBI, C. (Cote d'Ivoire), 114 KHAN, M. (Pakistan), 18 NTABA, H. (Malawi), 19, 80

KHAN, M.N. (Pakistan), President of the ORDZHONIKIDZE, S. (Under-Secretary­ Fifty-seventh World Health General of the United Nations, Director­ Assembly/President de la Cinquante­ General of the United Nations Office at Septieme Assemblee mondiale de la Geneva, Representative of the Secretary­ Sante, 5, 63 General of the United Nations/ Secretaire KIM Guen-tae (Republic of general adjoint de !'Organisation des Korea/Republique de Coree), 58 Nations Unies/Directeur general de KING, A. (New Zealand/Nouvelle­ l'Office des Nations Unies a Zelande ), Vice-Chairman of the Fifty­ Geneve/Representant du Secretaire eighth World Health AssemblyNice­ general de !'Organisation des Nations President de la Cinquante-Huitieme Unies), 2 Assemblee mondiale de la Sante, 51 KIRATA, N. (Kiribati), 123 ASSNR page 267

P ARIRENY A TWA, P .D. (Zimbabwe), 163 SAS AKA W A, Y. (Sasakawa Memorial PEHIN DATO ABU BAKARAPONG Health Foundation/Fondation (Brunei Darussalarn!Brunei Darussalam), commemorative Sasakawa pour la Sante), 86 145 PEREIRA MIGUEL, J. (Portugal), Vice­ SHA Zukang (China/Chine), 156 Chairman of Committee BNice­ SHARMANOV, T. (Leon Bemard President de la Commission B, 170 Foundation Prize/Prix de la Fondation PEZESHKIAN, M. (Islamic Republic of Leon Bemard), 144 Iran/Republique islamique d'Iran), 60, SHEIKH YUSUF, A. (Somalia/Somalie), 157 129 POLISHCHUK, M. (Ukraine), 120 SING AY, Jigmi (Bhutan/Bhoutan), 74 PONMEK DALALOY (Lao People's SOK TOUCH (Cambodia!Cambodge), 126 Democratic Republic/Republique STARODUBOV, V.I. (Russian democratique populaire lao ), 100 Federation/Federation de Russie), 44 POSTOY ALKO, L. (Belarus/Belarus), 112 STORACE, F. (Italy/Italie), 70 SUCHAICHAROENRATANAKUL QUASHIGAH, C.E.K. (Ghana), 67 (Thailand/Thallande), Vice-Chairman of the Fifty-eighth World Health RAMADOSS, A. (India!Inde), 97 AssemblyNice-President de la RAUCH-KALLAT, M. (Austria!Autriche), Cinquante-Huitieme Assemblee 7, 72 mondiale de la Saute, 65 RI TCHEUL (Democratic People's SUPARI, S.F. (Indonesia/Indonesie), 66 Republic of Korea/Republique populaire democratique de Coree ), 141 TAG-EL-DIN, M.A.A. (Egypt/Egypte), 41 TSHABALALA-MSIMANG, M.E. (South SADASIVAN, B. (Singapore/Singapour), Africa/Afrique du Sud), 49 109 SADRIZADEH, B. (Islamic Republic of UNGER, P.-F. (Representative of the Iran/Republique islamique d'Iran), Counseil d'Etat of the Republic and Chairman of Committee A/President Canton of Geneva/ Representant du de la Commission A, 169 Conseil d'Etat de la Republique et SALGADO, E. (Spain/Espagne), President Canton de Geneve ), 3 of the Fifty-eighth World Health Assembly/President de la Cinquante­ VENEMAN, A. (Executive Director, Huitieme Assemblee mondiale de la UNICEF/Directeur executif, UNICEF), Saute, 13, 172 30 ViT, M. (Czech Republic/Republique tcheque ), 109

Y ADGAROVA, C. (Uzbekistan/Ouzbekistan), 119 A58NR page 268

INDEX OF COUNTRIES AND ORGANIZATIONS

This index lists the countries, organizations and bodies represented by the speakers whose names appear in the index on the preceding pages.

AFGHANISTAN, 96 FINLAND, 113 AFRICAN REGION, 68, 163 FRANCE,139 AFRICAN UNION, 137 ALGERIA, 82 GAMBIA, 135, 136 ANGOLA, 129 GHANA, 67 ANTIGUA AND BARBUDA, 76 GREECE, 104 ARGENTINA, 94 AUSTRALIA, 73 HAITI, 127 AUSTRIA, 72, 76 HOLY SEE, 137 AZERBAIJAN, 101 ICELAND, 25, 91, 164 BANGLADESH, 75 INDIA, 97 BELARUS, 112 INDONESIA, 66 BHUTAN, 74 INTERNATIONAL FEDERATION OF RED BRAZIL, 61 CROSS AND RED CRESCENT SOCIETIES, BRUNEI DARUSSALAM, 86 138 IRAN, ISLAMIC REPUBLIC OF, 60, 157, 169 CAMBODIA, 126 IRELAND, 83 CANADA, 62, 158 ISRAEL, 56 CARIBBEAN COMMUNITY (CARICOM), 76 ITALY, 70 CENTRO DE CAPACITACION Y EDUCACION EN ECOLOGIA Y SALUD PARA JAPAN,40 CAMPESINOS, 146 CHAD, 17 KENYA, 91 CHILE, 121 KIRIBA TI, 123 CHINA, 21, 46, 135, 136, 156 KYRGYZSTAN, 133 CONSEIL D'ETAT OF THE REPUBLIC AND CANTON OF GENEVA, 3 LAO PEOPLE'S DEMOCRATIC REPUBLIC, 100 COTE D'IVOIRE, 114 LEAGUE OF ARAB STATES, 41 CROATIA, 57 LUXEMBOURG, 54, 159 CUBA, 89, 158 CZECH REPUBLIC, 109 MADAGASCAR, 130 MALAWI, 19,80 DEMOCRATIC PEOPLE'S REPUBLIC OF MALAYSIA, 59 KOREA, 141 MARS HALL ISLANDS, 107 DEMOCRATIC REPUBLIC OF THE CONGO, MEXICO, 106 131 MONGOLIA, 99 MYANMAR,85 EASTERN MEDITERRANEAN REGION, 157 EGYPT, 41 NEPAL, 117 ERITREA, 68 NEW ZEALAND, 51, 165 EUROPEAN UNION, 54, 159 NICARAGUA, 122 A58NR page 269

NIGERIA, 124 SRI LANKA, 118 NORDIC COUNTRIES, 164 SWEDEN, 84 NORWAY, 55 SWITZERLAND, 78

PACIFIC ISLAND COUNTRIES, 107 THAILAND, 65 PAKISTAN, 5, 18, 63 TUNISIA, 53 PERU, 116 TURKEY, 71 PORTUGAL, 87, 170 UGANDA, 125 REPUBLIC OF KOREA, 58 UKRAINE, 120 RUSSIAN FEDERATION, 44 UNITED ARAB EMIRATES HEALTH FOUNDATION, 147 SAO TOME AND PRINCIPE, 134 UNITED KINGDOM OF GREAT BRITAIN AND SASAKAW A MEMORIAL HEALTH NORTHERN IRELAND, 88 FOUNDATION, 145 UNITED NATIONS, 2 SAUDI ARABIA, 154 UNITED STATES OF AMERICA, 43, 155, 159, SERBIA AND MONTENEGRO, 103 160 SEYCHELLES, 93 URUGUAY, 104 SINGAPORE, 109 UZBEKISTAN, 119 SOMALIA, 129 SOUTH AFRICA, 49, 154, 163 VENEZUELA, BOLIVARIAN REPUBLIC OF, 95 SOUTHERN AFRICAN DEVELOPMENT VIENNA PHILHARMONIC, 8 COMMUNITY, 80 SPAIN, 13,115,172 ZIMBABWE, 163 A58NR page 270

INDEX DES PAYS ET ORGANISATIONS

Cet index contient les noms des pays, organisations et organismes divers representes par les orateurs dont les noms figurent dans l'index precedent.

AFGHANISTAN, 96 FEDERATION DE RUSSIE, 44 AFRIQUE DU SUD, 49, 154, 163 FEDERATION INTERNATIONALE DES ALGERIE, 82 SOCIETES DE LA CROIX-ROUGE ET ANGOLA, 129 DU CROISSANT-ROUGE, 138 ANTIGUA-ET -BARBUDA, 76 FINLANDE, 113 ARABlE SAOUDITE, 154 FOND A TION COMMEMORATIVE ARGENTINE, 94 SASAKA W A POUR LA SANTE, 145 AUSTRALIE, 73 FOND A TION DES EMIRATS ARABES AUTRICHE, 7, 72 UNIS POUR LA SANTE, 14 7 AZERBAIDJAN, 101 FRANCE, 139

BANGLADESH, 75 GAMBlE, 135, 136 BELARUS, 112 GHANA, 67 BHOUTAN, 74 GRECE, 104 BRESIL, 61 BRUNEI DARUSSALAM, 86 HAITI, 127

CAMBODGE, 126 ILES MARS HALL, 107 CANADA, 62, 158 INDE, 97 CENTRO DE CAPACITACION Y INDONESIE, 66 EDUCACION EN ECOLOGJA Y SALUD IRAN, REPUBLIQUE ISLAMIQUE D', 60, PARA CAMPESINOS, 146 157, 169 CHILl, 121 IRLANDE, 83 CHINE, 21, 46, 135, 136, 156 ISLANDE, 25, 91, 164 COMMUNAUTE DE DEVELOPPEMENT ISRAEL, 56 DE L' AFRIQUE AUSTRALE, 80 ITALIE, 70 COMMUNAUTE DES CARAIBES (CARICOM), 76 JAPON, 40 CONSEIL D'ETAT DE LA REPUBLIQUE ET CANTON DE GENEVE, 3 KENYA, 91 COTE D'IVOIRE, 114 KIRGHIZISTAN, 133 CROATIE, 57 KIRIBATI, 123 CUBA, 89, 158 LIGUE DES ETATS ARABES, 41 EGYPTE, 41 LUXEMBOURG, 54, 159 ERYTHREE, 68 ESPAGNE, 13, 115,172 MADAGASCAR, 130 ETATS-UNIS D'AMERIQUE, 43, 155, 159, MALAISIE, 59 160 MALAWI, 19, 80 MEXIQUE, 106 ASSNR Page 271

MONGOLIE, 99 REPUBLIQUE POPULAIRE MYANMAR, 85 DEMOCRATIQUE DE COREE, 141 NEPAL, 117 REPUBLIQUE TCHEQUE, 109 NICARAGUA, 122 ROYAUME-UNI DE GRANDE-BRETAGNE NIGERIA, 124 ET D'IRLANDE DU NORD, 88 NORVEGE, 55 NOUVELLE-ZELANDE, 51, 165 SAINT-SIEGE, 137 SAO TOME-ET-PRINCIPE, 134 ORCHESTRE PHILHARMONIQUE DE SERBlE ET MONTENEGRO, 103 VIENNE, 8 SEYCHELLES, 93 ORGANISATION DES NATIONS UNIES, SINGAPORE, 107 2 SOMALIE, 129 OUGANDA, 125 SRI LANKA, 118 OUZBEKISTAN, 119 SUEDE, 84 SUISSE, 78 PAKISTAN, 5, 18, 63 PAYS INSULAIRES DU PACIFIQUE, 107 TCHAD, 17 PAYS NORDIQUES, 164 THAILANDE, 65 PEROU, 116 TUNISIE, 53 PORTUGAL, 87, 170 TURQUIE, 71

REGION AFRICAINE, 68, 163 UKRAINE, 120 REGION DE LA MEDITERRANEE UNION AFRICAINE, 137 ORIENTALE, 157 UNION EUROPEENNE, 54, 159 REPUBLIQUE DE COREE, 58 URUGUAY, 105 REPUBLIQUE DEMOCRATIQUE DU CONGO, 131 VENEZUELA, REPUBLIQUE REPUBLIQUE DEMOCRATIQUE BOLIVARIENNE DU, 95 POPULAIRE LAO, 100 ZIMBABWE, 163