WORLD HEALTH ORGANISATION MONDIALE ORGANIZATION DE LA SANTÉ
EXECUTIVE BOARD EB35/20、 28 November 1964 Thirty-fifth Session » ORIGINAL: ENGLISH Provisional agenda item 5.5.1
REGIONAL СОУПУИТТЕЕ FOR THE EASTERN MEDITERRANEAN
Report on Fourteenth Session
The Director-General has the honour to present to the Executive Board the г report on the Fourteenth Session of the Regional Committee for the Eastern Mediterranean"^ which has been established in pursuance of resolution WHA7.35, 2 paragraph 2 (8) in order to harmonize the decisions of Sub-Committees "A" and "в" held respectively in Kuwait, from 3 to 7 October 1964, and in Geneva on 22 and 23 September 1964.
1 document Ем/ней/!!. 2 一 Handbook of Resolutions and Decisions, 7th ed., p.2)8. WORLD HEALTH ORGANISATION MONDIALE ORGANIZATION DE LA SANTÉ
EB35/20
ANNEX
REGIONAL OFFICE FOR THE BUREAU REGIONAL DE LA EASTERN MEDITERRANEAN MEDITERRANEE ORIEMTAbE
REGIONAL COMMITTEE FOR THE EM/RC14/11 EASTERN MEDITERRANEAN October 1964 Fourteenth Session ORIGINAL: ENGLISH
REPORT ON THE FOURTEENTH SESSION OF THE REGIONAL СОЖЕТТЕЕ FOR THE EASTERN MEDITERRANEAN EM/rci4/ii page i
CONTENTS
PART I. INTRODUCTION 1 2 General 1 3 Election of Officers ...... '...... 2 4 Adoption of the Agenda 2 Voting 2
PART II. REPORTS AND STATEMENTS
1. Annual Report of the Regional Director to the Fourteenth Session 3 of the Regional Committee 5 2. Co-operation with other Organizations arid Agencies
PART III.. SUB-DIVISION ON PROGRAMME 56 1. Appointment of Sub-Division' 2. Report on the Discussions PART IV. 1 TECHNICAL ‘ DÍSCUSSÍ OÑS ' '' 1.‘ 9 2. 1 о SubjecInfantilt efo Diarrhoer Technicaa l Discussion..‘..'...... s at Future Sessions . PART V.、 OTHER MATTERS
1. Proposal Concerning Commemoration of Late Dr A, T. Shousha .. 11 2. Use of the Arabic' Language in' the' Regional' Office for the Eastern Mediterranean 11 3- Resolutions of Regional Interest adopted by the Seventeenth World Health Assembly and by the Executive Board at its Thirty-third and Thirty-fourth Sessions 12 4. Representatives of Sub-Committee A (Rules of Procedure) 12 5. Place of Fifteenth and Sixteenth Sessions of the Regional Commit-bee 12 6. Adoption of Reports of Sub-Committees A and В 12 7. Closure of the Session of Sub-Committee A ...... 12
ANNEX I. Agenda
“ ‘ * • • ， ^ ANNEX II. List of Representatives, Alternates, Advisers and Observers to Sub-Committee A of the Regional Committee, Fourteenth Session
ANNEX 工工I. List of Representatives, Alternates, Advisers and Observers to Sub-Committee В of the Regional Committee, Fourteenth Session EM/RC14/11
page ii Summary of Discussions in Sub-Committees A and В on the Proposed Programme and Budget Estimates for 1966 for the Eastern ANNEX IV. Mediterranean Region and Technical Matters
ANNEX V. Summary Technical Report - Technical Discussions on Infantile Diarrhoea 一 Regional Committee for the Eastern Mediterranean, Fourteenth Session
INDEX OF RESOLUTIONS
REGIONAL ССШ1ТТЕЕ FOR THE EASTERN MEDITERRANEAN FOURTEENTH SESSION
Resolution No, ” Page
Annual Report of the Regional Director EM/hC14/R.1 4
Hospital Pharmacy and Medical Stores as part of Hospital Administration • • • • m/RClk/R.6 9
Infantile Diarrhoea • EM/RC14/R.7 9 • ‘ • • . .
Proposed Programme and Budget Estimates for 1966 EM/RC14/R.2 • 6
Public Health Aspects of Measles ш/miK/R.^ 7
Public Health Laboratory Service EM/RC14/R.斗. 7
Review of Some Aspects of Medical Education EM/RC14/R.5 8
Co-operation with other Organizations and Agencies
Sub-Committee к ...... EM/RC14A/R.8 5
Use of the Arabic Language in the Regional Office for the Eastern Mediterranean
Sub-Committee A EM/RC14A/R.9 11 Sub-Committee В EM/RC14b/r.3 12 EM/RC14/11 page 1
PART 工
INTRODUCTION
1- GENERAL
Sub-Committee A of the Regional Committee for the Eastern Mediterranean at its Fourteenth Session met in Kuwait from 3 to 7 October 1964. Sub-Committee В met in Geneva on 22 and 23 September 1964.
The resolutions adopted by the Sub-Committees on subjects common to both agenda, except in one case,l were either identical or the same in substance•
The present report gives the co-ordinated decisions of the two Sub-Committees and has been prepared for submission to the Executive Board of the World Health Organizat- ion in accordance with Resolution WHA703 and Rule 47 of the Rules of Procedure.
Sub_Committee A held five plenary meetings and the Sub-Division on Programme met twice. Sub-Committee В held three plenary meetings. Both Sub-Committees held Technical Discussions on "infantile Diarrhoea".
The following States were represented:.
Sub-C omm i11 e e A
Cyprus Qatar (Associate Member) Ethiopia Somalia France Sudan Iran Syrian Arab Republic Iraq Tunisia Jordan United Arab Republic Kuwait United Kingdom of Lebanon Great Britain and Libya Northern Ireland Pakistan Yemen
The Government of Saudi Arabia expressed the desire to attend but was not represented.
Sub-Committee В
Ethiopia Israel France United Kingdom of Great Britain 工ran and Northern Ireland
1 See page 11. EM/RC14/11 page 2
At Sub-Committee A the United Nations, the Technical Assistance Board, the United 1 Nations Children s Fund and the United Nations Relief and Works Agency for Palestine Refugees were represented.
Representatives or observers from the League of Arab States, the United States Naval Medical Research Unit No• 3 in Cairo as well as four international non-governmental organizationsl were present.
At Sub-Committee В the United Nations and the Technical Assistance Board were represented, and representatives from five non-governmental organizations as well as 1 an observer from the International Children s Centre were present.^
2. ELECTION OF OFFICERS (Agenda item 2)
Sub-Committee A elected its officers as follows :
Chairman； Mr Youssef Jassim Hijji (Kuwait)
Vice-Chairmen: Dr J. Anouti (Lebanon) H. E. Mr Abdullahi Issa Moha.nmud (Somalia)
Dr M. A. W. Shukry (United Arab Republic) was elected Chairman of the Sub-Division of Programme, and Dr Zein El Abdin Ibrahim (Sudan) was elected Chairman of the Technical Discussions•
Sub-Committee В elected its officers as follows :
Chairman； Dr P. W. Dill-Russell (United Kingdom)
Vice-Chairman: Médecin Colonel H. Morin (France)
3. ADOPTION OF THE AGENDA
Sub-Committee A adopted the provisional agenda with the addition of one item. Sub-Committee В adopted the provisional agenda as presented.
4. VOTING
The governments represented in both Sub-Committees exercised their right of vote in Sub-Committee A. Other governments exercised their right of vote in the Sub- Committee at which they were represented.
1 See Annex 工工-List of Representatives, Alternates, Advisers and Observers to Sub-Committee A. 2 See Annex III 一 List of Representatives, Alternates, Advisers and Observers to Sub-Committee B. 3 See Annex EM/RCI4/II page 5
PART工工
REPORTS AND STATEMENTS
ANNUAL REPORT OF THE REGIONAL DIRECTOR TO THE FOURTEENTH SESSION OF THE REGIONAL COMMITTEE (Agenda item 5, document EM/RC/I4/2)
The following are some of the main points that emerged from the statements made by representatives in considering the Annual Report of the Regional Director:
(a) Education and training activities were very important and should continue to receive priority. The establishment of new medical faculties was a great step forward but the curriculum of the existing faculties should be periodically reviewed and if necessary revised, so as to adjust it to the changing needs of the countries. Emphasis was laid on the appropriate training of medical educators• Training for nurses and auxiliaries should continue to receive due consideration. The need for closer collaboration between ministries of health and medical faculties or other medical teaching institutions was stressed.
(b) Border malaria meetings were found very useful for the co-ordination of inter-country eradication measures and should be enlarged as far as possible; malaria problem areas where the local vector had become resistant to insecticides required further epidemiological studies.
(c) The problem of trachoma retained attention. It was noted that research was proceeding, especially towards the preparation of vaccines against trachoma.
(d) Other communicat>le diseases were discussed； they included smallpox, leprosy poliomyelitis, enteric infections, venereal diseases, bilharziasis and onchocerciasis• The existence of cholera El Tor in areas previously free was of great epidemiological importance e (e) In the field of cancer, more attention should be given to research and to the establishment of national cancer registers. Epidemiological studies should be carried out on both cancer mortality and cancer morbidity- Concerted efforts on research, planning, case-finding and curative aspects should be pursued.
(f) Environmental health and community water supplies played an important role in the health field, and WHO assistance in this respect should continue.,
(g) Health planning was an essential component of any long term national plans for socio-economic development• Health ministries should be adequately represented at National Development Boards.
(h) Sound vital and health statistics services were very important and should be promoted or developed. EM/RCI4/H page 4
(i) The role played by health education in all health programmes was deemed of utmost importance。
(j) The control of drugs and pharmaceuticals deserved continued attention； in view of the great quantity of products which literally inundate the market, WHO assistance for the maintenance of adequate standards was urged。
Following is the resolution on the Annual Report of the Regional Director:
EM/RC14/RC1
The Regional Committee,
1 Having reviewed the Annual Report of the Regional Director for the period 1 July 1963 to 30 june 1964；
Noting with satisfaction the progress made during the last 15 years and especially during the last one；
Considering the trans formations and developments which are taking place in the economic and social structure of most of the countries of the Region and their repercussions on the health programme;
Realizing that these new programme trends will require more specialists, technicians and. research workers and that their training constitutes a high priority of national development and health plans；
1. REQUESTS the Regional Director to continue to render advisory assistance to Member States in the strengthening of their health services and particularly with their programmes for training of medical and paramedical personnel;
2. ENDORSES the emphasis being given to the field of medical education in general and to the training of specialists in various fields of public health in particular；
3. URGES governments to give due consideration in their national health planning schemes to the new health hazards which are gradually appearing in the Region and to appropriate research in these fields；
4 CCMVIENDS the Regional Director on his clear and comprehensive report. Я
1 ЕМ/ИС14/2. EM/RCI4/II page 5
2 CO-OPERATION WITH OTHER ORGANIZATIONS AND AGENCIES (Agenda item 五)— e
Statements were made by^four representatives or observers of organizations and agencies in Sub-Committee A, and two in Sub-Committee B. 3 Following is the resolution adopted by Sub-Committee A in connection with this agenda item:
The Sub-Committee,
Having heard with interest the statements and reports of representatives of organizations and agencies；
Having reviewed the Report of the Department of Health of the United Nations Relief and Works Agency for Palestine Refugees (Document ЕМ/ИС14/9),
l FXPIFIESSES its appreciation to UNRWA for its valuable work in Gar ing for the a health and welfare of the Palestine Refugees；
2， THANKS all international and other agencies for their continued co-operation in fields related to health.
PART工工工
SUB-DIVISION ON PRCGRAIVME
1« APPOINTMENT OF SUB-DIVISION (Agenda item 4)
Sub-Committee A, in conformity wihh Rule 14 of the Rules of Procedure established a Sub-Division on Programme comprising the Sub-Committee as a whole under the Chairmanship of Гг M. A, W. Shiikry (United Arab Republic) „
The Proposed Prograjnme and Budget Estimates for 19бб for the Eastern Mediterranean Region (agenda item 10) and Technical Matters (agenda item 11) were referred to the Sub-Divisicn 0
Sub-Committee В discussed these agenda items in.plenary session under its Chairman, Dr P. W Dill-Russell (United Kingdom). • e
1 See Document EM/RCI^A/?.
2 See Document EM/RCIAB".
)Resolution EM/RC14A/R,8. EM/RCI4/H page б
2, REPORT ON THE DISCUSS工ONS (Agenda item 12)
A summary of the discussions on agenda items 10 and 11 appears in Annex IV. Following are the resolutions :
PROPOSED PROGRAMME АЖ) BUDGET ESTIMATES FOR 1966 FOR THE EASTERN MEDITERRANEAN REGION (Document EM/RC14/3 and Corr.l)
EM/RCl4/R>2
The Regional Committee,
Having examined the Proposed Programme and Budget Estimates proposed by the Regional Director for the year 1966；
Bearing in mind that projects financed under the Expanded Programme of Technical Assistance are planned for their estimated duration；
^Viewing with concern the trend of decrease in the Technical Assistance funds earmarked by governments for health;
1. FINDS that the programme as presented assures a suitable balance between the major subject headings；
2, NOTES with satisfaction the prominence given to education and training in the regional programme, the general approach to health planning in relation to national secio-economic development plans, and the continued emphasis on provisions for fellowships;
REITERATES the importance of inter-country programmes, and supports the requests submitted to the Technical Assistance Board for activities included under this heading in the biennium 1965/66；
Ь. ENDORSES the proposed programme and budget for I966 to be implemented from the Regular Budget of the World Health Organization, the Expanded Programme of Technical Assistance funds, and the activities proposed to be financed from Special Accounts under the Voluntary Fund for Health Promotion；
5 -^REQUESTS the Regional Director to study the possibility of establishing a # Health Education Centre and a Nutrition Institute on a regional basis, in view of the importance of both subjects towards the promotion of health in the Region；
6, *REQUESTS Member States to include the necessary funds for health projects within their submission to the Technical Assistance Board；
7. THANKS UNICEF for its constant co-operation and continued valuable support.
Sub-Committee A only, Resolution EM/RC14A/R.3. EM/RC14/11 page 7
TECHNICAL MATTERS
(a) Public Health Aspects of Measles iri the Eastern Mediterranean Region (Document EM/RCl4/^) ey(/RCIVR.3
The Regional Committee,
Having examined with interest the document on the Public Health Aspects of Measles in the Eastern Mediterranean Region, presented by the Regional Director, particularly in respect of (a) epidemiological aspects and (b) vaccination；
Considering that measles is one of the most important diseases of child- hood with high morbidity rate and significant death-rate；
Noting the new developments in vaccination；
1. URGES the Governments of the Region to give due consideration to bio— statistics so that reliable information could be made available on the spread of the disease, and death resulting from this disease and its complications；
2, RECOMMENDS that no large scale use of measles vaccine be undertaken at the present time, without careful consideration and preparation， including plans for step-by-step progression；
REQUESTS the Regional Director to provide technical assistance to Governments, on request, in organizing limited measles vaccination trials prior to large scale campaigns；
FURTHER RECCJyiMENDS the continuation of research for a more attenuated measles strain giving low reaction rates, but conferring adequate protection as well as the setting up of standards for control of safety and potency.
(b) The Public Health Laboratory Service (Document EM/RC14/5)
EM/RCX4/R,4
The Regional Committee,
Having studied with interest the document on the Public Health Laboratory Service, presented by the Regional Director；,
Considering that the Public Health Laboratory Service is an essential and integral part of health services in general； EM/RCI4/II page 5
Noting with satisfaction that due consideration is being given to this activity by the countries of the Region；
Welcoming the views expressed in the document, 一 , - -‘ .-• ... 1. URGES the Governments of the Region to give due priority to their public health laboratory service, including virology and rickettsiology;
2. REC03V1MENT)S that the Governments give urgent attention to the solution of organizational and fiscal problems necessary for the development of these services；
FURTHER RECOMMENDS that more attention should be paid to the training and status of laboratory personnel；
4. REQUESTS the Regional Director to continue to make available to the Governments expert advice related to public health laboratory service and to promote and assist the development of facilities for the training at different levels of specialists required to operate, manage and maintain this essental service.
(c) Review of some aspects of medical education (Document EM/RC14/6)
EM/RCI4/R,5
The Regional Committee, ‘
Having reviewed the documents submitted by the Regional Director, on the subject of medical education；
Considering the future realization of this programme as an important basis for the development of sound public health and medical care programmes in the Region,
1. EXPRESSES its satisfaction with the work done so far in this field;
2. ENDORSES the proposals made by the Special Group Meeting on Medical Education as submitted in the document under review；
3. CALLS the attention of Member Governments which have wide facilities in medical education to the importance of research in medical education by the use of one of the existing medical schools in their country as a model medical school thus making it possible to adjust the training of future doctors to the particular needs of a socially and economically growing society and to the demands of changing communities；
4. REQUESTS the Regional Director to proceed further in strengthening the general programme for medical education particularly in assisting the Member States in 七he establishment of national model medical schools through advisory services and the award of fellowships. EM/RCI4/II page 5
(d) Hospital Pharmacy and Medical Stores as partVof Hospital Administration 1 (Documërrt ËM/RCÎ4/7 and Add.l) ^"“ *”.:.…..•...""““
EM/RCI4/R.6
The Regionál Committee,
-Having studied the document ón Hospital Pharmacy and Medical Stores as part of Hospital Administration, submitted by the Régional Director；
Considering the role the pharmacist can play by specializing in hospital pharmacy administration and the important pàrt he plays in promoting quality control of drugs, production of pharmaceutical preparations, hospital formulary, drug information centre and medical supply services；
1* ‘ COVIMENDS the Regional Director on his interest in general in thmanagemene t of pharmacy and medical stores and to his assistance in this field to many Member Governments;
2， REQUESTS the Regional Director to explore the possibilities of establishing advanced training of hospital pharmacy administration in any of the faculties of pharmacy in this Region and to assist further the Governments in their； efforts with the planning and development of their medical supply services.
PART IV
TECHNICAL DISÓUSSIOÑS
1. INFANTILE DIARRHOEA (Agenda Item 1), documents Ем/ReíV^ech.Disc1, 2, 3 and Add
Both Sub-Committees held Technical Discussions on Infantile Diarrhoea,^" , Sub-Committee A with Dr Zein El Abdin Ibrahim (Sudan) as Chairman and Sub-Committee В under the Chairmanship of Dr P. W Dill-Russell (United Kingdom). : Two documents and e an addendum, one prepared by the Regional Office and the two others by experts from countries in the Region, formed the background to.the subject. •� ...:...... :.. - ' •.. Following is the resolution adopted in connection with this agenda item:
EM/RCI4/R.7 ——… • . - • . • • The Regional Committee,
Having studied with interest the documentation on Infantile Diarrhoea in the Eastern Mediterranean Region, presented by the Regional Director;
1 See Annex V for Summary Technical Report. EM/RC14/11 page 10
Considering that infantile diarrhoea is one of the major health problems in this Region and the most Important cause of high morbidity arid mortality in infancy and early childhood；
Noting the development of preventive measures taken by various countries in the Region to decrease the incidence of infantile diarrhoea；
1. EXPRESSES its satisfaction with the surveys carried out by the World Health Organization in a few countries of the Region to study the problems related to diarrhoeal diseases；
2. ENDORSES the recommendations made in document EM/RCl4/Tech.Disc./2 with regard to both the preventive and curative aspects of the problem;
3. RECOMMENDS that the Governments give high priority to nlaternal and dhild health and give urgent attention to the development of related services to remedy the problem of infantile diarrhoea, including:
(a) *the establishment of rehydration units in maternal and child health centres；
(b) *the establishment of a virus research centre in the Region for investigating the role of viruses in the aetiology of infantile diarrhoea；
(c) *the holding of a seminar on diarrhoeal diseases in the Region in the near future under the auspices of the World Health Organization；
4 REQUESTS the Regional Director to explore the possibilities of carrying out f further surveys on diarrhoeal diseases in the Region and to continue to provide technical assistance to the Governments as required, in order to develop and promote training facilities for specialized health personnel.
2, SUBJECT FOR TECHNICAL DISCUSSIONS AT FUTURE SESSIONS (Agenda item 14)工
"School Health" had previously been chosen by both Sub-Committees as the subject for Technical Discussions in I965； during the 1964 session, Sub-Committee A decided to discuss "Health Aspects of Industrialization in Relation to Air Pollution" in 1966.
* Sub-Committee A only, resolution EM/RC14A/R,14.
1 See resolution SVI/RC14A/R.13. EM/RC14/11 page 11
PART V
OTHER MATTERS
1. PROPOSAL CONCERNING COIVIMEMQRATION OF LATE DR A. T. SHOUSHA (Agenda item 7)
Sub-Committee A proposed to commemorate the memory of late Dr A, T. Shousha by the establishment of a "Fund" bearing his name and similar to the Léon Bernard Foundation, with prizes to be granted to physicians or any other health workers in appreciation of their work in the field of public health in the Region. Sub-Committee A decided to refer this matter to the Director-General of the World Health Organization for his consideration, and to review the establishment of the "Dr A. T. Shousha Fund" at a future session of the Regional Committee in the light of the proposals that might be coming from the World Health Organization.
2. USE OF THE ARABIC LANGUAGE IN THE REGIONAL OFFICE FOR THE EASTERN MEDITERRANEAN (Agenda item 8，Document EM/RC14/8)
Both Sub-Committees, having reviewed the document submitted by the Regional Director, took note of the resolution^ adopted by the Executive Board of the World Health Organization during its thirty-third session. Sub-Committee A decided to refer again this question to the Director-General for further consideration by the Executive Board at a forthcoming session.
Following are the resolutions adopted by the two Sub-Committees in connection with this agenda item:
Sub-Committee A 2
Having reviewed the document submitted by the Regional Director on the subject of the Use of the Arabic Language in the Regional Office for the Eastern Mediterranean；
Noting the resolution adopted by the WHO Executive Board on the subject during its thirty-third session under number
1. REQUESTS the Executive Board through the Director-General to reconsider its above-mentioned resolution；
2. REQUESTS the Regional Director to bring the resolution of this Sub-Committee to the attention of the Director-General.
1 See resolution p EM/RC14A/R.9. EM/RC14/11 page 12
Sub-Committee B"^
Having reviewed the document submitted by the Regional Director on the subject of the Use of Arabic Language in the Regional Office for the Eastern Mediterranean,
TAKES NOTE of the resolution adopted by the Executive Board during its thirty- third session on this subject.
3. RESOLUTIONS OF REGIONAL INTEREST ADOPTED BY THE SEVENTEENTH WORLD HEALTH ASSEMBLY AND BY THE EXECUTIVE BOARD AT ITS THIRTY-THIRD AND THIRTY-FOURTH SESSIONS (Agenda item 9, Document EM/RC14/10) 2 Both Sub-Committees reviewed the resolutions included in the document and took note of their contents.
4. REPRESENTATIVES OF SUB—COMMITTEE A (RULES OF PROCEDURE) (Agenda item 1斗）
In pursuance of resolution WHA7.33 paragraph 2(8) and of Rule 47 of the Rules of Procedure of the two Sub-Committees of the Regional Committee for the Eastern Mediterr- anean ,Sub-Committee A) designated Dr A. H. Samii (Iran) as its representative to meet with the Regional Director in order to harmonize the decisions taken by both Sub- Committees during the 1964 session, and Sub—Committee В requested the Regional Director to act on its behalf in the same connection.
5. PLACE OF FIFTEENTH AND SIXTEENTH SESSIONS OF THE REGIONAL ССЖМ1ТТЕЕ (Agenda item 14)
Sub-Committee A noted its previous decisions to hold the fifteenth session in Addis Ababa in 1965 and its sixteenth session in Pakistan in 1966, 4 с 6. ADOPTION OF REPORTS OF SUB-COMMITTEES A AND B^ (Agenda item 15)
Both Sub-Committees adopted as presented the report submitted on their respective sessions.
7. CLOSURE OF THE SESSION OF SUB-COMMtTTEE A (Agenda item 15) 6 A vote of thanks to the Government of Kuwait for the generous hospitality extended towards all the participants of the fourteenth session was adopted.
1 EM/RCI4B/R.3.
2 Resolutions EM/RC14A/R.10 and EM/RC14B/R.4.
5 Resolution EM/RC14A/R.12.
^ Resolution EM/RC14A/R.15.
5 Resolution EVl/RClte/R.ll,
6 Resolution EM/RC14A/R,16. EM/RCI4/H
ANNEX 工 page 1
AGENDA
REGIONAL ССШГГТЕЕ FOR THE EASTERN MEDITERRANEAN FOURTEENTH SESSION
1. Opening of the session
2. Election of officers
3. Adoption of the agenda (EM/RC14/1)
4. Appointment of the Sub-Division on Programmes
5* Annual Report of the Regional Director to the Fourteenth Session of the Regional Committee: (EM/RC:IA/2)
Statements and reports by representatives of Member States
6. Co-operation with other organizations and agencies； (EM/RC14/9)
Statements and reports by representatives and observers of organizations and agencies
7. * Proposal concerning commemoration of late Dr A. T. Shousha
8. Use of the Arabic Language in the Regional Office for the Eastern Mediterranean (EM/RC14/8)
9. Resolutions of regional interest adopted by the Seventeenth World Health Assembly and by the Executive Board at its Thirty-third and Thirty-fourth Sessions (EM/RC14/10)
10. Proposed Programme and Budget Estimates for 1966 for the Eastern Me dit erranean Region (EM/RC14/3 and Corr.l)
Sub-Committee A only. Ш/RClb/ll Annex 工 page 2
11• Technical matters
(a) Public Health Aspects of Measles in the Eastern Mediterranean Region (SVI/RC14/4)
(b) The Public Health Laboratory Service (EM/RC14/5)
(c) Review of some aspects of Medical Education (ВУ1/ИС14/б)
(d) Hospital Pharmacy and Medical Stores as part of Hospital Administration (ш/ЯС14/7 and Add.l)
12• Approval of the Report of the Sub-Division on Programme
(EM/RClVTech^Disc. 15. Technical Discussions : "Infantile Diarrhoea" y 1, 2, 3 and Add.l)
14 • Other business
15. Adoption of the Report EM/RC14/11
ANNEX工工 page 1
LIST OF REPRESENTATIVES, ALTERNATES, ADVISERS AND OBSERVERS TO SUB-COMMITTEE A OF THE REGIONAL CCMMITTEE FOURTEENTH SESSION
CYPRUS
Representative Dr V. Vassilopoulos Director-General Ministry of Health
ETHIOPA
Representative Ato Hailu Sebsebie Assistant Minister of Public Health Ministry of Public Health
FRANCE
Representative Médecin Lieutenant-Colonel Y. Constant Chef des Services médicaux et du Service central de lutte anti-tuberculeuse en Cote française des Somalie Djibouti
工RAN
Representative Dr A. H, Samii Under-Secretary of State Ministry of Public Health
Adviser Mr Z. Davidian Director, Int ernat i onal Health Relations Department Ministry of Public Health
IRAQ
Representative Dr Sabih Al-Wahbi Director, International Health Ministry of Health
Adviser Dr Salman Taj-al-Dln Assistant Professor of Paediatrics Medical College University of Baghdad em/rci4/h Annex工工 page 2
JORDAN
Representative Dr Khaled El Shami Assistant Under-Secretary of State Ministry of Health
KUWAIT
Representative Mr Youssef Jassim Hijji Under-Secretary of State Ministry of Public Health
Advisers Dr A. Kamal El Borai Director of Health Services
Dr Yehia Shaker Consultant Paediatrician Al Sabah Hospital
Dr M. Abdulkader Director, Preventive Health Services Section
Dr Aly Onsi Chief, Laboratory Unit Central Laboratories
Dr Nabih Farhat Paediatrician Al Sabah Hospital
Dr G. French Director of Medical Services of the Kuwait Oil Company
Dr Riyad El Alamy Chief Pharmacist Ministry of Public Health
LEBANON
Reprès entative Dr Jamil Anouti Director-General of Health Ministry of Health EM/RC14/11 Annex工工 page 3
LIBYA
Representative Dr Abdul Megid Abdul Had! Assistant Under-Secretary of State for Technical Affairs Ministry of Health
PAKISTAN
Representative Colonel A. F. M. Borhanuddin Principal, Dacca Medical College Dacca
Advisers Dr S. Mahfuz Ali Assistant Director-General, Health Ministry of Health, Labour and Social Welfare 工slambad (Rawalpindi)
Dr Hajîiid Ali Khan Professor of Paediatrics Jinnah Post-graduate Medical Centre Karachi
SOMALIA
Re pre s ent at ive H. E, Mr Abdullahi 工ssa Mohammud Minister of Health, Labour and Veterinary Services
Adviser Mr Adan Farah Abrar Director of Health Department Ministry of Health, Labour and Veterinary Services
Secretary Mr Mohamed Hassan Adde ‘ Personal Secretary to H. E. the Minister of Health
SUDAN
Representative Dr Zein El Abdin Ibrahim Deputy Under-Secretary of State Ministry of Health EM/RCI斗/11 Annex工工 page 4
SYRIAN ARAB REPUBLIC
Representative Dr M. Laham Ministry of Health Kuwait
Adviser Mr Rassem Raslan First Secretary of the Syrian Embassy- Kuwait
TUNISIA
Representative Dr M. T. Hachicha Médecin-Inspecteur Chef de Service de 1'Hygièn e publique et des Hôpitaux Secrétariat d'Etat à la Santé publique et aux Affaires sociales
UNITED ARAB REPUBLIC
Representative Dr Mohammed Abdel Wahab Shukry Under-Secretary of State Ministry of Public Health
Advisers Dr Sayed Sweilim Under-Secretary of State Ministry of Public Health
Dr Hashem Mahmoud El Kadi Technical Director-General, Bureau of H. E. the Minister of Public Health and Director of International Health Affairs
Dr Abdul Azim Hussein El Gholmi Professor of Paediatrics Ein Shams Medical Faculty
Dr Abu El Potouh Shaheen Director-General of Curative Medicine Ministry of Public Health
Dr 工mam Zaghloul El Sayed Director of Virus Research Centre Directorate General for Laboratories Ministry of Public Health ЕМ/RClVll Annex II page 5
UNITED KINGDOM
Representative Dr C. R. Jones Director of Health Services Aden
YEMEN, ARAB REPUBLIC OF
Representative Dr-Mohammed A. El Zofri Director-General, Medical Services Ministry of Health
ASSOCIATE ME№ER QATAR
Representative Dr Mahmoud El Mishad Physician Rumailah Hospital Doha
REPRESENTATIVES OF THE UNITED NATIONS AND SPECIALIZED AGENCIES
UNITED NATIONS Mr S. Kar and Correspondent of the TECHNICAL ASSISTANCE Technical Assistance BOARD (UNTAB) Board in Kuwait
UNITED NATI (US Mr Werner G. F. Middelmann CHIIDREN'S FUND Resident Director (UNICEF) UNICEF Eastern Mediterranean Region Beirut
UNITED NATIONS RELIEF Dr M. Sharif AND WORKS AGENCY FOR Director of Health and WHO Representative PALESTINE REFUGEES UNRWA Beirut
REPRESENTATIVES AND CBSEHVERS OF INTERNATIONAL NON-GOVERNMENTAL INTER-GOVERNMENTAL AND NATIONAL ORGANIZATIONS
LEAGUE OF ARAB STATES Dr Ghait El Zerikly (Representative)
INTERNATIONAL ASSOCIATION Dr Toufik Turk (Representative) FOR THE PREVENTION OF BLINDNESS em/rci4/h Annex II page б
INTERNATIONAL SOCIETY Mr Mohamed El Fadli (Representative) OF CRIMINOLOGY
INTERNATIONAL DENTAL Dr George Soudah (Representative) FEDERATION Nigra, Kuwait
LEAGUE OF RED CROSS Dr Sabih Al-Wahbi (Representative) SOCIEriES
UNITED STATES NAVAL Dr J. D. Northway (Observer) MEDICAL RESEARCH UNIT NO, ) (US NAMRU 3) EM/RC14/11
ANNEX工工工 page 1
LIST OF REPRESENTATIVES, ALTERNATES, ADVISERS AND OBSERVERS TO SUB-CAVIMITTEE В OF THE REGIONAL ССМУ11ТТЕЕ FOURTEENTH SESSION
ETHIOPIA
Representative Mr Aberra Jembere Secretary General to the Council of Ministers Addis Ababa
FRANCE
Representative Médecin Colonel Henri Morin Directeur de la Santé publique en Cote française des Somalie- Djibouti
工RAN
Representative Dr A. T. Diba Technical Adviser on WHO Affairs to the Iranian Permanent Delegation to the European Office of the United Nations Geneva
ISRAEL
Representative DP Raphael Gjebin Director-General Ministry of Health Jerusalem
Adviser Mr N. M, Bavli Israeli Permanent Delegation to the European Office of the United Nations Geneva
UNITED KINGDOM
Representative Dr P. W. Dill-Russell Deputy Medical Adviser Department of Technical Co-operation Ministry of Health London EM/RC14/11 Annex III page 2
REPRESENTATIVES OF THE UNITED NATIONS AND SPECIALIZED AGENCIES
UNITED NATIONS Mr A. E. Saenger and Deputy Representative for Europe of the TECHNICAL ASSISTANCE Technical Assistance Board and BOARD (UWTAB) Special Fund Geneva
REPRESENTATIVES AND OBSERVERS OF INTERNATIONAL NON-GOVERWENTAL INTER-GOVERNMENTAL AND NATIONAL ORGANIZATIONS
INTERNATIONAL CHILDREN'S Dr E. D. Berthet (Observer) CENTRE
INTERNATIONAL COUNCIL Miss M. J. Marriott (Representative) OF NURSES
INTERNATIONAL DENTAL . Dr C. L. Bouvier (Representative) FEDERATION
LEAGUE OF RED CROSS Dr H. Zielinski (Representative) SOCIETIES
WORLD FEDERATION FOR Dr A. Audéoud-Naville (Representative) MENTAL HEALTH
WORLD MEDICAL ASSOCIATION Dr Jean Maystre (Representative) M/RC14/11
АЖЕХ IV page 1
SUMMARY OF DISCUSSIONS IN SI®-C(MyiITTEES A AND В ON THE PROPOSED PROGRAMME AND BUDGET ESTIMATES FOR 1966 FOR THE EASTERN MEDITERRANEAN REGION (Agenda item 10) 1 AND TECHNICAL MATTERS (Agenda item 11，(a) - (d))
1. PROPOSED PROGRAMME AND BUDGET ESTIMATES FOR 1966 (Documents ЕМ/НСЗЛ/З and СоггЛ, 2 Resolution EM/RC1VR.2)
In his introduction, the Regional Director, after commenting on form arid method of presentation and drawing attention to the various sections of the document, high- lighted the following points•
The proposals for I966, as well as certain modifications in the approved programme and budget for 1965, had been drawn up in close consultation with Member Governments and had been based on the assumption that $ 4 057 000 would become available under the Regular Budget for all purposes ^ including provision for the Regional Committee itself• This tentative ceiling represented an increase of $ 367 〇0〇, or approximately 10 per cent., on the comparable approved budget for 1965. Over 95 per cent, of these additional funds had been devoted to the strengthening of field activities other than malaria, for which the over-all provisions had been maintained at approximately the same level as in 1965. An amount of $ 25 000 only had been required to" meet additional requirements for the Regional Office and the Regional Committee. The implementation of the activities listed in Annex 工-Malaria Accelerated Programme, and Annex 工工- Community Water Supply Programme, depended on sufficient voluntary contributions forth- coming； Annex 工工工 - Additional Projects, contained activities which it had not been possible to accommodate either within the Regular Budget ceiling, or under the Technical Assistance funds, as they had been listed in category II by Member Governments in their submissions to the Technical Assistance Board for the biennium 19б5~19бб, The importance of approaching a number of activities on an inter-country basis was stressed; fourteen of such projects were described in some detail• These were intended to enable either the Region as a whole or groups of countries to undertake new programme trends- joint ly or to provide opportunities to deal with special subjects in seminars or group meetings. .；
During the discussion that followed, concern was expressed, especially by the representatives of 工ran and Iraq, over the tendency of reducing the portion available for health activities in the Technical Assistance Programme, to the benefit of fields such as industrialization and agriculture which fell under'the responsibility of ministries other than ministries of health. The necessity for the latter to be adequately represented in the national co-ordinating bodies responsible for elaborating requests, and for Member States to include sufficient provision for health projects in their submissions to the Technical Assistance Board was stressed.
These agenda items were discussed by the Sub-Division on Programme of. Sub- . Committee A, under the Chairmanship of Dr M. A. W. Shukry (UAR) and by Sub-Committee В in plenary session under the Chairmanship of Dr P W. Dill-Russell (United Kingdom). e
See page 6, EM/RCI4/II Annex IV page 2
The representative of Lebanon requested the Regional Director to study the possibility of setting up a health education centre and a nutrition institute on a regional basis, in view of the importance cf these two subjects for the promotion of health in the Region.
Specific proposals were made by the representatives of Kuwait and Libya regarding some minor alterations in their respective country programmes either in 1965 or 1966. These proposals were agreed upon. Regarding the replacement of the sanitary engineer whose services with the supervisory team for health centres in Ethiopia were to come to an end on 31 December 1965 to become adviser on general environmental health at the ministerial level, it was hoped that a solution would be found in the course of 1965-
In reply to queries from a number of representatives in connection with some inter-country proje.cts, the following information was provided: The terms of reference of the Malaria Eradication Evaluation Team were under review. Should the southern areas of Iraq and Iran be included amongst the responsibilities of the team, no progressive reduction of staff would take place in the period under review. The entomologist of the team would then be available to meet the request just received from Iraq.
The Advisory Services project (EMRO 43) was intended to meet urgent demands which had not been received at the time 七he programme was established. Such requests might result from unforeseen circumstances, especially of emergency character, or from recent developments or national health plans under preparation requiring urgent assistance.
The Regional Committee found that the proposed programme presented a suitable balance between the various types of activities and adopted a resolution endorsing the Proposed Programme and Budget Estima七es for 1966.
2. TECHNICAL MATTERS
(a) Public Health Aspects of Measles in the Eastern Mediterranean Region (Document EM/RCl4/^, Resolution EM/RCl^/R.))i
The problem of measles was discussed with emphasis on the vaccination aspect• The various types of vaccines produced were reviewed and their field trial considered. The salient point indicated that most of the vaccines were similar to the Enders vaccine, both in their side reactions and in their efficacy. About JO per cent, of the children having received the vaccine alone have shown fever of 39°C or above, and 50 per cent have developed rash» When the vaccine was administered D concomitantly with gamma-globulin, the incidence of fever decreased to 15 per cent, and that of rash to 20 per cent.
1 See page 7* Ем/Re14/11 Annex IV page 3
Schwartz vaccine appeared to be the most promising one； fever occurred in only 15 per cent, of the children and rash in five per cent. When used with gamma- ; : ; globulin, fever occurred in three per cent v " -;"；； “ ^‘：： ^；^：" ' ^
Inactivated vaccines were also discussed and the complete dosage of three injections was insisted ùpon since the immunity produced with one or two injections is inadequate• Although it is known that the immunity conferred by•live vaccines is maintained for at least four years without redùction in titres, it is however unknown whether this immunity may or .may not be life-long. If suoh was to be the case, there would only be a shift of the incidence to an older age-group and this might entail possible dangers: there could, 'for instance, be an adverse repercussion on the foetus if women were to be increasingly exposed to measles at an age where they, might be 'pregnant. Inactivated vaccines were not found practicable for use in mass vaccination and combinations of killed vaccine with other vaccines were recommended. The feasibility of using live vaccines in combination with other vaccines was also considered. The use' of inactivated vaccines prior to that of live vaccine to minimize the reacto-genecity was recommended.
The epidemiology of measles in three countries in the Region was described by the respective representatives and the. intention of the Government of one of them to 7 conduct small’èçale trials on measles vaccination was indicated. Vaccine trials in another country were also- discussed.
The position of WHO with regard to large, scale use of measles vaccine was stated and it was. finally agreed that mass vaccination campaigns should only be undertaken after careful preparation and limited trial, 1 (b) The Public Health Laboratory Services'(Document EM/RC14/5, Resolution EM/RC14/R.4)
The дшрю-гИзагюе oí -pubbic health laboratory service was discussedV It was proposed that a centralized laboratory system should be adopted, the components of which are a central public health laboratory service, regional laboratories and hospital laboratories. These laboratories should be co-ordinated together under a well-knit systérri. This system was recommended for developing countries because of its many inherent advantages； the role of the laboratories was described and their structure considered. The qualifications of scientific and technical personnel were discussed as well as the budget； although it was realized that it would be difficult for the public health laboratory service in most countries in the Region to dispose of an autonomous budget, it was however considered that a certain degree of autonomy would help the better functioning of the service. Building and equipment, as well as medical literature for the laboratories were also discussed• It was felt that inter- country arrangements for subjects like nutrition would be valuable for cases where they coTiild be applied. Stress was laid on the importance of training personnel ôn„these laboratories and of carrying out applied research.
丄 See pages 7 and 8. EM/RC]斗/11 Annex IV page 4
(c) Review of some Aspects of Medical Education (Document EM/RC14/6, Resolution EM/RC14/R.5)丄~‘ ‘
Several aspects of medical education were reviewed, stressing a number of problems with which the medical educator is being faced, including the introduction of the increasing scientific knowledge into an already crowded curriculum as well' as the 1 proper instilling of the new scientific information into the students minds. It was also mentioned that the revision of curricula was a task which demanded research and thorough analysis of existing programmes and future aims. The role of the medical school is no longer restricted to training students, it also implies following them up in the community and providing them with encouragement and guidance； in other words the medical school is expected to provide a lifetime education for the doctor. Other items of interest included preparation of doctors for rural health work and the desirable increase in the output of doctors keeping at good quality. The concept of the "Model" medical school was stressed for experimental and research purposes in medical education.
The need for more adequate collaboration between ministries of health and faculties of medicine and other medical teaching institutions was stressed* The training of well-informed medical librarians was found very valuable. The idea of a regional association of medical educators was considered deserving to be pursued,
A number of comments were made by various representatives, including emphasis on teaching of paediatrics and preventive medicine in the medical schools, training of teachers, fellowships in undergraduate and postgraduate medicine, revision of curricula language of teaching, and other related items.
(d) Hospital Pharmacy and Medical Stores as part of Hospital Administration (Document Ш/ИС14/7 and Add.l, Resolution EM/RC14/R,6)^
Document EM/RC14/7 on "Hospital Pharmacy and Medical Stores as part of Hospital Administrât ion" reviewed the role of a pharmacist in a hospital community» A pharmacist may undertake extra responsibilities such as production of pharmaceuticals assay and quality control of drugs and be an active member in the compilation of a hospital formulary system and in a central drug information service• His role in the various education and training activities undertaken by the hospital authorities, as well as in the organization within the hospital pharmacy of a central sterile supply- system and central medical supply stores, was also reviewed in detail, and favourably commented upon by various delegations•
See page 8. 2 See page 9» ЕМ/RClVll Annex IV page 5
In response to a comment made by a representative on the use of pharmacists in other health units than the hospital, it was stated that the primary function of the pharmacist is his drugs and pharmaceuticals. Considering that most health budgets are limited, and especially the hospital budget, the use of a qualified pharmacist in this respect and the diversion of his attention to the various other fields mentioned above were done merely for economical purposes.
1 The pharmacist s professional ability as well as his specialization in hospital pharmacy administrât ion may become an asset to the hospital community: he may be an active member of its executive board and consequently assist in the running of the hospital and become part of its administrât丄on. With the increase of medical products drugs and pharmaceuticals, as well as patent medicines and specialities that inundate the market daily, one representative confirmed that a qualified pharmacist in the country may save an appreciable amount of money within the over-all expenditure of a Ministry of Health•
It was further stated that no drugs, whether imported or manufactured locally, should be allowed on the market before having been tested and accepted by Ministries of Health.
1 The training of pharmacists was also considered； it was advocated that one year s in-service training be made compulsory for pharmacy graduates•
The hospital equipment supply list for 250 beds (Add.l) was favourably received by the Committee, as it assists in overcoming the needs for planning and equipping the many hospitals which are being developed in various countries of the Region. EM/RCI4/H
ANNEX V page 1
SUMMARY TECHNICAL REPORT TECHNICAL DISCUSSIONS ON INFANTILE DIARRHOEA REGIONAL COMMITTEE FOR THE EASTERN MEDITERRANEAN FOURTEENTH SESSION - 1964
1. INTRODUCTION
Both Sub-Committees had chosan "Infantile Diarrhoea" as the subject for Technicar Discussions at the Fourteenth Session of the Regional Committee» _
Dr Zein El Abdin Ibrahim (Sudan) was elected .Chairman of the discussions in Sub~Committee A, and Dr P. W» Dill-Russell (United Kingdom), Chairman of Sub- Committee B, remained in the Chair for the Technical Discussions of that Sub-Committee.
As a basis for the discussions, the representatives had before them two documeirfcs and an addendum, one prepared by the Regional Office and the others by experts from countries in the Region.^ ,
2. SUMMARY OF BACKGROU№) INFORMATION
Diarrhoèa, which has been known since antiquity, is a very important problem in paediatrics, and is of great concern to the countries of the Eastern Mediterranean Region where, in most of them, infantile diarrhoea accounts for more than 60 per cent, to 75 per cent, of eases seen or admitted in health centres, and for more than 50 per cent, of all fatalities among infants and children under two years of age. Although the term "infantile diarrhoea" should refer to this disease among infants only, i.e. children of 0-12 months, pre-school age children up to six years have been included in this group, countries in this Region having reported them under this term in their answers to the WHO questionnaire which was sent to them.
Diarrhoea, in fact, is much more a symptom of diseases such as cholera, typhoid fever, intestinal parasitism, enteric virus infections, malnutrition, and others, than a disease in itself. The classification of diarrhoeal diseases presents many difficulties, similar or even identical entities appearing under different names in different localities, and deaths being classified under different categories. The International Statistical Classification of Diseases, Injury and Causes of Death does not help to clarify the situation.
Infant death from infantile diarrhoea is still very high in many countries in the world, and particularly in this Region, the most critical period appearing to be between the ages of six and 24 months•
1 For agenda and list of documents, see page 4 of this Annex» HVI/RCI4/II Annex V page 2
Various factors may influence the disease, and among them age, sex, (the incidence is higher among males than females) season and flies deserve special attention.
Environmental sanitary factors reflect to some extent on the infantile diarrhoea death-rates as it reflects on infant mortality. The decline in morbidity and mortality rates in diarrhoeal diseases in the best developed areas in the world has been largely attributed to improvements in environmental health. Contajninated water, unsuitable sewage disposal and refuse disposal, non-sterilized or non- pasteurized milk favour the spread of enteric infections.
Poverty, promiscuity and malnutrition have an important bearing on the incidence of diarrhoea • That of the new-born is due to infection by bacteria or viruses and is of great importance in nurseries•
Other conditions which cause diarrhoea are parasitic infestation, food poisoning, nutritional deficiencies.
From a bacteriological point of view, agents of infectious diarrhoea may be divided into five categories: shigellosis, salmonellosis, enteropathogenic E. Coli, viral infections and doubtful pathogens.
During the survey which was carried out in 1961 in one of the countries visited by the WHO Diarrhoeal Disease Advisory Team, interesting data were found: the diarrhoea was 2^.2 per cent, in rural areas against l6.1 per cent, in urban areas； shigella of all types appeared to be the most frequent organism and accounted for 67.8 per cent, in rural areas and 50 per cent, in urban areas. Sensitivity tests showed that approximately 70 per cent, of shigella strains were sulfonamide-resistant.
Giardia (Lambia), Entamoeba histolyca and Entamoeba coli appear to be the most common parasitological agents found in diarrhoeal disease cases, although not being necessarily the cause of the disease•
The most serious complication observed in diarrhoeal diseases is dehydration, and rehydration therapy is therefore the most important and life-saving measure to be taken, especially in case of severe dehydration.
Measures to combat and prevent the disease should include : the improvement and extension of MCH services； the development of health education and health services； the establishment or development of suitable vital and health statistics services； the training of personnel; the establishment or improvement of laboratory and research facilities; the extension and improvement of -nutrition education; the development of family planning and community development programmes. HVI/RCI4/II Annex V page 3
3. SUMMARY OF DISCUSSIONS
Some representatives described the problem； of infantile diarrhoea as it exists in their own countries as well as the measures taken to combat the disease both from a curative and preventive point of view.
It was generally agreed that poverty, promiscuity, malnutrition, lack of personal hygiene, ignorance of the mothers, heat, flies, bad housing, and environmental sanitary factors accounted for much in the origin and spread of infantile diarrhoea•
The Importance of rehydration in the treatment of the disease was stressed and the setting up of rehydration units in all paediatric clinics and MCH centres was advocated• This would also entail the training of specialized personnel, especially nurses and auxiliaries• High priority should be given to MCH services and the number of MCH centres should be increased.
The necessity for improving means for the declaration of the disease was recognized, as well as for improving or developing health statistical services. It was suggested that epidemiological surveys be conducted in several countries and that the data thus collected be pooled together, so as to have a comparable picture. Laboratory and research facilities were found of utmost importance.
The role of health education, especially of mothers, was emphasized. Efforts in that direction should be intensified, and doctors, nurses and health workers should give due priority to this aspect of their work. Breast-feeding should be encouraged. Mothers should receive special training with regard to the prevention of enteric infections as well as the handling of diarrhoeic infants, so as to avoid their being referred to health centres when the disease is already too much advanced.
Nutritional factors were also considered, particularly for what concerns artificially-fed infants. Mothers should be trained in the preparation of adequate diet.
Environmental factors were recognized as one of the major causes of the spread of the disease. The import алее of safe water supply, food handling methods, including milk, at borne and in shops, restaurants and elsewhere was stressed.
With one exception, the general opinion was that the peak incidence of gastro- enteritis coincided with fly breeding, and anti-fly campaigns were therefore advocated
There was no doubt that the improvement of living standards would play an important role in the prevention of diarrhoeal diseases； this improvement is in direct relation with the socio-economic development which is taking place in the countries of the Eastern Mediterranean Region•
For the resolutions on Infantile Diarrhoea, see pages 9 and 10 in the body of this report• EM/HCI4/II Annex V page 4
AGENDA •
TECHNICAL DISCUSSIONS - INFANTILE DIARRHOEA
1• Opening remarks by the Regional Director
2. Election of Chairman and Rapporteur
Adoption of the Provisional Agenda for Technical Discussions
Introduction and Definition of Infantile Diarrhoea
5- The extent of the problem
6. Epidemiological factors influencing the morbidity and mortality
7. Sócio«econom3.c and environmental sanitary conditions
8. Etiological studies and bacteriological findings
9e Dehydration and Rehydration
10. Measures taken for prevention and control of diarrhoeal diseases
11.. Recommendations
LIST OP DOCUMENTS
Infantile Diarrhoae in the Eastern Mediterranean Region (EM/RCl4/Tech.Disc./2)
Infantile Diarrhoea 一（Contributions from various experts in the Eastern Mediterranean Region (In original language of presentation) (EM/RCl4/Tech.Disc,/3 axid Add.l)