WHO Library Cataloguing in Publication Data WHO Regional Office for the Eastern Mediterranean The work of WHO in the Eastern Mediterranean Region: annual report of the Regional Director, 1 January–31 December 2003/WHO Regional Office for the Eastern Mediterranean p. ISBN 92-9021-368-0 ISSN 1020-9166 1. Regional Health Planning I. Title [NLM Classification: WA 540] Photographic acknowledgements: Mohsen Allam, Ashraf Fares, Suzane Farhoud, Kaveh Kazemi, Ammar Keylani, Sharif Sonbol, WHO headquarters, WHO Representative’s Offices of Aghanistan, Djibouti, Lebanon, Pakistan, Sudan and Yemen The full text of this publication can also be found on www.emro.who.int © World Health Organization 2004 All rights reserved. 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Printed by Borg Al Arab Al Saleh, Alexandria, Egypt–700 2004 Contents Contents Abbreviations vi Introduction ix Executive summary xiii Governing bodies 1 1.1 World Health Assembly 2 1.2 Executive Board 2 1.3 Regional Committee 2 1.4 Regional Consultative Committee 5 Health policy and management 7 2.1 General programme development and management 7 2.2 Public policy and health 12 2.3 National health policies and programme development and management 19 2.4 Biomedical and health information and trends 23 Health systems and services development 29 3.1 Organization and management of health systems based on primary health care 29 3.2 Human resources for health 37 3.3 National drug policies based on essential drugs, and traditional medicine 43 3.4 Quality of care and health technology 45 Promotion and protection of health 47 4.1 Reproductive, family and community health and population issues 47 4.2 Healthy behaviour and mental health 57 4.3 Nutrition, food security and safety 71 4.4 Environmental health 75 Integrated control of disease 81 5.1 Eradication/elimination of specific communicable diseases 81 5.2 Control of other communicable diseases 91 5.3 Control of noncommunicable diseases 105 Administrative services 111 6.1 Personnel 111 6.2 General administration 112 6.3 Budget and finance 113 Country statistical profiles 115 1. Demographic indicators 116 2. Socioeconomic indicators 117 iv Annual report of the Regional Director, 2003 Contents v 3. Health expenditure indicators 118 4. Human and material resources indicators 119 5. Indicators of coverage with primary health care 120 6. Health status indicators 122 7. Selected morbidity indicators 123 Annexes 1. Organizational structure of the WHO Regional Office for the Eastern Mediterranean 126 2. Professional staff in the Eastern Mediterranean Region 129 3. WHO/EMRO meetings held in the Eastern Mediterranean Region, 2003 131 4. New publications and documents issued by WHO/EMRO in 2003 137 5. WHO collaborating centres in the Eastern Mediterranean Region 141 Tables 2.1 Research proposals received from Member States and short-listed and 17 approved by the Regional Office in 2003 3.1 Number of fellowships awarded by country of origin, Eastern Mediterranean 39 Region, 2002–2003 4.1 Prevalence of mental health disorders in countries of the Eastern Mediterranean 58 Region, 2003 5.1 Reported DPT routine coverage at district level in priority countries, 2003 91 5.2 Number of parasitologically confirmed cases in countries with no or sporadic 104 transmission and countries with low–moderate malaria endemicity 5.3 Number of recorded and estimated cases of malaria in countries with a severe 104 malaria problem 6.1 Professional posts as at 31 December 2003 (all sources of funds) 111 6.2 Distribution of recruited temporary professional staff by programme area, 2003 112 Figures 2.1 Projected annual growth in real per capita GDP, 2006–2015 14 2.2 Research proposals received on priority areas of public health in 2003 17 2.3 Projects accepted for funding by the Small Grants Scheme in 2003 18 2.4 Procurement of supplies and equipment by years, category and source of funds 19 2.5 Population affected or killed by disasters in countries of the Eastern 21 Mediterranean Region in 2003 2.6 Disasters in the Eastern Mediterranean Region, 2003 21 3.1 Distribution of fellowships by major area of study in 2002–2003 39 Contents v 3. Health expenditure indicators 118 3.2 Distribution of fellowships during 2002–2003 by region of placement 39 4. Human and material resources indicators 119 4.1 Contribution of Eastern Mediterranean countries to under-five deaths 50 5. Indicators of coverage with primary health care 120 in the Region, 2003 6. Health status indicators 122 4.2 Comparison between the performance of IMCI trained and untrained 51 7. Selected morbidity indicators 123 health providers in assessment tasks of sick children, IMCI Health Facility Survey, Sudan 2003 Annexes 4.3 Comparison between the performance of IMCI trained and untrained health 52 1. Organizational structure of the WHO Regional Office for the providers in prescription of antibiotics, IMCI Health Facility Survey, Sudan 2003 Eastern Mediterranean 126 4.4 Substance abuse problems in Eastern Mediterranean Region countries, 2003 61 2. Professional staff in the Eastern Mediterranean Region 129 4.5 Images associated with tobacco use in 100 Egyptian films, 1950s–present day 62 3. WHO/EMRO meetings held in the Eastern Mediterranean Region, 2003 131 5.1 Case detection rate of smear-positive cases before and after revision of estimates 94 4. New publications and documents issued by WHO/EMRO in 2003 137 5. WHO collaborating centres in the Eastern Mediterranean Region 141 Tables 2.1 Research proposals received from Member States and short-listed and 17 approved by the Regional Office in 2003 3.1 Number of fellowships awarded by country of origin, Eastern Mediterranean 39 Region, 2002–2003 4.1 Prevalence of mental health disorders in countries of the Eastern Mediterranean 58 Region, 2003 5.1 Reported DPT routine coverage at district level in priority countries, 2003 91 5.2 Number of parasitologically confirmed cases in countries with no or sporadic 104 transmission and countries with low–moderate malaria endemicity 5.3 Number of recorded and estimated cases of malaria in countries with a severe 104 malaria problem 6.1 Professional posts as at 31 December 2003 (all sources of funds) 111 6.2 Distribution of recruited temporary professional staff by programme area, 2003 112 Figures 2.1 Projected annual growth in real per capita GDP, 2006–2015 14 2.2 Research proposals received on priority areas of public health in 2003 17 2.3 Projects accepted for funding by the Small Grants Scheme in 2003 18 2.4 Procurement of supplies and equipment by years, category and source of funds 19 2.5 Population affected or killed by disasters in countries of the Eastern 21 Mediterranean Region in 2003 2.6 Disasters in the Eastern Mediterranean Region, 2003 21 3.1 Distribution of fellowships by major area of study in 2002–2003 39 vi Annual report of the Regional Director, 2003 Abbreviations AFP Acute flaccid paralysis AFRO WHO Regional Office for Africa AGFUND Arab Gulf Programme for United Nations Development Organizations AIDS Acquired immunodeficiency syndrome BDN Basic development needs CDC Centers for Disease Control and Prevention, Atlanta, USA CEHA Regional Centre for Environmental Health Activities DOTS Directly observed treatment, short course DPT Diphtheria, pertussis and tetanus EM/ACHR Eastern Mediterranean Advisory Committee on Health Research EMRO WHO Regional Office for the Eastern Mediterranean ESCWA Economic and Social Commission for Western Asia EPI Expanded Programme on Immunization FAO Food and Agriculture Organization of the United Nations FCTC Framework Convention on Tobacco Control GAVI Global Alliance for Vaccines and Immunization GCC Gulf Cooperation Council GFATM Global Fund to Fight AIDS, Tuberculosis and Malaria HIV Human immunodeficiency virus IDD Iodine deficiency disorders IMCI Integrated management of child health IOMS Islamic Organization for Medical Sciences ISESCO Islamic, Educational, Scientific and Cultural Organization JPRM Joint programme review and planning mission MDT Multidrug therapy NID National immunization day