OFFICIAL RECORDS OF THE WORLD ORGANIZATION No. 21

SECOND WORLD HEALTH ASSEMBLY ROME, 13 JUNE TO 2 JULY 1949

DECISIONS AND RESOLUTIONS

PLENARY MEETINGS Verbatim Records

COMMITTEES Minutes and Reports

ANNEXES

WORLD HEALTH ORGANIZATION

Palais des Nations, December 1949 FOREWORD

In pursuance of Article 14 of the Constitution, the First World Health Assembly resolved, on 17 July 1948, that the Second World Health Assembly should meet in Europe. The selection of a suitable place was left to the Executive Board, which decided at its second session to accept the invitation of the Italian Government to convene the Second Health Assembly in Rome. The session, held in the Palazzo Venezia, opened on 13 June and concluded on 2 July 1949.

H - TABLE OF CONTENTS

MEMBERSHIP OF THE ASSEMBLY Page List of Delegations and Observers 3 Officers of the Assembly and Membership of its Committees 11

Part I

DE CI SION S AND RE SOLUTIONS PROCEDURAL DECISIONS (i)Composition of the Committee on Credentials 15 (ii)Publication of an Assembly Journal 15 (iii)Verification of Credentials 15 (iv) Composition of the Committee on Nominations 15 (v) Election of Officers of the Second Health Assembly 15 (vi) Nomination of Officers of the Main Committees 16 (vii)Elections to the General Committee and Adoption of its Reports 16 (viii) Adoption of the Provisional and Supplementary Agendas 16 (ix) Election of Members entitled to designate a Person to serve on the Executive Board 16 (x)Seating of the State of and its Assignment to the Eastern Mediterra- nean Area 17 (xi) Time and Place of the Third World Health Assembly 17

REPORTS OF THE EXECUTIVE BOARD AND THE DIRECTOR-GENERAL (xii) Adoption of the Reports of the Executive Board and the Director-General 17

RESOLUTIONS ADOPTED ON THE REPORTS OF THE COMMITTEE ON PROGRAMME WHA 2.1 Procedure for the Examination of the Programme and Budget for 1950 18 WHA 2.2 Expert Committee on Maternal and Child Health :Report on the First Session 18 WHA 2.3 Expert Committee on Venereal Diseases :Report on the Second Session 18 WHA 2.4 Activities with the United Nations and Specialized Agencies and Non-Governmental Organizations on Venereal Disease Control 19 WHA 2.5 Co-ordinationofInternational Congresses of Medical Sciences : Proposed Collaboration with the Permanent Council 19 WHA 2.6 Co-operation with UNESCO in the Co-ordination of International Congresses of Medical Sciences 19 WHA 2.7 Technical Training of Medical and Auxiliary Personnel 20 WHA 2.8 Publications :International Digest of Health Legislation 20 WHA 2.9 Expert Committee on Biological Standardization :Report on the Third Session and Report of the Sub-Committee on Fat-Soluble Vitamins 20 Page WHA 2.10Expert Committee on the Unification of Pharmacopoeias :Reports on the Third and Fourth Sessions 21 WHA 2.11Expert Committee on Habit-forming Drugs :Report on the First Session 21

WHA 2.12Co-operation with FAO on Nutrition Problems...... 21 WHA 2.13National Nutrition Committees 21 WHA 2.14Production of Synthetic Vitamins 21 WHA 2.15Expert Committee on International Epidemiology and Ouarantine : Report on the First Session and Principles to govern WHO Sanitary Regulations 22 WHA 2.16Section on Quarantine of the Expert CoMmittee on International Epidemiology and Quarantine :Report on the First Session. 22 WHA 2.17Reports on International Epidemic Control 22

WHA 2.18Expert Committee on Insecticides :Report on the First Session . 23 WHA 2.19Co-ordination of Research 23 WHA 2.20Proposal to widen the Terms of Reference of the Expert Committee on 23 WHA 2.21Activities with ECOSOC and with Specialized Agencies on Malaria Control 24 WHA 2.22Expert Committee on Tuberculosis :Report on the Third Session 24 WHA 2.23Activities with UNICEF and the International Union against Tuberculosis 24 WHA 2.24Joint Committee on , UNICEF/WHO 24 WHA 2.25Nuclear Expert Committee on Mental Health 25 WHA 2.26Activities with the United Nations, Specialized Agencies and Non- Governmental Organizations on Matters connected with Mental Health 25 WHA 2.27Insulin 25 WHA 2.28Co-operation with the Economic Commission for Europe 25 WHA 2.29Physical Training 26 WHA 2.30Activities with the United Nations, Specialized Agencies and Non- Governmental Organizations on Public-Health Administration 26 WHA 2.31General Co-ordination with the United Nations and Specialized Agencies 26 WHA 2.32International Research Laboratories 26 WHA 2.33Health Situation of Displaced Persons 27 WHA 2.34Co-operation with the United Nations on the United Nations Library, Geneva 27 WHA 2.35World Health Day 27 WHA 2.36Bejel and other Treponematoses 27 WHA 2.37International Health Yearbook 28 WHA 2.38Expert Committee on Health Statistics :Report on the First Session 28

WHA 2.39Health Statistics : Registration, Compilation and Transmission . 29 WHA 2.40Use of Statistical Methods 29 WHA 2.41Joint Programme of FAO/WHO to increase World Food Production and raise Standards of Health 29 WHA 2.42Tuberculosis Programme :Staff 30 - 1V - Page WHA 2.43Leprosy 30 WHA 2.44Availability of technical Knowledge of Production Processes o Antibiotics 30

RESOLUTIONS ADOPTED ON THE REPORTS OF THE COMMITTEE ON ADMINISTRATION AND FINANCE WHA 2.45Administrative and Financial Relations between the United Nations and Specialized Agencies 31 WHA 2.46Transportation and/or per diem Allowances for Delegates to the Third and subsequent Health Assemblies 31 WHA 2.47Insurance against Travel Accidents of Delegates to the Health Assembly and of Members of the Executive Board 31 WHA 2.48Approval of Additions to the Provisional Staff Regulations 32 WHA 2.49Staff Pension Committee 32 WHA 2.50Financial Report and Accounts of the Interim Commission for the Financial Period 1 January to 31 August 1948 and Report of the External Auditor 32 WHA 2.51Financial Report and Accounts of the World Health Organization for the Financial Period 1 September to 31 December 1948 and Report of the External Auditor 32 WHA 2.52Feasibility of using the United Nations Board of Auditors 33 WHA 2.53Appointment of the External Auditor for 1950 33 WHA 2.54Status of Contributions to the Budget for 1948 35 WHA 2.55Status of Contributions to the Budget for 1949 35 WHA 2.56Policy to be followed concerning Contributions in arrears 35 WHA 2.57Establishment of the Working Capital Fund as a single Fund and Assessment of new Members 36 WHA 2.58Currency of Contributions 36 WHA 2.59Notification to Governments of Vacancies for Professional and Senior Staff 36 WHA 2.60Budget Estimates for the proposed 1950 Programme 37 WHA 2.61Headquarters Office Accommodation 37 WHA 2.62Financial Responsibilities of the Executive Board 38 WHA 2.63Reimbursement by Governments for Materials, Supplies and Equip- ment 39 WHA 2.64Appointment of Members and Alternates to the Staff Pension Committee 39 WHA 2.65Currency of Contributions 40 WHA 2.66Working Capital Fund for 1950 40 WHA 2.67Scale of Assessments :Contribution of Israel to the Budgets of 1949 and 1950 40 WHA 2.68Scale of Assessments :Determination of the maximum Contribution to the regular Expenses of the Organization 41 WHA 2.69Scale of Assessments :Contribution of the State of to the Budgets of 1949 and 1950 41 WHA 2.70Scale of Assessments :Financial Obligations of Associate Members 42 WHA 2.71Appropriation Resolution 42 - V - Page RESOLUTIONS ADOPTED ON THE REPORTS OF THE JOINT MEETINGS OF THE COMMITTEES ON PROGRAMME AND ADMINISTRATION AND FINANCE WHA 2.72Contributions to the Regular Operating Budget 44 WHA 2.73Programme Medical Supply Services 44 WHA 2.74Establishment of a Regional Organization for the European Area. 44 WHA 2.75Supplemental Operating Programme of Advisory and Technical Services Budget 44 WHA 2.76United Nations Project for the Relief of Palestine Refugees 45 WHA 2.77Establishment of an Expert Committee on Nursing 46 WHA 2.78Adoption of the Programme and Budget for 1950 46 WHA 2.79Supplemental Operating Programme of Advisory and Technical Services : Priority Items 48

RESOLUTIONS ADOPTED ON THE REPORTS OF THE COMMITTEE ON CONSTITUTIONAL MATTERS WHA 2.80Procedure for the Nomination and Election of Members entitled to designate a Person to serve on the Executive Board 49 WHA 2.81Approval of the Agreement with the Government of 49

WHA 2.82Negotiations for an Agreement with the Government of Egypt. 49 WHA 2.83Situation with regard to the Office International d'Hygiène Publique 50 WHA 2.84Amendments to Regulations and Rules of Procedure for Expert Committees and their Sub-Committees 50 WHA 2.85Policy on Invitations to appoint Members to Governing Bodies of Health Organizations :London School of Hygiene and Tropical Medicine 51 WHA 2.86Hygiene of Housing 51

WHA 2.87Relations with the Specialized Agencies of the United Nations. 51 WHA 2.88Relations with the International Trade Organization 51 WHA 2.89RelationswiththeIntergovernmentalMaritimeConsultative Organization 51 WHA 2.90Action taken by certain Countries with regard to Membership of WHO 52 WHA 2.91Approval of Agreement with the Pan American Sanitary Organization 52 WHA 2.92Recommendation on Accessions to the Convention on Privileges and Immunities 52 WHA 2.93 WHO Regulations on Nomenclature, 1948 :proposed Amendment to Article 20 53 WHA 2.94Adoption of Amendments to the Rules of Procedure of the World Health Assembly 53 WHA 2.95Proposed Amendments to the Rules of Procedure of the World Health Assembly 53 WHA 2.96Assignment of Greece to the European Regional Area 53 WHA 2.97Regional Organization :Western Pacific Area 54 WHA 2.98Application for Membership of WHO :San Marino 54 WHA 2.99Admission of Korea (South) 54 WHA 2.100 Inter-Organization Agreements :Correction of the French Texts 54 WHA 2.101 Agreement with ILO :Article VII 55 - VI - Page WHA 2.102Amendment to the Rules of Procedure of the World Health Assembly concerning the Status of Associate Members 55 WHA 2.103Rights and Obligations of Associate Members and other Territories in Regional Organizations 55 WHA 2.104Regional Organization :African Area 56 WHA 2.105Convention on Privileges and Immunities :Extension to Represen-

tatives of Associate Members and of other Territories . . . . 56

Part II

PROCEEDINGS

Agenda 61

VERBATIM RECORDS OF THE PLENARY MEETINGS

FIRST PLENARY MEETING, Monday, 13 June 1949, at 11 a.m.

1.Opening of Session by the President of the First World Health Assembly . . 67 2. Address by the President of the Italian Council of Ministers 67 3. Address by the High Commissioner for Hygiene and Public Health, Chief Delegate of Italy 68 4.Provisional Adoption of Amendments to the Rules of Procedure of the Health Assembly 69 5. Publication of an Assembly Journal 70 6. Announcements by the Acting President 70 7. Establishment of the Committee on Credentials 70

SECOND PLENARY MEETING, Monday, 13 June 1949, at 4.30 p.m. 8.First Report of the Committee on Credentials 70 9. Establishment of the Committee on Nominations 71

THIRD PLENARY MEETING, Tuesday, 14 June 1949, at 9.30 a.m. 10.First Report of the Committee on Nominations 71 11. Election of the President of the Assembly 71 12. Election of the Honorary President 72 13. Election of the three Vice-Presidents 72 14. Adoption of the Agenda 72 15. Establishment of the Committee on Programme 72 16. Establishment of the Committee on Constitutional Matters 72 17. Establishment of the Committee on Administration and Finance 73 18. Establishment of the General Committee 73 19. Admission of New Members 74 20. Presentation of the Report of the Director-General 74 21. Presentation of the Reports of the Executive Board 75

FOURTH PLENARY MEETING, Tuesday, 14 June 1949, at 3.30 p.m. 22. Establishment of the General Committee ( continuation) 75 23. Presidential Address 75 Page 24. Discussion on the Report of the Director-General and the Reports of the Executive Board Speeches by Dr. Stampar (Yugoslavia), Rajkumari Amrit Kaur (India), Dr. Melville Mackenzie (), Dr. Bandaranaike (Ceylon) 78

FIFTH PLENARY MEETING, Wednesday, 15 June 1949, at 9.30 a.m. 25. Discussion on the Report of the Director-General and the Reports of the Executive Board (continuation) Speeches by Dr. Claveaux (Uruguay), Dr. Villarama (Philippines), Dr. Karabetsos (Greece), Dr. Savonen () 86 26. Announcements by the President 91

SIXTH PLENARY MEETING, Thursday, 16 June 1949, at 9.30 a.m. 27. Announcements by the President 91 28. Announcement by the Director-General 91 29. Discussion on the Report of the Director-General and the Reports of the Executive Board (continuation) Speeches by Mr. Kazi (Pakistan), Dr. Khaum (), Dr. Fróes (Brazil),Mr. Plojhar (Czechoslovakia),Dr.Simonovits(Hungary), Dr. Tok (Turkey), Dr. Radji (Iran), Dr. Stoyanoff (Bulgaria), Professor Canaperia (Italy) 91

SEVENTH PLENARY MEETING, Thursday, 16 June 1949, at 3.30 p.m. 30. Discussion on the Report of the Director-General and the Reports of the Executive Board (continuation) Speeches by Dr. Scheele ( of America), Dr. Irène Domanska (Poland), Dr. Thomen (Dominican Republic) 102 31. Second Report of the Committee on Credentials 107 32. Second Report of the Committee on Nominations : Nominations for the three Vice-Chairmen of the Main Committees 107

33. Procedure for Examination of the Programme and Budget for 1950 . 107

EIGHTH PLENARY MEETING, Tuesday, 21 June 1949, at 3.30 p.m. 34. Adoption of the Supplementary Agenda 107 35. First Report of the Committee on Constitutional Matters 107 36. Announcement by the President concerning the nomination and election of Members entitled to designate a Person to serve on the Executive Board . 108 37. First and Second Reports of the Committee on Programme 108 38. Third Report of the Committee on Credentials 108 39. Other Business :Letter from the Venezuelan Association of Health Inspectors 108

NINTH PLENARY MEETING, Saturday, 25 June 1949, at 3.30 p.m.

40. Assignment of the State of Israel to the Eastern Mediterranean Area . 109

41. Rules of Procedure of the Health Assembly :Suspension of Rule 10 . . 109 42. Fourth Report of the Committee on Credentials 109 43. Election of Members entitled to designate a Person to serve on the Executive Board 110 44. First Report of the General Committee 113 45. Second Report of the Committee on Constitutional Matters 113 - VIII Page 46. Third Report of the Committee on Constitutional Matters 114 47. Fourth Report of the Committee on Constitutional Matters 114 48. Third Report of the Committee on Programme 116 49. Fourth Report of the Committee on Programme 116 50. Regional Offices 116 51. First Report of the Committee on Administration and Finance 116 52. Second Report of the Committee on Administration and Finance 117 53. Election of Members entitled to designate a Person to serve on the Executive Board (continuation) 117

TENTH PLENARY MEETING, Thursday, 30 June 1949, at 11.45 a.m. 54. Date of Closure of the Second World Health Assembly 118 55. Time and Place of the Third World Health Assembly 118 56. Adoption of Committee Reports :Fifth, Sixth, Seventh, Eighth, Ninth, Tenth and Eleventh Reports of the Committee on Programme ; Third, Fourth, Fifth and Sixth Reports of the Committee on Administration and Finance ;First, Second and Third Reports of the Joint Meetings of the Committees on Programme and Administration and Finance ;Fifth and Sixth Reports of the Committee on Constitutional Matters ; Second and Third Reports of the General Committee 118 57. Adoption of the Report of the Director-General and the Reports of the Execu- tive Board 124 58. Statement by the Delegate of Brazil 124

ELEVENTH PLENARY MEETING, Saturday, 2 July 1949, at 10.15 a.m. 59. Announcement by the President : Memorandum from Members of the Eastern

Mediterranean Area on the Composition of the Executive Board . . . 125 60. Presentation of the Forlanini Gold Medal to the World Health Organization 125 61. Statement by the Chief Delegate of Belgium 126 62. Decisions and Resolutions of the Second World Health Assembly 127 63. Statement by the Observer for South Korea 129 64. Closing Addresses 129

MINUTES OF THE GENERAL COMMITTEE AND MAIN COMMITTEES

General Committee Committee on Programme Page Page First meeting 136 First meeting 148 Second meeting 137 Second meeting 148 Third meeting 138Third meeting 150 Fourth meeting 139Fourth meeting 152 Fifth meeting 141 Fifth meeting 155 Sixth meeting 142Sixth meeting 159 Seventh meeting 143 Seventh meeting 164 Eighth meeting 143Eighth meeting 167 Ninth meeting 143Ninth meeting 172 Tenth meeting 144Tenth meeting 175 Eleventh meeting 145 Eleventh meeting 178 Twelfth meeting 146 Twelfth meeting 184 Thirteenth meeting 146 Thirteenth meeting 188 Page Joint Meetings of the Committees on Programme Fourteenth meeting 192 and Administration and Finance Fifteenth meeting 196 Page Sixteenth meeting 200First meeting 276 Seventeenth meeting 203Second meeting 279 Eighteenth meeting 208Third meeting 283 Nineteenth meeting 211 Fourth meeting 285 Twentieth meeting 218 Fifth meeting 286 Twenty-first meeting 218 Sixth meeting 288 Twenty-second meeting 222Seventh meeting 288 Eighth meeting 289 Committee on Administration and Finance Committee on Constitutional Matters First meeting 225 Second meeting 225 First meeting 290 Third meeting 227 Second meeting 290 Fourth meeting 231 Third meeting 292 Fifth meeting 235 Fourth meeting 295 Sixth meeting 238 Fifth meeting 299 Seventh meeting 243 Sixth meeting 301 Eighth meeting 248 Seventh meeting 303 Ninth meeting 254Eighth meeting 305 Tenth meeting 257Ninth meeting 308 Eleventh meeting 261 Tenth meeting 312 Twelfth meeting 266Eleventh meeting 315 Thirteenth meeting 270Twelfth meeting 318 Fourteenth meeting 273Thirteenth meeting 320

COMMITTEE REPORTS

Committee on Credentials Page PageTenth Report 333 First Report 321 Eleventh Report 335 Second Report 321 Third Report 322 Committee on Administration and Finance Fourth Report 322 First Report 336 Committee on Nominations Second Report 338 Third Report 341 First Report 322 Fourth Report 343 Second Report 323 Fifth Report 345 General Committee Sixth Report 346 First Report 323 Joint Meetings of the Committees on Second Report 324 Programme and Administration and Finance Third Report 324 First Report 347 Committee on Programme Second Report 347 Third Report 347 First Report 325 Second Report 325 Committee on Constitutional Matters Third Report 325 Fourth Report 327 First Report 350 Fifth Report 328 Second Report 350 Sixth Report 330 Third Report 352 Seventh Report 331 Fourth Report 353 Eighth Report 331 Fifth Report 353 Ninth Report 332 Sixth Report 355 Partfil

ANNEXES

Page 1. No minations by the General Committee of Members entitled to designate a Person to serve on the Executive Board 361 2. Ad Hoc Committee of the Executive Board

Part 1: Report on the External Auditor's Report and on the Audit of the Accounts of the World Health Organization for the Financial Period 1 September to 31 December 1948 361 Part 2 :Report on Expert Committee Reports 362 3. Malaria :Scope of the Expert Committee Part 1 : Note submitted by the Italian Delegation 363 Part 2 : Comments by the Delegation of the Philippines on the Note submitted by the Italian Delegation 364 4. Report by WHO Members on the Assumption by WHO of Responsibility for UNICEF Health Projects, and on the Functioning of the Joint Committee 365 5. Co-ordination - General 366 6. Health Statistics 367 7.Joint Programme based on Co-operation between Governments, FAO and WHO to increase World Food Production and raise Standards of Health 368 8. Administrative and Financial Relations between the United Nations and Specialized Agencies 371 9.Headquarters Office :Arrangements for Accommodation 374 10.Relief of Palestine Refugees 375 11. Agreement with the Government of India 375 12. Agreement with the Pan American Sanitary Organization 381 13. Supplementary Regulations to World Health Organization Regulations No. 1 regarding Nomenclature (including the Compilation and Publication of Statistics) with respect to Diseases and Causes of Death 383 14. Rights and Obligations in Regional Organizations :Statement by the Director of the Pan American Sanitary Bureau 384 15. A Memorandum on Research 384 16. Origin and Programme of the Tuberculosis Research Office 386 17. Tuberculosis Programme Proposals 387 18. Mental Health Programme Proposals 389 19. Leprosy 390 20. Health Demonstration Areas 392

21. Reimbursement by Governments for Materials, Supplies and Equipment. . . 393 22. Financing of the Supplemental Operating Programme of Advisory and Technical Services 396 23. Proposed Revised Budget Estimates 397 24. Participation of Associate Members and other Territories in Regional Organiza- tions :Interpretation of Article 47 of the Constitution 399

Subject Index 409

Name Index 417

- XI -

MEMBERSHIP OF THE ASSEMBLY

MEMBERSHIP OF THE ASSEMBLY LIST OF DELEGATIONS AND OBSERVERS

Delegations of States Members of W110 Alternates : Dr.J.F. GOOSSENS, Directeur general au Ministére de la Santé publique et de la AFGHANISTAN Delegates : Famille Dr. G. FAROUK, Deputy Minister for Public Dr. P. J. J. VAN DE CALSEYDE, Directeur general Health (Chief Delegate) de l'Hygiene, Ministère de la Santé publique et de la Famille Dr. A. ZAHIR, Director-General of the Kabul Municipal Hospitals Professeur J. A. H. RODHAIN, Conseiller medical au Ministère des Colonies Baron C. VAN DER BRUGGEN, Attaché de Cabinet ALBANIA au Ministère de la Santé publique et de la Delegates : Famille Dr. S. KLost, Inspector-General, Ministry of Public Health (Chief Delegate) BRAZIL Mr. F. KOTA, Assistant Chief, Department forDelegates : InternationalOrganizations,Ministryof Dr. H. P. FRÓES, Director, National Depart- Foreign Affairs ment of Health (Chief Delegate) Dr. G. H. DE PAULA SOUZA, Director and Pro- fessor,FacultyofHygiene andPublic Delegate : Health, University of Sao Paulo (Deputy Dr. A. A. Pozzo, Director of Technical Educa- Chief Delegate) tion and Scientific Research, Ministry of Dr. R. SANTOS, Professor of Hygiene and Public Public Health Health, Faculty of Medicine, Bahia Advisers : Dr.O. LOPES DA COSTA,MedicalOfficer, Delegates : Assistant to the Director-General, National Dr. H. E. DOWNES, Assistant Director-General Department of Health of Health (Chief Delegate) Dr. F. AFFONSO COSTA, Director, Division of Dr. D. A. DOWLING, Chief Medical Officer, SocialWelfare,National Departmentof Australia House, London Child Welfare Mr.J.PLIMSOLL, Department of External Mr. I. P. MARINHO, Consul of Brazil, Rome Affairs Alternate: Mr. J. R. ROWLAND, Department of External BULGARIA Affairs Delegates : Dr. P. TAGAROFF,MinisterPlenipotentiary AUSTRIA (Chief Delegate) Delegates : Dr. S. STOYANOFF, Chief Assistant, Faculty of Dr. A. KHAUM, Director of Public Health Medicine, Sofia (Chief Delegate) Adviser : Dr.F.PUNTIGAM, Counsellor, of Ministry Dr.V.PETROV-MEVORACH,PressAttaché, Social Welfare Bulgarian Legation, Rome Mr. K. STROBL, Counsellor, Ministry of Social Welfare

BELGIUM BURMA Delegates : Delegate: Professeur M. DE LAtT, Secrétaire general du Dr. BA MAUNG, Port Health Officer, Rangoon Ministere de la Santé publique et de la Famille (Chief Delegate) M. L. A. D. GEERAERTS, Directeur au Ministere CANADA des Affairesétrangéreset du CommerceDelegate: extérieur Dr. G. D. W. CAMERON, Deputy Minister of Dr.A.N. DUREN, Conseiller medical au National Health, Department of National Ministère des Colonies Health and Welfare - 3 - MEMBERSHIP OF THE ASSEMBLY

CANADA (continued) DOMINICAN REPUBLIC Alternates : Delegate : Dr. J. GRÉGOIRE, Deputy Minister of Health, Dr. L. F. THOMEN, Ambassador Extraordinary Province of Quebec and Plenipotentiary, United States of America Dr.J.E. PLUNKETT, Honorary Secretary- Treasurer, Royal College of Physicians and Surgeons of Canada, Ottawa EGYPT Delegates : Advisers : Dr. N. SCANDER, Pasha, Minister of Public Mr. J. G. H. HALSTEAD, Foreign Service Officer, Health (Chief Delegate) Office of the High Commissioner for Canada, London SirAly Tewfik SHOUSHA,Pasha,Under- Secretary of State, Ministry of Public Health Dr. A. M. SAVOIE, Immigration Medical Officer, Rome Dr. M. NAZIF Bey, Assistant Under-Secretary of State, Ministry of Public Health

CEYLON Adviser : Delegates : Dr. M. ABDEL AZIM Bey, Director-General of Mr. S. W. R. D. BANDARANAIKE, Minister of the Rural Health Department Health and Local Government (Chief Dele- gate) Dr. W. G. WICKREMESINGHE, Acting Director EL SALVADOR of Medical and Sanitary Services Delegate : Dr.S.RAJENDRAM, Superintendent,Anti- Dr. J. ALLWOOD-PAREDES, Director-General of malaria Campaigns Public Health

CHILE ETHIOPIA Delegate: Delegate : Dr. P. MARTINEZ, Deputy Director-General of Mr.A.RETTA, Envoy Extraordinary and Public Plenipotentiary, London Adviser : Dr.F.B. HYLANDER, Inspector-General, COSTA RICA Ministry of Public Health Delegates : Mr. E. STEINVORTH, Consul of Costa Rica, Geneva (Chief Delegate) FINLAND Dr. M. C. PEREZ Delegates : Dr. O. STEINVORTH Mr. H. HOLMA, Envoy Extraordinary and Minister Plenipotentiary, Rome Professor S. SAVONEN, Member of the State CZECHOSLOVAKIA Medical Board Delegates : Mr. J. PLOJHAR, Minister of Health (Chief Delegate) FRANCE Dr. B. SCHOBER, Head, Department of ForeignDelegates : Relations, Ministry of Health (Deputy Chief M. P. SCHNEITER, Ministre de la Santé publique Delegate) et de la Population (Chief Delegate) Dr.I.GONDA, Chief,Tuberculosis Control Dr. A. R. DUJARRIC DE LA RIVIÈRE, SOUS- Division, Department of Public Health for Directeur de l'Institut Pasteur, Paris Slovakia Médecin-Général Inspecteur M. A. VAUCEL, Direct-eur du Service de Santé colonial du DENMARK Ministère de la France d'Outre-Mer Delegates : Alternate : Dr. J. FRANDSEN, Director-General, National M. D. Bomt, Inspecteur général du Ministère Health Service (Chief Delegate) de la Santé publique et de la Population Dr. J. H. Hour', Chief, Tuberculosis Division, State Serum Institúte, Copenhagen Advisers : Dr. O. ANDERSEN, Professor, University of M. C. de LAVARENE, Attaché financier auprès Copenhagen de l'Ambassade de France a Rome M. P. BERTRAND, Délégué adjoint de la France Advisers : auprès de l'Office Européen desNations Dr.A.C.CLEMMESEN, Chairman, Danish Unies Medical Association Dr. L. BERNARD, Chef du Bureau d'Epidémio- Mr. B. SORENSEN, Chief of Section, Ministry logie au Ministère de la Santé publique et de of the Interior la Population

4 MEMBERSHIP OF THE ASSEMBLY

GREECE IRELAND Delegates : Delegates : Dr. S. KARABETSOS, Director-Generalof Dr. J. D. MACCORMACK, Deputy Chief Medical Hygiene, Ministry of Public Health (Chief Adviser, Department of Health (Chief Dele- Delegate) gate) Dr. N. C6CONOMOPOULOS, Professor of Tuber- Mr. T. J. BRADY, Principal Officer, Department culosis,UniversityofAthens ;Director, of Health State Sanatorium Alternates : Dr. S. BRISKAS, Professor, Medical Faculty, Paris ISRAEL Delegates: Dr. G. LIVADAS, Professor of Malariology and TropicalDiseases ;Director,Schoolof Dr. F. NOACK, Deputy Director, Ministry of Hygiene, Athens Health (Chief Delegate) Dr. G. G. MER, Professor of Epidemiology, University of Jerusalem ; Head, Antimalaria HUNGARY Services, Ministry of Health Delegates : Dr. L. STEINBERG, Liaison Officer with the Dr. I. SIMONOVITS, Chief, Public Health Section, Red Cross Ministry of Social Welfare (Chief Delegate) Dr. T. BAxii.cs,Chief Municipal Physician, Adviser : Budapest Dr. B. KADURY, Counsellor to the Legation, Rome ICELAND Delegate : Dr. J. SIGURJONSSON, Professor of Hygiene, ITALY University of Iceland, Reykjavik Delegates : Professor M. COTELLESSA, High Commissioner (Chief INDIA for Hygiene and Public Health Delegates : Delegate) Rajkumari AMRIT KAUR, Minister of Health Professor D. MAROTTA, Director-General, Higher (Chief Delegate) Health Institute Sir Arcot Lakshmanaswami MUDALIAR, Vice- ProfessorG. A. CANAPERIA, Chief Medical Chancellor, University of Madras (Deputy Inspector, Department of Public Health Chief Delegate) Alternates : Dr. K. C. K. E. RAJA, Director-General of Professor A. SPALLICCI, Senator, Assistant High Health Services Commissioner for Hygiene and Public Health Advisers : (Alternate Chief Delegate) Dr. P. V. BENJAMIN, Adviser in Tuberculosis, Professor S. CRAMAROSSA, Director, Office of Directorate General of Health Services Hygiene ;Head Physician of the City of Rome Sir Dhiren MITRA, Legal Adviser to the High Commissioner for India, London Professor V. PUNTONI, Director, Institute of Hygiene, University of Rome Lt.-Col. C. L. PASRICHA, Medical Adviser to the High Commissioner for India, London Advisers : Dr. S. C. SEN, Member of the Indian Medical Dr. G. TELESIO DI TORITTO, Counsellor of Association Legation ;Chief, TreatiesDepartment, Dr. R. G. COCHRANE, Chief Leprosy Adviser, Ministry of Foreign Affairs Government of Madras Dr.R.PAOLINI, Vice-Consul ;Secretary, Treaties Department, Ministry of Foreign Affairs IRAN Professor G. BASTIANELLI, Director, " Ettore Delegates : Marchiafava " Institute of Malariology, Rome Dr. A. H. RADA Chief Physician of the Bank ProfessorG. BERGAMI, Director,Nutrition Melli ;President, Parliament Health Com- Institute, University of Rome mission (Chief Delegate) ProfessorG. CARONIA, Director,Clinicfor Dr. B. F. AVERY, Adviser to the Ministry of Infectious Diseases, University of Rome Health Mr. M. CARTA, Secretary-General, Office of the IRAQ High Commissioner for Hygiene and Public Delegates : Health Dr.S. EL ZAHAWI, Director,Pathological Professor P. DI MATTEI, Director, Institute of Institute, Baghdad (Chief Delegate) Pharmacology, University of Rome Dr. S. AL-WAHBI, Director, Kirkh Hospital, Professor G. FRONTALI, Director, Paediatric Baghdad Clinic, University of Rome Dr. A. R. EL-CHORBACHI, Director, Royal Professor C. FRUGONI, Director, Institute of Hospital, Baghdad Clinical Medicine, University of Rome - 5 -- MEMBERSHIP OF THE ASSEMBLY

ITALY (continued) MEXICO Delegates: Dr. M. GRISOLIA,Chief. Medical Inspector, Dr. J. ZOZAYA, Technical Adviser, Ministry of Office of the High Commissioner for Hygiene Health and Welfare (Chief Delegate) and Public Health Dr. J. ALVAREZ DE LA CADENA, Deputy Direc- ProfessorG. L'ELTORE,Secretary-General, tor, Ministry of Health and Welfare Italian Anti-Tuberculosis Federation Professor E. MORELLI, Director, TuberculosisAdviser : Clinic, University of Rome Dr. M. GARZA-RAMOS, First Secretary, Mexican ProfessorM.PANTALEONI, HigherHealth Embassy, Rome Institute, Rome Professor G. PENSO, Higher Health Institute, MONACO Rome Delegates: Professor P. PozziLLI, Chief Medical Consultant, Dr. E. BOERI, Directeur du Service d'Hygiène " Istituto Infortuni ", Rome et de Salubrité publique ProfessorG.RAFFAELE,Director," Ettore Marchiafava " Institute of Malariology, Rome NETHERLANDS Professor A. CORRADETTI, Expert in Parasi-Delegates: tology, Higher Health Institute, Rome Dr. C. VAN DEN BERG, Director-General for ProfessorL.TOMMASI,Director,Dermato- International Health Affairs,Ministry of Syphiligraphic Clinic, University of Rome Social Affairs (Chief Delegate) Professor G. VERNONI, Director, Institute of Dr. W. Aeg. TIMMERMAN, Director, National General Pathology, University of Rome Institute for Public Health, Utrecht (Deputy Professor P. VERONESE, Director, Sanatorium Chief Delegate) of the O.N.M.I. Dr. N. A. ROOZENDAAL, Chief Pharmaceutical Professor C. DE SANCTIS, Italian Mental Hygiene Officer of Public Health Society Alternate: ProfessorC. CoccHr,Director,Paediatric Dr. A. POLMAN, Medical Inspector of Public Clinic, Florence Health, Groningen Professor P. DI DONNA, Chief Medical Inspector, Ministry of Labour and Social Security Advisers: Professor M. AscoLI, Director, Medical Clinic, Dr.J. R. ARENDS, Government Physician, Palermo Aruba Dr. G. SCOLA CAMERINI, Legation Counsellor, Mr. C. J. GOUDSMIT, Legal Adviser, Public Ministry of Foreign Affairs Health Section, Ministry of Social Affairs Dr. R. GUIDI DI BAGNO, Vice-Consul, Ministry Dr. R. SUWADJI PRAWIROHARDJO, Government of Foreign Affairs Physician, Batavia Dr. L. PIGNATELLI DELLA LEONESSA, Vice- Dr. D.P. TAHITU, Government Physician, Consul, Ministry of Foreign Affairs MinistryofHealthofEastIndonesia, Macassar Mr. S. CATTAN, Ministry of Foreign Affairs Miss H. C. HESSLING, Ministry of Social Affairs, The Hague

LEBANON Delegates: NEW ZEALAND Mr. E. KHOURY, Envoy Extraordinary andDelegates: Minister Plenipotentiary, Rome (Chief Dele- Dr. L. S. DAVIS, Director, Division of Child gate) Hygiene,DepartmentofHealth(Chief Dr. N. KHOURY, Director of Health Services Delegate) of Beirut Mr. T. P. DAVIN, Office of the High Com- missioner for New Zealand, London Adviser : Dr. E. A. RIzx, Professor, American University, Beirut NORWAY Delegates: Dr.K. EVANG, Director-General of Public LIBERIA Health (Chief Delegate) Delegate: Dr. J. BJØRNSSON, Chief, Division of Epide- Dr. J. N. TOGBA, Director of Public Health and miology and Hygiene, Ministry for Social Sanitation Affairs (Acting Chief Delegate) Dr. A. DIESEN, Chief, Public Health Service of the City of Oslo LUXEMBURG Delegate : Dr. H. Th. SANDBERG,' Public Health Officer M. P. SCHMOL, Directeur du Laboratoire bacté- 1 Originally alternate, but acted as delegate after riologique de l'Etat Dr Evang's election as President of the Assembly. - 6 - MEMBERSHIP OF THE ASSEMBLY

PAKISTAN Delegates: Delegates: Mr. F. U. KAM, Minister of Health, Government Dr. R. PHARAON, Envoy Extraordinary and of Sind (Chief Delegate) Minister Plenipotentiary, Paris (Chief Mr. H. BAHAR, Minister of Health, Government Delegate) of East Bengal (Deputy Chief Delegate) Mr. O. SAKKAF, Assistant Director, Protocol ColonelM. K.AFRIDI,Director,Malaria Department, Ministry of Foreign Affairs Institute of Pakistan and Bureau of Labo- ratories SWEDEN Advisers: Delegates: Colonel A. K. SAHIBZADA, Inspector-General Dr. J. A. HöJER, Director-General of Public of Civil Hospitals ; Director of Public Health, Health (Chief Delegate) North West Frontier Province Dr. R. BERGMAN, Chief, Section of Hygiene Lt.-Col. S. M. K. MALLICK, Inspector-General and Epidemiology, Public Health Administra- of Civil Hospitals ; Director of Public Health, tion (Deputy Chief Delegate) West Punjab Mr. S. F. V. BUCHT, First Secretary, Ministry of Lt.-Col. M. H. SHAH, Chief Medical Officer, the Interior and Public Health Karachi Adviser. : Dr. O. M. AKBANI, Director of Public Health, Sind Dr. G. A. R. LUNDQUIST, Chief Physician, Langbro Hospital, Stockholm

PHILIPPINES Delegates: Dr. A. VILLARAMA, Secretary (Minister)ofDelegates: Health (Chief Delegate) Dr. P. VOLLENWEIDER, Directeur du Service Dr.A.EJERCITO,Chief,MalariaSection, fédéral d'Hygiène publique (Chief Delegate) Department of Health Dr. F. FRASCHINA, Médecin cantonal du Canton Dr. T. ELICAÑO, Director, Bureau of Hospitals du Tessin, Bellinzone Dr. E. GRASSET, Professeur d'Hygiène et de Adviser : Bactériologie ; Directeur de l'Institut Mr. M. C. ANGELES, Administrative Officer, d'Hygiène, Université de Genève Department of Health Alternate: M. J. DE RHAM, Conseiller de la Légation de Suisse A. Rome POLAND Advisers : Delegates: M. C. MULLER, Economiste au Département Dr. Trène DOMANSKA, Vice-President of the politique fédéral, Service des Organisations Polish Red Cross (Chief Delegate) internationales Mr. E. MARKOWSKI, First Secretary, Polish Dr.A.REPOND, Neuro-psychiâtre ;Vice- Embassy, Rome Président de la Fédération mondiale de la Dr. V.J. BABECKI, Inspector,Ministry of Santé mentale Health

SYRIA PORTUGAL Delegate: Delegates: Dr. A. HAKIM, Director of Hygiene DT. A. DA SILVA TRAVASSOS, Director-General of Health, Ministry of the Interior (Chief Delegate) THAILAND Dr.F.J.CAMBOURNAC, Director,Malaria Delegates : Institute ;Professor, Institute of Tropical Dr. L. BHAYUNG, Director-General, Department Medicine of Public Health (Chief Delegate) Dr. A. A. DE CARVALHO DIAS, Director of Colonel M.C. VALPAKON, MedicalOfficer, Technical Services,General-Directorate of Department of Public Health Health, Ministry of the Interior Alternate: Dr. B. A. V. DE PINHO, Director of Technical TURKEY Services,General-DirectorateofHealth, Delegates: Ministry of the Interior Dr. E. Topic, Under-Secretary of State, Ministry ofHealth andSocialAssistance(Chief Adviser : Delegate) Dr. A. R. PEREIRA, Counsellor of the Portu- Dr. K. OLCAR, Director-General, Ministry of guese Embassy to the / Health and Social Assistance MEMBERSHIP OF THE ASSEMBLY

UNION OF SOUTH AFRICA Dr. H. HYDE, Medical Director, US Public Health Service, Federal Security Agency Delegates : Dr. J. R. MILLER, Member, Board of Trustees, Dr. H. S. GEAR, Deputy Chief Health Officer American Medical Association for the Union of South Africa (Chief Delegate) Mr. N. A. G. REELER, Under-Secretary forCongressional Advisers : Health, Department of Public Health The Honorable Allen J. ELLENDER, United Dr. D. H. S. ANNECKE, Senior Malaria Officer, States Senate Department of Public Health The Honorable Joseph L. PFEIFER, House of Representatives Alternate : Mr. C. H. TALJAARD, South African Legation, Advisers : Brussels Captain R. W. BABIONE Bureau of Medicine and Surgery, Department of the Navy Adviser : Professor Katherine E. FAVILLE, Dean, College Mr. A. S. MARE, South African Legation, Rome ofNursing,WayneUniversity,Detroit Michigan Dr. R. H. FELIX, Director, National Institute UNITED KINGDOM of Mental Health, US Public Health Service, Delegates : Federal Security Agency Dr.Melville MACKENZIE, Principal Medical Mr. G. M. INGRAM, Acting Chief, International Officer, Ministry of Health (Chief Delegate) Administration Staff, Office of United Nations Affairs, Department of State Dr. A. M. W. RAE, Deputy Chief Medical Officer, Colonial Office Mr. D. B. LEE, State Sanitary Engineer of Florida ;President,ConferenceofState Mr. T. LINDSAY, Principal Assistant Secretary, Sanitary Engineers Ministry of Health Mr. K. STOWMAN, Chief,Information and Advisers : Research,OfficeofInternationalHealth Dr. P. G. STOCK, Medical Adviser, Ministry of Relations, US Public Health Service, Federal Agency Dr. R. H. BARRETT, Ministry Of Health Miss M. E. SWITZER, Assistant to the Admini- strator, Federal Security Agency Dr. W. S. MACLAY, Medical Service Commission, Board of Control, Ministry of Health Dr.O.F. HEDLEY, Medical Director, US PublicHealthService,FederalSecurity Dame KatherineC.WATT, Chief Nursing Adviser, Ministry of Health Agency Mr. F. A. MELLS, Ministry of Health Miss K. V. GREEN, Executive Officer, Ministry of Health URUGUAY Delegates : Mr. J. O. MORETON, Colonial Office Dr. E. M. CLAVEAUX, Minister of Public Health Sir Andrew DAVIDSON, Medical Adviser, Depart- (Chief Delegate) ment of Health for Scotland Dr. V. ARMAND Uo(5N, Professor at Montevideo Mr. A. E. JOLT., Assistant Secretary, General Register Office, London Dr. B. VARELA FUENTES, Professor, Faculty of Medicine, Montevideo Mr. J. H. RIDDOCH, Ministry of Civil Aviation Miss M. B. A. CHURCHARD, Assistant Secretary, Adviser : Ministry of Transport Dr. F. J. SALVERAGLIO, Professor of Hygiene, Mr. G. P. HOLT, representing the Shipping Faculty of Medicine ; Specialist in Infectious Industry Diseases

VENEZUELA UNITED STATES OF AMERICA Delegates : Delegates : Dr. E. TEJERA, former Minister of Health and Dr. L. A. SCHEELE, Surgeon General, US Public Social Welfare (Chief Delegate) Health Service,Federal Security Agency Dr. A. CASTILLO PLAZA, Head Physician of the (Chief Delegate) State of Aragua Sanitary Region Mrs. Louise WRIGHT, Chairman, Chicago Council Dr. A. GABALDÓN, Chief, Malaria Division, on Foreign Relations, Chicago, Illinois Ministry of Health and Social Welfare Dr. E. S. ROGERS, Dean, School of Public Advisers : Health, University of California, Berkeley Dr. V. M. BOCARANDA, Head Physician of the Alternates : Sanitary Union, Trujillo, Ministry of Public Mr. H. B. CALDERWOOD, Division of United Health and Social Welfare Nations Economic and Social Affairs, Depart- Dr. J. J. GUTIERREZ OSORIO, Physician, Mili- ment of State tary Hospital, Ministry of National Defence - 8 - MEMBERSHIP OF THE ASSEMBLY

YUGOSLAVIA Dr. O. BUURMAN, Chief Medical Officer of Health, De le gates : Niedersachsen Dr. A. STAMPAR, President of the YugoslavDr. A. KNACK, President of the Board of Health, Academy of Sciences and Arts ;Professor Hansestadt, Hamburg of Public Health and Social Medicine, Uni-Dr. K. S. GLASER, Chief Medical Officer of Health, versity of Zagreb (Chief Delegate) Schleswig-Holstein Dr. J. MIL6INSKI, Professor of Forensic Medi- cine, Medical Faculty, Lyublyana Dr. C. PLAvgIe, Assistant Professor, Medical JAPAN Faculty, Belgrade Colonel H. G. JOHNSON, Chief, Medical Services Division, Public-Health and Welfare Section, Observers for States non-Members of WHO Supreme Commander, Allied Powers, Japan Dr. M. YAMAGUCHI, Chief, Quarantine Section, Ministry of Welfare (Technical Adviser) BOLIVIA Mr. R. P. HERTZOG, Secretary of the Bolivian Embassy to the Holy See Representativesof theUnited Nations and other International Organizations KOREA (SOUTH) 2

Dr. Chang-Soon CHoI, Deputy Minister for Social UNITED NATIONS Affairs Mr. M. HILL, DirectorofCo-ordination for PANAMA Specialized Agencies and Economic and Social Dr. G. ENGLER, Medical Superintendent, United Matters (Chief Representative of the Secretary- Fruit Company, Panama Division General, Head of Delegation) Sir Raphael CILENTO, Director, Division of Social REPUBLIC OF SAN MARINO Activities Mr. J. SZAPIRO, Director, United Nations Infor- Dr. B. LIFSHITZ, Consul-General, Liechtenstein mation Centre, Geneva (Chief Observer) Dr. A. BARKHUUS, Senior Medical Specialist, Dr. E. SuzzI-VALLI, Director, Hygiene and Public Department of Trusteeship and Information Health Services from Non-Self-Governing Territories Professor L. CHERUBINI, Health Adviser to theMr. L. STEINIG, Director, Division of Narcotic Consulate-General, Rome Drugs Mr. A. D. Meurig EVANS, Assistant Director of VATICAN STATE the United Nations European Office ( for the discussion on arrangements for accommodation Dr.R.GALEAZZI-LISI,DirectorofSanitary Services for Headquarters Office)

Observers for Control Authorities and Occupied FOOD AND AGRICULTURE ORGANIZATION (FAO) Territories Dr. W. R. AYKROYD, Director of the Nutrition Division Dr. J. M. LATSKY, Nutrition Representative in (1) American Zone of Occupation Europe (Alternate) Lt.-Col. W. R. DE FOREST, Chief, Public-Health Branch, Office of the Military Government for INTERNATIONAL LABOUR ORGANIZATION (ILO) Germany Dr. W. D. RADCLIFFE, Public-Health Adviser,Dr. A. GRUT, Chief, Industrial Hygiene Section OMG, Wiirt t emberg-Baden Professor G. SEIFFERT, Chief of Public Health, Bavaria INTERNATIONAL REFUGEE ORGANIZATION (IRO) Dr. A. UNGER, Chief of Public Health, Wfirt- Dr. R. L. COIGNY, Director, Health Division t emberg-Baden Dr. C. JONES, Chief Medical Officer of the Italian Mission (2)British Zone of Occupation

Brigadier W. STRELLY MARTIN, Public-Health UNITED NATIONS EDUCATIONAL, Adviser to the Military Governor, Control SCIENTIFIC AND CULTURAL ORGANIZATION Commission for Germany (UNESCO) Dr. H. LEWENSTEIN, Acting Chief Medical Officer of Health, North Rhine/Westphalia Dr. Irina M. ZHUKOVA, Head of Section of Applied Sciences, Department of Natural Sciences 2 See Resolution 195 (III), 12 December 1948, Mr. G. L. GOODWIN, Consultant of the General Assembly of the United Nations. Dr. J. KOEKEBAKKER, Consultant - 9 - MEMBERSHIP OF THE ASSEMBLY

INTERNATIONAL CHILDREN'S EMERGENCY FUND INTERNATIONAL LEPROSY ASSOCIATION (UNICEF) Dr. R. CHAUSSINAND, Secretary-Treasurer of the Dr. T. MADSEN, Chief of the Italian Mission Western Section and Member of the General Council ;Head of Leprosy Service, Institut OFFICE INTERNATIONAL D'HYGIÉNE PUBLIQUE Pasteur, Paris (OIHP) Dr. M. T. MORGAN, Président Dr. M. GAUD, Président de la Commission du INTERNATIONAL UNION Transfert AGAINST THE VENEREAL DISEASES Dr. G. CLARK, ProfessorofEpidemiology, Columbia University, New York PAN AMERICAN SANITARY ORGANIZATION (PASO) Professor G. A. CANAPERIA (Member of the Italian Delegation) Dr. F. L. SOPER, Director, Pan American Sanitary Bureau Dr. M. E. BUSTAMANTE, Secretary-General INTERNATIONAL UNION FOR CHILD WELFARE Dr. G. PIACENTINI, Member of the Executive Board Observers for Related Non-Governmental Mr. G. THÉLIN, Secretary-General Organizations

INTERNATIONAL ACADEMY OF LEGAL MEDICINE LEAGUE OF RED CROSS SOCIETIES AND OF SOCIAL MEDICINE Dr. G. ALSTED, Director, Health Bureau Professor M. DE LAET, President (Member of the Belgian Delegation) Dr. C. GERIN, Professor at the University of WORLD FEDERATION FOR MENTAL HEALTH Rome Dr. J. R. REES, President Dr. A. REPOND, Vice-President (Member of the INTERNATIONAL ASSOCIATION Swiss Delegation) FOR THE PREVENTION OF BLINDNESS Professor C. DE SANCTIS (Member of the Italian Dr. Alix J. CHURCHILL, Deputy Secretary-General Delegation)

INTER-AMERICAN ASSOCIATION OF SANITARY WORLD FEDERATION ENGINEERING OF UNITED NATIONS ASSOCIATIONS Mr. A. U. SOLAR, President of the Peruvian SectionProfessor R. AGO, Vice-Chairman of the Executive Professor M. G. SALVADORI, Columbia University, Committee New York Mr. J. A. F. ENNALS, Secretary-General M. F. DAUSSET, Secretary of the Education Com- INTERNATIONAL COUNCIL OF NURSES mission Miss D. C. BRIDGES, Executive Secretary WORLD MEDICAL ASSOCIATION INTERNATIONAL DENTAL FEDERATION Dr. J. MAYSTRE, Liaison Officer with WHO Professor O. HOFFER, Milan Dr. S. C. SEN, Assistant Secretary (Member of the Dr. A. KRIKOS, Athens Indian Delegation) Dr.J.R. MILLER, Vice-Chairman, Board of Trustees, American Medical Association INTERNATIONAL HOSPITAL FEDERATION (Member of the US Delegation) ProfessorF.PULCHER, Director,Hospitalof San Martino, Genoa PERMANENT COUNCIL FOR THE CO-ORDINATION OF INTERNATIONAL CONGRESSES OF MEDICAL SCIENCES 3 Serves as WHO Regional Organization for theProfessor J. MAISIN, President of the Executive Americas Committee

- 10 - MEMBERSHIP OF THE ASSEMBLY

OFFICERS OF THE ASSEMBLY AND MEMBERSHIP OF ITS COMMITTEES

Officers of the Assembly General Committee

Honorary President: The General Committee was composed of the Professor M. COTELLESSA (Italy) President and Vice-Presidents of the Assembly and the chairmen of the main committees, together President: with the delegates of the following countries : Dr. K. EVANG (Norway) Australia, Brazil, France, India, Liberia, Pakistan, Vice-Presidents: United Kingdom, Yugoslavia. Mr. S. W. R. D. BANDARANAIKE (Ceylon) Chairman: Dr. K. EVANG (Norway) Dr. N. SCANDER, Pasha (Egypt) Secretary: Dr. Brock CHISHOLM Dr. J. ZOZAYA (Mexico) Secretary: Dr. Brock CHISHOLM, Director-General Advisers to the Secretary: Main Committees Dr. R. GAUTIER, Assistant Director-General Dr. N. GOODMAN, Acting Assistant Director- Under Rule 28 of the Rules of Procedure, each General delegation was entitled to be represented on each Dr. Martha ELIOT, Assistant Director-Generalmain committee by one of its members. Dr. F. CALDERONE, Director of the New York Office Programme Committee on Credentials Chairman: Dr.H. HYDE (UnitedStatesof The Committee on Credentials was composed America) of the delegatesof the following countries : Vice-Chairman: Dr. Irène DOMANSKA (Poland) DominicanRepublic,Egypt,France,Italy,Rapporteur: Dr. A. H. RADJI (Iran) Pakistan, Philippines, Poland, Portugal, Union of South Africa, Uruguay, Venezuela.' Secretary: Dr. W. P. FORREST Chairman: Professor G. A. CANAPERIA (Italy) Vice-Chairman:ProfessorE. M.CLAVEAUX (Uruguay) Administration and Finance Rapporteur: Mr. F. U. KAZI (Pakistan) Chairman:Dr. B. SCHOBER(Czechoslovakia) Secretary: Dr. M. PASCUA Vice-Chairman: Dr. L. F. THOMEN (Dominican Republic) Committee on Nominations Rapporteur: Mr. T. LINDSAY (United Kingdom) Secretary: Mr. M. P. SIEGEL The Committee on Nominations was composed of the delegatesof the following countries : Brazil,Bulgaria,Canada,Czechoslovakia,El Salvador, India, Liberia, New Zealand, Saudi Constitutional Matters Arabia, Sweden, Switzerland, Turkey. Chairman: Dr. P. VOLLENWEIDER (Switzerland) Chairman: Rajkumari AMRIT KAUR (India) Vice-Chairman: Dr. L. S. DAVIS (New Zealand) Rapporteur : Dr. J. N. TOGBA (Liberia) Rapporteur :Mr. H. B. CALDERWOOD (United Secretary: Dr. Brock CHISHOLM States of America) Secretary: Dr. C. MANI 1 Roumania was also appointed to this committee but was not represented at the Assembly Legal Secretary: M. A. ZARB

- 11 -

PART I

DECISIONS AND RESOLUTIONS OF THE SECOND HEALTH ASSEMBLY

[A2/110] 30 June 1949

DECISIONS AND RESOLUTIONS OF THE SECOND HEALTH ASSEMBLY

The Second World Health Assembly was convened at 11 a.m. on Monday, 13 June 1949, in the Palazzo Venezia, Rome, under the chairmanship of Dr. A. Stampar, President of the First Health Assembly.

PROCEDURAL DECISIONS

(i)Composition of the Committee on Credentials A Committee on Credentials was appointed, consisting of representatives of the following countries : Dominican Republic, Egypt, France, Italy, Pakistan, Philippine Republic, Poland, Portugal, Union of South Africa, Uruguay and Venezuela. (First plenary meeting) (ii)Publication of an Assembly Journal It was decided that an Assembly Journal should be published (First plenary meeting) (iii)Verification of Credentials The Second World Health Assembly recognized the validity of the credentials of the following delegations :1 Afghanistan, Albania, Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Burma, Canada, Ceylon, , Costa Rica, Czechoslovakia, Denmark, Dominican Republic, Egypt, El Salvador, Ethiopia, Finland, France, Greece, Hungary, Iceland, India,Iran,Iraq,Ireland,Israel,Italy, Lebanon, Liberia, Luxemburg, Mexico, Monaco, Netherlands, New Zealand, Norway, Pakistan, Philippine Republic, Poland, Portugal, Saudi Arabia, Sweden, Switzerland, Syria, Thailand, Turkey, Union of South Africa, United Kingdom, United States of America, Uruguay, Venezuela and Yugoslavia. (First, second, third and fourth reports oftheCommitteeonCredentials, adopted at second, seventh, eighth and ninth plenary meetings) (iv)Composition of the Committee on Nominations Delegates of the following twelve Memberswere appointed to the Committee on Nominations : Brazil, Bulgaria, Canada, Czechoslovakia, ElSalvador, India, Liberia, New Zealand, Saudi Arabia, Sweden, Switzerland and Turkey. (Second plenary meeting) (y)Election of Officers of the Second Health Assembly After consideration of the recommendations of the Committee on Nominations, the following officers were elected : Dr. Karl Evang (Norway) as President of the Second World Health Assembly ; Professor Mario Cotellessa (Italy) as Honorary President ; Mr. S. W. R. D. Bandaranaike (Ceylon), Dr. Naguib Scander, Pasha (Egypt), and Dr. José Zozaya (Mexico), as Vice-Presidents. (Third plenary meeting)

1 For list of delegates, alternates, advisers and observers, see Membership of the Assernbly, p, 3. - 15 - DECISIONS AND RESOLUTIONS

(vi)Nomination of Officers of the Main Committees

The following officers 2 of the main committees were nominated :

COMMITTEE ON PROGRAMME Chairman : Dr. H. Hyde (United States of America) Vice-Chairman : Dr. Irène Domanska (Poland)

COMMITTEE ON CONSTITUTIONAL MATTERS Chairman :Dr. P. Vollenweider (Switzerland) Vice-Chairman : Dr. L. S. Davis (New Zealand)

COMMITTEE ON ADMINISTRATION AND FINANCE Chairman :Dr. Bruno Schober (Czechoslovakia) Vice-Chairman : Dr. L. F. Thomen (Dominican Republic) (Third plenary meeting)

(vii)Elections to the General Conunittee and Adoption of its Reports The following eight delegates were elected to the General Committee : Rajkumari Amrit Kaur (India) ; Dr. D. A. Dowling (Australia) ; Professor H. P. Fróes (Brazil), Mr. F. U. Kazi (Pakistan) ;Dr. Melville Mackenzie (United Kingdom) ; Dr. Andrija Stampar (Yugoslavia) ;Dr. J. N. Togba (Liberia) ;Médecin-Général Inspecteur M. A. Vaucel (France). (Third and fourth plenary meetings)

The three reports of this committee were adopted. (Ninth and tenth plenary meetings)

(viii)Adoption of the Provisional and Supplementary Agendas 4 The Health Assembly adopted the provisional agenda prepared by the Executive Board at its third session, and subsequently the supplementary agenda. (Third and eighth plenary meetings)

(ix)Election of Members entitled to designate a Person to serve on the Executive Board After consideration of the nominations of the General Committee,6 the Health Assembly elected the following six members to designate a person to serve on the Executive Board : 6 Philippine Republic, Sweden, Turkey, United Kingdom, United States of America and Venezuela. (Ninth plenary meeting)

2 The same officers were later elected by the main committees, which also elected the following rapporteurs : Committee on Programme-Dr. A. H. Radji (Iran) Committee on Constitutional Matters-Mr. H. B. Calderwood (United States of America) Committee on Administration and Finance-Mr. T. Lindsay (United Kingdom) 3 The General Committee consists of the President and Vice-Presidents of the Assembly, the Chairmen of the main committees and as many more delegates as are required to make a total membership of 15. 4 Reproduced on p. 61. 5 See Annex 1. The retiring Members were :Australia, Ceylon, Iran, Norway, United Kingdom, United States of America. - 16 - DECISIONS AND RESOLUTIONS

(x)Seating of the Slate of Israel and its Assignment to the Eastern Mediterranean Area

The State of Israel, a Member of the United Nations, having deposited its instruments of acceptance with the Secretary-General of the United Nations, took its seat at the Second World Health Assembly as a Member of WHO, and was assigned to the Eastern Mediterranean Area. (Ninth plenary meeting)

(xi)Time and Place of the Third Health Assembly It was decided that the Third World Health Assembly would be held in Geneva Switzerland, at the headquarters of the Organization, on 8 May 1950. (Tenth plenary meeting)

REPORTS OF THE EXECUTIVE BOARD AND THE DIRECTOR-GENERAL

(xii)Adoption of the Reports of the Executive Board and the Director-General

The Second World Health Assembly reviewed and approved the reports and activities of the Board 7 and of the Director-General 8 and took action thereon. (Tenth plenary meeting)

O. Rec. World Hlth Org. 14 and 17, and Annex 2 8 00. Rec. World Hlth Org. 16 - 17 - RESOLUTIONS ADOPTED ON THE REPORTS OF THE COMMITTEE ON PROGRAMME

For convenience of reference the resolutions below have been given serial numbers prefaced by the symbol "WHA2", which denotes "Second World Health Assem- bly".The resolutions of the First World Health Assembly were not serially numbered.

WHA2.1.Procedure for the Examination of the Programme and Budget for 1950

The Second World Health Assembly, Recognizing the necessity for a properly integrated approach in the consideration of the programme and budget for 1950,9 (1)DECIDES to refer to the Committee on Programme the proposed programme for 1950 ; (2)INSTRUCTS the Committee on Administration and Finance to recommend cost estimates for the programme recommended by the Committee on Programme and to comment generally on the administrative and financial aspects of the proposals ;and (3)DECIDES that the reports of the two committees shall be referred to a joint com- mittee on programme and administration and finance for joint recommendation to the Health Assembly of the final decisions on the 1950 programme and budget. (First report of Committee on Pro- gramme, adopted ateighth plenary meeting)

WHA2.2.Expert Committee on Maternal and Child Health :Report on the First Session

Whereas the Assembly recognizes the importance of the World Health Organization undertaking as rapidly as possible measures to assist governments, as requested, to develop their maternal and child health programmes, The Second World Health Assembly NOTES the report of the Expert Committee on Maternal and Child Health on its first session, with the recommendation of the Executive Board thereon.10 (Second report of Committee on Pro- gramme, adopted ateighth plenary meeting)

WHA2.3.Expert Committee on Venereal Diseases :Report on the Second Session

The Second World Health Assembly NOTES the report of the Expert Committee on Venereal Diseases on its second session 11 and the action taken thereon by the Executive Board and the Director-General. (Third report of Committee on Pro- gramme, adoptedatninth plenary meeting)

Off. Rec. World Hlth Org. 18 1° Off. Rec. World HIM Org. 19, 35 u Off. Rec. World Hlth Org. 15, 18 - 18 - DECISIONS AND RESOLUTIONS

WHA2.4.Activities with the United Nations and Specialized Agencies and Non-Governmental Organizations on Venereal-Disease Control The Second World Health Assembly NOTES (1)the activities with the United Nations and specialized agencies, in particular with regard to WHO and UNICEF participation in venereal-disease control programmes with governments in implementation of the recommendations of the Joint Committee on Health Policy, UNICEF/WHO ; (2)the full support of the programme proposals for 1950 given by the International Union against Venereal Diseases, representing non-governmental organizations in more than 40 countries. (Third report of Committee on Pro- gramme, adoptedatninthplenary meeting)

WHA2.5.Co-ordination of International Congresses of Medical Sciences : Proposed Collaboration with the Permanent Council The Second World Health Assembly 1. APPROVES the principles laid down by the Executive Board for collaboration of the World Health Organization with the Permanent Council for the Co-ordination of International Congresses of Medical Sciences, i.e.: (1)that the Council be recognized as a non-governmental organization to be brought into official relationship with the World Health Organization ; (2)that a senior staff member of the Secretariat of the World Health Organization be assigned by the Director-General to represent the World Health Organization in an advisory capacity at the meetings of the Council ; (3)that the World Health Organization assist the Council in its task by giving advice, upon request, to selected congresses of interest to the World Health Organ- ization and by supplying them with material support in the form of reimbursement of a part of the actual expenses for the secretariat (of the Council), technical services (of the congresses) and publication of their proceedings, or where possible, by direct participation in such technical services by the staff of the World Health Organ- ization ; (4)that adequate justification of the use made of any funds allocated to the Council by the World Health Organization should be regularly furnished by the Council ; (5)that the World Health Organization designate priorities for some of the Council's activities or sponsor some selected congresses.In such cases, the Council should use the funds provided by the World Health Organization in conformity with the latter's decision ; (6)that arrangements for collaboration be reviewed every year and set up in accordance with the policy and budgetary appropriations of WHO, with a view to the Council becoming eventually financially independent, and 2. REQUESTS the Director-General to implement the above by making arrangements for collaboration with the Council on the basis of this resolution and within the limits of annual budgetary appropriations. (Third report of Committee on Pro- gramme, adoptedatninth plenary meeting)

WHA2.6.Co-operation with UNESCO in the Co-ordination of International Congresses of Medical Sciences

In view of UNESCO's responsibilities in the field of sciences basic to medicine, and Considering that the resolution of the Third General Conference of UNESCO emphasizes its interest in the co-ordination of international congresses of medical sciences, - 19 - DECISIONS AND RESOLUTIONS

The Second World Health Assembly DECIDES that UNESCO be consulted on any question of common interest in this field, in the spirit of Article 1of the Agreement between UNESCO and WHO,12 each organization being free to follow its own policy regarding relationship with non- governmental organizations. (Third report of Committee on Pro- gramme, adoptedatninth plenary meeting)

WHA2.7.Technical Training of Medical and Auxiliary Personnel Having considered the policies to be followed in implementing the programme of technical training of medical and auxiliary personnel as set out in the programme and budget for 1950,13 The Second World Health Assembly REQUESTS the Director-General : (1)to arrange fellowships on a group basis as far as possible (this should not be inter- preted as excluding individual fellowships) ;and (2)to encourage the establishment and development by governments of national educational institutes in the field of health, and to encourage the development of courses having an international character at existing educational institutes or institutes to be created, by the provision of assistance in personnel and material. (Fourth report of Committee on Pro- gramme, adoptedatninth plenary meeting)

W RA2.8.Publications :International Digest of Health Legislation Whereas the publication of the International Digest of Health Legislation involves difficult problems of selection of material and of the relative prominence to be given to it, The Second World Health Assembly RESOLVES that the Director-General be requested to submit to the Third World Health Assembly a report on the methods considered to be most satisfactory of making available information on health legislation and of presentation and publication of such health legislation as is considered to be of international importance. (Fourth report of Committee on Pro- gramme, adoptedatninth plenary meeting)

WHA2.9.Expert Committee on Biological Standardization :Report on the Third Session and Report of the Sub-Committee on Fat. Soluble Vitamins The Second World Health Assembly (1)NOTES the report of the Expert Committee on Biological Standardization on its third session and the report of its Sub-Committee on Fat-Soluble Vitamins ; 14 (2)REFERS these reports to the Executive Board for consideration and action. Wishing to join in the homage rendered to the memory of Mr. P. Bruce White by the Expert Committee on Biological Standardization, The Second World Health Assembly REQUESTS the Director-General to convey to the family of Mr. Bruce White the sympathy of the Assembly. (Fourth report of Committee on Pro- gramme, adoptedatninth plenary meeting) 12 Off. Rec. World Hlth Org. 10, 76 ;13, 323 13 Off. Rec. World Hlth Org. 18, 118-127 14 The expert committee reports will be published in 011. Rec. World Hlth Org. 23.See also report of the ad hoc committee of the Executive Board, Annex 2. - 20 - DECISIONS AND RESOLUTIONS

WHA2.10.Expert Committee on the Unification of Pharmacopoeias :Reports on the Third and Fourth Sessions The Second World Health Assembly (1)NOTES the reports of the Expert Committee on the Unification of Pharmacopoeias on its third15and fourth16sessions ;and (2)REFERS these reports to the Executive Board for consideration and action. (Fourth report of Committee on Pro- gramme, adoptedatninth plenary meeting)

WHA2.H.Expert Committee on Habit-forming Drugs :Report on the First Session The Second World Health Assembly NOTES the report of the Expert Committee on Habit-forming Drugs on its first session.17 (Fourth report of Committee on Pro- gramme, adoptedatninthplenary meeting)

WHA2.12.Co-operation with FAO on Nutrition Problems The Second World Health Assembly 1) NOTES the harmonious relations which have been established with FAO, and (2)REQUESTS the Director-General to continue the policy of close co-operation with FAO on nutrition problems and projects. (Fourth report of Committee on Pro- gramme, adoptedatninth plenary meeting) WHA2.13.National Nutrition Committees The Second World Health Assembly, Considering the importance of national nutrition committees, (1)REQUESTS the Director-General to bring to the attention of the Joint Committee with FAO on Nutrition the question of the establishment of joint FAO/WHO national nutrition committees ;and (2)AUTHORIZES the Executive Board to make appropriate recommendations on this subject to the Third World Health Assembly after consideration of the report of the joint committee. (Fourth report of Committee on Pro- gramme, adoptedatninth plenary meeting) WHA2.14.Production of Synthetic Vitamins The Second World Health Assembly (1)REQUESTS the Director-General to bring to the attention of the Joint Committee with FAO on Nutrition the question of the manufacture of synthetic vitamins in under- developed countries ;and (2)AUTHORIZES the Executive Board to make appropriate recommendations on this subject to the Third World Health Assembly after consideration of the report of the above-mentioned committee. (Fourth report of Committee on Pro- gramme, adoptedatninth plenary meeting)

15011. Rec. World Hltla Org. 15, 39 16To be published.See also report of the ad hoc committee of the Executive Board, Annex 2. 37Off. Rec. World Hlaz Org. 19, 29 - 21 - DECISIONS AND RESOLUTIONS

WHA2.15.Expert Conunittee on International Epidemiology and Quarantine :Report on the First Session and Principles to govern WHO Sanitary Regulations The Second World Health Assembly (1)NOTES the report of the Expert Committee on International Epidemiology and Quarantine on its first session ; 19 (2)APPROVES the principles to govern WHO Sanitary Regulations contained therein and in the Memorandum of the expert committee's Rapporteur 19 with the exception of that section covering the sanitary inspection of sea and aircraft ; (3)REFERS the above-mentioned section back to the Expert Committee on Inter- national Epidemiology and Quarantine for re-examination in the light of the report of the Expert Committee on Insecticides,22 together with the observations of the Com- mittee on Programme on the subject ;21 (4)REQUESTS the Director-General to call the attention of national health-administra- tions to the need for eliminating quarantine restrictions of doubtful medical value which interfere with international trade and travel, and to the present unsatisfactory tendency to multiply the number of immunization certificates required from travellers. (Fifth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

W HA2.16.Section on Quarantine of the Expert Committee on International Epidemiology and Quarantine : Report on the First Session The Second World Health Assembly NOTES the report of the Section on Quarantine of the Expert Committee on Inter- national Epidemiology and Quarantine on its first session.22 (Fifth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.17.Reports on International Epidemic Control The Second World Health Assembly NOTES the reports of the following Study-Groups : Second session of the Joint OIHPIWHO Study-Group on Cholera,23 and the field research work on the factors of cholera endemicity being carried out by the Government of India as a result of the recommendations of the study-group ; Second session of the Joint OIHPIWHO Study-Group on Plague 24 and the offer made by the Government of India to set up a training centre for field plague-control personnel in the Haffkine Institute, Bombay ; Second session of the Joint OIHPIWHO Study-Group on 28 First session of the Joint OIHPIWHO Study-Group on Trachoma 28 Expert consultation on active immunization against common communicable diseases of childhood. 27 (Fifth report of Committee on Pro- gramme,adoptedattenthplenary meeting) 18 Off. Rec. World Hlth Org. 19, 5 13 Off. Rec. World Hlth Org. 19, 12 28 To be published. 21 See minutes of the tenth meetingof the Committee on Programme, p. 175. 22 Off. Rec. World Hlth Org. 19, 16 23 Off. Rec. World Hlth Org. 19, 24 24 Off. Rec. World Hlth Org. 19, 18.This study-group also considered rickettsioses and sanitary measures appropriate for merchandise ininternational traffic. 28 Off. Rec. World Hlth Org. 19, 22 28 Off. Rec. World Hlth Org. 19, 27 27 To be published. - 22 - DECISIONS AND RESOLUTIONS

WHA2.18.Expert Committee on Insecticides :Report on the First Session The Second World Health Assembly

(1)NOTES the report of the Expert Committee on Insecticides on its first session ;28and Considering that the report contains technical information and advice for the Expert Committee on Malaria and the Expert Committee on International Epidemiology and Quarantine, (2)REFERS this report to the above-mentioned expert committees, together with the observations contained in the summary records relating to the discussions on the subject ; (3)REQUESTS the Director-General to refer to the attention of the Economic and Social Council at its next session the serious consideration of the proposal that countries waive customs duties on material for insect control in view of the very important sanitary and economic benefits to be expected from their use on a large scale ; and (4)RECOMMENDS to all governments that they require from manufacturers of insecticidal products the correct labelling of such products as regards their content in active ingre- dients.Such requirement need not, however, be imposed in those countries where the national authorities have developed a machinery whereby insecticidal products are tested for efficacy for specific purposes and are officially " approved " for the said purposes. (Fifth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.19.Co-ordination of Research Whereas the development of planned programmes requires continuous application of research and investigation on many problems, the solution of which may be found essential for the diagnosis, treatment and prevention of disease, and for the promotion of positive health ; Whereas research includes field investigations as well as those conducted in laboratories, The Second World Health Assembly RESOLVES that the following guiding principles should be applied in the organization of research under the auspices of the World Health Organization : (1)research and co-ordination of research are essential functions of the World Health Organization ; (2)first priority should be given to research directly relating to the programmes of the World Health Organization ; (3)research should be supported in existing institutions and should form part of the duties of field teams supported by the World Health Organization ; (4)all locally supported research should be so directed as to encourage assumption of responsibility for its continuance by local agencies where indicated ; (5)the World Health Organization should not consider at the present time the establishment, under its own auspices, of international research institutions. (Fifth report of Committee on Pro- gramme, adoptedatninth plenary meeting)

WHA2.20.Proposal to widen the Terms of Reference of the Expert Committee on Malaria The Second World Health Assembly (1)NOTES the resolution proposed by the Italian delegation concerning the transfor- mation of the Expert Committee on Malaria into an expert committee on malaria and other insect-borne diseases,30

28To be published. 29See the minutes of the eleventh and fourteenth meetings of the Committee on Programme, p. 183, section 4, p. 192, section2. 39See Annex 3. - 23 - DECISIONS AND RESOLUTIONS

(2)NOTES the comments thereon expressed by the delegation of the Philippines,30a (3)RESOLVES that this question be referred to the Executive Board for consideration with a request to report on the subject to the Third World Health Assembly. (Sixth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.21.Activities with ECOSOC and with Specialized Agencies on Malaria Control The Second World Health Assembly (1)NOTES the joint activities carried out by WHO with the Economic and Social Council, FAO and UNICEF, and (2)REQUESTS the Director-General to continue the policy of close co-operation with these organizations in regard to methods of malaria control. (Sixth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.22.Expert Committee on Tuberculosis :Report on the Third Session The Second World Health Assembly (1)NOTES the report on the ihird session of the ad hoc Expert Committee on Tuber- culosis," and (2)ENDORSES the decision of the Executive Board at its third session 32 that the report be further considered by the enlarged expert committee. (Sixth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.23.Activities with UNICEF and the International Union against Tuberculosis The Second World Health Assembly NOTES with satisfaction the arrangements outlined for co-operation with UNICEF and the International Union against Tuberculosis in the field of tuberculosis.33 (Sixth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.24.Joint Committee on Health Policy, UNICEF/WHO Whereas the First World Health Assembly recommended the establishment by the World Health Organization and by the United Nations International Children's Emer- gency Fund of a joint committee on health policy, to regulate the health programmes and projects of UNICEF ; 34 Whereas this Joint Committee on Health Policy was established and has laid down principles and policies governing the co-operative relations of WHO and UNICEF, which have been approved by the respective Executive Boards of WHO and UNICEF ; Whereas the WHO members of the Joint Committee on Health Policy have submitted a report to the Second World Health Assembly on certain aspects of these relation- ships ; 35 ma See Annex 3. 31011. Rec. World Hlth Org.15,5 32 Off Rec, World Hlth Org. 17 , 11 33 dg. Rec. World Hlth Org.18,100 ; and minutes of the fourteenth meeting of- the Committee on Programme, p. 193, section 3. 34 Ofi. Rec. World Hlth Org.13,327 35 See Annex 4. - 24 - DECISIONS AND RESOLUTIONS

The Second World Health Assembly (1)NOTES with satisfaction the progress made in improving co-operation with UNICEF, as shown in the report of the WHO members of the Joint Committee on Health Policy ; (2)APPROVES this report, and (3)REAFFIRMS the resolution adopted by the First World Health Assembly,36 that the health projects of UNICEF fall within the competence of the World Health Organization, and that the World Health Organization is ready and willing to handle these projects.37 (Sixth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.25.Nuclear Expert Committee on Mental Health The Second World Health Assembly NOTES the action of the Director-General in convening a meeting of the nuclear expert committee on mental health, to be held during 1949. (Seventh report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.26.Activities with the United Nations, Specialized Agencies and Non-Governmental Organizations on Matters connected with Mental Health The Second World' Health Assembly NOTES (1)the activities with the United Nations, and specialized agencies, in particular with regard to the prevention of crime and treatment of offenders and the study of tensions affecting international understanding, and (2)the full support of the programme proposals for 1950 given by the World Federation for Mental Health. (Seventh report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.27.Insulin The Second World Health Assembly (1)NOTES the report of the Director-General on the study of the supply of insulin,38 which shows that present and future world supplies of insulin are adequate in quantity and quality to meet the normal requirements, and (2)REQUESTS the Director-General to advise governments, upon request, concerning the means of obtaining the necessary requirements of insulin and to explore the pos- sibilities of manufacture in various countries. (Eighth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.28.Co-operation with the Economic Commission for Europe The Second World Health Assembly (1)APPROVES the provisional programme of action," evolved jointly with the Economic Commission for Europe, of assisting the Governments of Czechoslovakia, Poland and Yugoslavia in the modernization of their UNRRA-donated penicillin plants ;

36 011. Rec. World Hlth Org. 13, 327 37 See -statement by the Acting President at tenth plenary meeting, p. 119. 38 See minutes of nineteenth meeting of Committee on Programme, p. 212, section 2 39 Off. Rec. World Illth Org. 18, 164 - 25 - DECISIONS AND RESOLUTIONS

(2)REQUESTS the Director-General to continue co-operation with the secretariatof the Economic Commission for Europe with a view to increasing the availability of other essential medical supplies, particularly for the war-damaged countries of Europe. (Eighth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.29.Physical Training The Second World Health Assembly REQUESTS the Director-General to proceed with the collection of information on physical training and to hold consultations with experts with a view to submitting a programme to the Third World Health Assembly. (Eighth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.30.Activities with the United Nations, Specialized Agencies and Non-Governmental Organizations on Public-Health Administration The Second World Health Assembly NOTES the activities carried on in co-operation with the United Nations, specialized agencies and non-governmental organizations, and in particular the report " on the joint ILO/WHO committees on occupational hygiene and hygiene of seafarers. (Eighth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.31.General Co-ordination with the United Nations and Specialized Agencies The Second World Health Assembly (1)NOTES the report of the Director-General on co-ordination," and (2)REQUESTS the Director-General to continue collaboration with the Secretary- General of the United Nations and the Directors-General of other specialized agencies through the mechanism of the Administrative Committee on Co-ordination and its subsidiary bodies, and by appropriate representation at the meetings of other United Nations bodies. (Eighth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.32.International Research Laboratories The Second World Health Assembly (1)NOTES resolutions 22(111) and 160(VII) of the Economic and Social Council regarding the establishment of United Nations research laboratories, and the report of the Secretary- General on this subject ; 42 (2)CONFIRMS the resolution concerning this subject which was adopted by the Interim Commission of WHO on 11 November 1946, and the views of the Interim Commission as stated to the Secretary-General of the United Nations by the Executive Secretary of the Interim Commission on 4 December 1946 ; " (3)CONSIDERS that research in the field of health is best advanced by assisting, co- ordinating and making use of the activities of existing institutions and that the Health Assembly and the expert committees of WHO provide an adequate mechanism for the implementation of such a policy ; (4)REQUESTS that, in view of the responsibility and authority placed upon WHO in respect of international research in the field of health and in implementation of the Agreement between the United Nations and WHO," the Economic and Social Council " Presented orally ; see minutes of the nineteenth meeting of the Committee on Programme, 215 p., section 4. 41 See Annex 5. 42 UN document Ej620 43 011. Rec. World Hlth Org. 4, 139 44 Off. Rec. World HlM Org. 10, 59 - 26 - DECISIONS AND RESOLUTIONS

communicate such recommendations as it may be considering within the field of health to WHO, which, under its Constitution and the Agreement, is required to consider such recommendations and to report to the Council on the steps taken by WHO to give effect to them. (Ninth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.33.Health Situation of Displaced Persons Considering the disastrous consequences of the situation of displaced persons in different parts of the world as regards its health aspects as well as the risks of epidemics in their respective regions, The Second World Health Assembly DRAWS THE ATTENTION Of the Economic and Social Council of the United Nations to this situation, and recommends its immediate examination at a meeting of the Economic and Social Council to be held in Geneva on 5 July 1949. (Ninth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.34.Co-operation with the United Nations on the United Nations Library, Geneva The Second World Health Assembly REQUESTS the Director-General to communicate to the Secretary-General of the United Nations its appreciation of the action taken by the Secretary-General in placing before the Ninth Session of the Economic and Social Council proposals for the loan to WHO by the United Nations Library, Geneva, for an indefinite period, of certain medical and health material needed by WHO. (Ninth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.35. Whereas it was decided by the First Health Assembly that the Organization should sponsor the observance of World Health Day on 22 July each year by all States Members ;44 Whereas in every country the schools and other educational institutions could and should act as important focal points for the observance of this day ; Whereas most schools in many countries are closed on 22 July and therefore cannot serve in such manner ; Whereas the date of 7 April, the day when the Constitution of WHO officially entered into force in 1948, provides a suitable alternative without such disadvantages, The Second World Health Assembly RESOLVES that, beginning in 1950 and each year thereafter, World Health Day should appropriately be observed on 7 April by all States Members. (Ninth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.36.Bejel and other Treponematoses The Second World Health Assembly (1)APPROVES the action taken by the Executive Board and the Expert Committee on Venereal Diseases as regards bejel ; 46 (2)REALIZES the importance of treponematoses other than syphilis, such as yaws and bejel ;

44 Off. Rec. World filth Org. 13, 307 46 Off. Rec. World Hlth Org. 17, 11 ; 15, 29 - 27 - DECISIONS AND RESOLUTIONS

(3)AUTHORIZES the Executive Board to establish an expert group on treponematoses, consisting of the experts on syphilis of the Expert Committee on Venereal Diseases and six experts on other treponematoses, to study these diseases and make recommendations for further action concerning them. (Tenth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.37.International Health Yearbook

Whereas the character and usefulness of the proposed International Health Y earbook require further careful consideration, The Second World Health Assembly RESOLVES (1)that the Director-General be requested to refer to the Executive Board the proposal that an International Health Y earbook be published, and to obtain the comments of the Board on its possible form, content, periodicity and usefulness ; (2)that the Director-General be requested to report further on this proposal to the Third World Health Assembly. (Tenth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.38.Expert Committee on Health Statistics :Report on the First Session The Second World Health Assembly NOTES the report of the Expert Committee on Health Statistics on its first session ; 47 and RESOLVES

(1)to request the Executive Board to establish during its fourth session : (a)a temporary sub-committee of the Expert Committee on Health Statistics to study the question of the definition of stillbirth and abortion ; (b) a sub-committee of the Expert Committee on Health Statistics to initiate the proper action to be taken by the committee in the field of hospital statistics, primary attention to be given to the application of the new International Statistical Classifi- cation of Diseases, Injuries, and Causes of Death and related subjects, appropriate questions being decentralized for study by national committees on health statistics ; (c)a sub-committee of the Expert Committee on Health Statistics entrusted with the study of problems concerning the registration of cases of cancer as well as their statistical presentation ; (2)to request the Director-General to establish a unit for maintaining relationship with national committees on vital and health statistics (or their national equivalents) ; (3)to request the Director-General to set up a clearing centre for problems arising in the application of the Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, including arrangements for the use of such national skills as might be necessary to supplement those available in the Organization ; (4)to request the Director-General to arrange for a handbook or handbooks to be prepared summarizing the present position in different countries with regard to the collection of health statistics ; (5)pending the result of the studies to be carried out by the sub-committee on cancer statistics referred to in (1)(c), to request the Director-General to make arrangements for the publication in 1950 of the Annual Report on the Results of Radio-therapy on Cancer of the Uterine Cervix, at present in operation, the sub-committee to consider the modi- fications to be made in the presentation of further possible editions of this Annual Report with a view to adapting it to the new conditions of international cancer statistics, which will have been studied by it ;

47 To be published. - 28 - DECISIONS AND RESOLUTIONS

(6)with the aim of initiating the establishment of vital and health statistics systems or services in underdeveloped areas or of bettering those already in existence in them, even if still in a primitive state, and also of making possible the evaluation of the effective- ness of projects carried out for improving health and nutrition in such areas, to request the Dirèctor-General to undertake the study of such questions by means of conferences, within the region concerned, between specialists or qualified representatives of the areas and one or more experts in health statistics from WHO, in co-operation with other United Nations agencies, if necessary. (Tenth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.39.Health Statistics :Registration, Compilation and Transmission In view of the value of health statistics in the proper understanding of epidemiological and other medical and public-health problems, The Second World Health Assembly DRAWS THE ATTENTION Of Member Governments to the great importance to be attaclied to the registration, compilation and transmission of health statistics, and to the means of implementing the recommendations contained in the report of the Expert Committee on Health Statistics. (Tenth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.40.Use of Statistical Methods Having considered the memorandum on Health Statistics by the United Kingdom delegation," The Second World Health Assembly RESOLVES (1)that in the field and laboratory investigations and action carried out by WHO or with its assistance, the fullest possible use of available statistics and modern statistical methods should be made in the planning and execution of such investigations and action and in the evaluation of their results ; (2)that it is desirable that, wherever suitable health statistics exist or can be made available within a reasonable time, they should be examined in order to make a pre- liminary assessment of the need for the investigation or action contemplated ; (3)that although it is recognized that, in many countries, such suitable statistics may not be readily available, the absence or insufficiency of these statistics should not prevent investigations and necessary action being undertaken in those countries where prima facie considerations necessitate such investigations or action ; (4)that it is essential in any event that continuous statistical control and analysis of the investigations and action should in eáery case be provided for and carried out to the fullest extent practicable ;and (5)that the Director-General be requested to submit to an early meeting of the Executive Board a report on the present administrative arrangement in the World Health Organ- ization in the sphere of statistics (health, epidemiological, medical and vital) and to indicate any changes he thinks necessary or has carried out. (Tenth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.41.Joint Programme of FAO/WHO to increase World Food Production and raise Standards of Health 49 Whereas the Economic and Social Council at its sixth session (2 March 1948) " invited the specialized agencies concerned and the regional economic commissions, in consultation with FAO, to study suitable measures to bring about an increase in food production " ; Whereas the present necessity of increasing food production in the world requires development of tropical and subtropical areas where standards of health in general 48 See Annex 6. 49 See Annex 7. - 29 - DECISIONS AND RESOLUTIONS

should be raised and in particular where malaria must be controlled before any scheme of agricultural development and settlement can be started ; Whereas FAO has already given favourable consideration to joint WHO/FAO broad-scale projects aiming at increasing food production, at raising standards of living and at achieving Malaria control in fertile areas, The Second World Health Assembly (1)RESOLVES that the 1950 programme should include provision to enable WHO to carry out, in collaboration with FAO, general surveys for the selection of the areas where operations will be undertaken in the following five years ; and (2)RECOGNIZES that such provision will involve the obligation to provide in the pro- gramme of WHO for the following five years for the operation of the various projects ; and (3)RECOMMENDS to FAO that similar action be taken with a view to enabling the two organizations to plan the projects in 1949 and to initiating joint surveys in 1950. (Tenth report of Committee on Pro- gramme,adoptedattenthplenary meeting) WHA2.42.Tuberculosis Programme :Staff The Second World Health Assembly (1)REFERS the question of the services of temporary consultants and the appointment of regional consultant tuberculosis officers to the Executive Board ; and (2)APPROVES an increase in personnel available for Field Services in 1950 from 27 to 37 in the Regular Budget for tuberculosis. (Tenth report of Committee on Pro- gramme,adoptedattenthplenary meeting) W HA2.43.Leprosy The Second World Health Assembly RESOLVES (1)that an expert committee on leprosy with the maximum number of nine be established and that provision be made for a meeting of this committee in 1950 ; (2)that provision be made for the exchange, during 1950, of four selected leprosy workers from among the existing leprosy institutes in different countries ; (3)that provision be made for making available three experts for an average period of eighth months in each case to countries requiring guidance in the development of anti-leprosy work ; (4)that provision be made for the supply of sulfones and other new leprosy drugs for control trials by selected leprosy workers under the conditions to be laid down by the expert committee. (Tenth report of Committee on Pro- gramme,adoptedattenthplenary meeting)

WHA2.44.Availability of technical Knowledge of Production Processes of Antibiotics The Second World Health Assembly CONSIDERS that any withholding of scientific or technical information on essential therapeutic and prophylactic drugs, in selling or otherwise supplying nations with the means for their production, or withholding the free exchange of medical scientists, is not compatible with the ideals of the World Health Organization and is against the interests of humanity. (Eleventh report of Committee on Pro- gramme,adoptedattenthplenary meeting)

- 30 - RESOLUTIONS ADOPTED ON THE REPORTS OF THE COMMITTEE ON ADMINISTRATION AND FINANCE

WHA2.45.Administrative and Financial Relations between the United Nations and Specialized Agencies The Second World Health Assembly

(1)APPROVES the action taken by the Director-General to achieve co-ordination on budgetary, administrative and financial practices between the World Health Organiz- ation, the United Nations and other specialized agencies ; " (2)REQUESTS the Director-General to continue participation in the Administrative 'Committee on Co-ordination and to take such other action as he believes necessary to achieve more complete co-ordination, providing always that due recognition be given in each case to the problems inherent in the individual requirements of each of the agencies concerned. (First report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting)

WHA2.46.Transportation and/or per diem Allowances for Delegates to the Third and subsequent Health Assemblies The Second World Health Assembly AUTHORIZES the reimbursement to each Member and Associate Member of WHO of the actual travelling expenses of one delegate or representative only to the Third and subsequent Health Assemblies, the maximum reimbursement to be restricted to the equivalent of first-class return accommodation by recognized public transport via an approved route from the seat of central administration of the Member or Associate Member to the place of the meeting, and not to include the payment of subsistence, except where this is included as an integral part of the regular posted schedule for first- class accommodation for recognized public transport. (First report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting)

WHA2.47: Insurance against Travel Accidents of Delegates to the Health Assembly and of Members of the Executive Board Considering that, in virtue of the decision of the First World Health Assembly» the Organization has accepted to reimburse the travelling expenses to the Health Assem- blies of one delegate or representative of each Member or Associate Member of WHO and of the members of the Executive Board to meetings of the Board, The Second World Health Assembly

(1)STATES that the Organization does not accept any liability for travel risks incurred by this provision ; and (2)REQUESTS the Director-General to communicate this decision to the governments of Member States, notifying them that WHO assumes no responsibility to provide insurance cover for persons travelling to meetings of the Health Assembly and of the Executive Board. (First report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting)

5° See Annex 8. 51 Ofl. Rec. World HIM Org. 13, 314, 317 - 31 - DECISIONS AND RESOLUTIONS

WHA2.48.Approval of Additions to the Provisional Staff Regulations The Second World Health Assembly RESOLVES that the following regulations should be added to the Provisional Staff Regulations :52 Regulation 29 The Director-General, by virtue of the authority vested in him as the chief technical and administrative officer of the Organization, may delegate to other officers of the Organization such of his powers as he considers necessary for the effective implementation of these regulations. Regulation 30 In case of doubt as to the meaning of any of the foregoing regulations, the Director-General is authorized to rule thereon, subject to confirmation of the ruling by the Board at the next meeting. (First report of Committee on Admi- nistration and Finance, adoptedat ninth plenary meeting) WHA2.49.Staff Pension Committee The Second World Health Assembly DECIDES that the WHO Staff Benefit Committee 62a shall be composed of nine members (and nine alternate members), three to be appointed by the Health Assembly, three to be appointed by the Director-General, and three to be elected by the participants of the Fund. (First report of Committee on Admi- nistration and Finance, adoptedat ninth plenary meeting)

WHA2.50.Financial Report and Accounts of the Interim Commission for the Financial Period 1 January to 31 August 1948, and the Report of the External Auditor The Second World Health Assembly, Having examined the final report of the External Auditor on the accounts of the Interim Commission covering the period from 1 January 1948 to 31 August 1948,53 and having considered the recommendation of the Executive Board with regard thereto,54 ACCEPTS the report. (First report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting)

WHA2.51.Financial Report and Accounts of the World Health Organization for the Financial Period 1 September to 31 December 1948, and Report of the External Auditor The Second World Health Assembly, Having examined the annual financial statement and the report .of the External Auditor on the audit of the accounts of the World Health Organization for the financial period 1 September 1948 to 31 December 1948, as contained in Official Records No. 20, and having considered the recommendation of the ad hoc committee acting on behalf of the Executive Board,55 ACCEPTS the report. (First report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting)

52 Off. Rec. World Huth Org. 13, 361. These additions to the Provisional Staff Regulations will appear under the heading " Delegation of Authority " and will entail renumbering of the former Regulations 29 and 30. 52a Since called WHO Staff Pension Committee 53 011. Rec. World Hlth Org. 17, 60 54 Ofl. Rec. World Hlth Org. 17, 21 55 See Annex 2. - 32 - DECISIONS AND RESOLUTIONS

WHA2.52.Feasibility of using the United Nations Board of Auditors The Second World Health Assembly

(1)ENDORSES the principles to govern audit procedures as agreed by the Administrative Committee on Co-ordination of the United Nations and Specialized Agencies56 and, in addition, the following principle : the External Auditor should attend the Assembly when his report is being discussed and make any necessary explanation or answer any question related thereto ; (2)AGREES in principle to the establishment of a panel of external auditors of the United Nations and specialized agencies ;56 (3)RE QUESTS the Director-General, if the proposed joint system of external audit is adopted, to initiate such action as may be necessary to have the External Auditor of the World Health Organization placed on the panel of external auditors of the United Nations and the specialized agencies. (Second report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting) WHA2.53.Appointment of the External Auditor for 1950

The Second World Health Assembly

RESOLVES 1.that Mr. Uno Brunskog be appointed as External Auditor of the accounts of WHO for the financial period ending 31 December 1950.Should the necessity arise, Mr. Brunskog may designate a representative to act in his absence ; 2.that in the year of the last financial period to be audited by the Auditor appointed under 1 above, the Health Assembly shall appoint an Auditor of the accounts of WHO ; 3.that the Auditor shall adopt his own rules of procedure ; 4.that the Auditor, subject to budgetary provision made by the Health Assembly for the cost of the audit, and after consultation with the appropriate committee of the Executive Board relative to the scope of the audit, may conduct the audit under the provisions of this resolution in such manner as he thinks fit and may engage commercial public auditors of international repute ; 5.that the Auditor shall submit his report, together with the certified accounts and such other statement as he thinks necessary, to the Health Assembly, to be available to the Executive Board not later than 1 May following the end of the financial year to which the accounts relate ; 6.that the audit should be carried out by the Auditor in accordance with the prin- ciples to govern audit procedure recommended by the Administrative Committee on Co-ordination of the Economic and Social Council and that in particular the Auditor shall have full regard to the following : 6.1The Auditor should satisfy himself 6.1.1that the accounts, including the balance sheet, represent a correct record of duly authorized financial transactions of the financial year ; 6.1.2that money has not been expended or obligated for other than the purpose or purposes for which the appropriations voted by the Assembly were intended to provide, except in so far as the Director-General has authorized transfers within the budget acting upon his authority contained in the Appro- priation Resolution and that expenditures conform to the authority which governs them ; 6.1.3that transfers from the working capital or other funds have received the necessary authority. 6.2 The Auditor, after satisfying himself that the vouchers have been examined and certified as correct by the accounting organization, may, in his discretion and having regard to the character of the examination within the department, in any particular case admit the sums so certified without further examination, provided, however, that if the Health Assembly or the appropriate committee of the Executive 56 See appendices to second report of Committee on Administration and Finance. -33 - DECISIONS AND RESOLUTIONS

Board on behalf of the Health Assembly requests that any accounts be examined in greater detail, the Auditor shall do so. 6.3 The Auditor shall examine at least once a year such stock or store accounts as are maintained by the Organization. 6.4 The Auditor shall have free access at all convenient times to the books of account and all information relevant to the accounts of the Organization.Requests for official files which may deal with matters of policy should be made only through the official designated for that purpose by the Director-General. 6.5 The Auditor should not criticize purely administrative matters, but it is within his discretion to comment upon the financial consequences of administrative action. 6.6Objections which may arise during audit to any items should be communicated immediately to the administration. As a general rule, criticism will not be made in the Auditor's report without first affording the administration an opportunity of explanation. 6.7 Documentary or other information obtained from a department should not be published by the Auditor without reference to the duly authorized official of the Organization. 6.8 The Auditor certifying the accounts should prepare a report of each account certified, in which he should mention : 6.8.1the extent and character of his examination or any important changes therein ; 6.8.2matters affecting the completeness or accuracy of the accounts, such as : (1)information necessary to the correct interpretation of the accounts. (2)any amounts which ought to have been received but which have not been brought to account ; (3)expenditures not properly vouched ; 6.8.3other matters which should be brought to the notice of the Health Assembly, such as : (1)cases of fraud or presumptive fraud ; (2)wasteful or improper expenditure of the Organization's money or stores (notwithstanding that the accounting for the transactions may be correct) ; (3)expenditure likely to commit the Organization to further outlay on a large scale ; (4)any defect in the general system or detailed regulation governing the control of receipts and expenditure, or of stores ; (5)expenditure not in accordance with the intention of the Health Assembly, after making allowance for duly authorized transfers within the budget ; (6)expenditure in excess of appropriations, as amended by duly authorized transfers within the budget ; (7)expenditure not in conformity with the authority which governs it ; 6.8.4 the accuracy or otherwise of the stores records as determined by stock- taking and examination of the records.In addition, the reports may contain reference to : 6.8.5transactions accounted for in a previous year concerning which further information has been obtained, or transactions in a later year concerning which it seems desirable that the Health Assembly should have early knowledge. 6.9 The Auditor, or such of his officers as he may delegate, should certify each account in the following terms : " The above accounts have been examined in accordance with my directions. I have obtained all the information and explanations that I have required, and I certify, as the result of the audit, that, in my opinion, the above account is correct "-adding, should it be necessary, "subject to the observations in my report." 6.10 The Auditor shall have no power to disallow items in the accounts, but shall recommend to the Director-General for appropriate action such disallowances as he is prepared to recommend to the Health Assembly based on his audit of the accounts and records. The Auditor shall bring to the attention of the Health - 34 - DECISIONS AND RESOLUTIONS

Assembly any cases where his recommendations for disallowances have not been acted upon by the Director-General. 6.11The Auditor should attend the Assembly when his report is being discussed and make any necessary explanation or answer any question related thereto. (Second report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting)

WHA2.54.Status of Contributions to the Budget for 1948 The Second World Health Assembly, Having in view the necessity of financing the programmes of the Organization, and recalling the resolution adopted at the First Health Assembly urging the prompt payment of contributions,57 AGAIN CALLS UPON States in arrears with their 1948 contributions to make payment thereof without further delay. (Second report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting)

WHA2.55.Status of Contributions to the Budget for 1949 The Second World Health Assembly, Conscious of the necessity of prompt payment of contributions to enable the Organ- ization to carry out its programmes, (1)DRAWS THE ATTENTION of Members of the Organization to their responsibility of financially supporting the Organization, and (2)URGES Members to pay their 1949 contributions without further delay. (Second report of Committee on Admi- nistration and Finance, adopted at ninth plenary meeting)

WHA2.56.Policy to be followed concerning Contributions in arrears The Second World Health Assembly RESOLVES to adopt the following policy and procedure when the contribution to be paid by a Member is in arrears : When the contribution has not been paid by any Member in full by the end of the year for which the assessment is made, that Member shall be considered to be in arrears. When any Member is in arrears, the Director-General shall communicate with the Member concerned to ascertain the reasons for the delay in payment and what arrangements can be made for payment. He shall submit to the next session of the Executive Board a report on the result of his enquiries. When the contribution has not been paid by any Member in full by the end of the year following the year for which the assessment is made, that Member shall be considered to be in arrears for one year, warranting consideration by the next convened meeting of the World Health Assembly. A full report on the circumstances of the case shall be furnished by the Executive Board to the World Health Assembly and the Health Assembly may, after con- sideration of that report, take such action, if any, as it considers necessary and appropriate, by invoking all or part of Article 7 of the Constitution. (Third report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

57 Off. Rec. World Hlth Org. 13, 315 - 35 - DECISIONS AND RESOLUTIONS

WHA2.57.Establishment of the Working Capital Fund as a single Fund and Assessment of new Members The Second World Health Assembly

(1)RESOLVES (a) that the working capital fund of the Organization shall be constituted as a single fund ; (b) that the interests of each Member of the Organization in the working capital fund shall be maintained ; (c)that the funds transferred to the World Health Organization from the League of Nations Liquidation Board for the Epidemiological Intelligence Station shall be maintained as a separate fund ; (d) that a separate fund shall be set up for the assessments of States not Members of the Organization for the repayment of the loan to the World Health Organization Interim Commission by the United Nations ; (2)CONFIRMS the action taken by the Director-General in making the assessment of new Members in the Organization during 1948 for the working capital fund," and (3)DECIDES that, notwithstanding the amount established from time to time by the Health Assembly as the size of the working capital fund, a new Member of the Organ- ization shall, upon its membership becoming effective, contribute to the working capital fund an amount equal to that which it would have been required to contribute had it been a Member of the Organization from its inception. (Third report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting) WHA2.58.Currency of Contributions The Second World Health Assembly, Having considered the matter of currency of contributions to the operating budget of WHO ;and Recognizing that it will be possible to use, to some extent, currencies other than US dollars and Swiss francs in carrying out the operating budget of the Organization, DECIDES that contributions to the operating budget in currencies other than US dollars and Swiss francs be accepted, on the basis that all Member Governments shall have equal rights in paying a proportionate share of their contribution in such currencies as may be acceptable, these currencies to be determined under the provisions of Financial Regulation 19.59 (Third report of Committee on Admi- nistration and Finance, adoptedat tenth plenary meeting)

WHA2.59.Notification to Governments of Vacancies for Professional and Senior Staff The Second World Health Assembly DECIDES that it is desirable that, as far as practicable, vacancies for professional and senior administrative posts in the Secretariat should be communicated to the govern- ments of Member States in order that they may be given publicity.'" (Third report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

58 See minutes of fifth meeting of Committee on Administration and Finance, section 2, footnote 22. 59 011. Rec. World Hlth Org. 13, 355 89 In the discussion at the eighth meeting of the Committee on Administration and Finance (p. 252), attention was also drawn to the desirability of achieving wider geographical distribution among senior staff. - 36 - DECISIONS AND RESOLUTIONS

WHA2.60.Budget Estimates for the proposed 1950 Programme The Second World Health Assembly

(1)TAKES NOTE of the resolution adopted in plenary session on 16 June 1949 which provides for the Committee on Administration and Finance to cost the programme approved by the Committee on Programme ;61 (2)UNDERSTANDS that the costing of the programme does not in any way commit the committee to a total budget and that consideration of the total budget will be undertaken by the Committees on Programme and Administration and Finance in joint session ; (3)BELIEVES it desirable in order to expedite the consideration of the budget for 1950, to adopt a procedure which should not establish a precedent for future years and, there- fore, (4)DECIDES that the costs of the programme provided by the Director-General are hereby accepted ; and further (5)REQUESTS the Executive Board to take note of the discussion in the Committee on Administration and Finance and give special consideration to the problem which has developed at this Assembly with the view of recommending a more satisfactory procedure for the Third Health Assembly.62 (Third report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

WHA2.61.Headquarters Office Accommodation Whereas the First World Health Assembly, after consultation with the United Nations in conformity with Article 42 of the Constitution, selected Geneva as the per- manent headquarters of the World Health Organization ;63 Whereas the Secretary-General of the United Nations has, subject to the approval of the General Assembly, offered to place at the disposal of the World Health Organ- ization, for the latter's permanent headquarters office, accommodation to be provided within the perimeter of the United Nations grounds at Geneva subject to the construc- tion of such additions to the existing structure of the Palais des Nations as may be necessary for the purpose ; Whereas by the letters of 28 March and 1 June 1949 from M. Max Petitpierre to the Director-General the Swiss Federal Council has, upon the conditions mentioned in the said letters, proposed three alternative plans for making available to the World Health Organization an amount up to Swiss francs 5,750,000 to finance the construction of a building either within the perimeter of the United Nations grounds or on an inde- pendent site which the Canton of Geneva has offered to place gratis at the Organization's disposal ; and Whereas the various projects submitted for the consideration of the Health Assembly have not yet been worked out in sufficient detail to enable a choice to be made among them at the present stage, The Second World Health Assembly

1. THANKS the Federal Council, the Canton of Geneva and the Secretary-General for the spirit of understanding in which they have approached this matter and for the offers which they have made ; 2. RESOLVES to delegate to the Executive Board, acting in concert with the Director- General and subject to the instructions mentioned in paragraphs (1),(2) and (3) below, and the proviso that the total cost of construction of the building shall not exceed 6,000,000 Swiss francs, full powers to take in the name of the World Health Assembly the final decision both as to the selection of the site and as to the choice of the proposal

61See resolution WHA2.1 and the verbatim records of the seventli and eighth plenary meetings, pp. 18, 102, 107, 62See the minutes of the tenth meeting of the Committee on Administration and Finance, p. 257, section 1. 88Off: Rec. World Hlth Org. 13, 344 64See Annex .9. - 37 - DECISIONS AND RESOLUTIONS

which the Board may deem most advantageous among the three presented by the Swiss Federal Council in the above-mentioned letters for the provision of the necessary funds : (1)In view of the administrative facilities and economies that might accrue to the mutual advantage of the United Nations and the World Health Organization from the provision for the latter of headquarters accommodation in the closest possible proximity to the United Nations buildings in Geneva, the Board is instructed, in consultation with the Swiss Government, to accept the offer of the Secretary- General of the United Nations on condition that the needs of the World Health Organization in this matter receive full consideration and that acceptable and adequate accommodation can be made available to the World Health Organization within the United Nations grounds at Geneva on terms to be agreed upon in advance with the Secretary-General of the United Nations and to be completely acceptable to the Director-General of the World Health Organization ; (2)Should, however, the final offer of the Secretary-General fail to satisfy the conditions set forth above, then the Board may accept the offer of an independent site made by the Swiss Federal Council on behalf of the Canton of Geneva ; (3)Should none of the offers made in accordance with paragraphs (1) and (2) above be completely acceptable to the Board and the Director-General, the Board is authorized to seek any other solution for headquarters at Geneva which in its opinion will satisfy the needs of the World Health Organization, in an adequate and practicable manner, and to report thereon to the Third World Health Assembly ; and 3. RE QUESTS the Executive Board to expedite, so far as it lies within its power to do so, the commencement of building operations at the earliest possible moment, and to report to the Members of the World Health Organization on the decisions taken for the execution of the present resolution. (Third report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

WHA2.62.Financial Responsibilities of the Executive Board Whereas Article 28(g) of the Constitution provides that the Executive Board shall submit to the Health Assembly for consideration and approval a general programme of work covering a specific period ; and Whereas Article 55 of the Constitution provides that the Director-General shall prepare and submit to the Board the annual budget estimates of the Organization, and that the Board shall consider and submit to the Health Assembly such budget estimates, together with any recommendations the Board may deem advisable ; and Whereas Article 56 of the Constitution provides that subject to any agreement between the Organization and the United Nations, the Health Assembly shall review and approve the budget estimates and shall apportion the expenses among the Members in accordance with a scale to be fixed by the Health Assembly ; The Second World Health Assembly 1. REQUESTS the Board to submit recommendations to the Third World Health Assembly pursuant to Article 28(g) of the Constitution, and 2. DIRECTS that the Board's review of the annual budget estimates in accordance with Article 55 of the Constitution shall include consideration of : (1)the adequacy of the budget estimates to meet health needs ; (2)whether the programme follows the general programme of work approved by the Health Assembly ; (3)whether the programme envisaged can be carried out during the budget year ; and (4)the broad financial implications of the budget estimates with a general state- ment of the information on which any such considerations are based ; and 3. RECOMMENDS that the position be reviewed not later than the Fifth World Health Assembly. (Fourth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting) - 38 - DECISIONS AND RESOLUTIONS

WHA2.63.Reimbursement by Governments for Materials, Supplies and Equipment The Second World Health Assembly, Having reconsidered paragraph VI of the appropriation resolution for the financial year 1949 65 as approved by the First World Health Assembly ; and Recognizing that governments receiving advisory and demonstration services from the Organization will normally contribute a large share of the cost of demonstration projects by providing for those expenditures of the project which can be met in local currency ; and Having considered that the provisions of paragraph VI of the appropriation resolution for the financial year 1949 represent a serious obstacle to providing these services to some of the countries where the greatest need exists, (1)RESOLVES that paragraph VI of the appropriation resolution for the financial year 1949 be rescinded, and replaced by the following text : " With respect to advisory and demonstration services to governments, the Director- General shall, in consultation with the receiving governments, take steps to recover the depreciated value of non-expendable equipment which may be left in the country after a demonstration team completes its work and such part of the cost of expendable materials and supplies as the governments are willing to repay, which repayment may be made by governments in their own currencies. The Director-General, prior to the furnishing of these services, should, if possible, reach agreement in advance as to the willingness of governments to make such payments under the provisions of this paragraph ", (2)RE QUESTS the Director-General to submit a report reviewing this policy to the Fifth World Health Assembly. (Fourth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

WHA2.64.Appointment of Members and Alternates to the Staff Pension Committee The Second World Health Assembly, Noting the resolution adopted by the Executive Board at its third session,66 as regards the adhesion of WHO to the United Nations Joint Staff Pension Plan, RESOLVES (1)that, when the WHO Staff Benefit Committee 66a is first constituted," one-third of the members and their alternates shall be appointed for a period of one year, one- third for a period of two years, and one-third for a period of three years ; (2)that the following persons be appointed to represent the Health Assembly on the WHO Staff Benefit Committee : (a) for a period of one year : as member, Dr. J. Zozaya (Mexico) as alternate member, Professor J. Parisot (France) (b)for a period of two years : as member, Sir Arcot Mudaliar (India) as alternate member, Dr. B. Kozusznik (Poland) (c)for a period of three years : as member, Dr. H. Hyde (United States of America) as alternate member, Dr. J. A. Höjer (Sweden). (Fourth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

65 Off. Rec. World HUI; Org.13, 319 66 011. Rec. World Hlth Org.17, 22 66a Since called the Staff Pension Committee 67 See also resolution WHA2.49 - 39 - DECISIONS AND RESOLUTIONS

WHA2.65.Currency of Contributions 68 The Second World Health Assembly REQUESTS the Director-General and the Executive Board to attempt to solve the problems involved in accepting part of the contributions to the operating budget in currencies other than US dollars and Swiss francs, in order to find a means whereby a portion of contributions can be accepted in such other currencies. (Fourth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

WHA2.66.Working Capital Fund for 1950 The Second World Health Assembly

(1)RESOLVES (a) that the working capital fund shall be established for the financial year 1950 in the amount of US $4,000,000 ; (b) that Members shall make additional advances to the working capital fund, in accordance with the scale adopted by the First Health Assembly for contributions of Members to the budgets of the World Health Organization for the financial years 1948-1949,"

(2)AUTHORIZES the Director-General (a)to advance from the working capital fund such sums as may be necessary to finance the appropriations for the financial year 1950, pending receipt of con- tributions from Members ;sums so advanced shall be reimbursed to the working capital fund as soon as contributions are available ; (b) to advance such sums in 1950 as may be necessary to meet unforeseen or extra- ordinary expenses, providing that not more than US $500,000 may be used for such purposes, except that with the prior concurrence of the Executive Board a total of US $1,000,000 may be used. The Director-General shall report to the next convening Health Assembly all advances made under this clause and the circumstances relating thereto, and shall make provision in the estimates for reimbursement of the working capital fund except when such advances are recoverable from some other source ; (3)AUTHORIZES the Executive Board to use, not to exceed, US $300,000 of the working capital fund as the special fund to be used at the discretion of the Board to meet emer- gencies and unforeseen contingencies, this authorization being made to comply with Article 58 of the Constitution. Any amounts used under this authorization are to be replaced by making specific provisions therefor in the next year's annual budget, except when expenditures made under this authority are recoverable from some other source. (Fourth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

WHA2.67.Seale of Assessments :Contribution of Israel to the Budgets of 1949 and 1950 Whereas Financial Regulation 18 provides that " Members shall be required to make a contribution for the year in which their membership becomes effective, and an advance to the working capital fund, at rates to be determined by the Health Assembly " ; and Whereas the Fitst World Health Assembly did not include a determination for the State of Israel in establishing the unit scale of assessments for 1948 and 1949,

68 See also resolution WHA2.58. 69 Off. Rec, World Hlth Org. 13, 316 -40 - DECISIONS AND RESOLUTIONS

The Second World Health Assembly RESOLVES that the State of Israel 70 shall maie an advance to the working capital fund and contribute to the budgets for 1949 and 1950 of the World Health Organization at a rate to be fixed by establishing the number of units corresponding to the contribution of Israel to the United Nations for the year 1950 ; [Further, an interim assessment of Israel shall be made of five units to be replaced by the definitive assessment, when known.] 71 (Fifth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

WHA2.68.Scale of Assessments :Determination of the maximum Contribution to the regular Expenses of the Organization The Second World Health Assembly, In considering the several questions referred to it under resolutions adopted by the First Health Assembly concerning the scale of assessments for 1950 and future years,72 (1)RECOGNIZES that it is in the best interests of WHO that no one Member State should contribute more than one-third to the regular expenses of WHO for any year, provided that the per capita contribution of any Member State shall not exceed the per capita contribution of the Member paying the highest contribution ; and (2)DECIDES that this principle be made effective as world economic conditions improve, in gradual stages, starting in 1950 ; (3)DECIDES that the unit scale of assessments be continued ; and (4)DECIDES that the scale of assessments be based on that for 1948 and 1949 with appropriate adjustments to establish the contribution of the United States of America at thirty-six per cent of the total, and that the per capita contribution of any Member State shall not exceed the per capita contribution of the Member making the highest contribution. (Fifth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

WHA2.69.Scale of Assessments : Contribution of the State of South Korea 73 to the Budgets of 1949 and 1950 Whereas Financial Regulation 18 provides that :" Members shall be required to make a contribution for the year in which their membership becomes effective, and an advance to the working capital fund, at rates to be determined by the Health Assembly " ;and Whereas the First World Health Assembly did not include a determination for the State of South Korea in establishing the unit scale of assessments for 1948 and 1949, The Second World Health Assembly RESOLVES (1)that the State of South Korea shall make an advance to the working capital fund and contribute to the budgets for 1949 and 1950 of the World Health Organization at a rate to be fixed by the Third World Health Assembly ;and further (2)that an interim assessment of South Korea shall be made of five units, to be replaced by the definitive assessment, when established. (Fifth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting) 70 See decision (x), p. 17. 71 The paragraph in square brackets was adopted by the Committee on Administration and Finance at its thirteenth meeting (p. 270) on the report of the working party set up to consider the scale of assess- ments for 1950 but by error omitted from the report of the committee and therefore also from the reso- lutions adopted by the Health Assembly. The paragraph will be submitted to the Third Health Assembly for confirmation. 72 Off. Rec. World Hlth Org. 13, 316 78 See Resolution 195 12 December 1948; of the General Assembly of the United Nations. - 41 - DECISIONS AND RESOLUTIONS

WHA2.70.Scale of Assessments :Financial Obligations of Associate Members The Second World Health Assembly (1)RESOLVES that the question of the financial obligations of Associate Members towards the budget of the Organization be referred to the Executive Board ; and (2)DELEGATES to the Executive Board authority to establish provisional scales of assessments for Associate Members to be confirmed or revised by the Third World Health Assembly. (Fifth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

WHA2.71.Appropriation Resolution The Second World Health Assembly I. RESOLVES that for the financial year 1950 the Regular Administrative and Operating Programme Budget is as follows : 74

Appropriation Section Purpose of Appropriation US $ PART I - ADMINISTRATIVE BUDGET

1 Organizational Meetings 229,000 2 Administrative Expenses 1,188,875 Total PART I 1,417,875

PART II - OPERATING PROGRAMME BUDGET 3 Operating Programmes Chapter 3.1 Operating Supervisory Staff 266,850 3.2 Regional Offices 902,535 3.3 Other Offices 71,925 3.4 Advisory and Demonstration Services to Governments 1,819,870 3.5 Technical Training of Medical and Auxiliary Personnel 779,380 3.6 Medical Literature and Teaching Equipment 75,000 3.7 Technical Services 1,373,470 3.8 Expert Committees 253,815 3.9 Supplies to Governments 115,000 3.10 Common Services for Part II, except chapters 3.2, 3.3 and 3.4 ' 425,780 Total Section 3 6,083,625 TOTAL ALL PARTS 7,501,500*

* The estimated income to be available in 1950 is $501,500, which after being applied to this appropriation provides for a contribution to be made by governments of $7,000,000.

Amounts not exceeding the above shall be available for the payment of obligations incurred during the period 1 January 1950 to 31 December 1950. II.AUTHORIZES the Director-General, with respect to Part II of the budget, in urgent circumstances, to transfer credits between chapters and, with the concurrence of the Executive Board, or of any committee to which it may delegate authority, to transfer credits between sections. III. RE QUESTS the Director-General to report to the next subsequent regular session of the Executive Board all transfers made under the authority of paragraph II hereof, together with the circumstances relating thereto.

74 See also the appendices to resolution WHA2.78 - 42 -- DECISIONS AND RESOLUTIONS

IV. MJTHORIZES the Director-General, notwithstanding the provisions of Financial Regulation 13, to transfer to the ensuing year the unexpended balances of allotments (made under the provisions of Financial Regulation 10) made to countries for Fellowships, under chapter, 3.5 of section 3 of Part II, and for Medical Literature and Teaching Equipment, chapter 3.6 of the same section. V.DIRECTS the Director-General, with r.espect to advisory and dembnstration services to governments, to take steps, in consultation with the receiving governments, to recover the depreciated value of non-expendable equipment which may be left in the country after a demonstration team completes its work and such part of the cost of expendable materials and supplies as the governments are willing to repay, which repayment may be made by governments in their own currencies. The Director-General, prior to the furnishing of these services should, if possible, reach agreement in advance as to the willingness of governments to make such payments under the provisions of this paragraph. In approving the above appropriation resolution for the Regular Administrative and Operating Programme Budget for the financial year 1950, The Second World Health Assembly EMPHASIZES that it in no way commits the Third or subsequent World Health Assemblies to any particular levels of expenditure. (Sixth report of Committee on Admi- nistration and Finance, adopted at tenth plenary meeting)

C-z

- 43 - RESOLUTIONS ADOPTED ON THE REPORTS OF THE JOINT MEETINGS OF THE COMMITTEES ON PROGRAMME AND ADMINISTRATION AND FINANCE

WHA2.72.Contributions to the Regular Operating Budget

The Second World Health Assembly RESOLVES that the contributions from Member Nations to the Regular Operating Budget for 1950 shall be seven million dollars.75 ( First report of Joint Meetings, adopted at tenth plenary meeting)

WHA2.73.Programme Medical Supply Services The Second World Health Assembly ENDORSES the policy of the Executive Board as contained in Official Records No. 18, page v, paragraph 2 (Supplies) it being understood that the policy as laid down does not exclude points 1.2.8 and 1.2.9 on page 5 of that volume and that the provision for these two points can be included in the provisions made in connexion with item 7.6.1 (Medical Literature, Teaching Equipment and Programme Supply Services) of the same volume. (SecondreportofJointMeetings, adopted at tenth plenary meeting)

WHA2.74.Establishment of a Regional Organization for the European Area The Second World Health Assembly, Having noted the resolution of the third of the Executive Board concerning the establishment of a Regional Organization for Europe,'" (1)AUTHORIZES the Executive Board to establish a Regional Organization for Europe as soon as the consent of the majority of Member States situated within the European area shall have been obtained ;and (2)NOTES that the Special Office for Europe would automatically be dissolved upon the establishment of a Regional Office for Europe. (SecondreportofjointMeetings, adopted at tenth plenary meeting)

WHA2.75.Supplemental Operating Programme of Advisory and Technical Services Budget The Second World Health Assembly, Having considered the Operating Programme of Advisory and Technical Services to governments prepared by the Director-General and forwarded by the Executive Board ; 77 Having noted with interest and approval Resolution No. 200(III) adopted by the United Nations General Assembly at its third regular session on 4 December 1948 with particular reference to paragraph 4(d) thereof, which reads : The technical assistance furnished shall (i) not be a means of foreign economic and political interference in the internal affairs of the country concerned and shall not be accompanied by any consideration of a political nature ;(ii) be given only

75 See also resolution WHA2.71 76 Og. Rec. World Hlth Org. 17, 16 77 Off. Rec. World Hlth Org. 18

---- 44 -- DECISIONS AND RESOLUTIONS

to or through governments ;(iii) be designed to meet the needs of the country concerned ;(iv) be provided, as far as possible, in the form which that country desires ;(v) be of high quality and technical competence ; Having noted with interest and approval Resolution No. 180(VIII) adopted by the Economic and Social Council on 4 March 1949 ;and Having noted that, by virtue of the above resolution, a comprehensive plan for an expanded co-operative programme of technical assistance for economic development through the United Nations and the specialized agencies has been prepared by the Secretary-General of the United Nations in consultation with the Executive Heads of the specialized agencies through the Administrative Committee on Co-ordination, and is to be submitted to the Economic and Social Council at its ninth session,79 1. APPROVES that part of the programme contained in Official Records No. 18, as amended by this Assembly and which, for budgetary reasons, is called the Supplemental Operating Programme of Advisory and Technical Services, subject to arrangements having been completed to provide funds for its implementation ; And further, as there is no financial provision in the 1949 budget for more than one meeting of the Health Assembly, 2. DELEGATES to the Executive Board authority to authorize the Director-General to undertake appropriate negotiations concerning the provision of funds to implement the Supplemental Operating Programme of Advisory and Technical Services ;and further 3. AUTHORIZES the Executive Board to act on behalf of the World Health Assembly until its next meeting in approving the results of such negotiations, and 4. EMPOWERS the Executive Board : (1)to authorize the Director-General to accept and administer such funds as will be made available for the purpose of implementing all or part of the Supplemental Operating Programme of Advisory and Technical Services approved by the Health Assembly provided that any conditions attached to the provision of such funds or any other conditions except those established by the Executive Board or the World Health Assembly are consistent with the principles contained in United Nations Resolution No. 200(III) with specific reference to paragraph 4(d) thereof and with Article 57 of the Constitution ; (2)to consider appropriate resolutions of the Economic and Social Council and the General Assembly of the United Nations in connexion with (1) above ; (3)to authorize the Director-General to negotiate agreements with Member Governments concerning the amounts and currencies of their contributions in accordance with (1) above. (ThirdreportofJointMeetings, adopted at tenth plenary meeting)

WHA2.76.United Nations Project for the Relief of Palestine Refugees

Whereas the Executive Board at its second session authorized the Director-General, in consultation with the Chairman of the Executive Board, within the limits of any resources made available for this purpose, to take the necessary emergency measures, under the terms of Article 28 (i) of the Constitution, to deal with events requiring imme- diate action in connexion with the health situation of Palestine refugees ; 79 Whereas the Executive Board at its third session approved the action of the Director- General under this authority ;80 Whereas the health situation of the refugees in the Palestine area continues to cause anxiety, and may, if measures are relaxed, lead to epidemics which could be a threat to other countries ; Whereas the United Nations Relief to Palestine Refugees is to be continued beyond the original termination date of 31 August, 1949, in order to provide time for the fourth regular session of the General Assembly to take new action ;

78 UN document E/1327 Add. 1 " Off. Rec. World Hlth Org. 14, 18 80 011. Rec. World Hlth Org. 17, 12 DECISIONS AND RESOLUTIONS

Whereas the Secretary-General of the United Nations has requested, in a letter to the Director-General dated 10 June, 1949,81 that the World Health Assembly consider the feasibility of making provision in the budget for 1950 for a substantially larger allo- cation towards the medical care provided among these refugees than was possible for 1949, and has stated that any such favourable action would be warmly welcomed by the United Nations, The Second World Health Assembly, Recognizing that continued assistance for the prevention of epidemics is required to prevent their outbreak among Palestine refugees, and their spread to surrounding countries, and Desiring to respond to the appeal of the Secretary-General of the United Nations, in so far as the financial resources of the World Health Organization will allow ; (1)RESOLVES that technical assistance in this field be rendered by the World Health Organization in 1950 through the United Nations as an emergency measure, and that an amount be provided for in the budget for 1950 to meet this expenditure;81aand further (2)CONSIDERS that the best solution of this problem as regards its health aspects lies in the rapid re-settlement of the refugees, and (3)REQUESTS the Director-General to transmit to the Secretary-General of the United Nations its views in this regard. (ThirdreportofJointMeetings, adopted at tenth plenary meeting)

WHA2.77.Establishment of an Expert Committee on Nursing Whereas the role of nurses is proving more and more important in the protection of public health ; Whereas it is necessary to ensure their recruitment in proportion to the needs of each country ; Whereas it is necessary in all countries to give them training in keeping with the numerous and complicated tasks which will devolve upon them ; Whereas the First World Health Assembly decided that the question of establishing an expert committee on nursing be examined by the Second World Health Assembly,82 The Second World Health Assembly REQUESTS the Director-General to establish an expert committee on nursing.

(ThirdreportofJointMeetings, adopted at tenth plenary meeting)

WHA2.78.Adoption of the Programme and Budget for 1950 The Second World Health Assembly (1)ADOPTS the programme and budget as set out in Official Records No. 18, and revised by the resolutions of this Assembly (see appendices below) ;

(2)NOTES with satisfaction the comments of the External Auditor ;83 and (3)REQUESTS the Executive Board to examine the organizational structure so that the Third World Health Assembly may be assisted in ensuring the administrative efficiency of the Organization and establishing general lines of policy in this respect. (ThirdreportofJointMeetings, adopted at tenth plenary meeting)

81 See Annex 10. 819See second footnote. p. 470 82Ofl. Rec. World Hlth Org. 13, 309 83011. Rec. World Hlth Org. 20 - 46 - DECISIONS AND RESOLUTIONS

Appendix 1

TRANSFERS FROM REGULAR TO SUPPLEMENTAL BUDGET

Reductions in Regular Estimates shown in Off.Rec.18 Regular and Transfers Revised Estimates shown to Supplemental Regular PART I - ADMINISTRATIVE BUDGET in 01j. Rec. 18 Estimates Estimates US $ US $ US $ World Health Assembly 190,000 12,500 * 177,500 Executive Board 64,000 12,500 * 51,500 Administrative Expenses 1,403,995 215,120 1,188,875 TOTAL DECREASE PART I 240,120

PART II - OPERATING BUDGET

Maternal and Child Health 331,050 46,660 284,390 Malaria ** 439,255 64,600 374,655 Environmental Sanitation 268,235 51,600 216,635 Venereal Diseases 429,415 92,400 337,015 Tuberculosis 363,040 22,600 340,440 Public Health Administration ** 161,080 16,000 145,080 Nutrition 72,440 9,000 63,440 Mental Health 217,180 43,000 174,180 Technical Training of Medical and Auxiliary Personnel 868,080 88,700 779,380 Publications *" 483,255 39,600 443,655 Epidemiological Studies 95,515 - 95,515 Co-ordination of Research 101,060 36,800 64,260 Medical Literature, Teaching Equipment and Programme Medical Supplies 309,875 75,000 234,855 Common Services (Operating) 505,480 79,700 425,780 Expert Committees 303,815 50,000 253,815 Operating Supervisory Staff 279,850 ' 13,000 266,850 Regional Offices 952,535 50,000 902,535 TOTAL DECREASE PART II 778,660 TOTAL DECREASE PARTS I and II 1,018,780

Appendix 2

SUMMARY OF REVISED BUDGET ESTIMATES FOR THE FINANCIAL YEAR 1 JANUARY-31 DECEMBER 1950

PART I - REGULAR AND SUPPLEMENTAL ADMINISTRATIVE BUDGET ESTIMATES

EstimatedExpenditure X950 Regular supplemental Uss US $ SECTION 1 ORGANIZATIONAL MEETINGS Chapter 1.1 World Health Assembly 177,500 Chapter 1.2Executive Board and Committees 51,500 TOTAL SECTION 1 229,000

SECTION 2 ADMINISTRATIVE EXPENSES 1,188,875 340,120 TOTAL PART I 1,417,875 340,120

Decrease from the regular estimates only.This amount was not transfered to the supplemental budget Provision has been made under these headings for estimated expenditure of $50,000 for the Palestine refugee programme No provision has been made in the supplemental estimates for the International Health Yearbook - 47 - DECISIONS AND RESOLUTIONS

PART II - REGULAR AA]) SUPPLEMENTAL OPERATING PROGRAMME BUDGET ESTIMATES

EstimatedExpenditure 1950 Regular Supplemental Uss US $ SECTION 3 OPERATING PROGRAMMES Chapter 3.1 Operating Supervisory staff 266,850 13,000 Chapter 3.2 Regional Offices 902,535 50,000 Chapter 3.3 Other Offices 71,925 - Chapter 3.4Advisory and Demonstration Services to Governments 1,819,870 6,845,770 Chapter 3.5Technical Training of Medical and Auxiliary Personnel 779,380 2,033,905 Chapter 3.6Medical Literature and Teaching Equipment 75,000 175,000 Chapter 3.7 Technical Services 1,373,470 344,370 Chapter 3.8Expert Committees 253,815 263,825 Chapter 3.9 Supplies to Governments 115,000 385,000 Chapter 3.10 Common Services for Part II except Chapters 3.2 and 3.3 . 425,780 173,420 TOTAL PART II 6,083,625 10,284,290 TOTAL PARTS I and II 7,501,500 10,624,410

Deduct :Available from UNRRA Fund 400,000 Casual Income 47,500 Estimatedcontributionsfor1949from new Members 54,000 501,500 Regular Budget - Health Assembly appropriation 7,000,000

HA2.79.Supplemental Operating Programme of Advisory and Technical Services :Priority Items The Second World Health Assembly INSTRUCTS the Executive Board, in implementing the Supplemental Operating Programme, to give major consideration to : (1)those items transferred from the Regular Operating Programme and such part of the administrative provisions therefor as may be appropriate ; P) strengthening or augmenting technical services ; (3)technical training of medical and auxiliary personnel ; (4)malaria, maternal and child health, environmental sanitation, venereal diseases, tuberculosis and nutrition ; (5)programme supply advisory services. (ThirdreportofJointMeetings, adopted at tenth plenary meeting)

- 48 - RESOLUTIONS ADOPTED ON THE REPORTS OF THE COMMITTEE ON CONSTITUTIONAL MATTERS

WHA2.80.Procedure for the Nomination and Election of Members entitled to designate a Person to serve on the Executive Board The Second World Health Assembly (1)ADOPTS the report of the Executive Board in which it is recommended that Chapter VI of the Constitution be preserved and which defines certain principles to govern the selection of Members entitled to designate persons to serve on the Executive Board ; 84 (2)ADOPTS also the amended and supplementary Rules of Procedure of the Health Assembly, which are appended to the Board's report ; 85and (3)INVITES the General Committee, when nominating Members for election by the Assembly, to take into account the views expressed during the discussion in the Com- mittee on Constitutional Matters regarding the principles defined by the Board and the interpretation of Articles 79 and 80 of these Rules of Procedure.86 (First report of Committee on Con- stitutional Matters, adopted at eighth plenary meeting)

WHA2.81.Approval of the Agreement with the Government of India The Second World Health Assembly, Acting in pursuance of Chapter XV of the Constitution, (1)APPROVES the draft agreement between the Government of India and the World Health Organization concerning the privileges and immunities and facilities to be granted by the Government of India to the World Health Organization with regard to its arrange- ments in the South-East Asia Region ; 87 (2)AUTHORIZES the Director-General or his representative to sign the said agreement on behalf of the World Health Assembly ; (3)REQUESTS the Director-General or his representative in furtherance of Article XII, Section 33 of the said agreement to notify the Government of India of the approval of the said agreement by the World Health AsseMbly. (Second Report of Committee on Con- stitutional Matters, adopted at eighth plenary meeting)

WHA2.82.Negotiations for au Agreement with the Government of Egypt The Second World Health Assembly RESOLVES (1)that the Director-General be invited to continue negotiations with the Government of Egypt in order to obtain an agreement extending privileges and immunities to the Regional Organization of WHO in the Eastern Mediterranean Area, including those persons properly taking .part, in order to carry out its functions, having regard to the proper interests of the Government of Egypt and having regard to agreements of the same nature which are in force and which have been concluded between the " host " governments and international organizations in several countries ; (2)that as a provisional measure, and until such agreement comes into force, the Government of Egypt be invited to extend to the Regional Organization established

84 011. Rec. World 111th Org. 14, 29, 66 85 Off. Rec. World Illth Org. 14, 66, 67 86 See minutes of the Committee on Constitutional Matters : third meeting, p.292 section 3; fourth meeting, p. 295, section 1. " See Annex 11. - 49 - DECISIONS AND RESOLUTIONS

on its territory, including those persons properly taking part, the privileges and immu- nities contained in the general Convention on the Privileges and Immunities of the Specialized Agencies, including Annex VII ; 8 (3)that the Director-General be requested to report on the results of negotiations at the next session of the Executive Board. (Second report of Committee on Con- stitutional Matters, adopted at ninth plenary meeting)

WHA2.83.Situation with regard to the Office International d'Hygiène Publique Whereas forty-nine States have accepted the Protocol of 1946 8 9 regarding the Office International d'Hygiène Publique ; Whereas a certain number of parties to the Rome Agreement of 1907 have not yet accepted the Protocol or have not otherwise taken steps to denounce the said Agreement ; Whereas it is desirable to terminate the Rome Agreement of 1907 and to transfer to WHO, after the complete liquidation of the Office, all its tasks and functions as well as the assets and liabilities concerned ; Whereas, certain governments, parties to the Rome Agreement of 1907, may be unable to proceed to the denunciation of the said Agreement ; The Second World Health Assembly INVITES (1)those parties to the Agreement of 1907 which have not already done so, to denounce the said Agreement, and if possible, to accept the Protocol of 1946 ; (2)those governments which are competent to act on behalf of any party not now in a position to act for itself, to denounce the Agreement of 1907 and to agree to the dis- solution of the Office on behalf of that party ; (3)those governments which are responsible for the conduct of the international rela- tions of any non-self-governing territories and which acceded to the Agreement of 1907 on behalf of any such territories, to denounce the Agreement of 1907 and agree to the dissolution of the Office on behalf of any such territories ; (4)the Executive Board and the Director-General of WHO to keep in touch with the Office International d'Hygiène Publique and to give their assistance if required in settling the situation which might arise should certain governments, parties to the Rome Agree- ment of 1907, be unable to denounce the said Agreement ; (5)the Director-General of WHO to inform without delay all interested governments of the text of the present resolution, for such purposes as they may deem fit. (Second report of Committee on Con- stitutional Matters, adopted at ninth plenary meeting)

WHA2.84. Amendments to Regulations and Rules of Procedure for Expert Committees and their Sub-Committees The Second World Health Assembly ADOPTS the additions and amendments to the Regulations and Rules of Procedure for Expert Committees and their Sub-Committees as approved by the Executive Board at its third session."' (Third report of Committee on Con- stitutional Matters, adopted at ninth plenary meeting)

88 011. Rec. World Hlth Org. 10, 111 ; 13, 364.The full text of the Convention, including Annex VII, is reproduced in the Handbook of Basic Documents. " For text, see oil. Rec. World Hlth Org. 2, 113. 9° 05. Rec. World Hlth Org. 17, 40 - 50 - DECISIONS AND RESOLUTIONS

WHA2.85.Policy on Invitations to appoint Members to Governing Bodies of Health Organiza- tions : London School of Hygiene and Tropical Medicine The Second World Health Assembly (1)ADOPTSthe policy that the World Health Organization cannot accept any invitation to appoint members to the governing bodies of health institutions or national health organizations ; (2)REQUESTSthe Director-General to thank the London School of Hygiene and Tropical Medicine for its invitation,91 and to inform the School that, in view of the principles involved, the World Health Organization cannot accept the invitation to appoint a member to the Court of Governors of the School. (Third report of Committee on Con- stitutional Matters, adopted at ninth plenary meeting) WHA2.86.Hygiene of Housing The Second World Health Assembly

(1)NOTESthe activities begun by WHO in the field of the hygiene of housing ; 92and (2)REQUESTSthe Director-General to continue these activities. (Third report of Committee on Con- stitutional Matters, adopted at ninth plenary meeting)

WHA2.87.Relations with the Specialized Agencies of the United Nations The Second World Health Assembly (1)EXPRESSESits satisfaction with the work achieved by WHO during the past year in its relations with the specialized agencies of the United Nations ; and (2)REQUESTSthat full co-operation in this field should be continued, with particular attention to the further development of such co-operation at the secretariat level during the planning stage. (Third reportof Committee on Con- stitutional Matters, adopted at ninth plenary meeting)

WHA2.88.Relations with the International Trade Organization The Second World Health Assembly APPROVESthe continuation of relations with the Interim Commission of the Inter- national Trade Organization on the basis of the letters exchanged by the Director- General of WHO and the Executive Secretary of the Interim Commission of IT0.93 (Third report of Committee on Con- stitutional Matters, adopted at ninth plenary meeting)

WHA2.89.Relations with the Intergovernmental Maritime Consultative Organization The Second World Health Assembly DECIDESthat for the time being, until the convening of the First Assembly of the International Maritime Consultative Organization, contact with this organization shall be maintained at the secretariat level, for the exchange of documents and the study of common problems. (Third report of Committee on Con- stitutional Matters, adopted at ninth plenary meeting)

91 Off Rec. World Hlth Org.14,27 and the minutes of the sixth meeting of the Committee on Constitutional Matters, p. 303, section 3 92 Ofi. Rec. World Hlth Org.14, 20 "011.Rec. World Hlth Org.14, 60 - 51 - DECISIONS AND RESOLUTIONS

WHA2.90.Action taken by certain Countries with regard to Membership of WHO Whereas the Vice-Minister of Health of the Union of Soviet Socialist Republics, the Vice-Minister of Health of the Ukrainian Soviet Socialist Republic and the Vice- Minister of Health of the Byelorussian Soviet Socialist Republic, expressing their dis- satisfaction with certain aspects of the work of WHO, have notified the Director-General that their States no longer consider themselves Members of the World Health Organ- ization ; Whereas the objective of the World Health Organization is the attainment by all peoples of the highest possible level of health, which involves the co-operation of all countries ;and Whereas this principle has been proclaimed by these States at the First World Health Assembly, The Second World Health Assembly, Regretting deeply the absence of representatives of these States from the Assembly and, in the case of the Union of Soviet Socialist Republics and the Byelorussian Soviet Socialist Republic, of members of the Executive Board ; Recognizing the consequent loss to the work of the Organization ;and Taking note of the observations in the communications sent to the Director- General ; 94 and Hoping that these States will in the near future wish to reconsider their position, (1)INVITES them to reconsider their intention and join if possible the present and following sessions of the Health Assembly and, in the case of the Union of Soviet Socialist Republics and the Byelorussian Soviet Socialist Republic, those of the Executive Board ; and in any event (2)Fully APPROVES the steps taken in this regard by the Executive Board and the Director-General ; 94. (3)REQUESTS the Chairman of the Executive Board and the Director-General to con- tinue endeavours to prevail upon the said States and their responsible authorities to change their decision and to report to the Third World Health Assembly on the results

of such endeavours ;and , (4)RECOMMENDS that States Members of the Organization take such steps as they may deem suitable in order that the said States may reconsider their decision. (Fourth report of Committee on Con- stitutional Matters, adopted at ninth plenary meeting)

WHA2.91.Approval of Agreement with the Pan American Sanitary Organization The Second World Health Assembly, Acting in pursuance of Chapter XI of the Constitution of the World Health Organ- ization (1)APPROVES the Agreement between the World Health Organization and the Pan American Sanitary Organization signed in Washington by the Director-General of the World Health Organization and the Director of the Pan American Sanitary Organization on 24 May 1949 ; 95 (2)DECLARES that the said Agreement shall have effect from 1 July 1949. (Fifth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.92.Recommendation on Accessions to the Convention on Privileges and Immunities The Second World Health Assembly, Considering the desirability of the application of the Convention on the Privileges and Immunities of the Specialized Agencies and its Annex VII 96 to the World Health Organization ; and, in particular,

54 011. Rec. World Ina Org. 17, 19, 52 95 See Annex 12. 96 oll. Rec. World filth Org.10, 111; 13, 364. The full text of the Convention, including Annex VII, is reproduced in the Handbook of Basic Documents. - 52 - DECISIONS AND RESOLUTIONS

Having regard to the necessity of conferring its benefits on the Organization and its staff while engaged on the programme of the Organization throughout the world, RECOMMENDS that Members should as soon as possible accede to this convention and, if necessary, take such legislative measures as may be necessary in order to extend its provisions to the World Health Organization. (Fifth reportof Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.93. WHO Regulations on Nomenclature, 1948 :proposed Amendment to Article 20 The Second World Health Assembly, Acting in pursuance of Article 23 of the Nomenclature Regulations, 1948," ADOPTS, this thirtieth day of June 1949, the Supplementary Regulations on Nomen- clature (including the compilation and publication of statistics) with respect to diseases and causes of death." (Fifth reportof Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.94.Adoption of Amendments to the Rules of Procedure of the World Health Assembly The Second World Health Assembly ADOPTS the additions and amendments to the Rules of Procedure of the World Health Assembly as approved by the Executive Board at its third session." (Fifth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.95.Proposed Amendments to the Rules of Procedure of the World Health Assembly The Second World Health Assembly REQUESTS the Executive Board to examine the additional amendments to the Rules of Procedure of the World Health Assembly, proposed by the Government of Belgium 1" and to report to the Third World Health Assembly. (Fifth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.96.Assignment of Greece to the European Regional Area The Second World Health Assembly, Having considered the request of the Greek Government for inclusion of Greece in Regional Organization Area 4,101 RESOLVES that Greece shall from now on form part of Regional Organization Area 4, which comprises countries of the European continent. (Fifth reportof Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

97 011. Rec. World Hlth Org. 13, 352 98 See Annex 13. " 011. Rec. World Hlth Org. 17, 19, 53 1" See minutes of ninth meeting of Committee on Constitutional Matters, p. 310, Section 6. 101 Off Rec. World Hlth Org. 17, 17 - 53 - DECISIONS AND RESOLUTIONS

WHA2.97.Regional Organization :Western Pacific Area The Second World Health Assembly, Having considered the proposal by the Delegation of the Philippine Republic for the establishment of a Regional Organization for the Western Pacific Region,102 NOTESthis proposal. (Fifth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.98.Application for Membership of WHO :San Marino Whereas the Republic of San Marino has announced that it cannot withdraw its reservation concerning the question of its financial contribution to the World Health Organization, should its application for membership be accepted, The Second World Health Assembly REGRETSnot being able to accept San Marino's application for membership in the World Health Organization with such reservation. (Sixth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.99.Admission of Korea (South)

The Second World Health Assembly RESOLVESthat the request for admission to the World Health Organization presented by the Government of Korea (South) 1°3 be accepted. (Sixth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.100.Inter-Organization Agreements :Correction of the French Texts The Second World Health Assembly, Having regard to the resolutions of 10 and 17 July 1948 of the First Health Assembly, approving the draft agreements between the World Health Organization on the one part and the United Nations, the International Labour Organization and the United Nations Educational, Scientific and Cultural Organization on the other part ; 104 Noting that the texts of these agreements in the French language are not in con- formity with the texts 105 as previously approved by the General Assembly of the United Nations on 15 November 1947, by the Governing Body of ILO on 15 December 1947 and by the Executive Board of UNESCO on 15 July 1948, RESOLVESthat these texts be replaced by the texts which are annexed I" which will be considered to have had effect as from 10 July 1948. (Sixth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting) 102 See minutes of the ninth meeting of the Committee on Constitutional Matters, p. 311, Section 8. 103 See Resolution 195 (III), 12 December 1948, of the General Assembly of the United Nations. 104 pg. Rec. World Hlth Org. 13, 321, 322, 323 105 Off. Rec. World Hlth Org. 10, 59, 73, 76 106 Annex 25, to French text only - 54 - DECISIONS AND RESOLUTIONS

WHA2.101.Agreement with ILOArticle VII The Second World Health Assembly, Having reconsidered the proposed substitution of the words " involves or would involve " for the words " would involve ", in the Agreement between the International Labour Organization and the World Health Organization ; 127 Noting that the substitution would make little difference to the Agreement, and would probably require similar amendments to a number of other agreements to which ILO is a party, DECIDES not to urge the proposed alteration of Article VII. (Sixth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.102. Amendment to the Rules of Procedure of the World Health Assembly concerning the Status of Associate Members The Second World Health Assembly, Having regard to the resolution of the First World Health Assembly of 21 July 1948 concerning the rights and obligations of Associate Members,122 ADOPTS the Amendments to the Rules of Procedure of the World Health Assembly concerning the Status of Associate Members.122 (Sixth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.103.Rights and Obligations of Associate Members and other Territories in Regional Organizations The Second World Health Assembly, Having regard to Articles 8 and 47 of the Constitution ;and Having regard to paragraph 4 of the resolution of the First World Health Assembly concerning the rights and obligations of Associate Members ; 110and Having regard to the reports of the Executive Board at its second and third sessions ; 111and Having regard to a statement concerning the Pan American Sanitary Organi- zation,112 RESOLVES as follows : 1. For the purposes of Article 47 of the Constitution, States Members in a region shall be deemed to be those States Members having their seat of government within the region ; 2. Those States Members not having their seat of government within the region, which (a) either by reason of their Constitution consider certain territories or groups of terri- tories in the region as part of their national territory, or (b) are responsible for the conduct of the international relations of territories or groups of territories within the region, shall participate as Members of the Regional Committee, in which case they shall have all the rights, privileges and obligations of Member States in the region, but with only one vote for all the territories or groups of territories in the region, as defined in (a) and (b) above ; 3. (1)Territories or groups of territories in the region which are not responsible for the conduct of their international relations, whether Associate Members or other- wise, may participate in Regional Committees, in accordance with Articles 8 and 47 of the Constitution ; 121 Off. Rec. World Hlth Org. 13,322 108 Off. Rec. World Hlth Org. 13,337 122 Off. Rec. World Hlth Org. 14,64 1" Off. Rec. World Hlth Org. 13,337 111 oll. Rec. World Hlth Org. 14,26,54 ;17,17 112 See Annex 14. - 55 - DECISIONS AND RESOLUTIONS

(2)Associate Members shall have all rights and obligations in the Regional Organ- izations, with the exception that they will have no vote in plenary meetings of the Regional Committee, nor in subdivisions dealing with finance or constitutional matters ; (3)Representatives of Associate Members should be qualified by their technical competence in the field of health and should be chosen from the native population in accordance with Article 8 of the Constitution ; (4)In the case of territories not responsible for the conduct of their international relations and not Associate Members, the rights and obligations in (2) above shall apply subject to consultation between the States Members in a region as defined in 1 above and the Members or other authority having responsibility for the international relations of these territories ; (5)In recommending any additional appropriation under Article 50 (f)of the Constitution, the Regional Committee shall take account of the difference in status between States Members on the one hand and Associate Members and other territories or groups of territories not responsible for the conduct of their international rela- tions, on the other ; 4. In view of the statement made by the Director of the Pan American Sanitary Organization 113 and of the fact that integration between PASO and WHO isstill in process, the application of the above recommendation in the American Region shall await the completion of these negotiations for such integration ; 5.The Executive Board should keep under review the implementation of these decisions and submit to the Fifth World Health Assembly at the latest, a report thereon in order that that Assembly might determine what, if any, modifications might be required in the above decisions in the light of experience. (Sixth report of Committee of Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.104.Regional Organization : African Area The Second World Health Assembly, Having considered the question of the' establishment of a Regional Organization for Africa ;and Having regard to its decision relating to the definition of Member States in Regional Organizations and the rights and obligations of Associate Members and other territories in Regional Organizations,114 NOTES and DRAWS TO THE ATTENTION of the Director-General the discussion Con- cerning consultation with Member States in the Region and with Member. States which may participate as Members in the Regional Committee, in regard to the establishment of a Regional Organization for Africa.116 (Sixth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

WHA2.105.Convention on Privilege and Immunities : Extension to Representatives of Associate Members and of other Territories The Second World Health Assembly

(1)AGREES in principle that the application of the Convention on the Privileges and Immunities of the Specialized Agencies, together with its Annex VI1,116 should be extended to representatives of Associate Members in the World Health Assembly, and

113 See Annex 14. 114 See Resolutions WHA2.103 and WHA2.105. 115 See minutes of the twelfth meeting of the Committee on Constitutional Matters, p. 318, Section 1. 115 011. Rec. World Hlth Org. 10, 111; 13, 364. The full text of the Convention, including Annex VII, is reproduced in the Handbook of Basic Documents. - 56 --- DECISIONS AND RESOLUTIONS in Regional COmmittees to representatives both of Associate Members and of other territories or groups of territories not responsible for the conduct of their international relations, participating under the provisions of Article 47 of the Constitution ; and (2)REQUESTS the Executive Board to study the implementation of this principle and to submit a report with recommendations to the Third World Health Assembly. (Sixth report of Committee on Con- stitutional Matters, adopted at tenth plenary meeting)

- 57 -

PART II

PROCEEDINGS

[A2/1 Rev. 1 and A2/70] 12 May and 20. June 1949 AGENDA Supplementary items added to the agenda under Rule 6 of the Rules of Procedure of the World Health Assembly are marked with an asterisk.

1.Formal opening by the President of the First World Health Assembly 2.Welcome to delegations and observers by the Chief Delegate of the Government of Italy 3.Establishment of Committee on Credentials 4.Establishment of Committee on Nominations 5.Election of officers 5.1 President 5.2 Three Vice-Presidents 6.Presidential address 7.Adoption of the agenda 8.Establishment of Committee on Programme 9.Establishment of Committee on Constitutional Matters 10.Establishment of Committee on Administration and Finance 11.Establishment of General Committee 12.Admission of new Members 13.Report of the Director-General 14.Reports of Executive Board 15.Reports of the main committees 16.Election of Members entitled to designate a person to serve on the Executive Board 17.Third World Health Assembly 18.Other business 19 . Adjournment

8. COMMITTEE ON PROGRAMME

8.1Election of Chairman and Vice-Chairman 8.2Election of Rapporteur 8.3Procedure for examination of Programme and Budget for 1950 8.4Report of the Director-General

8.5Malaria 8.5.1Expert Committee on Malaria :report on the second session 8.5.2Ouarantine regulations for prevention of re-importation of anophelines 8.5.3Activities with the United Nations,specialized agencies or non-governmental organizations 8.5.3.1Joint action programme of FAO/WHO to increase world food production and raise standards of health 8.5.4Programme for 1950

8. 6Tuberculosis 8.6 .1Expert Committee on Tuberculosis : report on the third session 8.6.2Activities with the United Nations,specialized agenciesor non-governmental organizations 8.6.3Tuberculosis Research Group 8.6.4Programme for 1950 - 61 - AGENDA

8.7Maternal and Child Health 8.7.1Expert Committee on Maternal and Child Health : report on the first session 8.7.2Activities with the United Nations, specialized agencies or non-governmental organizations 8.7.3Programme for 1950

8.8Venereal Diseases 8.8.1Expert Committee on Venereal Diseases : report on the second session 8.8.2Activities with the United Nations, specialized agencies or non-governmental organizations 8.8.3Programme for 1950

8.9Nutrition 8.9.1Activities with the United Nations,specialized agencies or non-governmental organizations 8.9.1.1Progress report on the Joint FAO/WHO Expert Committee on Nutrition 8.9.2Programme for 1950

8.10Environmental Sanitation 8.10.1Report on the establishment of an expert committee 8.10.2Activities with the United Nations, specialized agencies or non-governmental organizations 8.10.3Programme for 1950

8.11Publie-Health Administration 8.11.1Establishment of an expert committee on nursing 8.11.2Activities with the United Nations, specialized agencies or non-governmental organizations 8.11.2.1Report on the Joint ILO/WHO Expert Committee on Occupational Hygiene 8.11.2.2Report on the Joint ILO/WHO Expert Committee on Hygiene of Seafarers 8.11.3Stomatology and dental hygiene 8.11.4Physical training 8.11.5Programme for 1950

8.12Health Demonstration Areas 8.12.1Programme for 1950

8.13Training, Education and Fellowships 8.13.1Activities with the United Nations, specialized agencies or non-governmental organizations 8.13.1.1Co-ordination of international congresses of medical sciences - proposed collabo- ration with the Permanent Council 8.13.1.2Programme for 1950 8.13.2Technical training of medical and auxiliary personnel 8.13.2.1Programme for 1950 8,13.3Health education of the public - programme for 1950

8.14Mental Health 8.14.1Report on the nuclear expert committee on mental health 8.14.2Activities with the United Nations, specialized agencies or non-governmental organizations 8.14.3Programme for 1950 - 62 - AGENDA

8.15Epidemiological Services 8.15.1Revision of the international sanitary conventions 8.15.1.1Expert Committee on International Epidemiology and Quarantine :report on the first session 8 .15 .1 .1 .1Principles to govern WHO Sanitary Regulations 8.15.1.2Programme for 1950 8.15 .2Administration of the international sanitary conventions 8.15.2.1Section on Quarantine of the Expert Committee on International Epidemiology and Quarantine : report on the first session 8 .15 .2 .2Epidemiological notifications and information, including extension of radio- telegraphic system of epidemiological bulletins 8 .15 .3International epidemic control 8 .15.3 .1 Cholera 8.15 .3 .1 .1Report of the study-group 8.15 .3 .1 .2Programme for 1950 8 .15 .3.2Plague 8 .15 .3 .2 .1Report of the study-group 8.15 .3 .2 .2Programme for 1950 8.15.3.3Typhus and other rickettsioses 8 .15 .3 .3 .1Report of the study-group 8.15 .3 .3 .2Programme for 1950 for both typhus and relapsing fever 8.15.3.4Smallpox 8.15 .3 .4 .1Report of the study-group 8.15 .3 .4 .2Programme for 1950 8 .15 .3 .5Yellow Fever 8 .15 .3 .5 .1Programme for 1950 8.15 .3 .6Filariasis, onchocerciasis - programme for 1950 8 .15 .3 .7Leishmaniasis - programme for 1950 8.15 .3 .8Schistosomiasis - programme for 1950 8 .15 .3 .9Poliomyelitis - organization of the international exchange of iron lungs 8 .15 .3 .10Trachoma 8 .15 .3 .10 .1Report of the study-group 8 .15 .3 .10 .2Programme for 1950 8 .15 .3 .11Rabies - programme for 1950 8 .15 .3 .12Brucellosis - setting-up of national centres 8.15 .3 .13Immunization against common communicable diseases of childhood - pro- gramme for 1950 8 .15 .3 .14Insecticides 8.15 .3 .14 .1Expert Committee on Insecticides : report on the first session *8.15 .3 .15Leprosy (item proposed by the Government of India) 8.16Co-ordination of Research and Therapeutic Substances 8.16.1Biological standardization 8.16.1.1Expert Committee on Biological Standardization : report of the third session 8.16.1.2Programme for 1950 8.16.2Unification of pharmacopoeias 8 .16 .2 .1Expert Committee on the Unification of Pharmacopoeias : reports on the third and fourth sessions 8 .16 .2 .2Programme for 1950 8.16.3Habit-forming drugs 8.16.3.1Report of the Expert Committee on Habit-forming Drugs : report on the first session 8.16.3.2Programme for 1950 8.16 .4Co-ordination of research 8.16.4.1Expert Committee on Antibiotics 8.16.4.2World Influenza Centre 8.16.4.3International Salmonella Centre 8.16.4.4Programme for 1950 - 63 - AGENDA

8.17Health Statistics 8.17.1Expert Committee on Health Statistics : report onthe first session 8.17.2Activities with the United Nations, specializedagencies or non-governmental organizations 8.17.3Programme for 1950

8.18Medical Supplies Section 8.18.1Medical literature and teaching material 8.18 .2Insulin 8.18.3Activities with the United Nations, specialized agencies or non-governmental organizations 8.18.4Programme for 1950

8.19Regional Offices 8.19.1Status of regional offices 8.19.1.1South-East Asia 8.19.1.2Eastern Mediterranean 8.19.1.3The Americas 8.19.1.4Europe 8.19.1.5Africa 8.19.1.6Western Pacific *8.19.1.6.1Proposal by the Delegationof the Philippines for the establishment of a regional organization for the Western Pacific Region 8.19.2Special Office for Europe 8.19.2.1Co-operation with the Economic Commission for Europe 8.19.2.2Report on the rehabilitation of UNRRA penicillin plants 8.19.2.3Availability of medical supplies in Europe 8.19.2.4Availability of technical knowledge of production processes of antibiotics : peni- cillin, streptomycin, chloromycetin, aureomycin (item proposed by the Govern- ment of Poland)

8.20Editorial and Reference Services 8.20.1Publications 8.20.1.1Programme for 1950 8.20.1.1.1Bulletin of the World Health Organization 8.20.1.1.2Chronicle of the World Health Organization 8.20.1.1.3International Digest of Health Legislation 8.20.1.1.4Weekly Epidemiological Record 8.20.1.1.5Epidemiological and Vital Statistics Report 8.20.1.1.6International Health Yearbook 8.20.1.1.7Epidemiological Telegraphic Code (Codepid) 8.20.1.1.8Annual Epidemiological and Vital Statistics 8.20.1.1.9Supplements to the Bulletin and monographs 8.20.1.1.9.1Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death 8.20.1.1.9.2International Pharmacopoeia 8.20.1.1.10Treatment and control manuals 8.20.1.1.11International List of Treatment Centres for Venereal Diseases under the Brussels Agreement 8.20.1.1.12Statistical handbooks 8.20.1.1.13Weekly Fasciculus of the Epidemiological Intelligence Station 8.20.1.1.14Official Records of the World Health Organization 8.20.2Library and reference services - programme for 1950 8.20.3Activities with the United Nations, specialized agencies or non-governmental organizations - 64 - AGENDA

8.20.3.1United Nations Library, Geneva 8.20.3.2Medical and biological abstracting - collaboration with UNESCO

8.21 Activities with United Nations, Specialized Agencies, or Non-Governmental Organizations 8.21.1Co-ordination - general 8.21.2Joint Committee on Health Policy, UNICEF/WHO 8.21.2.1Report by WHO members on the assumption by WHO of responsibility for the UNICEF health projects, and on the functioning of the joint committee 8.21.3Resolution of the Economic and Social Council on technical assistance 8.21.4United Nations project for relief of Palestine refugees 8.21.5United Nations proposal to create international research laboratories 8.22World Health Day 8.23Programme and Budget for 1950 : joint meeting with Committee on Administration and Finance *8.24Proposal by the delegation of Greece on the assistance to be given to displaced persons in that country

9.COMMITTEE ON CONSTITUTIONAL MATTERS

9.1Election of Chairman and Vice-Chairman 9.2Election of Rapporteur 9.3Report of the Director-General 9.4Action taken by certain countries with regard to membership of WHO 9.5 Assembly 9.5.1Concerning status of Associate Members 9.5.2Nomination and election of Members entitled to designate a person to serve on the Executive Board 9.5 .3Other amendments *9.5.4Additional amendments proposed by the Government of Belgium 9.6Amendments to the Regulations and the Rules of Procedure for expert committees and their sub-committees 9.7Agreement with the Government of India 9.8Agreement with the Government of Egypt 9.9Agreement with the Pan American Sanitary Organization 9 .10Convention on the Privileges and Immunities of the Specialized Agencies 9 .10 .1Its application in territories of Associate Members 9.10.2Its application in non-self-governing territories or groups of territories 9 .11Rights and obligations in regional organizations 9.11.1Associate Members 9 .11 .2Territories or groups of territories which are not responsible for the conduct of their international affairs 9 .12Report on situation with regard to OIHP 9.13Request for reconsideration of assignment to geographical region (Greece) 9.14Policy on invitations to appoint members to governing bodies of health organizations (request from London School of Hygiene and Tropical Medicine) 9.15Committee on the Hygiene of Housing of the American Public Health Association 9 .16Relations with specialized agencies 9 .16 .1International Trade Organization 9 .16 .2Intergovernmental Maritime Consultative Organization - 65 - AGENDA

9 .16 .3Inter-organization agreements : correction 'of French texts *9.16 .4Agreement between the International Labour Organization and WHO : amendment to Article VII *9 .16 .5Accessions to the General Convention on the Privileges and Immunities of the Specialized Agencies *9.17Nomenclature Regulations 1948 :proposed amendments to Article 20

10. COMMITTEE ON ADMINISTRATION AND FINANCE

10.1Election of Chairman and Vice-Chairman 10.2Election of Rapporteur 10.3Procedure for examination of the Programme and Budget for 1950 10.4Report of the Director-General 10 .5Administrative and financial relations between the United Nations and specialized agencies 10.6Financial responsibilities of the Executive Board (item proposed by the United King- dom delegation) 10.7Transportation and/or per diem allowance for delegates to the third and subsequent Health Assemblies 10.7.1Insurance against travel accidents of delegates to the Health Assembly and of members of the Executive Board 10 .8Director-General's contract with respect to the representation allowance as discussed at the second session of the Executive Board 10.9Proposed amendments to the Provisional Staff Regulations *10.9.1Additional proposals by the Government of Belgium 10.10Election of members and alternate members of the Organization's Staff Benefit Committee 10.11Arrangements for accommodation for Headquarters Office 10.12 Financial Report and accounts of the Interim Commission for the financial period 1 January to 31 August 1948 and the report of the External Auditor 10.12 1 Report of the Executive Board on the audit report 10.13Financial Report and accounts of the World Health Organization for the financial period 1 September to 31 December 1948 and the report of the External Auditor 10.13 1Report of the Executive Board on the audit report 10.14Report of the Director-General on the feasibility of using the United Nations Board of Auditors, and appointment of the External Auditor for 1950 10.15Status of contributions to the budget for 1948 10.16Status of contributions to the budget for 1949 10.17Report on the working capital fund and assessment of new Members 10.18Budget estimates for the proposed 1950 Programme 10.19Programme and Budget for 1950 - joint meeting with Committee on Programme 10.20Scale of assessments for 1950 10.21 Currency of contributions *10.22 Report on reimbursement by governments for materials, supplies and equipment furnished by the Organization in connexion with advisory and demonstration services to governments

- 66 - VERBATIM RECORDS OF THE PLENARY MEETINGS

FIRST PLENARY MEETING Monday, 13 June 1949, at 11 a.m. Acting President: Dr. Andrija STAMPAR (Yugoslavia)

1. Opening of Session by the President of thenot to remain without shadows.Thefirst First World Health Assembly disappointment came when the ratifications hung The ACTING PRESIDENT : It iS my privilege, as fire and we had to wait for almost two years before President of the first session of the World Healththe Organization became a permanent one. Then Assembly, to open its second session.My firstthe tide of ratifications began to turn : during our thoughts are of gratitude to the Italian Govern-Assembly's first session they had passed 50, and ment for having offered to our Assembly theby now they have reached 62, thus making our hospitality of this ancient city, which has beenOrganization rank among those with the largest not only of great importance in the history ofmembership of all. mankind but whose medical traditions also stand But the awareness of the growth of our Organi- very high in their antiquity and significance.zation should not make us forget those shadows They have indeed never been interrupted sincethat have fallen upon it.There was first the Galen. acceptance of the Constitution with reservations ; But thisbeautiful country was not only,then the declaration by some Members that they together with Greece, the cradle of classicaldid not consider themselves Members any more ; medicine.Think only of Vesalius, who laid inthe inadequate financial means at our disposal Padua the foundations of modern medicine ;and the great delays with which Members are of Ramazzini, one of the originators of the socialfulfilling their financial obligations.I think you outlook in medicine ;of Morgagni, the founderwill forgive me if I speak to you frankly about of pathologic anatomy ; think of all those famousthese matters.Many of you hdve known me old medical schools at Salerno, Padua, Bolognasince we started to lay the foundations of the and elsewhere, attracting students from far andWorld Health Organization. Nevertheless, I feel wide.And then, think of all the outstandingconfident about its future, provided that we, all work accomplished in this country in the field ofnations large and small,co-operate honestly sanitation, right from the huge Roman aqueductand devotedly in a truly international spirit to the exemplary fight against malaria beguntowards the achievement of the great and noble by Italian scientists in the nineteenth century :tasks set forth in the Preamble to our Constitu- a splendid example of the victories science cantion. achieve in the fight against diseases, which through I should also like to take this opportunity to centuries were sapping the vital forces of mankind.thank you for the confidence shown me from the Finally, think of the agreement signed in Romebeginnings of our Organization.It has been a on the establishment of the Office Internationalgreat honour for me to be with you and to d'Hygiène Publique in Paris. contribute whatever I could to the progress of I hope you will soon be able to proceed to theour undertaking. constitution of this Second Assembly and then to deal successfully with the manifold and great tasks awaiting you in your agenda.I trust you2. Address by the President of the Italian will succeed in further strengthening our Organiza- Council of Ministers tion and the foundations of international health The ACTING PRESIDENT : The next speaker is work in general. His Excellency Signor Alcide de Gasperi, Pre- If I think back to June 1946 in New York, whensident of the Council of Ministers. we were drafting the Constitution of our Organiza- tion,' I remember our optimistic confidence. We Signor DE GASPERI(translationfromthe were conscious of building an instrument whichItalian) : I desire to welcome, on behalf of the would make it possible for the peoples to solve,Italian Government, the many members who are in a spirit of true international co-operation, manytaking part in this Assembly.I wish to pay a problems which are truly global and thus makespecial tribute to the distinguished men who are the world a better and in every respect a healthiergathered here and whose names are rightly place to live in.However, this bright vista wasassociated with glorious victories in science.I International Health Conference,Off.Rec. offer my homage to the tireless fighters upon World Hlth Org. 2 whom Providence bestowed a genius for research - 67 - FIRST PLENARY MEETING and whose will has been made strong in the Italy has always been profoundly consciouS struggle against physical evil, which is, so oftenof the need to establish effective international the cause and the effect of moral evil. I would alsocollaboration in the domain of health. express my thanks to the World Health Organiza- It was, in fact, in Rome, as long ago as the year tion for having chosen Rome as the meeting1907, that the international conference was held place for its Second Assembly. which led to the creation of the Office Inter- In Italy we have many anxieties and arenational d'Hygiène Publique, one of the first tormented by many struggles, and even at timesinternational health organizations, with its seat oppressed by the long labour of reconstruction.in Paris. It is our duty to recall today with special But an unconquerable hope reigns in our midst.sympathy and admiration the extremely valuable In Italy you will observe that spirit of universalityand important work of this body. Italian experts which permeates all our history, all our philosophyin the various fields of health and hygiene lent of life and all our faith in the future. This spirittheir support to the Health Section of the League enables us fully to understand your striving for ofNations,whose achievementswereout- universality and your work for humanity, andstanding in the differentbranches of public above all, it will facilitate your task of applyingmedicine. the new methods that are being adopted in The World Health Organization, which arose combating epidemics and physicalsuffering,from the union of the various existing bodies, has methodsofwhichthisyoung internationaladded to the noble tasks of this international organization is the champion.Whereas in thecollaboration by setting before itself as its essential past we had recourse to sanitary cordons, todayobjective the raising of the level of the health and offensive and defensive campaigns are launchedhygiene of all peoples and by affirming anew the against diseases and epidemics at their source. right of every human being to the supreme blessing All nations are united in these efforts and theirof health and the enjoyment of life, which are the action is now directed from the centre ratheressential bases of all social progress. than from the extremities. In Italy, a country rich in able technicians and These fundamental humanitarian principles, by workers, where customs unions are in course ofwhich the Government of my country is also preparation and where the conception of theinspired, have found a full and enthusiastic United States of Europe finds fervent advocates,echo in the heart of our generous people which, by we have no difficulty in understanding and praisingshowing to the world the energy and vitality of your work, for you are the builders of a greatits magnificent work of reconstruction, has thus moral edifice. We are following and shall continueconfirmed its resolve to share in the tasks which to follow your labours with enthusiasm. You canthis Assembly proposes to carry out. rely on our full support and on our profound hope As High Commissioner of Hygiene and Public in the progress of humanity. We shall take thatHealth I cannot conceal my legitimate pride when deep interest in your proceedings which is rightlyI think of the road which Italy, in the course shown by a nation confident of the creation of aof a few years, has traversed in the realm of public better world. health. Nor can I fail to express my satisfaction at the results obtained, thanks to the generous aid of the United Nations and to the admirable sacrificeand longself-denialofthehealth 3. Address by the High Commissioner forpersonnel and the bodies dealing with public Hygiene and Public Health, Chief Delegate ofhealth. Italy During the difficult and sombre post-war years, Italy's health situation was far from enviable. The ACTING PRESIDENT : I call upon Professor In 1944, the general death-rate was 15.9 per Mario Cotellessa, High Commissioner for Hygienethousand inhabitants as against 13.4 in 1939, and and Public Health, and chief delegate of Italy.the infant mortality rate in the first year of life was 102 per thousand live births. Professor COTELLESSA (Italy) (translation from the Italian) : It is a great honour for me, on behalf The threat of exotic diseases was most serious : oftheItalianPublic-Health Administration,between 1944 and 1945 some 6,000 cases of small- to welcome the World Health Assembly. pox were recorded ;at Naples exanthematous typhus was raging, and at Taranto several cases Italy is happy and proud to offer hospitality of bubonic plague appeared.It would be useful, tothegreatestinternationalorganization,also, to give here a few figures concerning tuber- concerned with the most humane and the mostculosis : there were 208 deaths per hundred thou- beneficent of sciences, in the Eternal City, whichsand inhabitants. In 1945, the number of persons for centuries ensured the union of the peoples andsuffering from malaria was half a million. was the unfailing beacon of civilization. The universality of Rome accords perfectly In the work of reconstruction, sanitary rehabi- with this Assembly, which knows no politicallitation was rapid and decisive : long-term plans barriers and is only concerned with the commonwere drawn up within the framework of UNRRA effort to subdue and exterminate the diseases withto combat tuberculosis, malaria and trachoma ; which humanity is afflicted, and to lend the helpto re-establish the maritime health services ; of science wherever a cry of pain is heard or someto import the new antibiotics, such as penicillin dreaded evil makes its presence felt. and streptomycin ; to furnish the hospitals with - 68 - FIRST PLENARY MEETING the most urgently needed equipment ;to allowthe number ofpreventoria and tuberculosis the specialized hospitals to admit a larger numbersanatoria, the organizationof which isstill of patients, and to set up new establishments.insufficient and indeed almost non-existent in The tuberculosis death-rate in fact fell in 1948many southern areas. to 61.5 per hundred thousand inhabitants, i.e., The items on the agenda of the Second Health to a level considerably lower than that registeredAssembly indicate clearly that WHO is anxious before the war. to find a solution for the great health problems Some reallysurprisingresultshavebeencommon to all the countries represented at this obtained in the malaria campaign by means of ameeting. vast five-year plan which began in 1947, and We can now welcome the appearance of an which made it possible to treat with DDT all theinternational medicine which has evolved from Italian areas infested by malaria, thus protectingthe old defensive quarantine measures towards the population and bringing the morbidity downthe infinitely higher objective of a state of health to the pre-war level. and wellbeing for the whole world. Particular credit is due in this field to ERLAS Grandiose perspectives are opening up to the which, created under the auspices of the Rocke-beneficent science of life in this tormented period feller Foundation, has succeeded in conqueringof history, after a monstrous war which technical the agelong and almost Biblical scourge of theprogress exploited to spread misery and destruc- anopheles in Sardinia, and in restoring happiness tion. in the marshy areas where death was always at These objectives, founded on scientific possi- work. bilities and on the co-operation of associated The general death-rate and the infant mortalitygovernments, should not seem Utopian. rate have gone down in our time to a level The scientific possibilities of medicine are such previously unknown in Italy :the statistics ofthat they permit of vast and concrete results. the past year show, for the general death-rate,If, as we ardently desire, there is co-operation 10.5 per thousand inhabitants and, for the infantby all countries, we can proceed with the fullest mortality rate (children who died before theyconfidence towards our desired aims. reached the age of one), 71 per thousand live It is in this spirit that we are today beginning births. Even lower rates have been registered inour work, which I ardently hope will be crowned the city of Rome, whose population has increasedwith success, so that each government may and become denser to a remarkable extent inderive from it the guidance and the appropriate the course of the past few years. means, of action in the field of hygiene and public That is a success which crowns the efforts ofhealth for the benefit of peoples who aspire to a wise and patient health policy, the technicalhealth and wellbeing. and administrativeorganizationof whichis In this historic palace which, on the threshold constantly being improved. To increase stillof the Capitol and the Forums of ancient Rome and furthertheeffectivenessofthesemeasures,in the shadow of Christianity, is surmounted by reforms are being carried out which, by modifyingthe untamed image of the Lion of Venice, the and modernizing the structure of health adminis-spirits of our great masters of the past are still tration and by improving its various intricateliving and present among us today. parts, will bring even to the rural populations The warm sunlight which sends its strong the benefits of science, thanks to the perfectbeams through these ancient windows is at once working of its many branches. a guarantee and a happy augury that this Second The difficulties arising from the very nature ofAssembly of the World Health Organization of the country are enormous. They are still furtherthe United Nations, in the accomplishment of its increased owing to our slender economic resources. great task and its noble mission, will bring the A small territory, which has now almost reachedpromise of a fairer future to a humanity still the full limits of its agricultural development, hastormented by hatred and still suffering amidst to feed too large a population distributed un-ruins, and of a stronger unity in the work of equally throughout areas with markedly differentcivilization and peace. standards of living due to the very special geo- graphical configuration, which hinders the raising The ACTING PRESIDENT : We are all grateful of the social level and adds greatly to the problemsto His Excellency the President of the Italian of assistance. Republic and to Their Excellencies, the Prime This state of affairs governs our sanitary andMinister and Members of the Cabinet, for finding economic policy, which is designed to improvetime to attend our meeting. the health of the inhabited centres, many of Now we will adjourn for a few minutes. which, unfortunately, are still without water- The meeting adjournedat12.10 p.m.and mains or drainage. We also propose to curb theresumed at 12.25 p.m. impetuosity of the southern torrents, to reafforest our mountains and to win back step by step the4. Provisional Adoption of Amendments to the land which has been burned by drought and Rules of Procedure of the Health Assembly infested by malaria, to bring the villages into close relations with one another, to create health The ACTING PRESIDENT :I IMISt inform you centres in places where living conditions arethat the Executive Board has proposed certain least satisfactory, - to improve a defective andamendments to our Rules of Procedure.In the inadequate network of hospitals, and to increasedocument distributed to you, Report of the - 69 - SECOND PLENARY MEETING

Executive Board, Third Session-No. 17 of thethe Nominations Committee-a very important Ogicial Records of the World Health Organization-committee ;and without a Nominations Com- the amendments are printed on page 53.It ismittee it would be very difficult, of course, to very important that the Assembly adopt provi-constitute our Assembly, to elect the President sionally, at this time, the amended Rules ofand vice-presidents and chairmen of committees, Procedure ;otherwise we cannot proceed withand members of the General Committee from the our work. We have now only three main com- floor.Therefore please take this very seriously mittees in the Assembly, and instead of sixand present your letters and credentials as soon members of the General Committee elected fromas possible. the floor there will be eight.Therefore, I think We thus have to postpone the election of the that the Assembly will accept provisionally theCommittee on Nominations until this afternoon. amended Rules.Is there any objection to this ? The amendments to the Rules of Procedure were 7. Establishment of the Committee on Creden- provisionally adopted. tials The ACTING PRESIDENT :I am now going to 5. Publication of an Assembly Journal propose the members of the Credentials Com- The ACTING PRESIDENT : Under Rule 74 of its mittee ;it consists of twelve members according Rules of Procedure,2 the Assembly has to decideto our Rules of Procedure. whetheritdesiresdailypublicationofan I propose that the following members of our Assembly Journal. The Journal contains theAssembly should constitute the Committee on programmes of each day's meetings with the Credentials.I will read them slowly in order to agenda, a very short account of the previousenable you to take notes : day's meetings, and any other announcements. Dominican Republic, Egypt, France,Italy, If there is no objection, I shall take it that thePakistan, Philippine Republic, Poland, Portugal, Assembly approves the publication of an AssemblyRoumania,3 Union of South Africa, Uruguay, Journal. Are there any objections ? Venezuela. I see there is no objection, so the Director- General will make arrangements for the publi- It has, of course, been very difficult to propose cation of the Assembly Journal. members for this committee because so few credentials have yet been submitted. Are you in agreement with my proposal, or are 6. Announcements by the Acting President there any other proposals ? The ACTING PRESIDENT :I must remind all I see no objections to my proposal. Therefore, delegations that many of them have not yetmay I ask the members of the Credentials Com- presented their credentials ;this must be donemittee to meet at 3 p.m. precisely ? The committee before the Committee on Credentials meets atmust first elect its Chairman and Rapporteur. 3 p.m.If some delegations are not in possession May I ask the Credentials Committee now of the credentials issued by their respectiveappointed to submit its report at 4.30 p.m., and Ministries of Foreign Affairs they can present thethe members of the Assembly to come here at letters of their legations in Rome. Thereforethat time ? I beg them to do so today. The meeting is adjourned until then. Very few have presented proper credentials, The meeting rose at 12.35 p.m. therefore it will be extremely difficult to appoint 3 Roumania was not represented at the Second 2 coll. Rec. World Hulh Org. 13, 373 Health Assembly.

SECOND PLENARY MEETING Monday, 13 June 1949, at 4.30 p.m. Acting President : Dr. Andrija STAMPAR (Yugoslavia)

8. First Report of the Committee on CredentialsCredentials met early this afternoon and I will ask the Rapporteur to read his report. The ACTING PRESIDENT : May I call on the Chairman of the Committee on Credentials to Mr. Kazi (Pakistan),Rapporteur, readthe give the report of that committee ? first report of the Committee on Credentials.4 Professor CANAPERIA (Italy), Chairman of the Committee on Credentials :The Committee on 4 See p. 321 - 70 - THIRD PLENARY MEETING

The ACTING PRESIDENT : Are there any remarks Administration and Finance-and, in addition, on the report of the Rapporteur of the Committeefor eight members from the floor ; all the persons on Credentials ? elected will form the General Committee. I must inform the World Health Assembly that Now I propose the following members of the the Czechoslovak delegation presented credentials,Assembly for the Committee on Nominations, issued by the Czechoslovak Legation here inwhichconsistsoftwelve members :Brazil, Rome, to the Committee on Credentials a fewBulgaria, Canada, Czechoslovakia, El Salvador, minutes after the committee had already decidedIndia,Liberia, New Zealand,Saudi Arabia, about the credentials submitted. Sweden, Switzerland, Turkey. The report of the Committee on Credentials was Are the Members inagreement with my approved. proposals ? Are there any objections ? I see there are no objections ; therefore I declare the Committee on Nominations elected. 9. Establishment of the Committee on Nomi- May I now ask this committee to meet imme- nations diately after this meeting ?The meeting of the Assembly is adjourned until tomorrow at 9.30 a.m. The ACTING PRESIDENT :The Committee onMay I ask the Committee on Nominations to Nominations has to propose to the World Healthprepare a report for tomorrow at 9.30 a.m., when Assembly nominations for the President,thewe will proceed to the election of officers ? three vice-presidents, the chairmen of the main committees-Programme, Constitutional Matters, The meeting rose at 4.50 p.m.

THIRD PLENARY MEETING Tuesday, 14 June 1949, at 9.30 a.m. Acting President: Dr. Andrija STAMPAR (Yugoslavia) later President: Dr. Karl EVANG (Norway)

10. First Report of the Committee on Nomi- President: Dr. Karl Evang, chief delegate of nations Norway ; The ACTING PRESIDENT : The first item on this Three Vice-Presidents: the chief delegates of morning's agenda is the first report of the Com-Ceylon, Egypt and Mexico ; mittee on Nominations.5 May I ask the Chairman Chairman of the Committee on Programme: of the Committee on Nominations to come to theDr. H. Hyde (United States of America) ; rostrum ? Chairman of the Committee on Constitutional Matters: Dr. P. Vollenweider (Switzerland) ; Rajkumari AMRIT KAUR (India), Chairman of Chairman of the Committee on Administration the Committee on Nominations :I have muchand Finance: Dr. B. Schober (Czechoslovakia) ; pleasure in asking the Rapporteur to read the Eight membersoftheGeneralCommittee decisions of the Committee on Nominations, Rajkumari Amrit Kaur (India) ; Dr. D. A. Dowling which were unanimous. (Australia) ; Dr. H. P. Fróes (Brazil) ; Mr. F. U. Kazi (Pakistan) ; Dr. Melville Mackenzie (United Dr. TOGBA (Liberia), Rapporteur of the Com-Kingdom) ; Dr. A. Stampar (Yugoslavia) ; Dr. J. mittee on Nominations :The Committee onN. Togba (Liberia) ; and Médecin-Général Inspec- Nominations met at 5 o'clock yesterday.Theteur M. A. Vaucel (France). members of the committee were Brazil, Bulgaria, I submit this for your consideration. Canada,Czechoslovakia,El Salvador,India, Liberia, New Zealand, Saudi Arabia, Sweden, Switzerland and Turkey. 11. Election of the President of the Assembly The committee presents the following nomina- tions for consideration by the Second World The ACTING PRESIDENT : I propose to proceed Health Assembly : to the election of the President of the Assembly. Is the Assembly in agreement with the proposal Honorary President: Professor Mario Cotellessa,of the Committee on Nominations as regards chief delegate of Italy ; the President of the Assembly ? Are any members against it ?It seems to me that there is no 5 See p. 322 opposition. If any one wishes to speak against the - 71 THIRD PLENARY MEETING proposal, will he please come to the rostrum ?14. Adoption of the Agenda I see no member coming to the rostrum, therefore I declare that the proposal of the Committee The PRESIDENT : We pass on to the next item on Nominations with regard to the presidency ison the agenda-adoption of the Agenda. Are accepted. there any remarks or opposition ? In the absence of opposition, the Provisional The announcement was received with acclamation. Agenda 6 is accepted.

The ACTING PRESIDENT :I am very happy indeed to be able to introduce my old friefid15. Establishment of the Committee on Pro- Dr. Karl Evang to the Chair.Dr. Evang, will gramme you please come here to replace me ? The PRESIDENT : The next three items on the Dr. Evang (Norway) took the chair. agenda are the establishment of the three main committees-the Committee on Programme, the Committee on Constitutional Matters and the 12. Election of the Honorary President Committee on Administration and Finance. I would like to suggest that we might now The PRESIDENT : Our next job will be to electadjourn this meeting and reconstitute it as the the Honorary President. You have all heard thefirst meeting of the Committee on Programme, nomination of the Nominations Committee andasking the Chairman who has been nominated I would like to ask if there is any opposition.to take the chair, and that we should ask the In the absence of any opposition I declare that committee to establish itself, electing its officers, Professor Mario Cotellessa of Italy has beenetc. Subsequently, we will again call to order the elected Honorary President of the Second Worldplenary session and will then, step by step, Health Assembly. constitute the other two main committees. There It is my great pleasure to invite Professorseems to be no objection to this procedure. Cotellessa to come to the rostrum and take the I then take pleasure in inviting Dr. Hyde of the place to my left. The Chairman of the ExecutiveUnited States of America to take the chair as Board, Sir Aly Shousha, Pasha, has just informedChairman of the Committee on Programme. me that he would like to join his own delegation. The meeting is adjourned. We thank him. The meeting adjourned at 10.5 a.m. and consti- Professor Cotellessa took the chair to the left oftuted itself the Committee on Programme,7 reassemb- the President. ling in plenary session at 10.10 a.m.

16. Establishment of the Committee on Consti- 13. Election of the three Vice-Presidents tutional Matters The PRESIDENT : We then proceed to the next The PRESIDENT : The next item on the agenda item, the election of the three vice-presidents.is the establishment of the Committee on Consti- The Nominations Committee has nominatedtutional Matters.Here again we run into the Dr. S. W. R. D. Bandaranaike, chief delegate ofsame difficulty. Who should be in the chair during Ceylon. Is there any opposition ? the election of the chairman of each of the main In the absence of any opposition I declare thatcommittees ?At the First World Health Assem- Dr. S. W. R. D. Bandaranaike, chief delegate ofbly, this problem was solved by having the Ceylon,has been unanimously electedVice- delegate nominated for the chairmanship preside President of the Second World Health Assembly.over the meeting, because the chairmen of the The Nominations Committee has nominatedmain committees are elected by those committees Dr. Naguib Scander, Pasha, chief delegate ofand not by the Assembly. However, some Egypt, as Vice-President. Is there any objection ?representatives seem to feel that that is not quite correct, and therefore your President was asked In the absence of opposition, I declare thatby the Chairman of the Committee on Programme Dr. Naguib Scander, Pasha, chief delegate ofto preside over the meeting of that committee Egypt, has been elected Vice-President of thetill its chairman had been elected. Is it also your Second World Health Assembly. wish that I should preside temporarily while we The Nominations Committee has nominatednow proceed toestablish the Committee on Dr. José Zozaya, chief delegate of Mexico, asConstitutional Matters ? Vice-President.Is there any objection ? In the absence of opposition, I declare that Dr. THOMEN (Dominican Republic) : It does not Dr. José Zozaya, chief delegate of Mexico, hasseem clear to me whether we have already chosen been elected Vice-President of the Second Worldthe members of the Committees on Programme, on Health Assembly. Constitutional Matters, and on Administration The next item on the agenda is the presidentialand Finance. If we have, I do not have them on address. I hope you will give me till this afternoon to prepare my presidential address, and with your 6 See p. 61 permission we will postpone this item on the 7 See first meeting of Committee on Programme, agenda.. Thank you very much. p. 148 - 72 - THIRD PLENARY MEETING my list.If we have not, then we are in plenarynistration and Finance. The Assembly now session. So it is my opinion that you, Mr. Presi-adjourns and will constitute itself the main dent, should continue presiding over the plenaryCommittee on Administration and Finance. session until all the members of all the committees The meetingadjourned,at10.26 a.m.and have been appointed. constituted itself the Committee on Administration and Finance,' reassembling in plenary session The PRESIDENT :I should like to thank Ourat 10.30 a.m. colleague from the Dominican Republic for his suggestion. However, I feel that this is a difficulty18. Establishment of the General Committee which can only be solved if we change our Rules of Procedure.The situation is as follows.The The PRESIDENT : We are again in plenary chairmen and other officers of the main com-session. The next item on the agenda is the mittees are, under the Rules of Procedure, notestablishment of the General Committee. To elected by the plenary session. They are electedestablish the General Committee we have to elect by the main committees themselves.Therefore,the eight members from the floor who have been we have to convene the main committees in ordernominated by the Nominations Committee, and to have those elections, which cannot be held inthe relevant document, A2/57,1° has just been plenary session. That is clear, and we can adjourndistributed to you. You will find the names of the the plenary session and reconstitute ourselves aseight members to be elected from the floor on the a meeting of the Committee on Programme, asecond page.I am going to read them to you : meeting of the Committee on ConstitutionalHer Excellency Rajkumari Amrit Kaur (India), Matters, etc.The question, however, is who isDr. D. A. Dowling (Australia), Dr. H. P. Fróes going to preside over such a meeting of the(Brazil), His Excellency Mr. F. U. Kazi (Pakistan), Committee on Programme, for example, untilDr. Melville Mackenzie (United Kingdom), Dr. A. that committee has elected its chairman ? ShouldStampar (Yugoslavia), Dr. J. N. Togba (Liberia), the chair be taken by the delegate nominatedand Médecin-Général Inspecteur M. A. Vaucel by the Nominations Committee ? That happened (France). at the First World Health Assembly. Or should Are there any other suggestions ? it be the President of the Assembly ?I was I would like on this occasion to remind all asked by Dr. Hyde to preside during his election.members that a mechanical record is made of every word that is said from the rostrum. There- think, myself, that it might be wise later tofore, we have not only to ask everyone to come change the Rules of Procedure in such a way that to the rostrum to speak, but we will also have the chairmen of the main committees would, into ask them to give their names and countries future, be elected by the plenary session. when they start to speak.If not, it will be very All Members of the Organization are membersdifficult to identify them on the record. of the Committee on Programme, the Committee I recognize the delegate from Venezuela. on Constitutional Matters and the Committee on Administration and Finance. Are there any Dr. GABALDÓN (Venezuela)(translation from further remarks ? the Spanish) : I have come here only to draw the attention of the Assembly to a question of Dr. TOGBA (Liberia) : I suggest that, in order toprinciple to which the inhabitants of America expedite matters, the President act as temporaryattach importance.The countries of America chairman for each of the different committeesthat have ratified the Constitution comprise until the regular chairman is elected. about 25% of the World Health Organization. The delegation of Venezuela would appreciate The PRESIDENT : Is the suggestion made by thethe same percentage being represented on the representative of Liberia acceptable to you ? General Committee. The suggestion has been seconded.Is anyone opposed ?No opposition. We shall follow this Dr. THOMEN (Dominican Republic) :I want procedure. to second the motion just presented by Dr. Gabal- dem.I think it proper that our hemisphere be We shall then adjourn this plenary sessionrepresented in the General Committee by more and reassemble as the Committee on Constitutionalthan one member, and I would further propose, Matters. as a member of that committee, Dr. Claveaux The meeting adjournedat10.20 a.m.andof the Uruguayan delegation. constituted itself the Committee on Constitutional Mailers,'reassemblinginplenarysessionat The PRESIDENT : Dr. Claveaux of Uruguay has 10.25 a.m. been suggested as a member of the General Committee. I recognize the delegate of the Philippine Republic. 17. Establishment of the Committee on Admi- nistration and Finance Dr. VILLARAMA(PhilippineRepublic) :In pursuance of, and in conformity with, the general The PRESIDENT : The next item On the agenda is the establishment of the Committee on Admi- 9 See first meeting of Committee on Adminis- tration and Finance, p. 225 8 See first meeting of Committee on Constitu- 18 First report of the Committee on Nominations, tional Matters, p. 290 p. 322 - 73 - THIRD PLENARY MEETING principle that each region or area be representedtheeightnominations by the ' Nominations in this General Committee, I believe that theCommittee and the two additional names given Philippine positionis unique :itcannot benow. No other suggestions have been made. considered properly as one with India, because We need two tellers, and I would like to ask the of its great distance from that vast country ;itdelegates from New Zealand and Sweden to is, geographically and commercially, the hub ofcome to the rostrum to act as tellers.I will now the wheel in the Far East, Australia and Newask the Director-General to call the names of the Zealand being far down south in the Westerncountries.You will be called by the name of Pacific Area, and thus being not quite disposedyour country in alphabetical order in English. to join hands with us in the consideration of theAs the names of Members are called, will delegates establishment of a regional organization in thatplease come one at a time and deposit the voting area, with headquarters in the Philippines.Itslip in the box in front of the rostrum. Some of seems to me,therefore,that the Philippinethe delegates require a little more time to write Republic, in the circumstances, should obviouslydown the names, so we will give them a few more be represented in the General Committee. minutes. I have just been iriformed that unfortunately the The PRESIDENT : Two more members have beenvoting slips are too small for eight names : you suggested for election from the floor.Before weare, of course, free to write the eight names on go on, it is my duty to ask whether there areany other piece of paper, or to use both the. front seconders to these suggestions.Are there anyand the back of the little slip. To avoid confusion seconders to the suggestion made by the repre-I think the best thing is to put the names on sentative of the Dominican Republic that Dr. Cla-the front and back of the small slip. veaux be elected ? The votes of the delegations were taken in turn In this connexion I would also like to draw yourby secret ballot. attention to the fact that for the General Com- mittee there is not only one representative from Dr. CLAVEAUX (Uruguay)(translation from the Western Hemisphere as has been stated. theSpanish): Under the circumstances,the There are three, namely the Chairman of thedelegation of Uruguay considers that it should Committee on Programme, Dr. Hyde of the Unitedabstain from voting. States of America ;then one of the vice-presi- dents, Dr. Zozaya of Mexico ; and Professor Fr6es The PRESIDENT : I will ask the tellers to go into Of Brazil : that is, three out of fifteen. the next room and start their work.That will Is the suggestion that Dr. Claveaux be electedtake some time.In the meantime, we will seconded ? It has been seconded by the repre-continue with the agenda. sentative of Venezuela. Then the other suggestion is that a representa-19. Admission of New Members tive of the Philippine Republic should be included as a member of the General Committee.Is that The PRESIDENT : The next item on the agenda suggestion seconded ? It has been seconded by theis the admission of new Members. I would suggest representative of Thailand. that this matter be referred to the Committee Are there any further suggestions for nameson Constitutional Matters. of members to be elected to the General Com- The President's suggestion was approved unani- mittee ?There are no further suggestions. mously. We shall then proceed to a vote. The President would like to suggest to you20. Presentation of the Report of the Director- that we proceed to the vote in the following General manner.The chief delegate of each delegation The PRESIDENT : I do not feel that we should will please put down on a slip of paper (to bestart the discussion of the report this morning, distributed) eight names representing those eightbut I should like to call upon the Director- members of the General Committee who should,General to present it now.After that we could in his opinion, be elected from the floor. perhaps adjourn the meeting and then start the Is that acceptable ?That is accepted. discussion of the report either this afternoon I have just been informed that the slips foror tomorrow. voting have been distributed. They are all on your desks and I should like to ask you to put down The DIRECTOR-GENERAL : The Annual Report the eight names of the eight members whom youof the Director-General to the World Health would like to have elected from the floor to theAssembly and to the United Nations is found General Committee. And as you have not beforein No. 16 of the Official Records of the World you the names of the two additional membersHealth Organization, which has been distributed suggested, I would like to read those names toto all delegations. This report covers the work of you now, spelling them out.The name of thethe Organization from the time in the summer representativeof Uruguay suggested by theof 1948 when the World Health Organization came Dominican Republic is Dr. Claveaux. The nameinto being to the end of 1948. It is therefore less of the representative of the Philippines is Dr. Villa-than half a year of work that is covered. rama. The eight names which you put down on the voting slips will, of course, have to be chosen The PRESIDENT : I suggest that we discuss later from among the ten names now before you-the Report of the Director-General and at the - 74 - FOURTH PLENARY MEETING same time the Reports of the Executive Board, The PRESIDENT : Thank you, Sir Aly. as both reports cover very much the same work. While we are waiting for the result of the voting, I should like to know whether that is agreeabledelegates who would like to speak this afternoon to you. on the reports might so signify. We could then There seems to be no objection, so that isdraw up the list of speakers, or at least the accepted. beginning of the list. I have already one name on my list, the delegate of Yugoslavia, and I should like to know whether any others would like to 21. Presentation of the Reports of the Executivespeak on the reports which have just been Board introduced to you.The President notes India, the United Kingdom, Ceylon, the Philippines. The PRESIDENT : I take great pleasure in calling I hope I made it clear that we will not start the upon the Chairman of the Executive Board, Sir Alydiscussion now.We are simply preparing the Shousha, Pasha, to introduce the Reports of thelist of speakers for this afternoon and tomorrow. Executive Board. There seem to be no more names for the list at the present time.Of course, delegates will Sir Aly SHOUSHA, Pasha (Egypt), Chairman ofhave an opportunity to add their names later if the Executive Board :I had the honour to bethey wish. elected Chairman of the Executive Board at the In a few moments, we shall be informed of last session of the World Health Assembly. Thehow long we still have to wait for the result of the Executive Board has held three sessions, thevoting.If it is too long, we shall adjourn the work of which has been printed in three reports.meeting. These reports have been distributed to the There is a lot of counting to be done ; it will members of the Assembly : No. 14 of the Officialstill take about half an hour.That is too long Records contains reports on the first and secondto wait, and we will adjourn the meeting until sessions of the Board, and No. 17 the report onthis afternoon at 3.30 p.m. the third session. These have been circulated for your consideration. The meeting rose at 11.25 a.m.

FOURTH PLENARY MEETING Tuesday, 14 June 1949, at 3.30 p.m. President : Dr. Karl EVANG (Norway)

22. Establishment of the General Committeehave thereby shown has moved me deeply. The (continuation) only thing I can do in return is to thank you, to The PRESIDENT : The meeting is called to order.ask your co-operation and to promise you to do I should first like to announce the result ofmy best to meet your wishes during the Second this morning's voting. The following eightWorld Health Assembly and, with your help, to delegates have been elected from the floor toturn this Second World Health Assembly into the General Committee : a success. A success it must be, not only because Her Excellency Rajkumari Amrit Kaur, India ;it means so much to the future life of this Organi- Dr. D. A. Dowling, Australia ; Dr. H. P. Fróes,zation but-and what is much more-because it Dr. Melvillemeans so much for the health and happiness of Brazil ;Mr. F. U. Kazi, Pakistan ; hundreds and millions of people all over the world. Mackenzie, United Kingdom ;Dr. A. Stampar, The Italian Government has graciously invited Yugoslavia ;Dr.J. N. Togba, Liberia ;andus to convene this Assembly in Rome and my Médecin-Général Inspecteur M. A. Vaucel, France.first, and I must say easy task, is to extend to the Number of members entitled to vote : 63 Italian Government, on your behalf and on my Number of voting papers null and void : 3 own, our deep gratitude for the international Number of members present and voting :45 hospitality shown by this war-torn country. The General Committee is thereby constituted.The magnificent way in which we have been The members are the President, the three vice-received, and the most charming and interesting presidents, the three chairmen of the mainprogramme of social activities announced to us, committees and the eight members whom we havecertainly give us all the most pleasant hopes for just elected from the floor. the coming weeks. Rome, however, to all of us, is much more than 23. Presidential Address merely a beautiful city.Here even the most The PRESIDENT : May I first of all express myinexperienced observer cannot escape the whis- deep appreciation for the great honour you havepering but insistent voice of history.Here we conferred upon me ; the confidence which youare looking back, not only through decades, but - 75 - FOURTH PLENARY MEETING through centuries, even millenniums, visualizinginternationalhealthactivitygraduallytook the struggle of mankind for happiness, securityshape. It grew naturally out of the needs of the and for power. Here we can read, not just frompeoples all over the world and also out of the stage books, but from buildings, monuments andto which medical science and public-health institutions the history of the fight of mankindadministration had developed. against the destructive forces of naturesur- It was therefore the main task of the First rounding us, and not least against the destructiveWorld Health Assembly to evaluate the work forces of human nature itself. Rome, in thisway,done by the Interim Commission, and to take represents both the most beautiful and the mostdecisions on the fundamental questions of the proper setting for the Second World Healthscope and framework of international health Assembly, convened in a difficult and complexactivity. What should it comprise ? Where were period. the limits ? What should be tackled first ? How should we put these things into practical opera- May I also express our thanks to the represen-tion ?How should we combine our knowledge tatives from the United Nations and the specia-and powers with those of the other specialized lized agencies for their interest in our work andagencies of the United Nations ? Was there room for their presence here among us ? for, yes, need for a broader approach than before I feel that on this occasion I should alsosayin the field of international health activities ? some words of thanks to the President of theYou all know the answers given to these and other First World Health Assembly, Dr. Stampar,questions by the First World Health Assembly. Professor of Hygiene at the University of Zagreb,They formed the basis upon which we now have Yugoslavia ;for Dr. Stampar was not onlyto continue. President of the First World Health Assembly, During the less than eleven months which have not only chairman of the Interim Commissionpassed since the First World Health Assembly during its few years of existence-he was, fromadjourned in Geneva, the tools of WHO have the very first day this Organization was calledbeen welded and have gone into operation : into life, giving freely of his time and of hisfirst and foremost, the Secretariat, but also the great experience in international health matters.expert committees, the visiting advisory experts, Without his wisdom, his patience, his knowledge,the demonstration teams, the fellowship pro- his integrity and, perhaps more than everythinggramme, the supply programme forspecial else, his unbreakable loyalty to the idea for whichmedical and teaching equipment, the information we all fight, WHO would not today be what it is.service of the Organization, etc.The danger of To him, it was not a question of personal orover-centralization has been happily avoided. even national prestige, but a question of bringingTwo regional offices, in India and in the Western and keeping together the nations in constructiveHemisphere, are already in operation ; one in the co-operation in a field where such co-operationEastern Mediterranean Area will come into is within reach.I am proud indeed to follow inoperation shortly. Others will follow in due time. his footsteps. The speed with which this development has There will, I am sure, be au opportunity latertaken place is breathtaking indeed.It cannot be to remember all the others who also deservecompared with the type of development which praise and to whom we owe thanks for thewe knew during the years after the First World achievements of WHO during its short periodWar. The machinery, of course,is not yet of existence :the Secretariat,the Executiveperfect ; neither is the programme.Both need Board, the expert committees, etc. improvements and I hope these will be made by A little more than three years ago, in the springthe Second World Health Assembly in the form of 1946, the Technical Preparatory Committeeof constructive criticism.The tools are there, appointed by the Economic and Social Councilthe needs of the world are pressing, the challenge of the United Nations, as you all know, draftedis before us, before the Second World Health the Constitution of WHO. It was therefore theAssembly. main task of the International Health Conference The main task of this Second World Health in New York in the summer of 1946, a gatheringAssembly therefore, to my mind, will be to give of not less than 63 nations, to modify, improvethis machinery of ours an opportunity to work and finally accept the Constitution, thus creatingin the coming year, as we hope it will and can work. the foundation for the future work of WHO. The Second World Health Assembly, it seems to For two years the Interim Commission of WHO,me, will have to fulfil three conditions to make backed by the United Nations, carried out thethis possible. First, we must adopt a programme, tasks of organizing what might be called the routineat the same time wide enough and practical international health work, that is to say, the mostenough to make it possible to solve some of the important statutory functions of WHO, andpressing health problems of the world. Secondly, in addition to that, some minor tasks taken overthe necessary money for carrying out such a from UNRRA. Owing to the extended life ofprogramme must be provided and, thirdly, the the Interim Commission, however, the Commissionprogramme and the budget must be presented in had to go further than that. It is, I think, justifiedsuch a form as to capture the understanding and to say that during those two years a new form ofthe imagination of the governments and peoples, - 76 - FOURTH PLENARY MEETING thereby opening their eyes to the enormous possi-we, being responsible for the health of the world, bilities in international health work. have to drive home again and again that, unless Many of the ideas accepted a year ago by thethe peoples of the world enjoy a certain degree First World Health Assembly were new ideas atof physical and mental health, which they have that time. Now they have had time to sink in.till now by no means reached, all the plans of the We know where we stand. We have firm groundeconomist will be in vain, all his programmes will under our feet. The social and economic conditionsgo to pieces. of the post-war world have gradually unfolded The main reason for my optimism, therefore, before our eyes with a mixture of encouraging andis the new outlook in international health, which discouraging features.Altogether, I think it is right to look forward with optimism to theis now gradually developing in WHO. We do proceedings of this Second World Health Assemblynot, as you know, limit ourselves to administra- and to the future of WHO. Of course, we musttive tasks only. We go into the field, into practical not underestimate the difficulties. operations, and we must do so on an increasing scale. We have not limited our work to inter- One of the greatest statesmen who has evernationalquarantine,standardization, lived, Franklin Delano Roosevelt, once expressed health the belief that the century after the Secondstatistics, etc.If you read the Constitution you World War would be " the century of the commonwill find that we have accepted the broadest man ".If we take a look at the distressed andpossible definition of health work. All aspects of insecure world of today we must admit that wehealth activities are covered.For convenience, areapproaching thisgoal only very slowlyI sometimes group medical activities under six indeed, a goal which was accepted as a slogan,headings : the promotion of health, the prevention as many of you will recall, by millions and millions ofdisease,curativemedicine,rehabilitation, all over the world with enthusiasm and hope.Iftaking care of the chronically ill and disabled, we should try to characterize the opening of theand lastly, health control of the so-called healthy century after the Second World War, admittedlypopulation. In all these fields, WHO has formed a very difficult task, many of us might perhapsor is forming its programme. agree that it has not yet developed into the century We also, fortunately, have developed beyond of the common man, nor into the century of thethe primitive stage in medical development where teacher, the scientist, the diplomat, or even thesharp distinction was made between physical politician.So far we have been living in theand mental health. We know now that without century of the economist.Export, import, hardmental health there exists no physical health, currencies,softcurrencies,balancebetweenand vice versa.We also know by most bitter prices and wages, inflation, deflation-these areexperience that, while the physically ill person is the terms dominating our daily life.The econo-a danger mainly to himself and a nuisance to his mist, more able than before to feel the pulse-rateclosest relatives, the mentally dangerously of economic life, is giving his predictions.Incontagious. His activities and his reactions have some countries inflation is threatening, in othersbeen contributing time and again towards precipi- perhaps deflation, and the economist is liftingtating the great catastrophes which have hit his warning finger : the difficulties ahead are great ;mankind with incredible regularity-the wars. let us wait and see. Do not invest too much moneyTherefore, to my mind, it is a special encourage- in what he, the economist, much too often regardsment that WHO in its programmes specifically as unproductive institutions, including amongstincludes mental health as a separate and impor- them social and medical institutions, hospitalstant item. and sanitary programmes. Let us wait, he often There is one dark cloud in our sky today. The says, until we have controlled all economic life,Russian family of nations is not with us. We have until we have a surplus ; then it will be time toadmired the contribution of the Soviet delegates develop social and medical security by puttingto the conferences at which WHO was created. money into this sector.It is our most importantTheir experience and knowledge is also needed task to supplement this point of view, becausehere, and I certainly hope that the Second World it does not give the whole truth. During all theseHealth Assembly willfind time to consider ups and downs in economic life which havemethods whereby the Soviet countries will again thrown Uow a hundred thousand, now a hundredtake their seats among the other nations. WHO million people into poverty, misery and disease,is not a political body. It must never be. Other there exists one basic factor in society, oneinternational organizations have been created fundamental value on which in the end we haveto tackle and try to solve the difficult political to build as the only basis of society. That factorproblems. That is not our job here. We must all isthe human being-the working,creating,think and feel one for all and all for one. I cannot hoping and struggling human being. Therefore itexpress this better than by quoting the English seems to me that the motto of the Second Worldpoet, John Donne.He says : Health Assembly might profitably be, " Let not " No man is an Hand, intire of it selfe ; every the economist make us forget the human being ".man is a peece of the continent, a part of the We have, of course, all respect for the economist maine ;if a Clod bee washed away by the Sea, and his work ;it is necessary and useful : butEurope is the lesse, as well as if a Promontorie - 77 - VOURTH PLENARY MEETING

were, as well as if a Mannor of thy friends or ofthe knowledge of our scientific workers and his thine owne were ;any mans death diminishesallowed us to fill many a gap in our medical me, because I am involved in Mankinde ; Andlibraries. Our people were able to go abroad and therefore never send to know for whome the bellwork on their special subjects, and when they tolls : It tolls for thee." returned home they brought into their institutions It is my liope that with your help we can carrynew knowledge and new methods.My country through the important work of the Second Worldis grateful to WHO for this help and I would like Health Assembly in this spirit. to take this opportunity of emphasizing this point. 24. Discussion on the Report of the Director- The World Health Organization has striven General and the Reports of the Executivesince the beginning of its Interim Commission, Board in so far as its means allowed, to bring into the Organization specialists and administrators from The PRESIDENT : We will start discussion onvarious countries, but it has not succeeded in items 13 and 14 of the Agenda, Report of theapplying satisfactorily the principle of a just Director-General 11 and Reports of the Executivegeographical distribution of its staff. Board." Already at the International Health Conference The first speaker is Dr. Stampar, Yugoslavia.in New York the great majority of the delegates were of the opinion that WHO should be built Dr. STAMPAR (Yugoslavia) : In the first place, on the principlesof regionalization. These I would like to stress the desire of the Yugoslavprinciples have been carried out constantly in the Government, which I represent in this Assembly, course of the last three years, because it was to take an active part in international activities,considered that many health problems are of a including this international work, for the realiza-regional rather than a global character. I consider tion of which my country has done all that was inthat this is one of the very positive aspects of the her power. World Health Organization and we can be gratified I have personally been in a very fortunatethat we have succeeded so far to the extent of position because of the fact that I was able tohavingalreadythreeregionalorganizations take an active part in this Organization for moreworking. A great centralization of world health than three years, right from its beginning up toaffairs would be harmful because it would require the present day. too great a concentration of experts in one place. In those days of July 1946, when the WorldIt would well seem that there is no greater danger Health Organization had only just been estab-for international affairs than the bureaucratic lished, we were all very optimistic about its futurespirit, which is bound to appear in an over- activities.But the modest material means atcentralized organization.I think we must apply our disposal did not permit an activity on a verythe principleofregionalization, but not so large scale, although the poor health conditionsextensively as to jeopardize the links between the after the war would have required it, especiallycentral organization and the regional organiza- in those countries which had been occupied ortions themselves. The latter always require devastated during the war. Moreover, our Organi-assistance from the central office of the World zation was confined to function for two yearsHealth Organization. We must do all we can to in an interim capacity until a sufficient numberstrengthen the regional organizations in every of ratifications had been deposited with therespect and to leave to their responsibility many Secretary-General of the United Nations. Duringquestions of strictly regional character. that time an Interim Commission was entrusted On the other hand, it is evident that there are with the management of the affairs of the Organi-also many questions of global importance which zation. The Interim Commission succeeded duringcan efficiently be tackled only by the central those years in linking up many scientists andadministration. Amongst those, I would like to public-health workers all over the world into onemention the spreading of knowledge about the community honestly endeavouring to promotelatest achievements of science and of its applica- world health. This was one of the most positivetion, epidemiological information and quarantine aspects of our Organization's history.In spitemeasures, standardization, the spreading of a of the meagre financial means, which the Organi-new and progressive outlook in health matters zation had constantly to borrow, some Members,and the expert handling of various specialized especially those having suffered from the war inquestions by convening meetings of experts with Europe, received some assistance which, althoughspecified terms of reference.But the brunt of it was not large, was sufficient to bring substantialregional health activities should be borne by the help to the various national health-administra-regional organizations, which should be assisted tions and to assist them in their rehabilitation.to build up their own body of experts, so that My country, Yugoslavia, has also received helpforeign experts may be sent only when there are for the specialization of doctors and other expertsno local ones. Regional health problems are best and for the purchase of books and periodicals, sosolved locally, because their solution depends essentially important because relations with thevery much on a correct appraisal of regional and scientific world abroad were severed for so manylocal conditions, especially in the educational, years. This help has greatly contributed topsychological, social and economic sense. 11 011. Rec. World Hlth Org. 16 It is self-evident, however, that the knowledge 22 U. Rec. World Hlth Org. 14 17 of highly specialized experts should be available - 78 - \

FOURTH PLENARY MEETING all over the world and it is a duty of WHO to dotoo we should play a particularly active part. all in its power to organize this.But its foremostThe question of housing, which is one of the duty is, I think, to help the national health-cornerstones in the protection of the people's administrations to promote special knowledgehealth, has so far been hardly touched at all. and to make it possible for their experts to Finally, I would like to mention that the war- acquaint themselvqs with the latest achievementsdevastated countries which are still handicapped in their specialities.I should say that it L rather as a consequence of the war have so far not received rare for foreign specialists of exceptional qualitiesfrom WHO the assistance they need and deserve. to be used very profitably.The number ofSome of them even have great difficulty in foreigners who are able to assess correctly theacquiring the elementary means for the protection internal conditions of countries which are newof health and treatment of disease.They also to them is small, especially if they stay there onlyhave difficulty in purchasing from other Member for a short time, or if they come with certainStates equipment, which would enable them to prejudices.They lose much time in adaptingproduce themselves some of the elementary themselves and very often they do not succeed.material without which modern medicineis Our Organization will be much more successfulunthinkable. WHO should make these problems ifinthe coming yearsitconcentrates onan object of its constant care, because if they strengthening the national and regional healthcannot be solved correctly, various Members organizations, particularly in the promotion ofmay begin to doubt the usefulness of our Organi- specialization of medical personnel and otherzation and that will greatly endanger our future technicians, by sending them to those countrieswork. where they can learn most.Unfortunately, in The country which I represent here, and in some places restrictions exist for foreign students,whose name I speak, was one of the first to ratify which make it much more difficult for WHO tothe Constitution of our Organization and has fulfil its task. been meticulous in fulfilling its financial obliga- I should like to add a few words on the pro-tions.It believes that the World Health Organi- gramme of our work.It is, as appears from thezation is a contribution to true international Director-General's Report, very comprehensive,understanding and co-operation and thus contri- and it is divided into priorities and non-priorities.butes to the maintenance of peace. These are aims It remains, of course, open to discussion whetherfor which my country has always striven and to WHO ought to cover so many items in one vastall of which it remains faithful. programme, or whether it should concentrate on a few sections-questions of great importance to The PRESIDENT : I next call upon the represen- all peoples of the world. tative of India. Our Constitution is, no doubt, one of the out- standing documents in the history of public Rajkumari AMRIT KAUR (India) : Almost a year health, and it stresses the need for a positiveago we met in Geneva and launched this Organi- approach to the problems of health. It is withoutzation with enthusiasm and with high hopes.It doubt a very important declaration of that largeis good that many of us who took part in the number of States which took 'part in its drafting.First Health Assembly are fortunate enough to Medicine still has, as you well know, a predo-be present today. Less than even a year does not minantly defensive character.I think you willreally give time enough for any organization agree with me that, in fact, positive medicine into show much in the field of achievement. And reality rests on four main principles :socialyet I do feel that on the whole we can congratulate and economic security, education, nutrition andthe Director-General and his staff on the prompt- housing.It might well be that our Organizationness with which they have got down to imple- should pay the greatest attention to these prin-menting in a practical manner the decisions of the ciples and to helping to promote these views allFirst World Health Assembly.The work of ovei the world.I should like particularly toWHO has fired the imagination of the governments stress the question of education, not only of theand peoples of the world. They want the appli- whole people, but especially of those persons tocation of available knowledge and are anxious whom mankind has entrusted the care of itsto see results. Application of available knowledge health.Are we not yet fully conscious that wemust, however, go hand in hand with inquiry must put forward a new type of physician whointo matters which need investigation. And would, from the ideological and technical pointinvestigation over such an immense field as the of view, be differently educated from those at whole world needs time. present training in most institutions for medical We have, however, already gained a certain education ? Would it not be useful if our Organi-degree of experience with the work which this zation collected as much information as possibleOrganization has commenced with commendable on this matter, and if it convened a conference atspeed.With the knowledge of this experience, which these questions concerning education couldand knowing also the great need which exists be fully discussed, and at which recommendationsin so many parts of the world, I am of the opinion could be passed which would, in my opinion, bethat the technical programme recommended by very useful to all Members ? the First World Health Assembly was funda- In respect of nutrition, we are under the obliga-mentally sound and should be maintained for the tion to work hand in hand with another inter-next year or two.Instead of dissipating our national organization, and I think that thereenergies in various directions, we shall be wise - 79 - FOURTH PLENARY MEETING if we concentrate mainly on the priorities alreadytechnical personnel, without which our other established and demonstrate the value of healthefforts will not yield permanent results. work by producing results in these special spheres A very important advance in our programme for all to see.This will be one way of securingis the proposed setting-up of health demonstration more and more co-operation from the commonareas. This is a sound undertaking. Criticism has man, which is what every organization needs if sometimes been levelled against the concentration it is to be a success in the sense of being a people'sin a small area of all healtb activities while so organization. To earn this distinction, I submitmany other areas are without any health pro- that there is only one royal road, and that istection at all. But this work is fundamental and active field work.I have always hoped, anda start has to be made somewhere. In one country continue to hope, that this Organization willin my region a health demonstration area was set become a dynamic force and not rely for growthup in 1926 and the same criticism was made. mainly on committees, questionnaires and paperIt weathered that criticism, and eventually this work. These are no doubt essential up to a point,area proved to be the guiding beacon for all but the salvation of the backward countries lies subsequent health work in that country.These In active work in their spheres, and in their soundareas are moreover of great value, inasmuch as development lies the key to world health. Comingthey act as field laboratories in health administra- as I do from a country which is primarily a ruraltion. The area selected should be one that bristles country,. with its people poor, ignorant and ill-with the usual problems of the country, so that housed, I would like to see much greater concen-it may provide an ample field for trying out the tration on environmental hygiene and sanitation,methods of dealing with each specific problem. which is the basis of all health work. A wholesome It will also serve as a training centre for all health water-supply and a proper disposal of night-soilpersonnel,medical students,doctors,public- are woefully lacking.People must have houseshealth nurses, midwives and sanitary inspectors ; where they can live like human beings.Ruraland with our experience in India I lay the greatest populations want a sanitary system that is bothemphasis on the proper and rapid training of cheap and efficient. Therefore the sanitaryancillary personnel.In addition, such an area engineer has to work out plans that will meetprovides instruction for lay people who need to these requirements.Attention to hygiene andhave some elementary knowledge of hygiene and sanitation, and the facilities to maintain them atsanitation. At least one such demonstration a high standard, will not only increase the people'sarea should be established in each region, or self-respect but will also have a definite bearingbetter still, if possible, in every country of our on the control of water- and soil-borne diseases andbackward regions. assist in carrying out the positive side of health programmes with which the care of the mother The fellowship scheme is a valuable feature of and the child is so closely linked. our work and should be continued.I would, As regards tuberculosis, may I suggest thathowever, point out that the knowledge gained some country in Asia, suitable for the purpose, be by students abroad is very often difficult to put selected to carry out a complete plan of tubercu-into practice under local conditions at home. losis control, as has been done in Denmark ? Therefore, while reserving fellowshipsfor the This disease is spreading with alarming rapiditysenior technical workers, we must concentrate on in my country and causing my Ministry deepthe strengthening of national health institutions concern. With WHO assistance, a country mayby the loan of foreign experts for short periods perhaps even be ready to put up the money forin order that the bulk of the national health staff such a programme.This might well constitutemay receive proper training in their own environ- a demonstration area which could in its turn bement and under their peculiar local conditions. used for training on an international basis. Suitable understudies must, of course, be provided I would also like to touch on that very ancientby national governments. disease, leprosy.Records of its existence date As regards field teams, I must confess that we from the earliest times and still millions are are very disturbed about the proposal that medical suffering from it.It is a disease that ostracizessupplies should be paid for by governments. not only the individual but also the family. ASuch a step will greatly limit the usefulness of great deal of research has been carried out andthese teams and many governments may not be continues to be carried out by various countries, able to meet this condition.It is a matter of but the time has come when this disease shouldsuch grave concern to the backward countries be dealt with on an international plane.I wouldthat I feel I must sound a note of warning against therefore earnestly urge that it be raised to theany drastic decision in this regard. same level as malaria and tuberculosis for purposes A word about regional offices. There were some of intensive and co-ordinated research, which willmisgivings as to the desirability of establishing lead to its cure, control and ultimate elimination.them at the start. The first office to be established Another matter to which more attention mustwas in South-East Asia and I can say without be paid is health education and the, training offear of contradiction that without such an office

- 80 - FOURTH PLENARY MEETING the implementation of WHO programmes ofThe great Union of Soviet Republics has as field operations would have created a great manyimportant a contribution to make to the improve- difficulties.Indeed, I venture to submit that thement, maintenance and conservation of health programmes for 1950 will not be possible withoutas any other country, and we who are backward regiohal offices. in these spheres have in particular much to learn from them.I do sincerely hope therefore that It is a matter for consideration whether regionalthese friends will return and cbllaborate with us offices do not need a proper staff of specialistsin whatisessentiallya human endeavour, in addition to public-health administrators. Theseeking to bring light and joy where there is dark- number of specialists would naturally vary forness and misery. each region.For example, in South-East Asia we should like to have at least one tuberculosis As I have said before, WHO is just about a year old.It has submitted a bold programme which specialist, one for venereal diseases and one forshould find favour with all the nations of the leprosy, as well as one maternal and child healthworld.It is bold because its initiators have seen specialist with a consultant nurse and a sanitarythe great needs of the world, but like all ambitious engineer. programmes it requires money. I hope the sinews Decentralization has proved useful and regionalof war for a world campaign of this noble nature directors should be allowed ample discretion inwill be forthcoming so that there may be no their work. turning back. In this connexion may I quote the slogan of the Health Department of the State of As regards our. relations with other specializedNew York-" Publichealthispurchasable ; agencies, it is very necessary that there should bewithin natural limitations any community can no duplication of work.Unless we are carefuldetermine its own death rate ". from the very beginning, work will overlap and, I would like to pay a very warm tribute to the with slender resources at our disposal, that wouldwisdom, ability and statesmanship with which the indeed be a pity. There should really be only oneoutgoing President has fulfilled his duties.His authority for public-health work. More than onehas not been an easy task, but his sympathy must inevitably lead to difficulties in administra-and understanding have won the hearts of all. tion as each will have its own ideas in regard to theI trust his services will continue to be at the method and carrying out of work and the countriesdisposal of this Organization. concerned will not know to whom to turn for I welcome the new President. Those of us who help nor how to execute their plans.I am surehave worked with Dr. Evang are confident that he that with reason and goodwill to come to ourwill prove a worthy successor to Dr. Stampar. aid we shall be able to arrive at a satisfactory decision in this vital matter. May I also say how happy we are to be in this lovely country, and inthisancientcapital It is heartening to know that the membershipresplendent with beauty and glorious traditions. of WHO now comprises 60 countries, including aInasmuch as environment influences greatly, I am large proportion of the countries of South America. hopeful that we shall derive inspiration from the This is indeed gratifying.At the same time aEternal City and make that contribution to full few of our friends-and they form an importantand frank collaborationof which the world group-have intimated their desire to withdrawstands so sorely in need. Ours is a great endeavour. from the Organization.I am sure all of us hereWe can succeed only if we have the requisite will deplore this decision.No organization isfaith and vision to go forward undeterred and, perfect ; least of all can perfection be expectedabove all, an abounding love of humanity in from an infant of one year that has yet to learnour hearts. how to stand and can only learn how to walk For my own country may I say how grateful and run if it is properly fed and nourished. Thewe are for the help we have received from WHO, surest way to remove grievances and remedyand I can assure you of India's continued and defects is to join hands and put our heads togetherwholehearted co-operation. and see where we have to correct ourselves, rather than to cut adrift from what should be a common Dr. Melville MACKENZIE (United Kingdom) : task.It is part and parcel of human frailty thatMay Ifirst express on behalf of the United the veil of suspicion, mistrust and fear oftenKingdom delegation our thanks to the Italian hangs between man and man, neighbour andGovernment that this, the Second World Health neighbour and between nation and nation.The Assembly, should have been afforded the privi- surest way to lift it is to serve each other.Ilege of meeting in Rome.It is from Rome that personally am convinced that if peace is to reignso much that is best in our modern civilization over this beautiful earth of ours it can only do sohas sprung and we are ever mindful of-nor through humanitarianactivity,and medicalfrom our schooldays onward are we allowed to science, par excellence, transcends all barriersforget-the debt our country owes to Roman law, of caste and creed and race and its activitieslanguage, literature, architecture and art.More may never be deterred by political considerations.recently, the work of Italy in malaria control in

- 81 - FOURTH PLENARY MEETING the Campagna, 'in Sardinia, in Sicily and in thecardo Jorge of Portugal, Dr. Hugh Cumming of valley of the Po is an outstanding example tothe United States, my countryman, Sir George the world of effective malaria work.It is nowBuchanan, and many others whose working over forty years ago that what in effect was thelives were largely devoted to the ideal which first worldwide health organization was set up inwe now see developing before us and in which Rome, and it seems to me a most happy augurywe are privileged to take a part. that, when such a wide programme of develop- We believe that we are most fortunate in having ment awaits us in the field of health, we shouldat the head of our Secretariat a man with the be meeting here. imagination, practical ability and drive displayed by our Director-General. The lines upon which the World Health Organi- We feel that after much labour the various zation has steadily developed since the lastrules and regulations governing administration, Assembly confirm thesincerebeliefofHisfinance and procedure in the Organization are Majesty's Government in the United Kingdom innow satisfactory and that we have the framework the value of international collaboration, not onlyof a secretariat capable of facing the large amount in health matters but in the building-up of theof difficult work ahead. various facets of the social and economic life As an organization we have been and still are to of the world as a whole. a great extent in our formative phase, but in We all know well from experience in our ownspite of this, certain definite achievements can countries the difficulty of getting together analready be recorded. How much has been done is efficient staff in a short time for a new piece ofconvincingly set out in the Director-General's work.There is, too, the necessity not only forReport, upon which His Majeity's Government careful planning based as far as practicable oncongratulates the whole Organization. Out- standing examples are the work completed in the statistics, but also for the determination of howstandardization of certain biological products, far the project really lends itself to internationalthe unification of pharmacopoeias, the establish- collaboration or is best done by national effort.ment of the rapid transmission of epidemiological Careful study has to be undertaken to ensureinformation, the international adoption of the that proposals for new work are not alreadylists of nomenclature of morbidity and causes of being carried out elsewhere. Due attention mustdeath, the progress made towards the revision be given to the proportionate importance ofof the Sanitary Conventions forthecontrol each proposal in a budget, which must necessarilyof infectious diseases in relation to ships and be limited by the painful efforts of many countriesaeroplanes, the technical responsibility for the to re-establish themselves economically at thepractical field work of UNICEF in connexion present time.The great possibilities of healthwith inoculation against tuberculosis and the work in the international field in themselvescontrol of venereal disease,the provision of constitute a danger, that of attempting to coverstudy tours for groups and individuals and, finally, too much ground superficially. Outside pressurethe provision of important publications dealing to obtain results rapidly and the desire to justifywith the work of the Organization, international the existence of the Organization in lay circlesepidemiology, statistics and legal developments may well be contributory factors to unsatisfactoryin different countries. and shallow work. Bearing in mind these funda- But much of this work was begun before the mental points, His Majesty's Government wel-last war.His Majesty's Government therefore comes the steady but deliberate developmentcongratulates the World Health Organization of the work of the World Health Organizationon its boldness in undertaking work in so many during the past year. new fields of international collaboration, such as regional organization, the adoption of the prin- We believe that the years of hard work andciple of associate membership, the establishment experience of the Health Organization of theof centres for the study of various diseases such League of Nations and of the Office Internationalas influenza, the potentialities of health demon- d'Hygiène Publique, the work of the Preparatorystration areas, the importance of mental health Committee in Paris, of the International Healthin the social structure, the implications of the Conference in New York, and of the Interimnew discoveries in connexion with insecticides, Commission all contributed to the structure ofcollaboration with non-governmental organiza- the new organization and have given it suretions, the co-ordination of international congresses foundations on which we can now build withand the newer developments in bibliographical confidence. In this connexion, I think itisabstracting. appropriate to remember some of the pioneers We feel that our relations with the United of international health work who have gone onNations are particularly important, inasmuch as before : men such as Dr. Lutrario, who represented they offer to international health through colla- Italy for many years on the Permanent Committeeboration with the United Nations and the other of the Office International d'Hygiène Publiquespecialized agencies the opportunity of much wider and on the Health Organization of the Leaguefields of activity, particularly those proposed with of Nations, Dr. Velghe of Belgium, Dr. LéonFAO in increasing food supplies by the control Bernard of France, Dr. Jitta of Holland, Dr. Ri-of malaria and other diseases. - 82 - FOURTH PLENARY MEETING

In conclusion, we are convinced that the Secondcollaboration in the field of health were limited Health Assembly will be another step towardsby certain factors, which were not the fault of that real collaboration in medicine which all ofthose organizations, but which were still limiting us desire. factors.In the first place, those efforts were mainly of a negative nature. They were attempts MT. BANDARANAIKE (Ceylon) : This is the firstto erect barriers against the invasion of disease, occasion on which I have had the privilege ofrather than a positive effort to control and attending a meeting of the World Health Organi-eliminate disease.Various factors that now are zation. My country is a small one. We have onlyquite rightly recognized as essential in any health very recently emerged inio a state of politicalprogramme-social, economic, mental, environ- freedom.It is more than likely that there aremental-were perhaps neglected in the earlier many amongst you who have scarcely heard thework. The World Health Organization enters name of Ceylon. upon its great tasks with a full and adequate You did my country the great honour of electingcomprehension of the problem that lies before it. us to the Executive Board at the First Assembly.It is positive, it hopes to deal with disease in a You have paid my country and myself personallypositive way, to control and eradicate disease.It the further signal honour of electing me a vice-is comprehensive, for it embraces all those social president of the Second Assembly. All I can doand economic factors which are so essential to is to give you the assurance, which I have alreadythe achievement of that high standard and level given you, of our fullest co-operation in all yourof health which it sets out for all mankind.It efforts and endeavours. recognizes for the first time as one of the most I am not an expert or a specialist, I am onlyimportant and fundamental rights of all human a politician.I do not know, Mr. President, ifbeings the right to the highest degree of health, the somewhat contemptuous terms implied inand italso most importantly, to my mind, your presidential address had reference to poli-recognizes the value of health in securing that ticians as well as economists.If they did, I canpeace and security for the world, of which we are only ask you to extend to me as a mere politicianall so much in need. that toleration and patience which I know you The Director-General very rightly stresses in the possess. May I join the other speakers today inintroduction to his Report that the work hitherto offering a word of congratulation first to thehas been chiefly of a transitory nature and by outgoing President, Dr. Stampar of Yugoslavia,way of preparation.That is quite correct.I whose devoted work, whose great tact and wisdomthink that in an infant organization of this has enabled this " portentous infant ", if I maynature we must all display qualities of patience, use the phrase, to start its life auspiciously andmutual tolerance and understanding of each well. other's difficulties, if we are to proceed further You, Mr. President, I have not had the privilegetowards the substantial realization of the ends of knowing before, but judging from the mostand objects for which we stand. excellent speech you made-a speech which would In the few remarks that I shall offer by way of do creditto any politician in the world-Icriticism, therefote, do not misunderstand me as think I may venture to hope that under yoursayingsomethingdiscouraging,disheartening guidance we will go on from strength to strength. or destructive.Fully realizing the value of the To the first Executive Board, under the guidancework of this Organization, fully appreciating the of its Chairman, Sir Aly Shousha, Pasha, ofvery good work that has already been done in Egypt, we owe a debt of gratitude for doing amost difficult circumstances, there are still some great deal of preliminary and very necessary andmatters to which we have to address ourselves valuable work ; as also to the Secretariat, led byat this Assembly, if the work of the coming year the Director-General, of whose patience, tactis to show any real and appreciable advance and ability we have the highest opinion, andtowards the attainment of that goal which we whose services, may I say, we have been mosthave set for ourselves in this Assembly. fortunateinobtaining,particularlyinthe I should like to refer to some points arising out difficult early years of the Organization's exis-of the Report of the Director-General and the tence. Reports of the Executive Board.In the first The World Health Organization to me repre-place, I should like to issue a word of warning sentsa splendidly new, bold and idealisticagainst too enthusiastic and keen a diffusion approach to the problem of international colla-of activities.In an Assembly of this nature, so boration in the field of health. I do not wish, whencomprehensive are the subjects which,quite I say that, in any way to belittle (as I know is therightly, it considers should fall within its purview, custom in certain quarters) the most valuablethat there is a danger of undertaking too much pioneereffortsof organizationsthat workedat the start and of trying to achieve all, and before WHO came into existence-the Healthperhapsof succeedinginachievingnothing. Organization of the League of Nations, the OfficeI feel that, while we carry on work generally International d'Hygine Publique, the Pan Ame-throughout the entire range of activities which rican Sanitary Organization, and other inter-fall within our purview, there must be concentra- national organizations before them, whose pioneertion in certain directions.In the first place, efforts have alone enabled WHO to enter uponregarding our areas of work I entirely agree with its great tasks with a reasonable hope of success.Dr. Stampar that the war-devastated areas of Nevertheless, all previous efforts at internationalthe world require special and concentrated effort. - 83 - FOURTH PLENARY MEETING

I should like to add to them certain other areasequipment, sufficient quantities of DDT, sufficient which have been referred to earlier in the Firstquantities of drugs such as streptomycin are not Assembly and elsewhere -the backward areasavailable to us. We want equipment and plant. of the world which rank as highly in considerationWe want trained personnel.That is a matter as purely war-devastated areas, perhaps eventhat is receiving a reasonable measure of recogni- higher.Many of the countries of Asia, parti-tion by WHO.There are teams visiting us, cularly of South-East Asia from which I come,demonstration units-very useful-but may I have only recently emerged intoa politicalask you not to lay too much stress upon the status of freedom.Let us remember that legalintrinsic value of demonstration units.You are status can be changed and conferred by a docu-offering fellowships. A number of my own people ment overnight.But it is not so easy to dealare taking advantage of that.That again is with the problems to which- our free countriesvery useful.We require literature.I do not have become inheritors. The systems of govern-think that we have progressed sufficiently in ment under which we existed in the past-believe providing the countries of the world with sufficient me, I am making no charge or complaints ;itliterature, bringing up to date the discoveries was all in the nature of things-created problemsof science in the realm of health.Nor do I feel which in the freedom we have now acquiredthat sufficient or adequate provision for doing so assume an importance that is not restricted to us,is contemplated in the budget for the forthcoming but which have repercussions on the entire world.year.That is a matter which I shall discuss in Seventy-five per centof our population aredetail in the Committee on Administration and living below the poverty line.The cultivatorsFinance. have no land, those who are engaged in industrial These are all necessities if we really intend enterprise have no work ;as the distinguishedseriously to make a good job of the task we have chief delegate of India rightly said, many ofundertaken, and a success of the very noble them have not houses suitable for any humanand high work we have embarked upon and the being to occupy. Social and economic conditionsgreat ideals we have adopted on paper.The in countries which are free and yet have largechief delegate of India referred to diseases such massesofsubmergedpopulationscreateaas leprosy, to which she very rightly drew atten- problem not only for those countries, but for thetion.That is certainly not one of the major whole world.Believe me, the question of thediseases in our country, but it does deserve some security and the peace of the world-one ofconsideration.I regret also to see an absence the matters referred to in the Preamble to theof any reference to cancer. Recent investigations Constitution of this Organization-will rest inin my own country have shown that cancer is future not in Europe, not in America :theprevalent to a really alarming degree.I should question of peace or war will be decided in Asia.like to see some attention, even as a small begin- And this problem of the health of Asia, consideredning, paid to diseases of that nature. in the wide context of our work, is one that Another subject I should like to see some consi- should and must receive special considerationderation of is one on which we have been hitherto from this Assembly.I do not think that in thediscreetly silent. There is a growing need for the programme and financial proposals for the yearconsideration of the problem of birth control on 1950 anything like adequate provision is made foran international plane. Do you realize that the those needs.I know the difficulties under whichvery health work we are doing is making that we have to work in this Assembly, but I doproblem increasingly urgent ?Without asking appeal to you to bear in mind the particularfor any decisions in this Assembly, I do suggest needs of those areas, just as much as the needsthat that subject receive some consideration ; of the war-devastated areas, which were rightlythat a beginning be made in the preparation of stressed by Dr. Stampar. the necessary statistics and data with the help What is the nature of the help that we particu-of the appropriate specialized agencies of the larly need ?The question of medical suppliesUnited Nations, so that later on, even next year, has been referred to.I stress it again.It is onewe can consider this problem which is becoming of the most disappointing features of our worka most urgent one in the world today. in the past and in our proposals for the future I now come to the question of administration. that this most important need is not adequatelyAs a Minister I am only too well aware of the considered and provided for in the proposals fordanger that we sometimes unconsciously run of the forthcoming year. If we are to work success-letting the machine become more important than fully, let us create the conditions of success. Wethe work the machine is intended to perform. need medical supplies in all our countries, facilitiesI know, in dealing with my own departments, for the obtaining of which we expect from anthat we always run a danger of red tape, of the international organization like the World Healthmultiplication of administrative offices and regu- Organization.We want help to facilitate thelations which sometimes hinder considerably preparation of drugs in our own countries, thethe efficiency of work.I can well imagine how, necessary plants for the purpose, the necessaryon the international plane, that situation may trained personnel who will be able to train ourdevelop on a much greater scale.I am not people in the production of these drugs. making any complaint or charge against our Although in the WHO programme malaria andmost efficient Director-General, but it is a matter tuberculosis rightly rank very high, in my countryon which we have to keep our eyes, or we will today we are hampered by the fact that sufficientsuddenly wake up one day to find that WHO - 84 - FOURTH PLENARY MEETING consists of an immensely intricate and complicatedhuman civilization are fast running out, and administrative machinery but that the actualeven at the cost of economic or other puritanism, output of effective work is, comparatively ateven at the cost of doing something that may be least, very small.I will have something to saysomewhat risky and not wise, let us bear in mind about that also when we deal with the budget.that time in the world today is a most essential WHO has proceeded very efficiently,I think,factor.I would like to see a sudden telescoping with this problem of merger and liaison withof the liort-term policy and the long-term policy, so many international organizations that conflictso that within a reasonable space of time we shall and overlap. We have agreements with many ofbe able to show appreciable benefits ; otherwise them, some of them satisfactory, some no doubtthere will be no room to show any work at all. the best we could obtain, but I do not thinkChaos would be upon us before our carefully verysatisfactoryinthemselves.We haveand cautiously thought out plans had time, in esta.blished liaison with other international bodies,fact, to materialize. specialized agencies of the United Nations. We Lastly, this is the age of internationalism. must proceed to take all steps necessary in theEverywhere we see various international organi- coming year to see that unnecessary duplication,zations ;they all glory in all sorts of letters, conflict and overlapping are done away with atXYZ, ABC, and heaven knows what. To a simple- the earliest possible date. minded person like myself it is difficult even to One word about regional organizations.It isknow sometimes what these letters stand for. perfectly correct that in a wide international bodyBut the world is internationally minded today for ofthis nature undue centralizationis mostthis reason, that there is a realization that it is undesirable. The creation of regional organiza-only by increasing international co-operation tions, therefore, is a very wise step.There areandcollaboration,sincereself-sacrificingco- three already, and I believe more to come later.operation and collaboration alone, that human I am disappointed in the provision made in theprogress can be secured in the complex and fast budget for the expenses of the regional organiza-moving world scene today.I may even say, the tions and for other work in connexion with thesurvival of humanity can only be secured in that regional organizations. I have not the least doubtmanner.It has been pointed out quite rightly that one of the most effective methods wherebythat with all the goodwill in the world there are WHO can function efficiently is not only ina number of international organizations which are creating, but in enabling such regional organiza-proving disappointing today.It is true, various tions to function efficiently in their own areas,factors and differences, divergent political ideo- and in their supervision, control and advice, oflogies, divergent and different power groups, all course, by the parent body, the World Healthkinds of personal ambitions and aims and axes to Organization. grind are to a great extent reducing the efficient A word about finance. A rather unusual pro-workingof many internationalorganizations cedure has been adopted in the financial proposalstoday.If there is one international organization for the coming year.They are bold, they arewhich should be free from such limitations and somewhat unusual, but may I hasten to say thatsuch difficulties it is surely this.There is still a in my opinion, they are not essentially unsound.common bond that bindsall men together. The division of the budget into regular expendi-Irrespective of differences of political ideology, ture and supplementary expenditure, dividedof race, creed, religion or anything else, there is the again administratively and operationally, is incommon factor of human suffering.That is the my opinion fundamentally not unsound.Thereone thing which we are here to deal with. Cannot are very cogent reasons why this step should haveI hope that in dealing with that we can at least been taken.In the case of the supplementalmake the effort to forget those differences here, budget we are dependent upon contributionsandinthat commoncollaborationremove that countries may make to us in the future.suffering from mankind ? There was a great man There is no essential harm in that. As you know,recently who experimented with truth. It was an the presentation of unbalanced budgets is by noexperiment that was very successful ;I am means unusual even in the case of nationalreferring to Mahatma Gandhi. I ask you here also budgets,and although our economic purists,to experiment with truth. To experiment with the particularly from the United Kingdom, may have,truth of common human suffering and the common and quite justifiably, to say quite a lot on theneed to overcome that suffering, and in doing subject when we reach the point, I sincerelyso to forget these differences and difficulties which hope that there will be no effort or attempt toare arising already amongst us.Reference has cut down or reduce this budget. Seventeen millionbeen made to certain countries who have joined dollars on both sides of the regular budgetus, powerful great countries, with reservations and and the supplemental budget ispatheticallylimitations, and to certain other countries who, small compared with the vast sums of moneyowing to their suspicion, doubts and difficulties, being expended today on various internationalhave expressed a desire to withdraw from this projects ;pathetically small when we consider Organization.Let us be tolerant of each other. the immense work which we have to do. We haveLet us understand the difficulties of each other. to be cautious, we have to be wise in ourLet us understand the constitutional difficulties proceedings, but let me also remind you of this,of certain countries which to many of us may that in the context of world affairs today timeseem extraordinary, but still nevertheless are is becoming an essential factor.The sands ofvery real today.Let us understand the fears of -85 - FIFTH PLENARY MEETING

certain other countries, and in a spirit of mutualone country against another, of one group against collaboration in that experiment with truth toanother or in finicking legal points ?I have come which I referred, let us make an effort to makea very long way here-my government had to this Organization at least the success which itmake special arrangements, for we are having a deserves to be.It is an experiment that is worthvery busy time now with the preparation of our the trial, believe me, that is fully worth the trial.budget, to enable me to come here-and I am Some years ago we had a very serious mitbreaksure you will agree with me when I say that I am of malaria in my country. Hundreds of thousandsentirely sincere in my desire to make the work of of people were ill and dying of it. In the course ofthis Assembly, this Organization, entirely success- my visits through my constituency I came toful ; it is an effort in which I assure you again that an outlying village occupied by those who wouldyou will have the fullest assistance and co-opera- be described as the depressed class. On my arrivaltion of my country, small though it may be. a group of people were harnessing a bull to a cart. I finally thank the authorities and the Govern- I asked them what it was all about and the storyment of Italy for the invitation which they have I heard was most remarkable. The whole villageextended to us to come here and have our meeting, was down with malaria. They had to go six or and for the great hospitality which we are receiving seven miles to the nearest dispensary to getat their hands. quinine. The occupants of one house, for example, It is only fitting, as more than one speaker has were all sick, including the breadwinner.Theysaid before me, that we should meet here in Rome had no money, they couldn't walk, they couldn'tto carry one step further for the coming year the find anybody to send to the dispensary for thegreat work which we are doing in the inspiring quinine mixture. They went into their little hut,atmosphere of this great city, which in its long closed and barred the door and just lay down tohistory of a thousand and five hundred years has die. Nobody knew what was happening for twocontributed so much to the spiritual, the cultural or three days ;then the neighbours observedand the legal progress of humanity.A great that these people had not been seen coming inRoman poet, one of the greatest poets of the and out of the house. They broke open the doorworld, one who was very sensitive to human and went in.The father, mother and threesuffering, and of whom it has rightly been said children were dead.One small child alone wasthat every page is touched with the tears of still living.The nearest hospital was about 20kings, every line melodious with sadness,in miles away ; that cart would never have reachedreferring to the sound of the legendary founder the hospital with the child alive.I took thisof Rome, said of Aeneas, who marched bravely child upon my lap in the car and told my driverforward fulfilling the destiny of the Roman to drive as fast as he could to the hospital. Thepeople and of the world :" Attolens humero fa- child died in my arms before I reached themamque et fata nepotum "-" bearing on his hospital.It was a dead body which I handed toshoulders the fame and the fate of his sons ". the doctor. I swore to myself that, if ever I hadWe too are inheritors of that tradition, and we are the power, such a state of affairs should notbearing on our shoulders today to a very consi- continue. derable extent the destinies and the fate of genera- I have much pleasure in informing you thattions to come.Let us address ourselves to that the intensive campaign carried on in my countrytask in a spirit of humility, in a spirit of collabora- -it was in the years 1945-1948--has, particularlytion, casting aside all our doubts and fears and with the help of DDT, enabled us to controldifferences.A grave and serious responsibility malaria, the incidence of which has been reducedrests on the shoulders of all of us. Let us see to by 75%. I shall now proceed to eradicateit that we prove worthy of that great responsi- malaria from my country altogether. On behalfbility. of the government of my country I give you the assurance that it will be done. The PRESIDENT : The meeting is adjourned. Do you wonder, feeling as I do, that I have not come here to be engaged in petty squabbles of The meeting rose at 6.40 p.m.

FIFTH PLENARY MEETING Wednesday, 15 June 1949, at 9.30 a.m. President: Dr. Karl EVANG (Norway)

25. Discussion on the Report of the Director-also stresses the necessity of adopting resolutions General and the Reports of the Executiveof a high-minded nature and of forming a common Board (continuation) front of all the nations of the world in dealing Dr. CLAVEAUX (Uruguay) (translation from the with health problems. He emphasizes the urgency Spanish): I have been greatly encouraged by aof treating concrete problems such as the budget letter from the Director-General in which heof the Organization, the tradition and character solicits the attendance of the Ministers of Publicof the regional organizations, and the necessity of Health at this Assembly.The Director-Generalagreement as to the future administration of the - 86 - FIFTH PLENARY MEETING

International Children's Emergency Fund. I havemonths of its existence with respect to specialized temporarily laid aside my pressing duties asactivities,operations carried out, information Minister of Public Health of Uruguay in order toservices and co-ordination and organization, it be able to contribute as well as I can towards theis very easy to appreciate the enormous field solution of the problems with which we are faced.of work covered by this Organization and the I have also come here to collaborate systematicallyneed to plan its activity in advance, so as both with those persons and institutions for whomto direct and continue its development, while the problems of public health are a dominantendeavouring to prevent any deformation or any preoccupation, the basis of their policy and theother anomalies of growth. very foundation of civilization.I have come here Health embraces everything : general hygiene, for administrative and practical reasons but alsothe prevention of illnesses by biological methods, for reasons of a philosophical nature and becausemedical assistance and therapeutics, culture and I am deeply convinced that in this Assembly,education which encourage the individual to with the administrative resources at its disposal,care for his own healthand guide him in this we shall reach a solution of those importantrespect,socialorganization and thegeneral problems which in the physical, moral and socialstandard of living. spheres control the future of man on this tor- Which sector or sectors of this enormous field mented planet. of action are on the national plane, and which I have come here not to defend regional and, are the specific work of this World Health Organi- still less, purely national interests, but as a citizenzation ?I feel that this Organization should not of Uruguay to collaborate in work of universaltry to assume the responsibilities which belong importance. Uruguay as a country will notto governments. It must not invade fields which attract to any large extent the attention of theare recognized to be the activity of private chari- Assembly and its executive committees, becausetable organizations.It must not try to assume from many points of view we are placed in anfunctions which are proper to the universities. exceptional position. It is a country whoseIt can and must, however, draw on established inhabitants are all of the same race, with a tempe-science, on goodwill and on reliable statistics in rate climate, and with a favourable topographyorder to direct its activities in the threefold which facilitates communications betweenallinterest of governments, peoples and technicians parts of the Republic.Uruguay is absolutelyas precisely as possible so as to achieve its objec- free from yellow fever,malaria, exanthematictives without becoming involved in extraneous typhus, bubonic plague and smallpox. The people issues. have been vaccinated on a large scale against The long collaboration with the Pan American diphtheria, typhoid fever, and tuberculosis. Sanitary Bureau, which is now closer than ever, Delegates from this Organization who haveenables us to appreciate the benefits and the recently visited the country under the auspicespossibilitiesof this type of co-operation and of the expert committee have recognized thesuggests that, for America, the connexion already perfection of the methods by which tuberculosisestablished will also help us in the future. is located and the efficacy of the results achieved It will, of course, be necessary to approach this in this field. The intensive treatment of venerealproblem with tact and political insight, using disease by antibiotics and other means is suchimagination and ripe experience, if the fruits of that we can now localize this problem and canour work are to be numerous and beneficial.I look forward with optimism tothefuture.must state, on behalf of the delegation of Uruguay, General mortality as well as specific mortalitythatthecontentsoftheDirector-General's for each disease is regularly decreasing in Uru-Report and the Reports of the Executive Board guay. The expectation of life is increasing on aare proof of a clearly defined orientation, of real parallel scale.The food situation in Uruguaycompetence and efficiency. is excellent and the food is of the highest quality. We congratulate the authors and assure them of Considerable quantities of meat, milk and greenour co-operation in the hope that our efforts will vegetables are available.The cost of living atbe crowned with success. present is one of the lowest in the world. Socially speaking, an effective democracy must The PRESIDENT :The representative of the guarantee protectionfor the individual from Philippines. many points of view. Legislative measures which have been in existence for many years have Dr. VILLARAMA (Philippines) :Reference has enabled us to reach this present level withoutbeen made to the historic city of Rome as the disorder, violence or social upheaval. depository of culture and progress. Realizing As Minister of Public Health of Uruguay, Ithat the World Health Organization is dedicated hope to find in the World Health Organizationto health promotion and disease prevention, the technical collaboration, the guidance, theand that it is holding its Second Assembly in this documentation, the advice on the methods to bewonderful city, the delegates representing practi- followed and the regulations to be framed in ordercally all nations of the earth cannot, fail to realize to solve our health problems with our ownthat we are here in answer to the beacon light that resources. was once Rome's engineering feat and toother On reading the very complete report presentedspecialized knowledge that will put to shame by the Director-General on the activities of theeven what are considered to be the achievements World Health Organization during the first fourof the Modern Era.The art and the sciences L- 87 - FIFTH PLENARY MEETING of today have yet much to learn from the master- I have no doubt that you have anticipated my pieces we see everywhere in Rome. desire in advocating a regional headquarters in In mentioning these facts I have in mind theManila with Japan, Korea, , and the Philip- Annual Report of the Director-General of thepines forming that region. The unsettled status World Health Organization, who has shown fullof Japan and the fratricidal civil wars in China grasp of the subject-matters which are believedwill leave South Korea and the Philippines to to be within the province of our Organization.form the block.The peoples in these countries His ability and foresight can be appreciated by aare not exactly backward peoples ; I say that they perusal of this detailed and itemized report ; thisare progressive peoples waiting only for the to a great extent portrays the ideal that he hasencouragement and help that other sister nations conscientiously followed in discharging the respon-could afford to give. sibilities of his high office, in the execution of which he puts servi;e above himself. In fact, in You all know of Japan before the last world all problems of public health,the report iswar ; China may be no longer the sleeping giant exhaustive and has such a telling effect on anyonethat she has been and Korea shows signs of who mav read it that we can say that, if there waspromise and hope for the future. My country, the the Rome of antiquity and the citadel of Christen-Philippines, has a population of 20,000,000 with dom, our present era has a World Health Assemblyan area of some 110,000 square miles ; it is bigger for the promotion of health and prevention ofthan many of the countries of Europe.As you disease in all parts of the world, without distinctionknow, it was under Spain for over three centuries of colour, race or creed. and then under the United States of America, This is, indeed, a your% organization ;itiswhich did not rule us, which did not govern us, young in the sense that we have to harness allbut which has cradled us to the democratic peoples of goodwill throughout the world andinstitutions that Washington, Jefferson, Lincoln, make them contribute what they can, so thatandlatelyFranklinDelanoRoosevelthad the funds thus raised may be distributed-asinculcated into the minds of the American people. indicated in the Report of the Director-General-My people, therefore, represents an occidental to regions that need them most. culture, nourished and guided by the altruistic We of the Far East have always taken it thatAmerican nation. Incidentally this is an apprecia- the occidental people have always been the leaderstion and acknowledgement before the whole in any movement, although in reality civilizationworld that if it were not for the United States, my started in the East. By the process of evolutioncountry, which was devastated by the cruellest and in accordance with recorded memory andwar of all times, could not have had a semblance the histories of nations, the Eastern Hemisphereof rehabilitation by this time. Our principal has somewhat taken the attitude of relying on thecities were reduced to ashes ; Manila, the capital, ability and leadership of the Western Hemisphere,was reputed to have been even more devastated so that progress in the East has given rise to thethan Warsaw.In 1945, therefore, we started expression, " the lightening of the white man'sfrom scratch with increased sanitary problems. burden .". But the United States lent us funds for the In this world movement it is not out of place toordinary functions of government. The War mention that the financial and the technicalDamage Act augmented our funds for health assistance extended to us by the Western peoplematters.The Williams-Waterman Funds made has been very significant.But certainly in thepossible our investigations in beriberi.Recently implementation or in the carrying-out of thewe were granted three fellowships by the World objectives of the World Health Assembly thereHealth Organization ;three demonstrators were sent to the Philippines, their expenses being shared may be honest differences of opinion.Itis presumed that there can be no universal formulaon a fifty-fifty basis. We are grateful for all the to meet all ills, and the Report of the Director-help that we have received so far.Of course, General is very clear on this point.Local orwe are not expecting and we should not expect regional problems willarise and the centralthat WHO will do miracles for us, but my country organization of the World Health Organizationand my people, I believe, have a right to expect should be condescending, not to say understandingthat you will not turn a deaf ear to our pleadings, and sympathetic, enough with the people affectedas we still need further help from the Organization in that area to give them a chance to solve theirfor the better control of preventable diseases. own problems and tribulations. Of course, The Philippine Government has started a tuber- supervision is necessary and probably also theculosis control programme. The French Govern- technical skill, but for the proper orientation andment has given us BCG vaccine, with which to better efficiency of the service, may I say thatinitiate our BCG vaccination scheme.We are there should be unity of purpose. That unity ofnow engaged in general immunization work, purpose should find a responsive chord throughfollowing the success in the South American the central office, which will set up a branch orrepublics and the inspiring lectures of Dr. Gumer- agency or headquarters of the Organization in asindo Sayago of Argentina during the last quarter particular region so as to develop and propagateof 1948. We have now a Fellow in Copenhagen the principles of better health and better medicalbeing trained for this work.Dr. Naffziger did care. splendid demonstrations in neurosurgery during - 88 - FIFTH PLENARY MEETING his stay in the Philippines.Dr. Steele has givenlargest toll of life and threaten the health of hope and faith to hypertensives.Dr. Amadorwhole populations. Guevarra ofCostaRica,a venereal-diseases Tuberculosis, malaria, venereal disease, mental specialist, has been given a prolonged assignmentdisease, etc., are the chief enemies of health. with us.All these representatives of WHO haveThe tribute exacted by them is heavy and it is given us encouragement. against these enemies that we must strive un- Lastly, may I bring to the attention of thisremittingly and with all the means at our disposal. Assembly that one Filipino dies of tuberculosisSerious infectious diseases, cholera, plague, typhus, every 15 minutes and that there are approximatelyetc., should also be among our main concerns. 60 Filipinos falling sick of malaria also everyIn addition, we should at once increase the effi- 15 minutes.In other words, the mortality ofciency of our maternal and child health services, tuberculosis and the morbidity of malaria showfor it is on the sound organization of these services startlingandglaringfigures,undoubtedlythat the fate of future generations depends. deserving serious consideration. These are priority To achieve the aim of our Organization we must public-health problems in the Philippines.Maytherefore make an immense effort on a wide scale. we expect substantial help in reducing to theIt will be a hard and exacting task and one calling minimum the toll of human suffering which myfor ample funds. Above all, however, the peoples country is paying for these scourges every year ?must be made to realize the scope and significance of our work, since without their active and intel- ligent support there can be no permanent results. Dr. KARABETSOS (Greece) (translation from the French): I desire to offer my cordial thanks to Let us unite our efforts on the lines proposed the distinguished members of the expert com-by the Executive Board.To win the battle mittees and of the Executive Board, and especiallyagainstour most dangerousenemies,every to the Chairman of the latter, Sir Aly Shousha,possible help should be given to the threatened Pasha, for the zeal they showed, during the shortpeoples who, owing to the devastation caused time in which they exercised their functions, inby the war, can only count on very slender dealing with a series of highly important scientificresources.It is to these peoples that Greece has questions raised by the First World Healththe melancholy privilege to belong. For centuries Assembly and in drawing up and submitting toshe has fought for her independence, for the the Second Assembly a complete programme,freedom of man, and for freedom of thought. which takes into account, on one hand, theShe has been forced to sacrifice for her ideals the financial resources of our Organization and, ongreater part of her economic potential and of her economic resources, which are insufficient because the other, the most urgent international problemsof the barrenness of her soil.The result is that in the field of public health. no margin is left for other needs, or even for I also offer my warm thanks to the eminentpublic-health requirements, since unhappily there Director-General, Dr. Brock Chisholm, who hasis no improvement in the situation, a situation been indefatigable in studying all the questionsfor which Greece is not responsible. in which we are interested and has done all in his Before the last world war, Greece had greatly power to facilitate the carrying-out of the taskincreased her sanitary equipment by cutting before us.I congratulate him on the excellentdown all other expenditure.Unfortunately, this report that accompanied the Executive Board'sprogress was later brought to a halt.Thanks programme for 1950, which was submitted to theto the help extended by our friends and various present Assembly for discussion and approval. organizations, and more particularly the conti- In his Report, the Director-General defines thenuous and generous aid of the United States of general principles we should follow in the bitterAmerica, we have been able to rebuild our struggle to improve the health of the peoples ofsanitary organization and even to add to it. But the world.These principles, I feel sure, will bewe are still far from having reached the required universally approved. level since, to the ordinary expenditure required The Director-General states that victory infor the development of our sanitary equipment, this struggle will not be gained by those whomust be added every day other heavy expenditure advocate defensive measures, which have hithertowhich we cannot meet.At present, Greece is been employed in the majority of cases despitefaced with particularly urgent problems due to the the opposition of those advocating offensivedisplacement, brought about by the insurgents, measures.In this view he is undoubtedly right,of 700,300 inhabitants.The position of these especially since the enemies of health often haverefugees, most of whom are homeless and live on their side the ignorance of the masses, lowunder the most wretched conditions,merits standards of living and, at times, even the apathyspecial attention.The country must therefore of the responsible authorities.But we mustmake an effort to find as quickly as possible the recognize the need for acting prudently, since themeans of putting an end to this particularly enemy is strong and implacable and holds swayregrettable state of affairs.I would ask the over most parts of the world, whereas our variousAssembly to take up this problem and to ask the resources, and especially our funds, are entirelyExecutive Board to examine it with particular inadequate for our needs.We must thereforecare at one of its earliest meetings. As I am quite act wisely. A vigorous combined effort is impera-aware that our Organization does not possess tive, especially in our initial attack, if we wishadequate means, I would ask that the question be to get the better of the diseases which take thesubmitted to the Economic and Social Council - 89 - FIFTH PLENARY MEETING of the United Nations, and that the Council beorganizations, UNICEF and WHO, come probably invited to help Greece to find, as soon as possible,further than any other country in the world. a satisfactory solution for this urgent and painfulAbout 75% of alftuberculin " negative " persons problem. in the age groups from 0 to 25 years have already Other countries are in a similar position.Allbeen vaccinated. - must be helped because of the urgency of their Finland has been fortunate in receiving great ne'eds.As a doctor, I have one observation tohelp from WHO and its Interim Commission make. You are aware that we have been calledduring the last two years in the form of fellow upon by the United Nations to create our Organi-ships, visiting experts and medical literature' zation with the purpose of improving and ofWe are very grateful for all this assistance, which raising the health standards of all peoples to thehas been a strong stimulus to the development highest level.I therefore assume that we haveof public-health services in a country that for the right to ask the United Nations to provideseveral war years had been isolated from inter- us with a surer foundation on which to build anational co-operation and from the new achieve- world organization designed to improve the healthments in medical science. Over twenty fellowships of all countries. allocated by WHO have enabled us to send most We doctors are closer than other men to theof our best public-health doctors and nurses pain, sorrows, fears and privations of humanity.abroad to brush up their knowledge and to bring We are therefore best qualified to appraise themany new and stimulating ideas for the intensi- pernicious influence of all these factors on physical ficationof various public-health programmes. and mental health. On the question of the bestThe benefit of these fellowships and of the visits method of supplying technical,scientific andof the excellent WHO expert consultants has financial help, and more particularly on the lastbeen doubled because of the fact that the whole point, we reserve the right to make a few remarkspublic-health legislation in Finland has been when the subject is brought up for discussion.renewed and Tevised during the last few years. At present we can say that no country is in aAs a resultof this recent development, the position to meet all its health needs out of itsfollowing facts may be mentioned : today over own regular budget. 90% of pregnant women and about 60% of infants are registered in health centres and visited A way must therefore be found to create a fundin their homes by midwives and public-health specially designed for this purpose for eachnurses. In addition to the earlier health centres, country. One method would be to organizeover 200 new health-centre buildings with living social insurance schemes on a firm basis, parti-accommodation for public-health nurses and mid- cularly health insurance.The latter should bewives have been constructed during the last two made compulsory for all citizens, and everyoneyears and 100-200 additional are under ought to contribute according to his income.construction. This is in keeping with sound insurance principles that the richer must help to pay for the poorer, In order to create the closest possible collabo- and it also follows the teaching of the Gospels.ration between our country and the World Health I request that my proposal be examined at theOrganization, about six months ago the Finnish proper time. Government appointed a special permanent com- mittee called the WHO Committee of Finland. In conclusion I would again thank the Director-This committee, which has a secretary employed General and the Executive Board for what theyfor this particular purpose and whose chairman have done, and I sincerely hope that the mostis the Director-General of the State Medical Board, complete success will attend the work of thehas members from all important governmental Second World Health Assembly. and voluntary offices and organizations dealing with public-health matters.The candidates for fellowships are selected by this committee.In The PRESIDENT : The last speaker on my listthe same way the committee makes proposals this morning is the representative from Finland.concerning Finland's participation in congresses and conferences dealing with medical and public- health matters ;it receives and takes care of Dr. SAVONEN (Finland) : I am grateful for yourvisiting consultants, and itis,in general, a permission to say a few words at this meetingconnecting link between Finland and WHO and on behalf of Finland.The international healthother international organizations in this field. work carried out by such a mighty organizationThe committee is planning, among other things, as WHO is of great importance, especially to thethe celebration of World Health Day. small nations.They cannot carry out scientific research work on as large a scale as the big Lastly, as a sidelight, it may be mentioned that nations, but the smaller nations have the possi-this committee has had a co-ordinating effect on bility of applying in practice the results of sciencethe relations between the different public-health achieved elsewhere.For instance, in the BCGorganizations,governmental andnon-govern- vaccination campaign Finland has, with themental, inside the country itself. The committee generous help of the Scandinavian Red Crosshas already shown its great practical importance, - 90 - SIXTH PLENARY MEETING

and I am bold enough to aSk whether perhapsmore speakers would like to take part in this there might not also be reason for other countriesgeneral debate, and I would therefore ask you to appoint similar committees. At l.a.st in Finland to indicate whether you would like to prolong our experience was that previously it was notthe list, and to announce your names to the sufficiently clear and evident which body hadChair, if possible today. the proper responsibility in matters now belonging I have a further announcement to make.If a to this WHO committee in my country. We indelegate prefers to speak in an official language Finland are convinced of the great internationalwhich is not French or English, then we would importance of the World Health Organizationask him to facilitate the work of the Assembly by and we wish it all possible success. presenting an extra copy at once. That will make it possible to make interpretations into the two working languages, French and English, simulta- 26. Announcements by the President neously. And I would also like to recall to the The PRESIDENT :There are HOW eight moremembers that we have a tremendous amount of speakers on my list for the general debate.work before us, that the time is short, and that, However, several of these speakers have said thattherefore, all delegates should try to make their they would like to speak tomorrow.Thereforestatements as short as possible. the general debate will continue at the plenary The meeting is adjourned. session tomorrow morning at 9.30. It is absolutely necessary for the Chair to know now whether The meeting rose at 11.55 a.m.

SIXTH PLENARY MEETING Thursday, 16 June 1949, at 9.30 a.m. President: Dr. Karl EVANG (Norway)

27. Announcements by the President announce the name of each speaker and I wil also announce the name of the next speaker. The PRESIDENT : At yesterday's meeting of the General Committee I was asked to make an The Director-General would like to make an attempt to finish the general discussion today. announcement. There will be two plenary sessions today-from 9.30 to 12 and from 3.30 till about 6.30.That28. Announcement by the Director-General gives us five to five-and-a-half hours, and I think The DIRECTOR-GENERAL : Under the amended it should be possible to finish the general discussionRules of Procedure which have been provisionally in that time. You will recall that I set a deadlineaccepted by the Assembly, tomorrow, Friday, is yesterday, asking that all delegates intending tothe last day for the acceptance of new items for speak in the general debate would kindly givethe Supplementary Agenda.13Any such new me notice.As a result I have now a final listitems are to be accompanied by the relevant of speakers in the general discussion, which I willdocumentation as requested in the Assembly read to you : Pakistan, Austria, Brazil, Czecho- guide.Any such documents should be handed slovakia, Hungary, Turkey, Italy, United States of.to the President or to the Director-General America, El Salvador, Iran, Bulgaria, and Poland.before tomorrow evening. That is, altogether 12 speakers. No more names will be admitted to this list. 29. Discussion on the Report of the Director- The General Committee also decided to try General and the Reports of the Executive today a new system to save time.It was Board (continuation) announced in the two main committees yesterday. The PRESIDENT :I now open the debate and We shall ask all speakers to present a translationtake pleasure in calling upon the representative of their speeches or, if they do not like to makeof Pakistan. The next country to speak will be a translation themselves, they may present their manuscripts to the Secretariat beforehand, soAustria. as to give the Secretariat time to make a transla- Mr. KAZI (Pakistan) : The delegation of Pakistan tion. In this way, when the speaker starts here inis glad to have this opportunity of associating the plenary session, we shall have a translationitselfwholeheartedlywiththesentiments ready ; if the speaker speaks in French, then youexpressed by the previous speakers regarding can listen simultaneously to the English inter-the part played by Dr. Stampar in this Organiza- pretation, which will be read over the earphones,tion. We will miss his towering personality, and vice versa ; that will, in many cases, save us time.I will signify when the speaker starts 13 Rule 6, as amended, Off. Rec. World Hlth Org. whether you can listen at once or not.I will 17, 53 - 91 - SIXTH PLENARY MEETING

which on many occasions has been of immensestudies by the Board and by the regional organi- help to the Organization in the initial stages of zations. its existence.Our sense of lossis, however, We feel that this procedure will ensure a solid compensated by the feeling that these responsi-ground for planning our fresh activities. bilities now devolve on you, Mr. President. This has been a happy choice of the Assembly, and it In certain directions we have, however, to go has given us assurance and confidence that theall out, for there is no turning back on the items future conduct of our affairs is in safe hands.of programme to which we have already com- mitted ourselves. But here also let actual expe- , We also fully and sincerely endorse the senserience guide us in the formulation of expansion of gratitude to the Government of Italy for itsschemes.For our task often denotes a state of marvellous hospitality and welcome. war with the forces of nature, and it is a pre- To appreciate the difficulties of this Organiza-requisiteof good generalship toconsolidate tion during 1948, we have to look carefully for anone's gains before going forwqrd. inconspicuoussentence tucked away inthe Analysing our needs, we come up repeatedly Director-General's introduction to his Report,against the one fundamental requirement of the where he says, " The Secretariat prepared theunderdeveloped and war-damaged areas, namely, report on 1948 activities, worked out the allocationthe need for technicians, without whom no of funds for 1949, and planned the programmeprogramme can possibly succeed. and budget for 1950 ".This short and pithy summary speaks volumes and is worthy of careful The solution offered to this problem is to extend note as the Director-General has therein indicatedhelp to the different countries in the shape of the triple achievements of the year, which shouldinstructors and equipment. Accordingly, we satisfy the most exacting critic. When we comewelcome theemphasis whichtheDirector- to consider the future programme, let us bear thisGeneral has rightly laid on this aspect of the statement in mind, for it also contains a definiteprogramme. warning, namely, that by hastening our develop- But the training of technicians is a slow, pains- ment incontinently we run a definite risk oftaking process, for the knowledge acquired by pressing the Organization to a breaking point. them has to be assimilated and matured before it There will be ample opportunities for discussingcan produce the desired result. This process could be greatly hastened by setting up comprehensive the future programme in different committees,teaching facilities in each region for each subject. but my delegation is inipelled to remark on a few points of broad policy. We feel that the impactWe feel, however, that there would still be a place of local conditions gives such diverse shape to thefor fellowships in foreign countries in our pro- problems of health in different partsof thegramme, as -the collateral benefits of such inter- world that practical solutions thereto can bechange of scholars are far too many to be set expected to evolve only after intensive localaside on the plea of utilitarianism. study. In our concept of future planning, there- In venturing these few words of advice, Pakistan fore, we must be guided more and more by thespeaks from experience.We are a newly born precise knowledge obtained through our regionalState which was faced with a multitude of organizations, which alone are best fitted toproblems at birth. We saw ahead of us a bewilde- study the prevailing problems and to suggestring variety of vistas, each tempting us for a appropriate remedies.The central Secretariatheadlong rush.In the short period of less than should concern itself with presenting a compositetwo years we have learnt that our greatest picture of the overall situation, secured throughprogress has been along the paths that had been these sources, thereby furnishing the Organizationcarefully studied and surveyed.The steady, with a safe and sound basis for activities. Wepersistent onward move has carried us forward realize that this procedure may entail a certainat a rate which at the time appeared to be slow amount of delay which may tax our patience,but which on retrospect has turned out to be a particularly when we see such misery around us:galloping speed. But in spite of this we would commend this policy, To summarize, our view, which is subject to for in the affairs of mankind in general, and ofmodification in the light of detailed discussions in health in particular, it does not always happen thatthe various committees, is to concentrate on the the seemingly shortest is the nearest route toprogramme to which we are committed,to our goal. develop our regional organizations to the full, and We observed that the First World Healthto prepare the ground carefully for further advance Assembly passed on most of the puzzling problemsby a detailed local study of each problem. to the Executive Board. We now see how right we were, for under the skilful and superb guidance Dr. KHAUM (Austria)(translation from the of Sir Aly Shousha, Pasha, the Board has nowFrench): As chief delegate of Austria to the thrashed out all these problems, and narrowedSecond World Health Assembly, I have the them down to concrete alternatives.It is ourgreat honour and pleasure of conveying to you humble submission that in this Assembly toothe greetings of the Austrian Government and of we should beware of rushing into irrevocableexpressing our best wishes for the success of the decisions and of disregarding the needs for furtherAssembly's work. - 92 - SIXTH PLENARY MEETING

I also wish to express our greetings to the Italianon the part of persons willing to accept treatment. Government,. which has given us such a friendlyIn the case of minors and legally incapacitated welcome, and to our Italian colleagues, as well aspersons, the consent of their legal representative to Professor Andrija Stampar, who presided overis required. The law also regulates the question the Interim Commission and over the Healthof cost so that the persons concerned may be Assembly last year, and to the new President,inoculated entirely without charge. Dr. Karl Evang. In this way a basis was created at the same time Austria is a small country and must be reckonedfor the use of preventive Calmette inoculation by among the European States that have been mostthe Scandinavian Red Cross Societies in collabo- heavily stricken by the frightful catastrophe ofration with UNICEF-called the Joint Enter- the Second World War.It is not, however,prise-with which the Austrian Government on that account only that Austria takes ansigned a contract and which, with the help of a active interest in the World Health Organization,few foreign teams and of a larger number of which she thanks for advice and help bestowedAustrian teams, began a successful campaign in in past years, but also because it is her intentionthe country. and resolve to promote the aims of the World Compared with 1947, there was also. a decline Health Organization with all her strength, and toin the number of new cases of venereal disease contribute to the achievement of these aims. -36% for gonorrhea and 35.5% for syphilis. In the course of the past few years Austria hasCompared with the year 1947, there was an made a great advance in public health, and hasincrease, notably in Lower Austria, of 120.7% thus helped to improve health conditions inin the number of persons bitten by animals either Central Europe. suffering from or suspected to be suffering from This improvement isalso reflected in therabies. A remarkable fact is that animals harmful number of cases of infectious disease that haveto game, and also black game to some extent, been reported. War epidemics, in the narrowerhave been infected in a few districts of Lower and sense of the term, are still declining.In 1948,Upper Austria. Austria was free from petechial fever. Abdominal In any case, the report for 1948 affords evidence typhus cases showed a decrease in 1948 of 51.3% ofsatisfactoryprogress towards healingthe compared with 1947, and dysentery of 65.2%.grievous wounds caused during the war and the In spite of the most vigorous efforts by the healthpost-war period. authorities, the incidence of the above-mentioned diseases has not yet been brought down to the Immediately after the cessation of hostilities, a average which obtained over a long period ofbeginning was made throughout Austria with years before the war. rehabilitation work. In particular,seriously damaged hospitals were reorganized. In the As already stated in the 1947 report, there wereabsence of essential raw materials reconstruction many cases of malaria among returned prisoners.was hampered at the outset by serious obstacles This accounts for the increase, which is compara-which, however, have frequently been overcome tively small, in that disease. in the past few years.Austria's own efforts, The number of compulsorily notifiable cases ofseconded by foreign help, have enabled many tuberculosis remained generally unchanged asinstitutions to resume their activities on the old compared with 1947, when infectious tuberculosis scale.This is proved by the number of hospital of the lungs and throat showed a slight. decrease.beds available.Whereas in 1945 only 43,870 The figures for tuberculosis of other organs werebeds were available, the number is now 60,738. a little higher. This increase is altogether surprising in Vienna In1948,tuberculosiscontrol wasgreatlywhere, in the year 1945, 1,300 beds were available, strengthened in two ways. The therapeuticwhile in 1949 there are again 19,167. stationsof Al land and Strengberg were re- established and put into working condition with Up to the present the need for medical instru- the vigorous support of Switzerland, and strepto-ments and medicaments has also been met largely mycin was imported and, as in other countries,out of relief supplies. There is, nevertheless, still distributed to the various treatment centres. a serious shortage of hospital linen, of x-ray The year covered by the report has also been afilms and of various instruments, such as injection- landmark for Austria in tuberculosis control.syringes, etc. Active preventive inoculation with BCG was Neither the Government nor the provinces and introduced, and thus a principle which had longcommunes have the means to carry out completely been practised in the treatment of acute infectiousthe work of reconstruction and to put the installa- diseases was now applied in connexion with thistions into full working order. grave affection, which is such a serious threat to Although much has been done since the war in public health. regard to housing, some 70,000 houses having An Austrian law of 23 February 1949 indicatesbeen rebuilt up to date, great hardship is still not only the categories of persons to be inoculated,being suffered owing to the destruction of about but also the technical requirements of inoculation.300,000 houses in Austria by military action. It provides for preventive inoculation againstAs a result, hundreds of thousands of persons tuberculosis on the basis of a voluntary declarationare today still housed in inadequate hutments, - 93 - SIXTH PLENARY MEETING camps and shelters.Naturally this situation haswill be continued and developed so as to promdte a direct bearing on general health. the co-ordination of such legislation throughout Foodconditions,however,havegreatlythe civilized world.Austria is of opinion that a improved, and the diet of the Austrian people ismost praiseworthy task of WHO would be the now approaching the old peacetime level.Thesetting-up of a committee of experts to co- fact that there were relatively few nutritionalordinate,modernize and simplifyallhealth ailments even during the most difficult period islegislation and regulations.Austria would be largely due to the strict control carried out byhappy to be able, not only to accept the benefits the health authorities in Austria with the helpof WHO, but also to collaborate with the Organi- of public inspection institutions and marketzation and to help it to achieve its aims. services. Dr. FRÓES (Brazil) (translation from the French) : Medicaments in Austria after the liberation inOn behalf of the Brazilian delegation, I desire first 1945 were not uniformly available throughoutof all to express the satisfaction we feel in repre- the Federal Territory, and in any case, the supplysenting our country at the Second World Health was entirely inadequate. Particularly in Vienna,Assembly, which has met in this ancient historic Lower Austria and Burgenland there was acity, the cradle of Western civilization. We marked shortage. should also like to lay before you certain very The civilpopulation,other than hospitalbrief and general considerations on a few impor- patients, continued to suffer from the catastrophictant points which are dealt with in the reports shortage of medicaments, which reached the lowest under discussion. level of all in the spring of 1946. At this period of As Director-General of the Health Services of acute suffering, UNRRA aid was initiated inBrazil, I have followed with the greatest interest April 1946, and later several foreign relief schemesthe gradual development of WHO, and I do not helped to bring about a steady improvement inthink I am over-optimistic in expressing my hope the supply of drugs, so that we must admit thatand confidence in the future of the Organization. thereis no longer a shortage, although someThe benefits it can confer will, I have no doubt, be medicaments are unobtainable. felt not only in Europe, in the countries devastated by the Second World War, but also in the other Finally, I should like to mention very brieflyparts of the world. We feel sure that the help that the health authorities in Austria have passedwhich WHO will be in a position to give such some important laws since the end of the war.countries will be in keeping with the urgency The confusion in health matters caused by theof their needs. German occupation of Austria will have to be In the introduction to his excellent Report, the overcome, and many laws, decrees and orders ofDirector-General gives an account of the remark- the Ministers of the German Reich, which hadable progress made in regionalization. This been in force in Austria, as well as Austrian healthprocess appears to us to be necessary to bring laws will have to be replaced by clear, precise andabout that decentralization which is indispensable modern regulations. These aims have not yet, itif the services in the various regions are to be is true, been achieved, but the results obtainedproperly carried on. In this connexion we should so far are remarkable. The Austrian Parliamentlike to state how pleased we were to be able to be has now passed fourteen laws, which have alreadypresent at the signing of the Agreement between been published, and approved a number of legalWHO and the Pan American Sanitary Organiza- regulations on health matters. Furthermore,tion at the meeting of the Directing Council of the twenty-twodecreeshave been promulgated.latter body, in Washington, a fortnight ago. With the above-mentioned laws, they have helpedWe hope that the oldest regional health organiza- to simplify and unify the existing Austrian public-tion, which is developing effectively and enthu- health system. siastically, may often serve as an inspiration for other offices of the same type. Of this legislation I would like to mention only As regards malaria, I think we are justified in the following examples :a modern law dealingsaying that this disease can be eradicated in with narcotics, which satisfies all the requirementsevery country in the world, although this may of the existing conventions on dangerous drugs ;prove rather difficult in such vast territories as new laws on vaccination against smallpox, andBrazil, India and Mexico, for example, notwith- also inoculation against tuberculosis, as alreadystanding the extraordinary progress already made mentioned(here the BCG method has beenin reducing the figures for infection.We have adopted) ;a redrafting of the law relating torecently had evidence of this in Brazil, where the epidemics ; new and up-to-date regulations dealingeconomic conditions of several areas have been with nurses and dentists ; a recently published lawgreatly improved in consequence. The aid on medical practitioners which not only regulatessuggested for schools of malariology is of the the practice of the medical profession but dealshighest importance, and we are happy to be able with the co-operation of the faculty, through theirto announce that we have just established an own representatives, in all health questions. Institute of Malariology in Brazil that will soon The work of the Austrian health authoritiesbe in a position to supplement the magnificent in simplifying and unifying health legislationwork of the Maracay Institute in Venezuela, - 94 - SIXTH PLENARY MEETING which up to now has been the only institution of There is no need to remind you of what occurred its kind on the American continent. With regardquite recently in Panama where, thanks to the to the relationship between medical teaching andimmediate intervention of the Pan American the training of personnel for public-health work,Sanitary Bureau, all danger of an epidemic out- we consider that this problem is so importantbreak was rapidly obviated.The last cholera for all countries that we have just advocatedepidemic in Egypt demonstrated the importance the establishment of a new school of publicof giving internationalassistance within the health in Brazil, which will form part of theshortest possible time and showed clearly that, National University of Brazil. on the outbreak of an epidemic in any country, Venereal disease is a health problem which wepractically no other nation, even the most remote, can now regard as capable of solution and, ifcan remain indifferent, since there is always a we accept the recent teaching of various specia-risk of its being itself infected. lists,it will soon be easier and less expensive The President of this Assembly pointed out that to cure than to diagnose this disease. the World Health Organization is not a political Although the creation of too many expert body.Its functions are, however, so complex committees is open to criticism, there is goodthat they can only be carried out successfully reason to approve the appointment by WHO,with the active and continuous co-operation of in accordance with the decision of its Executivegovernments, as well as of private institutions Board, of an international Expert Committeeand the public in general. on Maternal and Child Health.This committee This co-operation is indispensable in view of the will be able to offer valuable technical aid to thenecessity of combined operations against carriers health administrations of the countries concerned.and diseases.Our experience of what generally As regards the assistance we can give to theoccurs in the Western Hemipshere leads us to variouscountries in improving their public-underline the need of a spirit of understanding, health administrations, we should like to pointcollaboration and co-ordination, especially in the out that local health services would benefitcase of agencies with a common purpose which are greatly if part of the personnel devoted itselfnow often working in complete isolation.The exclusively to this work. That is a principle weresult is a duplication of effort which is all the have advocated on many occasions, viz., thatmore regrettable since there is no adequate return persons working full-time in one special fieldfor the labour and material resources expended. should be paid a salary corresponding to their WHO's programme of work for next year is exertions and the importance of their work.necessarily much more extensive, and the proposed In the field of international epidemiology itbudget is considerably larger. seems to us not only necessary, as stated in the Our delegation will have an opportunity to Report, but actually indispensable, to framemake some remarks in this connexion at the appro- international sanitary regulations which, whilepriate moment. providing the various countries with the greatest Obviously such a complex programme cannot be possible security, will hamper world trade as littlecarried out unless we can first be sure of obtaining as possible. the required technical and material resources. On There is no doubt, however, that the variousthe other hand, we must be cautious, and not health administrations must improve and bringsubordinate the most pressing problems to less to the highest degree of efficiency their means ofurgent matters. Above all, we must not sacrifice defence against epidemic diseases, and not merelyquality for quantity. We are in entire sympathy confine themselves to applying restrictive, andwith the views expressed by the delegates who often unreasonable, measures on their frontiers.have already addressed the Assembly and should The adoption of this policy would considerablylike to pay a tribute to the devotion and un- reduce, if not entirely do away with the need forremitting work of the Director-General of the protective measuresagainst the introductionOrganization and of all those who, from the of diseases and carriers in the several countries.beginning, have given him the invaluable support Moreover, various nations would no longer findof their labour, their experience and their zeal. it necessary, as they have done in the past, to appeal to WHO to secure the abolition of Mr. PLO JHAR (Czechoslovakia) (translation from certain measures required by the health authoritiesthe French) : The creation of the World Health of a number of countries. Organization, which was the result of action Mention is made in the Report of the un-taken by the Economic and Social Council, marks justifiable insistence on inoculation certificatesone of the most important stages in the work for plague, typhus and yellow fever. We shouldaccomplished by the United Nations since its like to stress the view we expressed at the lastinception. Brazilian Health Congress. We said then that it Think for a moment of our situation at the close is much more reasonable, for example, to eradicateof the Second World War. For several years men the urban vectors of yellow fever, as Boliviaand women were being killed or maimed. It was has done and as we are now doing in Brazil, thanabsolutely vital to discover a means of effectively to adopt irksome measures against travellersaiding the victims of war. That is why we greet arriving from seaports or airports where thethe creation of the World Health Organization, vector is no longer to be found, when such personswhich has made its aim the safeguarding of have not stopped at places in which the sylvanhuman lives and the bringing of aid to all those type of the disease might possibly be found. whose health has been gravely undermined by the - 95 - SIXTH PLENARY MEETING war. This war has not only left sick and woundedcannot be determined in a satisfactory manner. behind it ; its influence has been indirectly shown Each nation's specific needs must be taken into in the undernourishment of children and wholeaccount. populations, a state of affairs which created The World Health Organization was right in favourable conditions for the spread of disease anddeciding thatfellowshipsshould be granted the sapping of the biological foundation of severalaccording to a plan based on the relative impor- generations . tance of health problems. On the other hand, it Every nation was confronted by the problemwas wrong in ascribing equal importance to the of coming swiftly to the succour of human lives.same problems in different countries. The World That is why the whole world understood the scope, Health Organization for example offers Czecho- importance and nobility of the ideas on which theslovakia fellowships for specialists in maternal World Health Organization was based. This wasand child health, and also for tuberculosis control fully demonstrated by the spontaneity withexperts. But we are already getting these fellow- which the various countries rallied to this idealships through the International Children's Emer- of mutual aid and fraternity. Fifty-one countries,gency Fund of the United Nations. The Czecho- Members of the United Nations, have taken anslovak Ministry of Health is concerned with active part in it and 16 non-member States haveproblems which, although they do not appear on been represented by observers. The whole worldthe list of priorities drawn up by the World looked with hope upon this idea of fraternal aid.Health Organization, are nevertheless urgent for In 1946, the Interim Commission of the Worldus for reasons we have pointed out.These Health Organization was formed. This body hadproblems we must solve in the interest of the then already at its disposal a staff and sufficient -nation's health. funds to enable it to carry out its duties. It is more urgent for us to dispose of some When the Organization itself was set up it waspublic-health problems than to receive good clear that no change was required, either from theadvice. What is more, if we are to make practical standpoint of finance or staff, and that in itsuse of this advice, certain material pre-conditions provisional state WHO was already furnishedmust be fulfilled. The teaching of basic subjects, with all the necessary means of executing itssuch as biology, biochemistry and biophysics appointed tasks successfully. must be developed, and we must also introduce the study of modern anesthesiology in our uni- We are grateful to the World Health Organiza-versities. Our specialists must learn the modern tion for having concentrated its aid on themethods of medicine that are being applied in the countries that suffered in the war. The period ofinternational field.It is vitally important to six years during which international relationsplace the rearing of guinea-pigs in the hands of were broken created a gap in our public-healthour pharmaceutical industry and of our research system. We have now been able, thanks to theinstitutes.Mere advice is not enough for this World Health Organization, to learn of thepurpose. We require also, in order to carry out progress made by other countries during the warthis programme,tobe in possession of the in the sphere of public health. We were grantednecessary apparatus and to obtain animals.In fellowships for study. We have obtained medicalother words, our experts must have all the tools literature.We have received visits of varyingto hand that are indispensable for the carrying-out length from experts. In short, we have benefitedof their specialized work.The same thing can from the material aid which the World Healthbe said about the production of penicillin.The Organization furnishes to countries stricken bymeans of production require to be modernized the war. and we must therefore obtain the necessary The resumption by the World Health Organiza-apparatus that exists abroad.It should be one tion of the services begun by the League of Nationsof the tasks of the World Health Organization Health Organization is an action deserving allto facilitate the delivery of such apparatus to us. praise. I will mention merely the epidemiological The World Health Organization must consider service, the standardization of biological products, it its duty to help the various countries by all the control of narcotic drugs, the revision of thethe means in its power to raise the standard of international nomenclature of diseases and thelife of their peoples.Every Member of the formation of expert committees. Organization must therefore be ready to co- Those are positive aspects which we can appre-operate fully in accomplishing this task and must ciate and the value of which we recognize. Butplace at the disposal of the others its knowledge the World Health Organization has, at present,and possibly its material resources to permit certain shortcomings. It tends to limit its activi-of the achievement of this aim. My country is ties to its expert committees.The latter, it isfully prepared to act on these principles. true, publish reports on the state of medical If the World Health Organization means to science in this or that sphere, but do nothingmake an effective contribution to the solution of to see that the progress made in the field of publicthe health problems of the various areas and health is translated into action in other countries.countries, it must give proof of goodwill to trans- Again, the World Health Organization has notlate this wish into concrete terms. It cannot and fully understood that health problems cannot bemust not impose its own ideas and plans on the generalized.They vary from region to region,various countries.The World Health Organiza- and their importance for the individual countriestion must see that the various Member States aid - 96 - SIXTH PLENARY MEETING each other in the solution of these problems andtion of the supreme ideal which the World Health that they resort, if need be, to the World HealthOrganization has set itself. Organizationasanintermediary. Political It is only if the fundamental conditions of questions and the interests of private enterprisesuccess are assured that the various governments should not in any way be an obstacle to thecan agree to their countries remaining within the realization of this aim. World Health Organization in order to contribute I must unfortunately state that the Worldto its development. Health Organization is in the throes of ideological conflicts. It is being drawn into using its influence Dr. SIMONOITITS (Hungary) : When, a year ago, on behalf of one of these ideologies.I should likeI had the opportunity of representing the Hunga- to put you on your guard against the dangers ofrian Government at the First World Health such a policy, which might result in a split, orAssembly,I announced that the Hungarian even the completedissolutionofthis worldGovernment would most willingly join the World institution, which can only do effective work if itHealth Organization, being thoroughly convinced holds aloof from all conflicts, if it is supportedthat in the field of health there is a great need for by all countries, and if it takes into account theco-operation, and being in agreement with the importance of the special needs of the variousmain principlesof the Constitution,namely, countries. that threats to health anywhere in the world spell We are perturbed by the attitude adopted bya common danger for the whole of mankind, the United States to this Organization, in spitebecause health is one and indivisible. of the fact that their nationals play a prepon- Todayalso,theHungarianGovernment's derant part in it. The United States is refusing tounvaried standpoint is that there is an absolute grant export licences for Podbielniak extractorsnecessity for international co-operation.But it and other medical supplies ;and all efforts tomust be the right kind.It must be said too, obtain them have been without avail. We havetruly and sincerely, that the conditions for co- here the spectacle of a great Power that talks ofoperation have lately become lessfavourable. aid whilst refusing to furnish machinery, apparatusWe are doctors, and we know well that cure and other meansofsaving human life,of depends upon an exact diagnosis.I think I shall saving the lives of mothers, infants and children.render a good service to WHO, first of all, by On the one hand, this country refuses to come topointing out the difficulties with which Hungary, the aid of children underfed as a result of the war.as a small country, has to contend. On the other hand, this same country is ready to help other States, not only by providing them WHO's assistanceisof three kinds :first, with war material, but also by imposing such aidgranting of fellowships ;second, making books on them by means of dangerous pacts. andperiodicalsavailable :third,providing We have seen wars enough and do not wish forlecturers. more. We are confronted by the huge task of Hungary attached the greatest importance to succouring the victims of thelast war, andfellowships, and precisely in this field found the already we can see efforts being made which tendgreatest difficulties. We chose for this purpose, to increase the number of these victims. We raiseas being suitable to WHO's spirit, -ourbest a protest against this policy of duplicity which onscientists and health serviceorganizers who the one hand seeks to aid, and on the other toare in leading posts. You know well that there is a destroy. popular democracy in Hungary and naturally Those are the points we desired to bring to thethose leading posts are generally filled by the attention of the World Health Organization formost enthusiastic followers and workers of the its consideration.I have dwelt on all that waspopular democracy and the growing socialism. worthy of praise ;I have also made a criticalLately, it has more and more often happened that analysis of what we dislike.The delegates ofthose to whom fellowships were granted were Czechoslovakia and of the other Popular Demo-refused visas by the very countries which are cracies desire to collaborate in the great workMembers of WHO. It even occurred that a represented by the World Health Organization,professor of the University of Budapest, officially but we categorically demand that the essentialinvited to an international congress in America, claims I have put forward should be admitted,did not receive an entry permit. so that the World Health Organization may There are difficulties also about receiving books indeed lend its aid to the various countries, andand periodicals. The requested books and perio- not allow itself to be drawn into an ideology withdicals either arrive with great delay or arrive in which States Members could not agree. fragments. We do not even know which books or If we consider the interests of mankind asperiodicals we are likely to receive and which we supreme ideals, if we really desire to come to thehave to procure through other channels. aid of suffering humanity and save millions of At the beginning, we had great hopes about mothers and children affected with tuberculosis,lecturers. But now, it must be confessed, we have cancer and other diseases, if we desire medicalbeen somewhat disillusioned. Even the best science to be familiar with the progress andlecturer was hardly more useful than a good medical research of each country, then we mustarticle, because in many cases the lecturer had no set aside all political and ideological differences,knowledge of our special local problems. We are for they constitute an impediment to the realiza-of the opinion that WHO's activity in this field - 97 - SIXTH PLENARY MEETING can be considerably reduced, especially as this I think you agree with me if say more : could considerably decrease the Organization'sfighting for peace means fighting for the health expenses. of the whole of mankind. Furthermore, as far as co-operation is con- What do war and peace mean ? We Hungarians can really understand.Hungary is a country cerned, we have to complain about another thing :which was damaged a great deal by the war scientific research work is hindered also by thebecause of the adventurous politics of the fascist fact that the preparation of essential medicines,system. Owing to the war also our health service iuch as streptomycin, penicillin and so on, is collapsed. When liberation came the public- still a secret. We cannot get even isotopes.Allhealth service proved to be completely un- that Mr. Plojhar, the chief of the Czechoslovakorganized. Before the war we had 134 tuberculosis delegation, said on this subject, can be applieddispensaries, but after the liberation only 26 to Hungary, and the Hungarian delegation com-remained. Of 50,000 beds only 26,000 were pletely agrees with him. efficient.War damage to hospitals is estimated That is the situation as we see it in Hungary.at fifty million dollars.The general health of But if we look around here, in the Second Worldthe country was also at a very low level. General Health Assembly, we meet with even moremortality in 1945 sprang up to 23 per thousand difficult problems. A year ago there were presentand infant mortality was nearly 17%, and in the delegations of the Union of Soviet SocialistBudapest at the beginning of the year of the libe- Republics, the Ukrainian SSR and the Byelo-ration it reached 37%.There were also 8,500 russian SSR.Today, as our President and thecases of typhoid fever. chief of the Indian delegation referred with regret Now the Hungarian people have found what to their absence, we must do without them.peaceful rebuilding means. During the four years since the liberation, we have rebuilt comple- And those who participated in last year's Assemblytely our health-service system.Having rehabili- know well that these three delegations were thetated 24,000 hospital beds, today we dispose most active members of the First Assembly.again of 50,000 hospital beds.At the end of Though we can solve several problems, yet wethe five-year plan to be started next year, we must ask : can we call this a world organizationshall have 60,000 available hospital beds.As a without the USSR ?The answer is necessarilyresult of the reconstruction we now have 38 a negative one, not only because the USSRtuberculosis and 40 venereal-disease dispensaries includes one-sixth of the world-although thismore than before the war.In 1944 we had 52 fact alone is sufficient for consideration-but alsomaternity homes ; at the end of this year there because it has done the most in the field of ashould be nearly twice as many. people's health service.Particularly remarkable The resultof these four peaceful years of are the results gained in the improvement of thereconstruction work is that in Hungary the health health of the people, especially if we keep inservice is much better than at any time before mind the fact that, at the time of the Czars, thethe war. For instance, child mortality has declined situation of the various nationalities was hardlyfrom 13.1% to 9.6% ;in Budapest to 6.6%. better in than it is in the colonies today. Fighting for peace and fighting for progress, I think it is not enough to regret the Sovietwe follow today the living tradition of those great Union's absence ; we must examine the reason whyItalian physicians who, despite the persecution, the Soviet Union is not participating in the con-dissected corpses and fought with heroic efforts ference and we must find the way to a remedy.for the progress of science. At the First Assembly of the World Health Dr. TOK (Turkey) (translation from the French) : Organization, Dr. Vinogradov, the chief of theI am happy to extend the greetings of my country delegation of the Soviet Union, pointed to theto the delegates to the Second World Health facts endangering our great work.The presentAssembly, and I take this opportunity to express programme of WHO and its budget for the nextmy thanks to the Secretariat and the Executive year indicate that the warnings of the SovietBoard for the work carried out during this first delegation and the reason for its retirement, asyear of the Organization's activities.It is true recorded, have not been duly taken into conside-that the Organization has not yet been able to ration.I would like to emphasize a single fact :comply with all requests for assistance and that it the number of the employees in 1949 is 546,has not found it possible to deal with the particular which will be increased in 1950 to 1,132. health problems of all countries, including my We all know Dr. Evang's activity and we hopeown, but I do not doubt that with the goodwill that WHO under his guidance will find the wayby which the Organization is anima.ted and the to the solution of this problem. experience it is in the process of acquiring, it will be able to accomplish the immense work which I think that we doctors, more than anybodydevolves upon it. else, must struggle for a real international co- Consequently, and I take the liberty of repeating operation.One of the main principles of thethis,the work achieved and the resolutions Constitution is," The health of all peoples isadopted by the Organization in a relatively fundamental to the attainment of peace andshort space of time are worthy of praise. I do not security and is dependent upon the fullest co-think it superfluous to mention again the inter- operation of individuals and States." national situation with regard to diseases included - 98 - 'SIXTH\ PLENARY MEETING under the term " pestilential diseases ". Theleadership and the direction of operations by methods of communication and means of pre-trained technical personnel, the tentative 1950 vention of these diseases are at present clearlybudget provides only inadequately for fellowships, defined. As I said at the First Assembly, efforts fortraining and education.In contrast to the great their complete eradication must be concentratedincrease in many other fields, this vital item is and co-ordinated under the aegis of WHO. Onexactly the same in 1950 as it was in 1949, taking reading the Director-General's Report and theinto consideration the expected absence of aid Reports of the Executive Board, we note withfrom UNRRA. My delegation believes that to satisfaction that WHO has already envisagedprovide technical leadership in underdeveloped the required measures for this purpose in itscountries should be one of our first goals, and programme for next year's activities. that the item for fellowships, training and educa- To conclude, I should like to thank the Italiantion should at least be doubled. Government cordially for the mostgenerous A small crumb is also assigned to research on hospitality it has shown to us. Our delegation ischolera, but in relation to a disease so explosively exceedingly happy to be in Rome and is enchanted dangerous, we believe that a more urgent and by the splendour of this historic and Eternalintense investigation should be made of the City.I hope that the future activities of themethod of transmission, as it affects quarantine Assembly, as well as of the World Health Organi-procedures. zation, will be completely successful. The decentralization of WHO through the establishment of regional committees is a wise The PRESIDENT : The next speaker should bemove, provided that this does not mean breaking the representative of the United States of Ame-up the World Health Organization into six small rica. However, I have just been informed by theworlds. We should not slip back into becoming American delegation that the speaker has beenregionally minded, but we must always remember detained and the delegation has asked that hethe global aspect of health.There is a serious should have an opportunity to speak later. The needforcontinuedco-ordinationofpolicy same has happened to the representative ofplanning and overall direction.There must be El Salvador, and I would like to ask you whethera clear definition of the functions and limitations there is any objection to postponing the state-of regional offices or chaos will result. ments of these gentlemen until they arrive. In Iran, we are embarking on a tremendous I see there are no objections ; then we will passseven-yearprogrammeof development,of on, and I call upon the representative of Iran. which the health section is an impressive part. Parliament has already voted approval. Malaria Dr, RADJI (Iran) : My remarks will be extremelyis our number one problem, standing as it does in short and not political, for we have much to do ;the way of both health and economic advance. in fact not only here, but in our working com-Already a serious programme of control on a mittees, my delegation believes that the speechesmodest scale is in operation with plans being should be limited to about five minutes' time. made for a nation-wide attack in 1950. We are deeply grateful to WHO for help already begun or If my country was the fourth to become aplanned, and our testimony is that this is a live, Member of WHO, and is proud to be a small partproductive organization destined to have a great of this great Organization, it is because we since-and lasting effect on the health of the world. rely believe that through the collaboration of the nations here represented we can achieve peace and the improved health and wealth of all the peoples The PRESIDENT :I will ask for the missing of the world. delegates to be sent for, as we are approaching Our Director-General and the Executive Boardthe end of the list of speakers, and if they are should be highly complimented on the achieve-not here, then the last speakers have no oppor- ments of WHO in 1948. The Reports submittedtunity to speak.I would like to call upon the give a heartening picture of concrete projectsrepresentative of Bulgaria. accomplished. As to the proposals for 1950, they are prepared with vision and daring.The idea Dr. STOYANOFF (Bulgaria) (translation from the of having both a regular and a supplementalFrench): Very little time has elapsed-barely budget is particularly useful, and it is financiallyeleven months-since the First World Health sound, provided that projects adopted are givenAssembly.Yet much has happened since then, strict priorities.In this manner, the regularand we have witnessed many events which have budget will finance the projects of number onehad repercussions on the life and activities of the priority, and realization of part or all of theWorld Health Organization. And since we want supplemental budgetwill make possibletheto see clearly and not withdraw behind a curtain implementation of projects of number two priority.of net or velvet-this type of expression seems All the 1950 proposals are desirable, but a fewto be fasionable in some countries-we must not comments may be in order.First, althoughfail to point out the importance of certain events. many countries need, aboveall,to developWe must not be afraid to call things by their - 99 - SIXTH PLENARY MEETING proper names and we should not deal with themYesterday, in this very place, mention was made separately, because everything in life is inter-of the distress among these people and their related. We must consider facts and events asvery low standard of living. But whose primary parts of an organic whole. duty is it to help them to emerge from this deplo- If our eminent and honoured President willrable state ?Is it not the supreme duty of the allow me to say so, we cannot separate ourcountries which oppress and exploit them ?Our work, the work of the Organization, from thedelegation will ask the Committee on Administra- events that are taking place around us.Ourtion and Finance to ensure that the countries activities are so complex and so interdependentwhich derive the greatest profit from this colonial that, in addition to purely medical affairs, wepolicy should bear the major part of the necessary have to concern ourselves-although we are notexpenditure for assisting colonial or protected economists-with financial and economic ques-peoples. tions. We even have a Committee on Constitu- Last year,our delegation insisted on the tional Matters which will debate questions thatimportance of establishing a centre for medical are occasionally of an unmistakably political nature.and sanitary supplies.Although nominations Furthermore, is it not obvious that the reason forwere made, there have, as far as I am aware, dissatisfaction within the Organization is that itsbeen no results yet.Is the scheme meeting with activities are interpreted and conducted in ainsurmountable difficulties ?Or is there political particular sense and not in the general and com-discrimination ?This is highly probable. mon interest ? We cannot disregard this policy What is happening to the regional office for or be blind to it for, as we remarked previously,European countries devastated by the war ? it is precisely outside events which have affectedPerhaps it will be set up when the countries in the work of the Organization and which continuequestion are on their feet again as the result of to weigh upon it. their own efforts. Now what do we actually find ?The head- Another question which concerns us all at the quarters of the World Health Organization is moment is the absence of the Soviet peoples from content to wait and see, and hesitates to put intothe Second World Health Assembly. This absence effect even very modest measures arising out oflies heavily on our labours. We are sure that this theresolutionsoftheFirstWorld Healthis the opinion of the majority of the delegates. Assembly. We are deprived of the great experience of the Last year, many delegations expressed theirSoviets on all subjects, and especially on the concern as to the financial position of the Organi-subject of health.You have all wondered how zation in view of the fact that the countriesthis has been possible, and what could have which suffered least from the war, and had evenhappened for the Soviet Union to find itself obliged been enriched by it, were not willing to make ato leave the World Health Organization. larger and more generous contribution to defray In Dr. Vinogradov's short and very explicit the expenses of WHO. Indeed, instead of a policy letter, we note a similar criticism of the general of economy, we see the personnel of the Organi-and financial policy of the Organization's head- zation being enormously increased in number andquarters. We must face this question seriously. receiving relatively huge salaries at a time whenIf we go on as we are now doing, other countries the economic crisis, with its processions of un-will tomorrow ask themselves whether it is worth employed, is threatening the capitalist countries,theirwhileto remain intheOrganization. and when the people in socialist countries areDeprived of the support of the Soviet Union, making colossal efforts to build a society in whichand perhaps of other countries as well,our there will be no exploitation of man by man, andOrganization, born in a spirit of understanding in which health organization will be constantlyand of international co-oper ation, would no longer developed. This anomaly should no longer exist.be a World Health Organization, but perhaps The same criticisms may be levelled against theonly a health organization of the Atlantic Pact. recruitment of staff. The directorate has not taken Finally, I must not fail to emphasize that the into consideration the observations made byWorld Health Organization has certainly accom- certain delegations last year. plished some fine work, but in a unilateral sense. There are other statements of the same kind When our Organization changes its general which we feel bound to make. The delegation ofpolicy and thinks only of the common interest, the Soviet Union and those of other Popularwe are convinced that it will be able to make a Democracies have always urged that the excur-substantial contribution towards raising public sions of experts and expert teams to places wherehealth to the highest possible level. they are not asked for should be discontinued. To conclude, may I insist again on a point The money intended for this purpose could bewhich is so intimately linked with the activities paid to the countries concerned.This would beof our Organization, and which is at the basis of the best way to help the national health services.all the hesitant and erroneous policies of the What of the budget for 1950 ?The least oneheadquarters of WHO. can say is that itis enormous and probably Since our departure from Geneva last year, unattainable.In this budget it is the colonialwe have witnessed a continual menace of war. countries which get preferential aid.That is aCertain newspapers in the Marshall plan countries good thing, a very good thing. We side with thehave created an atmosphere of insecurity and colonial peoples and protectorates.We desiredisquiet.According to these newspapers and to their happiness and even their complete liberation. certain political and military personalities, we were - 100 - SIXTH PLENARY MEETING on the eve of a third world war. This has createdfalse impression that is sometimes conveyed of in these countries a psychosis which is notan organization which seems rather far from us propitious to better mental health. Happily,and, in a sense, above us.In reality WHO is the possibilities open to these people are muchcomposed of ourselves, Member States-that is, smaller than their wishes.Furthermore, theyof the various health administrations which form have mistaken their desires for realities.Theypart of it. have not taken intoconsiderationalsothe This lack of active co-operation between the fervent hope of large masses of the populationvarious States and WHO is probably due to the throughout the world who wish to live in peacefact that our Organization tends to be tob and to work for their happiness. This will of the centralized. We are all agreed that, for the effective people to impose peace has found expression inimplementation of our programme, we should the magnificent peace congresses which tookpush on vigorously with regional organization. place recently in Paris and in Prague.PerhapsIt is only by pursuing this course that we can certain of you will think that this question is notease the strain on our Organization and make our purely of a medical nature.I have already saidwork more profitable and useful throughout the at the beginning that all these things are linked world. We hope therefore that the regional together and inter-penetrate.When we areoffices will very soon be created, that their discussing measures to be taken for controllingduties and relations with headquarters will be tuberculosis, venereal diseases, malaria, or to aidclearly defined, and that they will be allotted mothers and children, this is not merely a bene-the financial and other means required to give volent act, but we are taking an active part inpractical effect to the programmes approved by the social life of society. the Assembly. Shall we then close our eyes when the menacing In any case, the Italian delegation hopes that clouds of a terrible conflict are gathering abovethe strengthening of the bonds between WHO and our heads, a conflict which at one blow wouldthe Member nations will lead to increased cultural annihilate all our efforts and endeavours andexchanges between the various health administra- again plunge suffering humanity into fire andtions, so that they may be informed of new blood ?We must not close our eyes.To wantscientific and social discoveries without delay. peace is to give the peoples the chance of raising With this end in view, as many nations as their moral and physical health to the highestpossible should take part in the committees, possible level as stated in the Constitution of thesub-committees and expertcommittees,and World Health Organization. each nation should have the responsibility and honour of appointing, and indicating to WHO, its Professor CANAPERIA (Italy) (translation fromown specialists whom it is prepared to place at the French): The Italian delegation has read withthe service of the world community. the greatest interest the Annual Report of the There is no doubt that the projected despatch Director-General of WHO and desires to congra-of experts in the various fields of action can be tulate him on the valuable work that has beenof great value in intensifying the cultural ex- accomplished in so short a time and in so vast achanges which we advocate.It should not be field. Not that this remarkable work has surprisedforgotten, however, as the Yugoslav delegate us, for we know the capacity of those who haverightly observed, thatitoften happens that guided the destinies of our Organization. We wereexperts sent to a country must begin by familiar- aware of the scope of this work in its broadizing themselves with the economic and social outlines, but we did not know the importantconditions which influence treatment of health details.Of these we have been glad to hearproblems and by acquainting themselves with today in a final report.It might perhaps havewhat has been accomplished, or is in process of been more profitable for us if we could havebeing accomplished, in the country in question followed this work in the course of its develop-before their collaboration can be of any real value. ment, and we should certainly have been glad We believe that this problem might best be to make a direct contribution ourselves and todealt with through the regionaloffices, since offer our experience in public-health administra-fuller and more accurate knowledge would then tion and in the control of certain infectious diseasesbe available regarding the difficulties and needs in the spirit which, as the United Kingdomof the territories which come under these offices. delegate has been good enough to remind us, In congratulating the eminent Director-General animated the work of our former Director ofand the Executive Board on the work accom- Health, Alberto Lutrario, and of his successors inplished with such insight and in so lofty a scien- theOfficeInternational d'Hygiène Publique,tific spirit, we hope that WHO will continue to which was established here in Rome 48 years ago.pursue successfully the path marked out for it, Italy wishes to make an active contribution tolightening the burdens of the various national the World Health Organization, but if she is to dohealth administrations and maintaining conti- so, there must be a fuller exchange of opinion,nuous and fruitful contacts with them. information and advice between the various health administrations and WHO. We should like WHO The PRESIDENT : We will adjourn the meeting to be a little nearer to the Member States. Wetill this afternoon at 3.30. should.like the contacts to be more frequent, more intimate and more active so as to remove the The meeting rose at 11.50 a.m.

- 101 - SEVENTH PLENARY MEETING

SEVENTH PLENARY MEETING Thursday, 16 June 1949, at 3.30 p.m.

President: Dr. Karl EVANG (Norway)

30. Discussion on the Report of the Director- UNRRA, the International Children's Emergency General and the Reports of the ExecutiveFund, the Institute of Inter-American Affairs, Board (continuation) the Economic Co-operation Administration, and The PRESIDENT :The meeting iscalled tothrough special rehabilitation programmes in order.The agenda for this afternoon is,first, areas of pressing need, the United States has the end of the general debate.If we have timeproved its determination to help in the great after that, we will consider the nominations oftask of worldwide social and economic develop- the Nominations Committee for the vice-chairmenment. Some of our great private organizations, of the main committees ; and document A2/58,also, are contributing extensively to this task. " Procedure for Examination of the Programme We call attention to this aid and assistance and Budget for 1950 ".14 which has come from our hearts as well as from We have made very satisfactory progress and ifour substance, to demonstrate that there is no we finish early enough this afternoon, there willbasis for any charge that the United States has be convened, a quarter of an hour after thefailed people in need anywhere. As the President adjournment of the plenary session, meetings ofof the United States stated in his inaugural the Committees on Programme and on Adminis-message in January of this year, the United tration and Finance. States intends to continue to contribute to the We shall therefore continue the general debatework for the benefit and improvement of mankind, and I call upon the representative of the Unitedespecially in under-developed areas.We look States of America. The succeeding speaker willto the World Health Organization as one means of be the representative of El Salvador. accomplishing this great objective, by pooling the medical and health resources of all the world Dr. SCHEELE (United States of America) : I amfor the benefit of each and every one of us. pleased to find on my arrival in Rome that the In view of the record of the United States, we general discussion of the Reports of the Director-are disturbed that a question has been raised General and the Executive Board is still underbefore this Assembly concerning the motives of way.I apologize to the Assembly for my delayour country.I wish to assure this Assembly that in arriving, but it was unavoidable. the motives of the United States in its programmes of aid and participation in international activities , I wish to express my great pleasure at being here and having the opportunity of becomingare identical with the principles of the Constitu- acquainted with the many distinguished delegatestion of the World Health Organization.When who have played such an important role, not onlymatters of misunderstanding, criticism or disagree- in the development of the World Health Organiza-ment arise, as they are bound to from time to time tion, but in public-health progress in their manyin any great assembly, the answers can be derived nations. And I might add that I am very happyonly from the desire for frank discussion.This to be back with many of my old friends with whommust be based on the assumption that we all I have worked for many years. seek the best means of steadily advancing the high As you are aware, the United States has takenobjectives that we share. an active part in the development of the World I agree fully with the delegate from Czecho- Health Organization as a permanent source ofslovakia that the World Health Organization and good in the world community. The United Statesthis Assembly should not become an arena for looks forward to the progressive growth andpolitical discussion or activity.It has been said development of the World Health Organizationthat the refusal of export licences for certain through the years ahead. We are proud of theapparatus has jeopardized human life. I wish to role that the United States has played, is playingdeny this charge on behalf of the Government and expects to play in the whole movement forof the United States. A specific piece of equip- social and economic advancement of which thement has been mentioned. It was implied that this World Health Organization is such an importantequipmentis necessary in the production of part. We appreciate the tributes that previouspenicillin. This is not the case. The highest grade speakers have paid to the participation of thecrystalline penicillin can be produced and is UnitedStatesinthismovement. Throughbeing produced commercially today in the United States without this equipment. A specific charge 14 For substanceof this document, see resolutionhas been made, therefore, which cannot be sub- WHA2.1, p. 18 stantiated. - 102 - SEVENTH PLENARY MEETING

The statement has also been made that theConference. It met in New York in June.15 Last United States has refused to help children sufferingyear the First Assembly establishing WHO took from malnutrition caused by the war.I do notplace and drew up a programme.16 understand this statement in view of the large According to Article 1 of the Constitution, the role the United States has played through UNRRAobjective of the World Health Organization is the in the past and at this very moment through theattainment by all peoples of the highest possible International Children's Emergency Fund andlevel of health.Article 2 sets out the functions much private effort. Through these agenciesof the Organization in order to achieve its the American people have rendered great assis- obj ective. tance in the nourishment of children of many The representatives of the USSR, the Ukrainian countries, including that of the delegate makingSSR and the Byelorussian SSR, as well as the this charge. Popular Democracies, attending the First World Health Assembly at Geneva, stressed the urgent Of course, it is unlikely that any nation isnecessity of clearing up the aftermath of the entirely satisfied with the programme of therecent war and of the Hitlerian occupation of World Health Organization at this early stage.Europe.They stated that it was essential to We expect this Assembly and each succeedingpermit the colonial peoples at the earliest possible Assembly to improve its administrative struc-moment to make up the leeway resulting from ture, to simplify its operations and to recommendcenturies of neglect in the field of public health. more useful programmes.However, we believeWe have a right to ask what the balance sheet of that all criticisms should be constructive and leadthe activities of WHO looks like one year after to tha improvement of this young organization.its creation, and three years after the International We hope to see the World Health OrganizationHealth Conference in New York. increase its activities in the field of technical To carry out the practical work of WHO, the assistance. We hope that it can help all nations Constitution provides for the setting-up of regional to find the most effective ways of accomplishingoffices and committees in various parts of the their tasks in public health.We, on our part,world. Up to the present, regional offices have look to the World Health Organization for helpbeen created for India and adjacent countries, and advice in finding these ways.The Unitedand also for Egypt and the Near East. States is particularly impressed with the need for There is no doubt that the clearing-up in Europe decentralization, through which the usefulnessof the consequences of the war and the occupation, of the Organization would be increased and itsin so far as they related to public health, also work brought closer to the Member States andcalled for the creation of an office for Europe. their peoples. But the setting-up of an independent office met The United States will continue to play anwith opposition from the United States delegation. After a rather heated discussion a partial solution active role in the World Health Organization,was found by the establishment, within the helping the Organization to build a better,framework of the WHO administration, of a healthier world. We will continue to do this intemporary office called the Special Office for the belief that we are helping to build permanentEurope.This office was to concern itself with peace and happiness by advancing the ideals special forms of relief and to provide immediate aicE stated in the Preamble to the Constitution of Today we can say that this office has accom- the World Health Organization. plished nothing in that field and has not even been able to frame a constructive programme. The PRESIDENT :The representative of El During the first session of the Health Assembly, Salvador has not yet arrived. May I call upon thewhen the programme was being prepared, wide representative of Poland ?The last speaker willdifferences of view regarding the definition of be the representative of the Dominican Republic.the tasks and aims of WHO were revealed between the delegates of the Soviet Union, Byelorussia, Dr.Irène DOMANSKA(Poland)(translationthe Ukraine and the Popular Democracies on the from the French) :Very many health problemsone hand,and certaindelegatesofvarious undoubtedlycallforinternationalsolution. countries on the other. Disease knows no frontiers, and it is undeniable The delegates of the Popular Democracies, the that the development of collaboration betweenSovietUnion,the Ukraine and Byelorussia, peoples makes it possible to raise the generalbelieve that the health problems of any given level of world health, and to act more swiftlycountry cannot be examined without taking and effectively against disease. into account that country's social and economic conditions. After the First World War, a Health Section was The programme drawn up by the First Health set up within the League of Nations in order toAssembly was in the end the result of a compro- hastenthesolutionofinternationalhealthmise, in which some satisfaction was given to the problems. Unfortunately, this body did not havewishes of the above-mentioned countries. sufficient time to achieve all its objectives. However, the whole debate, as well as the On 15 February 1946, after the Second Worldcomposition of the Executive Board and in War, the Economic and Social Council recom- mended that the Secretary-General of the United 15 09. Rec. World Hlth Org. 2 Nations should convene an International Health 16 09. Rec. World Hlth Org. 13 - 103 - SEVENTH PLENARY MEETING particular of the administration, gave rise toThe latter has been unable to publish some of doubts as to the ultimate execution even of athese results, or has only published them in programme that had been accepted by a unani-incomplete form or after very great delay, since mous vote.Events have shown these fears tothe policy followed during the war is still being have been well-grounded. Even at the 'time of thepursued.The whole world ought to be able First World Health Assembly several speakersto take advantage of the benefits of science. had pointed out that the health services of certain Such an attitude has therefore caused anxiety Member countries would not be in a position, foramongst American scientistsandpoliticians. various reasons, to carry out the programmeSenator Kilgore,scientists such asEinstein, recommended by the Organizat on.First of all,Urey and Fermi, and politicians like Wallace, there was a shortage of experts or adequatelyIckes and Vannevar Bush came forward as cham- trained personnel, particularly in those countriespions of the cause of the freedom of science. which, during the Hitlerian occupation, had beenUnfortunately, for military and industrial reasons, cut off from the rest of the world and had beenthe principle of the curtailment of the liberty unable to take advantage of the latest achieve-to exchange information and literature has won ments of science. In the second place there was athe day. scarcity of certain prophylactic and therapeutic The scientific and popular American press products and of medical equipment. The countriesfrequently dwells on the constructive nature of in question were not yet in a position to producethe results obtained at the Biological 'Weapon them for themselves, or else the means andResearch Centre at Camp Detrick. methods of production of certain healing drugs Five thousand specialists were studying medical remained a secret. The third of these reasons wasproblems at this centre.The most elementary the impossibility of purchasing or importinghumanitarian principles should have led to the certain therapeutic products, prophylactics orpublication of the results of their researches. medical equipment. However, all the discoveries were first exploited The representatives of the Popular Democraciesby the chemical industry, whose representative, therefore demanded at the First World HealthG. W. Merck, Director of the Merck combine, has Assembly, as well as at all the sessions of thebeen the scientific adviser to the United States Executive Board, that WHO should take stepsGovernment. to remove the difficultiesI have mentioned. Thus, instead of serving the interests of peace Solutions for this problem were to have beenand the welfare of humanity, scientific discoveries found by the allocation of fellowships and by thecame into the hands of trade. formation of a special office of supply in order to Perhaps it is only a coincidence that the pro- facilitate the purchase by States Members ofduction of streptomycin, to which so much labour certain products and the necessary technicalwas devotedat Camp Detrick, was almost equipment required by them for carrying out theentirely monopolized by the Merck combine, programme recommended by WHO. particularly in the early stages of its production. Neither the creation of fellowships nor theThe methods of production of chemical medica- formation of an office of supply have given thements whose value, if the experts are to be expected results. believed, exceeds the bounds of medicine and In the Preamble to the Constitution of WHOenters the realm of world economy (for example, we read that " The achievement of any State inin connexion with the disinfection of areas subject the promotion and protection of health is ofto sleeping-sickness), and even of demography, value to all. should not remain secret, seeing that the modern " Unequal development in different countriesproduction of these medicaments depends, to a in the promotion of health and control of disease,great extent, upon technical operations which especially communicable disease, is a commonare quite as important as the principles of pro- danger." duction themselves. Unfortunately, technological But what do these principles look like when putprocesses are not made public, either in reviews into practice ?We have taken the liberty ofor through direct news bulletins. The American quoting a few examples drawn from a country ofpharmaceutical factories permit probationers and the importance of the United States. holdersof fellowshipstovisitthescientific The scientific institution which used to have theresearch or testing laboratories, but never give greatest authority in the United States and whichany hints about the production of the medica- included the most eminent figures of the scientificments. It is unnecessary to stress the significance world was the National Academy of Science. and the humanitarian scope of a drug like strepto- During theFirst World War a Nationalmycin which, for the first time in history, has Research Council was set up. During the Secondmade it possible to deal with ailments such as World War this institution became, in Octobertuberculousmeningitis,a disease which was 1940, the National Defense Research Committee,previously incurable. The production of this and then in 1941 the Office of Scientific Researchdrug is still not only insufficient to cover medical and Development.At the end of the war, theneeds in general, but even the needs of paedia- activities of the last-named body were placedtricians in the campaign against tuberculosis in under military control. The records of thischildren. In spite of this, nothing has been done institution comprise some ninety volumes. to make a beginning with production outside The results of the work of the Medical Researchthe United States, and it is perhaps better to say Committee in particular can be found there.no more on the subject. - 104 - SEVENTH PLENARY MEETING

The efforts Poland has made through the inter-hundreds of scientists have worked enthusiasti- mediary of WHO to try and train specialists atcally for years without being able to publish American centres have not produced results, asthe results of their labours, either in reviews or in these centres refused to co-operate. monographs. Since itsdiscovery,penicillin has been an Owing to the political atmosphere in the United indispensable drug, the sole means of combatingStates,American scientistsarereluctantto various contagious and infectious diseases, in-receive holders of fellowships from the Popular cluding venereal diseases, which have great socialDemocracies, since their admission might be significance and are easily disseminated. considered an anti-American activity. When they A short time after the war five of the devastatedare admitted, these Fellows find great difficulty in countries, including Poland, were to receive, asobtaining information, especially up-to-date infor- part of their UNRRA aid, a complete industrialmation. installation for making penicillin, as well as all WHO can do nothing to remedy this state of useful information concerning the methods ofaffairs, and the sending of Fellows under such production. conditions is often useless. After eighteen months an incomplete set of The most recent successes in the medical field equipment was delivered with the excuse thatare, thanks to the latest progress of science, methodsofpenicillinproductionhadbeenbenefiting the United States commercially, and altered.Additional information was promised.are only available to the rich.These powerful Unfortunately, neither strains with a satisfactoryweapons against disease, instead of being of yield, nor suitable equipment, nor data concerningservice to humanity, are doing it harm in the the productionofcrystallinepenicillin werehands of capitalists and imperialists preparing for received, notwithstanding all the efforts that werewar. made either directly or through the intermediary Of 60 States which have ratified the Constitution of WHO. of WHO, the United States alone has made Publications in the field of the chemistry ofreservations which are not provided for in the penicillin are very incomplete. Up to the beginningConstitution, and has thereby limited its contri- of 1941 there were only a few general reports onbution to the common cause. the work carried out in that year by the 41 In doing this it was infringing the Constitution. scientific and industrial research institutes. Therefore,theUnitedNations,throughits In 1946 it was decided to publish a monographSecretary-General, Mr. Trygve Lie, felt obliged on the chemistry of penicillin which was toto refer the acceptance of the United States as a comprise all the chemical work undertaken sinceMember of WHO to the First Health Assembly." 1941. In point of fact, this monograph came out At that Assembly all the delegates expressed two years later, in January 1949, when some oftheir surprise and regret at the United States' the information was out of date or of no interest. decision.Nevertheless, taking into consideration A very important study on the precipitation ofthe necessity for international co-operation in penicillin, which had been ready for a long time,a sphere so important as the preservation of was published only in 1948. The technicalhealth, the United States was admitted unani- methods of the crystallization of penicillin havemously as a Member of WHO, but the hope was not yet been published. expressed that it would withdraw its reservations. The editorial committees for the monographUnfortunately, the United States delegates have on the chemistry of penicillin placed that drug innot yet altered their attitude and have thus the category of weapons of war (page VII of themaintained a privileged position, which prevents Preface). WHO from functioning effectively. The information so far published on the chemical In speaking of the activities of WHO we cannot properties and composition of the new anti-pass over in silence the goodwill shown by the biotic aureomycin is extremely scanty. The sameUSSR in order to enable the Interim Commission can be said of chloromycetin.Yet these anti-and the First Assembly to carry out their work, biotics have a very important part to play in theas well as the efforts the Soviet Union made to campaign against rickettsioses and certain viruses.create a favourable international atmosphere in The same thing can be said of biochemicalwhich WHO could work and develop under the research by means of radioactive isotopes. In thebest conditions. course of the last few years very intensive research Unfortunately, owing to the unjust and un- has been prosecuted on the assimilation of CO,warranted policy of the majority of the Executive by plants by means of isotopes of carbon C.Board, as well as of the Secretariat and administra- The research cycle carried out by Calvin andtion, the USSR, Byelorussia and the Ukraine Bansar has only been published in a very fragmen-have left WHO, declaring that collaboration tary fashion in spite of the extreme importancewith it had become useless, as WHO had not of these investigations. fulfilled its task and had failed in its mission. Most of the work relating to stable and radio- This decision by the USSR must be considered active isotopes is inspired by the United Statesas gravely prejudicing the ,work of the Organiza- Commission on Atomic Energy and is carried outtion. for it. WHO, like many other international organiza- Farrington Daniels, Director of the Metallur-tions, has become the battle-ground of two gical Laboratory of Chicago University, put the position in this field admirably when he said that 17 See 011. Rec. World Hlth Org. 13, 77 - 105 - SEVENTH PLENARY MEETING opposing points of view. Two rival camps faceview during the various discussions in the com- each other. The camp of peace, standing for themittee meetings.However, I think it propèr interests of humanity, which demands that theagain to call attention to the fact that the problems attainments of medical science should serve thevary in importance according to the conditions whole human race, is represented by the USSRof the various geographical zones. While in some and the Popular Democracies, while the capitalistregions very advanced plans will be advisable, camp represents the interests of a minority whoin others it will be necessary to concentrate parti- consider science as a source of income and as acularly on basic sanitary problems. weapon of war. The activities and behaviour of Since, in the Dominican Republic, the health the majority of the members of the Executivedepartment has been organized within the modern Board, as well as of the Administration, proveconcepts of public health, we carry out a complete that WHO inclines towards the capitalist andprogramme of modern public-health activities imperialist camp.Its activities are for the mostwithin our organization. However, the problems part limited to fine declarations of no real value. All this makes thecollaboration of certainof environmental sanitation, control of malaria countries with WHO doubtful and of no interestand tuberculosis, maternal and child health, and to them. other problems, which to us are fundamental, receive preferential attention. Present-day politics must be given a funda- It is our hope that in the deliberations of this mentalreorientation. The collaborationofAssemblya programmeofaction may be several States will depend, not on declarationsperfected which, in turn, may enable our Organi- and resolutions, not on fine speeches and brilliant debates, nor on theoretical and imaginary pro-zation to carry out more effective and useful work grammes, nor on promises, but on hard facts andduring 1950 and the ensuing years for the benefit an effective contribution towards the work ofof the health of humanity, which will lead to peace and world progress, in accordance with thegreater understanding among the peoples. terms of the Constitution, which states in its Preamble : The PRESIDENT : That has brought us to the " The health of all peoples is fundamental to theend of the general discussion, and I should like attainment of peace and security and is dependentto thank all the delegates who have taken part. upon the fullest co-operation of individuals andWe all realize that this part of the Assembly is a States ". very important one indeed. Although this is not a political organization in the sense that political Dr. THOMEN (Dominican Republic) :In thedecisions are made or should be made here, we name of the Dominican delegation, I must firstnevertheless represent governments.Therefore, of all express to the Government of Italy gratitudeit is of the greatest importance for the Assembly for the warm hospitality tendered to us.Theand for the Secretariat to learn, through such a facilities offered for the holding of this Assemblygeneral debate, what the governments think and the many social functions included in theof WHO and its work-what they approve of and programme will make our task both easy andwhat they have to criticize-and thisis the pleasant. main purpose of the geheral debate. I also want to give due credit to my respected Some delegates have also taken the occasion colleagues, Dr. Stampar and Dr. Evang, for theto present what might be called reports on the most able way in which they conducted, and areachievements in improving the health of the conducting, respectively, the debates of the Firstpopulations of their countries.Very interesting and Second World Health Assemblies. as this may be, I venture to submit that the Finally, a word of recognition should be saidgeneral debate is not exactly the place for that, for the silent but efficient work being performedand I would like, in this connexion, to draw the by the Director-General and the Secretariat. attention of delegates to Article 61 of the Consti- tution,reading," Each Member shall report It has been the cause of particular satisfaction toannually to the Organization on the action taken our country that the Agreement has already been signed whereby the Pan American Sanitaryand progress achieved in improving the health Bureau becomes the Regional Office of the Worldof its people." Health Organization. In this manner, we earnestly During this general discussion a great many hope that the benefits of co-ordinated work mayproblems have been touched upon. In the opinion be extended most effectively in our hemisphere.of some delegates, some of these questions seem This will undoubtedly result in the improvementto be difficult, controversial.I am quite sure of the health of our peoples and of those peoplethat these and several other questions will be with whom they come in contact. discussed thoroughly in one or more of the main Studying the proposed programme of actioncommittees as they get under way. for the year 1950 presented for the consideration Itis,of course, understood that, by this of this Assembly, we notice that due attentiondiscussion, we have not approved the Reports of has been given to the principal health problems.the Director-General and of the Executive Board. This is not the appropriate moment to discuss theWhat we have done is to discuss them and we now details of this important project, since we shallrefer them back to the main committees for further have the opportunity to present our, points ofstudy and report back to the Assembly. - 106 - EIGHTH PLENARY MEETING

31. SecondReportoftheCommittee onthe main committees.This needs no action on Credentials the part of the Assembly : we take note of the The PRESIDENT : have pleasure in callingmatter here in the plenary session.I shall read upontheChairmanoftheCommitteeon the names to you :Dr. Domanska (Poland), Credentials. Vice-Chairman of the Committee on Programme ; Dr. Davis (New Zealand), Vice-Chairman of the Professor CANAPERIA (Italy), Chairman of the CommitteeonConstitutionalMatters,and Committee on Credentials :The Committee on Dr. Thomen(Dominican Republic), Vice- Credentials met yesterday and I will ask theChairman of the Committee on Administration Rapporteur, the delegate of Pakistan, to read theand Finance. report. MY. Kazi (Pakistan),Rapporteur, read the second 33. Procedure for Examination of the Pro- report of the Committee on Credentials." gramme and Budget for 1950 The PRESIDENT : Are there any observations ? The PRESIDENT : Are there any observations In the absence of any opposition, the second on document A2/58 " Procedure for Examination report of the Committee on Credentials is accepted.of the Programme and Budget for 1950 " ? In the absence of observations or opposition, 32. Second Report of the Committee on Nomi-the resolution proposed by the Executive Board is adopt ed.2° nations :19Nominations for the three Vice- Chairmen of the Main Committees The meeting is adjourned. The PRESIDENT : The Committee on Nomina- tions has nominated the three vice-chairmen for The meeting rose at 4.30 p.m.

19See p. 321 19See p. 323 20 See Resolution WHA 2.1, p. 18

EIGHTH PLENARY MEETING Tuesday, 21 June 1949, at 3.30 p.m.

President: Dr. Karl EVA NG (Norway)

34. Adoption of the Supplementary Agenda to consider it as it stands in the document before you. The PRESIDENT :The meeting iscalled to order. Rajkumari AMRIT KAUR (India) :I should be It is recommended by the General Committeevery glad if the document were read, because I that the several items referred to in documentdo not have a copy of it. A2/70, Supplementary Agenda, should be allotted to the Committees on Programme, on Constitu- tional Matters and on Administration and Finance. The PRESIDENT : Before going 011 tO read the Are there any remarks ? report, there is one other question we have to decide,namely, whether you arewillingto In the absence of any opposition, the items ofconsider this report now nothwithstanding Rule 10 the Supplementary Agenda21will be allocatedof the Rules of Procedure, according to which to the committees as indicated in that document.48 hours' delay is necessary.It was the feeling of the General Committee that we should consider 35. First Report of the Committee on Consti-this report today, notwithstanding Rule 10.Is tutional Matters that agreeable to the Assembly ?Are there any objections ? Thank you. I then have pleasure The PRESIDENT : I have to draw your attentionin calling upon the Rapporteur of the Committee to a typographical error in the document beforeon Constitutional Matters to come to the rostrum you. The first clause of the resolution " ADOPTSand read the report. the report of the Executive Board in which it is recommended that Article VI " should Mr. Calderwood (United Statesof America), read, not " Article VI ", but " Chapter VI ".Rapporteur, read the first report of the Committee Before discussing this report, I should like to on Constitutional Matters.22 ask the Assembly whether you would like to have the report read, or whether you would be willing The PRESIDENT : Are there any observations ?

21See p. 61 22For final text, sec p. 350 - 107 - EIGHTH PLENARY MEETING

Is the Assembly then prepared to take note ofthe expert committee's report on maternal and this first report of the Committee on Constitu-child health is accepted as amended. tionalMatters and toaccept the suggested resolution at the bottom of the page ? Any objections ? 38. Third Report of the Committee on Creden- In the absence of any opposition, the first tials report of the Committee on Constitutional Matters The PRESIDENT : The next item on the agenda has been noted and the resolution therein hasis the third report of the Committee on Credentials. been adopted by the Assembly. This is an oral report.I have pleasure in calling upon theRapporteur of the Committee on Credentials. 36. Announcement by the President concerning the Nomination and Election of Members Mr. Kazi (Pakistan)Rapporteur,submitted entitled to designate a Person to serve on thethe third report of the Committee on Credentials." Executive Board The PRESIDENT :Again I have to ask the The PRESIDENT :The Rules of Procedure forAssembly whether it is prepared to accept this electing members to the Executive Board willreport, notwithstanding Rule 10 of the Rules be found in Official Records No. 14, pages 66 andof Procedure. 67.I would like especially to draw the attention Is there any opposition ?Then that is agreed. of all delegations to Rule 78, which I am nowAre there any comments or remarks on the going to read to you : report itself, or is there any opposition ? As there At the commencement of each regular session of is none, the third report of the Committee on the Health Assembly the President shall requestCredentials has been accepted. Members desirous of putting forward suaaestions regarding the annual election of those SYembers to be entitled to designate a person to serve on39. Other Business : Letter from the Venezuelan the Board to place their suggestions before the General Committee. Such suggestions shall reach Association of Health Inspectors the ChairmanoftheGeneral Committee not The PRESIDENT :Under " Other business " later than forty-eight hours after the President has made the announcement in accordance withthere is just one item for this afternoon.It is a this Rule. letter of greeting from the Venezuelan Association of Health Inspectors : In other words, the suggestions will have to be The Association has the honour of sending you forwarded within the time-limitof 48 hoursthrough Dr. Armando Castillo Plaza its hearty from now. salutations, in the hope that the deliberations of the Assembly will achieve the most complete success for all those nations whose delegates are 37. First and Second Reports of the Committeeunited by basic principles of fraternity and who on Programme have started a movement without distinction of race, religion or ideology in order to strengthen The PRESIDENT :I have pleasure in callingour relations for the accomplishment of our common upon the Rapporteur of the Committee on Pro-task of building a better future in which, physically and mentally healthy, we should be able to see gramme to read the reports. a deep sense of social progress take rest in the minds of all men. Dr. Radji (Iran), Rapporteur, read thefirst and second reports of the Committee on Programme.23 (Signed) Dr. Sergio Chapman, President of the Board of Directors The PRESIDENT. The General Committee recom- of the Association. mends the deletion of the last sentence of the I am quite sure that the Assembly will want the suggested resolution, which you will find in thePresident to send a letter of thanks to the Associa- secondreport,namely, " REQUESTSthe Director-General to take appropriate action ".tion for this friendly greeting. Are there any comments or objections ? As far as the Chair is concerned, there is n o further business before the Assembly. The President can see no opposition ; therefore the first and second reports of the Committee The meeting is adjourned. on Programme are noted and the resolution on The meeting rose at 4.10 p.m. 23 For final texts, see p. 325 24 See p. 322

- 108 - NINTH PLENARY MEETING

NINTH PLENARY MEETING Saturday, 25 June 1949, at 3.30 p.m. President: Dr. Karl EVANG (Norway)

40. Assignment of the State of Israel to theannounced that it would like to be assigned to the Eastern Mediterranean Area Eastern Mediterranean Area, being part of the The PRESIDENT : Before opening the discussion territory which has already been assigned to that on the items on the Agenda, I have the greatregion. I must ask whether there is any objection, although I feel that there will be none. pleasure of informing you that we have received Are there any objections ? notice from the Secretariat of the United Nations to the effect that the State of Israel has now That is accepted. deposited the proper instruments of ratification with the Secretary-General of the United Nations ; 41. Rules of Procedure of the Health Assembly : Israel being at the same time a Member of the Suspension of Rule 10 United Nations, the conditions are thereby ful- The PRESIDENT : The General Committee has filled, and Israel is a Member of WHO. proposed that the Assembly suspend Rule 10 It is indeed a great pleasure to be able toduring the remaining plenary meetings.25The welcome Israel as a Member of the Organization.Belgian delegation has submitted a document Israel, as we all know, fulfils the very strangesignifying that it agrees to this proposal provided position of being at the same time an old and athat the Assembly has first of all given its approval new nation.We are quite sure that Israel inineach particularcase."The matter was joining WHO will be able to contribute both withconsidered today by the General Committee, the experience of an old nation and the will towhich felt that the Belgian proposal would defeat develop which a new nation possesses. With thesethe purpose of the suggestion of the General few words I have pleasure on behalf of the SecondCommittee ; therefore that committee could not World Health Assembly in welcoming the newrecommend to the Assembly acceptance of the Member. Belgian amendment. Are there any objections to accepting the The Chair recognizes the chief delegate ofsuggestion of the General Committee ?In the Israel. absence of any opposition, the suggestion of the General Committee is accepted. Dr. NOACK (Israel) : Mr. President, I thank you for your kind congratulations and I thank the Assembly for its friendly welcome.I wish to42. FourthReportoftheCommitteeon express the satisfaction of my delegation with the Credentials fact that the State of Israel is now a Member of The PRESIDENT : I shall then ask your permis- the World Health Organization. I can assure yousion to consider first the fourth report of the that we shall do our best to co-operate fully andCommittee on Credentials. Are there any objec- loyally with the other Member States, especiallytions ? No objections ?I have pleasure in calling those in the Eastern Mediterranean Area, to whichupon the Rapporteur of the Committee on we belong. We wish to take an active part in theCredentials. work of WHO. I am glad to take the opportunity Mr. Kazi (Pakistan),Rapporteur, readthe to express the thanks of my Government to thefourth report of the Committee on Credentials." Executive Board, the Danish Red Cross and UNICEF for including Israel in the BCG campaign The PRESIDENT : You have heard the fourth which will start in our country next autumn. Wereport of the Committee on Credentials. Are there are an old nation but a young State and we haveany comments ?Any objections ? much to learn. We hope to receive the help and In the absence of opposition, the fourth report the guidance of WHO and of its institutions. Butofthe Committee on Credentialshas been we are ready not only to receive but also to give.accepted. We see in this peaceful co-operation of the nations of the world one of the greatest achievements of 25 The proposal was in the following terms : " In order to conduct the remaining business of our time and we shall be proud to contribute ourthe Assembly as expeditiously as possible, and in share to the noble work of the World Healthaccordance with Article 94 of the Rules of Pro- Organization. cedure, the General Committee gives notice here- with of its intention to propose to the Assembly the suspension of Rule 10 during the remaining The PRESIDENT : As you will recall, the Firstplenary sessions." World Health Assembly assigned Palestine to 26 See footnote 8, p. 145 the Eastern Mediterranean Area.Israel has now 27 See p. 322 - 109 - NINTH PLENARY MEETING

43. Election of Members entitled to designatewith the provision of the Constitution : that there a Person to serve on the Executive Board should be equitable geographical distribution. The PRESIDENT : I should like to suggest that In the same way, if you take the Eastern we now pass on to point 16 of the Agenda. WeMediterranean Area, you will find that we have must assume that some voting will take place, andnow 12 full Members.One country from that while the votes are being counted we shall havearea, Iran, is now leaving the Executive Board. If you accept the six names, another country from time for the other items on the agenda ; therefore,the same area-Turkey-will enter the Executive to my mind we should save time by taking itemBoard, giving the same proportion of members 16 now. Is that acceptable ? Thank you. on the Board. The relevant document is A2/88.28 In presenting If you take the Western Hemisphere, you will this paper to you on behalf of the General Com-find that, while there are now three members mittee, it will, I think, be unnecessary for me toof the Executive Board from that hemisphere, remind you of the very great importance of thethere would,if you accepted the six names elections which we are now going to undertake. Ipresented to, and recommended by, the General have to remind you that under Article 24 of theCommittee, be an increase from that area, giving Constitution there are two criteria which we havethat area four instead of three members. It would to take into consideration in electing Members tomean re-election of the United States of America, designate persons to serve on the Executiveand adding Venezuela as a member of the Board. Board. We have to take into account an equitableIn this connexion I should like to remind you of geographical distribution,and we alsohavethe discussion which took place during the to take into consideration the ability of theFirst World Health Assembly, where it was country elected to designate " a person technicallystated, not once but several times, that if the qualified in the field of health ". number of ratifications from the Western Hemi- I should also like to recall to your attentionsphere were increased, the Western Hemisphere Article 29 of the Constitution, " The Board shallwould have a certain moral right to increase its exercise on behalf of the whole Health Assemblymembership. the powers delegated to it by that body." That It seems, therefore, only fair that this area means that we are not here electing people whoshould increase its members on the Executive are going to act as representatives of their ownBoard from three to four. countries, following instructions from their govern- Under these circumstances, one area will have ments, on the Executive Board. We are going totosacrifice,and as you will see from the elect people who are trustees of the whole Healthdocuments, the area which will have to sacrifice, Assembly and who, under the Constitution, haveif you accept the list of six, is the South-East the duty to carry out the functions delegated toAsia Area.There are now two members on the them by the Constitution and by the WorldExecutive Board and five full Members in that Health Assembly.Therefore, I would ask youarea ;Ceylon is going out, and there is no sugges- all, in considering the suggestions put before you,tion for replacement from the area. to take into consideration also the ability of the Finally, if you take Europe, there are now eight designated country to elect a person with amembers on the Executive Board and 26 full truly international point of view. Members in the area.Greece has indicated its As you will see from the document before you,intention to be assigned to the European Area, it was unfortunately not possible to reach aand the number will thereby be increased to 27. unanimous decision in the General Committee.Again, if you accept the list suggested to you, it It would have made our task and yours easierwould mean that the European Area would have, had that been the case, but it did not happen.as now, eight members on the Executive Board. If you take the list before you of the six MembersThe suggestionisre-electionoftheUnited who, if elected, would, in the opinion of theKingdom, and Italy substituting for Norway. majority of the General Committee, give a balanced Again, as in the case of the Western Pacific Area, distribution of the Executive Board, and if youit has been questioned whether this is in full compare it with the present composition of thecompatibility with the Constitution, which asks Executive Board and with the number of ratifi-for an equitable geographical distribution. cations in the different geographical areas of the Under Rule 79 of the Rules of Procedure of the world, you will have the following picture. World Health Assembly it is the duty of the General Committee to present not only the six For the Western Pacific Area, where we havenames which we have (which I have dealt with now four Members, there are at present twonow), but also three additional names, making members on the Executive Board.If you acceptaltogether a list of nine names. The paper A2/88 the six names suggested to you, it will mean thathas been presented to you in this form to make that area will still have two members on theit quite clear that those three additional names Executive Board, but that one country, Australia,were selected by separate vote taken in the will have been substituted by another countryGeneral Committee after the first six names had from this same area, the Philippines.It hasbeen selected.I should also like to draw your been questioned whether this is in full conformityattention to the fact that there were only 12 members of the General Committee present and 28 See Annex 1 voting when the last vote was taken.Therefore - 110 - NINTH PLENARY MEETING you should not pay too much attention to theHealth Assembly, in electing Members entitled difference in the figures of votes which you willto designate a person to serve on the Board, has find between Australia and the two other countriesto take into account an equitable geographical on the list, Pakistan and Sweden. distribution.It therefore seems reasonable that In finishing, I should like to say that at thethe five countries in the Nordic area should be First World Health Assembly we had a greatrepresented on the Executive Board. The First deal of difficulty in electing an Executive BoardWorld Health Assembly took this into considera- which was satisfactory to everybody.It seemstion, and elected one of the five Nordic countries- to me, if I may say so (though I have been aNorway-to designate a person for the Executive member of the Executive Board myself), thatBoard. One out of five countries seems to be a thecriticismsraisedagainstthatExecutivefigure which corresponds rather well with the Board during this Assembly have not been manygeneraldistributionofthe Executive Board and have not been serious. Also I should like tomandates among all the Member States, which is say that if a geographical area for some reasonabout 1 :3.5. or other will have today to sacrifice one member In agreement with the principles expressed at of the Executive Board, it is in my opinion thethe First World Health Assembly, we think that duty of the next World Health Assembly torepresentation on the Board should rotate, and look with special care into the situation which willthat generally a Member State should not be have been thereby created-to see to it that suchentitled to be re-elected. This year it is Norway's a sacrifice would not in any way create a pre-turn to withdraw from the Board and conse- cedent. quently the Scandinavian area will not be repre- I have been asked several questions as to thesented unless the Assembly elects another of the procedure for the voting, and although we havefive Nordic countries. not reached the stage of voting yet, I should like at once to announce the main rules.There are In conclusion, I would say that it would not nOw nine nominations, six of them recommended.only be unfair to this geographic area, but also If, in the course of this discussion, there are noa loss to the work of the World Health Organiza- other nominations to be taken into consideration,tion if these northern countries should be pre- then the procedure will be that voting slips withvented from taking part in the work of the Exe- those nine names will be distributed before wecutive Board. Itherefore propose that this proceed to vote, and then the delegates will pleasegeographic area,consisting of fivecountries, delete from that paper three names, leaving theshould be represented on the Executive Board six others on the slips.If there are not six namesand that the Assembly should elect one of the on the voting slip that paper will be regarded asScandinavian countries to designate a person to null and void.Also if there are more than sixserve on the Board. names that paper will be null and void. The matter is open for discussion ; are there any Dr. TOGBA (Liberia) : I had intended to make comments ? my remarks after the voting, but seemingly there will not be an opportunity to do that.For that Dr. BERGMAN (Sweden) : In the north of Europe reason I shall have to make some observations there is a group of five countries, where the now.According to the list which is before us, climate, social conditions and way of life arewe have omitted one geographical region-the almost identical. This geographic area consistsSouth-East Asia Region-in order that we may of Denmark, Finland,Iceland, Norway andfulfil the requirements of another region-the Sweden.The education of the people in theseAmerican Region-which is justly due another countries is very good, and, as is well known to member. Last year, if I remember correctly, you, the medical and hygienic standard is high.someone suggested that we should increase the This is demonstrated by our exceedingly lownumber of persons on the Executive Board in infant mortality rate, and low epidemic incidenceorder that there might be equal geographical and death rate ; it is also shown by the very highdistribution amongst the members.But that expectation of life in our part of the world.proposal apparently did not hold ground ;for We attribute these circumstances to our demo-that reason we retained only the 18 members. cratic and well-developed system of medical careNow the American countries are beginning to for the population and to our effective public-ratify the Constitution of the World Health health supervision. Organization at a greater and faster pace than I am sure that the opinion of this Assembly iswas anticipated. Liberia is therefore proposing to that the Nordic representation on the Executivethis Assembly that we should increase the number Board has contributed considerably to the goodof members on the Executive Board so as to results achieved there.I think you will alsomeet this increasing membership of the World agree that our Scandinavian countries have takenHealth Organization.At present the Americas an active and important part in the work ofhave 15 Member countries ; last year the number developing the health of the peoples of the world.was less ; I believe they had only three represen- My delegation believes that it would be of greattatives. This year they are justly due four value if the Nordic geographic area could continuerepresentatives on the Board. Perhaps next year, to be represented on the Executive Board in theor within the next two years, a further six or future. more countries of the Americas will ratify the In Article 24 of the Constitution of the WorldConstitution of the World Health Organization, Health Organization, it is clearly stated that theand they will justly deserv.e another member on - 111 - NINTH PLENARY MEETING

the Board. We are at present-taking this list intothe only country concerned, as Siam, Burma consideration-depriving one region ;I wonderand Afghanistan had not offered themselves for what region will be the next to be deprived tO meetnomination. I assure you that we never influenced this increment of membership.I am quite sureany of those countries to stand down, asis that the European countries will not be willingsupposed to have been implied. As I said before, to have one or two fewer seats on the Executivewe offered ourselves for consideration in the best Board.The year after next, it will be Africa'sinterest of WHO. For the reasons I have given turn to be up for election, and I am sure that weabove may I ask you to support Australia and from Africa will not agree to be left off thePakistan ? Executive Board. I am therefore proposing, Mr. President, that we should, at this present The DIRECTOR-GENERAL :The proposal made Assembly, take action to increase the represen-by the delegate of Liberia is relevant to an tation on the Executive Board. Agenda item which has already been referred to the Committee on Constitutional Matters.It was studied there, and the report on that subject Dr. WICKREMESINGHE(Ceylon) : As thehas been adopted by the Assembly at this session. delegate of a country in the only region that hasThe substance is the same as the recommendation been asked to make a sacrifice, I think I mayof the delegation of Italy at the First World plead with you to give some consideration to twoHealth Assembly." This has already been dealt countries which are our neighbours and goodwith and is to be found in the documentation. f riends, and which we feel could help us in ourI would suggest that this matter has already region.I refer to our good friends Australia andbeen dealt with by this Assembly.The proper Pakistan.We, the Members of the South-Eastprocedure for reintroducing any such proposal Asia Region, were unanimously agreed on onewould of course be to submit it for consideration point :namely, that the circumstances of ourat the next World Health Assembly. region were so urgent that we should at all cost urge the retention of the two seats previously Rajkumari AMRIT KAUR (India) :I have only allotted to this area.It was immaterial whichasked for this opportunity to come here in order to countries should have those seats. contradict the statement that has been made by We are not happy that the only representativethe delegate of Ceylon with regard to the position . of the region should be a large country, especiallythat I took up in the General Committee.It is when the Director of the Regional Organizationnot true to say that I agreed to make the sacrifice. comes from that country and the headquartersAll I said was this :that if a region has got to of the region are located in the same country.make a sacrifice (and it was said that it was the We small countries have a sense of pride and haveSouth-East Asia zone that was to make the no desire to be mere lookers-on.We thereforesacrifice), I pleaded, then, that this zone should hoped that one small country from the South-have representation, and that if we did not get East Asia Region would be associated with thatenough votes in the General Committee to come big country on the Executive Board. amongst the first six, at any rate another country The decision regarding the Executive Boardfrom this zone might be put among the nine has been made and we accept it loyally and incountries. And I went further, and said that if the spirit in which it has been made.I do wishwe were unfortunate enough not to get votes to assure my fellow delegates that until my chiefeven to come amongst the nine countries that and I came to this Assembly we had no intentionwere to be put to the Health Assembly, then at any rate this absence of one representative from of seeking re-election to the Executive Board.the South-East Asia zone should not be looked We thought it was right that we should standupon as a precedent, and you, Mr. President, down. However, when we were made' to under-have been kind enough to say that to the Health stand that in conformity with the wish of the Assembly. Assembly, it was desirable that Members who could make some contribution to the great work Dr. HOLM (Denmark) :It is with great surprise of the World Health Organization should continuethat the Scandinavian countries have seen the for some little time, we, perhaps conceitedly, feltlist of the six countries proposed by the General we could make that contribution and thereforeCommittee for election to the Executive Board. submitted our name for consideration. Among the six countries there is no representative Well, Sir, as it will not be possible for us tofrom the Scandinavian countries, which means contribute to the work of the Executive Board,that if the list should be accepted by the Assembly, the only thing I can urge is that two of our friendsthe Scandinavian countries would not be repre- may be associated with you in your deliberationssented on the coming Executive Board.The in the Executive Board in order that our problemsfive Scandinavian countries make a very defined may not be voiced by one single country.I dogeographical area within the European Area, want to take this opportunity also to expresswith their own public-health problems, and some- our resentment at a statement that is supposedtimes these countries have their own special way to have been made by the chief delegate of India,of solving their health problems. In our opinion, that she was prepared to make a sacrifice of onethis fact alone should ensure that the five countries country in the South-East Asia Region. We do not want to be offered as a sacrifice. We were 29 See 011. Rec. World Hltit Org. 13, 93 - 112 - NINTH PLENARY MEETING have a right to at least one representative perma-WHO. You will then allow me to recommend nently on the Executive Board. that you give your vote to Sweden as the represen- I should like to add the following observation.tative for all the Scandinavian countries. The Scandinavian countries have a special tradi- tion in the field of international health work. The PRESIDENT : Are there any further May I remind you of the considerable role theremarks ? The Chair recognizes the delegate Scandinavian couttries played in the organizationof Hungary. which preceded the World Health Organization, Dr. SIMONOVITS (Hungary) :The Hungarian namely, the League of Nations Health Organi-delegation fully shares the opinion expressed by zation, of which a Scandinavian representativethe delegates of Sweden and Denmark. We are was President for sixteen years.We also feelconvinced that the representation of these coun- that,on theInterim Commission and thetries on the Executive Board is a great help in Executive Board of WHO, the representative ofour work.The Hungarian delegation therefore the Scandinavian countries - the President of thisstrongly supports the proposal made by the Assembly - has made a valuable contribution, andScandinavian delegations. especially has shown an example of how a member of the Executive Board should act, not only as a The PRESIDENT : Are there any further representative of his own country or countries,remarks ? We will then proceed to vote. There but as an international. are no further nominations ? One other peculiarity of the Scandinavian There are now nine nominations before you, countries in international health work is thatas presented in document A2/88."I would ask they do not wish any considerable support forthe Secretariat to distribute the ballot slips. themselves, but simply wish to make an activeYou will, then, get a special ballot slip which and practical contribution to the health of thehas been prepared for this special voting.On world, in assisting other countries, wherever theythat slip you will find the nine names nominated. can do so and wherever their assistance is wanted. There is an asterisk against the names which are the six first names on the list. That is mentioned They are also demonstrating this principle inin the ballot slip itself.The procedure will then practice now.Many WHO Fellows are beingbe that each delegate will strike out, by using taken by the Scandinavian countries. In addition,a pencil or pen, three of the nine names, leaving special courses have been sponsored and financedsix names. Again I must recall to you that there by Scandinavian organizations.During the lastmust be six names, not more and not less, when year, more than 100 doctors from all parts of theyou put your ballot slip finally in the box. world have been trained in the Scandinavian I would like to ask the chief delegate of Brazil countries. Furthermore, practical field wor out-and the chief delegate of Ireland to be kind side the Scandinavian countries has been organ-enough to come to the rostrum and serve as ized and partly financed by Scandinavia. tellers. We have at this moment more than 100 Scandi- Of course you are all aware that there is only navian doctors and nurses working in the BCGone vote for each delegation, for each Member programme in countries in Europe and Asia,State, and not one for each delegate. and are planning to extend the work to still more May I ask the Director-General to read the countries, in Africa and South America.I wishnames of the Member countries ? to stress that this work is not done by one of The Director-Generalread the names ofthe the Scandinaviat countries, but jointly by allMembers in the English alphabetical order. the Scandinavian countries. I admit that we are co-operating in this work44. First Report of the General Committee primarily with UNICEF, which is financing part of the enterprise. We also have close co-operation The PRESIDENT :While the counting is going with WHO, and we are all planning in the futureon, we will continue with the agenda. We will that WHO should more or less take over thisnow start with the first report of the General work.I am afraid that if the Second WorldCommittee." Health Assembly should decide not to have a Are there any observations ?As there are Scandinavian representative on the Executiveno observations the document is noted. Board, unfavourable feelings would be created in our countries.The decision might be inter-45. Second Report of the Committee on Consti. preted as a criticism of our work, and it would tutional Matters certainly not directly encourage our efforts in the The PRESIDENT :I have been asked now to practical co-operation with WHO in the future.proceed to consider the second report of the We feel that the Scandinavian countries canCommittee on Constitutional Matters." make a real contribution in international health Before calling upon the Rapporteur of the work, because we represent a group of five Member Committee on Constitutional Matters, I have countries, and because no other European country is able to represent these specific problems and 30 See Annex 1 knowledge.Therefore, we feel we have a right 81 See p. 323 to be represented on the Executive Board of 32 See p. 350 - 113 - NINTH PLENARY MEETING the authority of the General Committee to askhearted co-operation of the entire world.The you whether you would be willing to considerabsence of representation of the USSR and the these reports without having them read out inother two republics of the Soviet Union there- full in the Assembly. fore creates a lamentable gap in our ranks which In the absence of any opposition, that proce-it should be the endeavour of this Assembly to dure is agreed. fill with the utmost expedition. Are there any remarks or objections to docu- ment A2/78, second report of the Committee I am aware that the argument may be raised on Constitutional Matters ? as to why we should make any further endeavour In the absence of any opposition, the secondwhen the Executive Board has failed to elicit report of the Committee on Constitutional Mattersany reply from the governments concerned to has been accepted. their appeal to them.I am aware too that there is a body of opinion that feels that the letters did not do justice to WHO.I regret that no 46. Third Report of the Committee on Consti-reply to the first communication has been received tutional Matters from the countries concerned.I agree that it is The PRESIDENT : We come to the third reporttoo early yet to condemn this Organization for of the Committee on Constitutional Matters.33its sins of omission or commission.But if we Are there any observations or objections ? are really keen to have the collaboration of the In the absence of any objections, the thirdSoviet Union we should not allow any mistakes reportoftheCommittee onConstitutionalon their part to permit us to commit any error. Matters has been accepted. Generosity generally wins the hearts of the most implacable opponents. The representative of the United States of America said in his address 47. Fourth Report of the Committee on Consti-the other day to the Health Assembly, that his tutional Matters country was as anxious as any other not to The PRESIDENT : Fourthreport Oithebring politics into the arena of WHO. That has Committee on Constitutional Matters - actionbeen the opinion of India from the very beginning, taken by certain countries with regard to member-and I am sure we all welcome this assurance from ship of WHO.34 I have pleasure in calling uponthe leader of the delegation of the United States the Rapporteur of the Committee on Constitu-of America.This Organization has done useful tional Matters. work during its very short existence.This work has got to expand and there is no one here but Mr. CALDERWOOD (United Stafes of America) must think in terms of practical work, and that, Rapporteur : May I suggest that the chief delegatetoo, in the areas which need most assistance. of India be asked to introduce this report ? While constructive criticism is always welcome The PRESIDENT : The Chair recognizes theand indeed necessary for the proper development chief delegate of India. of any work, I think it will add to our stature if we cease to indulge in mutual recrimination. Rajkumari AMRIT KAUR (India) :I have muchThere is ample room in a representative body such pleasure in presenting the resolution on theas ours to place grievances and problems before action taken by certain countries with regard tothe General Committee, the Executive Board membership of WHO.It was good to feel theand the various committees and I hold that no unanimity of spirit which motivated this reso-problem is really insoluble if the will to solve lution and I am happy that it has been sentit is there. to the Assembly. There can have been no Member, I feel, moreover, that each one of us can obtain I am sure, who did not receive with regret thejustice and fair play if we are ready to work in a news contained in the letters to the Director-spirit of give-and-take.The essence of a good General from the Deputy Ministers of Healthlife is healthy compromise from the individual, of the USSR, the Ukraine and Byelorussia.the family unit, the village community, the city, Whether these letters constitute withdrawal orthe province, the country upwards to the world, not is something which must be decided by legaland I am firmly convinced that we can, through experts and I do not think it is necessary for this Assembly to go into the intricacies of the law.this agency of the United Nations-the largest I believe that we here should consider the positionand most representative specialized agency so from the human point of view, because if we have far formed-make an enormous contribution understood our calling we are first and foremosttowards the breaking-down of those barriers servants of humanity. which today divide nations.But we can only The aims and objects of this Organization aredo so if, in our conference itself, we refuse to clear. There can be no two opinions on the needsthink in terms of " blocs ". We are here as one of the world in the sphere of health, withoutsolid " bloc " to work for world health and I which there can be no wellbeing and no happiness. venture to submit that our work for health Nor can we attain our goal without the whole-includes mental health as well as physical.The epidemic of fear and suspicion is even more 33 See p. 352 dangerous for man than cancer or malaria or 34 See p. 353 tuberculosis. It is a virus that has to be eliminated - 114 - NINTH PLENARY MEETING if we are to live ;if we can eliminate it here,Assembly will take the steps necessary to im- we shall be the direct means of eliminating itprove the work of the Organization, but for elsewhere too. the reasons stated, my delegation cannot vote I ask this Assembly, therefore, to pass ' thisfor this resolution and would like to abstain resolution unanimously from their hearts, withoutfrom it. fear and with boundless faith, and I also plead with the countries concerned to respond to this The PRESIDENT :Any further remarks ? Any objections ?In the absence of any opposition gesture in the spirit in which it is made.I hopethen, the fourth report of the Committee on it may be possible for them to show their good-Constitutional Matters has been accepted.It is will by sending, at this late hour even, one repre-being recorded that the delegate of Czechoslo- sentative to participate in the deliberations ofvakia has abstained from voting. this session or at any rate in the next meetings of the Executive Board. They may not, indeed Dr. STOYANOFF (Bulgaria) (translation from the none may, withhold their contribution to aFrench) :Please forgive my intervention, but world endeavour of such value.It is even essen-I thought we would be voting on the resolution tial for the sake of its own vital needs for everysubmitted by the Indian delegation. As no vote country to work from within the Organizationis being taken, however, my delegation also rather than remain outside. abstains from this resolution. With these remarks, Mr. President,I have much pleasure in proposing this resolution and The PRESIDENT : The Chair regards the remarks I ask the Assembly to pass it with one voice andof the delegate of Bulgaria as a proposal for voting with éclat. on this resolution, and the Chair is glad to comply with that request. Would it be agreeable to you Dr. SCHOBER (Czechoslovakia) :I think thereif we took this vote by a show of cards. Are there can be no doubt in the minds of any of the dele-any objections ? The Chair recognizes the delegate gates here that there is no delegation who would of Albania. regret more than my delegation the absence of Dr.KLosi(Albania)(translation fromthe the Soviet States at this Assembly. It is not onlyFrench) :I should like to suggest a method of for the reasons which have been so ably statedvoting.It would be better to vote by roll-call in the speech by the chief delegate of India.and each country should indicate aloud whether We in Czechoslovakia are in the process ofit is in favour of or against the resolution, or building socialism, and our duty as public-healthwhether it abstains from voting. workers is to introduce socialist medicine. There- fore the Soviet States are for us a model and we The PRESIDENT : Under the Rules of Procedure, delegates at the lastany country has the right to ask for a vote by Assembly were our teachers.It was for thisroll-call.The vote will therefore be made by reason that my delegation actively participated roll-call.We shall call the names and you will in formulating the resolution before you. please answer " Yes " if you are willing to accept the fourth report of the Committee on Consti- However, the Soviet States, or their represen-tutional Matters, and " No "if you are not tatives, have stated definite reasons why theywilling to accept it-that is if you are opposed cannot consider themselves any longer Membersto it-and you will answer " Abstention " if of WHO. They have criticized certain aspectsyou would like to abstain from voting. Are you of the work of WHO and you are well awareready for the vote ?I call upon the Director- that the Czechoslovak delegation has on manyGeneral to call the names of the Member States. occasions voiced similar criticisms. At the first, The names of the Member States were called in or one of the first, plenary meetings of the Secondturn in the English alphabetical order. WorldHealthAssembly,theCzechoslovak Minister of Health in a detailed statement made The result of the vote was as follows: clear our position and our criticism of the work In favour :Afghanistan, Argentina, Australia, of WHO.We therefore fully understand theAustria, Belgium, Brazil, Burma, Canada, Ceylon, withdrawal of the Soviet States, and we believeChili, Costa Rica, Denmark, Dominican Republic, that this resolution is a well-meant but half-El Salvador, Ethiopia, Finland, France, Greece, hearted attempt to bring them back, becauseIceland,India,Iran,Ireland,Israel,Italy, only when the criticisms of the Soviet StatesLebanon, Liberia, Luxemburg, Mexico, Nether- have been met will there be a possibility of theirlands, New Zealand, Norway, Pakistan, return. Philippines, Portugal, Sweden, Switzerland, Syria, I think that the presence of my delegationThailand, Turkey, Union of South Africa, United here shows clearly that we in Czechoslovakia,Kingdom, United States of America, Uruguay, and, I sincerely believe, the people of the SovietVenezuela. Union too, do not believe in blocs.I therefore Abstained: Albania, Bulgaria, Czechoslovakia, assume that the remarks made by the chiefHungary, Poland, Yugoslavia. delegate of India were not meant for my dele- The fourth report of the Committee on Consti- gation or for the absent Soviet delegates.We tutional Matters was adopted by 44 votes to none, sincerely hope that this Second World Healthwith 6 abstentions. - 115 - NINTH PLENARY MEETING

48. Third Report of the Committee on Pro-Board. Here the confusion arises. This committee gramme consists of members and it is very clearly stated in document A2/16, page 4, "... the following The PRESIDENT : The next item on the agendapersons be appointed to represent the Health is the third report of the Committee on Pro-Assembly on the WHO Staff Benefit Com- gramme.85 Are there any comments ? Anymittee ... " ". We have to deal with persons, objections ?The third report of the Committeeand now it is proposed that these persons should on Programme has been accepted. be appointed from the membership of the Execu- tive Board. In the Committee on Administration 49. Fourth Report of the Committee on Pro-and Finance it was pointed out by the Chairman gramme that we could not have these elections before we have the elections for the Executive Board. The PRESIDENT :Fourth report of the Com-But we have no elections of members of the mittee on Programme." Are there any remarksExecutive Board ;we have only the elections or objections ? The fourth report of the Committeefor States who have the right to appoint members on Programme has been accepted. , of the Executive Board, and who are the members of the Executive Board for one, two or three 50. Regional Offices years.It is quite possible that the members of the Executive Board who will act the first year The PRESIDENT : The General Committeewill be designated by a certain country, which recommends that the Agenda items 8.19.1.5has also to designate a member the second year (Africa) and 8.19.1.6 (Western Pacific) be re-who will not be the same. During the first year allocated to the Committee on Constitutionalof the Executive Board-the same was the case Matters." Are there any remarks or objections ?during the two years of the Interim Commission- The recommendation of the General Committeewe have several members coming in the place of has been accepted. another member. So, to my mind, this confusion will cause many difficulties.If a member is appointed to the Staff Benefit Committee for 51. First Report of the Committee on Adminis-three years because he is a present member of tration and Finance the Executive Board, it does not mean that he The PRESIDENT :First report of the Committeewill be on the Board for three years. What is the onAdministrationandFinance,documentposition if there is another member the next A2/72 ; " any observations ? The Chair recognizes year on the Executive Board, though the first the chief delegate of the Netherlands. person is appointed to the Committee for three years ? Dr. VAN DEN BERG (Netherlands) :I should This proposal in the first place creates confusion. like to speak on a minor point which itself isIt does not consider the membership of the not unimportant, but which involves a veryExecutive Board in the right way. In the second important principle. place, I believe it is very impractical to combine In your introductory speech to the electionsmembership of the Executive Board with member- for the Executive Board, Mr. President, youAlp of this committee, because this committee rightly stated that the members of the Executivedeserves persons with certain special qualities. Board consist of persons designated by MembersIt is in the interest of the personnel to have the and that the persons do not represent the Statesright men on this committee, and it is not always who have designated them. I had the experiencecertain that this could be combined with member- in the First Assembly, and again in the Secondship of the Executive Board.Therefore, I have Assembly, that again and again there is a con-the honour to propose the deletion of the last fusion about the status of the members of theparagraph of section 6 in document A2/72.4° Executive Board, and this confusion persists in some of the documents here before us in this The PRESIDENT :I should like to call upon Assembly. Again and again there arises thethe Chairman of the Committee on Administration opinion that the States and the members of theand Finance. Board are the same. In the report of the Committee on Administra- Dr. SCHOBER (Czechoslovakia) :Being myself tion and Finance, which we are discussing now,a medical. man, of course I overlooked such a we have the same confusion.I should like tonice legal point as has been made by the chief ask you to examine section 6-" Election ofdelegate of the Netherlands. The reason for the Members and Alternate Members of the Organi- zation's Staff Benefit Committee ".There it is proposed to adopt the principle of appointing " This quotation is from the draft resolution suggested by the ' Secretariat in its explanatory the members and alternates to the Staff Benefitpaper (unpublished). The wording was retainea Committee from the membership of the Executivein the resolution adopted by the Health Assembly (see p. 39). " See p. 325 48 This paragraph read as follows : " DECIDES to adopt the principle that it will " See p. 327 appoint the members and alternates to the Staff 37 See p. 144 Benefit Committee from the membership of the 38 See p. 336 Executive Board." - 116 - NINTH PLENARY MEETING step which we have taken and the committee haslike to make quite clear that, if the Assembly agreed, was that we thought we might saveacceptsthe recommendationtodeletethis money to the Organization by having someoneparagraph, that would not prevent us from from the Executive Board to serve as the membersaving money in the way therein intended. of this Staff Benefit Committee. We fully appre- Are you prepared for the vote ? We shall vote ciate the difficulty which the chief delegate offirst on the amended text, which is that farthest the Netherlands has raised, and I wonder whetherremoved in substance from the original.Will it would meet his point if we could try to savethose in favour of accepting the first report of money by appointing a member of the Executivethe Committee on Administration and Finance, Board and alternates to this committee, but makeas amended, so signify by raising the cards it clearly understood that should this memberbearing the names of their countries.In other be replaced by his government, he still wouldwords, those in favour of deletion will now raise remain on this committee.In other words, wetheir cards. could try to save money and hope the govern- Opposed ? ment will leave-as we do sincerely hope, once The motion has been carried. The first report it has named its representative on the Executiveof the Committee on Administration and Finance, Board-the same person to come to the meetingsas amended, has been accepted. of the Executive Board ;but should the govern- ment decide to change, this j)erson would still serve in this capacity.If this would meet the52. Second Report of the Committee on Admi- criticism made by the chief delegate of the nistration and Finance Netherlands, I am pretty sure that the Secre- The PRESIDENT :Are there any observations ? tariat and I, as chairman of this committee, In the absence of observations, the second would be only too happy to accept it. report of the Committee on Administration and Finance has' been accepted.41 The PRESIDENT : Would that satisfy the delegate of the Netherlands ? 53. Election of Members entitled to designate a Person to serve on the Executive Board Dr. VAN DEN BERG (Netherlands) :I fully agree (continuation) with the procedure that is proposed by the Chair- man of the Committee on Administration and The PRESIDENT : We shall now return to Finance.But we could follow this procedureitem 16 of the Agenda. The results of the voting without having this dangerous statement here,are now ready : and I should like, to avoid another misunder- Number of Members entitled to vote64 standing in the future, to delete it.While fully Absent 11 agreeing with the procedure proposed by the Papers null and void 0 chairman of the committee, I propose therefore Abstentions 0 the deletion of this last paragraph of document Number of Members present and voting53 A2/72, section 6. Number required for simple majority.27

Dr. SCHOBER (Czechoslovakia) :After consul- I shall now name the countries concerned, the tation with the Secretariat we would accept thenumber of votes received, and whether or not deletion of this part of the document as suggestedthe countries have been elected.The countries by the chief delegate of the Netherlands, whenare named in order, according to the number of and if the Assembly agrees to it. votes received : United States of America 46 Elected The PRESIDENT :It has been suggested by the Venezuela 44 Elected chief delegate of the Netherlands and seconded Turkey 43 Elected by the Chairman of the Committe6 on Adminis- Philippine Republic 36 Elected tration and Finance that we delete the last para- Sweden 36 Elected graph of section 6 of document A2/72. Are there United Kingdom 35 Elected any objections ? Italy 30 Not elected Pakistan 28 Not elected Dr. CAMERON (Canada) : It appears to the Australia 20 Not elected Canadian delegation that the elimination of this paragraph completely undoes the purpose of The PRESIDENT :IS there any other business ? saving money.I would therefore suggest that The meeting is adjourned. this matter be put to a vote. The meeting rose at 6.15 p.m. The PRESIDENT :A vote has been requested and will now be taken. Before doing so, I should 41 See p. 338

- 11:7 - TENTH PLENARY MEETING

TENTH PLENARY MEETING Thursday, 30 June 1949, at 11.45 a.m. President: Dr. Karl EVANG (Norway) later Dr Naguib SCANDER, Pasha (Egypt)

54. Date of Closure of the Second World Health When we agree that it would be wise to meet Assembly in Geneva every second year we have two funda- mental reasons in mind ;first, that delegations The PRESIDENT : The meeting is called to from all lands should have occasion to see regularly order.I have the honour to call upon His Excel-with their own eyes the great headquarters where lency, Dr. Scander, Pasha, Vice-President, totheirdecisionsaretranslatedintoaction ; take the Chair today. secondly, that the Palais des Nations offers all the technical facilities required by such a great Dr. Seamier, Pasha (Egypt), took the Chair. meeting. When we also agree that in alternate years the The ACTING PRESIDENT :It gives me greatAssembly might profitably be held elsewhere it pleasure and it is a special honour to have theis because the World Health Organization needs opportunity of presiding at this plenary meeting,to make itself known in other countries through thanks to the courtesy of our President, Dr. Evang. the presenceofitssupremeauthority,the We shall now proceed to the first item ofAssembly. today's agenda.The General Committee has May I remind you that the World Health set the date of adjournment of the Second WorldOrganization was born in our country on 22 July Health Assembly as Saturday, 2 July. Are there 1946, when the Interim Commission received its any objections ? No objections. The proposal ismandate from the International Health Confe- adopted. rence.The Organization will be five years old when the Fourth World Health Assembly con- 55. Time and Place of the Third World Healthvenes. It will have grown in stature as in power, Assembly and will have set its mark upon public-health work throughout the world. The American people The ACTING PRESIDENT : The Executive Board,need to see in their miast the living reality of at its third session, recommended to the Assemblythat great organization which has been growing the holding of the Third World Health Assemblyalmost without their being aware of it. at Geneva on or about 15 May 1950.42 The Secre- The Fourth World Health Assembly will be tary-General of the United Nations has informedwarmly welcomed in the United States.The us,the World Health Organization, thatitpride aroused by its presence should provoke a would be preferable for reasons already explainedpermanent interest in this great cause in far in document A2/2342 to advance it eight days,wider circles than is now the case.I may add that is to 8 May, if the Assembly decides thatthat all the technical facilities which can be the site of the Third World Health Assemblydesired will be available, so that the incon- should be in Geneva.Are there any objections ?veniences of displacement will be heldat a No objections.Accepted. minimum. I recognize the delegate of the United States As Surgeon General of the United States of America. Public Health Service I speak for my co-workers in many institutes of research and medical care. Dr. SCHEELE (United States of America) :We are eager to open our laboratories to colleagues Although we are now discussing where next tofrom all countries and also to show them our meet in Assembly, permit me to look one moreoperating programmes in action. A fruitful year ahead to the Fourth World Health Assemblyexchange of views will surely follow.I know that in 1951. these feelings are shared by the heads of Federal agencies responsible for other programmes of 42 Off. Rec. World Hlth Org. 17, 10 research, training and medical care as well as 48 The document statéd that, pursuant to theby institutions outside the Government. decision of the Executive Board (see footnote 42), the Director-General had consulted the, Secretary- On behalf of the Government of the United General of the United Nations, who had informedStates of America, I invite the Fourth World him that, while he was agreeable to placing theHealth Assembly to meet at Washington in premises and services in the Palais des Nations 1951. at the disposal of WHO for the Third World Health Assembly in May 1950, it would be necessary, if the Assembly's session was to last three weeks, The ACTING PRESIDENT :I thank Dr. Scheele to advance the opening date from 15 May to 8 May, since the available space was likely to be requiredfor the kind invitation of the United States and for the annual International Labour Conferenceit will be considered, of course, by the next by 30 May. World Health Assembly. - 118 - TENTH PLENARY MEETING

56. Adoption of Committee Reports strengthened from this test.Consequently, our delegation proposes to adopt the ninth report Fifth, Sixth, Seventh, Eighth, Ninth, Tenth andof the Committee on Programme subject to the Eleventh Retorts of the Committee on Programmedeletion of item 2 of the report. The ACTING PRESIDENT :An amendment is to be introduced to the texít of the fifth report.44 The ACTING PRESIDENT : The delegate of Item 2-Co-ordination of Research-paragraph (3) Greece. of the resolution :delete " or " at the beginning of the second line and insert " and ". Dr. BRISKAS (Greece)(translation from the Are there any objections ?The fifth reportFrench) :I had not intended to speak, but I shall of the Committee on Programme, as amended,do so in order to reply to a provocation. is adopted. At the last meeting of the Committee on Pro- gramme, we asked for the opportunity to express ThesixthreportoftheCommitteeonour opinion before the closure of the discussion Programme. 4,The question has been raised ofof this question. But because of lack of time, and the relations between UNICEF and WHO duringthe large number of delegates who spoke, our the period which lies ahead and which willchairman was not able to allow us to do so, and elapse before the World Health Organizationthe discussion was pronounced closed. takes over these projects. It is my understanding that during this period WHO will continue its I am anxious to emphasize, after having heard collaboration with UNICEF along the sameall the delegates, that Greece does not ignore the fact that other nations are suffering and are lines as now, through the Joint Committee onat grips with the same problems. You all know Health Policy, UNICEF/WHO. the attitude from which my country has not Is this acceptable to you ?Are there anydeparted since the First World Health Assembly. objections ?No objections. The sixth report isEach time that a question of a humanitarian accepted. nature has been raised I have spoken, and you Are there any objections to the seventh reportwell know the views which I have supported of the Committee on Programme ? 46 The seventhbefore the Assembly and the committees. report is accepted. I find it strange that when Greece describes The eighth report of the Committee on Pro-the lamentable situation in which she finds gramme.47 Are there any objections ? Theherself, and makes known her urgent health eighth report is accepted. needs, political considerations should intervene The ninth report of the Committee on Pro-in this Assembly, and I ask myself why the gramme.48Any objections ?The delegate ofPresident allows the discussion to take such a Bulgaria. trend.We constitute a World Health Organi- zation which is supposed to occupy itself only Dr. STOYAN OFF (Bulgaria) (translation from the with health. Every country has the right to say French) :In the ninth report of the Committeewhat are its needs, both from the humanitarian on Programme, item 2, " Assistance toDis-and from the health viewpoint.Greece, like all placed Persons ", we revert to the resolution byother countries, has the right to request aid in Greece for aid to refugees in that country. We areso far as the state of health of its population is sorry to return to this question, but our dele-concerned. My country is menaced by grave gation attaches great importance to it. epidemics.In these circumstances, if you allow The fact that the Greek resolution has beenconsiderations of a political order to intervene, modified by the Egyptian delegation does notyou assume the grave responsibility of leaving alter the problem at all.When the Economicthis problem without solution. and Social Council comes to deal with the question, I am not a politician, I am a doctor and I am it will appear to them that it is primarily Greeceinterested in all humanitarian questions.If we that is involved. In this case, should we interveneasked that Greece should be mentioned, it is in a civil war, an ideological war ?Should webecause her case is extremely urgent.If similar aid a government which, while employing allproblemsarisefor other countries they are its resources to fight against a part of its popu-entitled to present them as we have done ;no lation, has not sufficient means to look after theone prevents them from doing so.Consequently, most pressing needs of its population ? We knowI consider that particular mention should have that henceforth wars are total wars. been made of Greece ;this has not been done, Everything that aids one side becomes abut nevertheless we have adopted this resolution. disadvantage to the other.In our capacity as I do not wish to linger on a question explained a specialized international organization we shouldin detail by the head of my delegation, but I not allow any political considerations to intervene.consider that the work of WHO is humanitarian The adoption of this resolution would constitutework for health. We have not the right, here, to a regrettable precedent. Let us leave it to the allow considerations of a political nature to inter- competent organizations to settle this question.vene, and, in this respect, I am sure that our This is the best line of conduct which we canOrganization will one day adopt as emblem the follow. Our Organizationwill then emergeolive branch, symbol of peace. 44 See p. 328 47 See p. 331 46 See p. 330 48 See p. 332 The ACTING PRESIDENT : Any other comments? 46 See p. 331 The delegate of the United States. - 119 - TENTH PLENARY MEETING

4 Dr. SCHEELE (United States of America) :IHealth Organization to be used for aims which cannot see that this resolution before us reallyare unrelated to its present task. Therefore, amounts to very much and says very much.the Hungarian delegation supports strongly the It is proposed that we draw the attention of theproposal made by the Bulgarian delegation. Economic and Social Council of the United Nations to the health problems of refugees. We Dr. NAZIF Bey (Egypt) :I beg to refer back know that, in the case of Greece, the Greek Govern-to the wording of the second item of the report. ment has already called the attention of theThis resolution relates to general conditions. Economic and Social Council to its problems.It does not relate to any specified country. The We have the greatest sympathy for refugees andresolution reads : appreciate the fact that one can sometimes have Considering the disastrous consequences of health problems of major importance in refugee the situation of displaced persons in different and displaced persons' groups.Yet, in the case parts of the world as regards its health aspects of the Greek situation, we have no tangible as well as the risks of epidemics in their respec- evidence before us regarding the health problem. tive regions ... I do not want to deny for a moment that there is one, yet it seems to me that in those instances We did not talk about refugees.We talked in which the Director-General of the Worldabout displaced persons in different parts of the Health Organization has to call the attentionworld, not in one part only. Again, I stress that of some other organization to a health problem,we are referring to displaced persons and the he would at least have to investigate the healthimportant imminent danger to public health that situation in question. might arise from such conditions. There is nothing in this item except the pointing out We should like to object to the passing of thisof the situation from this health point of view on proposed resolution, purely on medical grounds.the general question. There is no other point of Our objections are not of a similar nature to thoseview. We are all here to collaborate towards one of the delegate of Bulgaria. We believe it is aand only one object, and that is the health welfare proper function of WHO to concern itself withof the world. We are here to combat epidemics all health problems. A sick child, communicableand to ameliorate the sufferings of mankind, diseases, are not essentially different in refugeeregardless of nationality or religion.On that groups than they are in the ordinary groups ofbasis only we ask you to approve the resolution citizens of any country, and we believe, therefore, and to adopt the report as a whole, including that it is part of the work of WHO to concernitem 2. itself with these things.We should be very _disappointed if WHO placed itself in the posi- The ACTING PRESIDENT : Any other comments, tion of calling attention to a problem regardingplease ? which its own staff had not had time to make To sum up, Bulgaria proposes the deletion of adequate reconnaissance and on which there is,item 2 ;the United States of America supports at this moment at least, no tangible evidence ofthe proposal of Bulgaria, Hungary also supports existence. the proposal of Bulgaria, Egypt supports the The ACTING PRESIDENT : Any other comments? resolution and moves the adoption of the ninth The delegate of Hungary wishes to speak. report of the Committee on Programme. We shall now proceed to vote on the Bulgarian Dr. SnuoNovIrs (Hungary) :In the Committeeproposal.Those in favour of the Bulgarian pro- on Programme we have already discussed theposal will please show their cards.Thirteen in paper submitted by the delegation of Greece.favour. Those against this proposal ?There are Although we have the greatest sympathy for the13 votes for and 26 against the proposal of Bul- suffering Greek people, nevertheless the dele-garia.Therefore the proposal is defeated. gation of Hungary must also cast its vote against We shall now vote on the ninth report of the the resolution. Committee on Programme. Any comments, any objections ?There being The delegation of Hungary fully shares theno objections, the ninth report of the Committee views of the delegation of Bulgaria.There areon Programme is adopted. other international organizations for these special Are there any objections to the tenth report purposes-the International Red Cross and theof the Committee on Programme ? " The tenth United Nations International Refugee Organi-report is accepted. zation. The eleventh report of the Committee on Pro- But that is only the formal side of this question.gramme." Are there any objections ? No This is a question of principles also.So far weobjections. This report is accepted. have tried to solve our problems leaving out politics, but if this question is raised we must askThird, Fourth, Fifth and Sixth Reports of the also what will happen in regard to other refugees. Committee on Administration and Finance What will happen to the Greek people who are fighting in the mountains for their liberty against The ACTING PRESIDENT :We HOW proceed to this government ? Who will help them ?Theseconsider the third report of the Commitee on and like questions axe purely political, and the Hungarian delegation is convinced that we are 49 See p. 333 all agreed that we must not allow the World 50 See, p. 335 - 120 - TENTH PLENARY MEETING

Administration and Finance."Are there any The ACTING PRESIDENT :Are there any objec- objections ?The report is accepted. tions to the first report of the Joint Meetings The fourth report of the Committee on Adminis-of the Committees on Programme and Admi- tration and Finance.52Any comments ? Nonistration and Finance ?No objections.The objections ?The report is accepted. report is adopted. The fifth report of the Committee on Adminis- We pass now to the second report of the Joint tration and Finance." Are there any objections ?Meetings of the Committees on Programme and The fifth report is accepted. Administration and Finance." Any comments ? A new item is being inserted in the agenda now concerning the sixth report of the CommitteeNo objection.The report is adopted. on Administration and Finance,54which will The third report of the Joint Meetings of the be read by the Rapporteur of the committee.Committees on Programme and Administration and Finance.57Are there any objections ?The Mr. Lindsay (United Kingdom), Rapporteur,delegate of the United Kingdom. read the sixth report of the Committee on Adminis- tration and Finance. Dr. MACKENZIE (United Kingdom) :I should The ACTING PRESIDENT : Are there anyjust like to suggest an amendment to item 3 objections to the adoption of this report ? Thereof this document, to the second paragraph of are no objections.The report is accepted. the resolution.Both doctors and nurses are equally members of learned professions and I First, Second and Third Reports of the Jointthink the word " assistant " is inappropriate. I would suggest,therefore,that the second Meetings of the Committees on Programme andparagraph read, " Whereas itis necessary to Administration and Finance ensure recruitment ", and that we erase the The ACTING PRESIDENT : We shall HOW proceed words " of these assistants ".There would be a to the next item, the first report of the Jointconsequential alteration in the third paragraph Meetingsofthe Committees on Programmeso as to omit the word " assistants " :" Whereas and Administration and Finance." Will theit is necessary in all countries to give them the Rapporteur please come forward. training .. .". Are there any objections to the report ?The delegate of France. The ACTING PRESIDENT :Are there any objec- tions to the amendment presented by the delegate Dr. DUJARRIC DE LA RWIÈRE (France) (trans-of the United Kingdom ?No objections.The lation from the French) :In accordance withamendment is adopted. Are there any objections instructions which it has received from its Govern-to the whole report as amended ? No objections ? ment, the French delegation has voted in com-Then the third report, as amended, is adopted. mittee, on the different projects relating both to the budget and to the working capital fund, with the intention of assuring the OrganizationFifth and Sixth ReportsoftheConimittee on of reasonable financial support while at the Constitutional Matters same time ensuring that the contribution from France does not exceed the maximum figure The ACTING PRESIDENT : We come now to envisaged by the Government. We are not inthe fifth report of the Committee on Constitu- a position to know exactly whether this figuretional Matters.58 Are there any, comments, will be passed or not because of our ignoranceplease ?There are no objections. The report of regarding the readjusted scale of contributionsthe committee is accepted. which will certainly result from the various We pass to the sixth report of the Committee changes which have taken placeinside theon Constitutional Matters, document A2/99.58 The Organization.The French delegation can onlydelegate of Bulgaria. state that it will report the conditions relative to the budget and the working capital fund, as finally adopted, to its Government. Although Dr. STOYANOFF (Bulgaria)(translation from the question has not yet been discussed, I wouldthe French): For the reasons stated in the Appen- add, in order to avoid speaking twice, that thedix," our delegation will abstain from voting on French delegation can only reserve the questionitem 5, and we shall vote against item 1.2, of the as to whether the French Government andreport. Parliament will agree to contribute to the Supple- mental Budget.In the event of such a contri- The ACTING PRESIDENT :We have heard the bution being agreed to by Parliament, paymentcomments of the delegate of Bulgaria. Any could be made only in French francs. further comments ? The delegate of Poland.

52 See p. 341 56 See p. 347 52 See p. 343 " See p. 347 58 See p. 345 58 See p. 353 " See p. 346 59 See p. 355 " See p. 347 6° See p. 357 - 121 - TENTH PLENARY MEETING

Dr.Trène DOMANSKA (Poland)(translation The DIRECTOR-GENERAL :It should be made from the French) :I speak only unwillingly inclear that the action proposed by the Committee this discussion.It is very unpleasant to have toon Constitutional Matters would not have the oppose the admission of a member to an organi- effectof seating the delegation from South zation such as ours, whose success depends onKorea in this Assembly as a voting Member. the collaboration of all in order to realize commonThat could not take place until there had been ends.Nevertheless, I consider it my duty toa deposit of the instrument of adherence to the oppose, on behalf of my Government, the admis-Constitution with the Secretary-General of the sion of South Korea as a Member of WHO.United Nations. That has not taken place. The We have already refused admission to the Repu-action proposed by the Committee on Constitu- blic of San Marino, because the status of thattional Matters would simply clear the way for State calls for clarifications of a legal nature.the deposit of such an instrument, and the accep- ' However, the situation of Korea is still moretance of South Korea as a Member of the Organi- confused.Actually, we know that there are twozation. Koreas.It is not our concern to decide which has a greater right to represent the interests of The ACTING PRESIDENT : We Will then proceed the Korean people. The situation of Southto vote on the proposal advanced by the delegate Korea is certainly more confused than that ofof Bulgaria and supported by the delegate of North Korea, for it is difficult to speak of thePoland. independence of a country which is still occu- The delegate of Albania wishes to speak. pied by foreign troops. To a certain extent the situation resembles Dr.KLosI(Albania)(translationfromthe that of Germany, which isalso occupied byFrench) :The Albanian delegation would like foreign troops.Germany is not a Member ofto emphasize that the question with which we WHO, and at present no one is surprised aboutare dealing is a complex one, as it touches on this. Why is there such haste to admit Korea ?the internal politics of the various countries. Why not await a decision by the United NationsYou know already that two Koreas exist :South on the legal status of one or the other Korea ?Korea and North Korea. The Albanian delegation We have several times refused to allow politicalwould be happy to see the representative of the considerations to arise inside WHO. In order toKorean nation here, but up till now we do not maintain this line of conduct the Polish delegationknow what is the government of the Korean opposes the adoption of item 1.2 of the sixthnation.It would be too precipitate on our part report of the Committee on Constitutional Matters.to accept, at present, this proposal of South Korea. Our Organization, which since its found- The ACTING PRESIDENT :Are there any otheration at New York has been supposed to avoid comments or objections ? The delegate of Egypt.all entanglement with poblems of a political nature and to devote itself exclusively to scientific questions, would create a precedent in this way Dr. NAZIF Bey (Egypt) :I have nothing towhich would have awkward consequences. The say as regards this item except that the delegateAlbanian delegation, therefore, strongly supports of Poland has referred to the case of San Marino.the proposal of the Bulgarian and Polish dele- The reason why San Marino was not admitted wasgations, and requests that the proposal of South that the Republic of San Marino had announcedKorea be struck off the agenda. thatitcould not withdraw itsreservation concerning its financial contribution, which, I The ACTING PRESIDENT :The delegate of the think, is against the Constitution. United States of America.

Dr. EJERCITO (Philippines) : I should just Dr. SCHEELE (United States of America) :The like to say that in the meeting of the committeeUnited States supports the recommendation of the matter of the admission of South Koreathe Committee on Constitutional Matters to was thoroughly considered. The committee wasadmit Korea to membership of the World Health practically unanimous in recommendingthisOrganization, particularly because such action admission on the ground that that country hadis in accord with the declared policy of the World already received recognition from several nations.Health Organization of having as wide a member- In view of this fact, I do not think that theship as possible.Korea is functioning as an statement made by the delegate of Poland, toindependent State with effective internal govern- theeffectthat the statusof Korea-Southmental institutions and is competent to conduct Korea-is still uncertain, is quite correct.Inits own foreign affairs.Diplomatic recognition view of the willingness of this country to co-of Korea has been accorded by the United States, operate with other nations in the promotionthe United Kingdom, the Philippines, China, of health, especially in the Western Pacific Area,Brazil, Chile and by the Vatican.Furthermore, I should like to recommend its admission. the resolution of 12 December 1948 passed by an overwhelming majority in the Assembly of The ACTING PRESIDENT : The Director-the United Nations 61 affirms this fact.That General will kindly give us a short explanation of this question so thatitwill be clear to 61 SeeResolution 195(III)ofthe General everyone. Assembly of the United Nations. - 122 - TENTH PLENARY MEETING resolution expressed the opinion that Korea is abecause of instructions by her Government.It nation eligible for membership. is our duty to try to get our governments to under- stand that we are doctors trying to take care of the sick and not politicians.Therefore let us The ACTING PRESIDENT : I think we could MOW close the debate on this issue and come to an proceed to a vote on the acceptance of the wholeagreement and accept Korea as a Member of the report of the Committee on Constitutional Matters. World Health Organization. The delegate of Hungary. The ACTING PRESIDENT : We Will proceed to Dr. SIMONOVITS (Hungary) : The question isa vote on the acceptance of the sixth report of whether there is one Korea, or two Koreas.Ifthe Committee on Constitutional Matters. we accept the resolution, which Korea will be a Member of WHO ? I have just read an American Dr. VAN DEN BERG (Netherlands) : A point of periodical, from which I will quote the following :order, Mr. Chairman.You have proposed that " Heavy fighting in Korea "-" Heavy fightingwe vote on the report of the committee. Now between the forces of North and South Korea "there is an amendment proposed by the delega- (it seems there are two Koreas) " is in progresstion of Bulgaria. This amendment was seconded, in the Ongjin region of Korea along the 30thand to my mind the proper procedure is to vote parallel, the United Nations Korean Commissionfirst on the amendment and then on the report reported today. No other details were available."of the committee. So as we can see, there are two Koreas. In Korea there is fighting between the North and the South. The DIRECTOR-GENERAL :I have BO record There are other, even clearer cases also.Forof anyone proposing an amendment to this report. instance, my country, Hungary, has ratifiedSeveral nations stated that they could not accept part of this report but there was no proposal to peace treaties with all countries, and Hungaryamend the report. cannot be a Member of the United Nations.So, if a country such as Hungary, many years after the ratifications of peace treaties, cannot be a The ACTING PRESIDENT :The delegateof Member of the United Nations, I ask why weBulgaria. should vote on this question-a thing which seems' to be full of politics. Dr. STOYANOFF (Bulgaria)(translation from the French) :I am sorry to intervene again, but in my previous statement I had proposed to take The ACTING PRESIDENT : I ShOUld like to drawseparate votes on items 5 and 1.2, and another the attention of the Assembly to the fact thatdelegation has also proposed to take votes on we are dealing with South Korea ;not withthese items. Our delegation will vote against the Korea, but with South Korea only. adoption of item 1.2.Furthermore, our delega- tion will abstain from voting on item 5, and I propose that the Assembly take a vote on item Dr. TOGBA (Liberia) :It seems as if, when it comes to constitutional matters, many of us5 also.These are definite proposals for voting. forget what our occupations are.We are here as physicians, not as politicians. On this question The ACTING PRESIDENT : We Will vote on the dealing with Korea, many of us evidently haveBulgarian proposal, supported by other members taken the political point of view instead of theof the Assembly that is, to delete paragraph 1.2 medical point of view. We debated this matteraltogether. Those approving the proposal of the considerably in the committee and I thought theBulgarian delegate kindly raise their cards.The matter might be left there, but many MembersHungarian delegate wishes to speak. are not satisfied and want to waste our time by talking on and on upon the subject. Korea Dr. BAKAcs (Hungary) (translation from the should be admitted on the basis that it is a nationFrench) : Mr. Chairman, I would like a roll-call desiring to come into our Organization, a nationvote to be taken. which has many people in it ; and probably many of them are sick and might have diseases which The ACTING PRESIDENT : We Will then proceed may spread to other parts of the world.Nowby roll-call.I give the floor to the delegate of why should we reject, on political grounds, athe Philippines. nation which has applied to .us for membership ? Why should we now try to establish a frontier Dr. VILLARAMA (Philippines) :I am raising a for diseases ?Diseases know no national bound-point of order.It seems to me that when there aries, and for that reason I move that we close theis voting you cannot allow anybody to talk on debate on this issue and take a vote if necessary.the subject. It must be stopped. All things must I am quite sure, as has been expressed by thebe stopped, and that is the point of order I am delegate of Poland, that all of us are willing toraising. I really cannot understand the procedure let Korea come in. But, of course, as the delegatebeing followed in this Assembly.There are of Poland says, she was talking against her willmotions that are being voted without any reference - 123 - TENTH PLENARY MEETING

whatsoever, and for this reason I am raising that Number of Members voting " No ". . 33 point. That is the real point in the question that Abstentions 9 we are facing. At the time of voting there should Absent 6' be no more chance for anybody to talk, and this is the reason for nominal voting.It seems to The motion is therefore lost. me that nominal voting must be supported by Does the Bulgarian delegate still insist upon at least two-thirds of the members present.asking for a separate vote on item 5 ? Otherwise, the voting should always go in the ordinary way.That is the procedure that I Dr. STOYANOFF (Bulgaria) : No, I do not insist understand, though I am not in the Chair. any more.

The ACTING PRESIDENT : The Director-General The ACTING PRESIDENT : Then we will vote will comment on that please. on the whole report. Any objections to its adop- tion now ?The report is adopted. The DIRECTOR-GENERAL : The Rules of Pro- cedure of the Assembly deal with this matterSecond and Third Reports of the General Committee in Rule 57 : The ACTING PRESIDENT : Are there any objec- The Health Assembly shall normally vote bytions to the second report of the General Com- show of hands or by standing, except that any delegate may request a roll-call, which shall mittee ? 62The report is adopted. then be taken in the English alphabetical order The third report of the General Committee.68 of the names of the Members. I should like to draw attention to the fact that there are two additions to this report : to " third, There is no choice.As soon as any Memberfourth and fifth reports of the Committee on requests a roll-call it must be proceeded withAdministration and Finance " add " sixth " ; in that way. after the last paragraph, add " The General Committee recommends to the Assembly that The ACTING PRESIDENT : The Director-Generalthe Third World Health Assembly should be will proceed now to a nominal vote and you mustheld in Geneva, commencing on 8 May 1950 ". say " Yes "," No ", or " Abstain ". Are there any objections to the adoption of this report ?There are no objections ; the report M. GEERAERTS (Belgium) (translation from theis accepted. French) :I would like details on the subject of the vote. 57. Adoption of the Report of the Director- General and the Reports of the Executive The ACTING PRESIDENT : I win ask the Director- Board 64 - General to explain. The ACTING PRESIDENT : The General Com- The DIRECTOR-GENERAL : We are voting onmittee suggests the adoption of the following the proposal of the delegate of Bulgaria to deleteresolution : paragraph 1.2of document A2/99, the sixth The Second World Health Assembly has report of the Committee on Constitutional Matters. reviewed and approved the reports and activities The names of the Member States were called in of the Executive Board and of the Director- turn in the English alphabetical order. General and has taken action thereon. The result of the vote was as follows : Any objections,please ? The reportsare In favour : Albania, Bulgaria, Czechoslovakia,adopted. Hungary, Poland, Yugoslavia. Against: Australia, Belgium, Brazil, Canada,58. Statement by the Delegate of Brazil Ceylon, Chile, Costa Rica, Dominican Republic, Egypt, Ethiopia, France, Greece, Iceland, India, Dr. SANTOS (Brazil)(translationfromthe French) :At this moment, when our work is Iran,Iraq,Ireland,Italy, Lebanon, Liberia,drawing to a close,the Brazilian delegation Mexico, Netherlands, New Zealand, Pakistan,desires to express its great satisfaction that all Philippines,Portugal,SaudiArabia,Syria,the Member States of WHO are endeavouring to Thailand,Turkey,United Kingdom,Unitedcontribute to our Organization the indispensable States of America, Venezuela. elements for the fulfilment of a working plan Abstained :Afghanistan, Argentina, Austria,which will ensure attention being paid to " one Denmark, El Salvador, Finland, Israel, Sweden, of the fundamental rights of every human being ". Switzerland. Brazil will follow the development of this pro- gramme with the greatest attention, and its The ACTING PRESIDENT : Here is the result ofGovernment will not fail in the future as in the the vote : past to lend its moral, technical and financial Number of Members present and voting39 Number of votes required for simple 62 See p. 324 majority 20 68 For final text, see p. 324 Number of Members voting " Yes ". 6 64 Oft. Rec. World Hlth Org. 16 ; 14 ; 17 - 124 - ELEVENTH PLENARY MEETING support in the greatest degree possible, in order As regards BCG vaccination, my country has to allow WHO to realize its very high aims. already used it for 22 years and as from next If the Brazilian delegation has not been ableyear it will be made almost compulsory.If it during this Assembly to engage itself to supplyis true that ill-health existing in one nation has considerable sums, greatly surpassing its presentrepercussions on neighbouring nations, we are contribution, it is because the Brazilian Govern-also convinced that the wellbeing sought by the ment is carrying out a five-year plan for trans-Brazilian Government for its people will spread port, power, food and health.In the field ofto other nations of the world. health,it must be remarked that this plan coincides in more than one respect with the pro- The ACTING PRESIDENT :If you will allow gramme which WHO proposes to put underme, gentlemen, I should like to congratulate the way.The execution of the Brazilian five-yearAssembly on completing its business today, and plan for health necessitates considerable sums,to thank you all. but we believe that in a short time malaria and The meeting is adjourned. other endemic diseases will cease to constitute grave problems for our Government. The meeting rose at 2.0 p.m.

ELEVENTH PLENARY MEETING Saturday, 2 July 1949, at 10.15 a.m. President: Dr. K. EVANG (Norway)

59. Announcement by the President : Memo-of tuberculosis, and the important contribution randum from Members of the Easternmade by him to the relief of human suffering. Mediterranean Area on the CompositionThe Italian Anti-Tuberculosis Federation has of the Executive Board deemed it to be its duty to commemorate the The PRESIDENT : As President of the Secondname of this great pioneer of our country by World Health Assembly,Ihave received aawarding a gold medal to persons or organiza- memorandum signed by all the Member Statestions which have further added to the illustrious belonging to the Eastern Mediterranean Area.tradition established by Forlanini in the treat- In this memorandum the questionisraisedment of this disease. whether the number of members of the Executive All those in Italy who are participating in the Board from that geographical area is sufficientlycampaign against tuberculosis have noted the great, taking into consideration the number ofbirth and development of the World Health Member States belonging to that region.I haveOrganization with the liveliest satisfaction, and been given to understand that these countries areparticularly happy toobserve that the would like to have this matter mentioned heretuberculosis-controlcampaignisgivenhigh -and I am glad to do so-but it will, of course,priority in the programmes of the Organization, be the duty of the Third World Health Assemblyboth at headquarters and in the field. We have and the General Committee of that Assembly tofound the reports and documents published by take into very careful consideration indeed thethe Organization very valuable, and Italy is arguments and points of view which have beenhappy to note the extent of the tuberculosis- brought forward by this important group ofcontrol programme which the expert committee Member States. has outlined. Tuberculosis constitutes a serious problem in Italy, and we are all aware of the trials and 60. Presentation of the Forlanini Gold Medaldifficulties which this disease has caused in the to the World Health Organization past, and which are far from being surmounted. The PRESIDENT : I have pleasure in recognizingWe are all the more able to appreciate the extent Professor Giovanni l'Eltore of the Italian delega-of the campaign undertaken by the World Health tion. Organization with the aim of aiding those numer- ous countries in the world whose difficulties are Professor L'ELTORE(Italy) (translation frominfinitely greater than our own. We are conscious the French): On behalf of the Italian Anti-of the ravages of the disease in Asia, in the Tuberculosis Federation, I have the honour toPacific Islands, and in many parts of Africa and invite the World Health Organization to acceptSouth America. Thus, in the task you still have the Forlanini Gold Medal as a token of apprecia-to accomplish, you can be assured of the warm tion of the efforts which WHO has already exerted support and most sincere encouragement of all and is still exerting in the fight against tuberculosisItalians who are taking part in the fight against throughout the world. this scourge. Our country, which claims eminent representa- May I hope that you will accept this medal, tives in many fields of medical science, feels aand with it our most sincere wishes for the reali- legitimate pride in thinking of the advance whichzation of the noble ideal which you have set your- Carlo Forlanini brought about in the treatment selves. - 125 - ELEVENTH PLENARY MEETING

Professor l'Eltore then presented the Forlanini It is in this spirit that we share the regret Gold Medal to the President of the Health Assembly. expressed here for the abstention of certain members, and the cordially formulated wish to The PRESIDENT : On behalf of the World Healthsee them reoccupy a place whose prolonged Organization, I have the great honour and pleasurevacancy can only jeopardize the interests of to thank Professor l'Eltore and the Italian Anti-humanity as a whole. Tuberculosis Federation.It is a great honour The spirit which animated us at New York for the World Health Organization that thein 1946, and again last year at Geneva, must Forlanini Gold Medal has been bestowed uponagain clear the atmosphere of our debates.I the Organization in appreciation of itsanti-sincerely wish this to come about, and I am tuberculosis work. confident that our united voices will be heard. The great Italian scientist and clinician, Carlo If I have alluded to the necessity for perfect Forlanini, was born, as you know, in 1847 andinternational understanding in the struggle to died in 1918.He was the first to propose theimprove the health of humanity, it is because artificial pneumothorax as a method for treat-this feeling of solidarity indicates the part that ment of tuberculosis.His suggestion was metBelgium wishes to play in the work of our Orga- with very heavy criticism indeed, but now itnization.My country has made, and is still is one of the fundamental methods for the treat-making, great efforts to maintain a balanced ment of tuberculosis all over the world. budget, demanding sacrifices from its citizens We are very glad indeed that the strugglewhich frequently make deep inroads into the against tuberculosis, in which WHO is takingresources which their work brings them. part, has been honoured in this way through Our public-health equipment isinsufficient, our Organization, and I can assure you, Professorand our budget does not permit us to perfect it l'Eltore, that this will encourage our Organiza-as quickly as we should like.If we have sought, tion even more to go on with the task of eradicat-during these discussions, to reduce the expendi- ing this scourge from the world. ture submitted for the consideration of this I should like to thank you, and ask you toAssembly, it is because of these difficulties. bring our thanks to the Italian Anti-Tuberculosis But, on the other hand, we are aware that if Federation. resources are insufficient, WHO will not be able to carry out any really effective programme, and that not only its work but in the long run its 61. Statement by the Chief Delegate of Belgiumvery existence, subject to the hazards of annual The PRESIDENT :I have pleasure in callingfluctuations and shortsightedprojects,would upon the chief delegate of Belgium. be gradually compromised. Dr. Evang, who is presiding today over our Professor DE LART (Belgium) (translation fromAssembly, demanded last year an effort of the the French) : The Belgian delegation has followedimagination from each one of us for the support, the work of this Second World Health Assemblydevelopment and success of our health work. with keen interest, with the desire to see practicalI believe that I can reply to this wish by formulat- results, and in a spirit of conciliation and justice. ing here a new suggestion of principle. You cannot As we do not wish to prolong the discussions offail to have been struck by the slowness and the conference unduly and thereby increase themediocre results of our discussions whenever expenditure involved, we decided to take thethey dealt with the establishment of the budget floor only in order to uphold concrete proposals and resources which WHO will have at its disposal or to bring forward necessary details.This isin 1950.It was the same last year, and we have why, at the close of the present session, we wishevery reason to believe that it will be the same to give our general impression and make a newin the future, unless we find and adopt other suggestion. means and other methods.The most serious My country is aware that it is the duty of allcomplaint which I will bring forward is that our nations to collaborate in the defence of publicmethods do not allow us to draw up a real pro- health to the fullest extent of their capabilities.gramme of health action with precision and Her population, whose very existence has allcertitude, since every programme of this nature too often been menaced, is fully conscious of themust naturally form part of a plan extending right to life, recognized as belonging to everyover several years.Under such conditions the human being ; that is to say, the right to defendWorld Health Organization will never really to the utmost the full development of his person-accomplish any important work. ality both in the biological and mental spheres. We must be able to count on assured financial This right takes precedence over all others andresources, and I see no other means of procuring is the condition for their being possible.It isthem than the creation of a world fund for health therefore one of the essential foundations ofdefence.It would be the responsibility of the world structure and necessarily implies inter-Assembly to assign a fraction of this fund, which national solidarity.In the olden days, when ashould not exceed the average percentage based fire broke out in a village, all the citizens formedupon the minimum number of years foreseen a chain so as to carry water right to the fire.for the execution of the whole programme, in Anyone who refused to participate in the fightaccordance with that part of the general pro- against the fire would have been considered agramme which should prove to be realizable in bad citizen. the course of the forthcoming financial year. - 126 - ELEVENTH PLENARY MEETING

It is for the financial experts to say how this There is no doubt that the work accomplished world health defence fund could be constituted,shows many positive aspects.First of all, the but we may ask ourselves if it could not be setdrawing-up of a working programme constitutes up by an international loan contracted anda positive achievement, although the programme managed under the auspices of the Internationalincludes a few weak points to which we will BankforReconstructionand Development,return later on. All delegations have concentrated under the guarantee of all the Member States oftheir efforts upon the programme and, in draw- the World Health Organization, each of theming it up, have shown the best of goodwill. contributing, according to the respective coeffi- The second positive fact is the spirit of con- cients in force, towards the interest charges andciliation which has manifested itself in many amortization of the loan. This contributioncases during the discussion of certain points. would replace in a constant manner that whichWe are convinced that the exchange of views at present is the subject every year of the difficultwhich has taken place in these discussions will discussions with which you are familiar. Havingcontribute towards clarifying and harmonizing at its disposal a portion of this fund every year,the opinions of the various delegations on a series which would thus constitute a kind of ordinaryof scientific and medical problems and on ques- budget, WHO would be able, in addition, totions relating to sanitary organization.It is draw on voluntary contributions to obtain theobvious that personal relationships which have necessary resources for investment, expendituredeveloped between the members of the various or any other object which circumstances Mightdelegations also constitute an important positive show to be important or urgent. factor. Finally, the fund might be increased or fed by We are grateful to the administrative personnel capital transferred from organizations in processand to the Secretariat for the work which they of liquidation, or by other contributions, suchhave accomplished after having overcome a few as, for example, proceeds from World Healthinitial difficulties due to unusual working con- Day. ditions.Likewise, we express our gratitude to We hope that the Director-General will care-the Italian authorities for the care they have fully consider this suggestion and study, withtaken in organizing this Assembly and for the the competent experts, the possible ways ofhospitality which they have extended to all. realizing it, so that the Third World Health While emphasizingthesepositiveaspects, Assembly can examine the results of this investi-our delegation would like to draw attention to gation and take the decisions it may call for. the negative aspects and to point out the omis- We have, in this respect, every confidence insions and inadequacies which have appeared Dr. Chisholm, and I take this opportunity ofmore or less clearly in the course of our work. expressing to him our most cordial wish that he However, the fact that we are dwelling on may long continue to preside over the work ofthese inadequacies must not lead to erroneous the remarkable team which he directs with suchconclusions : greater attention must be paid to skill.I am convinced that he would find in thenegative aspects for it is precisely such aspects realization of the project which I have justwhich must be eliminated, as their disappearance outlined a more certain and effective means ofis a precondition for the future of our Organiza- action, and I think that in making such meanstion. available to him, the World Health Assembly Among the weak points, we should first of all would be able to fulfil the fundamental aimlike to mention that certain delegates among us, assigned, to it by its Constitution better in thepossessing undeniable oratorical gifts, have unduly future than in the past. exercised their proficiency. The lack of co- ordination between the work of the Committee The PRESIDENT :I should like to thank theon Programme and that of the Committee on delegate of Belgium. Administration and Finance shouldalso be pointed out. This lack of co-ordination has 62. Decisions and Resolutions of the Secondmade the joint meetings of these two committees World Health Assembly difficult, and it has been necessary to either The PRESIDENT :Document A2/110 " hascompletely redraft or omit a series of resolutions been distributed and is placed before you foralready adopted. final approval by the Assembly. But such deficiencies are relatively insignificant The Chair recognizes the chief delegate ofand, one might say, practically inevitable.Un- Bulgaria. fortunately, more serious defects have hindered the work of meetings on more than one occa- Dr. TAGAROFF (Bulgaria) (translation from thesion. Thus for example, during the deliberations Russian) : Before the end of the Second Assemblyof the Committee on Programme, we can point of our Organization, the Bulgarian delegationto the superficial manner ,of examining problems, feels that it is necessary to make an appraisal ofand the fact that there was no effort made to the work of the present Assembly and to statemake a proper study of the economic and social its opinion in this connexion. causes of certain diseases.Thus, the question of tuberculosis-this scourge which afflicts workers " For the decisions and resolutionsofthe-was placed on the same level as an ordinary Second Health Assembly given in this documentcontagious disease. Sufficient stress was not and in document A2/110 Add. 1, see p. 15 placed on the fact that streptomycin which, up - 127 - ELEVENTH PLENARY MEETING to now, is the only effective drug against tuber- With regard to this attempt to influence our culosis, is the monopoly of a few countries whichgeneral policies in this way, we note the absence traffic in the health and lives of millions ofof three Members of our Organization, an absence human beings. which is felt by all delegates.We are of the ThiS situation is obviously contrary to thebelief that platonic appeals to the three countries Constitution of our Organization, which makesin question do not suffice.It is indispensable provision for the extension to all peoples of theradically to change the policies that some would benefits of medical knowledge. have our Organization follow.It is indispensable Such was also the case with regard to mentalcompletely to do away with all attempts to health, which has been dealt with in the pro-introduce in the activities of the Organization gramme with inexplicable superficiality. Oursubjects which do not pertain to the health field. delegation has endeavoured to make up for this Our delegation takes the liberty of recalling deficiency by pointing out that, apart from theto the Assembly the great responsibility which various biological theories, it is always possibledevolves upon it with regard to our countries, to find the true causes of mental diseases byto millions of human beings who are in pain, searching for them in the social and economicand to all humanity, in accordance with the structure of our society.Our delegation hastext of the Constitution, which states that the pointed out that the war and the creation of aWorld Health Organization must strive for " the war psychosis are fundamental factors whichenjoyment of the highest attainable standard of have contributed to the tragic increase of thesehealth. . ." by all peoples. psycho-pathological cases.In fact, it is difficult May I be allowed to address to the delegates, to understand why no mention is made in thethe Executive Board and the Director-General documents of the necessity of combating pro-this appeal : Let us return to the Constitution ! paganda favouring a new war.If the statementLet us return to the Constitution in order that contained inthe Preambleistrue,namely,the principles on which it is based may be realized. that " the health of all peoples is fundamentalIt is only in respecting these principles that our to the attainment of peace and security ", it isOrganization will be able to increase its power none the less true that peace and security con-and developitshumanitarianactivities,the stitute the essential factors of the health of allpurpose of which is to guarantee that man shall peoples. enjoy his greatest boon-health. Apart from the superficial manner of discuss- The PRESIDENT :The Chair recognizes the ing certain questions, a current disease, whichchief delegate of Australia. is rampant in all present international confer- ences and which I would call the " automatic Dr. DOWNES (Australia) : I should like to make vote ", has been noticeable in our meetings.a statement on the Budget and Programme. The This method is characterized by the fact thatprocedure for the examination of the Programme even the strongest and most convincing argu-and Budget recommended by the Executive ments remain ignored and strike no echo whenBoard resulted at this Assembly in delaying the countries' name-cards are lifted on the callvital decisions until the first three days of the to vote.These name-cards have imposed manyfinal week, when there was no time for a thorough unilateral decisions which are in contradictionor realistic examination of the problems involved. to the fundamental principles of the Organiza-My Government is disturbed at the possible tion and to the necessity of finding a commoneffects if the largest contributor fails to contribute meeting ground.Such decisions have, generallyits full share of 36% of the Budget and if some speaking, been contrary to common sense. Suchother major contributors do not meet their was the case when South Korea was admitted obligations.The effects of this are aggravated as a Member of WHO, since its qualifications asby the need to make further contributions during a sovereign state are more than doubtful.(The 1950 to the working capital fund-contributions New York Herald Tribune of 30 June states thatwhich have to be made in hard currency. Accord- South Korea is in fact a protectorate of theingly, I have no authority to commit Australia United States.) Even more revealing is theto the Budget as determined by the majority of example of the moral support given by theMember nations of this Assembly. majority of the Assembly to the Government It is strongly urged that the procedure adopted of Athens. By acting in this way, our Organiza-at the Third World Health Assembly should tion has openly taken sides and has seconded aallow an early consideration of the Budget and government which is in arms against its ownworking capital fund so that governments may people. be consulted before important commitments are The defects which have been enumerated aremade. not accidental, but are rather interdependent. The PRESIDENT : There are no more speakers Our delegation states that their common causeon my list regarding document A2/110. Are you is to be explained by the fact that a few countriesnow ready to approve this document ?I should are attempting to give a particular slant to thelike to add that there is an addendum to this work, both of the present session and of thedocument, which has also been distributed to Organization.This orientation not only failsyou-document A2/110 Add. 1.Are there any to coincide with the broad outline of the Constitu-objections to the final approval of this document ? tion, but is constantly in flagrant contradiction The Chair recognizes the delegate of Czecho- to it. slovakia. - 128 - ELEVENTH PLENARY MEETING

Dr. SCHOBER (Czechoslovakia) :I suggest thatin our view the Second World Health Assembly the vote should be for, against, or abstention.has been a great success.The people of every nation represented here can be proud, I believe, The PRESIDENT : The Chair will be happy toof the work their delegations have accomplished. comply with the requestof the delegate of As all of us expected, there have been many Cz echoslovakia. difficult problems to solve.Our World Health Would those delegations in favour of finallyOrganization is young, and we know that the approving this document please signify theirgrowth and development of any infant is accom- approval by raising their cards ?Thank you.panied by periods of trial.We, as the family of Against ? Abstentions ? our young Organization, are expected to give Document A2/110 and A2/110 Add. 1 66 hasour advice as to how the child shall be reared, been finally approved by a vote of 42 in favour,as well as to provide for its physical needs. none against and 8 abstentions. Naturally, such a large family will not agree unanimously on every issue, but the faith that 63. Statement by the Observer for South Koreaall of us have in the future of the World Health Organization when it has grown to full stature The PRESIDENT :The observerforSouthhas overcome any serious disagreement. We are Korea has asked permission to speak. The Chairunited in our desire and purpose to see the recognizes the observer for South Korea. Organization go forward, bringing to the peoples of the world higher levels of health and greater Dr. CHoI (Observer, South Korea) :I amhappiness. deeply honoured to speak on behalf of Korea at the Assembly.As a representative of the All of us can return to our homes with the Republic of Korea, I wish to express to you ourmessage to our people that the World Health Organizationis sincereappreciation and gratitudeforyour a living reality,a source of acceptance of Korea's application for member-continuing strengh upon which their national ship in the World Health Organization. health agencies may call for counsel and help. Since the World Health Organization cameAll of us can report to our governments that a into existence for the express purpose of improv-sound and effective programme for 1950 has been ing the health conditions of the world, remarkabledeveloped and approved by the Second World headway has already been made through theHealth Assembly. Organization's conscientious study and sacrifice. The completion of such a large task in the And as a result of your faithful study and sacrifice short space of three weeks is an achievement. you have not only improved the deterioratedMuch of the credit for that accomplishment is health conditions of the world caused by thedue to the Director-General and his staff, and Second World War, but you may, I believe,especially to the untiring task force of the World develop much improved and progressive curativeHealth Organization, responsible for the conduct and preventive methods, so that the peopleof this conference in Rome. throughout the world may henceforward enjoy We wish also to express our appreciation of a better and longer life. the splendid manner in which you, Mr. President, I also believe that it is the duty of this greatand the other officers of the Assembly have con- Organization not only to improve the healthducted our sessions.That we have completed conditions of the world, but to promote amongour work according to schedule is all the more the nations and people of the world those friendlyremarkable when we consid,er the fascinations relations and thatgoodwill which are veryof Rome, the Eternal City. necessary for the maintenance of world peace It is impossible for me to pay full tribute in and happiness. May I say, sincerely, that withoutwords to the hospitality of our hosts, the Govern- your guidance and assistance we should be facingment of Italy,itsdelegation to the Second much worse conditions, particularly in regardWorld Health Assembly and to the City of to public health and welfare. Rome. They have given us experiences of intellec- In conclusion, I wish to express my greattual and aesthetic pleasure which are indescrib- confidence that this Organization will do every-able and can be found only here. They have thing possible to live up to the humanitarianwelcomed us and entertained us with spontaneity principles for which it stands, and I wish theand affection which we shall always remember and World Health Organization much success andtreasure in our hearts. progress in the future. Historians say that when a great people have gone through times of trouble the creative spirit flowers again with new vitality. I believe that 64. Closing Addresses we have seen this rebirth among the Italian The PRESIDENT :The Chair recognizes thepeople here in Rome and elsewhere in their chief delegate of the United States of America.country. The perfection of the music we have heard, the beauty of the vistas and performances Dr. SCHEELE (United Statesof America) :we have seen will spring to mind in the years Mr. President, Dr. Cotellessa, Members of theto come. And we shall wonder how so many large Assembly :I speak for the entire delegation ofentertainments could be arranged so smoothly and the United States of America when I say thatwith such care for our comfort and convenience. The creative impulse of the Italian people finds 66 See p. 15 expression in scientific and professional spheres, - 129 - ELEVENTH PLENARY MEETING as well as in the arts and the art of living. Thechairmen of the different committees who have United States delegation, and I am sure that Ihad to work so hard to bring the proceedings to can speak for all delegations, wishes particularlya successful conclusion in the time available, we to congratulate our Italian colleagues on theare deeply grateful.We realize the amount of excellent work which is being done in research andwork and the responsibilities they have had to development in medical and hospital care andshoulder for the smooth and successful working public health. I have had the pleasure of visitingof this difficult task in the Committees on Pro- the Superior Institute of Public Health and somegramme, Administration and Finance, Constitu- of its institutions, and I have been impressed bytional Matters and in the other committees, and the vigorous programmes going forward there. we therefore feel all the more grateful to them Our technical advisers also have visited some offor the devotion with which they undertook the programmes in sanitation and public healththose tasks and the time they gave to them. as well as the institutions and they are enthu- For the Director-General and the Secretariat siastic about these activities.Our delegationI have nothing but words of admiration.I do has had a personal experience with medical andnot know how they managed it, but towards the hospital care in Rome.One of our group wasend of the session, after dispersing in the early hospitalized with an acute case of appendicitis.hours of the, morning, we were met the next day She was operated on by a young Italian surgeonby their fresh faces, and all the documentation and we are indeed gratified by the splendid carewe needed. So much so that I sometimes wished she has received at his hands and in one ofthey could work less efficiently than they actually Rome's excellent hospitals. didI am sure that it is the unanimous feeling Because we cannot express in words our appre-of all delegations that the work of the Secretariat ciation to our hosts forall their generosityat the Second World Health Assembly stands and cordiality, I call upon the Second Worldunrivalledforefficiency,speed and smooth Health Assembly for a vote of thanks to theworking. Italian people and to their beautiful city-Roma. May I now say a word about, ourselves ?It (Applause) is a matter for congratulation that we were able to do all the tasks in the time allotted to us.It Dr. Pozzo (Argentina)(translation from theis true that occasionally there have been differ- French) :In the name of the Government ofences of opinion expressed in this or that com- my country, which is linked in close friendshipmittee, but I venture to state that no organiza- with the Italian people, I have the honour oftion can be considered to be a live organization, asking the delegates to accord a vote of thankseven in its infancy, when there is a level of to Italy, which has so well maintained its magni-uniformity in its proceedings, when every delegaté ficent tradition as a hospitable and generousfinds himself in unanimous agreement with every nation. other delegate.I, for one, do not hold any pessimistic views about the differences of opinion The PRESIDENT :The Chair recognizes thenow and again in the committees ; for I realize delegate of India. that, as time goes on, as we come to know each other better, and as we more fully appreciate Sir Arcot MUDALIAR (India) :I thank you forthe objective we had in setting up the World the opportunity you have given me of appearingHealth Organization, we shall have the supreme before this audience for a few short moments tosatisfaction of knowing that we had to work for give expression to the feelings of pleasure of thethat common goal, that great achievement which Indian delegation at the successful terminationwill bring to the common man in every nation of the Second World Health Assembly. We havethat modicum of health and of happiness which been here for the past three weeks, and we haveis the surest foundation for peace. had splendid opportunities of meeting each other, We are here forging the golden chain of health. renewing old contacts and establishing fresh onesLet us realize that the strength of that chain with the delegations of many countries.I candepends upon its weakest link.Some may be assure you we shall carry back with us pleasurabledisappointed at the rate at which this Organiza- impressions of the work here, although thattion is working : some may have felt that we work has been of a somewhat hard nature. were going a little too slowly ;others that we We realized,Mr. President, that when wewere going a little too fast. On the other hand, elected you Presidentof the Second WorldI do feel that in every organization such differ- Health Assembly we had to look forward to aences of opinion will soon be dispelled by the strenuous time, because we knew from youractivities of the Organization, by the method work and your nature as a hard taskmaster thatwith which we approach the task, and I hope there was no alternative for us but to workthat when we return to our different nations we throughout the day and at night sessions inshall convince our governments that the World order to complete the task we had aimed to do.Health Organization is a unique organization, I should like, on behalf of the Indian delegation,based upon the highest ideals of humanity, and to express to you our great admiration for thethat it deserves the support of every one of us. manner in which you have conducted these And therefore to the few who are of a some- proceedings, and for the courtesy which youwhat sceptical frame of mind, to those who are have extended to every delegation that has beena little pessimistic, I would recall the words of present here.To the chairmen and the vice-the poet and say :It is not in the speed with - 130 - ELEVENTH PLENARY MEETING which things are done, it is not exactly in theand that the future belongs to those who shall achievements that we can recognize easily tohave done the most for suffering humanity ". have been done, but in the trend of the workIs not that a magnificent preface to international that is to be done that much of our success lies.medicine ?It is a very, fine conclusion to our Let us not be unduly pessimistic, and let mework. repeat the words of the poet Clough : The PRESIDENT :I have the great pleasure of If hopes were dupes, fears may be liars ; recognizing the Honorary President of the Second It may be in yon smoke conceard, World Health Assembly, Professor Cotellessa. Your comrades chase e'en now the fliers, And, but for you, possess the field. Professor COTELLESSA (Italy) (translation from the French) :First of all I wish to express my And not by eastern windows only, sincere thanks for my nomination as Honorary When daylight comes, comes in the light ; President of this Second World Health Assembly In front the sun climbs slow, how slowly ! which is today concluding its work in Italy, and But westward, look, the land is bright ! for the good wishes which .the delegates have presented to the Government of Italy. The PRESIDENT :The Chair recognizes the I deeply regret that my duties and the discus- chief delegate of France. sion which recently took place in Parliament on the public-health budget have prevented me Dr. DUJARRIC DE LA RIVIÈRE (France) (trans-from participating to any great extent in the lation from the French): We have just passedmeetings of the Assembly.However, I have days which will remain in our memory in thebeen continually informed of the course of the splendid settingof the Eternal City, wherediscussions, and I am anxious to express to you there is so much to appeal to the spirit andmy deepest admiration for the impressive work touch the heart. We have greatly appreciated allaccomplished in such a short space of time and the ceremonies to which the Italian Governmentfor the important decisions which you have made and delegation have so kindly invited us andconcerning the programme of WHO, as well as which they have organized with that generosity offor the spirit of sincere collaboration which has feeling and greatness of heart which are essentialconstantly inspired your discussions. characteristics of the Italian soul, and for which In putting this historic palace as the disposal we tender our most sincere and warmest thanks.of the Assembly, the Italian Government had But we have also appreciated, perhaps still more,to solve real difficulties from the point of view the chance which has been given us of studyingoforganization.I am sure that you have here questions of a medico-social nature whichappreciated theseeffortsand, aboveall,the we found of the greatest interest. goodwill which actuated my collaborators in A health organization which has few equalstheir efforts to make your stay agreeable and anywhere in the world, where all manner offruitful. medico-social questions are studied, magnificently I shall not comment on the work of the organized laboratories in which great scientistsAssembly and the results obtained under the study questions involving the health of humanity,competent direction of our eminent President, the fight against tuberculosis and, above all (toDr. Evang, and the chairmen of the different cite only this example) the campaign againstCommittees.I wish to say only a few words on malaria which may truly stand as an examplethis subject.The technical programmes which to the world-these are the things which theyou have just approved, and which pertain to Italian Government and our Italian colleaguesthe mostpressingproblemsconfrontingall have allowed us to see, and we can never behealth administrations, constitute an enormous sufficiently grateful to them. task for our Organization. The competence and I am also happy to thank the President of thethe broadness of outlook of the Director-General Assembly as well as the Director-General andand his collaborators guarantee the realization all his collaborators for their initiative and theirof these programmes. unremitting labours, to which is due the very Many important questions have been settled, great success of this Assembly. such as the status of Associate Members and the Finally, fellow delegates and colleagues, theestablishment of the regional bureaux, and I French delegation wish to thank you veryhope that a clear and definite solution will soon sincerely and to say how glad they have beenbe found for these last problems, since in my to be able to work together with you in such aopinion they can make a remarkable contribu- valuablespiritofcollaboration-collaborationtion to the practical realization of our aims.It which is valuable because itis international.is perhaps true that the task of these regional May I recall the words addressed by Pasteur tooffices within the general framework of WHO the representatives of foreign nations at thehas not yet been clearly laid down. In my opinion, Sorbonne at the time of his jubilee : " And you,the decentralization of duties of an executive delegates of foreign nations, who have come socharacter isnecessary. This decentralization far to show your sympathetic interest, you seewould give a greater flexibility to the central before you a man who has the unalterable beliefoffice, from which WHO would be able to draw that science and peace will triumph over ignor-advantage from both the functional and the ance and war, not to destroy but to construct,economic points of view. - 131 - ELEVENTH PLENARY MEETING

The headquarters office should limit itself to None of us is unaware of or would deny the issuing general directives in conformity with themerits of the Scandinavian nations and the deliberations of the Assembly. This rationalremarkable support which they have given and principle would avoid burdening more and moreare giving to the development of international the administrative and bureaucratic structurehealth programmes. None the less, it should be of WHO, and would prevent a costly mutlipli-observed that other groups of European nations cation of services, while bringing about a reduc-can also bring a considerable joint contribution, tion of general c9sts. As I have just participatedfor example, the Southern European group, in a discussion on the Italian public-healthwhich has never been represented either on the budget,Iknow thedifficultieswhichareInterim Commission or on the Executive Board. encountered in obtaining allocations sufficientThis group, which comprises such a numerous to deal with the most urgent national healthpopulation with special health problems, very problems.It therefore seems to me that it isdifferent from those of Northern Europe, could necessary to adopt a policy of reasonable economymake the contribution of its practical experience in our Organization, and to have recourse toto the Board, particularly in the field of malaria, every method in order to avoid burdening theone of the problems which has priority in this budgets of many governments. Assembly. The choice of the nations called to designate We do not wish to maintain, as others have members for the Executive Board has givendone, that the exclusion of this group makes our rise to some discussion again this year, for itcollaboration with WHO difficult, but it is clear is a delicate point. I wish to thank the delegatesthat this exclusion is hardly calculated to bind who were good enough to show their confidenceall the peoples more closely together in the in my country by including it among the sixcommon aim of strengthening bonds which are nations proposed by the General Committee.indispensable for the functioning of this Organi- I do not wish to dwell on the election, but I must zation. Neither does it correspond to those recall none the less that last year, when criticismsprinciples of equity and justice which have been were directed against the system of proceduremany times affirmed and upheld by this Assembly. adopted for the election of the Executive BoardI hope that the Executive Board will seriously and when it was remarked that the majority ofexamine this pressing problem in order to reach the nations proposed were those which hada just and equitable solution and avoid inconsis- already formed part of the Interim Commission,tencies and discussions in our meetings. whereas a rotation would have been preferable, Our Organization is taking its first steps, and the President of the First Assembly, Dr. Stampar,it certainly could not be expected that an inter- observed that it had been " generally agreednational organization of such vast scope could that the Members of the Interim Commission, ifmeet, from the start, the complex and various they are elected to the Executive Board ...,willaims which it has set itself. retire in time to leave room for new Members ".67 The experience and constructive support of The same opinion was expressed by the delegatesdifferent countries should help to avoid draw- who supported the President's proposal. backs which have appeared in preceding years. However, this was not applied, and the Italian Above all, it is essential not to alter the uni- delegation cannot but associate itself with theversal character which WHO had at its inception, proposal made by the Indian delegation, whichso that every nation, in making its contribution suggested an amendment to the Constitution inand in receiving common support, feels itself order to establish this principle, affirmed at theto be an integral part of the Organization. First Assembly. This principle can only be applied if WHO, It remains for me to consider still another point.by eliminating particularism, succeeds in main- You will remember that the Italian delegationtaining the spirits which was present at its creation. laid before the First Assembly a proposal aiming We should conclude our work with this common to ensure to every nation the possibility , ofresolve and depart wishing the most active and participating directly in the work of the Executivesuccesful future to our Organization. Board.It appeared to us that this proposal I hope that you will retain pleasant memories would satisfy the just desire of each nation toof your stay in Rome and of the work that the participate in the active life of WHO, for, accor-Assembly has carried out here, and that the ding to this procedure, it would be represented,contacts you have made and the knowledge you in a way, by a nation of its group.This wouldhave acquired of the people and things of our have assured liaison and the laying of healthcountry will serve in the future to ensure more problems common to the group before the Board. and more cordial relations for the development This proposal, as you know, was not acceptedof our joint scientific and practical interest in by the Executive Board, and the Assemblythe wellbeing and health of the peoples which ratified this decision.I was therefore surprisedthis Organization proposes to unite fraternally when, on reading the minutes of the meetings,in the fight against disease, and in the raising I saw again the same proposal presented by theof the social and health levels. Scandinavian group, which has claimed the right of rotation of the nations of their group on the The PRESIDENT :We have reached the end Executive Board. of our labours and it is my first and most pleasant duty and honour to give expression, on behalf 67 See Og. Rec. World Hlth Org. 13, 83 oftheSecond World Health Assembly-in - 132 - ELEVENTH PLENARY MEETING addition to others who have already done so-on the agenda of this Second World Health to the deep gratitude which we feel towards theAssembly. Italian Government and the City of Rome for Now, what has the Second World Health inviting us to convene the Assembly here.IAssembly accomplished ?It is, of course, too should like to address this thanks to the Italianearly to judge.Only the Third World Health delegation and to the Honorary President ofAssembly next year, and events in the coming the Second World Health Assembly, Professoryears, will enable us to see which of our decisions Cotellessa. By generously providing in greatwere wise and where we failed. WHO is still a numbers personnel to assist the Secretariat andyoung organization and it is perhaps. too early theAssembly,theItalianGovernment hasyet to trace a trend in the development of inter- contributedsubstantiallytowards makingitnational health work since the Second World possible to carry out the heavy duties of theWar.However, there are a few points which Second World Health Assembly in the relativelyI shouid like to make at the close of this session. short space of three weeks. My first point is this.It is already obvious This, however, is only one side of the picture.that we have had the good luck of establishing The programme of social events with which oura constructive and effective Secretariat. We Italian hosts have presented us has certainlyhave not created what might be characterized as taken our breath away, and I, for one, coulda passive bureaucracy, nor have we brought not think where I should begin and where Itogether a group of people working only at their should finish-the reception at the Institute ofdesks. A team has already been developed with Health ;the excursion to the Villa d'Este atthe Director-General at its head, a team of people Tivoli ;the reception at the Campidoglio ;thewith their hearts and brains in their work. They performance of " Medea " at the Roman Theatrebelieve in the future of WHO and in the tremen- of Ostia ;the symphony concert at the Basilicadous importance ofits work, and this belief of Massenzio ;the opera at the Baths of Cara-seems to have spread throughout the whole calla, etc.How can I describe it, or how canSecretariat, making it a group of people working I discover what represented the climax to eachfor the cause and not only for the salary.It is individual here ? The only thing I can say,our duty to take care of the values thereby Professor Cotellessa, is that you and the Italiancreated and not to discourage, but to encourage authorities have given us three unforgettablethe initiative and the vision of a good secretariat. weeks in the Eternal City. It is only natural that we have not yet found 61t1 Secondly,I have to thank the Secretariat,a final form of our administration.There are under the inspired leadership of its able Director-now 64 Member States in the Organization. General,Dr. Brock Chisholm. The workingTherefore it is also obvious that many different papers presented to the Assembly were in perfectsystems of administration and organization will shape.I do not think a word of criticism hasbe presented by the various Member States. been raised against them from the formal orIt is difficult indeed to find a solution which will technical point of view.I do feel that I havesatisfy everybody.So far, we have been able the whole Assembly with me when I thank theto avoid, and I hope we shall also be able to Secretariat for the patience, efficiency and speedavoid in the future, the disillusion which some- with which it has worked during these threetimes offers itself as the easiest one :to super- weeks, and which have been a condition for theimpose one administration on top of another. success of this Assembly.To handle a very My second point is this.I do feel that this heavy agenda such as ours in three weeks asksSecond World Health A;sembly has brought out for the untiring efforts of the Secretariat, dayeven more clearly than before the enormous and night. We go home nightly tired when thepotentialities of WHO. We have already passed meetings are over for the day.Most delegatesthe stage where we speak in terms of combating do not realize perhaps that after the meetingsindividual diseases, important as this may be. are adjourned the Secretariat continues its workThe idea of demonstration areas which has been at increased speed, and under pressure of time.accepted by this Assembly represents a new and, Just to mention one example :to produce aI am sure,fruitful approach to international document such as was presented to you todayhealth work.In such demonstration areas, all in the course of 36 hours is a feat in itself. health problems pertinent to that area will be Thirdly, I would like to thank the interpreters.tackled with modern methods adapted to the Without their intelligent and efficient assistancearea in question. This will, if we succeed, to my we would not have been able to do our workmind, represent also an important step forward properly. in the fundamental task of strengthening the The Executive Board also, to my mind, shouldnational health services. be remembered today, and the Assembly should One of the most difficult tasks of WHO, and put on record its appreciation of their work.one which we have not perhaps yet been able to During three strenuous meetings the Executivesolve quite satisfactorily, is to present to the Board, under its wise and experienced chairman,governments of the world in a simple and under- Sir Aly Tewfik Shousha, Pasha, has carried outstandable way the health needs of more than the duties entrusted to it by the First Worldtwo thousand million people all over the world. Health Assembly and has, in close co-operationJustified pride in national achievements in the with the Director-General, prepared the Pro-field of health should not be permitted to obscure gramme and Budget for 1950 and other itemsthe fact that no country so far has solved its - 133 - ELEVENTH PLENARY MEETING own health problems completely.Look at theand working capacities of rural populations' in poor farmers and fishermen all over the world ;certain areas of the world.This amount was look at the slums in the large industrial cities.reduced by the Executive Board to 21 million We know that more than half of the world'sdollars, including the four million dollars for population has an average income of less than onethe joint FAO/WHO undertaking. The 17 million hundred dollars per year.Look at the loss ofdollar budget was split up into the regular pro- millions of lives every year from malaria, tuber-gramme, to be financed by contributions from culosis,cholera,etc. In some countries, theMember States, and a supplementary budget, to average expectancy of life at the age of one hasbe financed through voluntary contributions. At already reached 70 years ;in other areas it isthis Assembly we have voted a budget of seven still as low as 33 years.Therefore, and rightly,million dollars, and two countries, Ceylon and much emphasis is now put on the economicYugoslavia, have informed WHO that they will development, through technical assistance,ofpay specified amounts in addition to their normal underdeveloped areas.This certainly opens upcontributions. Several other countries have new horizons. signified their willingness to contribute to the Statesmen and economists all over the worldSupplemental Budget without being yet in a seem to realize the close relation between healthposition to specify the size of the contribution. and economy,health and socialconditions,We are greatly indebted to these countries for health and the standard of living.Through thethis generous gesture and we certainly hope it specialized agencies of the United Nations thewill be followed by other countries. peoples of the world have, for the first time in If voluntary contributions are not forthcoming, history, created organizations for a practical, co-WHO will find itself in a predicament. To ordinated approach to these problems. Muchconvince the governments of the world that hope, therefore,isattached to the resolutionthey should increase their normal contributions passed by the Economic and Social Council into WHO, we would have to present convincing this respect, and also to the initiative whichand striking results in the promotion of health preceded it.On the whole, the Second Worldand the combat of disease. To be able to present Health Assembly has clearly emphasized thatsuch results, however, WHO would first need our greatest and most urgent problems are tothe money to carry out the work. The Regular be found in underdeveloped areas.At the sameBudget voted by a majority of this Assembly time, we must not forget the necessity of givingclearly demonstrates that we,as responsible those countries, which have proved their abilityhealth administrators of our individual countries, to do so, an opportunity to experiment and tohave not yet been able to sell fully to our govern- develop further effective modern methods forments the idea which has given life to WHO. promoting health and fighting disease. These We know that we are in a position to render progressive countries are our pilots and theyservices to governments which would far out- also need our continued support. weigh fhe contributions they made. We know The great interest taken in this Assembly bythat after two destructive wars within 30 years, many countries, large and small, the friendly wayworld health problems should now be tackled in which they have worked together during thesethrough a well-planned and well-executed world- weeks, and the tolerance and understanding whichwide attack upon disease.We know that in have been the dominating features, give greatenvironmental hygiene, in malaria control, the hopes for the future of international health work.combating of tuberculosis and venereal disease, We have voted a kegular Budget of sevenin the promotion of a higher nutritional standard, million dollars, and adding some money frometc., even the basic simple problems have not other sources the total budget for 1950 will bebeen satisfactorily solved in some areas of the about seven-and-a-half million dollars. Withworld. We know that not only world health and this amount of money the Organization is indeedhappiness would be furthered if they were, but trying to accomplish two completely differentalso that the economic conditions of those areas types of work :(1) Centrally to plan internationaland thereby of the whole world would be improved. health work. WHO acts here as a general staff When we, the health administrators of the for world health, through its Secretariat, expertindividual Member States have so far failed in committees, technical services, etc. ;(2)decen-bringing our governments fully to accept these tralizing its efforts, WHO is trying through itsviews and-in spite of the obvious financial Regional Offices to carry the work out into thedifficulties-to take the consequences through field,into the sphere of practical operations.higher normal contributions, the reason must, to We are bound to do both these things.It ismy mind, be sought in the fact that the national the only way in which WHO can survive. Somehealth administrations in many countries are people ask :What can we do within a budget ofstill too weak. Again we must recall the Consti- seven-and-half million dollars ? In this connexion, tution of WHO, whereby the Organization should I think it wise to remind you that the Secretariatassist in strengthening national health services. presented, as a suggestion to the Executive A budget of seven-and-a-half million dollars Board's third session in February 1949, a pro-is to my mind ridiculously low when compared gramme for world health which would costwith the services which we are in a position to approximately 24 million dollars, including fourrender. There are very few countries in the world, million for a joint project with FAO to increaseeven small ones, that have not individually much agricultural production by improving the healthhigher appropriations for health.Under these - 134 - ELEVENTH PLENARY MEETING circumstances, we are also faced with the problem Finally, dear colleagues, I have to thank you, of bringing these health problems out directlythe members of the Assembly, not only for the to the peoples of the world. confidence you have shown in me and the patience which you have shown during the meetings, What passes through the mind of a motherbut first and foremost for your constructive co- looking down at her dead baby to which she had,operation. During this Assembly several problems in pain, given birth after months full of anxiety ? have arisen which might easily have spread a What does a father think who is following hisfeeling of resentment among the members of the son to an early grave ?Will they know that itAssembly. Most of these problems, I am happy isunnecessary ? Thatitshould not haveto say, have been solved by your wise decisions happened ?Will they know that it is a questionand your willingness to accept compromises. The of medical knowledge, of health adminsitration, speed and efficiency with which you have worked of education and of standards of living ?Willis also most impressive.I should like to quote to they know that international organizations exist,you a passage from a letter which I received able at least to help them on their way if properlyfrom the representative of the United Nations supported ?As soon as they do, I for one amto the World Health Assembly, Mr. Martin Hill : convinced that the necessary money will be" I should like to say that I have been greatly forthcoming. Therefore, I would urge all delegatesimpressed by the speed and efficiency with which to feel it a part of their duty to WHO to spreadthis conference is getting through its business ". knowledge about WHO, its work and its poten- To my mind, it is of great psychological impor- tialities, throughout the entire populations oftance that we have demonstrated to the world- their own countries.But do not promise tooat present none too satisfied with the progress much. There are no short cuts to improvedof international work-that we are efficient, that health. we do not lose time, that we feel responsibility. The various international organizations whichAlso our own governments will,I am sure, constitute the United Nations have been set up,appreciate this attitude. We need the goodwill as we all know, with the single purpose of makingof governments because we have the right, at nations work together, thereby avoiding thethe present stage of scientific, clinical and adminis- differences and tensions which eventually leadtrative medicine, to reword a well-known phrase to war. In other words, WHO is part bf a vastby saying to governments, " We have got teh machinery working for peace. The Second Worldtools, give us the money, and we will do the Health Assembly has, to my mind, contributedjob ". substantially towards giving life to the Consti- I hereby declare the Second World Health tution of WHO on thispoint, by stronglyAssembly closed. emphasizing, for example, maternal and child health and, especially, mental hygiene. The meeting rose at 12.20 p.m.

- 135 - MINUTES OF THE GENERAL COMMITTEE AND MAIN COMMITTEES

GENERAL COMM1TT EE

FIRST MEETING W ednesday, 15 June 1949, at 12 noon Chairman: Dr. K. EVANG (Norway)

1.Opening of Meeting by the Chairman polated, if necessary, into the general debate in The CHAIRMAN, in opening the meeting, pointed plenary session. out that the committee's procedure was governed by Rules 25 and 26 of the Rules of Procedure of Mr. BANDARANAIKE (Ceylon),Dr. VOLLEN- the World Health Assembly. He called attention WEIDER(Switzerland),andDr. MACKENZIE to the fact that members of the General Commit-(TJnited Kingdom) felt that the general discussion tee did not act as representatives of their coun- on the Director-General's Report and the Reports of the Executive Board should be completed tries, but as members of the Assembly as such.before the committees began work on their 2.Programme for the Health Assembly andagenda, Dr. Mackenzie pointing out that this the Main Committees would curtail the amount of time the various governmental expeits would have to spend in The CHAIRMAN recalled that at the fifth plenary Rome. meeting he had requested all delegates who still wished to speak in the general debate to give him Dr. TOGBA (Liberia) suggested that the Presi- their names, if possible, today.In deference todent appeal to delegates to limit their statements the request of some of the nine delegates alreadyin the general debate to a given time. on the list of speakers for more time to prepare their speeches, it had been agreed to devote the Rajkumari AMRIT KATJR (India) supported the afternoon to meetings of the Committees onidea that the duration of speeches should be Programme and on Constitutional Matters. Suchlimited. The experience of the First World procedure was, however, contrary to the principle Health Assembly showed that the main work that the main committees should not start workwas done in committee.It should be clearly on their agenda till they had received the gui-laid down that the general debate would be dance they would obtain from a general debateconcluded on the following day. on the work of the Organization as a whole. Professor FRÓES (Brazil) suggested that since The DIRECTOR-GENERAL pointed out that itsome delegates had already spoken, it was too was essential to take an early decision on thelate to impose a time-limit. The President could, requests made by two States for admission to thehowever, appeal to delegates to be brief. Organization,sothatthe two governments concerned could present the necessary documents The CHAIRMAN stated that in his experience of in Lake Success in order to enable the status ofinternational meetings it had been customary not their delegations to the Health Assembly to beto impose time-limits on speeches until it became raised from that of observers to that of delegates.absolutely necessary.Although he would not It was therefore highly desirable that the Assem-advise such procedure, it would be possible for bly interpolate, if necessary, into the generalhim to ensure the conclusionof the general debate in plenary session consideration of, anddebate on the following day by progressive limi- decisionon, the report to be submitted on this item of the agenda by the Committee ontation of the time allowed to speakers. Constitutional Matters. Dr. SCHOBER (Czechoslovakia)pointed out The committee decided that consideration of,the value of a general debate, which might and decision on, the report of the Committee onembrace many points that could not be covered Constitutional Matters regarding the requests forin the discussions of the Committee on Programme admission to the Organization would be inter-or any other committee. It would be both unfair - 136 - GENHRAL COMMITTEE and unwise to impose time-limits on delegatesand as such they received considerable publicity. who still wished to speak in such a debate. He felt that it would be wise to leave to the If, however, written translations of speechesdiscretion of the Chairman and the co-operation could be provided, the time at present taken upof delegates the questionofexpediting the by interpretation would be cut down considerably.general debate.

The CHAIRMAN welcomed Dr. Schober's sug- Dr. HYDE (United States of America), sup- gestion and asked the chairmen of the twoported by Rajkumari AMRIT KAUR, suggested committees that were to meet that afternoon tothat it would expedite the general debate if request delegates wishing to speak in the generalnight meetings were held the following day and debate either to provide written translations ofevery subsequent day until it was concluded. their speeches, or to submit copies of their The committee decided that thePresident manuscripts during the day for translation byof the Assembly should do all in his power to the Secretariat, so that the translated speechesexpedite the general debate, taking into account could be read out by the interpreters at the samesuggestions made during the discussion. It time as the originals. further decided to review the situation at its next meeting to be held the following day. Mr. BANDARANAIKE asked the Chairman to take all steps, including those suggested during Replying to Dr. Hyde, the DIRECTOR-GENERAL the discussion, to ensure that the general debateagreed that the committees should proceed at was concluded at the latest by midday on 17once with the election of rapporteurs, who, he June. pointed out, should be selected purely for their personal ability to perform a very difficult and Dr. DOWLING (Australia) said it was impossibledelicate task, without regard to geographical to impose a time-limit to the debate withoutdistribution. limiting the time of individual speeches. To do so might lead to early speakers consuming most of3.Procedure for Nomination of Vice-Chairmen the time available for debate. of Main Committees The DIRECTOR-GENERAL apologized for the Dr. STAMPAR (Yugoslavia) and Dr. VAUCELfact that the question of the nominations for (France) felt that it was most important that thevice-chairmen of the main committees had been committees, in which most of the work of theoverlooked at the meeting of the Committee on Assembly would be done, should tackle theirNominations. agendas as soon as possible. The general debate The proper procedure would be, 'first, to instruct was not so much a debate as a series of statementsthe committees to proceed with their work as of view, and it should be possible for the President arranged and, secondly, to convene the Committee to bring it to a close the following day. on Nominations the following day for the purpose of nominating vice-chairmen for the main com- Dr. MACKENZIE agreed with Dr. Schober thatmittees. there were many questions which could be covered The committee decided that the procedure adequately only in general debate. Moreover,outlined by theDirector-General should be the statements of view given in such a debate followed. were the considered views of governments on the general orientation of the Organization's work, The meeting rose at 12.55 p.m.

SECOND MEETING Thursday, 16 June 1949, at 11.50 a.m. Chairman : Dr. K. EVANG (Norway)

1.Programme for the Health Assembly andelection of Members entitled to designate persons the Main Committees to serve on the Executive Board. The General Committee established the times of meetings of the main committees. 2.Procedure for Examination of Programme On the proposal of Dr. MACKENZIE (United and Budget for 1950 Kingdom), the committee decided to request the The committee considered the procedure for Chairman of the Committee on Constitutionalexamination of the Programme and Budget for Matters to proceed as soon as possible with con-1950, prepared by the Secretariat and considered sideration of the procedure to be adopted for thein the ligth of financial availlabilities, by a working - 137 - THIRD MEETING party of the Executive Board and by the Board The CHAIRMAN OF THE COMMITTEE ON PRO- itself. GRAMME statedthatduring the preliminary discussionsheldinthatcommittee,general Mr. BANDARANAIKE (Ceylon), Vice-President, agreement had been expressed with the recom- suggested that the only items which needed tomendations of the Executive Board, as amplified be examined by the Committee on Administra-by the Director-General. tion and Finance were those entailing an increase in the total of the Regular Budget or of the3.Rights of Non-Governmental Organizations Supplemental Budget, by the addition of new to participate in Committee Discussions items to either Budget or by the transfer of The DIRECTOR-GENERAL pointed out to the items between them. chairmen of the main committees that, although Rule 38 of the Rules of Procedure of the World The DIRECTOR-GENERAL pointed out that theHealth Assembly provided for the participation Executive Board had recommended to the Healthof non-governmental organizations in discussions Assembly for its consideration, and for its con-of interest to them only at the request of the sideration alone, that the Committee on Adminis-chairmen of meetings, the First World Health Assembly had decided that they would be entitled tration and Finance recommend cost estimatesto make statements of an expository nature for the programme recommended by the Commit-" on the invitation of the chairman of the meeting tee on Programme, whether it had been modifiedor on his acceding to a request from the organi- or not by the latter committee. The Board hadzation ".1 A list of the non-governmental orga- further proposed that the two committees sub-nizations brought into relationship with the World sequently hold joint meetings to agree uponHealth Organization would be circulated to the common proposals for submission to the Healthchairmen of the main committees. Assembly.He recalled that although a single programme had been submitted, the Budget had4.Procedure for Addition of Items to the been divided into a Regular Budget and a Sup- Agenda plemental Budget ; the Committee on Programme, The CHAIRMAN explainedthattheproper whose task it would be to establish a scale ofprocedure for any representative wishing to add priorities, should the financial availabilities bean item to the agenda would be for him to submit adjudged insufficient for the programme as finallya document on the item in question to the General established, should bear in mind that the placingCommittee before the time-limit fixed as midnight of a project in the Supplemental Budget in no waythe following day.The committee would then implied that the Executive Board attached lessdecide on the best procedure to be followed in importance to it, but rather, in many cases, feltrespect of such items. it was of such importance and interest to indi- The meeting rose at 12.45 p.m. vidual governments that they would be willing to make additional contributions to finance it. 1 Off. Rec. World Hlth Org. 13, 327

THIRD MEETING Friday, 17 June 1949, at 12 noon Chairman: Dr. K. EVANG (Norway)

1.Programme for the Health Assembly and 3.Associate Members the Main Committees The General Committee decided to recommend The General Committee established the times ofto the Committee on Constitutional Matters that meetings of the main committees. it consider the possibility of examining the item relating to Associate Members (item 9.11.1 of the In responsetoarequest,the DIRECTOR- Agenda) immediately after it had examined the GENERAL undertook that items given priorityprocedure for the election of Members entitled by the General Committee would be placed as farto designate persons to serve on the Executive as possible at the head of committees' agenda.Board. 4.Action taken by Certain Countries with 2.Document submitted by the Delegation of regard to Membership of WHO Greece on the Subject of Aid to Refugees With reference to the letters received from the After some discussion, the General CommitteeDeputy Ministers of Health of the USSR, the decided, on a motion for adjournment of theUkrainian SSR and the Byelorussian SSR,2 the debate, to defer further consideration of this item till the next meeting. Off. Rec. World Hlth Org. 17, 19, item 8.1 - 138 - GENERAL COMMITTEE

General Committee adopted a proposal made bytion's primary concern, and that question lay Rajkumari AMRIT KAUR (India)to the effectrather in the competence of thePopulation that she submit a draft resolution for considera-Commission. Moreover, two of thelargest tion by the General Committee with a view to itsreligious groups in the world were firmly opposed being transmitted direct to the Health Assembly.to any kind of birth control. He therefore opposed the addition of this item to the agenda. MT. BANDARANAIKE (Ceylon), Vice-President, suggested that the Committee on Constitutional Dr. HYDE (United States of America) agreed Matters should also consider the question ofthat in the absence of any documentation it any seats on the Executive Board held by thewould be wise to accept the offer of the represen- three Members concerned. tative of Ceylon to withdraw his proposal.He suggested that in accordance with Rule 11 (c) of The DIRECTOR-GENERAL statedthat,afterthe Executive Board's Rules of Procedure,3 the lengthy consultation, it appeared that the seatsGovernment of Ceylon would be free to place it could not be considered vacant unless the Assemblyon the agenda of the next session of the Board, accepted as constituting notices of withdrawal thewhich could then arrange, if it wished, for a pre- letters, which were not from ministries of foreignparatory study of the question. affairs, as was normal, but from the Deputy Ministers of Health of the three governments, Dr. TOGBA (Liberia) felt that there were many intimating only that they no longer consideredother tasks of a strictly medical nature which themselves as Members of WHO. had a prior call on the Organization's limited resources. 5.Recommendations to the Health Assembly for Allocations to the Main Committees Mr. BANDARANAIKE withdrew hisproposal, of Additional Agenda Items reserving the right to propose it for the agenda of the next session of the Executive Board. MT. BANDARANAIKE stated that if there were Subject to omission of the item on Limitation serious objection to discussion at the presentof Population, the General Committee decided Assembly of the additional item proposed by histo recommend to the Health Assembly the inclu- delegation, " Limitation of Population ", or assion in the Agenda of the items proposed in the it might be more accurately termed, " Limitationdraft supplementary agenda (under Rule 26 (d), of the Tncrease of Population ", he would beand the allocation to committees of these items prepared to withdraw it, while reserving the rightin accordance with Rule 26 (c) of the Rules of to reintroduce it at a later session. Procedure.(For allocation of these items see first report of the General Committee, p. 323.) Dr. MACKENZIE (United Kingdom) felt that the increase of population was only one of the many The meeting rose at 1 p.m. extraneous factors affecting the prevention and treatment of disease, which was the Organiza- 3 Off. Rec. World Hlth Org. 14, 81

FOURTH MEETING Monday, 20 June 1949, at 12 noon Chairman : Dr. K. EVANG (Norway)

1.Programme for the Health Assembly andof the General Committee to exert their influence the Main Committees with members of the Committee on Constitutional TheGeneral Committeeestablishedthetime Matters with a view to avoiding the exposition of the next plenary meeting and of meetings of the of purely national viewpoints in what should be main committees. deliberations on a worldwide basis ;it should be quite possible for that committee to complete The chairmen of the main committees reported its work before the end of the week. on the progress made in their work. After some discussion, the General Committee decided that the closing meeting of the Assembly The DIRECTOR-GENERAL pointedoutthatshould be held on Saturday morning, 2 July, after the Assembly had completed examinationand that the joint meetings of the Committees of its committees' final reports, a process whichon Programme and Administration and Finance woulddoubtlessrequiretwomeetings,theshould complete their work by noon on Wednesday, Secretariat would need 36 hours to prepare the29 June, thus allowing the Assembly to examine final documentation for submission to the Assem-the committees' reports that afternoon and the bly at its closing meeting.He urged membersfollowing morning.

139 - FOURTH MEETING

2.Draft Resolution submitted by the Delegationwithdrawal from them of the services provided of India on Action taken by Certain Coun-by the Organization, as suggested in the draft tries with regard to Membership of WHOresohition, might be interpreted in that way. He Rajkumari AMRIT KAUR (India) presented athought, therefore, that it would be more con- draft resolution on action taken by certainstructive to point out to them that every effort countries with regard to membership of WHOwas being made to meet their points, and that (document A2/67) 4 in accordance with the deci-the best way of removing any defects in the sion taken at the third meeting. Organization's work would be to remain within it and play a part in the shaping of its pro- Mr. BANDARANAIKE (Ceylon), Vice-President, grammes. The Assembly should, however, point felt that, in the absence of any explicit provisionsout to them that it could not consider any commu- to the contrary in an organization's constitution,nications as constituting notices of withdrawals the right of withdrawal from it had to be consi-unless they came, as was necessary, from the dered implicit in the right of voluntary accessionresponsible ministers of foreign affairs. to it.If that were admitted, the Assembly had After further discussion, the General Committee to decide whether the letters received from thedecided to refer to the Committee on Constitu- Deputy Ministers of Health of the Union oftional Matters document A2/67, or any revised Soviet Socialist Republics and of the Ukrainiandraft resolution submitted by the Indian dele- and Byelorussian Soviet Socialist Republics con- stituted valid notices of withdrawal. For thatgation for early examination in the light of the would determine to a large extent the wording tocomments of the Chairman of the Committee on be used in any resolution passed by the Assembly.Administration and Finance.

The DIRECTOR-GENERAL stated that in dealing3.Document submitted by the Delegation of with any similar case where no provision was made Greece on the Subject of Aid to Refugees in an organization's constitution for a certain (continuation from p. 138) contingency, the normal procedure, and that followed by the International Court of Justice, Replying to the Chairman of the Committee was to refer to the discussions on the draftingon Administration and Finance, the DIRECTOR- of the constitution.If that were done in the GENERAL Suggested that there could be no doubt present case, it would be seen that not only didas to the Assembly's right to examine any question the International Health Conference in Newconcerned with health or to bring it to the atten- York not envisage any procedure for withdrawaltion of any other body, especially the United from the Organization, but did not envisage any Nations. He tookitfor granted, however, withdrawals. In the second place, he feltitthat the Committee on Programme, to which was obvious that a letter received from anyit had been suggested the document submitted country's deputy minister of health could notby the Greek delegation be referred, would be taken as constituting that country's abro-consider it as only one illustration of a world- gation of a formal international agreement ;wide problem, and that any resolution drafted that could only be done through the ministerby that committee would deal with the problem responsible for foreign affairs. The legal positionof refugees, wherever they were to be found. was obscure, but if the Assembly wished to accept the three letters received as constituting The General Committee decided to refer the notices of withdrawal from the Organization, itdraft resolution submitted by the Greek delega- should, under its Constitution and the terms oftion to the Committee on Programme. (For final its Agreement with the United Nations, first refertext of this resolution, see ninth report of the the matter to the International Court of Justice.Committee on Programme, p. 332.)

The CHAIRMAN OF THE COMMITTEE ON ADMI- 4.Attendance at Committee Meetings NISTRATION AND FINANCE urged that the question should not be considered in too formalistic a The DIRECTOR-GENERAL asked the General spirit. Committee to draw the attention of all delegates to the inadequate attendance at sorne committee There were reasons for the action taken by the meetings and to the absolute necessity of a quorum's three countries concerned. That was, however,being present before decisions were taken. not brought up in the draft resolution submitted by the Indian delegation, which appeared to lay the blame on those countries. Such a resolution5.Recommendations to the Health Assembly would hardly be likely to achieve the result which for Allocations to the Main Committees of they all, he thought, desired, namely that of Additional Agenda Items bringing them back into active participation in the Organization. He suggested further that the The General Committee examined the five items on the revised draft supplementary agenda 4 For text of this resolution, see fourth reportwhich had not previously been allocated to of the Committee on Constitutional Matters, p. 353.committees.

- 140 - GENERAL COMMITTEE

The committee adopted the allocation of itemsallocation of these items, see first report of the to committees as proposed in that document, General Committee, p. 323.) subject to the reference to the Committee on Constitutional Matters of item 8.19.1.6.1, 5 the The CHAIRMAN OF THE COMMITTEE ON PRO- proposal by the delegation of the PhilippineGRAMME felt that all the other items in the Republic for the establishment of a regionalAgenda under 8.19.1 were of an organizational organization for the Western Pacific Region. (For nature. He would propose to his committee that it request the Assembly to re-allocate them to 5 In the draft supplementary agenda, this itemthe Committee on Constitutional Matters. was originally allocatedto the Committee on Programme. The meeting rose at 1.55 p.m.

FIFTH MEETING Tueselay, 21 June 1949, at 12noon Chairman: Dr. K. EVANG (Norway)

1.Programme for the Health Assembly andin the joint report to be presented by the Com- the Main Committees mittees on Programme and Administration and The General Committee established the times of Finance.(Forfirstand secondreports,see meetings of the main committees. p. 325.) The committee decided to defer consideration 3.Proposal to suspend Rule 10 of the Rules of when the next plenary session would be held. of Procedure of the Health Assembly The General Committee also decided to re- 2.Committee Reports submitted to the Healthcommend to the Assembly that it take advantage Assembly for Consideration of the " escape-clause " contained in Rule 10 of First Report of the Committee on Constitutionalthe Rules of Procedure and decide to ignore the Matters 48-hour delay imposed by that rule, in order to The committee decided to submit this reportbe able to discuss, at the afternoon meeting, the to the Assembly for its consideration. (For firstfirst report of the Committee on Constitutional report, see p. 350.) Matters and the second report of the Committee After discussion, the General Committee decided on Programme, although those documents had to suggest to the Assembly that it was unnecessary only been distributed the previous day ;and for this report, and other reports of the com-further to recommend that, acting in virtue of mittees submitted to the Assembly, to be readRule 94 of the Rules of Procedures, it arrange out by the rapporteurs in plenary session ;if, to suspend Rule 10 at the subsequent plenary however, the Assembly wished them to be readmeeting for the remainder of. the Second World out, it was agreed that the translation into theHealth Assembly. other working language would be read out simultaneously over the microphone.It was 4.Proposal Submitted by the United Kingdom agreed, however, that during discussion of any DelegationforAssignmentofCertain committee's report in plenary session, the rap- Countries to the Eastern Mediterranean porteur of that committee would, in any case, Region take his place near the rostrum to be readily At the request of the United Kingdom delega- available to furnish any explanations,or totion, the General Committee deferred considera- answer any questions relating to the report. tion of this item.

First and Second Reports of the Committee on 5.Membership of the State of Israel in WHO Programme The DIRECTOR-GENERAL pointedoutthat In addition to the decisions relating to theseIsrael, which had now been admitted as a Member reports taken under the previous item,theof the United Nations, was thereby entitled to General Committee decided to recommend tobecome a Member of WHO automatically on the Assembly that the words " REQUESTS theaccepting the Constitution and depositing the Director-General to take appropriate action "necessary documents with the Secretary-General be omitted from the draft resolution on theof the United Nations.He had been shown a Report of the Expert Committee on Maternalcablegram received by the Israeli delegation to and Child Health, set out in the second report,the Assembly from the Israeli representatives since such a request impinged on the Organiza-in New York, in which it was stated that the tion's programme and would therefore be coverednecessary formal instrument had been deposited - 141 - SIXTH MEETING with the Secretary-General on 17 June 1949.recommend to the Assembly that the Israeli He had not yet received confirmation from thedelegation be at once permitted provisionally Secretary-General, but that time-lapse was byto sit in the Assembly with full voting rights, no means unusual. The Israeli delegation hadthe second that it recommend that no action be requested that they be allowed provisionally totaken pending receipt by the Director-General sit in the Assembly with full voting rights withof confirmation from the Secretary-General of effect from that afternoon's plenary meeting.the United Nations that the necessary formal He pointed out that at the First Health Assembly,instrument had been deposited. It also considered the United States, the Argentine Republic andthe suggestion that the matter was one which a number of other countries had been in anshould be referred to the Committee on Constitu- identical situation and had been allowed to sittional Matters. provisionally with full voting rights pending It was finally decided, by a majority vote, to formal confirmation of the deposit by them ofrecommend to the Assembly that the Israeli the necessary documents. delegation be at once permitted provisionally to The General Committee considered two alterna- sit in the Assembly with full voting rights. tive proposals :thefirst,that the committee The meeting rose at 1.15 p.m.

SIXTH MEETING W ednesday, 22 June 1949, at 12 noon Chairman : Dr. K. EVANG (Norway)

1.Programme for the Health Assembly andtion and Finance with a view to co-ordination the Main Committees and editing.It decided to refer the report to the The General Committee established the times ofAssembly. (For first report, see p. 336.) meetings of the main committees. The CHAIRMAN stated that, in accordance with 2.Special Meeting of the General Committeethe decision taken at the previous meeting, he The General Committee decidedthat,onwould again ask the Assembly whether there Thursday, 23 June 1949, in addition to its meetingwas general agreement that the report need not at 12 noon, it would also meet at 6.30 p.m. tobe read. draw up a list of nine Members in the light of the suggestions received from members of the Assem-4.Proposal to suspend Rule 10 of the Rules bly and of any other suggestions made by members of Procedure of the Health Assembly (con- of the General Committee, such list to be trans- tinuation from p. 141) mitted to the Health Assembly at a plenary meet- The General Committee adopted document ing on the afternoon of Saturday, 25 June, forA2/75,6 in which it was stated that in order to the purpose of electing six Members entitled toconduct the remaining business of the Assembly designate a person to serve on the Executiveas expeditiously as possible, and in accordance B oard. with Rule 94 of the Rules of Procedure, the The committee further decided that an an-General Committee gave notice of its intention nouncement would be made by the chairmen ofto propose to the Assembly the suspension of the main committees that afternoon to the effectRule 10 during the remaining plenary meetings that Members who were nominated by otherof the Health Assembly. Members but were unwilling to serve on the Executive Board should inform the Secretariat5.Membership of the State of Israel in WHO before the General Committee met at 6.30 p.m. (continuation from p. 141) on 23 June. The Director-General was also The Director-General informed the General requested to prepare,for submission to theCommittee that he had now received a cable General Committee, an analytical note showing,from the Head of the Legal Department of the as well as the names of Members ndminated andUnited Nations stating that the Israeli authori- willing to serve, the present composition of theties had deposited the necessary formal instru- Board, the names of those Members retiring fromment in Lake Success.There was therefore no the Board, the names and regional distributionfurther obstacle to the President's announcing of those remaining, and the number of ratifica-to the Assembly that Israel had been accepted tions for each region. into full membership. 3. The General Committee therefore rescinded Committee Report submitted to the Healththe decision taken at its fifth meeting to propose Assembly for Consideration to the Assembly that the Israeli delegation be First Report of the Committee on Administrationallowed provisionally to enjoy full voting rights. and Finance In accordance with Rule 42 of the Rules of The meeting rose at 12.50 p.m. Procedure, the General Committee considered 6 This document was adopted by the Health the first report of the Committee on Administra-Assembly at its ninth plenary meeting, p. 116. - 142 - GENERAL COMMITTEE

SEVENTH MEETING Thursday, 23 June 1949, at 12 noon Chairman: Dr. K. EVANG (Norway)

1.Programme for the Health Assembly and 3.Committee Reports submitted to the Health the Main Committees Assembly for Consideration The General Committee approved the pro-First Report of the General Committee gramme for the Health Assembly and the main The first report of the General Committee (see committees as previously arranged. p. 323) was accepted without discussion. Second Report of the Committee on Constitutional Matters In reply to a question by the CHAIRMAN as to The second report of the Committee on Consti- the desirability of holding a night meeting oftutional Matters (see p. 350) was accepted without the Committee on Administration and Finance discussion. in accordance with a suggestion of the Secretariat, Second Report of the Committee on Administration the CHAIRMAN OF THE COMMITTEE ON ADMINIS- and Finance TRATION AND FINANCE said that he thought this The second report of the Committee on Admi- unnecessary at present. nistration and Finance (see p. 338) was accepted without discussion. 2.Special Meeting of the General Committee 4.Procedure for Examination of Programme (continuation from p. 142) and Budget for 1950 (continuation from p. 137) The CHAIRMAN explained that it would not be Following a suggestion by the CHAIRMAN OF convenient to hold the special meeting of the THE COMMITTEE ON PROGRAMME, the General General Committee at 6.30 p.m. that evening asCommittee re-examined the procedure approved planned.Several members having stated that by the Assembly for examination of the proposed an afternoon meeting would be difficult for them,Programme and Budget for 1950.After a full because their attendance would be required atdiscussion, the General Committee decided that meetings of the main committees, it was agreedthere was no alternative but to continue along the that the special meeting of the General Committeelines already laid down and reconsider them at the should be held at 9.30 p.m.This would be aend of the Assembly in the light of experience. closed meeting. The meeting rose at 1.25 p.m.

EIGHTH MEETING Thursday, 23 June 1949, at 9.30 p.m.

This meeting was held in private and no minutes were taken.

NINTH MEETIN G Friday, 24 June 1949, at 11.30 a.m. Chairman: Dr. K. EVANG (Norway)

1.Programme for the Health Assembly andthe General Committee that, if an evening meet- the Main Committees ing were called, there would be enough delegates The General Committee established the time ofin attendance to ensure a quorum. the next plenary meeting. The DIRECTOR-GENERAL informed the Com- mittee that the question of attendance at meet- 2.Attendance at Committee Meetings (con-ings by delegates was very serious.In several tinuation from p. 140) instances the work of comMittees had been inter- Dr. SCHOBER (Czechoslovakia), Chairman ofrupted and delayed because not enough delegates the Committee on Administration and Finance,were present. He would like to ask the General said that he would like to receive assurance fromCommittee's agreement that when a quorum - 143 - TENTH MEETING was not reached, the names of the delegates The General Committee agreed tocall the present at the meeting would be published in the meeting for 3 p.m. on Saturday. Assembly Journal, thereby drawing attention to the fact that some delegations were not taking Mr. BANDARANAIKE (Ceylon) asked the COM- an active part in the work of the Assembly andmittee to consider whether it would not be pos- its committees.He also asked permission tosible to suspend Rule 43 of the Rules of Procedure, make an announcement on the matter in thewhich governed the question of quorum at meet- committees in session that morning and afternoon. ings. Dr. DOWLING (Australia) was of opinion that It was the opinion of several members that this the Director-General should go a step further,would not be practicable or advisable, and that and bring the matter to the attention of eachthe regulation governing attendance at meetings head of delegation, pointing out the seriousnesswould have to be observed. implicationsof andthe non-attendance by The DIRECTOR-GENERAL suggested that when delegates at meetings. a working party was formed, the Chairman of Dr. STAMPAR (Yugoslavia) thought that nightthe Committee should bear in mind whether a meetings should commence as early in the even-delegation could be represented on the working ing as possible.It was not advisable to start asparty and still have a representative in the com- late as 9.30 p.m. as many of the delegates hadmittee.There had been cases where delegates already sat through the day's proceedings, andhad been withdrawn from the committees to a 9.30 meeting generally meant a sittingtillserve on working parties and had not been midnight. He suggested 8.30 p.m. as the latestreplaced by alternates in the committees, with time for the beginning of an evening meeting. the result that there had not been a quorum. The CHAIRMAN felt that a meeting of the Com-3.Recommendations to the Health Assembly mittee on Administration and Finance should be for re-allocations to a Main Committee of called for 8.30 p.m. that day.The Director- Agenda Items General's suggestion and also that of Dr. Dow- The committee discussed the Agenda items ling would be followed in an endeavour to obtainunder 8.19,Regional Offices. It decided to better attendance at meetings. recommend to the Assembly that items 8.19.1.5 It was agreed on Dr. HYDE'S suggestion thatand 8.19.1.6 should be re-allocated to the Com- a meeting of the Committee on Programme shouldmittee on Constitutional Matters. be called for that evening. The committee decided that the following items should be considered by the joint meetings The DIRECTOR-GENERAL announced that as of the Committees on Programme and on Admini- there had not been a quorum at the last meetingstration and Finance : 8.19.1, 8.19.1.1, 8.19.1.2, of the Credentials Committee, it was now neces-8.19.1.3, 8.19.1.4, and such part of 8.19.2 as did sary to arrange a meeting at 3 p.m. on Saturday,not refer specifically to pure matters of programme. 25 June, half an hour before the plenary meet-It decided that the Committee on Programme ing. Three countries had presented their creden-should retainonitsagenda items8.19.2.1, tials, and it was absolutely essential that they8.19.2.2, 8.19.2.3, and 8.19.2.4. should be able to take part in the next plenary meeting asfully accredited members of the The General Committee went into secret session Assembly. at 12.30 p.m.

TENTH MEETING Satwday, 25 June 1949, at 12 noon Chairman : Dr. K. EVANG (Norway)

1.Programme for the Health Assembly andChairman of the Committee on Administration the Main Committees and Finance his place should be taken by the The General Committee established the times ofVice-Chairman of that committee. meetings of the main committees. 2.Election of Members entitled to designate In reply to a question, the CHAIRMAN explained a Person to serve on the Executive Board that by " joint committee " was meant a meet- ing of the Committees on Programme and Admin- Document A2/88,7 which had been circulated, istration and Finance, with all delegations present.was considered, and after a very full discussion It was agreed that the Chairmen of these two committees should alternate as Chairmen of the 7 The text of this document is reproduced as joint meetings, and that in the absence of theAnnex 1. - 144 - GENERAL COMMITTEE a vote was taken on a resolution, proposed by 5.Suspension of Rule 10 of Rules of Procedure : Dr. TOGBA (Liberia) and seconded by Rajkumari Note by Delegation of Belgium 8 AMBIT KAUR (India), that the document be Following the observation of the CHAIRMAN that approved. The resolution was carried by 8 votesthe suggestion of the Belgian delegation would, if in f avour. accepted, defeat the purpose of the suspension of Rule 10 of the Rules of Procedure, the General Committee decided that the note be accepted. 3.Committee Reports submitted to the Health Assembly for Consideration 6.Assignment of Israel to the Eastern Medi- terranean Region Third and Fourth Reports of the Committee on The DIRECTOR-GENERAL explained the circum- Constitutional Matters stances in which Israel had requested that it be assigned to the Eastern Mediterranean Region. The third and fourth reports of the CommitteeThe General Committee approved this request, on Constitutional Matters (see pp. 352, 353) were which would be presented to the Health Assembly. accepted without discussion. 7.Attendance at Committee Meetings (con- Third and Fourth Reports of the Committee on tinuation from p. 144) Programme In response to a request by the delegation of Iran, presented by the Director-General, the The third and fourth reports of the CommitteeGeneral Committee agreed that, when it became on Programme (see pp. 325, 327) were acceptednecessary to publish the names of the members without discussion. present at a meeting of one of the main com- mittees, the Secretariat should be authorized to add to that list the names of delegates who were present at a working party at the time. 4.Recommendation to the Health Assembly for re-allocations to a Main Committee of The meeting rose at 2 p.m. Agenda Items 8 This note read as follows :" The Belgian delegation signifies its assent to the proposal of A recommendation that items 8.19.1.5 Africathe General Committee to suspend Rule 10 of the and 8.19.1.6 Western Pacific be re-allocated toRules of Procedure during the remaining plenary meetings of the present session, provided that the the Committee on Constitutional Matters, wasAssembly has first of all given itsapproval in adopted without discussion. each particular case."

ELEVENTH MEETING Monday, 27 June 1949, at 12 noon Chairman: Dr. K. EVANG (Norway)

L Programme for the Health Assembly and The General Committee reaffirmed its objec- the Main Committees tive of trying to complete all meetings of the The General Committee established the time ofmain committees by Wednessday evening. the next plenary meeting. 2.Proposed Amendment to the Constitution The General Committee confirmed its previous decision that the Second World Health Assembly A paper giving notice of a proposal by the should adjourn on Saturday, 2 July 1949, at noon.delegation of India to amend Article 25 of the After discussion on the progress of the jointConstitution was discussed.It was agreed that, meetings of the Committees on Programme andalthough there was nothing to prevent the docu- Administration and Finance, it was agreed thatment from being circulated as information to the committees meeting jointly should try todelegations, no discussion should take place on reach a decision on the ceiling of the Regularit during a plenary meeting.After the delegate Budget for 1950 that afternoon.If this wereof India had accepted a modification in the head- achieved, separate meetings of the two committeesing of the document it was approved for general would be convened in the eveningIf not, theycirculation. would have to be held on Tuesday or later. The CHAIRMAN OF THE COMMITTEE ON PROGRAMME 3.Committee Report submitted to the Health said that he thought the remaining business of Assembly for Consideration this committee would be finished in one meeting.Fifth Report of the Committee on Programme The VICE-CHAIRMAN OF THE COMMITTEE ON The fifth report of the Committee on Programme ADMINISTRATION AND FINANCE thoughtthat two meetings would be required to complete the(see p. 328) was accepted without discussion. separate business of that committee. The meeting rose at 12.55 p.m. - 145 - TWELFTH AND THIRTEENTH MEETINGS

TWELFTH MEETING Tuesday, 28 June 1949, at 12 noon Chairman: Dr. K. EVANG (Norway)

1.Programme for the Health Assembly andwith the resolution contained in document A2/91 Main Committees (sixth report) before it had been put to the vote. He felt UNICEF was not in a position to reopen The General Committee established the time of the question. the next plenary meeting and of Meetings of the He recalled that it had been stated in the main committees. Committee on Programme by a member of the Executive Board of UNICEF that that agency 2.Committee Reports submitted to the Healthhad no powers to transfer its residual funds to Assembly for Consideration WHO. He wished to place on record that UNICEF had infactalready transferredconsiderable Second Report of the General Committee sums of money to WHO up to the end of May The General Committee decided to adopt its1949. Not only was there nothing to prevent second report, subject to the amendment of theUNICEF from transferring its funds to WHO ; words " After prolongeddiscussion "atthesuch had actually been the intention of the beginning of the fourth paragraph to read " AfterEconomic and Social Council's resolution, under careful consideration ". which the Fund had been established. Fifth Report of the Committee on Constitutional Dr. MACKENZIE (United Kingdom), Chairman Matters of the Joint Committee on Health Policy, UNICEF/ WHO, pointed out that the legal question ot The General Committee decided to transmittransferability of funds need not arise, since WHO the fifth report of the Committee on Constitutional was already acting as the agent of UNICEF. Matters (see p. 353) to the Assembly. After further discussion, the General Committee Sixth, Seventh and Eighth Reports of the Com-decided, on the suggestion of Dr. STAMPAR, that mittee on Programme the President, before putting the draft resolution With reference to the Joint Committee onto the vote, would call the Assembly's attention HealthPolicy UNICEF/WHO (sixthreport,to the fact that interim arrangements had to be section 3), Dr. STAMPAR (Yugoslavia) stated thatmade until such time as WHO was in a position he had been informed by representativesof to take over full responsibility for UNICEF's UNICEF that the Executive Board of thathealth projects and would suggest that joint agency considered it was not in a position tooperation should be maintained along lines to hand over to WHO the funds it had receivedbe determined by the Executive Board. for its own use, and that it wished joint operation Subject to this understanding, the General to continue, at any rate until the middle of 1950, Committee decided to transmit the sixth, seventh when UNICEF was due to close down. and eighth reports of the Committee on Pro- gramme to the Assembly. (For these reports, see The CHAIRMAN OF THE COMMITTEE ON PRO-pp. 330, 331.) GRAMME stated that the Executive Director of UNICEF had clearly expressed himself as satisfied The meeting rose at 1 p.m.

THIRTEENTH MEETING Thursday, 30 June 1949, at 10.45 a.m. Chairman: Dr. K. EVANG (Norway)

1.Time and Place of the Third World Health2.Committee Reports submitted to the Health Assembly Assembly for Consideration The General Committee decided to recommendThird Report of the General Committee to the Assembly that the Third World Health Assembly should be held in Geneva, beginning The General Committee adopteditsthird on 8 May 1950. report (see p. 324) and authorized the Chairman - 146 - GENERAL COMMITTEE to have read out a textual addition at the plenary THE COMMITTEE ON PROGRAMME stated that his session.9 committee had agreed that this report, which had been read out to the committee, should be Third, Fourth and Fifth Reports of the Committeetransmitted to the General Committee without on Administration and Finance further consideration.Although he agreed that The committee decided to transmit to thethe drafting of the resolution might be improved, Assembly the third, fourth and fifth reports of theit was undesirable to make any changes in the Committee on Administration and Finance (seewording, as it had been formally adopted by the pp. 341, 343, 345). Committee on Programme. The General Committee decided to transmit First, Second and Third Reports of the Jointthese reports(see pp. 332, 333, 335) to the Meetings of the Committees on ProgrammeAssembly. and Administration and Finance The committee decidedtotransmitthese 3.Report of the Director-General and Reports reports (see p. 347) to the Health Assembly. of the Executive Board 10 After some discussion, the General Committee Sixth Report of the Committee on Constitutionaldecided to request the President of the Assembly Matters and the Chairman of the Committee on Pro- The committee decided to transmit the sixthgramme to establish a satisfactory form of word- reportof ing for a resolution whereby the Assembly, in theCommitteeonConstitutionalaccordance with Article 18 (d) of the Constitution, Matters (see p. 355) to the Assembly. would approve the Reports submitted by the Executive Board and the Director-General, and Ninth, Tenth and Eleventh Reports of the Com-take the necessary action in respect of the com- mittee on Programme ments made on them by the main committees. With reference to the eleventh report of the Committee on Programme, the CHAIRMAN OF The meeting yose at 11.15 a.m. 9 See tenth plenary meeting, p. 124. " Off. Rec. World Hlth Org. 16 ; 14 ; 17

- 147 - COMMITTEE ON PROGRAMME

COMMITTEE ON PROGRAMME

FIRST MEETING Tuesday, 14 June 1949, at 10.5 a.m. Acting Chairman : Dr. K. EVANG (Norway) later Chairman : Dr. H. HYDE (United States of America)

1.Election of Chairman the committee and asked whether there were any Agenda, 8.1 other proposals for that office. There were no other proposals and Dr. Hyde Dr. HYDE (United States of America) said was accordingly elected chairman. that, as there appeared to be some difference of opinion as to who should preside at the outset, Dr. Hyde thereupon took the Chair. he would request the President of the Assembly to take the Chair during the election of the chair- The CHAIRMAN thanked the committee for the man of the committee. honour it had paid him in electing him chairman Dr. Evang (Norway), President of the Assembly, and expressed the hope that he would preside thereupon took the Chair. effectively over the work and, in spite of the many problems involved, bring it to a successful The ACTING CHAIRMAN pointedoutthat conclusion. Dr. Hyde had been nominated as chairman of The meeting rose at 10.10 a.m.

SECOND MEETING Wednesday, 15 June 1949, at 3.30 p.m. Chairman: Dr. H. HYDE (United States of America)

1.Remarks by the Chairman upon those organizations would be found in In opening the meeting, the CHAIRMAN extended Official Records No. 13, page 327. a welcome to the members of delegations and to The agenda adopted by the Health Assembly the observers present. was before the committee (see p. 61), but as In his capacity as Chairman, he would dospecial circumstances might render it advisable everything possible to carry out the will of theto alter the order of consideration of the various committee and to expedite its work. He hopeditems, he suggested that the committee decide formalities would be reduced to a minimum inat the end of each day the items to be considered order to enable efficacious decisions to be reached at the following day's meetings. A daily agenda as quickly as possible. could then be issued as a committee document. He then directed attention to the Rules of Procedure 1 which would govern the work of He recalled that, according to Rule 19 of the the committee, particularly Rules 28,31, 33Assembly's Rules of Procedure,2 the Committee and 37. on Nominations should nominate theVice- He welcomed the representatives of certainChairman of the committee. The Committee non-governmental organizations which had beenon Nominations would meet on the following day brought into relationship with WHO since thein order to do so. last Health Assembly and who were therefore On the Chairman's suggestion, it was agreed participating in the Assembly's work for thethat the item should be left over until the nomi- first time.A note of the privileges conferrednation had been received.

011. Rec. World Hlth Org. 13, 365 ; 17, 53 2 Off. Rec. World Hlth Org. 13, 367 - 148 - SECOND MEETING

2.Election of Rapporteur Sir Arcot MUDALIAR (India) was unable to Agenda, 8.2see how the Committee on Administration and On the proposal of Dr. MACCORMACK (Ireland),Finance could apportion the budget without seconded by Colonel AFRIDI (Pakistan), Dr. A.having the full recommendations on the pro- H. Radji (Iran) was elected Rapporteur. gramme before it.On the other hand, it was necessary for the Committee on Programme to have a clear conception of the cost involved 3.Procedure for Examination of Programmebefore the joint meeting of the committees. and Budget for 1950 The budget was divided into two parts :regular Agenda, 8.3and supplemental. It might be necessary for the The CHAIRMAN directed attention to a recom-committee not only to establish priorities in mendation of the Executive Board to the Healthregard to the various items of the programme, but Assembly. sIt was recommended that the Com-also to establish priorities within those items, mittee on Programme should consider and makeand transfers might be recommended between recommendations for the 1950 programme andthe Regular and Supplemental Budgets. thatthe Committee on Administration and He suggested that a small working party Finance should recommend cost estimates forshould be appointed to work out, with the help the programme proposed. Each item of the pro-of the Secretariat, a cost estimate for each item of gramme, as adopted, would be referred imme-the programme adopted and to present a report diately to the Committee on Administration andthereon to the committee every few days.In Finance, which would then be in a position tothe light of that report the committee could, if have revised cost estimates prepared.In thatnecessary, reconsider the items in question. way, it was hoped that the work of the two committees would be facilitated and duplication Dr. CAMERON (Canada), while in sympathy of consideration avoided.When the full pro-with the viewpoint of the delegate of India, felt gramme had been established, the reports of thethat time might be saved by adopting the method two committees would be referred to a jointsuggested by the Executive Board. He therefore committee on programme and administrationproposed that the committee recommend to the and finance, which would put forward jointHealth Assembly the adoption of the draft recommendations to the Health Assembly. resolution embodying the proposal of the Execu- tive Board. Dr. TIMMERMAN (Netherlands) and Dr. DOWLING (Australia) were doubtful whether the proposed procedurewouldbeeffectiveinpractice. Dr.GRASSET(Switzerland), supportingthe Dr. Timmerman said that it would be difficultCanadian proposal, said the question of priorities for the Committee on Administration and Financeshould be examined first. Certain problems to reach a decision on any one item withoutwere already being studied by WHO, and if others knowing the complete recommendations of thewere to be considered, they should be dealt with Committee on Programme. first by small working groups and then submitted in a clearly defined form to the committee itself. In reply, the CHAIRMAN stated that the Com- mittee on Administration and Finance would Dr. GEAR (Union of South Africa) also supported consider the cost estimates involved for eachthe Canadian proposal. item :the final decision on the programme and budget would, however, be taken by the joint The CHAIRMAN pointed out that the Indian committee, when the complete programme pro-delegate's suggestion that a working party be posed was available. established to report to the committee on the financial implications of its decisions was extre- Colonel AFRIDI considered that it would bemely interesting but might lead to duplication useful for the committee to have the cost estimatesof work with the Committee on Administration for each item of the programme as it was adopted,and Finance.He therefore requested him to rather than to wait until the joint meeting of thewithdraw the suggestion on the understanding committees for that information. that it might be reintroduced at a later stage.

Dr. FORREST, Secretary, stated that, as items Sir Arcot MUDALIAR agreed to the Chairman's of the programme were adopted, revised cost estimates, where necessary, would be preparedrequest. immediately and distributed as Committee on Programme documents :they would be available Dr. ALLWOOD-PAREDES (El Salvador) stressed to members of both the committees concerned.thatthe governments representedin WHO AfterconsidérationbytheCommitteeonwould only be prepared to approve supplementary Administration and Finance, the report of thatestimates for those projects which they con- committee, which should be ready very shortlysidered worthwhile. afterwards, would be available to all members of the Assembly. Dr. ROGERS (United States of America) said there were two methods of approach to budgetary 3 011. Rec. World Hlth Org. 17, 9, item 1.1.1 problems-thelong-termidealisticapproach, - 149 - COMMITTEE ON PROGRAMME based on the real needs experienced in particular by the Committee on Programme and to programme areas, and the immediate practical comment generally on the administrative approach,basedon suchconsiderationsas and financial aspects of the proposals ;and availablity of personnel, facilities and organi- DECIDES that the reportsof the two zation. The committee should make a clear committeesshall be referredto a joint distinction between these two approaches in any committee on programme and administra- consideration of the budget. tion and finance for joint recommendation to the Health Assembly of the final decisions Dr. MACCORMACK associated himself with the remarks of the United States delegate and sup- on the 1950 Programme and Budget. ported the proposal of the delegate of Canada. 4.Report of the Director-General Decision: The committee approved the pro- Agenda, 8.4 posal of the delegate of Canada to recommend to the Health Assembly the adoption of the The CHAIRMAN asked delegates whether they draft resolution, reading as follows : wished to enter into a general discussion of the The Second World Health Assembly, Director-General's Report or discuss' immediately Recognizing the necessity for a properlythe substantive points as set out in the agenda. integrated approach in the consideration of The committee considered that no general the Programme and Budget for 1950, discussion of the report was necessary, but that DECIDES to refer to the Committee onits various parts should be considered forthwith Programme the proposed programme forin the order set out in the agenda. However, the 1950, discussion of certain items could be postponed to suit the wishes either of delegations or of the INSTRUCTS the Committee on Adminis- Secret ari at. tration and Finance to recommend cost estimates for the programme recommended The meeting rose at 5.35 p.m.

THIRD MEETING Thursday, 16 June 1949, at 4.55 p.m. Chairman: Dr. H. HYPE (United States of America)

1.Election of Vice-Chairman In reply to the delegate of Canada, he explained Agenda, 8.1 that the Executive Board had considered in The CHAIRMAN recalled that the chief delegatedetail the report of the expert committee and a of Poland, Dr. Irène Domanska, had been nomi-summary ofits comments was published in nated by the Committee on Nominations forOfficial Records No. 17, page 33. the office of Vice-Chairman of the Committee. Decision:There being no further proposals, Dr. ELICANO (Philippines), referring to recom- Dr. Domanska was unanimously elected and mendation(4)of the report(Official Records took her place as Vice-Chairman. No. 19, p. 41), said no mention had been made of the use of BCG vaccination in mass immunization 2.Maternal and Child Health programmes. BCG vaccine had been used success- Agenda, 8.7fully in countries such as France, Spain and South America, and work on that drug had already Decision: The section of the Director-General'spassed the initial stage and was giving good Report dealing with Maternal and Child Healthresults. Laboratories for developing BCG vaccine was adopted.' were already working in the Philippines and its Report on the First Session of the Expert Com-use had contributed to a large extent towards mittee on Maternal and Child Health lowering infant mortality from respiratory diseases in that country.More weight should therefore The CHAIRMAN directed attention to the report of the Expert Committee on Maternal and Childbe given to the importance of this vaccine in any Health , and the draft resolution relating to itrecommendation concerned with mass immuni- suggested by the Director-General (for text, seezation programmes. second report, p. 325, section 2). The CHAIRMAN replied that WHO had already 4 Off. Rec. World Hlth Org. 16, 15 accomplished considerable work in encouraging 5 Off. Rec. World Hlth Org. 19, 35 the use of BCG vaccine, particularly in collabo- - 150 - THIRD MEETING ration with UNICEF. The point raised by thebeing prepared on the legislation in the various delegateof thePhilippines mightthereforecountries on child and family welfare.These conveniently be raised when item 8.21 of thereports were not entirely satisfactory, as infor- agenda was discussed and perhaps also undermation was not always forthcoming from govern- 8.6-Tuberculosis. ments. The main activity of the United Nations in this field was the allocation to the various Decision :The committee noted the reportcountries, on their own request, of child welfare of the Expert Committee on Maternal andexperts. He had been astonished at the number ChildHealth and recommended thattheof applications that had been received for such Health Assembly adopt the draft resolution experts.The medical and social aspects of the suggested by the Director-General. problem were so closely interrelated that he looked forward to the time when teams of experts could be sent jointly by WHO and the United Activities with theUnited Nations, SpecializedNations. An experiment was already being made Agencies and Non-Governmental Organizationsin the case of Ecuador, where it was proposed to send four experts representing different inter- Dr. FORREST,Secretary,said many othernational organizations.Collaboration had also international organizations were concerned withbeen established with WHO on the question of the problemof maternal and childhealth. fellowships. References to those organizations would be found He was convinced that the programme for in the report of the Expert Committee on Maternal1950 constituted an excellent basis for the expert and Child Health (page 37),6 in Official Recordscommittee's work, and stressed that the United No. 16 (page 15) and in Official Records No. 18Nations had already collaborated to a very large (page 65).Further, the Social Commission of the United Nations had been entrusted by theextent towards the solution of this important Economic and Social Council with a generalproblem. survey of the field of child and family welfare and was elaborating a Declaration of the RightsProgramme for 1950 of the Child, and taking measures to prevent the traffic in women and children.Finally, a The CHAIRMAN drew attention to the programme non-governmental organization, the Internationalfor Maternal and Child Health on pages 65 to 70 Union for Child Welfare, was also active in thisof Official Records No. 18 and invited comments. field and had recently been brought into relation- ship with WHO. A representative of this organi- Dr. RAJA (India),referring to the budget zation would be prepared to speak before theestimates (page 71) for the programme, said that \ committee at a later stage. the importance of health education had been stressed both by the Director-Géneral in his ' Sir Raphael CILENTO, Director, Division ofreport and by the Expert Committee on Maternal Social Activities, United Nations, expressed hisand Child Health, but no provision had been gratification that WHO had entered the highlymade in the budget for that item. Nor had any important field of maternal and child health.provision been made for investigations by WHO As had been pointed out by the Secretariat ofinto maternal and child welfare.He expressed WHO, the United Nations Secretariat had beena desire to know the composition of the teams given the responsibility of instituting programmesof consultants which would be available under for social welfare and in particular for child andthe 1950 budget. family welfare.However, work in this field was impossible without the help of WHO, and the The CHAIRMAN replied that, as regards the closest possible collaboration was necessary sincequestion of health education, an insertion might the work was incapable of sub-division. He wasbe made on page 117 of Official Records No. 18, extremely satisfied with the report of the expertwhich contained the budget estimates for Health committee on this important subject. Education of the Public. As regards the question of the composition of the teams of consultants The activities of the United Nations in theto be sent to the various countries he requested sphereofchild welfare had been somewhatDr. Williams, Chief of the Maternal and Child inchoate, as attention had first to be given to theHealth Section of the Secretariat, to explain most urgent problems. However, much progress had been accomplished. An information centrethe position. on family and child welfare had been instituted. This was only a preliminary measure and the Dr.Cicely WILLIAMS (Secretariat)said the United Nations would be happy to avail them-section of the Secretariat dealing with maternal selves of all the expert documentation whichand child health had only recently been established WHO could give. and had no experience of working on an inter- national level. Maternal and child health was not The United Nations published an annuala subject to which an established and well- report on child welfare based on reports sub-known technique could be universally applied. mitted by the governments. Reports wereEach problem had its own local flavour and had to be dealt with according to the particular 6 Ofl. Rec. World Huh org. 19 conditionsobtaininginany givencountry. - 151 - COMMITTEE ON PROGRAMME

Accordingly, the Secretariat would not envisagepregnant mothers and ofchildren,and the any definite composition of the teams for fieldelaboration of standards so that investigations work until it had ascertained exactly what thecould be carried out on a comparable basis. More- tasks of those teams would be. The programmeover, it was essential that WHO should provide had consequently been left as flexible as possiblefinancial assistance for any specific investigations and teams would be composed of from one tothat were indispensable in certain countries. four experts.At the moment three categories were contemplated :three teams of four experts, In reply to the CHAIRMAN, he agreed to submit four of three experts and six of two experts. a document containing his proposals in regard to the research policy of WHO, to be considered The CHAIRMAN said the third issue raised byat an appropriate time by the committee. the Indian delegate, that of research by WHO, was an important one which might very well be The CHAIRMAN proposed that the two questions discussed immediately by the committee. A listraised by the Indian delegate, namely the omission of subjects for research had been included in theof any mention of health education and research report of the expert committee 7 and delegatesin the budget estimates, should be brought to might consider what questions could be added tothe attention of the Committee on Administration that list. and Finance when the joint meeting with that body took place. Dr. RAJA said there were two fields, not included Decision: The programmefor1950for in the list, in which WHO could usefully under- Maternal and Child Health (Official Records take research :the allocation of experts for No. 18, pp. 65-70) was adopted, together with special inquiries in certain countries, particularly the proposal of the Chairman in regard to inquiries into the problem of the nutrition of health education and research. 7 oll. Rec. World Hlth Org. 19 The meeting rose at 6.35 p.m.

FOURTH MEETING Friday, 17 June 1949, at 9.30 a.m. Chairman : Dr. H. HYDE (United States of America)

1.Maternal and Child Health (continuation) Expert Committee on Venereal Diseases:Report on the Second Session Agenda, 8.7 The report and the summary of recommen- The CHAIRMAN reminded the committee thatdations of the expert committee contained in at the previous meeting discussion on MaternalOfficial Records No. 15, pages 18 and 30 respectively, and Child Health had been completed, but it hadwere noted. been agreed that the representative of the Inter- national Union for Child Welfare might give hisActivities with theUnited Nations, Specialized comments at the present meeting. Agencies or Non-Governmental Organizations Dr. PIACENTINI (International Union for Child Dr. GUTHE (Secretariat) gave a brief account Welfare) said that the work of the Internationalof the co-operation of WHO with various inter- Union for Child Welfare, which had been goingnational organizations concerning venereal on for over 20 years and extended to more thandiseases.' 50 countries, took no heed of political prinCiples, The representativeof the United Nations nationality or race.He was grateful for thehaving indicated that he had no comment to official recognition which had been promised tomake on theitem,Professor Gurney Clark the Union and would assure WHO of the utmost(Observer for the International Union against co-operation. Venereal Diseases) was invited to make a state- ment. 2.Venereal Diseases Professor Gurney CLARK expressed the Union's Agenda, 8.8appreciation of the action which had brought it into relationship with WHO.The aims and Decision: The section of the Director-General'spurposes of the Union, representing affiliated Report dealing with venereal diseases8 wasorganizations in some 40 countries, were definitely adopted. in conformity with the broad purposes and prin-

09. Rec. World Hlth Or. 16, 13 9 09. Rec. World Hlth Org. 15, 27 ; 16, 13 - 152 - FOURTH MEETING

ciples of the WHO Constitution. That a start haddemonstration teams shouldincludeexperts already been made towards implementing thosetoassist in setting up national laboratories, aims in the venereal diseases field was apparentgive help with equipment and also in the animal from various WHO reports, and the Union pledgedbreeding sections, so that, when those teams continued support and co-operation on both thewithdrew, they would leave behind them not long-term and immediate objectives of WHO.only therapeutic and other administrative mecha- nism for dealing with venereal diseases but a Programme for 1950 laboratory service on up-to-date lines. The CHAIRMAN referred toOfiicial Records In reply, Dr. GUTHE stated that the first No. 18, page 86, 7.4.6, " The Problem and itspoint was already under consideration. The Significance ". He also drew attention to 7.4.6.2,second point had also been taken into conside- " Work Previously Accomplished " and 7.4.6.3,ration, as was shown in the section of the expert " Statement of Objectives ". committee's report headed " Teams ". 10 Sero- There were no comments on these sections.logists were included in teams and team equip- ment was available. In regard to 7.4.6.4, " Work to be accomplished in 1950 ", the CHAIRMAN asked Dr. Guthe if he Colonel AFRIDI said that his intention was to would interpret the programme in terms of thedraw the attention of the Secretariat to the fact teams visualized.This would amplify the infor-that many national laboratories needed expert mation given in the budget estimates (page 95)help with animal breeding and equipment, and and would help the committee to understand theto ask that that need be emphasized. programme. The CHAIRMAN requested the Secretariat to Dr. GUTHE said that 1950 would see the begin-take note of both the points raised and to bring ning of the implementation of the immediate andthem to the notice of the Director-General in long-term objectives as set out on pages 86-90. connexion with programme planning. Section 7.4.6.4.1 stated the authority for the proposals, and the methods to be used were set In reply to a question raised by Dr. BABIONE out in section 7.4.6.4.2. On page 91 was indicated(USA Technical Adviser) and Dr. DOWLING the approach to be taken.He drew attention(Australia), as to the availability of sufficient to the statement on page 92 under the headingexpert personnel to carry out the programme of " Supplies ".The supplies there referred tooutlined, Dr. GUTHE explained that the position were not included in the specific budget proposalsin regard to venereal diseases was similar to for venereal diseases on page 95, but were to bethat of all other fields :the matter had been considered under item 8.18 of the agenda. discussedandconsidered by theExecutive Teams were provided for under the headingBoard in approving the Programme and Budget " Field " in the budget estimates (page 95),Estimates and both the Director-General and By the end of 1949 there would be three venereal-the Executive Board were of the opinion that disease consultation and demonstration teams inthe number of experts required was within the the field, the operations of which would continuereach of possibility. into 1950 ;three additional teams were planned for 1950.Personnel considered to be necessary The CHAIRMAN considered that the availability for the special port-demonstration scheme, con-of personnel must be taken into serious account ; ceived by theInternationalUnionagainstit was important to ensure that the Organi- Venereal Diseases, were also included under thiszation was not committed to a programme which heading. Regional full-time consultants werecould not be carried out because of lack of per- likewise included in the totals.The headingsonnel.It would be helpful if the Secretariat " Consultants " included part-time consultantswould indicate whether any specific inquiries required to cover responsibilities of WHO underor, estimates had been made on this point. the mandate given by the Joint WHO/UNICEF Health Policy Committee, as well as WHO consultants to meet the requirements of govern- Dr. RAJA (India) was of the opinion that, as ments for advisory services on programme deve-the Executive Board and the Secretariat appeared lopment, etc.The estimates for part-time con-to be satisfied that expert personnel would be sultants were based on an average period ofavailable, it was not necessary to pursue the service of two months.The total number tomatter. cover WHO and WHO/UNICEF activities was 34. Therebeingnofurthercomments,the Colonel AFRIDI (Pakistan) made two sugges-CHAIRMAN said he assumed that the committee was satisfied that the programme recommended tions :(1)that when new demonstration teams were set up, they should be established, whenby the Director-General in the Venereal Diseases Section could be carried out in so far as personnel desirable, in international ports ; (2) many countries had no fully established laboratorywas concerned. service and found difficulty in starting such services. Where suchconditions prevailed, 10 011. Rec. World HIM Org. 15, 22 - 153 - COMMITTEE ON PROGRAMME

In reply to a question by Dr. ALLWOOD- Dr. RHODAIN (Belgium) was of the opinion that PAREDES (El Salvador) regarding the distributionbejelpresented an individual problem,and of venereal-disease consultants as between fieldspecial laboratory research should be started. services,regionaloffices andheadquarters, Dr.FORREST,Secretary,explained thatthe consultants were not intended for headquarters Dr. THOMEN (Dominican Republic) asked that but had been recruited to meet the requests ofyaws, a disease very prevalent in many islands governments ; they would be deployed as required of the West Indies, should also be considered. and in consultation with the Regional Directors. Like bejel, it was believed to be non-venereal, In 1950 there would probably be many countriesbut italso seemed to need more laboratory which did not fall within a region and to whomresearch, and, being of a similar nature to bejel consultants would be supplied from headquarters.and syphilis, it would seem proper that it should One consultant would be attached to each regionbe studied by the same committee.Treatment to advise the Regional Director, and the regionalwas similar to that for syphilis but shorter and organization was provided for. easier, and the disease might be completely eradicated. Dr. RAJA asked whether provision existed in the 1950 budget for developing a follow-up Dr. MACCORMACK (Ireland)suggested that programme in association with the work of thechanging the name of the expert committee to teams. " Expert Committee on Acute Spirochaetal Infec- tions " might get over many of the difficulties Dr. GUTHE replied that it was assumed thatwhich had arisen, and it would avoid the necessity demonstration teams would stay in the fieldof appointing yet another expert committee. sufficiently long to teach and train available local personnel, and the regional consultants The CHAIRMAN pointed out that most of the would keep contact with those groups, helpingexperts on the committee had been appointed and advising them on the follow-up of the pro-mainly in relation to syphilis and other usual grammes inaugurated. venereal diseases and it might be necessary to expand the committee to include experts working Dr. RAJA explained that he was referring tospecifically with spirochaetal infections. a follow-up programme in the sense of contact with the homes of the people, education in pre- ventive measures, etc., and he would like to Dr. RAE (United Kingdom) urged that the know if that had been considered as part of thesubject of bejel should be taken up and pursued work of the teams. as efficiently and rapidly as possible. The disease was localized in one part of the world and might The CHAIRMAN suggested that as these teariisbe entirely eradicated. Such a result would have were still in an experimental stage, it was perhapsenormous propaganda value with the lay public early to examine the question of follow-up inthroughout the world. any detail. Dr. BABIONE (USA Technical Adviser) stressed Dr. EL ZAHAWI (Iraq) raised the question ofthe need for scientific research on all three diseases. bejel. Field investigation had established its relation with syphilis and spirochaetoses butBecause of their similarity in immunology, sero- nothing had yet been done by WHO since thelogy, methods of bacteriological study and therapy, item had been considered by the First Healththese three diseases should be studied together. Assembly. The Iraq delegation hoped that a full investigation would be made as soon as possible. Dr. DU JARRIC DE LA RWIÈRE (France) said that venereal diseases, spirochaetoses and syphilis Dr. GUTHE outlined the action so far takencould not be grouped together. The diseases now in regard to bejel following the First Healthunder discussion needed special laboratory study. Assembly.The Expert Committee on Venereal Diseases took the view that it was predominantly of a non-venereal nature. Nevertheless, after Dr. THOMEN agreed, that the different groups consideration of valuable information which hadof diseases required separate study, and suggested been collected by WHO and presented to thethat possibly two expert committees should be thirdsessionoftheExecutive Board,thecreated, one to deal with venereal disease in Executive Board had referred the question backgeneral, mainly from the point of view of epi- to the expert committee and it was on the agendademiology and control, the other to deal with of the committee for its next session, td be heldspirochaetal infections, mainly from the point in October 1949.The Executive Board furtherof view of study and laboratory research. considered that,as most of the information This view was supported by Dr. GRASSET regarding the disease had come from the East(Switzerland) and Dr. PENSO (Italy), the latter Mediterranean Area, bejel should be an item onexpressing the view that, although some spiro- the agenda of the meeting of the East Mediter-chaetal infections had great social importance, ranean Regional Committee, which was also to bethey were wholly distinct from venereal disease held in October of this year. and should be a separate item on the agenda. - 154 - FIFTH MEETING

Colonel AFRIDI, while agreeing with thepre- Dr. TIMMERMAN (Netherlands) was opposed vious speakers, thought it undesirable to multiplyto the creation of any new expert committees or expand the existing expert committees.Hewhere not absolutely necessary, and suggested suggested that the Expert Committee on Venerealchanging the name of the present committee to Diseases might co-opt three members whowere " Expert Committee on Venereal Diseases and experts on the disepses under discussion. Bejel ". The CHAIRMAN, in summing up the discussion, Dr. DUJARRIC DE LA RIITIÈRE considered thatsaid that the desire of the committee would the study should continue of the diseases whichappear to be that WHO should set up machinery were closely akin to venereal diseases, and thatfor further consideration of treponematoses such it should be left to the Expert Committeeonas bejel and yaws, and that it should do so with Venereal Diseases to decide whether such diseasesthe minimum of additional machinery or expense. came within its purview. He asked permission to prepare, together with the Secretariat, a specific proposal to that effect Dr. EL ZAHAWI suggested that a committeeto be placed before the committee at its afternoon should be formed for research and should includemeeting. specialists on yaws and bejel. The meeting rose at 12 noon.

FIFTH MEETING Friday, 17 June 1949, at 3.45 p.m. Chairman: Dr. H. HYDE (United States of America)

1.Veneral Diseases (continuation) The teaching of maternity and child hygiene Agenda, 8.8(section 3 of the report) should be begun in girls' secondary schools, as had already been The CHAIRMAN submitted a recommendationdone in Italy since 1937.Experience in Italy for the setting up of an expert group on trepone-had shown that this method of early teaching matoses (for final text, see tenth report, p. 333,was a good one, as many Italian girls assisted section 1), which he had prepared in the lighttheir mothers in the home from an early age. of the discussion on the subject at the previousCentres for prenuptial orientation and guidance meeting. were of great value :he stressed, however, the Decision: The Chairman's recommendation,pre-eminent importance of maternal and child together with the programme for 1950 onwelfare centres, where the mother was taught venereal directly by the doctor with the example of her diseases(OfficialRecords No. 18,own child-a method which was much more satis- pp. 86-94), was adopted. factory than the use of radio, films and exhibitions. Of course, a certain amount of useful instruction 2.Maternal and Child Health (continuation)could be given to mothers directly by visiting nurses. Agenda, 8.7 On the question of the provision of milk for Dr. FRONTALI (Italy) regretted that he had beenchildren and pregnant and lactating mothers unavoidably absent from the meeting of the(section 4.1.1) stress should be laid on the fact committee at which maternal and child healththat a supplement of milk should be given to had been discussed and said he would like tonursing mothers eveniftheir children were state his country's point of view on the reportentirely breast fed.It had been the experience of the Expert Committee on Maternal and Childin Italy thatif supplementary rations were Health." given only to weaned children, the mothers often As regards the bibliographies to be submittedweaned the child merely in order to obtain an to doctors in charge of maternity and childadditional supply of milk.It would be better welfare centres (section 2 of the report) thetherefore, if, in the order of priorities suggested, material could be summarized in a bulletin to bepregnant and lactating mothers should come sent to all Member countries of WHO. Entirebefore children of pre-school age. articles could be micro-photographed and sent In view of the necessity of assessing accurately on request.Important news and documentsthe effect of dietary allowances on the develop- could be broadcast in a special hour devoted toment of children in determined areas, a recom- maternity and child welfare. mendation should be made that every school be provided with simple apparatus for measuring Oft. Rec. World Hlth Org. 19, 35 the weight and height of its pupils. - 155 - COMMITTEE ON PROGRAMME

In the field of prophylaxis and congenitalclinic doctors included syphilology and dermato- syphilis, experiments had been carried out inlogy. By this means one medical officer instead Italy which did not support the view that syphilisof two could run a child welfare centre.The should be treated only with penicillin and notcourse could be given either by governments or with other antibiotics.It had been proved thatby universities. pregnant women treated only with penicillin He also suggested that a definite form for often gave birthto children with syphiliticpresentation of the annual reports of child welfare symptoms. centres should be evolved, so that the reports of As regards infant mortality studies (section 5.3)all countries might be homogeneous. he would point out that in many countries, including Italy,infant mortality, particularly Dr. WICKREMESINGHE (Ceylon) drew attention that due to nutritional disturbances and acuteto section (2) of that part of the Director-General's broncho-pneumonic diseases, was decreasing, butReport dealing with fellowships,12 which stated : mortality in the first two weeks of life through" Fellowships are limited to graduates, with genital or obstetrical causes was still invariablypreference to senior graduates, except in coun- high.The attention of obstetricians should betries not possessing suitable graduate candidates ". drawn to the urgency of combating this high WHO should visualize the position of certain infant mortality. countries where graduates were not available Turning to the question of the developmentto take advantage of these fellowships. For of programmes in maternal and child healthexample, in Ceylon a scheme of fellowships had (section 6) he stressed that a widespread enquirybeen evolved to supplement the United Nations had been instituted in Italy to ascertain thescheme and covered 65 doctors drawn from the existing nutritional condition of children, thevarious medical branches.Thus, while senior food ration actually consumed and the resultingdoctors had been fully trained, medical and development between 0 and 12 years. The resultsauxiliary personnel had not. However, such of this inquiry would be communicated to WHOpersonnel were prevented from obtaining the as soon as they were complpte. necessary training by the clause to which he had In the field of rural development (section 6.4),referred. To quote a particular instance, a it was necessary to extend maternity and childcandidate sent from Ceylon for a fellowship in welfare centres by means of a capillary systemvenereal diseases had been rejected because he to the most outlying rural districts.In Italy awas not a graduate. system ofso-called" Cattedre ambulantidi Moreover, the clause in question seemed to be puericultura " had been instituted. A physiciancontradictory to the classification on page 21 of specialized in paediatricslived in the ruralOfficial Records No.15, which included two centre and visited daily the other minor centresgroups of fellowships, the first for senior physi- in the district to examine the children assembledcians and personnel, and the second for physicians, there for his visit.Where it was difficult tolaboratory workers, public-health nurses or social obtain suitable premises the doctor and nursesworkers.Some clarification of the point should travelled in a special car equipped with all thebe given. necessary facilities. The lack of nurses and midwives had been The CHAIRMAN replied that the Report of the deeply felt in Italy, particularly as many trainedDirector-General was concerned merely with nurses had found higher wages in other countrieswhat had been done in 1948 and it could be and in international organizations like IRO. Theassumed that a broader policy with regard to problem was essentially one ofsalary, socialfellowships would be followed in 1949. conditions and housing for the nurses. A minimum of both wages and housing facilities should be Dr. DOWLING (Australia)said thatOfficial internationally recommended to avoid undueRecords No. 16 (page 24) showed that most differences in the treatment of nurses. fellowships had been held in the United States. It might be more economical if fellowships were given for countries nearer to those of students and not in dollar countries.In that respect, 3.Training, Education and Fellowships Australia and New Zealand offered a promising field. Agenda, 8.13 Dr. SWEILIM (Egypt) suggested that, in view The CHAIRMAN replied that the suggestion of of the shortage of doctors in his own countrythe Australian delegate had already been discussed and probably in many others, in order to fill theat previous meetings of the Executive Board posts of medical officers in child welfare centresand would be taken into account in the general post-graduate courses for such officers shouldpolicy with regard to fellowships in the future. include both paediatrics and obstetrics, in the same way as the combined course for venereal 12 CV. Rec. World Hlth Org. 16, 24

- 156 - FIFTH MEETING

Activities with theUnited Nations, Specializedfrom Non-Self-Governing Territories was at the Agencies or Non-Governmental Organizations moment preparing itsannual summary and analysis of the data submitted by governments Dr. GRZEGORZEWSKI (Secretariat) said the itemadministering non-self-governing territories. included activities which had been in operationThose data, submitted underarticle73eof for some time, such as the co-ordination ofthe Charter of the United Nations, were being medical congresses, the fellowships programmeprepared for the Special Committee of the Assem- and medical and public-health training. Trainingbly of the United Nations.That committee of auxiliary personnel received special attention,would meet two weeks prior to the forthcoming while the health education of the public was General Assembly. presented as a separate item. The public-health side of the analysis was Collaboration was maintained with UNESCObeing prepared in Lake Success and dealt this on co-ordination of congresses, on the work ofyear with training facilities of technical medical universities, and on such other matters of commonstaff in the non-self-governing territories.The interest as technical training, fundamental edu-subject had been chosen because of the general cation and audio-visual teaching material. interest in technical assistance and as a contri- WHO was also in liaison with other Unitedbution to a larger worldwide survey of training Nations agencies on certain aspects of trainingfacilities. The study would give a short descrip- problems :for example, with ILO on vocationaltion of the local training of physicians, medical education, IRO on medical qualifications, andassistants, nurses, midwives, sanitary inspectors, with UNICEF on international courses in socialetc. The lack of international standards in paediatrics. designations of different categories-for example, of medical assistants,nurses,dressers, etc- A relationship had likewise been establishedmade comparison from territory to territory with several non-governmental organizations inte-rather difficult. He would very much appreciate rested in training problems :for example, withany efforts in the field of standardization which the World Medical Association as regards medical education, with the International Council ofWHO might find possible. Nurses as regards the training of nurses, etc.It was expected that closer collaboration would be developed with those and other organizations Dr.Irina ZHUKOVA (Observer,UNESCO), as WHO activities in that field progressed. after conveying the best wishes of the Director- General of UNESCO for the success of the Health The relationship with the Council for Co-ordi-Assembly, said that UNESCO, from its incep- nation of International Congresses of Medicaltion, had always maintained the closest contact Sciences was of a special kind, since WHO,with WHO. Collaboration had not been confined together with UNESCO, had sponsoredtheto the exchange of observers but expressed itself establishment of that Council, which had met inin joint activities.These activities covered not April 1949 in Brussels. The nature of this rela-only thefieldof natural sciences, but also tionship was outlined in the draft resolution oneducation, the social sciences, mass communi- the subject which was before the committeecation, exchange of persons and so on. (for text, see third report, p. 326). In the field of natural sciences, the Council Collaboration with and assistance to medicalfor Co-ordination of International Congresses of congresses could be effected through the Council without prejudice to other forms of co-operationMedical Sciences had been set up in Brussels in April.That Council was an independent non- carriedoutdirectly with each organization.governmental body which had its legal seat in Advance courses in connexion with internationalBrussels and its Secretariat in Paris. The Direc- medical congresses were also envisaged. tor-General of UNESCO had submitted a draft In the field of fellowships close collaborationbudget for 1950, including adequate funds for existed between WHO, the Social Department ofthe Secretariat and for grants to international the United Nations, UNICEF, and other specia-congresses. At the same time UNESCO was offe- lized agencies, particularly UNESCO, as well asring to the Council premises for its Secretariat internationalnon-governmentalorganizations. and facilities for its general services.She hoped The effectiveness of the fellowship programmethat collaboration between the two organizations depended to a large extent on collaboration ke-would be continued in this field. tween a large number of institutions, both public and private, which agreed to accept the holders TheInterimCo-ordinatingCommittee on of WHO fellowships. Medical and Biological Abstracting had met from 1 to 4 June 1949 and had been attended by repreSentativesofbiological and medical Dr.BARKHUUS,SeniorMedicalSpecialist, abstracting services of Europe and the Western Department of Trusteeship and Information fromHemisphere. She was glad that WHO was Non-Self-Governing Territories, United Nations,actively participating in that project and quoted said the United Nations Division of Informationa resolution passed by the above committee

- 157 - COMMITTEE ON PROGRAMME which recommended thatsuchparticipation Co-ordination of International Congressesof should continue. Medical Sciences : Proposed Collaboration with The UNESCO FieldScienceCo-operation the Permanent Council Offices which were now operating in the Middle East, India, South Asia and Latin America were The CHAIRMAN saidthatOfficialRecords co-operating with the regional offices of WHO toNo. 18 (page 163) outlined the result of nearly avoid duplication of work. two years' work in collaboration with UNESCO towards the establishment of the Council for In the field of education, co-operation betweenthe Co-ordination of International Congresses the two organizations on the various educationof Medical Sciences. There was a proposed draft projects was essential.The Education Depart-resolution for submission to the Second World ment. of UNESCO was also keenly interested inHealth Assembly before the committee (for final various topics relating to school health, of interesttext, see third report, section 2). to WHO. Dr. MACCORMACK (Ireland) asked for informa- In connexion with the International Council oftion concerning the text of the resolution as Universities which had recently been established,compared with that of the original resolution the Secretariats of both WHO and UNESCOadopted by the First World Health Assembly." had been in close co-operation, while in the field of social sciences, projects on tensions affecting The CHAIRMAN, referring to page 323 of Official international understanding and the study ofRecords No. 13, explained that the Director- international co-operation should be ofcon- General, in accordance with instructions, had siderable interest to WHO. opened negotiationswith UNESCO forthe The UNESCO clearing house for publicationstransfer to WHO of responsibility for the co- was continuing to promote the direct exchangeordination of international congresses of medical sciences, but that UNESCO not being prepared of medical publications between libraries in allto agree to such a transfer, the Director-General States Members of UNESCO. had decided to proceed on a co-operative basis. In close co-operation with UNESCO, CARE (Co-operativeforAmericanRemittancesto Dr. FORREST, Secretary, pointed out that the Europe) had decided to start a book programmeaction of the Executive Board was explained for distributing large numbers of books to institu-on page 22 of Official Records No. 14, and that tions in war-damaged countries.These booksas the Council was now established as a non- would be chiefly concerned with medicine andgovernmental organization, no single body could public health. take it over. The UNESCO Book Coupon Scheme had been operating successfully since last December with Dr. MACCORMACK said he was satisfied with the active participation of Czechoslovakia, France,the explanation. Hungary, India, Switzerland, United Kingdom The CHAIRMAN said that the committee would and the United States of America.It was beingnow have to take a decision on the draft resolu- extended to other countries. The other specializedtion, which would govern the relationship be- agencies of the United Nations had been requestedtween WHO and the Council of International by UNESCO to devote some of their hard cur-Congresses of Medical Sciences under the provi- rency reserves to the implementation of thissions of the programme set forth on page 163 scheme, which should be of particular interestof Official Records No. 18. to WHO. Finally, another field in which UNESCO and Dr. BARRETT (United Kingdom) raised the WHO could continue to co-operate was thequestion of the financing of the Council which, exchange of persons. it had been generally understood, would even- The above summary of the fields in whichtually become self-supporting. He asked whether both organizations were interested demonstratedthe draft resolution covered that point, and also the possibility of carrying out joint projectswhat would be the relationship of the Council, without duplication.As the activities of theas a non-governmental body, to WHO. two organizations grew in importance, fields of common interest would necessarily enlarge. Dr. GRZEGORZEWSKI explained that the desire of WHO to see the Council self-supporting in future had been communicated to it, but that Dr. GRUT (Observer, ILO) transmitted to thethe financial situation of the Council and its committee the good wishes of the Director-Generalmember organizations was unsatisfactory and of the International Labour Organization andWHO would have to contribute towards it, to stated that ILO was interested in the trainingcover its needs until it was able to support itself. of nurses and midwives not only frorri the point The General Assembly of the Council had decided of view of their recruitment and registration butthat all its member organizations should con- also from that of their general working condi-tribute financially to its work, but the sum tions, salaries and organization ;the technicalexpected from that source would be rather small. training of nurses was especially important in underdeveloped countries. 18 011. Rec. World Hlth Org.13, 323 - 158 SIXTH MEETING

Dr. BARRETT proposed that the following words was adopted, together with the draft resolu- be added to the end of paragraph (6) of the draft tion regarding co-operation with UNESCO resolution :" ... with a yiew to the Council (for texts, see third report, section 2). becoming financially independent. " The CHAIRMAN then read a letter received Dr. GEAR (Union of South Africa) thoughtfrom Professor Maisin, President of the Executive that such points should be submitted also to theCommittee of the Council for the Co-ordination Committee on Administration and Finance. of International Congresses of Medical Sciences and observer for the Council.After expressing The CHAIRMAN stated that it was a matter ofhis regret at being unable to be present any policy appropriate to the Committee on Pro-longer at the World Health Assembly, Dr. Maisin gramme, but that it would nevertheless be con-in his letter thanked WHO for inviting him to sidered later at a joint meeting with the Com-attend in the capacity of observer. The opportun- mittee on Administration and Finance when theity thus given him to come into contact with items on page 163 of Official Records No. 18 wereWHO had enabled him to appreciate the signifi- raised. cance of the work being undertaken and the importance of enabling doctors and medical Dr. GRZEGORZEWSKI, in reply to a query raised scientists from all over the world to assemble by Dr. BARRETT on paragraph (5) of the drafttogether and reach conclusions of great benefit resolution, thought that any available fundsfor the health and welfare of humanity. He also in the possession of WHO should be used onlyexpressed his satisfaction at the interest shown for activities approved by WHO. by the Health Assembly in matters of medical As regards the question of relationship be-education and other training problems. tween WHO and the Council, the position was It was stressed by Professor Maisin that the not the same as in the case of the relationshiporganization of which he was president was between WHO andothernon-governmentalanxious to collaborate fully in the achievement organizations, because the Council was establishedof the aims that had been set before the World with the support of WHO. The matter wouldHealth Organization, and he hoped and believed be taken up at the fourth session of the Executivethat the interest which WHO had already shown Board. in his organization, as already evinced by the allocation of funds, would continue to grow. The CHAIRMAN pointed out that the Executive Board had authority to admit non-governmental Decision: The programme for 1950 (Official organizations into relationship with the WHO. Records No. 18, p. 163) was approved by the committee. Decision: The draft resolution as amended by the proposal of the United Kingdom delegate The meeting rose at 6.15 p.m.

SIXTH MEETING Saturday, 18 June 1949, at 9.30 a.m. Chairman: Dr. H. HYDE (United States of America)

1.Training, Education and Fellowships (con- fellowships programme.Distribution of fellow- timiation) ships among the programme subjects depended Agenda, 8.13on the requests from governments and on the availability of training facilities.The Director- Technical Training of Medical and AuxiliaryGeneral must have responsibility and discretion Personnel: Programme for 1950 to meet requests in such a way that the maximum The CHAIRMAN said that the item was one ofbenefit would result. the most important in the work of WHO. The programme for the training of auxiliary Although an expert committee was proposed,personnel met the suggestions put forward at the none existed as yet and there was consequentlyprevious meeting by the delegate of Ceylon for no exiiert report to serve as a basis for discussion, a broadening of the scope of that activity. but the committee had before it the views of the Chapter 7.5.1 of Official Records No. 18 was Director-General and the Executive Board. Whileconsidered section by section. all members would have ideas on medical training, the discussion should be confined to general The Problem and its Significance policy. The programme for the technical training of Dr. RAJA (India) stressed the importance of medical and auxiliary personnel covered thethe training of nurses.While India hoped soon - 159 - COMMITTEE ON PROGRAMME to have an adequate supply of nurses for the Dr. DE PAULA SOUZA (Brazil) said it was difficult care of the sick, there was a ,dire shortage ofto discuss this important subject without a public-health nurses, who were essential to th ereport from an expert committee. extensionofhealtheducation,mother and The teachingof public health and social child care, and domiciliary services.A collegemedicine should form part of the normal medical of nursing of university standard had been startedcurriculum during the whole of the period of in India but in view of the backward conditionstraining, and not, as in many schools at present, hitherto prevailing greatdifficulty was beingbe an additional subject at the end of the course. experienced in finding teaching staff. He appealed The introduction of public health into the normal to WHO for help in securing such staff, parti-medical training at an early stage had been done cularly over the next three years.No progresswith success in the United States of America in the control of the excessively high child andand he hoped that the same procedure would be infant mortality rate could be made without anadopted elsewhere in existing schools and in the increase in the number of public-health nursesschools to be set up in parts of the world which and an intensified control over the homes andnow lacked training facilities. living conditions of the people. In countries such as India, with large rural The CHAIRMAN assured the committee that populations, trained auxiliary personnel couldthe importance of introducing public-health train- contribute greatly to the extension of medicaling into the medical curriculum at an early and preventive care to villages and countrystage would be referred to the expert committee. areas,through such work as DDT-spraying, There were no remarks on the following two inoculation against infections diseases and minorsections," Examples of previous international sanitary undertakings.Moreover, it was easierwork " and " Objectives ". and quicker to train such auxiliary personnel than fully qualified doctors. However, the train- Work to be done in 1950 ing of auxiliary personnel was relegated to the Supplemental Budget; some provision for this Dr. GRZEGORZEWSKI (Secretariat)said that activity should be included in the Regular Budget the programme for 1950 would require 15 full- for 1950. time consultants for organizing training courses and lectures in schools and seminars for medical, The CHAIRMAN said that the Director-Generalpublic-health and auxiliary personnel.Thirteen wbuld be asked to take note of the statement ofshort-term consultants would also be required. Dr. Raja when preparing the detailed programme It was proposed that WHO should convene within the broad limits of the programme ap-two conferences (one in the Western Hemisphere proved by the Assembly. He would also be askedand one in Europe) of about 15 directors of to pass those remarks to the expert committeepublic-health schools.WHO would also share should the Assembly decide to establish it.Thethe cost of the World Conference of Universities presentcommittee was concerned withtheto be called by UNESCO, if a programme on general programme :it would be for the jointmedical education were included. meetings of the Committees on Programme and It was intended that as far as possible trainees Administration and Finance to allocate prioritiesshould be sent to suitable existing schools within and decide the content of the Regular and Supple-their own regions.Such schools would require mental Budgets. encouragement in the form of equipment and technical advice if they were to adapt them- Dr. WICKREMESINGHE (Ceylon) welcomed theselves to receive an increased number of students. Chairman's assurance that the Director-GeneralIt might also be necessary to pay the travel fares would have latitude in the allocation of fellow-of the trainees and give them a stipend. ships. His country was setting up a cancer The expert committee might require a special institute, and help from WHO on that subjectsub-committee to consider the training of auxi- was essential. He hoped that among the fellow-liary personnel if the programme were adopted ships allotted to their region, Ceylon would beby the Assembly. able to have specialists in the subjects (even if Five hundred and fifty fellowships were pro- they were not among WHO priorities) in whichposed for 1950. help was needed.There was sometimes some difference of opinion within the regions on the Dr. RADA Rapporteur, speaking as delegate allocation of fellowships. of Iran, thought that in view of the importance of the fellowship programme, the number of The CHAIRMAN said that the aim of the fellow- ship programme was to further the total pro-Fellows should be increased in 1950. gramme of WHO. Although primarily devoted to the priority subjects, there was nothing to The CHAIRMAN said that that was a matter for prevent fellowships being given for other prob-the joint meetings of the Committees on Pro- lems of special importance. gramme and Administration and Finance.

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Dr. BRISKAS (Greece) said that the chapterclear that efforts were being made to decentralize under consideration was one of the most impor-training,usingfacilitiesnear the pointof tant in the programme as it formed the veryorigin of the student to the maximum degree structure of WHO. possible. In connexion with medical training, emphasis had been laid in 1948 on paediatrics and other Dr. DOWLING (Australia) stressed the value of branches for which existing training facilitiesthe contribution made by Dr. Holm. There was were inadequate, and a motion to that effect had been passed." He emphasized that a recommen-real risk of individual fellowships in many cases dation should be made to governments to thedeveloping into a sort of tourism. There should effect that the uniN.rersities should provide trainingbe specified courses in certain institutions to in paediatrics at the end of the normal medicalwhich Fellows should be directed. He urged that course. By that means the countries wouldthe Secretariat consider the matter very seriously acquire a medical corps competent in all branchesfrom the point of view of directing the fellow- of modern medicine.Provision should also beships into the channels whence the maximum made for the improved technical training ofbenefit could be derived at the lowest cost. nurses.The training of these two categories of personnel would form the basis of a country's health services. Dr. SImoisrovrrs (Hungary) agreed that regional Fellowships should only be given to a feworganizations must be strengthened,so that advanced specialists who in a given time wouldpersonsto whom fellowshipsweregranted be able to understand all the recent scientificmight be able to study in countries within developments in their own subject in the countrytheir region. to which they were sent, and who would be able on their return to spread the knowledge thus Dr. BARRETT (United Kingdom) said that gained. pr. Holm's proposals were fully supported by The programme should be developed on thoseexperience in the United Kingdom.He added lines according to the means at the disposal ofthat the Fellow should have a very good know- the Organization. ledge of the language of the country of study before he arrived in that country, so that he The CHAIRMAN said that the Director-Generalcould discuss symptoms with a patient accu- would take note of the remarks of the delegaterately and sympathetically. Without this qualifi- of Greece. cation a fellowship might well prove to be of Dr. HOLM (Denmark) said that the sending oflittle value. individual Fellows to places far from their home areas tended to be a burden upon the institutes Colonel AFRIDI (Pakistan), while in general and was only moderately successful.Many ofagreement with Dr. Holm, warned against the the Fellows were unable to apply their newpossible danger of certain undeveloped areas knowledge to their own local conditions.Shortbeing satisfied with the level of training of per- regular courses for group training were required,sonnel in their regions :it was necessary to such as had recently been started in Copenhagenguard against a regionalized and parochial spirit. in tuberculosis. WHO should give direct helpSocial and cultural contact with foreign countries in equipment, salaries and teaching personnel todid much good, and where institutions had to suitable institutes in areas needing assistance.be started in a new country it was valuable For example, one of the five new tuberculosisto havemen aiminginwiththewider training centres to be established in India could, outlook. with the help of WHO, become an international centre for South-East Asia.A change in the Sir Arcot MUDALIAR (India) pointed out that Organization's policy would be required to allowmedical education differed greatly in different it to sponsor national training centres (whichregions :it would be well for WHO to give at would, in fact, become international centres)least a minimum concept for efficient medical and provision for that purpose should be madetraining, including public health. in the budget. Fellowships might be grouped under two headings : junior, possibly for younger men, The CHAIRMAN said that Dr. Holm had raisedwho should be given a definite period and pro- a most important question of programme policy.gramme of specialized training in consultation His suggestions envisaged a change in the train-with experts in WHO ;senior, for men of senior ing policy of WHO, which had hitherto beenstanding who were in a position to be more largely, though not entirely, focused on indi-receptive to the advances in different specialized vidual fellowships. A point regarding regionali-subjects in different parts of the world. He zation had already been discussed and it waswarmly endorsedDr. Holm'ssuggestionof grouptrainingincertainspecializedfields : 34O. Rec. World Hlth Org. 13, 310 several students from one country could be

- 161 - COMMITTEE ON PROGRAMME trained together and would then be able to startwritten suggestion of three points as a basis for a centre together. discussion ;these were read by the Chairman The strengthening of institutions in the differentto the meeting. countries was most important.At some stage fellowships would naturally decrease and there Decision :That a working party be set up should be more important institutions established consistingofrepresentativesofHungary, in the different regions for the thorough training Pakistan,Denmark,the United Kingdom, of persons of all the countries in the region Australia,India, the Philippines, Uruguay, concerned. Brazil and Czechoslovakia to study the follow- As regards the personnel engaged in regional ing suggestions and report to the Committee training, they must be sent out for sufficiently on Programme : long periods to make their influence felt.It was (1)that WHO should concentrate more on no use going for only short periods of study ; arranginggrouptraininginthespecial they had to learn the conditions of the country fields of public health, giving assistance to and to make their impress on the training centres national institutions for arranging courses, and and it would be most helpful if, to that end, should limitindividual fellowshipsto key experiencedpersonswereavailablefor .the personnel ; starting or the upgrading of certain of those (2)that WHO should take active part in centres in the various regions. the establishment of such training centres in the different regions,especially the regions The CHAIRMAN proposed that, in view of the where training of personnel was most needed ; extreme importance of the points raised by (3)provision for such assistance should be Dr. Holm, a working party consisting of repre- made in the programme. sentatives of Hungary, Pakistan, Denmark, the United Kingdom, Australia, India, the Philippines, Uruguay, Brazil and Czechoslovakia should be Dr. TAGAROFF (Bulgaria) suggested that, if the established at a later stage in the proceedings,proposal regarding training of Fellows in special to prepare and present to the committee recom-groups were accepted, it would be advisable to mendations as to what changes should be madeinstitute examinations at the end of their instruc- in the programme.In the meantime discussiontion, which should have a stimulatingeffect would continue. on their work and produce better results. Dr. GRUT (Observer, ILO) wished to make two Dr. GEAR (Union of South Africa), on a pointobservations on behalf of his organization regard- of order, informed the meeting that the Committeeing the technical training of medical and auxi- on Constitutional Matters had ruled that aliary personnel.First, the programme should working party could not concern itself withnot only have in view the technical training of matters of policy.It would appear thereforehealth personnel but should also include other that a working party could not concern itselfaspects of the work, such as social security. with such a basic matter of policy as the creation Secondly,inviewoftheinclusioninthe of international centres of medical educationprogramme of the training of nurses, his organi- and hygiene. zation would like to know whether WHO was concerned only with the technical training of The CHAIRMAN said that the working party ifthe nurses or whether it was also concerned with established would take no decisions :it wouldthe social conditions of nurses after their training. merely try to crystallize the points of viewIn the latter case, this being a field in which his which had been expressed on certain very impor-organization was particularly interested, ILO tant programme matters, in order to expedite thewould like the closest co-operation to be estab- decisionsof the committee at a subsequentlished. meeting. Such a procedure would appear to be within its competence. The CHAIRMAN assured Dr. Grut that, as in the past, there would always be complete co-operation Dr. EJERCITO (Philippines) agreed with theand co-ordination with the International Labour views expressed by previous speakers and addedOrganization. Under another item of the agenda that he was in favour of the proposal for havingthere was a proposal for an expert committee centresforthe regions which were groupedon nursing. Dr. Grut's remarks would be brought together. That had proved practical in the pastto the notice of the Director-General with the and would no doubt prove practicalagain.request that they be transmitted to that committe Conditions in undeveloped countries were different, and thattheDirector-Generalconsiderthe and workers must be trained accordingly, appropriateness of inviting ILO to meet with that committee. The CHAIRMAN asked whether the committee would decide at this point whether it was desired Dr. FRASCHINA (Switzerland)consideredit to establish a working party constituted as henecessary that all countries which were Members had suggested. Dr. Holm had handed in aof WHO should agree in principle to reciprocal

- 162 - SIXTH MEETING t recognition of university medical degrees. Tomedical problems. United Nations practice was, achieve this a minimum standard would have towherever there seemed a desire, for a particular be agreed which would enable all medical practi-reason, to deal with problems of social welfare, tioners to practise in all countries.'In someto encourage one national group to invite the countries, at present, there were too many doctorsUnited Nations to hold a seminar in that area for the needs of the people, and in others too few.on subjects of importance to the whole region ; The same remarks would apply to nursing per-it was generally found that the countries in the sonnel, but not to chemists, because there wereregion were anxious to co-operate.The United still differences between the national pharma-Nations usually sent eight lecturers, for whom copoeias. it paid, and encouraged the countries concerned to provide an equal or greater number of local The CHAIRMAN drew attentiontoOfficial lecturers. A considerable amount of money had Records No. 18,on page 124 of which " tobeen allotted for this purpose.He suggested ascertain that high standards of training arethat the United Nations and WHO might co- internationally accepted and followed " was givenoperate in holding some of these seminars :he as a long-term objective.A beginning waswas sure the Director-General would regard such being made towards this aim in the presenta proposal favourably and the money available programme. could perhaps be spent with the closer co-ope- ration of WHO and to its greater benefit. WHO might care to consider joint seminars on sub- Health Education of the Public:Programme forjects of joint importance from the social and 1950 medical point of view during 1950. The CHAIRMAN, in introducing the item, said that the programme proposed by the Director- The CHAIRMAN expressed the great appre- Genera115 represented a beginning in this impor-ciation of the committee for the constructive tant field, providing an opportunity for collationand helpful suggestion made by Sir Raphael of information. Cilento on behalf of the United Nations.It would be brought to the attention of the Director- Dr. DOWLING stated that, while not denyingGeneral so that it might receive favourable con- the importance of the subject, his Governmentsideration and result in development along the was not convinced that it was an essential onelines suggested. at the present stage of development of WHO, being a matter more for national governments Dr. PENSO (Italy) agreed with the delegate of than for international organization. Australia that health education of the public was a national and not an international problem. Dr. RAJA disagreed. In countries where generalIndeed the programme proposed was limited to education was not at a high level it was essentialthe collection and dissemination of information. that something should be done to promoteIn paragraph 7.4.13.1 of Official Records No. 18 health education on as wide a scale as possible, there was confusion between the simple elements and assistance given to national governments byof health education given to the public and the WHO with advice and, where necessary, equip-more detailed courses for . professional men such ment, would be of the greatest value. as architects and school-teachers.There was also a disparity between the small programme Dr. FORREST, Secretary, said it would beproposed and the comparatively large budget apparent from each item of the programme thatprovision. health education of the public, as well as being regarded as an activity in itself, was an essential part of all activities of the Organization ;it The CHAIRMAN took Dr. Penso's remarks as would be a focal point for all experts going outseconding Dr. Dowling's proposal to delete the on demonstration teams, etc. item from the programme. Sir Raphael CILENTO, Director, Division of Dr. EJERCITO opposed thedeletion. The SocialActivities,UnitedNations,drew thedevelopment of an " informed public opinion attention of the committee to the importanceamong all peoples on matters of health " was a of the seminar, especially the regional seminar,constitutional obligation which must be imple- in the education of the public and the develop-mented. ment of various aspects of particular health problems ;it was most valuable in areas which The CHAIRMAN said that all work of WHO were just beginning to enter into active co-contributed to an informed public opinion on ordinated work in public health and generalhealth matters. The point at issue was Whether or not a focal point for health education of the 15 Off. Rec. World Hlth Org. 18, 116 public was required.

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Dr. RAJA said that all aspects of public healththat considerable expenditurewas inappropriate formed a part of national responsibilities.Ifat the present time when there was more important WHO were concerned with international res-work to be done. ponsibilities only its activity would cease. Health education was too important an item to be deleted. Dr. DOWLING confirmed that he had madeno formal proposal. Dr. SIMONOVITS supported that view. No progress in public health was possible without The CHAIRMAN, in the absence of,any definite widespread health education. proposals, said that Dr. Penso's suggestionson the budgetary allocation for this item would Dr. GOOSSENS (Belgium) said the question was be considered by the Joint Meetingon Pro- one of priorities which had been already partlygramme and Administration and Finance. solved, in that the item was in the supplemental budget only. Decision: The committeegavegeneral approval to the programme on health education Dr. PENSO thought that the programme for of the public as stated inOfficial Records 1950 should be limited to the most important No. 18, section 7.4.13. activities.Whilst he had been misinterpreted as supporting the deletion of the item, he considered The meeting rose at 1.15 p.m.

SEVENTH MEETING Monday, 20 June 1949, at 9.45 a.m. Chairman: Dr. H. HYDE (United States of America)

1.Adoption of Draft Reports of the Committeewas summarized on pages 34 to 36 of Official Records No. 16.Publications proposed for 1950 Decision :The committee adopted its draftwere described, with estimates of cost, on pages second report to the Health Assembly with 128 to 131 of Official Records No. 18. The number minor drafting changes (final text, p. 325), andof editorial and translation staff required to its draft first report for consideration by theexecute the 1950 programme was shown on Committee on Administration and Finance 16page 132. with the deletion of 'the final two paragraphs. A substantial part of the time of this staff would be occupied in necessary duties having 2.Editorial and Reference Services no direct relation to publications. These included editorial assistance in the preparation of docu- Agenda, 8.20ments, editorial assistance at meetings, super- Dr. HOWARD-JONES,Director,Divisionof vision of précis-writing, translations, etc. Editorial and Reference Services, said that a When WHO was permanentlyestablished, general account of the publications policy whicharrangements had been made for the centrali- had been proposed by the Interim Commissionzation of all medical documentation activities and endorsed by the First World Health Assemblywithin a single unit.These activities included was contained in Official Records No. 12, pagesthe selection of material for publication, editing, 18 to 22. A short explanatory note on eachtranslation, bibliographical and reference work, publication was printed in Ogcial Records No. 18, typographical preparation of manuscripts and pages 128 to 129. arrangements for sales and distribution.Such Sonie of the publications referred to had nota unit could not be built up effectively within yet appeared but copies Of those which hada few months and the first priority afforded to could be obtained by delegates on request. the Official Records inevitably involved some Editorial,translationandreferenceworkdelay in the issueoftechnical publications. accomplished in the last four months of 1948Nevertheless, considerable improvement had been made and output was steadily rising.In the 10 Since this report was a working paper only, it isfirst quarter of 1949 over 2,000 printed pages 17 not published as such. Decisions taken on the basis of the recommendations it contained were sub- " Not includingtheWeekly Epidemiological mitted to the Health Assembly in the regularRecord and the Epidemiological and Vital Statistics reports of the committees. Report - 164 - SEVENTH MEETING had been issued and over 800,000 words trans-governments. He would like to repeat this lated. The programme of publications for 195018proposal in the committee, as such an exchange involved an output of over 18,000 printed pages,would prove extremely useful. or some 80 pages per working day. Finally, he associated himself with the remarks To the information on Library and Referenceof the United States delegate as to the importance Services," it should be added that the greaterof the utilization and distribution of publications. part of the library of the Office International d'Hygine Publique had now been transferred Dr. HOWARD- JONES said that only one number to the WHO library, and a request for the loanof the International Digest of Health Legislation of specific material to the WHO library from thehad so far been published, but material was now United Nations Geneva library had been madeavailableforapproximately one and a half by the Director-General of WHO to the Secretary-numbers and the second number was expected General of the United Nations. The letter con-at the end of July or the beginning of August. taining this request would be discussed at theThe delay was due to the need for examining, gth session of the Economic and Social Council.classifying and translating the information on The last item under the general heading oflegislation received from various countries. This Editorial and Reference Services (medical and bio-was a considerable task. logical abstracting-collaboration with UNESCO) As regards the Italian suggestion that WHO was briefly described on page 166 of 0 fiicialshould sponsor an exchange of medical literature Records No. 18. Earlier in 1949 an observer frombetween countries, he recalled that the proposal WHO had attended a further meeting of thein question had been referred to the Executive Executive Committeeof UNESCO's InterimBoard, which had transmitted a recommendation Co-ordinating Committee on Medical and Biolo-to the Director-General that a questionnaire be gical Abstracting and also the second session ofsent to governments, asking what deficiencies the Interim Committee which had taken placeexisted as regards publications, and the reasons from 1 to 4 June. At th'at meeting the Interim This recommendation had also been Committee had proposed that it should becomefor them. a permanent committee and that its scope besent to UNESCO, which was actively concerned extended to include the indexing of medicalin the problem of exchanging publications be- and biological literature. tween countries. UNESCO had stated that the proposed questionnaire was undesirable, since it Dr. SCHEELE (United States of America) saidwould duplicate others which UNESCO itself the publications programme was a very importanthad initiated. Moreover, UNESCO had a clearing- field, and one in which broad planning washouse for publications. Discussions with UNESCO required. However, the report on publications,"were not yet completed, and some time would be while providing many details as to the numbernecessary before a specific policy could be evolved of publications, the number of pages they con-which defined the appropriate fields of action of tained, and the number of personnel involved,the two organizations. made no mention of the ways in which these publications were to be utilized or distributed. Dr. BERNARD (France)afterstressingthe Moreover, there were certain gaps in the budgetaryimportance attached by his delegation to the estimates for publications and, in particular, nopublications programme, and expressing his agree- mention was made of how much money was toment with the statement made by the United be retrieved by sales. States delegate, said three points should be borne in mind regarding the International Digest of Professor CANAPERIA (Italy) agreed with the Health Legislation.First, the Digest had to be United States delegate as to the importance ofcomplete ;it would have to contain all legis- the publications programme and congratulatedlation concerned with the maintenance of health the Secretariat on the report it had submitted.in the world.Secondly, there was the problem At the present time, when social medicine wasof selection.All the texts to be published did evolving rapidly in the various countries,itnot possess the same interest :some would have was vital that all governments should be informedto be published entirely, others summarized, and of the latest developments.In this respect, theothers merely cited.Thirdly, the Digest should International Digest ofHealth Legislation, thebe kept as up to date as possible, and its numbers first copy of which he had seen that morning,appear at sufficiently regular intervals, so that was far from being complete. The Digest shouldthe latest information on national health admi- be published regularly and brought to the noticenistrations could always be obtained. of all governments. Finally, he stressed that the Manual of the Secondly, the Italian delegation at the FirstInternational Statistical Classification of Diseases, World Health Assembly had proposed that healthInjuries and Causes of Death should be published publications should be exchanged between allin French and Spanish as soon as possible.

18 011. Rec. World Hlth Org. 18, 130 Dr. GRASSET (Switzerland) said that publi- 18 Off. Rec. World Hlth Org. 18, 157 cations should not only be considered from the " 011. Rec. World Hlth Org. 18, 128 point of view of information, but also from the - 165 - COMMITTEE ON PROGRAMME point of view of their importance in university Dr. DOWLING (Australia),whilst approving and higher education. He himself had often hadthe publications programme, asked why in the occasion to use information of an epidemiologicalbudget estimates 21 three times as much money character in his university teaching. This aspecthad been allocated for travel and transportation of publications should be borne in mind. in 1950 aS had been allocated for the same num- bers of staff in 1949. Sir Raphael CILENTO, Director, Division of Social Activities, United Nations, said that the Dr. HOWARD- JONES replied that this was a field of publications was one in which the Unitedmatter for the Committee on Administration Nations and WHO could assist each other. Oneand Finance. He understood that a global sum of the principal activities of the United Nationsfor travel had been estimated for the whole was the collection of statistics, and here co-organization and divided among the various operation with WHO was already working well. di:visions. However, certain difficulties had been encoun- tered. In the first place, statistical information Sir Arcot MUDALIAR (India) said the Inter- collected by the United Nations and the specia-national Health Y earbook was anextremely lized agencies had not always been drawn fromuseful publication, but might well include infor- the same sources and minor inconsistencies hadmation on educational facilities, including special resulted which had proved embarrassing. Secondly, CourseS. governments resented what he called the double Secondly, the need for keeping publications as approach, that is, enquiries made twice to theup to date as possible should be stressed.For same department or sometimes even to differentexample information concerning the year 1949 departments.These difficulties would be elimi-should be made available before the end of 1950. nated by increased collaboration. If it were published later that information would He had already referred to the assistance givenbe stale. Regional directors might assist in collec- by WHO in the preparation by the Unitedting information as rapidly as possible to obviate Nations of a report on child welfare.That wasthis difficulty. a topic on which collaboration with WHO was absolutely essential. The information so far Dr. HOWARD- JONES replied that it was extre- submitted by governments for inclusion in themely difficult to include material for any given report had not been exactly of the type required.year in a Yearbook which would appear in the It was hoped to evolve a questionnaire forfollowing year.The material was usually based obtaining the necessary information which shouldon information submitted by governments which be comparable and cover equally the social andinvolved a certain delay ; moreover, certain health aspects of child welfare.The assistanceinformation was based on the calendar year of WHO would be welcomed in the preparationwhile other data were based on the financial of this questionnaire. year.It would therefore be extremely difficult to include in a 1950 Y earbook data later than Dr. FORREST, Secretary, said that the Co-those for 1948. ordination Committee, which was composed of the Secretary-General of the United Nations and Dr. BARRETT (UnitedKingdom)doubted the Directors-General of the specialized agencies,whether the International Health Y earbook in had set up a special working group on publi-itspresent form served any useful purpose. cations which was functioning well and preven-If two years were required for compiling data ting considerable duplication of work. then it was obvious that those data would be out Moreover, it was the general policy that anyof date. Moreover, all the information contained international organization desiring to send outin the Y earbook was to be found in the health questionnaires should clear those questionnairesreports submitted by governments and it seemed through the other organizations. unnecessary to repeat them. The committee The specific question of the co-ordination ofshould thereforeconsider how the Y earbook statistical work would more profitably be discussedcould be rendered more up to date. later in the agenda. The CHAIRMAN drew attention to Article 61 Dr. GEAR (Union of South Africa),afterof theConstitution, which stated : " Each agreeing with the statements of the UnitedMember shall report annually to the Organization States delegate as to the importance of publi-on the action taken and progress achieved in cations, said the first number of the Internationalimproving the health of its people." This article Digest of Health Legislation showed that therehad so far not been implemented but it was had been considerable difficulty in analysing theexpected that it would be carried into force the material. The problem was largely one of selection,following year.The committee should therefore since a large proportion of the information givendecide whether it was worthwhile continuing was not useful. publication of the Y earbook or whether it was He suggested therefore that the position shouldbetter to waittillthe governmental reports be reviewed at the next Assembly and in particularbecame available. the best method of analysing material on legis- lation should be ascertained. 21 Off. Rec. World Hlth Org. 18, 47 - 166 - EIGHTH MEETING

Dr. BARRETT proposed that publication ofand revising the list concerned with free distri- the International HealthYearbook should bebution was a never-ending one. As regards paid suspended until the matter could be discusseddistribution, and the income thereby obtained, more fully. it should be stressed that some publications, such as the Official Records and the International Professor CANAPERIA seconded theUnitedDigest of Health Legislation,were essentially Kingdom proposal. uneconomical propositions and could not pay their way.Publications such as the Bulletin Decision:On being put to the vote theand the Chronicle might be expected ultimately United Kingdom proposal was adopted byto produce a material amount of revenue.As 23 votes to 3. an example of an attempt to bring WHO publi- cations to the notice of potential subscribers, In reply to the CHAIRMAN, Dr. HOWARD- JONES he would quote the example of the United States explainedthattheTreatment andControlPublic Health Service, which had transmitted Manuals were to be small practical handbooks7,600 copies of the Chronicle, with subscription summarizing recent techniques of treatment orforms, to all recipients of the United States prevention. They would be published onlyPublic Health Reports.WHO would be glad with the approval of the appropriate expertto repeat any such distribution on request from committee. other health administrations. Figures for the sale of publications were as Dr. MACCORMACK (Ireland) said that the main follows : in 1947 2,300 Swiss francs, in 1948 problem raised by such handbooks was one of9,000, and during the first quarter of 1949 48,000 , distribution within the various countries.The (a substantial part of the last figure being due work of the Secretariat would be greatly facili-to sales of the Manual of the International Sta- tated if governments were given advance noticetisticalClassification of Diseases, Injuries and of what manuals were to be published so thatCauses of Death). they could inform the Secretariat of how many In reply to the delegates of France and the copies they wanted and in what languages theyUnion of South Africa, he stressed that the first should appear. number of the International Digest of Health Legislation was not typical because it was mainly The CHAIRMAN replied that the Manuals wouldan improvisation. The second number should be only be published in the working languages ofat once more complete and selective, and would WHO and that if governments wanted them in contain an index of all health legislation identified. other languages they would have to make their As regards the International Health Y earbook, own arrangements.He stressed that unfortu-the Director-General had recently set up a small nately WHO could not distribute publicationsworking group with the task of studying the on the scale on which it would have liked to do so.form that a year book should take, with .particular reference to the annual reports received from Dr. HOWARD- JONES, summarizing the pointsgovernments. raised in the discussion, said that the problem of free distribution was one receiving particular Decision:The committee, after the above attention from the Director-General and that a observations, approved the publications pro- revision .of policy was to be expected in the near gramme for 1950(Official Records No.18, future.Distribution was of two kinds-free and pp. 128-131), excluding the International Health paid-and the broad categories of free distri- Yearbook. bution were to be found in a table on page 19 of Official Records No. 12. The task of expanding The meeting rose at 11.40 a.m.

EIGHTH MEETING Monday, 20 June 1949, at 3.30 p.m. Chairman : Dr. H. HYDE (United States of America)

1.Editorial and Reference Services (continu-the provisional estimate of $8,500 for books and ation) periodicals had been drawn up when the number Agenda, 8.20of technical staff of the Organization was still very small, and it was now proposed to increase Library and Reference Services - Programmeit to $15,000. for 1950. Dr. HOWARD- JONES,Director,Divisionof Decision: The programme for 1950(Official Editorial and Reference Services, explained that Records No. 18, p. 157), with the increase in - 167 - COMMITTEE ON PROGRAMME

the figure for books and periodicals in theto be a matter of normal administrative procedure : Budget Estimates to $15,000, was approved.it would therefore seem unnecessary to include it in the resolution. United Nations Library, Geneva The document giving the latest information The CHAIRMAN suggested that the appearance in regard to this matter was noted. of the remarks of Dr. Gear and of the Chairman of the working party in the minutes should meet Medical and Biological Abstracting:Collabo- the present need and guide the Director-General ration with UNESCO in planning the programme under discussion, without the necessity for an amendment of the Decision: The programme for 1950 (Officialresolution. Records No. 18, p. 166) was approved. This view was accepted by Dr. Gear. Decision: Thecommitteeapprovedthe 2.Training, Education and Fellowships (con- report of the working party and agreed to tinuation from p. 164) recommend to the Health Assembly the adop- Agenda, 8.13 tion of the resolution contained therein (text reproduced in fourth report, section 1). Technical Training of Medical and Auxiliary Personnel (continuation) This completed the approval of the total The committee received the report of theprogramme contained in item 8.13 of the agenda working party, which took the form of a draft(Official Records No. 18, pp. 116, 118-126, 163), resolution(text reproduced in fourth report,subject to the proposals contained in the report p. 327). of the working party.

The CHAIRMAN expressed appreciation of the3.Environmental Sanitation diligence of the working party and the speed Agenda, 8.10 with which they had submitted their proposals. The section dealing with Environmental Sani- Dr. GEAR (Union of South Africa) was oftation in the Report of the Director-General " opinion that the draft resolution did not fullywas accepted. cover two points which had been submitted during previous discussion of the item in the Report on the Establishment of an Expert Committee committee, one by the delegate of Denmark, The committee noted the decision to establish that it was essential that group arrangementsan Expert Committee on Environmental Sani- should be made for the instruction of Fellows,tation, 23 the CHAIRMAN adding that the expert and the other by the of the Unitedcommittee would meet in September 1949. Kingdom, that countries receiving Fellows should make suggestionsasto how thefellowship Activities with theUnited Nations, Specialized arrangements in such countries could be improved. He therefore proposed as an amendment that Agencies OY Non-Governmental Organizations the first sentence of clause (1) of the resolution Mr. PINcus (Secretariat) outlined briefly the be altered to read : present collaboration of WHO with the United (1)requests the Director-General to arrangeNations, specialized agencies and non-govern- fellowships and the instruction of Fellows on amental organizations in the field of environ- group basis as far as possible ; mental sanitation. and that a third clause be added : The representatives of the United Nations and (3)requests the Director-General to consultobservers of the specialized agencies and non- countries receiving Fellows in order to ensuregovernmental organizations were invited by the that the most suitable arrangements for theirCHAIRMAN to give their observations but did not instruction are made :this consultation shouldwish to make any comment. provide for the submission of reports on the results of such arrangements. Rajkumari AMRIT KAUR (India) asked whether the East was represented on the Expert Committee Dr. DOWLING (Australia), Chairman of theon Environmental Sanitation, because climatic working party, explained that the working partyconditionsvaried greatly between East and had considered that the instructions from theWest, and India was particularly interested in Assembly to the Director-General should not behouse planning in rural areas. over-specific but should be framed in fairly wide terms, on the assumption that the Director- The CHAIRMAN, in reply, said he understood General would use his administrative ability tothata representative from South-East Asia interpret them in the sense of the discussions.would be a member of that committee. As to the additional third clause proposed, such a suggestion had not received specific consider- Og. Rec. World 111th Org. 16, 16-17 ation in the working party, but it would appear 22 Off. Rec. World Illth Org. 17, 13, item 4.1 (1)

- 168 - EIGHTH MEETING

Programme for 1950 was, in fact, the view of the Director-General, and said that the Secretariat would be glad to The committee proceeded to consider sectionhave a copy of his statement for future use. 7.4.4. of Official Records No. 18, page 72. Dr. RAJA (India) considered that the problem The Problem and its Significance. of dealing adequately with environmental sani- Mr. LEE (United States of America) expressedtation, including urban and rural hygiene as well the pleasure and satisfaction of the United Statesas town and country planning, was of such delegation that Environmental Sanitation hadimportance that it should form one of the main retained the high priority given to it by the Firstfunctions of the national health ministries and governments. Health Assembly.Approximately threequarters Housing requirements differed widely in diffe- of the world's population were still afflicted byrent countries and continents and it was doubtful diseases caused by unsafe water supplies, poorwhether the expert committee would be able excreta disposal, etc., and many of the specialto lay down certain common standards. In order disease programmes to be carried out by WHOto benefit the East, it was desirable that the were dependent on environmental sanitationexpert committee should consider housing in methods. The United States delegation believedregard to the prevalence of plague.Plague was that the major efforts of demonstration and train-largely bubonic in eastern countries and the ing teams in under-developed and undevelopedclose association of the rat with men was an all- areas should be directed to the improvement ofimportant factor. The evolution of a cheap type bad environmental sanitation and hygiene. of ratproof house, within the economic means of the people of those countries, would do much The CHAIRMAN reminded the committee thatto promote control of plague. the First Health Assembly had given first prio- Training facilities for architects, town planners, rity to this item ;the Director-General in hisetc., was another important point. The number Programme had emphasized its importance.Inof such specialists in the East was very small, view of this, and of the limited time at the disposaland if the expert committee could consider the of the committee, he would suggest that consi-possibility of establishing training facilitiesit deration be given principally to any variance ofwould be very valuable. opinion and that time should not be spent on re-emphasizing what had already been agreed. The CHAIRMAN statedthattheDirector- General and the expert committee would take Dr. MACCORMACK(Ireland)supportedthenote of the importance attached to housing and statement of the delegate of the United States.town and country planning.There was already There was one aspect to which he wished toconsiderable emphasis on this in the section draw attention :improved environmental sani-under consideration and under " Objectives " and tation could be most easily attained in the areas" Work to be accomplished in 1950 ". in which it was most needed, notably the under- developed areas, in which dramatic results could Dr. WICKREMESINGHE (Ceylon) endorsed the sometimes be achieved in a relatively shortstatements of the delegates of the United States time. Such results would create a very favourableand India.Environmental sanitation was of situation and would further the progressof paramount importance to tropical countries and public health in those areas, where the peopleto backward countries.In consideration of the were generally untutored in their knowledge ofproblem as it applied to the great bulk of the scientific progress and accepted diseases as aunder-developed countries it should be realized necessary part of life.Attempted health edu-that it was more a rural than an urban problem, cation by talks and instruction was usuallyand two specific items needed to be stressed :(1) a waste of time but if, for example, as a result ofthe disposal of human excreta ;(2) provision of spraying and other work carried out by healthsafe drinking water. Such projects as town teams, malaria could be eradicated, the peopleplanning, while widely necessary, were not the would then be in a receptive mood, ready tospecific problem of WHO, which should first accept the advice of the " miracle-workers " ;stress those two fundamental, elementary require- and that would be the time to advocate environ-ments of humanity. A great deal of information mental sanitation with every hope of success.was available to the expert committee, including Dr. MacCormack therefore suggested that environ-results of experiments carried out by the Rocke- mental sanitation be co-ordinated with work forfeller Foundation and of other experiments in the extermination of endemic diseases and shouldvarious countries.The problem was not what form a necessary part of the follow-up programmeto do but how to do it.Rural sanitation was in any such scheme. an individual matter :individual houses required individual latrines and individual water supplies. The CHAIRMAN thanked Dr. MacCormack for Therefore an endeavour should be made to devise his remarks, which expressed very clearly whatpractical means of serving individual persons.

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SirAndrew DAVIDSON(UnitedKingdom) Professor CRAMAROSSA (Italy) stated that the considered that the First World Health Assemblygreat importance of environmental sanitation should be congratulated on having made Environ-had been recognized by the priority given to mental Sanitation a first priority, for in someit at the First World Health Assembly when an quarters there was evidence that emphasis inexpert committee had been set up for this aspect public health was tending to shift from theof the work. Whilst fully approving the objectives environment to the care of the individual. Thereimplicit in environmental sanitation, his dele- was need for WHO to lay emphasis on a moregation felt that the expense involved often pre- clearly-defined policy of environmental hygiene :cluded States from carrying out their programmes its programme so far appeared to be one ofand that WHO should help States in proportion continuing some of the field work started byto their needs. UNRRA and of co-operating with the United The 1950 programme was rather indefinite and Nations, FAO, UNESCO, etc., in joint conferenceshis delegation felt that it was desirable that the and surveys, and the proposals for 1950 seemedlimited funds available should serve clear-cut to provide for continuation of such activities, aims. with considerable expansion in field teams and Fellowships were almost always allocated to advisory consultants to governments. Thatyoung people, but administrative or sanitary policy raised two related questions. First, couldofficers were rarely in a position to leave their suitable men be found for the work and forcountries and therefore he felt that it would be advising governments ?Secondly, would it notof great benefit to them if WHO could publish be more profitable, in some cases at least, toa technical bulletin for the information of sani- grant fellowships to selected nationals to studytary and public health officers, in which they abroad and to return as missionaries to theircould read of experiments and research work own countries ? Fellowships in housing werecarried out in different countries. being granted by the United Nations, and there would seem to be a case for co-ordination of The CHAIRMAN explainedthattheexpert effort between WHO and the United Nationscommittee already appointed would meet in in that connexion. September 1949 and would endeavour to draw up a more clearly-defined programme. The CHAIRMAN pointed out that the general The Director-General'sattention would be , question of availability of professional personneldrawn to the desirability of issuing a technical had been raised in the discussion on venerealbulletin as suggested. diseases. The needs would probably be greater Mr. RETTA (Ethiopia) pointed out that agree- than the funds available but it was hoped that,ment was general on the importance of environ- according to estimates, the work could be donemental hygiene, since most ailments and ill- with the personnel and the budget available.nesses could be attributed to the lack of it. The proposals under Training and EducationUrban dwellers were in a more favourable posi- included fellowships.WHO was in close co-tion in this respect owing to their accessibility. operation with other specialized agencies with The proper way to promote environmental regard to individual fellowships as well as generalsanitation was by education, but this was often work. a lengthy process.Experiences in the Second World War had proved that people could be Dr. EJERCITO (Philippines) agreed with theeducated in special subjects in a very short time, previous speakers, and in particular with theand this could surely be done also for environ- delegates of Ireland and the United States ofmental hygiene. America, as to the importance of environmental The missions sent out by UNRRA and WHO, sanitation but said that although many undeve-though limited in their effects on account of the loped or under-developed countries were agreedsize of his country, had done much good and as to the problems, the fundamental questionuseful work, and he hoped that such missions was that of funds, which were generally lacking,would continue since they undoubtedly helped especially in the Far East.Recently WHO hadto direct public information. sent a malaria specialist to investigate conditions He suggested that in the matter of admini- in the Philippines, but the use of teams andstration areas and fellowships, backward areas surveyors, though much appreciated, often ledmight be chosen as demonstration fields and to planning without any action.He suggestedworkers from other countries should be invited that aid made available should be financial ifto go there to study with a view to adapting the WHO was to help under-developed countries.results for their own countries.Such a system, He was of the opinion that the committee shouldthe successive stages of which might spread over take up the question with the Committee onten years, would be appropriate for countries Administration and Finance with a view towhich had no background knowledge, and would, finding ways and means of carrying out theirin addition to curtailing the time spent on train- programme for 1950 if action were to be takening, give the under-developed areas chosen the before the Third World Health Assembly. advantages of such an experiment. - 170 - EIGHTH MEETING

The CHAIRMAN felt that the great interest He said that the field of biological standardi- shown in the subject both by advanced andzation was so vast and so varied that workers backward countries might be an indication thatwho were specialists in all the aspects of the in the view of the committee the subject had notsubject were not available.For that reason the been sufficiently emphasized in its programme.committee at its third session had co-opted three The subject might be borne in mind when itmembers, and seven experts in various fields came up for discussion with the Committee onhad also attended the meetings.Their names Administration and Finance. He drew attentionwere to be found in the report. The presence of to page 76 of Official Records No. 18, in which thethese experts had been of great benefit to the provisionsforthe personnel under Environ-work of the committee. mental Sanitation included 15 teams and three The Committee on Biological Standardization regional training courses.The suggestions andof the League of Nations had restricted its work remarks made during the discussion of this sub-to standardization in a narrow sense, but the ject would be of great use to the expert com-presentexpert committee had expandedits mittee and to the Director-General in the deve-activities and discussed several problems without, lopment of the programme for 1950. however, leading immediately to the setting up of standards or to the definition of units. Dr. FORREST, Secretary, had explained thatIn that connexion, Dr. Timmerman made a the teams would generally be composed of twospecial reference to anti-pertussis vaccine, to persons and in some cases of three, and that insmallpox lymph and to the bacteriological detec- the Haiti special project there would be threetion of tubercle bacilli and others. The important Grade I consultants, and six consultants forsubject of BCG had been discussed and as a the Hylean Amazon project,inaddition toresult the requirements for laboratories engaged equipment and supplies. in the preparation of BCG vaccine for UNICEF Decision:The programme for 1950 (Officialhad been laid down in the report. Records No. 18, pp. 72-76), subject to approval Dr. Timmerman also drew attention to the in conjunction with the Committee on Admi-Report of the Sub-Committee on Fat-Soluble nistration and Finance, was adopted. Vitamins."The sub-committee recommended the adoption of a crystalline vitamin D.3 standard 4.Co-ordination of Research and Therapeuticto replace the second standard which was a Substances solution of irradiated ergosterol.It also recom- Agenda, 8.16mended replacement of the carotene preparation, which served as a reference standard for deter- The CHAIRMAN pointed out that the item wasmining vitamin A, by a crystalline vitamin A divided and sub-divided, and proposed that theacetatestandard,which had been prepared committee should proceed with its discussionduring recent years.He wished to express his according to. the printed agenda. gratitude to the members of the two committees for their willingness in carrying out the researches Biological Standardization indispensable for the work of the committee and The CHAIRMAN noted that the report of thewhich had undoubtedly laid a very heavy burden Director-General contained a statement of theon their individual laboratories. work on biological standardization carried out In reply to Dr. DUJARRIC DE LA RIVIÈRE in 1948.24 The subject was also covered in the(France), who advocated further study in the reports of the Expert Committee on the Unifi-important field of blood groups and transfusions, cation of Pharmacopoeias, the Expert CommitteeDr. GAUTIER, Assistant Director-General, stated on BiologicalStandardization, 25the ad hocthat last year the Expert Committee on Biolo- Committee of the Executive Board," and ingical Standardization had taken into conside- Official Records No. 18, page 147.WHO hadrationtheappointmentofaspecialsub- taken over and carried forward the work donecommittee on blood groups. The sub-committee in the past by the League of Nations Healthwas not so far in being but would probably be Organisation. established later in the year. Dr. TIMMERMAN (Netherlands), Chairman of Dr. RAJA and Dr. DU JARRIC DE LA RIVIÈRE the Expert Committee on Biological Standardi-expressed a desire that the committee should zation, commented briefly on the report of thatrecommend to the Health Assembly the trans- committee. mission of an appropriate expression of sympathy to the family of the late Mr. P. Bruce White, who 24 Oil. Rec. World Hlth Org. 16, 31 had long been associated with work on cholera. 25 To be published The Committee approved this suggestion and 26 The ad hoc Committee of the Executive Boardrequested Dr. Raja and Dr. Dujarric de la Rivière (see Annex 2), meeting immediately prior to theto draft an appropriate recommendation to be Second Health Assembly, noted the report of theplaced before the Health Assembly (for text, see Expert Committee on Biological Standardization,fourth report, p. 327). as instructed by the third session of the Executive Board,and endorsedtheexpert committee's Decision: The committee recommended that expression of regret on the loss of Mr. P. Bruce White, outstanding bacteriologist and serologist, the Health Assembly should adopt the reso- who had been closely connected with the work of the expert committee. 27 To be published - 171 - COMMITTEE ON PROGRAMME

lutions noting the report on the third session Replying to Dr. BARRETT (United Kingdom), oftheExpertCommitteeonBiologicalthe Chairman said that the two points raised Standardization and the report of the Sub-by Dr. Barrett on the undesirability of sending Committee on Fat-Soluble Vitamins, and re-experts to countries without their governments' ferring the reports to the Executive Boardknowledge and on the desirability of giving for consideration and action (for final text,habit-forming drugs a single name had already see fourth report, section 3). been discussed.It was not expected that any The committee also approved the programmeexpert would visit a country without an invi- for 1950 (Official Records No. 18, P. 147, itemtation from and the co-operation of the govern- 7.5.6.1). ment concerned.He added that the Executive Board fully recognized the usefulness of estab- Unification of Pharmacopoeias lishing a single name for such drugs. The CHAIRMAN called attention to the reports on the third " and fourth " sessions of the Dr. BRISKAS (Greece) drew attention to the Expert Committee on the Unification of Pharma-uncontrolled use of Vitamin D.3, which provoked copoeias and to the report of the ad hoc Committee grave and even mortal accidents and had con- of the Executive Board in regard to the lattersiderable influence on the growth of the human (see Annex 2). organism.This matter had already been raised at the International Congress for Children in Decision:These reports were approved byNew York and should be borne in mind by the the committee and it was agreed that appro-expert committee. priate recommendations be included in the report to the Health Assembly (for text, see The CHAIRMAN stated that the matter would fourth report, section 3). be referred to the Director-General for consi- deration of its suitability for inclusion in the Programme for 1950 programme. Decision :The committee approved the above The Committee noted the report on the first programme (OfficialRecords No. 18, p. 147, sessionof the Expert Committee on Habit- item 7.5.6.2). Forming Drugs." Habit-Forming Drugs Decision: The programme for 1950 and the The CHAIRMAN explained that the subject- statement on personnel contained in Official matter for discussion was being published in Records No. 18, page 148, item 7.5.6.3, and Official Records No. 19, which was not so far page 149 respectively, were approved. available :a mimeographed copy was, however, hand. The meeting rose at 6.20 p.m.

28 011. Rec. World Hlth Org.15,39 " To be published " Ofl. Rec. World Hlth Org.19,29

NINTH MEETING Tuesday, 21 June 1949, at 9.45 a.m. Chairman: Dr. H. HYDE (United States of America)

1.Adoption of Draft First Report of the The CHAIRMAN replied that the question of Committee budget estimates might be raised at the joint meeting with the Committee on Administration Decision: Thedraftfirstreportofthe committee to the Health Assembly was adoptedand Finance and that the remarks of the Czecho- after amendment (for final text, see P. 325).slovak delegate would be borne in mind by the Director-General. As regards the composition 2.Co-ordination of Research and Therapeuticof the committee referred to, he would stress that Substances (continuation) committee members were selected not as repre- sentatives of States but in their personal capa- Agenda, 8.16cities. Expert Committee on Antibiotics Dr. ALLWOOD-PAREDES (El Salvador) asked Dr. GONDA (Czechoslovakia), referring to thehow WHO intended to carry out the objective, budget estimates " suggested that the estimates, mentioned on page 164 of Official Records No 18, for the Expert Committee on Antibiotics andof encouraging the production of penicillin in Technological Problems were insufficient.More- the various countries. over, the composition of that committee was not sufficiently representative. Dr. BEGG (Secretariat) replied that this was an activity which would be pursued in co-operation " Off. Rec. World Hlth Org.18,165 with ECE and other international organizations. - 172 - NINTH MEETING

W orld Influenza C entre item which could be used as a basis for discussion of the 1950 programme.It appeared that the The CHAIRMAN drew attention to the documen-paper had not yet been circulated and therefore tation referring to this item :Official Records he would suggest that the committee meantime No. 13, page 309 ;No. 17, page 15, and a reportapprove the programme outlined on pages 156 by the Director-General. and 164 of Official Records No. 18, and consider Dr.DUJARRIC DE LA RIVIÈRE(France), its broader aspect at a later meeting when the referring to the report on the work carried outIndian proposal's were ready. by the Centre during the influenza epidemic of the winter of 1948-49, said the conclusion might Decision : The committeeagreedto the be drawn from the second paragraph that while above proposal. the epidemic was raging in France a specialist from the World Influenza Centre in London had 3.Nutrition Agenda, 8.9 had to come to Paris in order to isolate the Decision :The committee took note of the influenza virus.The fact was that long before section on nutrition in the Director-General's the establishment of the World Influenza Centre Annual Report.33 there existed in the Institut Pasteur, in Paris, a laboratory for the study of influenza. As soonActivities with theUnited N ations,Specialized as the 1949 epidemic had declared itself strain A gencies or N on- Governmental Or ganizations No. B48 had been isolated and considerable work accomplished on the identification and preser- Dr. AYKROYD (Observer, FAO) said that the vation of influenza viruses. preamble to the section on nutrition in the WHO programme for 1950 " made special reference The CHAIRMAN replied that the Secretariatto collaboration with FAO. The second paragraph would make the necessary corrections to the text.of that preamble was a direct quotation from the Dr. GAUTIER, AssistantDirector-General, report of the FAO's Standing Advisory Committee regretted any ambiguity which might have crepton Nutrition, a meeting of which had been held into the report and said there had been no inten-in Washington the previous November. WHO tion in the paragraph in question to suggest thathad, been represented on that committee by the work of the Institut Pasteur was unknown.two members and the statement had been most The aim had been merely to describe the workcarefully drafted.Emphasis had been laid on of the Influenza Centre and it was in this sensethe need for collaboration and it had been expressly that the paragraph should be interpreted. stated that such collaboration should be flexible Dr. GRASSET (Switzerland) stressed the usefuland not confined to any hard and fast spheres of services which collaboration with the Worldactivity. Influenza Centre had produced.In the case That kind of collaboration was in fact more of Switzerland, as soon as several strains haddifficult to ensure in practice, but it could be been isolated at Geneva, an expert had been sentachieved in two ways.The first was free and to the World Centre and had returned with anintimate contact at the secretariat level.The exact typing of the virus. He had also suggestedappointment of Dr. Clements as head of the the appropriate vaccine to be used, and that hadNutrition Section of WHO would help to ensure enabled the Swiss authorities to compare thesuch contact.Secondly, the Joint FAO/WHO limitations of protection of commercial vaccines NutritionCommittee which would meetin with vaccines made from the new strain. AOctober of this year would have as one of its world centre could furnish considerable assistancemain responsibilities the co-ordination of the in the establishment of national centres, suchactivities of the two organizations in the field of as that being formed in Switzerland. Thosenutrition. national centres would not only serve their In the course of three years' work, the Nutri- purpose in times of epidemics, but could alsotion Division of FAO had acquired considerable carry out useful research work on viruses likelyexperience and knowledge which would willingly to appear in future epidemics. be placed at the disposal of WHO. During the Decision :The above-mentionedreportonpast few years problems had repeatedly cropped the World Influenza Centre was noted. up which could have appropriately been tackled jointly by the two Organizations. International Salmonella C entre Some collaboration in the field of nutrition The CHAIRMAN explained that the First Worldwith other specialized agencies might also prove Health Assembly had recommended that WHOnecessary. That could be a subject for discussion should take over the International Salmonellaat the meeting of the joint committee. Centre at Copenhagen.32This item had been Nutrition, while of basic importance to public placed on the agenda to show that that decisionhealth, was a field in which it was difficult to had been implemented. No discussion wasproduce spectacular results.However, progress therefore necessary. could be and was being made. Food deficiency diseases such as beri-beri and pellagra, rampant Pro gramme for 1950 a few decades ago, were now on the wane. Thtre The CHAIRMAN recalled that the delegate ofhad been a definite improvement in child feeding, India had promised to submit a paper on this 83 og. Rec. World Hlth Org. 18, 156 and 164 32 (v. Rec. World Hlth Org. 13, 307 34 09. Rec. World Hlth Org. 18, 108 - 173 - COMMITTEE ON PROGRAMME etc.It would be the responsibility of WHO and Dr. EJERCITO (Philippines) felt that the dis- FAO in the future to accelerate that process.cussion had strayed from the point at issue, which was the collaboration between WHO and Dr. DE PINHO (Portugal) submitted the followingFAO. All that was needed was an endorsement draft resolution : of the resolution passed at the First World Health Assembly expressing satisfaction at the Considering the advantage of co-ordinatingcollaborationbetween WHO and FAO and work on food and nutrition, urging that it be continued. Considering that there are at the moment two specialized agencies of the United Nations Decision: Thecommitteeapprovedthe concerned with this subject, suggestion of the Philippine delegate and it Taking account of the establishment of the was agreed that an appropriate recommen- joint FAO/WHO committee on food and dation be included in the teport to the Health nutrition, Assembly (for text, see fourth report, p. 328, section 4). The Committee on Programme RECOMMENDS theestablishmentineach Mr. THELIN (Observer, International Union for country of national food and nutrition com-Child Welfare) said that in recent mónths the mittees composed ofexperts drawn fromInternational Union for Child Welfare had been organizations brought into relationship withworking in the closest co-operation with the WHO and FAO. Maternal and Child Health Section of the WHO Secretariat.In particular, his organization had undertaken a study of the means whereby inter- Dr. AYKROYD said that the policy of FAO,national non-governmental organizations, such from its inception, had aimed at the establish-as his own, could collaborate with WHO in that ment of national nutrition committees. Suchfield.As regards the topic under discussion by committees had been set up in many countriesthe committee, his organization had been in but varied considerably in scope and effectiveness.close contact with Dr. Aykroyd of FAO to In some cases they were working in close colla-determine in what measure the Union could boration with the national FAO committees, and in one or two instances the national nutritionassist in the work of FAO on both the international committee and the national FAO committeeand the national level. constituted the same body.The co-ordination The International Union for Child Welfare, of the work of those two kinds of national com-which had already been in existence 30 years and mittees could most usefully be discussed by thehad worked in close collaboration with the League joint meeting of WHO and FAO to be held inof Nations, was ready to collaborate as closely October.It should not be difficult to evolve aas possible with both WHO and FAO. The procedure which would produce beneficial results.Union could be particularly useful in the field of food and nutrition and more particularly in that of the education of the masses.Such edu- Dr. CLEMENTS (Secretariat) agreed that the bestcation could be organized by governments but way of dealing with the problem was to ask theit had been his experience that the work was joint FAO/WHO committee to find a suitablebetter done by organizations such as his own. formula for constituting national FAO nutrition The International Union for Child Welfare, with committeesandjointFAO/WHO nutritionthe help of its Secretariat at Geneva and its 52 committees. national organizations, was prepared to colla- borate in that field by its publications, its Inter- The CHAIRMAN said thatifthe Portugesenational Review of Child Health, by special resolution were adopted at the present juncture, researchesor by theconveningofspecial it might lead to the hasty establishment of a newmeetings. committee without the necessary preparatory work of co-ordination.The most appropriateProgramme for 1950 procedure, if the principle of the resolution were approved, would be to authorize the Executive Dr. CLEMENTS, referring to the programme for Board, after it had considered the report of thenutrition on page 108 of Official Records No. 18, joint committee, to make recommendations insaid that six teams had been envisaged-each regard to the work of national committees. containing one category 1 consultant and one category 2 consultant-for attachment to mater- Dr. DE PINHO agreed to this procedure. nal and child health units or tuberculosis units or to act independently. Seven full-time consul- Dr.BRISKAS(Greece),afterstressingthetants would be available for Member countries importance of collaboration between WHO andor for regionaloffices or to conduct special FAO, suggested that more consideration shouldinvestigations.Moreover, 10 part-time consul- be given to the proposal made by the Greektants would be available each for a period of two delegate the previous year for the establishmentmonths.Provision had been made for WHO to of central stocks of milk for nursing mothers.conduct training courses in collaboration with Such stocks had proved extremely useful inFAO and to participate with FAO in a series of Belgium, France and the United States. special projects. - 174 - TENTH MEETING

Dr. RAJA (India) asked whether WHO couldby Dr. Dujarric de la Riviére, Rapporteur of the assist countries in the production of synthetic Committee.35Both these documents were sub- vitamins in the same way in which it had assistedmitted for approval by the Assembly so that the them in the production of penicillin. text of any future regulations might be accorded with its views. The CHAIRMAN replied that the question would Two meetings of the Expert Committee on be referred to the Executive Board for conside-International Epidemiology and Quarantine had ration. been envisaged for 1950 to consider the text of those regulations.The work was outlined in Decision: TheCommitteeapprovedtheOfficial Records No. 18, pages 142 to 145. During programme for nutrition (Official Records No. 18,1950 the committee would have the assistance pp. 108-109). of a group of experts on yellow fever as well as a group of specialists on juridical matters for 4.Epidemiological Services the transformation of existing conventions into Agenda, 8.15regulations. In establishing those regulations WHO intended Revision of International Sanitary Conventionsto maintain the closest possible collaboration with the International Civil Aviation Organi- Dr. BIRAUD, Director, Division of Epidemio-zation and with those specialized agencies of the logy,said the revisionof the InternationalUnited Nations dealing with maritime and trans- Sanitary Conventions had been a statutoryport questions. obligation of the Organization and had been undertaken as such by the Interim Commission. Dr. NAZIF Bey (Egypt) drew attention to the The work of the Expert Committee on Inter-sentence in section 2.1.3.2 of the commentary : national Epidemiology and Quarantine in 1948" No special regulations would then be required was the subject of a section in the Director-for pilgrimage ".It seemed to him that the General's Report.35 The expert committee hadsentence should read " No special chapter would been assisted by study groups working on cholera,then be required for pilgrimage ". plague, typhus and smallpox, trachoma and yellow fever. The expert committee had formu- Decision:The committee so agreed. lated a series of principles designed to govern WHO Sanitary Regulations in the future and a The meeting rose at 11.55 a.m. commentary on the principles had been prepared 36 Both documents reproducedinoll.Rec. 35 Off. Rec. World Hlth Org. 16, 29 World Hlth Org. 19, 7 and 12

TENTH MEETING Tuesday, 21 June 1949, at 440 p.m. Chairman: Dr. H. HYDE (United States of America

1.Epidemiological Services (continuation) at its present stage it should not be the function Agenda, 8.15 of medical administrators to hamper unneces- sarily international travel. The committee should Revision of International Sanitary Conventionsrecommend thatinadopting theprinciples governing those new sanitary regulations, the Expert Committee on International Epidemio-Health Assembly should draw the attention of logy and Quarantine:Report on the Firstnational health administrators to the importance Session of preventing quarantine restrictions of doubtful value from interfering with international travel. Dr. GEAR (Union of South Africa) said he was in full agreement with the Chairman that it was The CHAIRMAN asked Dr. Gear, in view of the not the moment to discuss details of the prin-fundamental importance of his remarks, to put ciples to govern WHO Sanitary Regulations andhis proposals in writing so that at a later stage the commentary thereon,37 which, though verythe committee could consider them and eventually important documents, were those of an expertincorporate them in a report to the Assembly. committee and should only be discussed on broadHe felt it was the duty of the committee to avoid lines at the present stage, as the draft regulationstoo detailed considerations at the present stage based on them would be considered in greaterand that members should confine themselves detail later by individual governments and byto broad principles. a later Health Assembly. With medical knowledge Dr. MACCORMACK (Ireland) requested infor- " Off. Rec. World Hlth Org. 19, 7 and 12 mation on two points which he deemed of practi - 175 - COMMITTEE ON PROGRAMME cal importance :first, what measure of consul-points.Also, the limited budget for 1949 had tation with ICAO and the International Airresulted in lapses in the engagement of staff and Travel Association existed, and secondly, whatconsequently in delays in the execution of the provision, if any, was being made for framingitem under discussion, as well as many others of the new sanitary regulations in consultation withthe Organization's programme. representatives of those two organizations. With regard to the first point, persons who Dr.WICKREMESINGHE (Ceylon)calledthe were familiar with air travel conventions wereattention of the committee to item 1.4.1 of the well aware of the chaos that reigned, owing tocommentary on the principles, which stated : the fact that different regulations were applied" the measures specified in the WHO Regu- in different countries and that in some countries none were in force. The unco-operative attitudelations should not be exceeded by national health and sometimes the active opposition of certainadministrations ". operating air companies led to unnecessary irri- He felt that it was not always possible for all tation where passengers were concerned and tocountries to accept uniform regulations since great difficulties in countries such as his ownsome had specific problems to deal with.This which were trying faithfully to comply withwas particularly true of his country, which was regulations.He felt that there had been tooa small island, and he would suggest that national much delay in bringing air travel conventionspolicies be enabled-within the framework of up to date.When the 1944 Conventions hadgeneral regulations and with the approval of been drawn up there had been insufficient back-the appropriate WHO body-to seek exemption ground experience and he thought that a revisionin particular cases and to apply tighter regula- of the Conventions was necessary and should betions than those prescribed by WHO. the object of urgent attention. As regards the second point, Dr. MacCormack Decision:The committee agreed that the felt that, in the elaboration of new regulations proposal of the delegate of Ceylon be put to on air travel, the assistance of representatives the expert committee for its consideration. of ICAO and IATA was essential. It was necessary to have on the expert committee persons who Dr. RAJA (India) expressed his satisfaction had a practical knowledge of the requirementsat the acceptance of the proposal.There was and difficulties of air companies ; the point shouldone point in particular which was of vital impor- be borne in mind when the members of the experttance for eastern countries such as India, Ceylon committee were nominated.The machinery ofand Pakistan, and that was the incubation period the present International Sanitary Conventionsfor yellow fever.The quarantine of a person was creaking and he wished to put in a strong,suspected of contamination and not properly plea for its reconsideration at the earliest possibleimmunized was 12 days ;it was considered in moment. some circles that 10 days would suffice, but practical experience had shown that there was Dr. BIRAUD, Director, Division of Epidemiology,grave risk for India and other countries of the Secretary of the Expert Committee on Interna-East in lowering the time limit for quarantine. tional Epidemiology and Quarantine, explained,The presence of the Agcles aegypti and of a recep- with reference to Dr. MacCormack's first point,tive population in many parts of India led to a that delay and differences in the application ofgrave danger of infection which, if it occurred, conventions were due to the fact that somewould have disastrous results. He felt the point countries had ratified the 1933 Convention, somecould receive adequate consideration if the pro- the 1933 Convention revised in 1944 and othersposal put forward by the delegate for Ceylon had made no ratifications. Regulations nowwas accepted and specific exceptions granted being prepared would unify practice and suppress by the appropriate WHO expert committee. the present chaos. Regarding the second pointraised, ICAO representatives had been invited to participate Mr. STOWMAN (United States of America) con- in all meetings dealing with international sanitarysidered that the highest priority should be given regulations for air traffic, and WHO represen-jointly to epidemiology and quarantine, which tatives had attended the meetings of the ICAOformed an organic whole although distributed Quarantine Committee. There was completein several sections of the programme for 1950. accord between the two organizations. IATA was His delegation desired that adequate conside- a private air association of air navigation com-ration be given, during the framing of sanitary panies and was on a different footing. There hadregulations governing air and sea travel, to legal been,however,unofficialexchanges withit,and economic aspects :experts well versed in particularlyinregardtodisinsectizationofthose matters should be available generally as aircraft and other technical points. consultants. The revision of conventions took time, owing It was also indispensable that the regulations to their complex nature and the need for consul-should be circulated in draft form to governments ting a series of expert study groups on variousin ample time for consultation of the interested - 176 - TENTH MEETING services, prior to the World Health Assembly at He had now received the written recommen- which they would be considered. dation of Dr. Gear for which he had asked earlier in the meeting. Dr. BIRAUD stated that the budget for 1950 provided for two experts on quarantine. One of Decision: Following the reading of Dr. Gear's those should be a legal expert experienced in sea recommendation, it was agreed that it should and air travel quarantine.The programme for be included in the report of the committee 1950 covered a consultation of legal experts to (for final text, see fifth report, section 1). guide the Expert Committee on International Epidemiology and Quarantine on the change ofAdministrationoftheInternationalSanitary form from Conventions into WHO Regulations. Conventions Dr. STUART (Secretariat)recalledthat the Dr. DU JARRIC DE LA RIVIÈRE (France) statedobligations and duties laid on WHO in pages that it was the intention of the expert committee142-145 of Official Records No. 18, dated from to lay as few obstacles as possible in the way ofDecember 1946 when WHO took over from the sea and air travel.He pointed out that, in theOffice International d'Hygiène Publique, UNRRA commentary on the principles, under item 1.2.2,and the Health Section of the League of Nations. that view was clearly expressed.The question The outline of the work envisaged was set out of transit passengers had also been dealt withon pages 142-144, and the work done in 1948 was in the same document (item 2.7). recorded on pages 29-30 of the Director-General's report." Dr. STOCK (United Kingdom), referringto item 2.5.3 of the commentary on the principles, Report on the First Session of the Section on said that the aim of those principles was the QuarantineoftheExpertCommitteeon obtaining of maximum security against inter- International Epidemiology and Quarantine national transmission of disease with the mini- mum interference with international traffic.No Dr. STUART said that the Secretariat had the opportunity should be lost of consulting withbenefit of the advice of a special section on the authorities representing world traffic, whoquarantine of the Expert Committee on Inter- should have the right to put forward their views.national Epidemiology and Quarantine in regard With reference to the second two paragraphsto questions arising out of the application and of item 2.5.3, he submitted that the knowledgeinterpretation of the Sanitary Conventions which required to implement those proposals was notmight prove to be beyond the competence of the available and that the subject-matter should beSecretariat. deleted and referred to the Executive Board for Dr. STOCK thought that when a complaint made further study. against a country came up for consideration by the Section on Quarantine the country should The CHAIRMAN pointed out that the Executivehave an opportunity of sending representatives Board would be meeting almost immediatelyor of furnishing relevant information. after the present Assembly and that the expert committee concerned with the matter would be The CHAIRMAN stated thatthe Executive meeting prior to the succeeding meeting of theBoard had made a similar recommendation, Executive Board. He suggested that the proposalrecorded on page 14 of Official Records No. 17 be referred to the expert committee which would(item 5.1.2). then report to the Executive Board's succeeding Decision: The reportoftheSection on meeting. Quarantine on its first session was noted. Decision:It was agreed that the last two Epidemiological Notifications and Information, paragraphs of item 2.5.3 of the commentary includingExte;isionofRadio-Telegraphic on the principles to govern WHO Sanitary System of Epidemiological Bulletins Regulations be referred back to the expert committee for re-examination. Dr. STUART said thatit was the constant preoccupation of the Director-General to find Dr. DE CARVALHO DIAS (Portugal), referring tomeans of improving the reliability of such infor- item 4.7.2 of the report of the expert committeemation and of increasing facilities for its dissemi- (Periodic Sanitary Inspection of Ships), was ofnation. Thus, as from 27 January 1949, there had the opinion that regulations to be drafted by thebeen emitted from Geneva a daily broadcast of Expert Committee on Epidemiology and Qua-an epidemiological bulletin. rantine of WHO should take into consideration The CHAIRMAN directed attention to page 14 special circumstances as regards laden ships notof Official Records No. 17, in which the action of returning to their home ports and carrying derati-the Executive Board was recorded under item sation certificates the validity of which had 5.1.3. expired. Dr. STOCK doubted the necessity for the setting The CHAIRMAN said that the remarks made byup of a technical committee, as envisaged in Dr. de Carvalho Dias would be transmitted to the expert committee for consideration. "Off. Rec. World Hlth Org. 16 - 177 - COMMITTEE ON PROGRAMME

paragraph (2) of item 7.5.5.2 (Notification Service)recommendations of the study-group and of the of Official Records No. 18 (page 142) :he was ofExpert Committee on International Epidemio- the opinion that the necessary results could belogy and Quarantine." It was proposed to send, achieved by correspondence. in1950, two international teams of cholera The CHAIRMAN agreed that it would be desi-specialists into two districts of the endemic area rable, over a period of at least one year, for the of Bengal. Secretariat to obtain, if possible by correspon- Dr. RAJA gave a brief account of the work dence and by consultation with the Internationalbeing done at present in his country, India Telecommunications Union, the technical infor-having undertaken to carry out the research into mation required for the improvement ofitscholera suggested by the expert committee. After system of radio-telegraphic broadcasting of epi-outlining past research work, he explained that demiological bulletins. a particular area in South India, a group of The committee agreed to that recommendation.40 villages where cholera had occurred practically In regard to item 7.5.5.6.2 (Increase in staff),every year, had been selected and the population Dr. STOCK considered that the engagement ofwas being put under examination for a period two medical officers was an unnecessary expense, of one year.It was hoped that the investigation, as it should be possible to find one manwho couldconcerning the whole community, might possibly combine the qualifications necessary for boththrow light on the epidemiology of cholera in sea and air port procedure. such a way as to give some insight into what happened in an inter-epidemic period.It was The CHAIRMAN suggested that, for the 1950hoped that the result of the studies being made programme, the need was for one medical officerin India might be made available to the expert and a legal expert.Perhaps the functions enu-committee when it met in India towards the merated on page 145 of Official Records No. 18,end of November.If the causes of the ende- items 7.5.5.6.3 and 7.5.5.6.4, might be performedmicity of cholera could be established, the prob- by one medical officer ;at the same time, he lem of eliminating such endemicity would become understood the feeling of the committee to beeasy, and that would be a much better means that the programme as planned did not makeof putting a stop to the international spread of sufficient provision for legal work in connexioncholera than the quarantine barriers at frontiers with the development of sanitary regulationsexisting at present. and, that being so, he was sure that the Director- General would bear the point in mind when The CHAIRMAN, in thanking Dr. Raja, said that increasing the staff and carrying out the pro-the attention of the Director-General would be gramme under discussion. called to his remarks. Decision: Section 7.5.5 Sanitary Conventions In answer to a question by Colonel AFRIDI and Quarantine,(OfficialRecordsNo.18, (Pakistan), Dr. KAUL explained that it was the pp. 142-146) was approved as amended. intention that study and field work would be started in adjacent areas in East and West International Epidemic Control Bengal, that is, in both India and Pakistan. Cholera:Report of the Study-Group The report of the study-group was noted. The report on the second session of the JointProgramme 107 1950 OIHP/WHO Study-Group on Cholera 39was Decision:The programme for 1950 (Official presented by Dr. KAUL (Secretariat), who observed Records No. 18, p. 110) was approved. that the programme for 1950 given in Official Records No. 18, pages 110-111, was based on the The meeting rose at 6.30 p.m.

39 Ofi. Rec. World Hlth Org. 19, 24 49 Off. Rec. World Hlth Org. 19, 6

ELEVENTH MEETING Wednesday, 22 June 1949, at 9.30 a.m. Chairman: Dr: H. HYDE (United States of America) later Dr. Irene DOMANSKA (Poland)

I.Announcements by the Chairman submitted their views on health education of the public. The CHAIRMAN drew attention to two memo- The document, " A Memorandum on Research " randa 41 which had been circulated, and thanked(Annex 15),submitted by the delegation of the delegations of Belgium and Brazil for havingIndia would be discussed in the committee when 41 Unpublisheddocuments(A2/Prog/8 andthe delegates had had an opportunity of con- A2/Prog/9) sidering the paper. - 178 - ELEVENTH MEETING

2.Co-ordination of Research and Therapeutic The Commission had decided also " to endorse Substances (continuation from p. 173) the recommendation of the Expert Committee Agenda, 8.16on Habit-forming Drugs of WHO that a mecha- nism should be established whereby every habit- Habit-forming Drugs:Statement by the Director of the Division of Narcotic Drugs of the Unitedforming drug subject to international control Nations could be given a single name to be used for all international purposes." Mr. STEINIG, Director of the Division of Nar- The Commission was looking forward to further cotic Drugs, United Nations, thanked the Chair-information from the expert committee on the man for the opportunity of speaking on theuse of heroin in certain countries. decisions and recommendations passed by the Commission on Narcotic Drugs, which had a The wish of the Organization to be represented bearing on the programme of WHO. on the future control bodies to be established The report on the last session of the Comis-under the single convention which was to replace 5i011,42 which had recently been issued, containedthe eight existing treaties now in force on narcotic the Commission's recommendations on the pro-drugs had been approved by the Commission. posalsof the Expert Committee on Habit- The Organization was to be asked to assist forming Drugs,43 which had been referred to itthe United Nations in the drafting of the new by the Executive Board of WHO and the Econo-convention and the Commission had recommended mic and Social Council. to the Economic and Social Council that WHO He observed that the expert committee hadbe requested to provide the United Nations taken a number of decisions under the existingSecretariat with definitions of the terms " drug Conventions which extended the scope of theaddiction ", " addiction-forming drugs ", " habit- applications of those Conventions and becameforming drugs " and " fundamental structure immediately binding upon governments.Thoseof addiction-forming drugs ", and to illustrate decisions had been duly communicated to govern-such definitions with reference to appropriate inents. drugs. The protocol concluded in Paris in November The Commission had requested that WHO be 1948 44 to extend international control of habit-consulted on the present state of medical research forming drugs to synthetic drugs had been ratifiedon drug addiction and he stressed the importance by Italy, Norway and Yugoslavia.It was hopedof continued close collaboration between the two that the four remaining ratifications requiredbodies. At the request of the Economic and before the protocol could come into force wouldSocial Council, WHO had nominated six experts, be effected shortly. He recalled that the expertof whom two had been chosen (Professor Verzar committee had passed recommendations whichof Basle and Professor Granier-Doyeux from could be applied as soon as the new protocolVenezuela) to serve on the Commission of Latin became effective. America which was to study addiction to the The Commission on Narcotic Drugs had for-chewing of coca leaves.That commission was warded the following recommendation to theto leave for Bolivia and Peru in September and Economic and Social Council : its report to the Economic and Social Council The Economic and Social Council, would be an important document at the Inter- With a view to accelerating the applicationnational Conference which would decide upon in similar cases of the principle contained in thethe limitation of production and the control of recommendation of the Expert Committee ofdistribution of certain raw materials. the World Health Organization on chemical The Commission, in its efforts which, in a compounds of the dolantin and amidone typeslimited field, were considered as a testing ground (WHO/HFD/9, paragraph 8). for new methods of international administration Requests the Secretary-General to transmitand control, was grateful for the valuable co- to all Governments the recommendation of theoperation, support and advice of WHO. Expert Committee of WHO that each Govern- ment should endeavour to apply at the earliest The CHAIRMAN said the committee was glad possible moment provisions whereby drugs of ato learn of the co-operation existing between the particular chemical type, analogues of whichOrganization and the Commission on Narcotic have been proved to be habit-forming (forDrugs, and wished such co-operation to be con- example, analogues of dolantin and aniidone)tinued through the Director-General, the Execu- could be placed under control until such timetive Board and the Expert Committee on Habit- as they have been shown not to be habit-f orming Drugs. forming. Mr. STEINIG stated that he would transmit 42 UN document E/1361 42 Off. Rec. World Hlth Org. 19, 29 the views of the Chairman to the Commission 44 Text reproduced in UN document A/810,on Narcotk Drugs and to the Economic and 211 (III) Social Council. - 179 -- COMMITTEE ON PROGRAMME

3.Mental Health The CHAIRMAN thanked Dr. Rees for his state- ment, which would be borne in mind by the Agenda, 8.14committee during the discussion of the mental- Activities with theUnited Nations, Specializedhealth programme. Agencies or Non-Governmental Organizations: Statement by the President of the World Fede- 4.Epidemiological Services (continuation from ration for Mental Health p. 178) Agenda, 8.15 Dr. REES, President of the World FederationInternational Epidemic Control for Mental Health, said that the Federation was one of the youngest of non-governmental The CHAIRMAN suggested that the discussion organizations and had been created largely toshould be limited to matters of general policy co-operate with WHO. It consisted of 55 societies and to such technical points as would influence from 33 countries representing not exclusivelythe programme. medicalinterestsbutalsootherprofessions Pla gue interested in the mental-health field. Dr. RAJA (India) referring to Official Records The Federation greatly appreciated the state-No. 18, page 112, section 7.4.11.4, on centres ment of the Director-General in Official Recordsfor special training, said that India was prepared No. 18. The programme of mental health 46 wasto investigate the possibility of establishing a the first of its kind on an international scale andtraining centre in connexion with the Haffkine was adequate as a beginning. The note on mental-Institute, Bombay, which had been associated health programme proposals submitted by thewith plague activities for over half a century. delegations of Denmark, Italy, Sweden, Switzer- The CHAIRMAN expressed the appreciation of land and the United States of America (Annex18),the committee for that offer, which would be which suggested an alteration in the order ofbrought to the attention of the Director-General, priorities, had his full support. There were few problems discussed at the Decision:The committee noted the report Health Assembly which had no mental-health on the second session of the Joint OIHP/WHO Mental health was not a matter for Study-Group on Plague 46 and approved the aspect. programme for 1950 (Official Records No. 18, psychiatrists working in a mental hospital but section 7.4.11). was something which affected all human rela- tionships.In some countries one-third of the Typhus and other Rickettsioses cases of prolonged illness were due to emotional disturbance.Sickness and delinquency rates fell Decision:The committee approved the pro- incountries where mental health was high. gramme for 1950(OfficialRecords No18, Psychoses accounted only for 10% of mental- section 7.4.12). health problems ;the dull and backward people Smallpox formed a much bigger group but one which, if properly handled, could produce first-class citi- Dr. ALLWOOD-PAREDES (El Salvador) stressed the difficulties encountered in the execution of zens.The biggest field for mental-health workmass-vaccination programmes in remote areas was among people who were emotionally disturbedbecause of the impossibility of preserving active and, consequently, non-co-operative, difficult andfluid vaccine for more than a few days. He sug- ill.Prevention of mental illness was essential asgested that the expert committee should study enough specialists to deal with all mentally sickmethods of conserving vaccine for longer periods persons could never be forthcoming, and itand without its fluid vehicle. would be necessary to begin work at an earlier stage than ever before.Marriage guidance and The CHAIRMAN assured the committee that the marriage advice were needed so that childrendifficulty was emphasized in the programme for 1950, which provided for a meeting of experts in could have happy homes and grow up in ansmallpox vaccination in tropical areas, at which atmosphere of emotional stability.The mental-the main emphasis would be placed on that health specialists were also concerned with theproblem. maternal and child health programme of WHO, as, indeed, with all social activites which made Decision: The committee noted the report for better human relationships. on the second session of the Joint OIHP/WHO Study-Group on Smallpox 47 and approved the He offered the active co-operationof the programme for 1950 (Official Records No. 18, Federation, which in turn would submit prob- section 7.5.4.2.1). lems to the Organization.He hoped that dele- gates would encourage professional non-govern- Yellow Fever mental groups in their own countries to co-operate Dr. RAE (United Kingdom) asked whether it actively in solving the great problems facingwas intended to call upon the whole Yellow-Fever the Organization. 46 01 . Rec. World Hlth Org.19,18 46 Off. Rec. World Hlth Org.18,77 47 011. Rec. World Hlth Org.19,22 - 180 - ELEVENTH MEETING

Panel to meet in conjunction with the Expert Dr. RAE stressed the enormous number of Committee on Epidemiology and Quarantine, orsubjects which WHO was hoping to tackle under only that section dealing with field work.Histhe item, Epidemiological Services. Some prio- second point referred to the second paragraph ofrities would have to be established if dissipation section 7.5.4.2.2.4 (Official Records No. 18, p. 135). of effort were to be avoided. He proposed, there- He considered it unnecessary for the Organiza-fore, that in its 1950 programme, WHO should tion to undertake a bibliographical survey of thenot carry out itself the therapeutic trials in epidemiological work on yellow fever, since nocertain new drugs, but should rather obtain subject was so well documented. The records ofinformation on these from the research teams the Rockefeller Foundation and the Bulletinwhich were already working in the various of Tropical Medicine and Hygiene made a newcountries. survey unnecessary. Colonel AFRIDI (Pakistan) seconded the United Dr. RODHAIN (Belgium) agreed that sufficientKingdom proposal. bibliographical documentation was available on yellow fever and that no new survey was therefore Decision:The programme for 1950 for fila- required. riasis and onchocerciasis (Official Records No.18, section 7.5.4.3.1) was approved, together with Dr. STUART (Secretariat) said that only the the United Kingdom amendment. part of the Yellow-Fever Panel conversant with field work would be called to meet with the Expert Committee on Epidemiology and Qua- The CHAIRMAN wished to correct the statement : rantine.As the material on yellow fever men-" No international work has been done hitherto tioned by the delegate of the United Kingdom wason filariasis " (Official Records No. 18, section available to the Secretariat, they would not7.5.4.3.1.2). The fact was that the Pan American continue the bibliography on yellow fever butSanitary Bureau, which was now serving as a would note that material in the records for use byregional office of WHO, had been working in that the Yellow-Fever Panel. field in Central America on an international level. The CHAIRMAN suggested the deletion from the programme of the bibliographical survey Trypanosomiasis on yellow fever. Decision : Thecommitteenotedsection It was so agreed. 7.5.4.3.2 of Official Records No. 18. Decision : The programme on yellow fever (Official Records No. 18, section 7.5.4.2.2.) was Leishmaniasis :Programme for 1950 approved as amended. ProfessorCORRADETTI (Italy)gave some Filariasis, Onchocerciasis : Programme for 1950information concerning an experiment in the Dr. RODHAIN said he had noted with satis-control of cutaneous leishmaniasis which had faction the inclusionoffilariasisin WHO'sbeen begun in Italy last year and was still in programme for 1950.In view of the fact thatprogress. With the funds provided by the High onchocerciasis had affected in certain regions ofCommissariat of Public Health and under the Central Africa as many as 90% of the population,direction of the Institute of Public Health of and that the disease could cause blindness, heRome, a rural zone of Abruzzo with endemic would stress the importance of the researchesoriental sore had been selected in June 1948 and made by the Belgian doctors, who had discoveredDDT sprayed in all houses and stables. Previous that onchocerciasis could be cured by means ofexamination of the entire population in the Bayer 205. treated zone had given the following figures : Secondly, the statement under item 7.5.4.3.1.1out of 28,599 persons, 847 were found to be (Official Records No. 18,p.136) : " Certainactuallyaffected by cutaneousleishmaniasis forms cause considerable reduction in mobilityand 5,953 with cicatrized cutaneous leishmaniasis. and working power, e.g.elephantiasis due toThose figures showed that in the zone a total of W.bancrofti and blindness toO.volvulus"6,800 persons, i.e. 23.7% of the entire population, might be misunderstood.The phrase " due towere suffering or had suffered from cutaneous to W. bancrofti " should be omitted, since ele-leishmaniasis. DDT spraying in the same zone phantiasis could also be provoked by onchocer-was being repeated in 1949 and a second exami- ciasis. nation of the entire population had been made last month.Results of the second examination Dr. SIDKY (Secretariat) said that the researchwere being studied and would be published as work on Bayer 205 carried out in Belgium wouldsoon as possible but one could already say, that be brought to the attention of the Director-no new case of cutaneous leishmaniasis had General, and the necessary corrections made toappeared in the treated zone after the spraying the section referred to by the Belgian delegate.of DDT. - 181 - COMMITTEE ON PROGRAMME

Dr. EL ZAHAWI (Iraq) said that DDT was not The two principal problems which should be onlyeffectiveagainstleishmaniasis butalso considered by the expert committee, and later against malaria and other infectious diseases. Heby the conference itself, were :(1) the methods would like to see the use of DDT extended to allof vaccination against rabies and (2) the methods countries of the world, and particularly tropicalof prophylaxis necessary to eradicate rabies, countries. particularly preventive vaccination of dogs.

Decision:The programme for 1950 for leish- Dr. STOCK (United Kingdom) supported strong- maniasis(OfficialRecordsNo.18,sectionly the proposal to call an international conference 7.5.4.3.3) was adopted. on rabies in 1950. He recollected that the previous conference on the subject, held under the aus- Schistosomiasis: Programme for 1950 pices of the League of Nations, had been most Decision:The programme in Official Recordssuccessful. He proposed, however, that the No. 18, section 7.5.11, was adopted. conference should meet without being preceded by a meeting of an expert committee.

Poliomyelitis: Organization of the International Dr. STUART said it had been intended that an Exchange of Iron Lungs expert committee should meet before the con- ference itself in order to decide whether the time Decision: The action by the Director-Generalreally was appropriate for such a conference. in respect to poliomyelitis was noted 48 Dr. RAJA fully supported the proposal that Trachoma an expert committee should meet before the Decision: The report on the first session of theconference and thoughtitsattention should Joint OIHP/WHO Study-Group on Trachoma 48be drawn to one particular aspect of rabies, and the programme for 1950 (Official Recordsnamely the morbidity and mortality in persons No. 18, section 7.5.4.4.2) were adopted. bitten but not treated, as opposed to those bitten and who had received prophylactic treatment. Rabies : Programme for 1950 Dr. SIMONOVITS (Hungary) said that, except Professor Pmcrortt(Italy)saidthe Italianduring the war, rabies had completely disap- delegation had noted with satisfaction the proposalpeared from Hungary owing to the practice of included in the 1950 programme for an expertvaccinating dogs. committee on rabies which would prepare recom- On being put to the vote, the United Kingdom mendations as to the desirability of an inter-proposal to make no provision for a meeting of an national to discuss the disease. expert committee in the 1950 programme was Italy was extremely interested in the subjectrejected by 20 votes to 11. because rabies had always been closely studied by Italian scientists and because the disease, though Decision:The committee adopted the pro- it had decreased considerably before the war, gramme for 1950 for rabies (Official Records had unfortunately reappeared owingtowar No. 18, section 7.5.4.4.3). conditions. Although rabies caused very few deaths,it Brucellosis:Setting-up of National Centres required special consideration becauseofits dramatic and terribleeffects. International Decision: The report on this subject in Official action towards its eradication should be under- Records No. 17, page 15, and the reference under taken for two reasons : (1)rabies could be section 7.5.8 of Official Records No. 18 were stamped our fairly easily, as had been shown in noted. theUnitedKingdomand othercountries. (2) rabies, although unimportant from a social standpoint, entailed a considerable amount of The Vice-Chairman took the chair. expense for countries where it is widespread. Immunization against Common Communicable Diseases of Childhood-Programme for 1950 48 The report outlined steps taken by the Director- General in implementation of the instructions of the First World Health Assembly (Official Records Dr. BIRAUD,Director,DivisionofEpide- No. 13, p. 309) and stated that health adminis-miology, said the Expert Committee on Maternal trations had been asked for their views on theand Child Health having, in January 1949, international loan of respirators and whether they would consider the actual participation of theirrecommended a conference of experts on pro- countries in the organization of such a scheme, ifcedures for active immunization against commu- there was a consensus of opinion as to its practica-nicablediseasesof childhood,the Executive bility.The report added that when the majorityBoard sought a decision from the Assembly on of answers had been received and if such a consensus of opinion was revealed, concrete plans would be that question. The Director-General had consulted submitted to the Executive Board and to thecertain specialists on the advisability of holding Health Assembly for their consideration. such a conference, on its agenda and its parti- 48 011. Rec. World Milt Org. 19, 27 cipants.

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The consultants, as shown in their report," Dr. STOCK said work had beenundertaken in had recommended that the conference be heldhis country to develop and improveaerosol but that its participants be limited to a dozen" bomb "for the disinsectizationofaircraft. experts to cover the production of immunizingThe performance of aerosols producedfrom a agents against diphtheria and whooping-cough.number of candidate insecticide solutionsby the This agreed with the proposals made for the 1950use of a lever-controlledcarbon-dioxide-propelled programme in Official Records No. 18, sectionaerosol dispenser had been comparedwith that 7.5.4.5. of aerosols produced from a number of commer- Before reaching their conclusions the expertscially available aerosol bombs. Using insecticide consulted reviewed the situation as regards activesolutions containing pyrethrins and DDT or immunization againstdiseasesofchildhood ;BHC, higher " knock-down and kill " ofthe their observations were also contained in theircommon insect carriers of diseaseshad been report. achieved than with aerosol bombs operated in accordance with advertised instructions. Dr. RODHAIN drew attention to Item 3.1.1 Spraying of aircraft with certain insecticide in the report, which stated " The experts recom-solutions had a detrimental effect on plastics mended that in countries(with a temperate(perspex windows in particular), as they caused climate) where diphtheria is prevalent, all children" crazing ".If the defective window were left be immunized against that disease.This recom-in situ, such a " crazing " could lead to a blowing mendation did not apply to tropical countries inof a port, which, at high altitude, would be a which infection with thediphtheria bacillusmost serious matter for the aircraft and its occurred but caused no clinical disease ". Thatoccupants. paragraph should not be interpreted in an abso- Findings indicated how essentialit was to lute sense, since it had been found that, in the in Belgian Congo, diphtheria in white children couldconsultaircraftconstructors and experts be quite severe. fabric, metals and plastics during the develop- ment of insecticides for use in aircraft. Decision:The programme for 1950 dealing Work was also in hand in East Africa to with immunization against common commu-investigate the efficiency of residual deposits nicable diseases of childhood (Official Recordson aircraft interiors as a means of controlling No. 18, section 7.5.4.5.) was adopted. Theinsect disease vectors.Further interim reports committee noted the reportof the expertwould be forthcoming in due course. consultation on the same subject.

Insecticides Dr. BIRAUD thanked the delegate of the United Kingdom for the extremely important Dr. BIRAUD said the First World Health Assem-tion which he had laid before the committee and bly, recognizing the need for up-to-date informa-said it would be brought to the notice of the tion on insecticides and methods of their use inExpert Committee on International Epidemiology the control of malaria and a number of otherand Quarantine. insect-bornediseases,had recommended the establishment of an insecticides committee, to be composed of a nucleus of experts with a broad Professor CORRADETTI wished to examine two knowledge of insecticides, assisted by additionalpoints of the report of the Expert Committee on members specialized in the various subjects toInsecticides 62First, it was stated (paragraph be covered by the committee's agenda. 7.4) : " In areas where malaria-carrying ano- The committee had met in Sardinia in Mayphelines have been eradicated the maintenance of 1949 and drawn up specifications for existingresidual spraying activities for general domestic insecticides and apparatus for their use, andinsect-control constituted an effective means of for the information and advice of the Expertdestroying accidentally imported anophelines ". Committee on International Epidemiology andThis seemed to imply that even where anopheline Quarantine, had made recommendations on theeradication had been accomplished in a given practical means of disinsecticizing aircraft andarea, regular distribution of residual insecticides ships. in all houses and stables was necessary in order The committee had also studied the practiceboth to control other insects and to prevent of disinsectization in Sardinia as a means ofthe reintroduction of anophelines. The fact was preventing re-importation of anophelines of whichthatin many countriescontrol by residual the island had been freed. sprays inside houses and stables was sufficient The programme for 1950 included provisionto prevent the diseases being transmitted by for the convening of experts on insecticides indomestic insects. conjunction with other expert bodies requiring their services. 61 51 Off. Rec. World Hlth Org. 18, 141 " To be published 52 To be published

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Secondly, in paragraph 8.4, the committeevessel was approximately one-and-a-half hours, had suggested the study of the possibilities ofbut the committee had not been in a position controlling fly-breeding places by effective flyto recommend any particular method of disin- larvicides. The committee had previously recog-sectization for heavy-tonnage passenger vessels. nized (paragraph 8.2)that a high degree ofIn this respect the committee should consider control of domestic flies had already been achievedwhether mosquitos did in fact survive in the by residual spraying alone,and that DDT-holds of ocean-going vessels during long voyages. resistant flies could be controlled by using chlor-If it could be proved that they did not, then the dane. The only disadvantage the committeeexpense incurred by spraying insecticide in holds found in using chlordane (paragraph 8.5) wascould be avoided.The question would repay the shorter time of activity in comparison withinvestigation. DDT ;the use of chlordane, in the opinion of the committee, might necessitate additional spraying The CHAIRMAN said that the remarks of the operations involving extra labour cost. delegate of Pakistan would be referred to the Unfortunately no expert of the Italian Instituteexpert committee. of Public Health had been invited to join the committee at the Sardinia meeting.He could In reply to a question by Dr. STOCK, Dr. have told the committee that much had been doneFORREST, Secretary, said that the report of the the previous year in the field of resistant-fliesExpert Committee on Insecticides would be sent control in the Pontine region with the simulta-to the Expert Committee on Epidemiology and neous use of both DDT and chlordane. One spray-Quarantine with the comments of the Committee ing with chlordane and DDT of entrance halls,on Programme, and thereafter to the Executive kitchens and stables and the spraying of DDT inBoard, unless a different procedure were desired. the other rooms of houses had proved effective in destroying DDT-resistant house flies in the Dr. STOCK said he would be satisfied with that region throughout the whole year. The important process.The present knowledge was insufficient fact to be observed was that good results hadand more research was required before a policy been obtained merely by using the insecticideson disinsectization of ships and aircraft could inside houses and stables only.The proposalbe decided upon. put forward by the expert committee to control flies' breeding places by larvicides (in paragraph The SECRETARY explained that the Expert 8.4) seemed therefore both impracticable andCommittee onInsecticides was an advisory costly. committee for other expert committees-including those on malaria and on epidemiology and Dr. RAJA thought an important subject ofquarantine, and the relevant sections would be investigation for the expert committee wouldreferred to those committees. be the effectof insecticides on those insects which were vital to plant and animal economy. Decision: The committee noted the report of the Expert Committee on Insecticides. 53 Colonel AFRIDI said the use of insecticides in ocean-going vessels should be considered, as well The meeting rose at 12.45 p.m. as in aircraft.The report of the expert com- mittee stated, in paragraph 6.1.3.3, that the time required for disinsectization of a 2,000-ton cargo " To be published

TWELFTH MEETING Wednesday, 22 June 1949, at 3.30 p.m. Chairman: Dr. H. HYDE (United States of America)

1.Adoption of Draft Reports of the Committee2.Epidemiological Services (continuation)

Decision: The draft second report to theInternational Epidemic Control (continuation) Committee on Administration and Finance 54 and the draft third report to the Health Assembly were approved (for final text, see Agenda, 8.15 p. 325). Decision: Section 7.5.4.ofOfficial Records No. 18 (Epidemiological Studies) was approved, 54 See footnote 16, .p. 164 as modified by decisions on various items taken - 184 - TWELFTH MEETING

during the course of previous discussions, and.to the whole section. He outlined the origin and subject to. any later decision which might begrowth of the Health Statistics Section and taken on Leprosy, an item still to be considered.reminded the committee that it was intended to be the co-ordinator, promoter and secretariat of 3.Health Statistics a system of national committees joined in inter- national collaboration.The Expert Committee Agenda, 8.17on Health Statistics, at a meeting held imme- The relevant section of the Report of thediatelypriortothe Health Assembly, had Director-General 55 was noted. recommended that WHO should renew its efforts through normal channels for the creation of The CHAIRMAN drew attention to two inter-national committees in the field of medical and related documents submitted by the Unitedpublic-healthstatistics. The UnitedStates Kingdom delegation, a memorandum on healthGovernment was very anxious that something statistics (Annex 6) and a resolution on the sameshould be done in that field. The United Kingdom subject (for final text, see tenth report, section 3).resolution made no mention of the background, Discussion was opened on both documents. nor of the wishes of the expert committee ;it should be amplified to make it more complete. Mr. km, (United Kingdom), presenting hisParagraph (5) would appear to be too mandatory delegation's resolution, said that it would bein its terms :it might be preferable to say " The generally recognizedthatstatisticswere anDirector-General might wish to submit . indispensable instrument of policy and action, and vital to the work of WHO. The views of the The CHAIRMAN pointed out that the United United Kingdom, set out in its memorandumKingdom resolution dealt with internal organi- on health statistics, had been epitomised in thezation and the attitude of WHO to its own resolution.In regard to paragraph (5) 56 of theactivities. The report of the expert committee 57 resolution, Mr. Joll explained that there was nohad formed the basis for a proposed resolution intention of attempting to lay down instructions(for text, see tenth report, section 3)which included provision for maintaining relationship to the Director-General, but merely to ask him towith national committees. That matter was there- review the present administrative arrangementsfore already covered. and consider whether any change should be made : for example, whether the subject of statistics justified a higher administrative status than a Mr. STOWMAN did nqt agree on the latter point.The first part of the United Kingdom section of the Secretariat. resolution laid down lines for the development of health statistics which disregarded the find- Dr. DE PAULA SOUZA (Brazil) supported theings of the expert committee :the second part resolution, stressing the importance of paragraphof the resolution depended entirely on the first (3).International action would be of assistancepart. to countries where difficulties were experienced The subject-matter covered by the United in comparing international statistics. Kingdom and the expert committee resolutions being interrelated, the CHAIRMAN proposed that Dr.RAJA(India)strongly supportedthethe possible incorporation of both proposals into resolution. On the question of the status of theone resolution should be considered. The expert statistical section in the Secretariat, it shouldcommittee resolution, if adopted, would neces- be remembered that the services of that sectionsitate a change in the programme as submitted would be required for a wide field :'all investi-by the Director-General. gations, whether taken in the laboratory or the field, required planning on suitable statistical Dr. DTJJARRIC DE LA RIVIÈRE (France) agreed lines. with the United Kingdom resolution in regard to its first four points. He could not, however, Mr. STOWMAN (United Statesof America)accept paragraph (5), because that dealt with a considered the wording of the resolution tooquestion of internal organization which was the narrow :a much wider scope needed to be givenresponsibility of the Director-General without any necessity for reference to the Executive 55 011. Rec. World MA Org. 16, 30 Board. 56 The original paragraph (5) read : The Director-General is requested to submit to Mr. JOLL said that, as the Chairman had already an early meeting of the Executive Board a report : stated, the United Kingdom resolution dealt (a)reviewing in detail the present administra-solely with the place of statistics in the Organi- tive arrangements in WHO in the sphere of statistics (health, epidemiological, medical andzation and not in relation to national committees. vital) and The latter point was fully covered in para- (b)setting out such changes (if any) in thosegraph (2) of the resolution based on the expert arrangements as appear to him to be necessarycommittee's findings. The United Kingdom or desirable to secure that effect is given to theresolution was therefore a separate one and principles set out in (1) to (4) above and generally that the resulting statistical set-up is able toshould be taken on that basis. play that full, continuous and active part in all the work of the Organization which it should. 57 To be published - 185 -- COMMITTEE ON PROGRAMME

As regards paragraph (5) he would repeat +hatNo. 18, discussion on the item should be deferred it constituted only a request that the Director-and taken in conjunction with consideration of General should review the present administrativethe programme for 1950: arrangements and consider whether they were adequate to the task. Activities with theUnited Nations, Specialized Agencies or Non-Governmental Organizations The CHAIRMAN said that, as discussion pro- ceeded, the question emerged whether the Com- Dr. PASCUA (Secretariat) gave a brief account mittee on Programme was the right place inof the collaboration of WHO with the United which to discuss the proposals of the UnitedNations, specialized agencies and non-govern- Kingdom. Any Member of the Organizationmental organizations. could request that an item be placed on the The representatives of the United Nations and agenda of the Executive Board :he asked theobservers of specialized agencies and non-govern- United Kingdom delegation whether its propo-mental organizations having indicated that they sals might be handled in that way. What para-had no comments to make, the committee graph (5) of the resolution proposed was a reviewreturned to consideration of item 8.17.1 with of the internal machinery of health statistics,item 8.17.3. and that would seem to be a function of the Executive Board rather than of the CommitteeExpert Committee on Health Statistics: Report on on Programme. the First Session 58 taken together with Pro- gramme for 1950 Mr. JOLL dissented. The whole subject-matter Dr. RAJA proposed that in the third paragraph ofhisdelegation'sresolution,includingtheof the report of the ad hoc Committee of the suggestion in paragraph (5), was given in itsExecutive Board," the word " registration " be memorandum which had been circulated :theinserted before " compilation and transmission World Health Assembly had therefore had fullof health statistics ", registration being of parti- notice of the matter. The Health Assembly wascular importance. a forum before which one should be able to place such points of general principle, namely, whether The CHAIRMAN explained that additions could proper provision was being made at the momentnot be made at the present stage to the report : for such a fundamental service as statistics. it represented the findings of a body which had met and reported. A statement with the point Dr. DOWLING (Australia) supported the prin-made by the delegate of India might be included ciples set out in the United Kingdom resolution,in the report to the Assembly. but was inclined to agree that paragraph (5) was a little too precise in its directions.He Dr. RAJA agreed that that would be satis- suggested that it be re-worded to read : factory. The Director-General is requested to submit Mr. JoLL noted that the publication of the to an early meeting of the Executive Board astatistical handbooks, which had been left over report on this subject. when dealing withEditorialand Reference Services, was provided forin the resolution Mr. JoLL said he was anxious to meet thebased on the expert committee's findings.He suggestions made and would be prepared to alterstrongly supported that recommendation. paragraph (5) of the resolution to read as follows : Decision: Thecommittee agreed on the The Director-General is requested to submit desirabiliiy of publishing the statistical hand- to an early meeting of the Executive Board a books. report on the present administrative arrange- Dr. RAJA said that the resolution of the expert ments in WHO in the sphere of statisticscommittee did not lay sufficient emphasis on the (health, epidemiological, medical and vital) andinternational development of health statistics to indicate any changes he thinks necessary orin undeveloped areas or the teaching of health has carried out. statistics and the training of health-statistics The United Kingdom resolution, as amended, 58 To be published was put to the vote. 58 The ad hoc Committee of the Executive Board (see Annex 2), meeting immediately prior to the Decision:The resolution was adopted bySecond Health Assembly, noted the report of the 29 votes. Expert Committee on Health Statistics, as in- structed by the third session of the Executive Board (0fl. Rec. World Hlth Org. 17, 13), and Expert Committee on Health Statistics:Reportin view of the value which health statistics have on the First Session for the proper understanding of epidemiological and other medical and public-health problems, On the proposal of the CHAIRMAN, it wasdraws the attention of the Second World Health Assembly to the desirability of impressing upon agreed that, as the resolution based on the expertMember Governments the great importance to be committee's findings contained proposals whichattached to the compilation and transmission of would entail major alterations to the programmehealth statistics, and to the means of implementing of the Director-General set out in Official Recordsthe recommendations contained in the report, - 186 - TWELFTH MEETING personnel, both of which matters had been stronglythe programme for 1950 with the alm of deve- stressed in the report of the expert committee.loping the work along the lines indicated by He asked that the possibility of positive help inDr. Raja. The function of WHO in this field was promoting the development of statistics in undeve-to co-ordinate the research work carried out by loped areas should be considered and that someindividual national and local institutes. appropriate action should be taken, and also that the recommendations in paragraph 8 of the The suggestion made under paragraph(c) report of the expert committee on the teachingof the memorandum had already been dealt of health statistics and training of health-sta-with under the heading, " Training, Education tistics personnel should be brought to the noticeand Fellowships." of governments for appropriate action. Dr. CAMERON (Canada), in congratulating the The CHAIRMAN stated that the remarks ofdelegation of India on its paper, expressed his Dr. Raja would be brought to the attention ofagreement with the general principles set forth the committee which had been proposed to goin it. He felt it was of the utmost importance that into the whole question of personnel. policy in relation to research should be clearly defmed. Investigation was of greater immediate Decisions: The committee noted the reportimportance for WHO than research. Demonstra- of the Expert Committee on Health Statisticstion programmes should be preceded by field and adopted the resolution based thereon forstudies carried out locally. He suggested that the submission to the Second Health Assemblydocument under consideration be adopted as a (for text, see tenth report, section 3). preamble to a declaration of principles which he summarized as follows : The committee also adopted the programme for 1950 (Official Records No. 18, section 7.5.7). (1)that investigation or research is an essen- tial part of the work of WHO ; 4.Epidemiological Statistics and Information (2)that first priority be given to investigations The CHAIRMAN mentioned that the item on directly relating to the WHO programme ; Epidemiological Statistics and Information had (3)that investigations or research be sup- been inadvertently omitted from the agenda, ported in existing institutions or form part of and had not yet been considered by the committee. the duties of field teams sup'ported by WHO ; (4)that all locally supported investigations Decision: Thecommitteeapprovedthe programme for 1950 (Official Records No. 18, or research be so directed as to encourage or section 7.5.10). ensure the assumption of responsibility for continuance work by the local agency ; that WHO should not consider at the 5.Co-ordination of Research and Therapeutic (5) substances (continuation from p. 179) present time the establishment of international research centres. Agenda, 8.16 Co-ordination of Research Colonel AFRIDI (Pakistan) felt that a further Dr. RAJA presented the paper submitted bypoint should be added : WHO should use existing hisdelegationentitled" A Memorandum onexpert committees to the full in co-ordinating Research " (Annex 15). methods of research carried outindifferent countries. Dr. FORREST, Secretary, said that the Director- General welcomed the opportunity of comment- The CHAIRMAN suggested that a drafting com- ing on the important questions raised in themittee, consisting of the Rapporteur, and Dr. Raja, document submitted by thedelegationforDr. Cameron and Colonel Afridi, should draft India. a resolution for submission to the Assembly, From an administrative point of view, thewhich would embody the views of the delegations establishment of international research institutesof India, Canada and Pakistan on the question was not feasible, and the Director-General wasof research. glad to note that this was the conclusion reached in the paper submitted.Section 7.5.8 on the Decision: The Chairman's suggestion was co-ordination of research 60 had been inserted in approved.

60 Off. Rec. World Hlth Org., 18, 156 The meeting rose at 6.15 p.m.

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THIRTEENTH MEETING Thursday, 23 June 1949, at 9.30 a.m. Chairman: Dr. H. HYDE (United States of America)

1.Announcement by the Chairman Dr. PAMPANA recalled that, as a resultof For the guidance of the General Committee inrecommendations 62submitted by the Expert making nominationsfor membershipoftheCommittee on Malaria, the First Health Assembly Executive Board, delegates were invited by thehad adopted a resolution on the subject.63 'The CHAIRMAN to indicate to the President of theresolution had been communicated by the Director- Assembly, not later than 4 p.m. the same after-General to all Members of WHO with a request noon, whether or not their countries would befor their views. So far 14 replies had been received. willing to designate persons to serve on theIn addition, the Italian Government had been Board. requested to furnish a report on the measures it had taken. The Director-General had already 2.Malaria submitted the question to the Expert Committee Agenda, 8.5on Insecticides, the conclusions of which would be found in the report on its first session." The CHAIRMAN,inintroducingtheitem, observed that malaria was a problem of major There being no observations, the committee importance which had been given first priority by passed to the next item. the First Health Assembly. An Expert Committee on Malaria had existed from the time of theActivities with the United Nations, Specialized Interim Commission and its reports had proved or Non-Governmental Organizations of great value in formulating the malaria pro- Agencies gramme of WHO.The report of the second Joint Action Programme of FAO/WHO to session of the expert committee was submitted increase World Food Production and raise for the consideration of the committee. Standards of Health (Annex 7) An informal discussion on the technical level between the Secretariat and delegates interested The CHAIRMAN noted that the joint FAO/WHO in malaria had taken place the previous eveningprogramme was additionaltotheDirector- and would be continued at an early opportunity.General's proposal for the 1950 programme, set The ideas emanating from the discussion would,forth in Official Records No. 18, page 62 ;this he was sure, prove of value to the Director-proposal would be discussed separately. General in the carrying out of the WHO pro- gramme. Dr. PAMPANA recalled that the Expert Com- mittee on Malaria atits second session had Expert Committee on Malaria:Report on therecommended that there should be collaboration Second Session 61 between FAO and WHO.66 The Executive Board Dr. PAMPANA (Secretariat) recalled that theat its first session had approved the suggested report had been presented to the First Healthcollaboration 66 and had further recommended Assembly, which had adopted two resolutions,that proposals for a joint action programme be the first establishing the Expert Committee onsubmittedtotheSecond Health Assembly, Malaria of WHO and the second dealing with thetogether with the recommendations of the Econo- Darling Foundation. With the exception of themic and Social Council. The Economic and sub-sections on the " Expert Sub-Committee onSocial Council at its eighth session had been Insecticides ",and" Quarantineagainstre-informed of the project but had taken no action importation of anophelines ", the Assembly hadat that time. referred the report to the Executive Board for its consideration. At its first session the Execu- He invited attention to the draft resolution tive Board had approved the report and thesubmitted by the Director-General (for final text Director-General was in process of implementingsee tenth report, section 4).As a result of the the recommendations contained therein. resolution adopted by FAO's Council " atits

Decision:The committee noted the report 62 Off. Rec. World Hlth Org. 11, 59 on the second session of the Expert Committee on Malaria. 63 Off. Rec. World Hlth Org. 13, 301 64 To be published QuarantineRegulationsforPreventionofthe 65 Off. Rec. World Hlth Org. 11, 48 and 58 Reimportation of Anophelines 66 Off. Rec. World Hlth Org. 14, 10 67 This resolution read : The CHAIRMAN called upon Dr. Pampana to The Council, submit a progress report on the subject. Having considered the memorandum sub- mitted by theDirector-General(CL6/29), 61 Off. Rec. World Huth Org. 11, 43 enclosing a document prepared by WHO for - 188 - THIRTEENTH MEETING meeting in Paris of 18 June 1949 certain altera-ration between the two organizations, which tions to the original programme (final text inshould bear fruitful results. Annex 7) had been introduced. On the CHAIRMAN'S, suggestion it was agreed On the invitation of the Chairman, Dr. Aykroydto amend the draft resolution as follows :(1) the (Observer, FAO) addressed the committee. word" Programme "tobesubstitutedfor " Budget " in thefirstoperative paragraph Dr. AYKROYD said that the FAO Council was (2)the second operative paragraph 08 to read' " and RECOGNIZES that such provisionwill, strongly in favour of continued collaborationinvolve the obligation to provide in the pro- between the two organizations in carrying outgramme of WHO in the following five years for joint programmes for the elimination of malariathe operation of the various projects ". and other diseases and for the stimulation of food production. There existed abundant evidence Decision :It was agreed to recommend to that in many areas of the world ill-health and the Health Assembly that it adopt the draft disease were proving serious obstacles to the resolution submitted by the Director-General, as development of agriculture and the extension amended. of food production. It would be noted from the joint programmeProgramme for 1950 (Annex 7) that the choice of areas in which the project would be carried out would depend on There being no observations, sections 7.4.2.1 their agricultural potential and that preliminaryto 7.4.2.5, inclusive, ofOfficial Records No. 18 selection would be made by FAO. (page 58), were successively approved. The gist of the changes introduced into the programme by the Council of FAO was to limit In regard to section 7.4.2.6.3, Research Special the responsibility of FAO in supplying agri-Project, Professor CORRADETTI (Italy) expressed cultural equipment, where large areas were con-doubts of the usefulness of the project,as cerned. It was outside the limits of FAO'sproposed,indealingwithAfricanmalarial resources to do so and it was regarded as theproblems.First, it was not clear whether the responsibility of the governments concerned toeradication experiment would be attempted in a A . funeslus or a A .gambiae area, in an area with both provide such equipment for the development ofthose vectors or in an area with other malaria- large-scale food production programmes.FAO carrying anopheles.Secondly, as the epidemio- would, however, be able to provide expert advicelogy of malaria in Central Africa varied consi- and assistance. derably according to the region and the altitude, it would be select a zone which might ration in the field between the two organizationsbe considered typical of Central Africa and, should had already begun.An agricultural expert oferadication be attempted, it would be necessary FAO had recently visited areas in India andto carry out many experiments, following the Pakistan where anti-malarial projects had beenmany entomological and epidemiological varia- initiated and he had conferred with the WHOtions that existed. experts and government authorities concerned. He It had been found from experience that eradi- directed attention to the fact that full partici-cation was an expensive process and was not pation by FAO in such projects would be possiblemore effective in preventing malaria than the only under the supplementary technical assistancetreating of human and animal habitations by programme for economic development, whichcontact insecticide sprays.He was aware that had been worked out in consultation with thein some Central African gambiae regions, mala- United Nations and other specialized agencies.riologists using that method were meeting with difficulties which they attributed to infection He read a statement from the Director-Generalfrom gambiae bites received out of doors. On the of FAO in which stress was laid on the keenother hand, reports of successful antimalaria interest of FAO in the joint projects. control solely through the use of DDT sprays had come from other African gambiae regions. In thanking Dr. Aykroyd, the CHAIRMAN Accordingly, he concluded that the malaria stated that WHO welcomed the close collabo-problems of Central Africa, which were of a very complicated nature, could not be solved by a submissiontothe World Health Assemblysingle experiment. It would be necessary to meeting in Rome during June, carry out a series of experiments on insect control ENDORSES the continued collaboration between in houses :only if and when those experiments, FAO and WHO in preparing and implementingcarefully carried out by experts, had proved schemes for the elimination of malaria and the stimulation of food production, and, RECOMMENDS totheConferencethat,in 08 This paragraph originally read : preparing schemes of extended technical assis- RECOGNIZES that such provision will involve tance, provision should be made for full FAO the obligation to provide, in the following five co-operation in the joint FAO/WHO scheme years, the necessary funds for the operation of (CL 6/29). the various projects. - 189 - COMMITTEE ON PROGRAMME the method tobeineffectiveinpreventing Dr. RODHAIN supported Dr. Rae's observations malaria, should more expensive methods be used.regarding theavailabilityof information on trypanosomiasis.He had presided in February Dr. EJERCITO (Philippines) agreed with the1949 over the meeting of the Permanent Research delegate of Italy in regard to the varied epide-Committee intotrypanosomiasis andtse-tse. miology of malaria, not only in different countriesThe Director-General might obtain the required but in different regions of the same country. Heinformation from that committee, the head- therefore considered that it would be wiser ifquarters of which were in London. WHO extended its research to include work He wondered whether it would not be advisable being done in other parts of the world.It wouldto await the results of the proposed research also, he felt, be more economical for WHO to sendwork before holding the conference :the con- representatives to all countries undertaking experi-ference would then be able to base its studies on mental research in malaria control ;on the com-the results. pletion of those experiments, knowledge of the problem on a worldwide scale would be available. Colonel AFRIDI (Pakistan) was in favour of the proposed conference being held without Dr. RODHAIN (Belgium) stressed the importanceawaiting the results of the research work contem- of the observations made by the delegate ofplated.There existed already a considerable Italy. He agreed that research into the problemamount of data on malaria,collected from should be started by means of a single experimentdifferent parts of Africa and giving conflicting but proposed that, to produce the maximumresults.If the conference were held first, those benefit, the experiment should be carried outdata might be reviewed and attention could then in the area where local conditions were the mostbe focused on the experimental work to be under- difficult. taken on conflicting points. He was also in favour of the presence of trypanosomiasis experts at The CHAIRMAN said the proposed researchthe conference. There were so many related project would be re-examined by the Expertproblems that their presence would, in his opinion, Committee on Malaria of WHO. When the WHOfacilitate the work of the conference and enable malaria-control programme had been approvedconclusions to be reached more rapidly. He by the Health Assembly, the expert committeesuggested that the number of such experts be would provide guidance for the Director-Generalnot specified. in the carrying out of the programme. The observations of the delegates of Italy and Dr. RAE said that he did not wish to press the the Philippines would be transmitted to thepoint. If the presence of trypanosomiasis experts expertcommittee,andtheDirector-Generalat the conference were considered essential, he would take them into account when implementingwould not raise any objection.The question the programme. might be left open. Dr. RAE (United Kingdom) raised a query on The CHAIRMAN requested the Secretariat to the number of trypanosomiasis experts contem-take into account, in planning the conference, plated for the proposed Malaria Conference inthe views expressed by Dr. Rae. Equatorial Africa (section 7.4.2.6.5). He recalled Dr. RAE supported the view of the delegate that an international conference on trypanoso-of Pakistan that it was necessary to hold the con- miasis had been held the previous year at whichference before deciding upon the area in which it had been decided to establish close collaborationthe proposed research work would be carried out. and the sharing of results of research work. The necessary information on the subject of trypanoso- Dr. RODHAIN was of opinion that sufficient miasis would therefore appear to be alreadyknowledge on the subject already existed to available. Moreover, malaria in Africa constitutedenable the expert committee to choose an area so vast a problem that the proposed conferencefor the first experimental work to be carried out, might well confine itself to its study.It seemedwithout the holding of the conference to do so. to him, therefore, that the expense of having 10Further experiments would, he was certain, have trypanosomiasis experts at the conference wasto follow. Such a conference would be extremely unnecessary. costly and, while he did not press the point, he felt that a different decision might have been Dr. PAMPANA, in reply, noted the close inter-t aken. relationship between the two diseases in some areas and the necessity for expert knowledge to The CHAIRMAN said Dr. Rodhain's observations be available to the conference, in order that itswould be transmitted to the Expert Committee recommendations might be the most efficaciouson Malaria. possible.If all necessary information on try- Dr. PAMPANA, introducing the budget estimates panosomiasis were available to the conference(Official Records No. 18, p. 64) said that, in 1950, in regard to any area which it might indicate asit was proposed to put into the field seven full liable to be a priority area for the institution ofdemonstration and operational malaria-control malaria control, he agreed that the presence ofteams. trypanosomiasis experts would be superfluous : if such information were not available then their The CHAIRMAN noted that the estimates included presence would be necessary. provision for 17 consultants. - 190 - THIRTEENTH MEETING

Dr. KLosI (Albania) said malaria was a majormum amount of work that could be undertaken, problem for his country, from the viewpoint oftaking into account the availability of expert health, economy and agriculture.Encouragedpersonnel for international work in 1950. by the excellent results obtained from the use of modern antimalarial methods, his govern- Dr. RAJENDRAM (Ceylon) suggested that mala- ment had decided to increase its efforts againstria eradication, which was the aim of the WHO the disease.In 1938, malaria had accountedprogramme, might be considered as partof for 22% of the cases of illness and that percen-species eradication. By residual DDT spraying, tage had increased during the war, but by 1947,that aiin was in a fair way to being realized in after the institution of antimalarial measures,Ceylon, at a cost of approximately 20 US cents it had decreased to 14%, and in 1948 to 8%.per head of the population.Species eradication He was of opinion that the budgetary estimateswould mean considerable capital expenditure and formalaria wereinsufficient,particularly inthe maintenance of a quarantine service. Would regard to immediate objectives.Much usefulit not be advisable, therefore, to advocate the work would, he was sure,be accomplished,extension of malaria eradication to a larger thanks to the training of specialized personnelnumber of countries and bigger areas, rather and the furnishing of supplies, but he consideredthan limit themselves to species eradication in thattheaidcontemplated wasinsufficient,one area ?If that were done, in the course of particularly for those countries non-producers oftime the incidence of malaria would be reduced antimalarial products, such as DDT. The wide-to such an extent that the disease would become spread ravages of the disease merited a wideralmost extinct. programme than had been established, and to make the work effective, it would be necessary The CHAIRMAN directed attention to page 60 to increase the furnishing of supplies, medica-of Oticial Records No. 18, where the long-term ments and other necessary means of combatingobjectives of WHO in regard to malaria were malaria to those countries, devastated by the war given.The emphasis there was on the control and non-producers of the necessary products,of malaria ;only in the case of the Special which already possessed trained personnel forResearch Project had that emphasis been placed the carrying out of the measures contemplated.on species eradication.The point raised by the He therefore felt that it would be in order to delegate of Ceylon also figured on the agenda of suggest to the Assembly an increase in the budge-the Expert Committee on Malaria and would tary provision for such supplies. thus be reconsidered by that committee.

Dr. AVERY (Iran) supported the observations Dr. RAJENDRAM was satisfied with the Chair- of the delegate of Albania. He made two pointsman's reply. which he thought might be brought to the atten- tion of the Committee on Administration and Dr. KLosI again urged that governments, non- Finance.First, considering the importance ofproducers of medical products but having a the disease, the proportion of the total budgettrained personnel for implementing the pro- devoted to the malaria programme was insuffi-gramme, should have increased supplies and cient.Secondly, a greater return for the moneyequipment made available. expended would be obtained if a larger proportion of the budgetary provision was assigned to the Dr. BABECKI (Poland) supported the view of supply of materials, to providing leadership andthe delegate of Albania.For certain countries to the education and training of local personnel.the furnishingof materials was much more important than the supplying of teams.More- The CHAIRMAN stated that the question ofover, local teams would be much less expensive supplies was not confined to the programme onthan WHO teams. malaria ;it was common to all the programmes and would be considered by the committee under Dr. EJERCITO suggested, in regard to demon- item 8.18 of the agenda. The decisions taken atstration teams, that the availability of competent that time would apply to all items of the pro-persons in the countries concerned should be gramme. A further opportunity for discussiontaken into consideration.Such persons, being of the point would also occur later, when theaccustomed to local conditions, would be able joint meeting with the Committee on Admini-to work more quickly.He agreed with the stration and Finance took place. observation of the delegate of Poland on the In regard to the observation that the programmepoint. on malaria was not sufficiently extensive, he He suggested that the three teams mentioned recalled that there was the further programmein paragraph 7.4.2.5.1 should be established at to be undertaken in collaboration with FAO. the same time. In reply to Dr. Avery he stated that the supplies and equipment referred to in the budget estimates On the CHAIRMAN'S suggestion, it was agreed were for the use of WHO teams, which it wasto discuss the question of medical supplies under hoped would provide the leadership desired. Theitem 8.18 of the agenda. total of the estimate had been determined by the Director-General, as providing for the maxi- The meeting rose at 12.15 p.m.

- 191 - COMMITTEE ON PROGRAMME

FOURTEENTH MEETING Thursday, 23 June 1949, at 3.40 p.m. Chairman: Dr. H. HYDE (United States of America)

later :

Dr. Irêne DOMANSKA (Poland)

1.Regional Offices Peru where both diseases were endemic.Those Agenda, 8.19examples from personal experience were similar to others observed in certain other countries. The CHAIRMAN proposed that item 8.19 should be transferred to the agenda of the Committee It was clear, therefore, that a single method, on Constitutional Matters. namely, the distribution of contact insecticides This was agreed. in houses, could prevent diseases which, owing to the etiological classification used, appeared in 2.Malaria (continuation) the programme under different paragraphs and Agenda, 8.5with separate funds. It would consequently seem Programme /or 1950 desirable that all activities and funds relating to insect-borne diseases should be co-ordinated : The CHAIRMAN drew attention to the proposalsuch co-ordination could only be obtained by of the Italian delegation (Annex 3) that thewidening the terms of reference of the Expert Expert Committee on Malaria should be givenCommittee on Malaria and transforming it into wider terms of reference and be constituted asan expert committee on malaria and other an expert committee on malaria and other insect-insect-borne diseases. borne diseases.As the committee in question had only recently been established and would It was unnecessary to emphasize the importance hold its first meeting in August, the best proce-of domestic insect control from the health point dure would seem to be to refer the proposal toof view. It was in the interest of all governments the Executive Board, which would report on itwhose territory was malarious, to enjoy the to the Third World Health Assembly. advantage of employing for the prevention of other insect-borne diseases personnel trained in Dr. WICKREMESINGHE (Ceylon) supported the the control of malaria.Such an authority as proposal :the Expert Committee on VeneralDr. Soper, of the Pan American Sanitary Bureau, Diseases had been similarly enlarged to deal withhad suggested to the First World Health Assembly yaws and bejel. the establishment of a special committee on house disinfestation, citing the fact that for some Professor CORRADETTI (Italy) in explaining hisAmerican countries separate malaria services had delegation's proposal, stated that insect-bornebeen extended to cover that field.In the experi- diseases were generally classified according tomental study carried out in Abruzzo to ascertain the nature of the etiological agent, as bacterial,how far DDT spraying could prevent cutaneous viral,protozoal,and helminthicinsect-borneleishmaniasis, personnel trained in malaria-con- diseases. Such classification,while useful introl were being used. It seemed, therefore, medical and biological teaching, might give risehighly desirable that personnel should be trained to difficulties in public-health programmes. in the whole field of insect control as a measure The introduction of contact insecticides hadof public health.Such training was already been a veritable revolution, and had permittedbeing given at the Institute of Public Health in effective control of numerous insect-borne di-Rome, under the auspices of WHO. seases. It had been shown that contact insecticides, Referring to the comments of the Philippine sprayedformalaria-controlinhouses, weredelegation on the Italian proposal (Annex 3), effectivenot only againstmalaria butalso he stressed that his delegation had not proposed against general mortality and morbidity. Inthe control of domestic anopheles vectors, which Italy a marked decrease of general and infantwould involve the destruction of house insects, mortality had been noted in those regions inbut had suggested that WHO should help govern- which DDT had been distributed in houses forments toundertake large-scalecontrolpro- malaria-control. grammes against house insects all over the world. His personal experience in Peru had alsoThe disappearance of malaria vectors in houses shown that general morbidity from infectiousin most of the malarious countries would be a diseases was much reduced where houses wereconsequence of such control.In that manner sprayed with DDT. Such spraying had preventedcontrol of insect-borne diseases other than malaria both malaria and verruga peruana in a region ofby the spraying of contact insecticides in houses - 192 - FOURTEENTH MEETING would make malaria-control less expensive. More-of medical research into the BCG-vaccination over,the drawing-upof - programmes againstprogramme of UNICEF had been accepted. The house insects, which were responsible for manysix types of medical research envisaged were diseases, did not imply the neglect of new meansoutlined in the appendix to Annex 10 of Official for controlling wild insects, including wild ano-Records No. 14. pheles. Official Records No. 15, page 5, gave the full He stressed finally that most powerful meansreport of the third session of the expert committee. were available at the present day for destroyingThat report had been studied in some detail by insects in houses, and therefore for preventingthe third session of the Executive Board," when diseases being transmitted in houses.It was theit had been decided to refer the report and the comments of the Board, as given in Annex 6 of duty of WHO towards mankind to use thoseOfficial Records No. 17, to the new Expert Com- means on the maximum scale and with themittee on Tuberculosis, which would meet in minimum cost. July 1949. The third report of the ad hoc expert committee Dr. DUJARRIC DE LA RIITIÈRE (France) agreed contained three important annexes :Tuberculin with the delegate of Italy that DDT was ex-and BCG, streptomycin, and suggestions for the tremely effective against malaria, but could notcontrol of tuberculosis in countries with undeve- support the proposal to extend the terms ofloped programmes, Annexes 2, 3 and 5 respec- reference of the expert committee, for threetively.It had, however, been decided by the reasons : (1) the problems of malaria wereExecutive Board that, as a matter of emergency, already large enough without other fields beingthe Director-General should draw the attention explored ;(2) DDT was not the only prophy-of Member Governments and their public health laxis ;(3)liaison with the Expert Committeeadministrations to the desirability of guiding on Insecticides, if any problems regarding otherthe medical profession and the public in such insect-borne diseases were encountered, was rela- a way as to avoid as far as possible the creation tively easy. of streptomycin-resistant tubercle bacilli.That had been done. Dr. EJERCITO (Philippines) said the Italian Professor CECONOMOPOULOS(Greece)stated proposal implied that all diseases which werethat nutrition was of fundamental importance communicated by insects would have to beto health and so far as tuberculosis was concerned, studied by the expert committee.Therefore inparticularly among the lower income groups, view of the prominence given to malaria, the nameinadequate nutrition was one of the predominant suggested did not seem appropriate.Moreover, factors. WHO should impress upon Member if the name were so changed, it might imply thatGovernments the necessity of altering their fiscal a solution had been found to all malarial prob-laws and, inparticular,of reducing indirect lems. Most malariologists did not agree that thetaxation on the principal foodstuffs consumed use of DDT was the only means of combatingby the working classes.Every effort should be malaria.Finally the experts themselves mightmade to ensure that economic policy was formu- resent any such change of name. lated in such a way as to take into account health considerations.It was to be hoped that A motion by Dr. TIMMERMAN (Netherlands) by the simultaneous application both of pro- for closure of the debate was adopted. phylactic measures against the virus and thera- peutic measures, the disease would be in large Decision: Thecommitteeapprovedthemeasure overcome.BCG vaccination was one programme for 1950 (Official Records No. 18,of the most important of the prophylactic mea- pp. 58-63). sures, but he would touch on that point at a later st age. The Vice-Chairman took the Chair. The CHAIRMAN stated that the observations made by the delegate of Greece would be for- 3. Tuberculosis warded to the expert committee. Agenda, 8.6 Dr. DUJARRIC DE LA RIVIERE observed that a Expert Committee on Tuberculosis: Report on thenumber of factors were involved in the struggle Third Session against tuberculosis. The delegate of Greece was correct in his contention that prophylactic mea- Dr. MCDOUGALL (Secretariat) said it would besures had to be taken in order to prevent it from noted in Official Records No. 14, page 19, itemspreading.He himself wished to speak only of 1.8.1, that the second session of the ExecutiveBCG vaccination and, in particular, to emphasize Board had taken note of the report on the thirdthe very remarkable results which had been session of the ad hoc Expert Committee on Tuber-achieved in that connexion by WHO and the culosis and decided to publish it as submitted,ad hoc Expert Committee on Tuberculosis, under without observations, but with a note statingthe leadership of Dr. Holm.It was imperative that the Board had postponed discussion untilthat there should be close co-operation between its third session.At the second session of the Executive Board responsibility for the promotion " Off. Rec. World Hlth Org. 17, 11 - 193 - COMMITTEE ON PROGRAMME all those who were working in that field, and due The CHAIRMAN stated that the observations attention should therefore be given to the educa-made by the delegate of Greece would be for- tional aspect. warded to the Executive Board. Dr. BABECKI (Poland) stated that the committee Activities with theUnited Nations, Specialized might be interested to hear some facts concerning A gencies or Non-Governmental Organizations the Polish campaign against tuberculosis.The tuberculosis rate was extremely high at present, Dr. MCDOUGALL informed the committee that due to the war and the occupation. The annualthe Tuberculosis Section had been in constant deaths were now 40,000 and the sickness ratecontact with two organizations.One was the 300,000. At the end of a six-year national planInternational Union against Tuberculosis, with in 1955, it was hoped that the number of deathswhich liaison had been established in accordance would be reduced to 26,000.An. extensive cam-with the Executive Board's decision.7° That body paign had been planned and had already beenhad now been reorganized, which would facilitate set in motion.Among other measures taken,the work of WHO. A vast field still remained to be 3,700,000 children and young people' had under-covered by voluntary action and in that connexion gone tuberculin tests. Of that number, 1,700,000the committee would no doubt be interested to had yielded negative results and had been vacci-hear a statement from Dr. Alsted, the Director nated with BCG by the intradermal method.of Medical Services of the League of Red Cross About 600,000 people had been examined bySocieties. means of mass radiography.Some 1.2% had The second organization with which the Secre- been found to be suffering from active tuber-tariat had been in contact was UNICEF. Close culosis, requiring treatment. The rate of activeco-operation had been maintained with regard tuberculosisindifferentgroups varied fromto tuberculin testing and the BCG campaign. 0.5 to 1.5%, the highest rate being found among university students :the percentage for factoryWHO had no responsibility in the field work of workers was 1.7.In the near future, aboutthe campaign but was acting in an advisory 90,000 teachers would be tested.Under thecapacity. six-year plan, all children and youths up to the age of 18 years would be tuberculin-tested and those On the invitation of the Chairman, Dr. ALSTED with negative results would be vaccinated with(International League of Red Cross Societies) BCG. It was planned to increase the number ofmade a statement. He felt there was no need to beds for tuberculous patients from 17,000 toemphasize the importance of the fight against 27,000.At the same time, a special anti-tuber-tuberculosis.In a considerable number of the culosis institute had been established in Warsaw,68 countries of the League, it constituted one of which was to deal, among other matters, withthe major health problems. In order to overcome questions of chemo-therapy.Very encouragingit, every effort should be mgcle to co-ordinate results had already been obtained in the treat-action. Many Red Cross Societies had contributed ment of various typesoftuberculosis witha great deal in that respect by providing funds, streptomycin and para-aminosalicylicacid,asequipment and trained personnel, and his organi- well as in the treatment of bone and lymph glandzation was determined to explore every avenue tuberculosis with injections of nitrogen mustard.to promote collaboration with WHO. The difficulty of obtaining streptomycin was a great handicap in the treatment of tuberculosis. Professor PENSO (Italy) asked whether contact had been made with the International Associa- Professor CECONOMOPOULOS(Greece)statedtion of Microbiologists, which had recently set that Greece had adopted BCG vaccination from 1926 and excellent results had been obtained inup a commission to study problems of micro- administeringitby the mouth to newbornbacteriology. children.He advocated the adoption of that method for newborn children and the admini- Dr. FORREST, Secretary, in reply, referred to stration of intradermic vaccination to childrenthe recent discussion on co-ordination of research of over a year, in cases where tuberculin testsand co-operation with medical congresses (see were found to be negative.He requested thatp. 157).A number of non-governmental inter- his report on the subject, which he had trans-national organizations had applied to enter into mitted to the Secretariat, be translated from therelationship with WHO, and 16 had so far been Greek and published in English. admitted.The position was constantly under As regards streptomycin, he drew the attentionrevision, but it was not the normal procedure of WHO to the fact that the quantity allocatedfor the Executive Board to admit congresses as to his country was not even adequate for the such.If the body referred to by the delegate of treatment of tubercular meningitis and miliaryItaly possessed the necessary status,it could tuberculosis. He then gave some technical infor-apply to enter into relationship with WHO. mation on his personal observations of the useAt all events, there was no obstacle to the inter- of streptomycin for the treatment of primarychange of information between the Director- infection, and requested that his report in EnglishGeneral and the secretariats of such organizations. on the subject, which he had forwarded to the Secretariat might be translated and published. 70 Off. Rec. World Hlth Org. 14, 28 - 194 - FOURTEENTH MEETING

Decision :The committee noted the reporting research. That was the best way of collecting on the third session of the ad hoc Expertinformation, particularly from countries the sta- Committee on Tuberculosis, and agreed thattisticsofwhich wereeitherincompleteor the observations made in the course of debateunreliable.Visits of short-term consultants, as should be forwarded to the Executive Board.proposed in - the Director-General's report, did not appear to them to meet the situation and Tuberculosis Research Group (Annex 16) there was an extremely strong case for Ole appoint- ment of full-time tuberculosis officers for each Professor PENSO congratulated the Tuberculosisregion.He commended the resolution accom- Research Office on its programme, but said thatpanying the proposals to the consideration of the scientific study of anti-tubercular vaccinesthe committee. should not be restricted to BCG, the exact value of which had not yet definitely been established. Other vaccines should also be considered, such Dr. GONDA (Czechoslovakia) pointed out that as those at present being investigated in Italy andthe proposals would involve special budgetary the United Kingdom. provision in order to finance the increased field- He noted that the necessity for standardizingservice personnel.He felt that the additional vaccines figured in the programme, and felt thatcost was justified owing to the urgency of the astandard methodofassessingpathogenicproblem and the great need of countries requiring powers of tubercle bacilli should also be studied,help. He hoped the committee would accept the as that would be useful for diagnostic purposes.proposals and submit them for consideration at the joint meeting with the Committee on Admini- Dr. PALMER (Secretariat) replied that researchstration and Finance. would in no way be restricted to BCG vaccine. Dr. CAMERON (Canada) was not in favour of the The SECRETARY said that the question ofproposals submitted by the four delegations. biological standardization raised by ProfessorThey appeared to him to be a reversal of the Penso would be referred by the Director-Generalprocedure that should be followed. The recruit- to the competent committee. ment of temporary consultants was, in his opinion, the most effective way of 'obtaining the services Dr. TIMMERMAN stated that biological standardi-of experts, since personnel with executive and zation had already been taken up by the appro-administrative experience based on sound medical priate committee, which was concerned to findknowledge were required. what could be done in the matter of standardi- zation and cultural techniques. Dr. RAJA (India) asked the Chairman whether Decision :The programme of the Tubercu-Dr. Benjamin, the adviser on tuberculosis to the losis Research Office (Annex 16) was approved. Indian delegation, might make a statement.

Programme for 1950 The request being granted, Dr. BENJAMIN (India) stated that he was strongly in favour of Dr. MCDOUGALL drew the attention of thethe proposals put forward by the four delegations, committee to the largely factual informationparticularly as the problem of tuberculosis was supplied inOfiicial Records No. 18, page 96,very serious in South-East Asia.Measures for describing the work accomplished and the methodsdealing with it were inadequate.He doubted by which the programme for 1950 was to bewhether short-term consultants would be able conducted. The committee would note thatto obtain any information additional to that certain obligations might devolve on WHO when UNICEF terminated its activities.Appropriatealready available in official publications.What budgetary provision had been made to meet thatwas lacking in those areas was not plans but the contingency. means for their implementation. Many countries had drawn up schemes for tuberculosis control, Dr. Soul (Denmark) drew the attention ofbut they needed an external stimulus to put the committee to the proposals on the tubercu-them into operation.For example, the question losis programme submitted by the delegationsof introducing BCG vaccination had been under of Czechoslovakia, Denmark, Finland and Indiadiscussion in his country for some years, but it (Annex 17) and explained that,if they werewas only after the necessary impetus had been accepted, substantial alterations would have tosupplied by the action of WHO and UNICEF be made in the WHO programme. that the project had been launched. WHO could The tuberculosis experts who had met pri-do much in helping to establish international vately to draw up those proposals felt stronglystandards in technique and in accelerating na- that time should not be wasted in collectingtional plans for tuberculosis control by the pro- information. There was an imperative necessityvision of equipment and expert personnel. Centres to get down to field work. Demonstration centreshad been set up to deal with the preventive aspect should be set up as one of the means of conduct-of tuberculosis control, which had hitherto been - 195 - COMMITTEE ON PROGRAMME somewhat neglected. He was therefore in favour 4.Adoption of Draft Reports of the Committee oftheappointmentofregionaltuberculosis officers with the necessary qualifications.They Decision :The committee adopted its draft should be men of seniority with experience in third and fourth reports to the Health Assembly field work, able to command the respect of (see pp. 325, 327) and its draft third report 71 for local officials.It was essential to select the right consideration by the Committee on Admini- type of man, namely, one with tact and the stration and Finance. ability to adjust himself to difficult conditions. In view of the late hour, it was agreed that The meeting rose at 6.40 p.m. further discussion on this item should be deferred until the following meeting. 71 See footnote 16, p. 164.

FIFTEENTH MEETING Friday, 24 June 1949, at 9.30 a.m. Chairman : Dr. H. HYDE (United States of America) later Dr. Irène DOMANSKA (Poland)

1.Co-ordination of Research and Therapeuticly co-operative and were imbued withthe Substances (continuation from p. 187) desire to reach the largest number of recipients possible in an effective way. Agenda, 8.16 Co-ordination of Research (continuation) The CHAIRMAN then presented the draft reso- lution on co-operation with UNICEF submitted Decision: The committee agreed to recom-by the Director-General (for text, see sixth report, mend to the Health Assembly the adoption ofsection 3). the resolution on this subject drawn up by the drafting committee (for text, see fifth report, Dr. RAJA (India) asked whether, from the section 2). resolution, it should be understood that WHO assumed full technical responsibility and execu- 2.Activities with United Nations, Specializedtive authority in respect of all these projects, and Agencies, or Non-Governmental Organiza-that UNICEF would be assisting financially. fions Agenda, 8.21 Dr. GOODMAN replied that so far as technical responsibility was concerned the answer was in Joint Committee on Health Policy, UNICEF IW HOthe affirmative ;with regard to executive re- sponsibility, it was in the negative. In one sense Dr.GoODMAN,ActingAssistantDirector-WHO had already resumed responsibility in that General, presented the report by WHO membersall UNICEF health projects passed through the of the joint committee on the assumption byjoint committee and each particular project had WHO of responsibility for the UNICEF healthto be approved by the Director-General of WHO projects, and on the functioning of the jointon technical grounds before it was put into action. committee (Annex 4). Dr. RAJA (India) asked for further clarification. Mr. PATE, Executive Director, UNICEF, as-Paragraph (d) of the section " Co-operative Poli- sured the committee that between the Director-cies " of the report by the WHO members stated : General of WHO and himself there existed the closest co-operation, not only official but personal. UNICEF's role in health programmes is in The same co-operation existed between the staffs accordance with its charter to furnish under of the two organizations, at headquarters, in the its agreements with governments the required regional offices and in the field.UNICEF was supplies and services, and through its staff to essentially a supply organization, set up to meet observe that the principles of the Executive an emergency situation, a large part of its staff Board are maintained in their utilization. being lay people, and the assistance of WHO in its medical programmes for assistance to children He asked what was meant by the last clause was not only of great value but a necessity.of that paragraph. Presumably, " the Executive At all levels the staff of UNICEF were complete-Board," meant the Executive Board of WHO. - 196 - FIFTEENTH MEETING

Mr. PATE said that the point raised wastee for, in the field, the arrangemént was work- an important one, the clarification of which would-ing very satisfactorily ;officers worked in such be of assistance, to both organizations and toclose and complete partnership thatitwas the governments of the countries assisted.Itsometimes difficult to know which were UNICEF had been the understanding of UNICEF since theand which WHO staff members. beginning of its operations that the programme of operationsfor the utilizations of supplies The CHAIRMAN directed the attention of the furnished to governments rested under the ad-delegate of Ceylon to a recommendation in the ministration of the government of the countryreport :" The developments under this policy assisted or of a local organization, which wasshould be kept under review by the Executive mutually agreed upon between the governmentBoard of WHO ",There was nothing static, concerned and UNICEF.While UNICEF wasbut a continuing development towards closer sensible of its obligation towards its donors thatco-operation. supplies in medical programmes should be used in the most effective way and was therefore very Dr. SCHOBER (Czechoslovakia) said he had glad to rely on the technical services providedrepresented his Government on both bodies, by WHO in the joint programmes, administra-and he thought some clarification of the position tion of a given programme was the concernnecessary.UNICEF was a part of the United of the government of the country assisted. Nations, created by a resolution of the General Assembly, which stated that UNICEF would be The CHAIRMAN further explained, with refe-directed by an Executive Board within the rence to the question concerning the wordsterms of reference given to it by the General " Executive Board " in paragraph (d), that thisAssembly. It seemed to him that many members referred to the Executive Board of UNICEFof the Executive Board of WHO did not clearly and it was certainly the responsibility of the staffrecognize that the Executive Board of UNICEF of UNICEF to see that in this joint relationshiphad not the power to make arrangements in the policies of their own Executive Board werecertain ways, such as transfer of funds, that power carried out. resting with the United Nations General Assembly. One of the duties with which UNICEF had Dr. RAJA (India), in thanking Mr. Pate andbeen charged was control of the programmes in the Chairman for their explanations, said he nowdifferent countries :to do so it had established understood that the staff of UNICEF acted inmissions and on that level co-operation could be accordance with the principlesof their ownachieved and was in most places already being Executive Board to ensure that supplies andachieved between WHO and UNICEF. services made available by it were carried out properly.In so far as governments were con- Dr. RAJA (India) was grateful for the explana- cerned, it would, no doubt, be more satisfac-tions given ;he tory from the practical point of view if therewere accepted, the whole question should be were one joint body, on which WHO and UNICEFreviewed at the end of the year in order to see wereequallyrepresented,withwhichtheyhow the total programme was working. could have dealings. The CHAIRMAN pointed out that adoption of The CHAIRMAN stated that the joint committeethe draft resolution submitted by the Director- recognized that problem and in the section ofGeneral would automatically entail approval of the report on Co-operative Policies called atten-the report and therefore would have the effect of tion to the desirability of joint missions for thatrequesting the Executive Board to keep the purpose. The Director-General and Executivequestion under review, as recommended in the Director were working towards such a develop-latter document. ment, so that governments would be dealing Decision: The committee agreed to recom- with one point of contact instead of two. mend to the Health Assembly the adoption of DT. WICKREMESINGHE (Ceylon) said that on thedraftresolutionon co-operationwith reading the report he had thought some reasonable UNICEF submitted by the Director-General agreement had been arrivedat,that WHO (for text, see sixth report, section 3). would be responsible for technical services and UNICEF for supplies, but as he listened to the3.Tuberculosis (continuation from p. 196) present discussion the position seemed to have become confused.It appeared that in various Agenda, 8.6 parts of the world there might be duplicationProgramme Pr 1950 and a certain amount of overlapping. However, The committee proceeded to consider the paper it was better to have such duplication andsubmitted by the delegations of Czechoslovakia, overlapping than that any countries should beDenmark, Finland and India (Annex 17), which deprived of services.Was it the position that,proposed amendments to the programme as put in present conditions, the status quo must beforward by the Director-General. maintained ? Dr. GOODMAN said that the Director-General Mr. PATE regretted that there should be con-had certain observations to make on the pro- fusion in the mind of any member of the commit- posals ;his particular objection was that the - 197 - COMMITTEE, ON PROGRAMME resolution and its appendix went into more detailrequired advice from many types of experts. and were more rigid than was necessary for theIf the suggestions in the paper were accepted, execution of the programme. The provision ofWHO would be deprived of the help of many secretaries and stenographers, for example, wasdistinguished experts in various branches of the a matter entirely within the prerogative of thework. One of the arguments advanced in favour Director-General.Further, the second clause ofof establishing an expert in each region was the resolution recommended that in each regionalthat a short-time specialist could not meet the office of WHO a full-time tuberculosis officerdemands. But there was no reason why a spe- should be employed, whereas in practice it mightcialist should not remain a sufficient length of be found preferable to assign, as necessary, atime to assist and advise on local problems, and tuberculosis officer. The Director-General wouldthe social and economic background was best suggest that the wording of the resolution andassessed if the experts benefited from the " man particularly of the appendix thereto should beon the spot ", namely, the health officer. made considerably less detailed and rigid. From his understanding of the paper it would appear that there was a proposal to change the The CHAIRMAN said he fully agreed with thepolicy from the use of outstanding experts in comments of the Director-General :the docu-tuberculosis to a regional tuberculosis director ment concerned itself with matters which wereoperating from an office somewhere in the region, of an administrative character, and also withpossibly detached from clinicalpractice. He what should be in the Regular Budget and thecould not subscribe to that suggestion. Supplemental Budget, whereas the committee Further,thesuggestions would involvea had to consider the total budget. He invitedsubstantial increase in the financial appropriation discussion on the three clauses of the proposedfortuberculosis :with a limited amountof resolution, the first two of which were, in fact,money available for all purposes, the increase amendments to principles incorporated in thewould have to be made at the expense of some Director-General's proposal, the third being aother service. Who would determine a priority recommendation for extension of the field service. of that nature ? Discussion proceeded on the first and second He proposed that the paper be referred to the clauses : Executive Board for consideration.

REQUESTS the Director-General to limit the The CHAIRMAN pointed out that the recommend- services of temporary consultants in tuber-ations under discussion were included in the report culosis to a minimum ; of the ad hoc expert committee,72 which had RECOMMENDS that in each Regional Office of been considered at the third session of the Exe- WHO a full-time tuberculosis officer be em-cutive Board and referred to the new Expert ployed. Committee on Tuberulosisof WHO.73 They had been taken into consideration by the Director- Colonel AFRIDI (Pakistan) congratulated theGeneral and the Executive Board in connexion four delegations concerned on the paper theywith programme proposals. The findings of the had submitted, which in general he thought wasexpert conimittee would be reported to the excellent. With regard to the appointment ofExecutive Board and the question was therefore full-time regional tuberculosis officers, he observedwhether the present committee wished to take that a regional tuberculosis officer was not aaction on a matter now under review by the tuberculosis consultant.If full-time consultantsExecutive Board with the assistance of the expert were accepted for tuberculosis, demand for con-committee. sultants in other fields would arise.Such a step would mark a reversal of policy and should not Dr. BABECKI (Poland) supported the proposals be taken without very careful consideration. made in the paper. He stressed the necessity of having a permanent tuberculosis consultant in Colonel MALLICK (Pakistan) said that tuber-each region :it was essential to live in a country culosis had a marked regional variation as onein order to know thoroughly the background of went from East to West ;environmental factorsits people and its bearing on tuberculosis. played a great part and a preliminary survey as proposed by the Director-General was essential, The CHAIRMAN stated that the issue emerging to provide the necessary data on which to for-from the discussion appeared to be the relative mulate plans. The stage had not yet beenemphasis to be placed on temporary consultants reached for the appointment of a whole-timeas against full-time staff officers in the regional consultant in tuberculosis in each region :thatoffices. He asked Dr. Holm whether the deleg- should follow after the preliminary survey hadations of Denmark and the other countries which been completed. had presented the proposals would be prepared to agree that the first and second clauses of their SirAndrew DAVIDSON(UnitedKingdom)resolution be referred to the Executive Board : emphasized the seriousness of tuberculosis in allin regard to regional tuberculosis officers the its aspects. The problems were complex in their social and economic aspects as well as on the 72 Off. Rec. World Hlth Org. 15, 5 preventive and curative side, and their solution 78 Oft. Rec. World Hlth Org. 17, 11 - FIFTEENTH MEETING

Director-General might consult with the regionalcommittee, which it was hoped would meet at organizations as to their desires and inform thethe beginning of September. Executive Board of the results. The report was noted. Dr. HOLM (Denmark) replied that the procedure proposed would be entirely satisfactory. Activities with theUnited Nations, Specialized Agencies or Non-Governmental Organizations Decision: That the note submitted by the delegations of Czechoslovakia, Denmark, Fin- Dr. HARGREAVES gave a brief account of the land and India (Annex 17) be referred to thecollaboration of WHO with the United Nations, Executive Board for particular considerationspecialized agencies and non-governmental orga- of thefirst two clauses of the resolution nizations. contained therein. His report was noted without discussion. Professor PENSO (Italy) recorded the dissent of the Italian delegation from the decision :toProgramme for 1950 ask the Executive Board to take such action was to transform it into a deliberative body. Dr. HARGREAVES presented the programme The committee proceeded to consider the thirdfor 1950 as set out in Official Records No. 18, clause of the resolution : pages 77-84. RECOMMENDS that the personnel available for field services in 1950 be increased in accordance Dr. VAN DEN BERG (Netherlands) supported with the proposals submitted in the appendixthe programme and expressed his satisfaction to this note. that mental health had now been given a high priority. Dr. MCDOUGALL (Secretariat) referred the com- mittee to section 7.4.7. of Official Records No. 18 Dr. TAGAROFF (Bulgaria) considered that the (page 101). The proposals under discussion gaveprogramme did not take into sufficient account an increase in the field personnel of from 27 tothe factors which led to an increase of mental 37 in the Regular Budget, leaving the figuresillness.It also arrived at conclusions with which under the Supplemental Budget the same. Inhe disagreed, as, for example, that the transition reply to a question by the Chairman he addedfrom a rural to an industrialized community that, from the standpoint of the availability ofcreated problems of mental health :exactly the personnel, it should be possible to mobilize theopposite was the experience in his own country. increased staff. The vital factor of war was only briefly touched Decisions : The committee approved the thirdon : such an important factor could not be ignored clause of the proposed resolution recommend-or minimized in a document of WHO. Measures ing an increase in the personnel available forto be taken against war propaganda were not field service in 1950. even mentioned, although such propaganda was The Programme for 1950 as contained inthe cause of many psychoses, and was certainly Official Records No. 18, pp. 96-101, was approved within the sphere of WHO, as affecting mental as modified by the amendment now adopted,health. It was true that the programme provided and subject to decisions taken in the reviewfor collaboration with UNESCO in the project by the Executive Board of the proposalsfor the study of tensions affecting international brought to its attention in the paper submittedunderstanding, but that was not sufficient. One by the delegations of Czechoslovakia, Denmark, Finland and India. had to give to such an important subject the emphasis which Was its due.Measures for the rehabilitationof the masses affected by the 4.Mental Health fascist ideology should be included in the pro- Agenda, 8.14gramme :that was not a political matter, for fascism was considered by the United Nations The statement contained in Official Recordsas a plague afflicting humanity.A campaign No. 16, page 18, was noted. should also be carried out against literature and films which were detrimental to mental health. The Chair was taken by the Vice-Chairman. Those activities should be the basis of collabora- tion between WHO and organizations of similar Report on the Nuclear Expert Committee on Mentalaims such as the Social Affairs Department of Health 74 the United Nations, the World Federation for Dr. HARGREAVES (Secretariat) gave a verbalMental Health, the Congress on Criminology, report on the establishment of the nuclear expertand UNESCO. 74 011. Rec. World Hlth Org. 13, 399 ; 14, 21, item 1.14(6) ;17, 11, item 2.6 The meeting rose at 12.55 p.m.

- 199 - COMMITTEE ON PROGRAMME

SIXTEENTH MEETING Friday, 24 June 1949, at 3.30 p.m. Chairman: Dr. H. HYDE (United States of America)

1.Mental Health (continuation) about one-third of the discharges from the British Agenda, 8.14Army in 1943 had been for psychiatric reasons. It was therefore essential that money should be Activities with theUnited Nations, Specializedspent on the problems of mental illness and the Agencies or Non-Governmental Organizationsachievement of mental health, even if the results could not be evaluated in the quick returns which Dr. GRUT (Observer, ILO) stressed the interestgovernment departments were apt to require. of ILO in mental health and the importance of the mental health aspect of industrial and other occupational problems, such as relationship vith He agreed with the proposals in the note sub- workers, vocational guidance, and rehabilitation.mitted by the mental health advisers of several As the mental health of the working populationother delegations (Annex 18), proposing a re- could not be separated from that of the popula-allocation of priorities among the items suggested tion as a whole, ILO and WHO faced many com-for the 1950 programme. He welcomed the stress mon problems.ILO had had many years oflaid on the prevention of illness, on positive experience in dealing with occupational hygieneattempts to improve mental health, and on those and would welcome the opportunity of collaborat-proposals which aimed at establishing a link ing closely with WHO, particularly in regard tobetween mental hospitals and the lifeof the the surveys and activities proposed for rural andcommunity.The programme should encourage industrial communities. countries m an early stage of development to profit by the experience of others and to introduce The CHAIRMAN noted the interest of ILO inpositive preventive measures at an early stage. broad co-operation with WHO in mental health His delegation supported the acceptance of and said that that agency should be included onthe programme subject to the redistribution of the list-mentioned by the delegate of Bulgariaitems between the Regular and Supplemental at the previous meeting-of organizations withBudgets as suggested in the above-mentioned which co-operation on mental health mattersnote. was desirable. The CHAIRMAN observed that the importance of the mental health programme had already Programme for 1950 been emphasized in the committee and invited Dr. RAJA (India) said his delegation welcomedcomments on the adjustments suggested in the the mental health programme, which was designednote. to enable individuals to adjust themselves to their environment.It was one which should Dr. REPOND (Switzerland) expressed complete make an important contribution to the healthagreement with the programme for mental health of mankind. Although Asia lacked many of thepresented by the Director-General. Although elementary conditions for health work, he con-his country had not had direct experience of the sidered that the mental health programme inproblems arising from two world wars (except that continent should have equal place with thethrough the help extended to other less fortunate other essential activities, since, without mentalcountries), Switzerland was none the less aware health, the community and the individual wouldof the increasing need for mental health to help be unable to attain the necessary standard ofindividuals to adjust themselves to their ever health. more complex environment. He agreed with the remarks made by the Dr. MACLAY (United Kingdom) welcomed thedelegate of Bulgaria, but suggested that the recognition- by WHO of the importance of mentaltrends the latter had mentioned might them- health by making it a specific item on the pro-selves be the result of bad mental health. Mental gramme with a considerable budget.That washealth was concernedwithdiscoveringthe an event of great importance in the history ofscientific reasons for all elements which threatened public-health administration and should give athe psychological stability of the individual and lead to countries all over the world.Mentalof the community. Since in some areas over 20% illness was probably responsible for more un-of the population suffered from psychological happiness and economic loss than any otherproblems of various kinds, it was obvious that form of illness.It was estimated that some 30%mental health and the prevention of mental of all out-patients in England and Wales attendedillness should be among the first of the activities for reasons that were largely psychological, andof WHO. The subject, however, was one fraught - 200 - SIXTEENTH MEETING

with ignorance and prejudice.It was therefore1949 level.It was vital for the whole future of essential to prepare a prudent programme. Hethe Organization. approved the programme which provided, as a first step, for the collection of data in all countries. Decision : The proposal to restrict the 1950 Mental health work, much more than physical programme for mental health to the level of health measures, called for a very marked diffe- the 1949 programme was put to the vote and rentiation to be made, according to the varied rejected by 25 votes to 4. mentalities of populations.His country would be glad to collaborate in the pioneer work to be undertaken by WHO in this field. The CHAIRMAN said that the Secretariat would note the wish expressed in the committee for Dr. DOWLING (Australia) said that his Govern-co-operation between WHO and other agencies, ment recognized the extreme importanceofparticularly UNESCO, on the part which mental mental health on a national but not on an inter-health might play in contributing to world peace. national level and was opposed to a large pro- gramme for mental health on the limited income Dr. HARGREAVES, in reply to a question by available to the Organization. The subject shouldDr. DOWLING, said that the effect of the re- be one of low priority. allocation of priorities proposed in the note on the mental health programme proposals would Dr. FELIX (United States of America) welcomedbe to reduce the posts in the Regular Programme the interest in Mental health shown by theby nine by transferring them to the Supplemental delegatestothe committee and particularlyProgramme. The sub-totals and the main totals congratulated the delegate of Bulgaria on hisof the budget were unaltered. address. No progress in the other forms of public health was possible without consideration of the Decision : The committee approved the pro- mental health aspect of the problems involved. posals in the note (Annex 18) submitted by Mental health had a contribution to make to all otheractivitiesof WHO and mental-health the delegations of Denmark, Italy, Sweden, personnel should be integrated with other units Switzerland and the United States and the of the Organization.The development of good programme as set out in Official Records No. 18, public-health practices was to a large extent a section 7.4.5, for transmission to the Committee matter of understanding the attitudes and ways on Administration and Finance, subject to the of thought of the people and of influencing them redistribution of items proposed in the above- to alter their way of life to achieve more hygienic mentioned note. conditions' and a more healthful existence.He hoped that the committee would adopt the pro- gramme as set out in Official Records No. 18 and2.Health Demonstration Areas in the note under discussion. Agenda, 8.12 Dr.GOODMAN, ActingAssistantDirector- Dr. SIMONOVITS (Hungary) shared the viewGeneral, drew attention to several general points expressed by the delegate of Bulgaria. The health policy in Hungary concentrated on the preven-in regard to health demonstration areas :first, tion of disease, and that policy should be appliedalthough the concept was not new, the project to mental health.The causes of mental illness,was the first of its kind on an international scale ; however, were largely sociological and economic :secondly, to be successful the project must be war, unemployment, insecurity and other factsa co-operative effort between the government relating to the social and economic structure ofof the area and WHO ; thirdly, the basic concept society. It was not so much a question of adjust-of the health demonstration area was to include ing man to his environment as of adjusting theall specialities and techniques needed to deal environment to man.While appreciating thewith the health problems in the region selected importance of the item under discussion he con--it must be an integrated approach under the sidered that the mental health programme forumbrella of public-health administrations and 1950 was out of proportion to those suggestedof preventive medicine ; fourthly, the area selected for such major problems as tuberculosis andshould havea: major disease which could be malaria. He doubted whether the proposals fortackled by the eradication method in order to surveys in rural areas and industrial communitiespopularize the programme in that area ; lastly, would be effective and proposed that the pro-the health demonstration area should be a train- gramme should be retained at the 1949 level. ing ground for staff both of the country of the region and from outside-participation being if Dr. DOWLING and Dr. KLOSI (Albania) sup-necessary facilitated by fellowships. ported that proposal. Dr. DOWLING said his Government gave full Dr. SCHEELE (United States of America) saidsupport to this important item. South-East Asia his Government felt that the mental-health pro-and the Western Pacific needed a health demon- gramme was too important to be confined to thestration area and he wondered whether any of - 201 - COMMITTEE ON PROGRAMME the proposed health demonstration areas would certained that the contemplated procedure be established in those regions. was acceptable to the people of the region ; the demonstration should not be a service The CHAIRMAN replied that it was premature provided and operated by an outside agency ; to state the regions selected for health demon- (3) the government and possibly the local area stration areas. should provide some resources for the demon- stration, and either provide some of the technical Dr. RAE (United Kingdom) also considered personnel or else place individuals in training, health demonstration areas to be of the first to replace the WHO technical personnel in a importance. The Director-General should be reasonable period of time ; there must be some allowed elasticity in their development. He assurance that the nation would help itself stressed the importance of the preliminary survey shortly after the start of the demonstration ; of the area and its problems ; the survey team (4) throughout the whole demonstration atten- should start the survey without preconceived tion should be given to encouraging the leaders ideas. He would give the Secretariat some notes of the people in the area to participate in the on the experience gained by the United King- health practices indicated.That presupposed dom in the operating of health demonstration a thorough knowledge of the mental attitude areas. and culture of the people by some member of the team ; Dr. RAJA also offered to provide information on the health demonstration area near Calcutta. (5) attention should be given to stimulating He stressed the importance of establishing a the people of the area who wanted to improve programme in close proximity to a teaching their health situation and to maintaining the institute. improvement after the end of the demonstra- tion : that should be a prerequisite to securing their support of and interest in the programme ; Dr. GEAR (Union of South Africa) agreed on the importance of health demonstration areas (6) in establishing a demonstration great regard and suggested that WHO, in their development, should be given to the local costs : the entire should concentrate on stimulating and strengthen- project should be developed in terms of the ing local and national health administrations. area to be served. In many areas the problem was to develop the local machinery in such a way that modern With proper planning, demonstrations could technical methods could be applied. He wishedbe one of the most valuable activities of WHO : particularly that that point should be borne inwithout it, and if they failed to lead to. the adop- mind, in addition to the other objectives listedtion of long-range continuing programmes, they under section 7.4.1.3. could be a waste of manpower and money. Activitiesof that kind should be developed Dr. DE PAULA SOUZA (Brazil) gave informationslowly and on sound lines. on the health demonstration area established in connexion with the public-health courses of the In answer to a question by the Chairman, Dr. Universityof São Paulo, which was givingFELIX added that his principles were not fully excellent results.His country would supportcovered by the provisions in section 7.4.1.3(9) similar projects on an international scale. of Official Records No. 18.He had stressed the importance of local contribution to the operation, Dr. FELIX said that although demonstrationssince the chances of its continuation were in of new techniques could be valuable and stimulatedirect proportion to the amount of that local and improve health services and practices, theycontribution. could also fail to bring about permanent change or the continuation of new practices after the The CHAIRMAN said that this most important withdrawal of the demonstration personnel.Inactivity of WHO merited careful consideration order to ensure the greatest possible success hesinceifit were not started properly it might suggested that the following principles shouldbecome a conspicuous failure.He invited com- be kept in mind : ment on Dr. Felix's principles, particularly in regard to the responsibilities of the local area. (1) a demonstration operation should not be established without prior consideration of the Dr. GOODMAN explained the reasons why it financial and technical ability of the countrywas proposed that WHO should bear the whole or jurisdiction to continue the work after thecost of the programme :as the demonstration termination of the demonstration ; areas were to be treated as training centres for (2) the demonstration should not necessarilypersonnel outside the country of the demonstra- show how to obtain results under ideal condi-tion it would be unfair to require that country tions, but should be adapted to the area andto bear the whole cost.Moreover, a number of show how to obtain the greatest results possiblecountries suitable for demonstration areas would within ' the resources of the nation or area.not be in a position to make a financial contribu- Before establishing the unit it should be as-tion. - 202 - SEVENTEENTH MEETING

Dr. MACCORMACK (Ireland) said that, while served as a training centre for other countries agreeing in principle with the delegate of thein the area. The establishment of the centre near United States of America on the importance ofan existing training . institute would promote localcontributions, he understood,after thelocal participation. explanation of the Assistant Director-General, why it would be undesirable to insist on local The CHAIRMAN asked the committee whether financial contributions.The main problem wasit wished to modify the programme or cost to ensure the continuation of the programmeestimates in the light Of the principles stated by after the termination of the demonstration ; anythe delegate of the United States of America. country receivingademonstration must be required to give a guarantee that the measures Dr. KLost stressed two points in connexion started in that area would be continued. with health demonstration areas.During the survey of a given area it should be realized that Dr. FORREST, Secretary, in reply to a questionthe chief responsibility rested with the govern- by Dr. GRUT (Observer, ILO) said that co-opera-ment of that country.It should also be clearly tion with ILO on occupational hygiene wouldunderstood -thatthe demonstration teams of be considered under item 8.11.2.1 of the agenda.WHO should work in close contact with the local The planning of demonstration projects requiredauthorities and should restrict their action to considerable preparatory work and at the presentscientific and health propaganda.There should stage no consultations with the ILO on thatbe no question of interference with the internal matter had been made. affairs or the sovereignty of the country in which they would be working. The demonstration team should be impartial and concerned with scientific The CHAIRMAN felt that the delegate of thematters only.Those principles should be borne United States of America was more concernedin mind in connexion with any demonstration with local participation than with financial contri-project. bution :that point was not sufficiently stressed in section 7.4.1.3(9). The CHAIRMAN proposed that Dr. Felix, in consultation with the Secretariat, should prepare Dr. FELIX confirmed that local participationa paper combining the principles elaborated would be contribution .in kind. during the meeting with those contained in Official Records No. 18, section 7.4.1, for considera- Dr. RAJA hoped that local participation couldtion by the committee. be provided through the association of local Decision : The Chairman's proposal was accepted personnel.Help from WHO would presumably have to continue so long as the demonstration The meeting rose at 6.15 p.m.

SEVENTEENTH MEETING Friday, 24 June 1949, at 8.30 p.m. Chairman: Dr. H. HYDE (United States of America)

1.Epidemiological Services (continuation fromments of those countries, the disease was steadily p. 184) increasing in many districts. Agenda, 8.15 With the help of modern potential therapeutic EpidemicControl(continuation) resources leprosy should become a rare disease International in the next twenty years provided an enlightened Leprosy 75 and well organized anti-leprosy campaign could be put into operation.Leprosy was practically Dr.CHAUSSINAND (Observer,International Leprosy Association) said leprosy was still onenon-contagious in its initial stages, and if treated of the chief scourges of humanity, the totalthen could at least be " whitened " after two number of lepers in the world being estimatedyears' treatment. Leprosy was moreover a disease Such an estimate was prob-which was not easily transmitted.To escape at about 5,000,000. infection it was generally enough to avoid intimate ably very far from the truth. How could it beand prolonged contact with infected persons. otherwise when theearlymanifestationsof leprosy were hard to detect and the registered Too stringent legislation against leprosy would cases were often those of people who were un-however, encourage sufferers to avoid detection. mistakable sufferers ?Probably more than sixProtective measures should therefore be similar million individuals, distributed chiefly in tropicalto those taken against all social plagues, and and sub-tropical zones, were infected with leprosy. include the education of doctors and population In spite of considerable efforts by the govern-groups, discreet case finding, speedy , treatment and the hospitalization of incapacitated patients 75 09. Rec. World Hlth Org. 18, 140 who were destitute or dangerous to the community. - 203 - COMMITTEE ON PROGRAMME

Unfortunately many countries where leprosyment of an expert committee.That was most was rife did not dispose either of sufficientlyimportant, for success in the fight against leprosy qualified medical personnel or of the requiredwas dependent on the co-operation of the admi- funds for financing such a programme.Leprosynistrator, the research worker in the basic sciences control was therefore a problem which meritedof pathology,bacteriology and biochemistry, the particular attention of WHO.Action inand the epidemiologist,all working alongside that field could take the form of co-ordinating-the leprologist.The creation of an expert com- the research work und&taken in the variousmittee would greatly encourage such co-opera- countries.The following subjects should betion. dealt with :culture of the pathogenic agent, etiology, and also the method by which infec- Sub-paragraph (2) of the resolution, referring tionwastransmitted,endemiology,studyto the establishment of a world centre for research of allergy, drawing-up of an international classi-in leprosy, recommended that the matter should fication, research on chemotherapy, etc. WHObe considered by the expert committee, when could also make arrangements for training spe-formed. He doubted whether the time was oppor- cialists and have therapeutic work' carried outtune for the establishment of such a centre, but if, by qualified leprosy experts in the various coun-as a result of the present resolution, increased aid tries. became available for national research institutions in countries where leprosy was endemic, it would In conclusion, Dr. Chaussinand stated thatbe a source of great encouragement. the International Leprosy Association was entirely at the disposal of WHO for the implementation Referring to sub-paragraphs (3) and (4), he of any programme for the control of leprosy. stressed that valuable work in the field of epide- miology had been carried out in the Philippines Dr. DUJARRIC DE LA RIVIÈRE stressed theby the American Leprosy Foundation and that, urgency of the leprosy problem. The stage seemedthough Indian workers had done much in the now to have been reached where that diseasesame field,assistance from expert epidemio- could be mastered through the advances madelogists was greatly needed. in chemotherapy and especially in work on The subject of rehabilitation and social welfare sulfones.He had read with extreme interesthad rightly received attention during the last the memorandum on the subject submitted bytwo years.The South American countries, as the Indian delegation (Annex 19) and would addwell as India, had shown considerable initiative to the listof problems, study of which wasin exploring the social implications of leprosy advocated therein, laboratory research, whichand both countries had produced leaders in the would lead to more definite knowledge of chemo-field of social welfare. Even if a certain cure were therapy. found for leprosy, the problems of rehabilitation, occupational therapy and reliefof deformity Dr. COCHRANE (India)said the subject ofwould remain. leprosy had assumed a position of importance The provision in sub-paragraph (3) for the ex- in scientific medicine within the last twenty-fivechange of workers was most timely. The only sure years and governments had shown an increas-way of unravelling many of the questions which ing concern for an adequate scientific approachwere still controversial was for experienced workers to the problem. in one country to visit those of another country, The incidence of the disease was high in most tropical and sub-tropical countries and as a mitted by the Delegation of the Government result of World War II it might become an of India resolves : increasing problem both in the United States (1) that an expert committee witn the maximum and the United Kingdom. number of nine be established and that provision Estimates as to the number of cases of leprosy be made for two meetings of this committee in in the world had varied from 3 to 5 million. The 1950 ; (2) that the question of the esta blishment of a latter figure was considered by some to be too world centre for research in leprosy be referred low. Africa, for eicample, had some 900,000 cases, to the expert committee for consideration and Europe 21,000, the Americas 100,000 and the report ; Islands of the South Pacific 10,000. The greatest (3) that provision be made for the exchange, number of cases, however, was to be found in during 1950, of four selected leprosy workers the Far East, in particular, in China and India. from among the existing leprosy institutes in India's concern in the problem was increased different countries ; (4) that provision be made for making available by the fact that possibly 20% of the world's three experts for an average period of eight leprosy patient population was to be found within months in each case to countries requiring the confines of that dominion. guidance in the development of anti-leprosy Sub-paragraph (1) of his delegation's resolu- work ; (5) that leprosy be included in the fellowship tion on the subject 76 provided for the establish- programme, and (6) that provision be made for the free supply of sulfones and other new leprosy drugs for 76 This read : control trials by selected leprosy workers under The Second World Health Assembly, having the conditions to be laid down by the expert considered the memorandum on leprosy sub- committee. - 204 - SEVENTEENTH MEETING so that by friendly association and through Dr. RAJA (India) agreed. private conversation differences of opinion could be straightened out. Dr. GEAR (Union of South Africa), while agree- The inclusion of leprosy in the fellowship pro-ing that leprosy constituted an important prob- gramme, proposed in sub-paragraph (5) wouldlem in many regions of the world, thought it be received with great enthusiasm by leprologists.might be better if, under Article 50(f) of the Sub-paragraph (6) of the resolution dealt withConstitution, the leprosy programme were carried therapy. Here acknowledgement should be madeout by regional offices (in particular that of South- to pioneer workers in the United States and laterEast Asia) rather than by WHO itself. in South America, who had led the way in the new sulfone therapy.Reports received up to Dr. DE PAULA SOUZA (Brazil), after thanking now had shown that excellent results could beDr. Chaussinand for his observations, stressed hoped for from the drug. However, its use wouldthe considerable interest taken by Brazil in the be of little avail unless the following conditionsproblem of leprosy. The disease had been studied were satisfied :it should be inexpensive, non-very seriously in his country and had not only toxic and easy to administer.Research work inbeen treated from the medical point of view but India, Malaya and North Africa showed thathad become an integral part of public-health those conditions could be fulfilled with regardwork. Such treatment had incorporated the to sulfone therapy.Sub-paragraph (6) aimedmost modern ideas and laid stress on the educa- at giving financial encouragement to experimentstional side of the problem.Thus, lepers were in that new method. attracted to villages and colonies sponsored by Finally,if the resolution were accepted itthe Government where they received good treat- would herald the opening of a new era in regardment and lived completely normal lives.The to leprosy as productive of good as any in thetreatment of lepers in Brazil was perhaps more past and would hasten the day when leprosyhumane than in any other country. would be yet another scourge of mankind which The finding of cases of leprosy was not confined co-operative human effort had conquered. to specialists but formed part of the stock in trade of the general practitioner, who was trained Dr. RAE (United Kingdom) supporting thealways to have in mind the possibility of leprosy Indian proposal, thought WHO should takediagnosis.In short, Brazil was doing its utmost active steps to eradicate the scourge of leprosyto eradicate the disease. which affected the whole surface of the globe. Twenty-five years' experience in the field of Dr. RAJA agreed with the delegate of the Union leprosy had shown him that the figures usuallyof South Africa that there might be occasion for given for leprosy cases in the world were by nothe South-East Asia Office to take over the means exaggerated.He would, however, stressleprosy programme from WHO, but thought it two points :first, the fact that leprosy was annevertheless unfair that that office should bear extremely complex problem and, secondly, thatthe whole cost of a project which would benefit the awarding of fellowships should form anmany other parts of the world. important part of WHO's programme. M. VAN DER BRUGGEN (Belgium) stressed that leprosy was a world problem rather than a regional Dr. DOWLING (Australia)after commendingone and that therefore the proposed expert com- the Indian delegation for having introduced itsmittee should be given the same scope as, for resolution on leprosy, said Australia would beexample, the Expert Committee on Tuberculosis. glad to support any action envisaged to combat that disease. Dr. GEAR agreed that leprosy was an important There had been a considerable increase in theproblem in all regions of the world.In his incidence of leprosy in Asia and particularlysuggestion he had really meant that the South- among the aboriginal populationof tropicalEast Asia Office should make a start with the Australia. The use of new chemotherapeuticprogramme, which would be continued by other methods mentioned in the resolution should doregional offices.However, as his proposal had much to reduce the disease. not received support, he would not press it. Dr. RODHAIN (Belgium), whilst agreeing in Dr. KAUL (Secretariat), referring to sub-para- general with the Indian proposal, stressed thatgraph (1) of the Indian resolution, thought one the principle underlying sub-paragraph (2) wasmeeting would suffice for the expert committee a prudent one.Indeed, if a world centre forduring the first year of its existence.Secondly, research in leprosy were established too quickly,if sub-paragraph (1) were accepted, leprosy would the smaller national bodies working in that fieldautomatically be included in the WHO fellow- might feel discouraged. ship programme.Thirdly, as regards sub-para- graph (6), the question of drugs and equipment The CHAIRMAN thought that sub-paragraphmight better be discussed under the item of the (2) was not wholly consistent with the state-agenda dealing with that subject. ment on research policy previously adopted, and asked the Indian delegate whether he would The CHAIRMAN thought that sub-paragraph agree to deleting that section for the moment and(6) might be adopted immediately, provided that having it discussed at a later stage. the word " free " were omitted. - 205 - COMMITTEE ON' PROGRAMME

Dr. RAJA said he had included the word " free "was a self-governing non-political federation of as, in his view, the supply of drugs for experi-national nurses' associations which was founded mental purposes and research was not the samein1899.The national associations of30countries as the supply of drugs in relation to programmes.were in full membership, and in addition, 16 He would agree to the deletion of sub-para-others had associate status.The Council repre- graph (2) if that were the will of the committee.sented approximately350,000nurses. On the question of the number of meetings, hisdelegation had considered that thefirst The objectives of the Council were the main- meeting of the expert committee should be atenance of the highest possible standards of preliminary one, and that a further meeting innursing service and nursing education in the the same year might be useful. However, if thecountries which were in membership, and the experience of the Secretariat showed that oneattainment of such standards by countries not meeting would be sufficient, he would agree toyet in membership. alter the resolution accordingly. The International Council of Nurses welcomed He was glad to note that, if the resolution werethe proposal that an expert committee on nursing adopted, leprosy would be included in the fellow-should be set up because it believed that that ship programme. would help to clarify the way in which nurses should best play their part, together with other Decision: The Indiandraftresolutionon leprosy was adopted, subject to the abovemembers of the " health team ", in the public amendments (for text, see tenth report, sec-health work of WHO. tion 6). It had been evident from the discussion that the collaboration of nurses should be an essential feature of the programme of WHO.It was 2.Public- Health Administration particularly in the fields of maternal and child Agenda,8.11 health, preventive work in tuberculosis, and mental health, that the well-qualified expert in Establishment of an Expert Committee on Nursingpublic-healthnursingcould make her most essential contribution. Dr. LECLAINCHE (Secretariat) said the different In most countries there was a grave shortage activities to be undertaken by the section in1950 had been set out in the proposed programme.of trained personnel for all forms of nursing work. The Director-General's proposal for the establish-That shortage could be attributed to two main ment of an expert committee on nursing requiredcauses :(1) a shortage of potential candidates for no lengthy commentary. The importance of thethe profession, due to the effect of a decreasing question was universally known, though to abirth-rate on the18-19age group and to the fact degree which varied with the different countries.that other professions had opened their doors The number of auxiliaries should be increasedmore widely to women ; (2) the increased demands and they should be given the best possible educa-on nursing personnel arising from new forms of tion.Those were two essential problems whichmedical treatment, together with an increased could only be solved by WHO with the help ofconsciousness by the public of the need for all competent specialists.In view of the variousforms of nursingcare,both preventive and local problems involved, those experts should be curative. recruited on the widest geographical basis. They Those facts should be borne in mind because would deal with all the questions of recruitment, there seemed to be a great need for a new approach education and utilization of nurses. The position of psychiatric assistants shouldto and estimate of the relevant functions of the be studied by a sub-committee in view of theprofessional nurse and of auxiliary personnel. special education they required. A slight modifi- There was, therefore, an immense amount of cation should therefore be made to the last para-essential information, which needed to be col- graph of the draft resolution before the committeelected and co-ordinated, on how to make the (for final text, see third report of the Joint Meetingsupply meet the demand and how to make the on Programme and Administration and Finance,supply of personnel to the nursing profession section3),which should read as follows : compatible with the total economic needs of the country. In other words, it was an economic as REQUESTS the Director-General to establish an Expert Committee on Nursingwith awell as a humanitarian problem. membership of nine, to study problems con- It would seem that an accurate survey of the cerning nurses, health visitors, social workersneeds of countries for nurses and of the types of and other related auxiliary workers. A specialschool or training centre required, as well as the sub-committee should be invited to study allavailability of suitably qualified teaching per- the questions concerning psychiatric assistants.sonnel, might even precede the decision to set up such schools, and would constitute invaluable Miss BRIDGES (Observer, International Councilinformation which an expert committee could of Nurses) said the organization she representedhandle. Should it be decided at the present stage to authorize the establishment of an expert " Off. Rec. World Hlth Org. 18, 105 committee on nursing, one plea should be made - 206 - SEVENTEENTH MEETING

-that the committee consist of a majority of Dr. DOWLING, while appreciating the urgency nurses who should be selected not only for theirof the nursing problem, wished to sound a note expert knowledge of conditions in their countriesof alarm. The Committee on Programme during but also for some international vision obtainedthe past week had made addition after addition through past association with international healthto its programme for 1950 and it seemed higfily bodies. doubtful whether resources would be available The International Council of Nurses had activeto cover them. He therefore urged the committee committees working on the problems of nursingto adopt a more realistic attitude. education, nursing service, economic welfare and status of nurses, exchanges of nurses between Dr. LECLAINCHE agreed with the proposals put countries, etc., and would be gratified if theforward by the United Statesdelegate, but results of such researches could be used and co-thought that some mention of medico-social ordinated by an expert committee for use byworkers might be included in the resolution. WHO and the countries it served. In reply to the delegate of Australia, he said In conclusion she stressed that the Councilthe proposed expert committee on nursing was valued greatly its relationship with WHO andan integral part of the 1950 programme and was wished to work in complete collaboration with it.covered by the Regular Budget. Dr. SCHEELE (United States of America) was well aware of the acute shortage of nurses in the Dr. SCHEELE agreed that perhaps the field to various countries and thought that the situationbe covered by the expert committee should be could be remedied by bringing all the problemsthe general one of nursing, rather than the parti- of nursing into focus through the medium of ancular one of public-health nursing as he had expert committee. originally suggested. Referring to the draft resolution on the subject, He realized, as the delegate of Australia had he stressed that, in view of the limited resourcespointed out, that the committee was paying at WHO's disposal, the proposed committeelittle regard to the financial implications of the should occupy itself mainly with the public-many additions it had made to the programme, health aspects of nursing.Secondly, the exactbut he stressed that the committee was merely membership of the committee should not beapproving the principle of those additions and specified in the resolution. Thirdly, social workersthat the financial implications could better be should not be included as one of the subjects fordiscussed at the joint meeting with the Committee study since they constituted a special category.on Administration and Finance.It would there- Finally the word " auxiliary ", which frequentlyfore seem unfair to reject the programme for gave rise to misunderstandings, might better benursing at the present stage :it should be given omitted. the same consideration as other additions to the The text of the final paragraph of the resolutionprogramme. might therefore be worded as follows : Dame Katherine WATT (United Kingdom) said REQUESTS the Director-General to establishit was abundantly clear that everyone concerned an expert committee on public-health andwith health services and health programmes other nursing, to study the problems concerningrecognized that nurses, whether engaged in the nurses,heakhvisitors,andotherrelatedpublic-health field of prevention of illness and workers. preservation of health, or in the treatment of illness in hospitals, were key people.It therefore Dr. MACCORMACK (Ireland)supportedthefollowed that much thought must be given to remarks of the United States delegate, exceptthe recruitment, training and education of nurses, that he considered the expert committee shouldmidwives and health visitors. deal with the whole problem of nursing. If atten- The appointment of widely experienced nursing tion had to be concentrated on any particularofficers to the headquarters staff of WHO was branch, that should be left to the expert com-welcomed throughout the nursing world.The mittee itself to decide. United Kingdom delegation supported the setting- Dr. RAJA, after associating himself with theup of an expert committee on nursing. proposals of the United States delegate, stressed Decision : The draft resolution on the establish- the importance and urgency of the problems of ment of an expert committee on nursing was public-health nursing.Particularly in the coun- tries of the East, where maternal and child health approved in principle, the Rapporteur to make was so acute a problem, the domestic services the necessary drafting changes in the light of provided by nurses could play an important part the above discussion (for text, see third report in WHO's health programme. He therefore of the Joint Meeting on Programme and welcomed the proposal to establish an expert Administration and Finance, section 3). committee on nursing as providing invaluable guidance to the various countries. The meeting rose at 11.10 p.m.

- 207 - COMMITTEE ON PROGRAMME

EIGHTEENTH MEETING Saturday, 25 June 1949, at 9.30 a.m. Chairman: Dr. H. HYDE (United States of America)

1.Adoption of Draft Reports of the Committeeand distribution of chemical and biological pro- ducts and the standardization of medical equip- Decision: The draft fourth report 78 of thement, and would act as a procurement agent in committee for consideration by the Committeecase of emergency. A Medical Supplies Section on Administration and Finance and the drafthad been created at the end of 1948.In Official fifth report to the Health Assembly (see p. 328)Records No. 18, page 167, reference was made were approved. to the funds required for medical literature and teaching equipment for the 1950 programme, 2.Medical Supplies Section but there was no information in any of the Agenda, 8.18 Assembly documents on other activities of the Dr. MAYSTRE (Observer, World Medical Associa- section. tion) said that his association expected that a In many countries the question of supplies medical code of ethics would be ratified by itsand equipment was of the utmost importance. national associations at the annual assembly inIt was no use sending experts to a country to the autumn of the present year.The adoptiongive advice if, when they left, there were not of such a code would be in conformity with thesufficient supplies in that country for their work aims of WHO and would be a step towardsto be continued. unification of a medical ideal. Politicalpressurepreventedproducersof The World Medical Association was also near-important medical supplies from sending them ing completion ofits preliminary studies onto some countries ;it should be the duty of the medical education, the practice of medicine bysection to find a means of preventing such political unqualifiedpeopleandmedicaladvertising.methods from interfering with the supply of WHO, for its part, was making a study of habit-vital medical necessities. The question of regula- forming drugs.The association assured WHOtion of production and distribution of chemical of its collaboration and believed that throughand biological productions, such as penicillin, its relationships with national medical associa-insecticides (including DDT), streptomycin and tions and practitioners it could be of considerableother antibiotics was of extreme importance. assistance in obtaining data. Situations had occurred in which people had been refused vital drugs and he asked for a The CHAIRMAN, after thanking Dr. Maystrerecommendation to the Director-General and for his report, suggested that discussion shouldthe Executive Board that the necessary measures be directed to the general programme policyshould be taken to prevent such situations from aspect of supplies, as the specific financial aspectsrecurring. were being considered in the Committee on It would be desirable to include in each expert Administration and Finance. The results of theteam an expert from the country concerned who discussions of both committees could be broughtwould be aware of the special needs of that together in the joint meetings. country. Dr. KLosI (Albania) considered that the ques- On the request of the Chairman, Dr. Sim tion of supplies was not only a financial but a(Secretariat) gave a brief account of the functions medical problem, and it was necessary that theundertaken by the Medical Supplies Section programme should be quite clear as to the actionduring the first part of 1949. to be taken to enable those countries which found difficulty in obtaining vital supplies to Dr. BABECKI (Poland) presented a document 79 procure them. giving the views of his delegation on availability Dr. TAGAROFF (Bulgaria) reminded the com- 79 This document read : mittee that at the First World Health Assembly Poland proposes the following item for discussion at the Second Health Assembly, namely, the his delegation, supported by the delegation ofproblem of action taken by certain countries, Czechoslovakia, had proposed the creation of aMembers of the World Health Organization, with. bureau of medical supplies which should notregard to the secrets of production of the pharma- only give advice to governments but should takeceutical products which have a preponderant importance in the battle against disease. any necessary measures to regulate production We should like to draw the attention of the Executive Board to the fact that the secret, the 78 See footnote 16, p. 164. process and methods of production of the three - 208 - EIGHTEENTH MEETING of technical knowledge of production processes In order to clarify discussion, the SECRETARY of antibiotics :penicillin, streptomycin, chloro-read the above-mentioned recommendations of mycetin and aureomycin. the Executive Board.

The CHAIRMAN stated that the question of Dr. SIMONOWTS (Hungary) directed the atten- penicillin and other antibiotics would come uption of the committee to a proposal of the delega- for discussion under items 8.19.2.2 and ,8.19.2.4tion of Hungary to the First World Health of the agenda. Assembly, csontained in Official Records No. 13, page 151, to the effect that the Executive Board Dr. BEGG, Acting Chief, Administrative Officeshould establish an office of the Secretariat to for Europe, said that, within the framework ofcarry out various functions in regard to the co-operation between the Special Administrativeprocurement of medical supplies. Office for Europe and the Economic Commission for Europe, there had been set up a working The CHAIRMAN said that that office had been party,originally dealing with penicillin,butestablished and further information could be which had since taken under consideration othersupplied to the delegation of Hungary, if it were essential medical supplies and was now approach-desired. ing the point at which a programme could be recommended on the subjectofinsecticides, Dr. CAMERON (Canada) proposed recommenda- particularly DDT. tion to the Assembly of the policy in dealing with the question of supplies, as contained in page V Dr. FORREST, Secretary, explained that theof Official Records No. 18. matter was not only being dealt with on a European basis, through the Economic Commis- Dr.SCHEELE(UnitedStatesofAmerica) sion for Europe, but also on a world basis throughseconded the recommendation of the delegate the mechanism of the Economic and Socialof Canada. Council. Dr. DOWLING (Australia) also supported the The CHAIRMAN referred to the point raised bymotion of the delegate of Canada, which was in Dr. Klosi (Albania) on the need for supplies andaccordance with the view of his own government. the difficulties experienced by some governmentsSince the operational work might depend on the in obtaining them. That need had been recognizedability of the countries in which field work took and provision for it made under the item " Pro-place to obtain specialized equipment, he thought gramme supplies to governments " inOfficialthat in such cases the Organization should assist Records No. 18, page 169 ; the recommendationsthem to do so by informing them where supplies of the Executive Board on the same subjectmight be obtained and by standardizing nomen- appeared under section 2 on pages V and VI ofclature and biological, pharmaceutical and other the same volume. products.However, it was not within the com- petence of the Organization to act as an agent Dr. RAJA (India) said he assumed that thefor medical supplies.It was the duty of the ainount allocated on page 169 of Official RecordsInternational Trade Organization to deal with No. 18 related to supplies in connexion with WHOsuch problems. programmes. There was no provision for assist- Dr. TAGAROFF noted that the Chairman had ing governments to obtain supplies at reasonablesuggested a working party on the study of peni- cost and with reasonable speed for their owncillin supplies and,proposed that before adopting activities. the report of the Executive Board on the Office The CHAIRMAN observed that in each of theof Medical Supplies it would be useful to form subsequent items of the agenda-Malaria, Tuber-a working party to make concrete suggestions. culosis, etc.-there was an item in the proposed programmes forsupplies and equipment for The CHAIRMAN replied that the committee WHO teams. The proposal on page 169 of Officialhad merely recommended the establishment of Records No. 18 was for programme supplies toan expert committee on antibiotics under item governments, which was a separate item. 8.16.4.1(Co-ordination of research). He had intended to bring forward the problem of anti- very important antibiotics, streptomycin, chloro-biotics and penicillin, as outlined by Dr. Babecki mycetin, aureomycin, have not been published.of Poland, after disposing of the general policy This is true also of penicillin. The newest methodsin regard to the administration of the supply of production are kept strictly secret. programme, and he saw no necessity for a work- In the opinion of the Polish Government such behaviour is not in accordance with the Constitu-ing party in regard to that policy. tion of the World Health Organization which was signed by these countries. Dr. WICKREMESINGHE (Ceylon) said he wished This is a fundamental problem, and it is felt that the Health Assembly must take up a definiteto correct a misconception arising from a previous position with regard to it. statement by his delegation : his Government did - 209 - COMMITTEE ON PROGRAMME not think the supply question was an essentialFund and the International Bank of Reconstruc- function of WHO. He thought the most importanttion had been set up on a permanent basis. WHO point was the availability of medical supplies atcould contribute to making medical supplies reasonable priees and it was vital that the suppliesavailable on a sound economic basis rather than sectionshouldadvise governments on suchon the insecure basis of emergency measures. purchases and on how to become self-sufficientAid in raising the standard of living and the in the production of those supplies. improvementofmedical supplies should be sought from international economic organiza- The SECRETARY said that the programme didtions able to analyse the needs and propose not envisage advising governments on the stepssolutions in production, procurement and dis- necessarytomakethemselvesself-sufficient tribution. regarding medical supplies.The research group He recalled the statement made by President and consultant advisers on antibiotics approved under item 8.16.4.1 of the agenda would coverTruman to the United States Congress on the that particular field, but there were no provisionsTechnical Assistance Programme, when he had for medical supplies in general.The Office forspoken of the r6le of both private enterprise and Medical Supplies was arranging to bring govern-voluntary organizations of the United States ments and manufacturerstogether,butthein the alleviation of health problems in under- Organization was not equipped to advise on thedeveloped countries by technical, scientific and feasibility of technique in establishing pharma-managerialknowledge,productionofgoods, ceutical industries. machinery and equipment, and financial assist- ance in the creation of productive enterprises. Dr. RAJA, referring to page V of Official Records He felt that the danger of the WHO's under- No. 18, said he was concerned 'about the state-taking a large-scale supply programme direct to ment in paragraph 2.1 to the effect that thegovernments would be that the constructive supplies problem was basically an economic oneefforts of the Organization towards continuing -a point which had been emphasized by theimprovement of the health of the peoples of the delegate of Australia. He agreed with the delegateworld on a broad scale would be neutralized, of Ceylon that the objective of WHO was toand he opposed such a policy, which would require assist governments to obtain medical suppliesincreasing expenditures from the Organization's at a reasonable price.Certain financial measuresslender resources. The establishmentof an were envisaged in paragraph 2.2.1, which wereequitable basisfor the determination of the important. Regarding the suggestion by theeconomic needs and the distribution of quantities Executive Board in paragraph 2.2 that suppliesof medical supplies might cause political disrup- should be made available for specific projectstion within the framework of the Organization. examined in advance in detail and approved byAlthough opposing that policy, his Government the Board, he thought that if the purpose of thebelieved that the Organization should provide World Health Organization was to promote theall necessary supplies for the conduct ofits rapid development of health measures in thedemonstrations. When large-scaleepidemics backward countries, measures of that kind wouldmade the supply of drugs and medicine vital, be not only welcome but essential. the governments concerned should pay for the supplies, either in full or in part, on a scale to be The CHAIRMAN reminded the committee thatdetermined by the Economic and Social Council the financial measures mentioned in paragraphor some other competent authority. The United 2.2.1 were being examined by the Committee onStates, while recognizing that the solution of the Administration and Finance :the decisions ofproblem of medical supplies was of vital import- both committees would be considered at theirance to the health progress of the world, hoped joint meeting. that the committee and the Assembly, bearing in mind the limited resources available for 1950, Dr. SCHEELE agreed that WHO had a specialwould approve the comments of the Executive interest in the solution of the problem of medicalBoard on page V of Official Records No. 18 rather supplies, upon which depended the success of thethan vote for an extensive supply programme. advisoryservicesand demonstrations. His Government thought the procurement of supplies3. Announcement by Chairman was basically an economic question. While emergency organizations had provided medical The CHAIRMAN stated that three speakers supplies and equipment during and after theremained on his list ; he proposed that a meeting war, the problem had become one of securingshould be held the following day, Sunday, at the necessary medical supplies for all parts of10 a.m. the world through the normal channels of peace- time economy. For that purpose organizations Dr. GEAR (Union of South Africa) suggested such as the Economic and Social Council of thethat the note on the proposed programme, sub- United Nations,theInternationalMonetarymitted by the delegations of Australia, Canada,

- 210 - NINETEENTH MEETING

Ceylon, Ireland, the Netherlands and the Union The CHAIRMAN said the matter would be consi- of South Africa '(see p. 286),.should be considereddered at the next meeting of the committee. at that meeting, as the matter of priorities was an important one. The meeting rose at 12 noon.

NINETEENTH MEETING Sunday, 26 June 1949, at 10 a.m. Chairman : Dr. H. HYDE (United States of America) later Dr. Trène DOMANSKA (Poland)

1.Health Demonstration Areas (continuation fund might be controlled, in which the Executive from p. 203) Board was given the responsibility of supervis- Agenda, 8.12ing the administration of the fund, following the same practice as that operating in UNICEF. Decision: The proposed substitute for item The subject for consideration was whether that 7.4.1.3 of Official Records No. 18, prepared byrecommendation was a proper one which the the United States and Indian delegations incommittee wished to approve as a policy that consultation with the Director-General, waswould govern the funds provided in the budget approved (Annex 20). for supplies to be made available to governments for their own health projects or for continuing 2.Medical Supplies Section (continuation) the programmes which had been started and Agenda, 8.18stimulated as a result of WHO demonstration teams. The financial aspects were not a concern The CHAIRMAN summarized thediscussionof the committee but would be considered in the which had so far taken place on this item. joint meetings with the Committee on Administra- The question of supplies had various facets :tion and Finance. 1.Supplies for WHO demonstration teams (these teams including, when available, personnel Dr. STAMPAR (Yugoslavia) considered that the of the areas in which the demonstration wasmost important aspect of the problem was that carried out). The principle that WHO shouldof countries which had experts of high standing provide supplies for its own teams had metof their own but were unable to carry out projects with the approval of the committee wheneverin certain fields because they were prevented, by it arose under the various items of the agenda.economic or political barriers, from obtaining 2. Advisory services on procurement ofthe necessary supplies.Even countries which supplies. The Medical Supply Section assistedcould pay for supplies in hard currency were, in and advised governments in various ways.certain cases, unable to obtain them because of Provision was made in the programme forpolitical barriers. Although WHO could not the continuation of that service. interfere too much in such matters it should cer- 3.Medical literature and teaching material.tainly make every effort to devise means of giving 4.The need of certain countries for suppliesreal help, and not only advice, to such countries. for their day-to-day health activities.It would Dr. Stampar raised again a point which he had appear from the discussions that the committeemade at a previous meeting, that he doubted the agreed that the responsibility of supplyingusefulness of many of the teams of experts, even that need belonged to the economic machinery,when such teams had been requested by govern- international and national, and the rôle ofments, because he felt that outside people could WHO was to attempt to assist and stimulatenot always give the best help to a country. WHO the economic machinery in that respect. That,should try to help the national health administra- however, was notsufficient,thereforethetions by assisting the experts of those countries Director-General and the Executive Boardwith supplies and training. had made provision in the programme for pro- gramme supplies to governments, for which The CHAIRMAN thought some confusion Might a fund of something over half a million dollarshave arisen in connexion with section 1.2.9 on had been allocated. page 5 of Official Records No. 18, " Other supplies The committee had before it a recommenda-for which no specific provision has been made tion by the Executive Board 8 o as to how thisin this proposed budget ". The Director-General had agreed with the interpretation of the Chair 80 pg. Rec. World Hlth Org. 18, pp. V and VI that the item on page 169, " Programme supplies - 211 -- COMMITTEE ON PROGRAMME to Governments ", was a specific item whichPresident Truman on the Technical Assistance covered that very point and that the proposal Plan.In Dr. Stoyanoff's opinion that plan had of the Executive Board would set up the controlthe same aims and would achieve the same and the method of administering that particularresults as the Marshall Plan. item of supply. Therefore the principle to which The Health Assembly delegateswere not Dr. Stampar had referred, that WHO shouldexperts on economic questions, but they could make supplies available to governments for-theirarrive at general principles in order to give own health projects, was established in the pro-precise and concrete directions to the Medical gramme, and the quantitative question wouldSupplies Section.It was for these reasons that be considered in the joint meeting. he had suggested at the previous meeting that Dr. KLosi (Albania) thanked the Chairmana working party should be established and its for his clarification.The Albanian delegationreport considered before the recommendations approved sections 1.2.8 and 1.2.9.81 They attachedof the Executive Board were approved. the greatest importance to the making available of certain drugs needed to combat grave diseases The CHAIRMAN doubted whether there was such as malaria, cholera, tuberculosis, etc. Manyany need to set up a working party since there countries could not finance projects in regardseemed general approval of the Executive Board's to such diseases without outside help :in hisrecommendations. own country, for instance, even the application of the entire budget to the fight against malaria Dr. KLosI supported the proposal to set up a would be insufficient to achieve good results.working party. Therefore,inaddition to supporting section 1.2.9, he would ask that the allocations might DT. BARRETT, seconded by Dr. TIMMERMAN be increased. The question was not only one of(Netherlands), moved the closure of the debate. economics but equally of health, and in that light the proposals of the Executive Board and Decisions: The motion for closure of the debate of the Director-General should be reconsidered. was carried by 26 votes to 3. ' The proposal of the delegate of Bulgaria to The CHAIRMAN reminded the committee that set up a working party to consider the matter acceptance of the Executive Board's recommenda- in all its aspects was rejected. tions as contained in 2.1 and 2.2 of Ofiicial Records No. 18, page V, without the sub-paragraph 2.2.1, The motion of the delegate of Canada that had been moved by the delegate of Canada at the committee approve the recommendations the previous meeting, and seconded.Today's of the Executive Board was carried. discussion seemed to confirm the policy enunciated in those paragraphs.The delegate of AlbaniaMedical Literature and Teaching Material had suggested that the budget allocation on the item might well be increased, but that was a Dr. SHU (Secretariat) explained that medical matter for discussion in the joint committee. literature and teaching material was distinct from special literature. Dr. BARRETT (United Kingdom) supported the The assistance was not necessarily restricted proposal of the delegation of Canada that thenor related to any particulat subject or pro- recommendations of the Executive Board ongramme.Special literature on the other hand supplies be endorsed and the programme bewas distributed directly by the sections con- approved by the committee.The subject hadcerned to advisory and demonstration teams, been fully discussed both by the Executiveconsultants, etc.In 1947 and 1948 the supply Board and in the present committee and itof medical literature and teaching material had appeared that the very best compromise had beenbeen confined to UNRRA-aided countries.In reached. 1949 it had been extended to all Members of Dr. STOYANOFF (Bulgaria) stressed the lastWHO requiring assistance. sentence of section 1.2.9, " Should governments decide that direct action should be taken by Decision: The programme was approved. WHO to alleviate this condition, consideration may be given to adding to this budget such additional amounts for 1950 as are consideredInsulin proper." One must consider the tragic situation of people in those countries which had need of The CHAIRMAN drew attention to a report 8" on essential drugs and were unable to obtain them.the supply of insulin submitted by the Director- The question should not be left only in the hands General. of the economists : WHO was an organization of doctors and the health of the people was its 81a The Director-General's report staled that re- plies sent by governments to a questionnaire showed prime responsibility. that present and future supplies of insulin would At the previous meeting the delegate of the more than meet the requirements of those countries. Requirements of countries which had not replied United States had referred to the statement ofremained naturally unknown, but the known esti- mated surpluses were large and it was expected that 81 CV Rec. World Hlth Org. 18, 5 requirements could be met adequately. - 212 - NINETEENTH MEETING

DT. WICKREMESINGHE (Ceylon)stated thatActivities with the United Nations, Specialized a number of countries in South-East Asia had Agencies or Non-Governmental Organizations experienced greatdifficulties during the war The CHAIRMAN asked if any observers present with regard to insulin. There had been a proposalwished to speak on this item. that raw materials should be sent by countries There being no speakers, the next item was lacking the necessary processingfacilitiesto manufacturing countries. He felt that that wouldtaken up. be a radically incorrect approach to the problem. It would be costly and would result in undeve-3.Regional Offices loped countries being forced to be dependent upon Agenda, 8.19 external sources of supply, which might in the event of war be cut off.The policy of WHOSpecial Office for Europe should be to encourage local production. Co-operation with the Economic Commission for Europe The CHAIRMAN replied that the attention of the Director-General would be drawn to the Decision: The resolution contained in the report 83 observations made by the delegate of Ceylon. on the above subject was approved (for text, see eighth report, section 2). Dr. RAJA (India) agreed that local production should be stimulated. Technical help from WHO would be gratefully accepted.In his country a Report on the Rehabilitation of UNRRA Peni- method had been evolved for producing insulin cillin Plants in small units. Decision: The committee noted the report of The CHAIRMAN pointed out that the views the Executive Board on the rehabilitation of UNRRA penicillinplants(OgcialRecords expressed by the delegates of Ceylon and India No. 17, p. 13). did not necessarily conflict with the purport of the resolution before the committee.82 Availability of Medical Supplies in Europe Dr. BERNARD (France) supported the resolu- Decision: The committee took note of the sec- tion, but was in favour of amending the French tion of the Executive Board's report dealing text so as to indicate that present and future world supplies of insulin were adequate both in quantity and quality. 83 This report read : 1.Following recommendations contailied in the report of the Expert Committee on Venereal Colonel AFRIDI (Pakistan) associated himself Diseases, the Executive Board at its second with the view of the delegates of Ceylon and session (011. Rec. World Hlth Org. 14, 19, item India.He agreed that their comments did not 1.10, para. 1), decided to request the assistance of the Economic Commission for Europe to affect the resolution in substance.Nevertheless, survey the UNRRA penicillin plants with a he felt that its scope should be expanded by view to their rehabilitation. The importance of requesting the Director-General to explore the increasing the availability of all types of pharma- ceutical and sanitary supplies was later empha- possibilities of manufacture in various countries. sized at a meeting of war-devastated countries in Europe on 15-16 November 1948 in relation The CHAIRMAN agreed that theresolution to setting up the Special Office for Europe. TheConferencerequestedjoint WHO/ECE should be amended in that sense. action in this field. 2.Co-operation between the two Secretariats Professor PENSO (Italy) was in favour of apply- was established before the end of 1948.The ing to the English text also the amendment Secretariat of ECE is assisting the Secretariat suggested by the delegate of France. of WHO on economic and technical aspects of these problems, e.g., requirements and availa- bilities of raw materials and equipment, technical Decision: The resolution, as amended by the informationon productionprocessesand proposalsof the delegatesof France and obstacles to trade. Pakistan, was adopted(forfinaltext,see 3.In view of the great importance of stimulat- ing penicillin production in countries where it eighth report, section 1). does not now exist, joint WHO/ECE action was directed initially towards formulating a pro- gramme with theGovernmentsofCzecho- 82 This resolution read : slovakia, Poland and Yugoslavia for getting The Second World Health Assembly their UNRRA-donated penicillinplants into (1)NOTES the report of the Director-General operation (011. Rec. World Hlth Org. 17, 13, item on the Study of the Supply of Insulin which 3.6, para. 2). shows that present and future world supplies 4.The Secretariats of WHO and ECE are now of insulin are adequate to meet normal require- engaged in a study of economic and technical ments, and aspectsofotheressentialmedicalsupplies. (2)REQUESTS the Director-General to advise However the information collected to date is Governments, upon request,concerning the not sufficiently detailed to formulate afull means of obtaining the necessary requirements programme of action for submission to the for insulin. Assembly. - 213 - COMMITTEE ON PROGRAMME

with this subject (Official kecords No. 17, p. 13, (c)provided for periodic visits to the respec- item 3.6). tive trust territories at times agreed upon with the administering authority ; Availability of T echnical Knowledge of Produc- (d)took these and other actions in conformity tionProcessesofAntibiotics :Penicillin, with the terms of the trusteeship agreements. Streptomycin,Chloromycetin, Aureomycin The CHAIRMAN asked the representative of In the field of health, the Trusteeship Council Poland whether he wished to make any state-would welcome a possible response by WHO to ment in connexion with the paper submitted bythe request for co-operation contained in resolu- his delegation (see footnote 79, p. 208). tion 47 (IV) 84 adopted by the Trusteeship Council on 1 March 1949. Dr. BABECKI (Poland) replied that the point It might be possible to work out the procedures of view of his delegation had been fully presentedfor doing so between the Secretariat of the United in the discussion in the plenary meeting (seeNations and WHO. p. 103). The questions on health contained in the trusteeship questionnaire had been submitted .Public-Health Administration (continuationto WHO for recommendations and improvements. from p. 207) The Secretariat of the United Nations had been Agenda, 8.11supplying the Secretariat of WHO with such Activities with the U nited N ations,Specializedanalytical health data as had been prepared in A gencies or N on-Governmental Or ganizations Lake Success and the collaboration between the two secretariats was progressing satisfactorily. Dr. LECLAINCHE, Secretariat, stated that the Section on Public Health Administration worked The Special Committee had been constituted in collaboration with the United Nations Secreta-as a committee of the General Assembly to riat and certain specialized agencies.As far asexamine the summaries and analyses of data the United Nations was concerned, liaison wasreceived by the Secretary-General under Chapter particularly close with the Trusteeship CouncilXI, Article 73e, of the Charter. and the Social Affairs Division. WHO had been Members of the United Nations having respon- asked to revise the questionnaire drawn up by thesibility or having assumed responsibility for the Trusteeship Council concerning public health inadministration of territories the peoples of which trusteeship territories. The section was interestedhad not so far attained a full measure of self- in receiving statistical information on economicgovernment were,according to thatArticle, andhealthconditionsinnon-self-governinginter alia, " to transmit regularly to the Secretary- territories and it had also been asked to reviseGeneral for information purposes, subject to the scheme for the assembly of such information.such limitation as security and constitutional The section had called for the assistance of threeconsiderations may require, statistical and other experts from countries particularly interested,information of a technical nature relating to who were to meet in Geneva in the second parteconomic, social, and educational conditions in of July or the beginning of September.It wasthe territories for which they are respectively hoped that the work of the section in that fieldresponsible other than those territories to which would be expanded during 1950. Chapters XII and XIII apply ". A standard form for submission of this type Dr.BARKHUUS, SeniorMedicalSpecialist,of data had been worked out by the committee DepartmentofTrusteeship and Information fromNon-Self-GoverningTerritories,Unitedand the section concerned with public health had Nations, made a short statement on collabora-been submitted to WHO for comment. tion between the United Nations and WHO in The Secretariat of the Division of Information the fields concerning the Trusteeship Councilfrom the Non-Self-Governing Territories summa- and the Special Committee, first explaining therized and analysed not only the reports received functions of the latter two bodies. annually, but also a vast amount of supplementary Chapters XII and XIIi of the United Nations'information contained in official publications of Charter established theinternationaltrustee-administering powers. A card filing system had ship system for the " administration and super-been evolved in order to have such information in vision of such territories as may be placed there-ready form and a copy of each card was being under by subsequent individual agreement ".transmitted to the Secretariat of WHO. These territories were called trust territories. The division was chiefly interested in the The Trusteeship Council, operating under theadministrative aspects of the public-health ser- authority of the General Assembly, assisted thevices in the non-self-governing territories and General Assembly in carrying out the functionsthe availability of material and personnel, teach- of the United Nations in regard to trusteeshiping facilities, etc.The more technical problems agreements.The Council : of diseases and their control had been treated in (a)consideredreportssubmittedbytheless detail. A short report on teaching facilities administering authority ; for medical staff in such territories had been (b)accepted petitions and examined them in consultation with the administering authority ; 84 UN document T/328 - 214 - NINETEENTH MEETING prepared for the forthcoming sessionof therecommended that the study of Stomatology Special Committee. and Dental Hygiene be referred to the Executive In all those matters, collaboration with theBoard. 86The latter had found with regret that, WHO Secretariat had proved very valuable andin the absence of adequate documentation, a it was hoped that it would be extended in theprogramme conld not be drawn up.87 Since then, future. the Secretariat had continued to assemble as much material as possible and was now in a posi- Report on the Joint ILOIWHO Expert Com-tion to submit some suggestions as to the approach mittee on Occupational Hygiene: Report onwhich might be adopted by WHO. It was felt the Joint ILO/WHO Expert Committee onthat the attention of Member Governments should Hygiene of Seafarers be drawn to the problem and to the necessity of Dr. LECLAINCHE stated that as far as specialized finding an answer to it. They should be encouraged agencies were concerned the Section on Public-to initiate research and particularly to consider HealthAdministration hadchieflybeeninthe rôle of malnutrition in the incidence of dental contact with ILO. A representative of WHO hadcaries.The prevalence of dental infections in taken partinthe workofthe Permanentdifferent countries and in different age-groups, Migration Committee, which met in Geneva inas well as the means for combating the infection, January 1949.During that session a revisedthe number and qualifications of local personnel, draft of the Convention and Recommendationsthe equipment and financial resources, should' of 1939 relative to migration had been consideredbe studied.Provision had been made in the and on the instigation of the WHO representa-supplemental Budget for 1950 for the appoint- tive certain health factors had been taken intoment of a specialist in that field. account and appropriate amendments made in the text.As a result, the activities of WHO inPhysical Training that field would undoubtedly increase in 1950. Dr. LECLAINCHE stated that the documenta- As regards the question of manpower, WHOtion concerning the possibilitiesof improving had sent a representative to the joint meetingphysical training was still insufficient for the between the United Nations and specializedpreparation of a programme.Accordingly, the agencies which was concerned with the examina-committee might wish to consider the draft tion of the manpower programme of ILO.Aresolution presented by the. Director-General, joint committee of experts was to be set up on reading : industrial hygiene and would be meeting in Geneva in the autumn.In agreement With ILO The Second World Health Assembly : a joint committee to study the hygiene of sea- REQUESTS the Director-General to proceed farers had also been established and would be with the collection of information on physical meeting in Geneva in September. training with a view to submitting a programme to the Third World Health Assembly. Dr. FORREST, Secretary, informed the com- mittee that Dr. Grut, the representative of ILO, The Secretariat had received extremely useful had been obliged to leave Rome and had askedinformationfromtheInternationalMedico- him to state that ILO had been pleased with theScientific Federation.The data so far studied arrangements for co-operation with WHO andhad shown that the first step to be taken was to hoped they would continue in the future on thedraw public attention to the importance of same lines. physical training and to encourage the medical profession to consider the possibility of special Stomatology and Dental Hygiene training for that purpose. The Secretariat would The CHAIRMAN said that the observer for thesuggest that an expert committee might be set International Dental Federation had already leftup to consider a plan of action, when, with the Rome. A statement of his views, hdwever, hadassistance of the International Medico-Scientific been circulated in a document.85 Federation, information on special aspects of the problem in the largest possible number of coun- Dr. LECLAINCHE recalled that at the Firsttries had been assembled. Health Assembly, on the suggestion of the Polish delegation, the Committee on Programme hadreducing theincidenceofdentalcaries,and suggested the following procedures 85 This document stated that, with the progress (1)education of the people ; of civilization,dental caries had increased so (2)improvement in professional efficiency so extensively that it affected 90% of civilized people that there might be a better understanding of over the age of six years with varying degrees of preventive dentistry ; intensity. Satisfactory methods of preventing (3) promotion of closer relations between dental such progressive susceptibility were not yet in and health organizations ; sight and meantime the disintegration was causing many disturbances to general health. (4) increase in manpower for dental services In view of the fact that less than one-tenth of the with the object of protecting the people against children in the world had had any prophylactic untrained and empirical dental practice ; or preventive measures applied to the mouth (5)strict discipline of all students so that they and also because of the extreme shortage of trained might keep their own mouths in healthy condi- dentists,theInternationalDentalFederation tion. calledattention to the need for more active 86 Off. Rec. World Illth Org. 13, 152 measures to increase oral hygiene with the hope of 87 Off. Rec. World Hlth Org. 14, 21, item 1.15.1 - 215 - COMMITTEE ON PROGRAMME

Dr. STOYANOFF proposed the following amend- a consultant could obtain data from physical ment : training experts in different countries and collate the information for submission to the Third The Second World Health Assembly World Health Assembly. REQUESTS the Director-General (1)to proceed with the collection of informa- The CHAIRMAN explained that the Bulgarian tion on physical training and proposal would permit of this being done at the (2)to establish a committee of experts whichdiscretion of the Director-General. would prepare an effective programme for In view of the modification of the amendment, presentationtotheThirdWorld HealthDr. Dowling withdrew his objection, and the Assembly. Bulgarian amendment to the draft resolution was adopted. In regard to the second point, the delegation of Bulgaria wished to propose as a member Decision: The draft resolution, as amended Dr. Mateeff, Rector of the College of Physical above, was adopted, the Director-General's Education of Sofia, who had made the initial report on the subject being noted. suggestion. With reference to the draft resolution sub- the Dr. DOWLING (Australia) opposed the amend-mitted by thePortuguesedelegation,88 ment, for the same reasons as those he had givenCHAIRMAN suggested that, as the matter raised on the question of the creation of an expert com-was very complex and required study, it might mittee on nursing. be submitted to the Executive Board for pre- liminary exploration. The CHAIRMAN reminded the committee that the Secretariat was preparing a document, show- Dr. de PINHID (Portugal) agreed to this pro- ing the expert committee structure, which wouldcedure being adopted. be available on the following day. Decision: That the draft resolution by the Portuguese delegation on Physical Culture 88 Dr. EJERCITO(Philippines)considered that be submitted to the Executive Board for pre- establishment of an expert committee should be liminary exploration. deferred until after the studies being made by the Executive Board and the Director-GeneralProgramme for 1950 had been completed. The CHAIRMAN reminded the committee that Dr. SIMONOVITS (Hungary) and Dr. BABECKIthe redrafted resolution on nursing was still seconded the proposal of the Bulgarian delega-awaited, but as this was only a drafting matter tion. it would be possible in the meantime to approve the programme for 1950 on public-health admi- Dr. STOYANOFF said that it had not been hisnistration. intention to burden the Organization with a Decision: The programme for 1950 (Official great number of expert committees : his proposal Records No. 18, pp. 102-106) was approved. was for a small group of experts to deal with the matter of physical training, and this group could5.Activities with United Nations, Specialized be formed after the Executive Board had sub- Agencies, or Non-Governmental Organiza- mitted the results of its enquiries. tions (continuation from p. 197) The CHAIRMAN asked whether, in that case, Agenda, 8.21 the following wording would be acceptable : Co-ordination-General REQUESTS the Director-General to proceed The CHAIRMAN presented a report by the with the collection of information on physicalDirector-General on the co-ordination mechanism training and to hold consultation with expertsof the United Nations (Annex 5), within which with a view to submitting a programme to theframework the Director-General of WHO was Third World Health Assembly. working, and a draft resolution noting the report and requesting the Director-General to continue This wording was accepted by the proposerscollaboration with the Secretary-General of the and seconders of the amendment, Dr. STOYANOFFUnited Nations and the Directors-General of adding the request that his recommendation ofother specialized agencies through the mechanism Dr. Mateeff should be borne in mind. of the Administrative Committee on Co-ordina- tion and its subsidiary bodies, and by appropriate The CHAIRMAN replied that that was a matterrepresentation at the meetings of other United which rested entirely with the Director-General,Nations bodies (for text, see eighth report, sec- who would, no doubt, take note of the suggestion.tion 4). Decision: The draft resolution was adopted, Dr. EJERCITO thought it might be sufficient, the Director-General's report being noted. in the interests of economy, if the Organization engaged a consultant in physical training, to be 88 As this draft resolution was referred to the attached to the Physical Training Section. SuchExecutive Board, it is not printed in this volume. - 216 - NINETEENTH MEETING

Resolution of the Economic and Social Council onsolution of the Palestine refugee problem.Such Technical Assistance a solution, however, could only be reached by successive stages.In the best of circumstances, The CHAIRMAN, in presenting a note by thetherefore, a substantial proportion of the refugees Director-General on the financing of the supple-would have to be financially supported not only mental operating programme of advisory and tech-throughout the remainder of the present year, nical services, said that the subject matter ofbut also through most of the coming year. Not the document would be considered by the jointonly would feeding have to go on, but medical meeting of the Committees on Programme andfacilities, if possible on a more extensive scale Administration and Finance (see pp. 276, 279).than hitherto, would be essential. The continued help of WHO was consequently of vital impor- Decision: On that understanding, the documenttance, and in the Secretary-General's view might (Annex 22) was noted. indeed represent the difference between success and failure not only in saving countless lives, United Nations Project for Relief of Palestinebut also in obviating the danger of widespread Refugees epidemics. That was the reason for the request (Annex 10) which he had addressed to the World Mr. MARTIN HILL (RepresentativeoftheHealth Assembly. Secretary-General of the United Nations) recalled that the United Nations Relief for Palestine In conclusion, Mr. Martin Hill repeated the Refugees had been established by the GeneralSecretary-General's words that any action which Assembly in November 1948 as an emergencyWHO felt able to take in response to that request and exceptional undertaking, in the light ofwould be warmly welcomed not only by him, but forceful representations by the Mediator andalso by the United Nations as a whole. subsequently by the Acting Mediator that the plight of these refugees presented a humanitarian Dr.GOODMAN, AssistantDirector-General, problem of immense urgency which could begave a summary of the action already taken in met only by international action and, further,regard to United Nations relief for Palestine that the alleviation of conditions of starvationrefugees.The Medical Officer in charge of the and distress among the refugees was one of theprogramme, Dr. Cottrell, was present and ready minimum conditions for the success of the effortsto report or to answer questions. of the United Nations to bring peace to Palestine. The Secretary-General had asked Mr. Martin Hill Sir Aly SHOUSHA, Pasha (Egypt), stated that to express his deep appreciation of the promptthe resolution proposed by his delegation (por response which had been given by WHO to hisfinal text, see third report of the Joint Meetings appeal for assistance in carrying out the pro-on Programme andonAdministration and gramme of relief.The services of WHO Finance, section 2)represented the minimum field, as well as the financial support which thethat could be done for the Palestine refugees. Organization had furnished, had been invaluable.He had nothing further to add after the state- The General Assembly had contemplated anments made bytherepresentativesof the operation lasting up to the end of August 1949 ;United Nations and of the Secretariat. He then however, by the spring of the present year it hadmoved its adoption with a small amendment in become all too apparent that, in the absence ofthe third clause 89 whereby the word " exceeding " a solution to the refugee problem, the relief,would be replaced by the words " less than ". operation would have to be continued until the General Assembly meeting in September had Dr. DOWLING asked whether it was for the had an opportunity to decide on longer termcommittee to stipulate any sum.He felt that measures. The Secretary-General had made thethe provisions of the third clause would require necessary arrangements with the three operat-consideration by the Committee on Adminis- ing agencies to continue their work in the fieldtration and Finance. after August on a month-to-month basis, provided the necessary funds were forthcoming.He had The CHAIRMAN considered that the financial appealed to UNICEF, which from the outset hadprovision in the clause in question should be assumed an important share of the burden, toomitted and that the resolution as a whole should continue its programme.He had noted withbe sent to the joint meeting for implementation. much satisfaction the offer by the FAO Council, made during the previous week, to maintain and extend FAO's collaboration in the future. Dr. EL-CHORBACHI (Iraq) supported the Egyp- He had addressed to governments a: new andtian resolution. most pressing appeal for funds, which were at the present time critically short. 89 This clause, as thus amended, read : The Secretary-General earnestly hoped that RESOLVES that technical assistance in this the forthcoming General Assembly, at which he field be rendered by the World Health Organi- would ask that the question be considered a first zation in 1950 through the United Nations as priority, might be in a position, on the basis of an emergency measure and that an amount not less than the amount allocated for this purpose proposals by the Palestine Conciliation Com- in 1949 be provided for in the budget for 1950 mission, to assist in bringing about a permanent to meet this expenditure. - 217 - COMMITTEE ON PROGRAMME

Dr. RAJA pointed out that the item before thespecial one and could not be related to other committee inyolved a question of general principle,refugee problems. The point raised by the and a common policy would have to be evolvedIndian delegate therefore seemed to him to be since it was likely that other refugee problems, ininvalid, and was based on confusion between particular that of Greece, wonld be brought up.refugees and displaced persons within their own countries. The CHAIRMAN pointed out that the question of Palestine refugees was a special case for which Dr. DOWLING moved the adjournment of the the United Nations had taken responsibility. meeting :the committee had reached a point The policy therefore had already been laid down, of substance which could not be adequately and WHO was simply being asked to take action.discussed at that late hour. Decision:' The motion for adjournment was Dr. NOACK (Israel) recognized that the resolu- carried. tion reflected a humanitarian attempt to secure relief for refugees, but considered that its last two clauses were of a political nature. The6. Announcement by Chairman political aspect of the problem was already being Beforeclosing the meeting the CHAIRMAN dealt with by the appropriate bodies of theasked whether the committee was in favour of United Nations.It was altogether outside thereferring the note submitted by the delegations competence of WHO. He therefore moved theof Australia, Ceylon, Canada, Ireland, Nether- deletion of those two clauses. lands and the Union of South Africa on the proposed 1950 Programme (see p. 286) to the Sir Aly SHOUSHA, Pasha, was unable to agreeJoint Meetings of the Committees on Programme with the delegate ofIsrael that the clausesand Administration and Finance. referred to had political implications : they merely indicated that the solution of the problem Decision: It was so agreed. was resettlement. He agreed with the Chairman that the question of Palestine refugees was a The meeting rose at 2 p.m.

TWENTIETH MEETING Monday, 27 June 1949, at 9.40 a.m. Chairman: Dr. H. HYDE (United States of America)

1.Adoption of Draft Reports of the Committee tion by the Joint Meeting of the Committees on Decision: The draft fifth, sixth, seventh and Programme and on Administration and Finance eighth reports of the committee to the Health were adopted. Assembly (see pp. 328, 330, 331), the draft fifth and sixth reports 90 for consideration by The meeting rose at 9.50 a.m. the Committee on Administration and Finance, and the draft seventh report 90 for considera- 90 See footnote 16, p. 164.

TWENTY-FIRST MEETING Tuesday, 28 June 1949, at 9.30 a.m. Chairman : Dr. H. HYDE (United States of America)

1.Activities with United Nations, Specializedthe request of the United Nations to WHO with Agencies, or Non-Governmental Organiza-regard to .Palestine refugees. tions (continuation) Dr. RAJA (India) said that, the question of Agenda, 8.21 Palestine refugees had already been considered by the United Nations. India also was confronted United Nations Project for Relief of Palestineby the problem of a large refugee population, was Refugees (continuation) experienced in the settling of displaced, refugees, and was fully sympathetic. Nevertheless,his The CHAIRMAN recalled that at a previousdelegation did not feel that it could support the meeting the committee had been consideringresolution put forward by the delegate of Greece. - 218 - TWENTY-FIRST MEETING

The CHAIRMAN drew attention to the resolution should appeal to the highest humanitarian and on the subject which had been submitted by theprofessional instincts of the members of the delegationofEgypt. During the previouscommittee. In such a case as was under discussion, discussions, it had been agreed that the thirdopportunities for the spread of epidemic diseases clause should read :" that an amount not lesswere rife.Resettlement should be part of any than the amount allocatedforthis purposescheme to deal with the problem ; on that point in 1949...". he supported the delegate of Egypt and hoped that the committee as a whole would do likewise, Sir Aly SHOUSHA, Pasha (Egypt), said he wanted since the fundamental problem was non-political. to refute the implication that he had introduced a political aspect into the discussion on the ques- Dr. DOWLING (Australia) was unable to under- tion. He considered that the proposed resolutionstand the insistence of the delegate of Egypt on could not be read otherwise than as affectingthe financialclause. Provisionof technical matters of health only, and he had had noassistance naturally involved funds, but he would intention of involving WHO in political discus-propose that the section of the resolution dealing sions.The most desirable solution lay in thewith finance should be omitted, as it was not for rapid resettlement of refugees, but it was not forthe committee to decide on financial matters. the Health Assembly to decide where or how that should be done. The resolution in itself was an The CHAIRMAN noted that, should the sugges- answer to the request of the Secretary-Generaltion of the delegate for Australia be accepted, of the United Nations to the Director-General.the resolution could go directly to the Assembly ; if a financial clause were included, it would have The CHAIRMAN asked whether the delegate ofto go first to the Committee on Administration Israel was prepared to accept the modification'and Finance. put forward at the previous meeting by the delegate of Egypt in the text of the resolution Sir Aly SHOUSHA, Pasha, thought that the (third clause, substitutionof "less than" forresolution could not be implemented if WHO did "exceeding") (see footnote 89, p. 217). not undertake financial obligations.Reference to the exact amount to be allocated should, Dr. NOACK (Israel) stated that the solution ofhowever, be omitted. the problem should not be sought at the Health Assembly :otherthanhealthaspectswere Dr. DOWLING thought that that would necessi- involved, and the General Assembly of thetate a similar procedure for every item of the United Nations had set up a Palestine Reconcilia-programme. He felt that it was not the task of tion Commission. He felt, therefore, that WHOthe committee to take financial decisions. should not interfere, and indicate what the direc- tion of the solution should be.It could not be Dr. RAJA. had no objection to the reference to decided on health aspects only. the funds to be provided, since every budgetary If the delegate of Egypt would agree to the item in Official Records No. 18 had been discussed. deletion of the words "return or" in the resolution (penultimate clause), his own delegation would The CHAIRMAN did not consider that it would accept the Egyptian amendment. The resolutionbe necessary to amend every financial clause, would thereby be couched in more general terms.and requested the consent of the delegation of Australia to retain the clause as amended by the The CHAIRMAN said that it should not be thedelegate of Egypt. policy of the committee to take up specific financial questions.In view of the development Decision : With the agreement of the delegate of the discussions on the budget at the joint of Australia, the resolution as amended was meeting, he suggested that the resolution should approved by the committee(fortext,see be left in general terms and that the financial third report of the Joint Meeting of the Com- clause should be omitted. mittees on Programme and Administration and Finance, section 2). Sir My SHOUSHA, Pasha, agreed that the committee should notdeal with budgetaryUnited Nations Proposal to create International considerations, and to meet the point suggested Research Laboratories that the words "not exceeding the amount allo- Dr. FORREST, Secretary, said that at its second cated for this purpose in 1949 " be omitted fromsession, in November 1946, the Interim Commission the resolution. He felt it would be unwise forof WHO had examined the resolution presented the Director-General to commit himself to aby the delegation of France to the third session fixed amount. of ECOSOC relatingtothe submission by the Secretary-General, after con'sultation with Dr. MACCORMACK (Ireland), speaking as theUNESCO and other specialized agencies con- representative of a country with no politicalcerned, to ECOSOC of a general report on the axestogrind,thoughlthatthesubjectproblem of establishing United Nations research - 219 - COMMITTEE ON PROGRAMME laboratories. The Interim Commission had drawnof Greece. He felt that WHO should avoicil the attention of - ECOSOC to certain articles ofinterference in the internal affairs of a country, the Constitution relating to scientific researchand that the draft resolution should not be and to the dangers inherent in excessive centraliza-adopted. tion and regimentation,and had requested ECOSOC to restrictits actions in regard to Dr. PAOLINI (Italy)said that hundreds of international research in health to consultationthousands of refugees had had to seek refuge in with the interested agencies, until the problemAthens, and that their resettlement placed a could be considered by WHO.91 grave social problem before the Greek Govern- In conformity with that resolution, the Secre-ment.The Economic and Social Council, at its tary-General of the United Nations had submittedsession beginning on 5 July 1949, should, in his to ECOSOC at its seventh meeting (Septemberopinion, consider the question of special assis- 1948) a report 92 of 441 pages which analysed thetance for those people, which should include the communications received from specialized agen-provision of food and, above all,of medical cies, various scientific organizations and individualsupplies. He supported the draft resolution and scientists, on the subject of the establishmenthoped that it would meet with the unanimous by the United Nations of international researchconsent of the committee. laboratories. ECOSOC had authorized the Secre- tary-General to set up, in collaboration with Dr. SIMONOITITS (Hungary) shared the views UNESCO, a small committee of experts whichof the delegate of Czechoslovakia opposing the would examine, in consultation with the special-adoption of the draft resolution.Other interna- ized agencies, the advisability of convening antional organizations existed which could intervene international conference of scientists, with in-more appropriately in the matter-the Interna- structions to submit a general report on thetional Committee of the Red Cross and the establishment of international research labora-United Nations International Refugee Organi- tories. zation. WHO should abide by the principle of At its third session, the Executive Board hadnon-interference in political questions that were considered the resolutionof ECOSOC 99 andirrelevant to its own tasks.For that reason, decided to recommend to the Second Worldhis delegation suggested the removal of this Health Assembly the adoption of the resolutionpolitical question from the agenda. set out on page 15 of Official Records No. 17, item 5.3.3. Sir Aly SHOUSHA, Pasha, thought that the Chairman should give time to the committee for The CHAIRMAN said that the Executive Boarddelegations to express their opinions and attempt had studied the whole question and recommendedto bring the matter from a national to an inter- the resolution set forth in Official Records No. 17, page 15, item 5.3.3.He noted that it was innational field. conformity with the resolution on co-ordination The CHAIRMAN reminded the committee that of research already adopted (for text, see fifththe question under consideration was whether it report, section 2). was appropriate for the committee to take action Decision: The resolution on page 15 of Officialon an international matter, and he would like Records No. 17, item 5.3.3, was approved byto limit the discussion to that aspect. the committee (see ninth report, section 1). Sir Aly SHOUSHA, Pasha, said that his delegation 2.Proposal by the Delegation of Greece on thewas in sympathy with the resolution and wished Assistance to be given to Displaced Personsto support it, but the problem was not a local one, in that Country 94 and WHO should consider the situation from Agenda, 8.24a health point of view. Dr. GONDA (Czechoslovakia)expressed the The resolution might be worded so as to cover sympathy of his delegation with the sufferingsall displaced persons all over the world, and he of the Greek people. Nevertheless, his delegationmoved that the text be amended to that end : felt that the committee had made a mistake inthe first two paragraphs to be deleted and the considering the draft resolution, which was aresolution to read, "Considering the disastrous purely political matter and an internal concernconsequences of the situation of displaced persons in different parts of the world from its health aspect, as well as the risks of the breaking out 91 011. Rec. World Hlth Org. 4, 26 and 139 of epidemics in their respective regions ...". 92 UN doc. E/245/Rev. 1 93 ECOSOC resolution 160 (VII) such a situation from the point of view of their 94 This proposal read : health as well as the risks of the breaking out of Deeply touched by the statement made by the epidemics in the regions in question, delegate of Greece on the situation of 700,000 The Second World Health Assembly inhabitants of this country-one-tenth of the DRAWS THE ATTENTION of the Economic and whole population-who have been compelled to Social Council of the United Nations to this leave their homes owing to the events, situation, and Consideringthesufferingstowhichthis RECOMMENDS its immediate examination at population is submitted, a meeting of the Economic and Social Council to Considering the disastrous consequences of be held in Geneva on 5 July 1949. - 220 - TWENTY-FIRST MEETING

Dr. Irène DOMANSKA (Poland) said her Govern- Dr. RAJA felt that the matter was of such ment was not unaware of the suffering of themagnitude thatitcould not adequately be Greek people, but it considered that the proposaldealt with either by WHO or ECOSOC.The had a political character and that, if approved,problem ofdisplaced personsaffected many it would do harm to the Greek people. It wouldmillions of people, and he doubted whether also constitute a danger to WHO if the Organiza-international agencies could bring much useful tion were to interfere in political questions. aid to them at the moment. The health aspects of the matter deserved consideration and ECOSOC The CHAIRMAN asked whether the delegationhad to consider other aspects than the health aspect ;consequently the proposal as it now of Greece was willing to accept the amendmentstood, with its extended significance, became proposed by the delegate of Egypt. difficult of acceptance. Dr. BRISKAS (Greece) was in favour of the Dr. DOWLING said the purpose of the World amendment, but reserved the right to discuss theHealth Organization was to prevent epidemics question further when other delegates had ex-from becoming worldwide. Statements about the pressed their opinions. political issues involved had no place in the dis- cussion.He supported the proposal which had The CHAIRMAN said that a decision could bebeen placed before the committee. reached when the amendment was available to the committee in writing.In its amended form Dr. KLosI (Albania) said the point of view of the resolution would be of a very general nature,his delegation was that the question of Greek referring to all displaced persons, and ECOSOCrefugees was entirely an internal one. No parallel would be asked to consideritthe followingcould be drawn between the Greek case and that week. of the Arab refugees in Palestine, where the matter was one of the Jews striving for their Other specialized agencies, such as IRO, alsoindependence, whereas the Greek people were dealt with refugee problems, and the committeefighting their own government for liberation. should consider whether WHO, in adopting theThere was no question of any epidemic in Greece resolution, was helping the general programme onwhich might menace Europe or the world.He refugees, which was a matter broadly within thesupported the proposal of the delegate of Czecho- purview of the United Nations. slovakia, which had been seconded by the dele- gate of Hungary, to delete the item from the Dr. STAMPAR (Yugoslavia) said that the prob-agenda. lem of refugees had been on the agenda of the United Nations since January 1946, and that Dr. VILLARAMA (Philippines) moved the closure ILO and ECOSOC had also been discussing theof the debate, proposing that the amendment matter for the last three years, and were conse-before the committee be put to a vote. quently familar with the health aspects of the problem.So far, no solution had been found. Dr.POLMAN (Netherlands)supportedDr. Every Member of the United Nations was entitledVillarama's proposal. to present such problems for consideration to ECOSOC, and he did not think it was desirable Dr. BRISKAS, recalling his previous remarks, that WHO should put forward a proposal whichasked if he might speak on the proposal in order could be dealt with by the delegation of Greeceto clarify the matter, which had been misinter- itself. The refugee problem was a world problem,preted by certain delegates. and it was difficult to deal with one specific country. His delegation was opposed to the resolu- The CHAIRMAN, quoting the rules of procedure," tion as presented by the delegation of Greece, andsaid he could permit only two speakers for and also to the more general resolution. two against the closure of the debate. Dr. TAGAROFF (Bulgaria) requested that the The CHAIRMAN pointed out that the amend-debate might be continued. ment to the resolution proposed by the delegate of Egypt having been accepted by the delegation The CHAIRMAN informed the committee that of Greece, the original proposal was withdrawna vote on the motion for closure would be from consideration. necessary.

Dr. MILLER (United States), while expressing The motion for closure of the debate was adopted sympathy with the Greek people, supported theby 19 votes to 7. point of view of the delegates of Czechoslovakia Decision: The proposal of the 'delegation of and Yugoslavia. He felt that WHO, being a Greece, as amended by the delegate of Egypt, technicalorganization,could not appeal to was adopted for submission to the Health ECOSOC without full examination of all data Assembly (for text, see ninth report, section from a scientific point of view ; as that did not 2). appear to have been done, his delegation would have to oppose the proposed resolution. "IOU. Rec. World Health Org. 13, 365 - 221 - COMMITTEE ON PROGRAMME

3.Editorial and Reference Services (continua-arrangements had been undertakenforthe tion from p. 168) obsetvance of World Health Day on 22 July Agenda, 8.20 1949. Activities with United Nations, Specialized Agen- That date, however, involved a significant cies or Non-Governmental Organizations disadvantage, to which attention was directed. From the long-term aspect, one of the most impor- United Nations Library, Geneva tant population groups in any country with Decision: The committee notécl a further reportregard to the observance of that day was repre- on this subject 96 and adopted without amend-sented by children and young adults, and perhaps ment for submission to the Health Assemblythe most effective means of reaching that group the draft resolution submitted by the Director-was through the schools.In a large number of General (for text, see ninth report, sectioncountries,however,school children were on 3). vacation during July and were thus inaccessible. 4.World Health Day The date of 7 April, the day when the Consti- Agenda, 8.22tution of WHO officially came into force in 1948, would seem in those circumstances to provide A document submitted by the Director-Generalan alternative which might obviate that disad- recalled that the First World Health Assemblyvantage.Most schools would then be in session had decided that the Organization should sponsor and could thus act as important focal points for the celebration of World Health Day on 22the observance of World Health Day. A draft July each year, and that, accordingly, certainresolution to that effect was set out in the docu- 96 This report read : ment. The following is an excerpt from a Note for the Ninth Sessionof the Economic and Social Mr. HOLMA (Finland) proposed that the date of Council submitted by the Secretary-General of 7 April should be adopted as World Health Day, the United Nations. as it would fall during the school term in most 12.In conformity with the relevant prin- ciples set out in paragraphs 1 to 11, it iscountries. proposed that arrangements along the following lines be made between the Geneva Library The CHAIRMAN stated that he had been reques- and the World [Health] Organization. (a)The Geneva Library will lend to WHO, ted by Dr. Wickremesinghe (Ceylon) to inform for an indefinite period, certain medical andthe committee, in his absence, that he suggested health material needed by that organization,that World Health Day might be a movable date, in such categories as :medicine ;anatomy ;such as the first Saturday or the first Monday of physiology ; hygiene ; public health ; materia medica,therapeutics,pharmacology ;toxi-April. cology ;internal and external pathology ; surgery ; gynaecology, obstetrics ; pediatrics ; Dr. RADJI (Iran) supported the proposed date comparative medicine ;veterinary medicine.of 7 April, the date of ratification of the WHO (b)The material lent will be housed in aConstitution by 26 governments. place convenient to WHO. (c) WHO will undertake to maintain sub- scriptions to the serials lent to it, and to Decision: The draft resolution submitted by the purchase the new books it needs in the cate- Director-General was adopted without amend- gories set out in (a) above. WHO will retain ment (for text, see ninth report, section 4). title to such accessions. (c1) WHO will also undertake that all mate- rials transferred to it on loan will be adequately The CHAIRMAN thanked the members of the serviced and made available to the Unitedcommittee for their co-operation. Nations Organization and specialized agencies, and to other suitable readers. A vote of thanks to the Chairman, moved by Further details of the arrangement will beDr. VILLARAMA (Philippines), was carried by agreed upon by the Director of the European Office and/or the Director of the Headquartersacclamation. Library on the one hand, and the Director- General of WHO on the other. The meeting rose at 12 noon.

TWENTY-SECOND MEETING W ednesday, 29 June 1949, at 3.30 p.m. Chairman : Dr. H. HYDE (United States of America)

1.Regional Offices (continuation from p. 214)gate of Poland for reopening of consideration of Agenda, 8.19 this item of the agenda which had been discussed at an earlier meeting (see p. 214). Special Ogice for Europe The committee agreed to the request. Availability of Technical Knowledge of Produc- tion Processes of Antibiotics Dr. BABECKI (Poland) thanked the Chairman The CHAIRMAN asked whether the committeefor permission to speak on the item. At a previous was prepared to agree to the request of the dele- meeting the chief delegate of Poland had presented - 222 - TWENTY-SECOND MEETING thequestionwithallsupporting evidence,approved when supplies were available.While butit had been considered at the end of apenicillin and streptomycin were in limited supply long meeting and had not been given thethere was a shortage of aureomycin and chloro- attention which hisdelegation consideredit mycetin. deserved. In his country manufacturers held protected Since the previous discussions his delegationpatents but could at their own discretion disclose had been informed, unofficially, that any discri-information on their methods ;any necessary mination as regarded essential drugs or thelicensing arrangements for foreign manufacture means of short production was a matter of indus-of those drugs must be made directly with the trial policy and not of governmental action.Since manufacturer.While the United States Govern- then he had received two documents suggestingment was not a party to private negotiations, it that that iLad not always been the case. would co-operate, to the extent legally permissible, The first was a proposal from an Americanwith any country desiring to undertake produc- firm concerning equipment required for thetion of the drugs by facilitating contact and Polish penicillin factory to be opened during thenegotiations with the firms concerned. The coming month which mentioned Podbielniakdiscovery of a drug did not assure its usefulness. extractors as being necessary for the productionAureomycin and chloromycetin were still con- of penicillin.The second was a letter to thesidered too experimental to permit oftheir PolishUnder-SecretaryofStateforPubliclicensing for sale in the United States for the Health from the Acting Director of the Specialtreatment of diseases in which only limited Office for Europe of WHO containing the following favourableclinical reports had sofar been st at ement : made. He stressed the prominent part played by You will remember that immediately follow- American industry in research which had led ing the Penicillin Plant Conference in Genevato the development of many antibiotics and many on 17 February 1949, we commenced detailed other drugs.The emphasis on research and the negotiations to obtain Podbielniak extractorsincreasedresearchfinancingintheUnited for the penicillin plants in Czechoslovakia,States had led to many advances in medical Poland and Yugoslavia. I regret that we have knowledge which were ofconsiderable benefit just been informed through our New Yorkto the peoples of the world. The recent announce- Office that, after full consideration of thisment that neomycin had passed the experimental request,the United States Government istrials and was considered safe for trials on human unable to agree to issue the necessary exportbeings was an example of the valuable team-work licences for this equipment. in research between American scientists and American industry. Although the system of patents might seem to some to work against the His delegationfeltthat no discriminationgeneral interest, that view was not borne out should be applied either by private firms or byby facts. The rapid progress made in the develop- governments to the provision of scientific orment of antibiotics and their production in the technical information or to the supply of theUnited States testified to the soundness of the means of production of drugs required for savingsystem. life. He therefore proposed the following resolu- tion for submission to the Assembly. The Podbielniak extractors were not essential to the production of penicillin :one large firm in the United States continued to use Sharples The Second World Health Assembly extractors. Podbielniak extractors were not CONSIDERS that withholding of scientific orinvolved in the process of producing crystalline technical information on the essential thera-instead of amorphous penicillin,as had been peutic and prophylactic drugs and the meansstated.The United States representative on of their production, as well as any discrimina-the Executive Board had informed WHO regard- tion in selling or otherwise supplying nationsing equipment necessary to modernize UNRRA with these drugs or the means of their produc-penicillin plants. tion, is not compatible with the ideals of WHO He agreed that scientific information should and is against the interests of humanity. be as free as possible although individual scientists might legitimately wish to keep the results of Dr. SCHEELE (United States of America) saidresearch a secret until they had made a chain of that his Government had stated already itsdiscoveries. The United States had not a mono- position in the matter under discussion butpoly of scientific research and had tried to obtain wished to reiterate the fact that there were meansinformation from some countries and had not by which countries could obtainantibiotics.found it available. He expressed sympathy with While a licence was required from the Unitedthe proposal of WHO to create a small expert States Department of Commerce, there was nogroup to attempt to solve the difficulties of the intention on the part of his government to prevent matter, and wished it every success.He hoped export for medical purposes, and licences wereallcountries would eliminate any possibility - 223 - COMMITTEE ON PROGRAMME of introducing national policies into medical pro- The CHAIRMAN therefore proposed inserting grammes, and that the discussions would bein the resolution the words " withholding the undertaken by specialists and scientists withoutfair exchange of medical scientists ". political instructions. Decision: The draft resolution, as amended, Frequently problems arose, not from the lack was approved and it was agreed that it should of willingness on the part of the United States be sent direct to the Health Assembly (for final to give information, but from the fact that text, see eleventh report, section 1). individuals designated by countries to work with the United States experts were not always fully competent to understand all the highly compli- 2.Adoption of Draft Reports of the Committee cated technical problems involved. He suggested Decision: The draft eighth report for considera- that countries should not attempt to start pro- tion by the Joint Meeting of the Committees duction of penicillin with the most complicated onProgrammeandAdministrationand equipment, which was exceedingly difficult to Finance,97 and the draft ninth report (see p. 332) control, until they had mastered the simpler for submission to the Health Assembly were processes. approved. The CHAIRMAN put to the committee the3.Closing Remarks resolution proposed by the delegate of Poland. The CHAIRMAN thanked the Vice-Chairman for her help, the Rapporteur for his diligence in Dr. SCHEELE (United States of America) saiddrawing up the numerous reports,and the his delegation would be glad to support the prin-members of the committee for their help and ciples of the proposed resolution if the delegationsupport. The committee could adjourn with of Poland would extend its scope to include thea feeling of satisfaction at having accomplished a free movement of scientists between nations,difficult task. in addition to exchange of information. The meeting rose at 4.35 p.m. Dr. BABECKI (Poland) agreed to that suggestion. 97 See footnote 16, p. 164

- 224 - COMMITTEE ON ADMINISTRATION AND FINANCE

COMMITTEE ON ADMINISTRATION AND FINANCE

FIRST MEETING Tuesday, 14 June 1949, at 10.25 a.m. Acting Chairman: Dr. K. EVANG (Norway) later Chairman : Dr. B. SCHOBER (Czechoslovakia)

1.Election of Chairman There were no other proposals and Dr. Schober Agenda, 10.1 was accordingly elected Chairman. In accordance with the decision taken at the Dr. Schober thereupon took the Chair. first meeting of the Committee on Programme, it was agreed that the President of the Assembly The CHAIRMAN thanked the delegates for the should act as temporary Chairman of the com-honour they had shown to Czechoslovakia, his mittee until it had elected its own Chairman. delegation and himself. The Committee on Administration and Finance was a means of achieving the aims of the World Health Assembly, The ACTING CHAIRMAN said that Dr. Schober (Czechoslovakia) had been nominated as Chairmanand he, for his part, would do his best to make it of the committee and asked whether there werea success. any other proposals for the office. The meeting rose at 10.30 a.m.

SECOND MEETING Thursday, 16 June 1949, at 5.0 p.m. Chairman : Dr. B. SCHOBER (Czechoslovakia)

1.Announcement by the Chairman On his proposal, seconded by Dr. DUJARRIC The CHAIRMAN said that the conduct of theDE LA RIVIERE (France), the committee elected committee's work would be governed by theMr. Lindsay (United Kingdom) Rapporteur by Rules of Procedure of the World Health Assembly1acclamation. where they were applicable. Mr.' Lindsay (United Kingdom) took his place as Rapporteur. 2.Election of Vice-Chairman Agenda, 10.1 4.Procedure for Examination of Programme The committee confirmed the nomination made and Budget for 1950 by the Committee on Nominations (see p. 323) Agenda, 10.3 and elected Dr. Thomen (Dominican Republic) The CHAIRMAN recalled that the procedure Vice-Chairman by acclamation. proposed by the Executive Board for examination Dr. Thomen took his place as Vice-Chairman. of the Programme and Budget for 1950 had been approvedinplenarysession(seeresolution WHA2.1, p. 18). No Action by the committee 3.Election of Rapporteur was therefore required under that item of the Agenda, 10.2 agenda. The CHAIRMAN point ed out that the Rapporteur5.Report of the Director-General should be elected purely for his personal ability to perform a very important task and without Agenda, 10.4 regard to geographical distribution. Mr. SIEGEL,Secretary,explained that the item had been placed on the agenda of the com- 1 Off. Rec. World Hlth Org. 13, 365 ;17, 53 mittee so that it might, if it wished, discuss the - 225 - SECOND MEETING confidential report on the composition of theCommittee on Administrative and Budgetary Secretariat which had been prepared by theQuestions had gone somewhat beyond its terms Director-General and distributed to the chiefof reference in some directions would not deflect delegate of each delegation two days previously,the committee's attention from other recom- as well as any other administrative or financialmendations which, he thought all were agreed, questions raised in the Director-General's report.lay within the competence of such an advisory body.He drew attention in particular to the On the proposal of M. VAN DER BRUGGENrecommendations that agencies should stabilize (Belgium), the committee decided to defer con-their budgets at the minimum consistent with sideration of the item until delegates had had anthe implementation of their charters and the opportunity to acquaint themselves with thefinancial resources oftheir membersforall confidential report.(See fifth meeting, section 3). international activities 3 and that the develop- ment oftheir structureandstaffing should proceed cautiously.4 6.Administrativeand FinancialRelations between the United Nations and Specialized The CHAIRMAN proposed the adoption of the Agencies draftresolutionsubmitted by theDirector- Agenda, 10.5General. The SECRETARY said that documents A2/9 and Decision :The committee agreed to recom- A2/9 Add. 1 (Annex 8) gave an account of the mend to the Assembly that it adopt the draft progress made towards the co-ordination of the resolution submitted by the Director-General financial and administrative practicesofthe on administrative and financial relations be- Organization with those of the United Nations tween the United Nations and specialized and the other specialized agencies. They referred agencies (for text, see first report, section 2). to reciprocal arrangements for the transfer of staff between theOrganization,theUnited Nations and other specialized agencies, as well7.Financial Responsibilities of the Executive as to the Organization's co-operation with the Board United Nations Expert Committee on Salaries Agenda, 10.6 and Allowances and itsparticipation in the The CHAIRMAN proposed that consideration of activitiesoftheInternationalCivilServicethis item be deferred since the United Kingdom Advisory Board. delegation, which had proposed it, was not yet He drew attention to the correspondence (seeready to discuss it. Annex 8) between the Director-General and the Secretary-General of the United Nations on the Decision : The committee adopted the Chair- United Nations Advisory Committee on Admi- man's proposal to defer consideration of the nistrative and Budgetary Questions. item (see sixth meeting, section 4). Document A2/9 Add. 1 reproduced those portions of the Fifth Report of the Administrative8.Transportation and/or per diem Allowance Committee on Co-ordination which dealt with for Delegates to the Third and Subsequent the common collection of contributions and various Health Assemblies personnel problems, including that of geographi- Agenda, 10.7 cal distribution of staff.In addition, the Exe- cutive Board, acting on the authorization of the The SECRETARY pointed Out that the draft First Health Assembly, had taken a favourableresolution contained in the document submitted decision 2 on the question of the participation ofby the Director-General (for text, see first report, the Organization's staff in the United Nationssection 3) would have the effectof authoriz- pension scheme ; and although certain questionsing reimbursement of the travelling expenses of one of detail still remained to be worked out, thedelegate to the Third and subsequent Health staff had, in fact, been participating in thatAssemblies, as was approved for the present scheme since 1 May, subject to final agreementAssembly, by virtue of a decision of the First between the Director-General and the Secretary-Assembly.4 General. Finally, he drew the committee's attention to Dr. VILLARAMA (Philippines) suggested that the draft resolution submitted by the Director-the $800 which he understood to be the average General (fortext, seefirstreport, section 2)sum required to cover the round trip of one whereby the Health Assembly would approvedelegate could be employed in other ways with the action so far taken by the Director-Generalmuch greater advantage to the Organization. toachieveadministrativeandfinancialco- ordination and would request him to pursue such The SECRETARY stated that the First Health action and tocontinue participation in theAssembly had borne in mind that if the Orga- Administrative Committee on Co-ordination. nization reimbursed a single delegate from each delegation, it would make no difference to Mem- Mr. LINDSAY hoped that the fact that the Executive Board had considered that the Advisory 3 011. Rec. World Hlth Org. 14, 72, section 44 (a) 4 011. Rec. World Hlth Org. 14, 71, section 29 2 011. Rec. World Hlth Org. 17, 22 5 011. Rec. World Hlth Org. 13, 314 - 226 - COMMITTEE ON ADMINISTRATION AND FINANCE bers wherever the Assembly was held. The As-posal authorizing reimbursement of the travelling sembly's decision to authorize reimbursement forexpenses of one delegate only. a single delegate had been mainly the result of a desire to ensure that every Member State would The CHAIRMAN moved adoption of the draft be able to send a delegate to the Assembly noresolution submitted by the Director-General. matter where it was held. Decision: The committee agreed to recom- mend to the Assembly that it adopt the draft Mr. LINDSAY added that since it seemed prob- resolution submitted by the Director-General able that every alternate Assembly would, for in connexion with transportation and/or per some time, be held in Geneva, reimbursement diem allowances for delegates to the Third and would be more equitable as between European subsequent Health Assemblies (for text, see and non-European Member States. first report, section 3). Mr. DAVIN (New Zealand) supported the pro- The meeting rose at 5.50 p.

THIRD MEETING Friday, 17 June 1949, at 3.30 p.m. Chairman: Dr. B. SCHOBER (Czechoslovakia) later Dr. L. F. THOMEN (Dominican Republic)

1.Transportation and/or per diem Allowance Mr. DAVIN (New Zealand), Mr. LINDSAY (United for Delegates totheHealth AssemblyKingdom) and Mr. PLIMSOLL (Australia) sup- (continuation) ported the adoption of the proposed resolution, Agenda 10.7Mr. Lindsay noting that such insurance cover was not provided by any other specialized agency. Insurance against Travel Accidents of Delegates to the Health Assembly and of Members of the To meet a point raised by Mr. GOUDSMIT Executive Board (Netherlands), the SECRETARY suggested and the committee agreed, that the words " on their Mr. SIEGEL, Secretary, in introducing the itembehalf " should be deleted from the last paragraph stated that, in the light of a legal opinion thatof the resolution. had been obtained, it would not appear that the Organization was under any legal liability to Decision: On the motion of Dr. VILLARAMA provide insurance coverwhile an Assembly (Philippines), it was agreed to recommend to delegate or member of the Executive Board was the Health Assembly the adoption of the resolu- travelling to or from a meeting of the Assembly tion submitted by the Director-General as or the Executive Board, despite the fact that amended. (For final text,seefirst report, travelling expenses were paid by WHO. He section 4.) directed attention to the proposed resolution submitted by the Director-General(forfinal 2.Director-General'sContract with respect text,seefirstreport,section 4)theobject to the Representation Allowance as dis- of which was to make it quite clear that the cussed at the Second Session of the Execu- Organization accepted no responsibility in such tive Board instances. Agenda, 10.8 The SECRETARY directed attention to Official The CHAIRMAN agreed with the proposed reso-Records No. 14, page 75, containing a statement lution in so far as it applied to Assembly delegates: of the considerations which had led the Executive as the Organization paid travelling expenses forBoard to propose an alteration in the provisions only one delegate or representative of each Mem-of the Director-General's contract. The change ber, it would be difficult to decide in advanceproposed would result in the Director-General's which member of a delegation would be covered becoming eligible to receive the same allowances by insurance against travel accidents.On theto which other members of the staff were entitled. other hand, the identity of members of the He noted that the Director-General's contract Executive Board was e,stablished and it mighthad been signed on 21 July 1948-two months be advisable to consider providing insurancebefore theOrganization formally came into cover for them. The expenditure involved by so existence :itsterms precludedhisreceiving doing would be $25 per person. those allowances. The Executive Board therefore submitted for consideration a resolution (con- Dr. THOMEN (DominicanRepublic),Vice- tained in Official Records No. 14, p. 31, section Chairman, opposed the Chairman's suggestion :7.3.3), by the adoption of which the President he felt it was for the governments concerned toof the Assembly would be authorized to sign a provide insurance cover. revision of the Director-General's contract. - 227 - THIRD MEETING

He drew attention to the fact that the amountof two years :at the end of two years, therefore, involved by the granting of those allowances tothat amount would be reduced to $2,400. the Director-General of the Organization would vary according, to the number of his children. Dr. PANTALEONI (Italy) agreed with the view In reply to a point raised by the delegate ofexpressed by the representative of Australia. Australia, he stated that, for the present Director- Sir Arcot MUDULIAR (India) considered that the General, who had two children, the allowancescontention of the Australian delegate was quite would be asfollows :expatriation allowance,untenable. He directed attention to clause III $500 per annum ;children's allowance, $400 ;of the Director-General's contract as given in education grant, $400 ;travelling expenses forOfficial Records No. 14, P. 36.In conformity education grant, $1,600 ;in all, approximatelywith that clause, the Executive Board had con- $2,900. sidered the question in all its aspects and had submitted a proposal.Unless there was very Mr. INGRAM (United States of America), whileserious objection, therefore, he considered that the agreeing that there should be an increase in theExecutive Board's proposal should be accepted, amount of the Director-General'sallowances, and moved accordingly. considered that the present principle, namely, that the representation allowance should be deemed The CHAIRMAN put to the vote the amendment to include the allowances mentioned by theto the Executive Board's resolution proposed by Secretary, should be retained. That was a prin-the United States delegate. ciple which applied in the United Nations and in The amendment -was rejected by 18 votes to 1. all the other specialized agencies except FAO. The CHAIRMAN put to the vote the resolution Furthermore, according to Staff Regulation 16,6submitted by the Executive Board. the " normal allowances " referred to in the The proposed resolution was rejected by 12 proposed resolution were the same as the Unitedvotes to 8 with 8 abstentions, and the Chairman, Nations allowances.In his opinion, also,thewho was also the Czechoslovak representative at salary and allowances of top officials had beenthe meeting, not voting. fixed at sufficiently high levels to make it un- necessary to take into consideration any varia- Decision:It was agreed not to recommend to tion in the number of their children. the Health Assembly any change in the contract He accordingly proposed the following modi- of the Director-General. fications to the resolution :(1) the deletion of the words " In addition to the normal allowances3.Proposed Amendments to the Provisional authorized to staff members under the Staff Staff Regulations Rules " ;(2) the alteration of the word " six " Agenda, 10.9 to " eight ", in line 3 ;(3) the deletion of the In reply to M. VAN DER BRUGGEN (Belgium) words " entirely in respect of representation inthe CHAIRMAN stated that he did not consider connexion with his official duties ". that discussion of the item at the present time would preclude further discussion, at a future Mr. PLIMSOLL opposed the resolution submitteddate, of other points pertaining to the Staff by the Executive Board and also the proposalRegulations. of the United States delegate. The Director- The SECRETARY stated that, as the result of an General's contract was of recent date and, asoversight, two provisions in the Financial Regula- conditions had not materially changed since ittions having general application had been omitted had been drawn up, he saw no valid reasons forfrom the Provisional Staff Regulations adopted revising itat the present time. The Unitedby the First Health Assembly.7 In order to States proposal might be considered when theremedytheoversight,theDirector-General present contract had expired. proposed that two new regulations should be Dr. VILLARAMA said that, in effect, paymentadded to the Staff Regulations and submitted a of the allowances in question 'would amount to adraft resolution to that effect. raising of the Director-General's salary :in his Decision: On the proposal of Dr. VILLARAMA, opinion,it would be preferable to word the it was agreed to recommend to the Health resolution to that effect. Assembly the adoption of the resolution pro- posed by the Director-General (for text, see In reply to points raised by Mr. LINDSAY, the first report, section 5). SECRETARY stated that the amount of allowances involved would depend on the nationality and4.Election of Members and Alternate Members previous domicile of the Director-General and to the Organization's Staff Benefit Com- the country in which his children would attend mittee 7a school. Takingthehypotheticalcaseofa Agenda, 10.10 director-general having two children aged 15 and The SECRETARY,inintroducing the item, 13respectively,the average amount of therecalled that WHO had adhered to the United allowances in question would be approximatelyNations Joint Pension Plan.8 According to the $2,900. Under present regulations, payment of expatriation allowance was limited to a period 7 Off. Rec. World Hlth Org. 13, 358 7a Since called Staff Pension Committee. 6 Oft. Rec. World HIM Org. 13, 359 8 Oft. Rec. World Hlth Org. 17, 22 - 228 - COMMITTEE ON ADMINISTRATION AND FINANCE provisions of the plan, WHO should have a Staff5.Financial Report and Accounts of the Benefit Committee and theDirector-General InterimCommissionfortheFinancial suggested that the composition of the committee Period 1 January to 31 August 1948 and should be analogous to that of the Staff Benefit the Report of the External Auditor : Report Committee of the United Nations. Therefore the of the Executive Board on the Audit Report Health Assembly, the Director-General and the Agenda, 10.12 participants in the fund would each appoint three members and three alternate members. Decision :There being no objection, it was Normally, the members and alternate members agreed to recommend to the Health Assembly would be appointed for three years but, in order the adoption of the resolution submitted by to provide continuity of membership, it was the Executive Board (for text, see first report, proposed that, for the first election, one-third of section 7). the members and their alternates should be appointed for one year, one-third for two years6.Financial Report and Accounts of the and one-third for three years.Thereafter appoint- World Health Organization for the Financial ments would be for three years. The Director- Period 1 September to 31 December 1948 General had submitted a resolution to that effect, and the Report of the External Auditor ; spaces being left for names to be inserted. Report of the Executive Board on the Audit Report On the CHAIRMAN'S suggestion it was agreed Agenda, 10.13 to discuss the item in two parts :(1) the com- The SECRETARY stated that, in view of the position of the committee ;(2) the members tofact that no meeting of the Executive Board had be appointed by the Health Assembly. been held between its third session and the Decision :There being no objection,it waspresent Assembly, an ad hoc committee had been agreed that the composition of the WHO Staffappointed,' to meet immediately prior to the Benefit Committee should be analogous to thatAssembly, for the purpose of considering the of the United Nations. report of the External Auditor. The report of that committee was containedin document Mr. DAVIN proposed that, as a matter of prin-A2/55, Part I (Annex 2) ;the report of the ciple, the Assembly should elect the membersExternal Auditor would be found inOfficial and alternates to the Staff Benefit CommitteeRecords No. 20. from the membership of the Executive Board. On theinvitationofthe CHAIRMAN, Mr. If that principle were adopted, the committeeBRUNSKOG, External Auditor, addressed the com- might proceed immediately to elect the membersmittee. He stressed that the most important for the one- and two-year terms, election for thefact emerging from his report was thatthe three-year term being deferred until after thefinancial position of the Organization was un- election of the new members of the Executive sound :infact,on 31 December 1948,the Board. Organization had been insolvent. In reply to a point raised by Mr. LINDSAY, the Mr.LINDSAY associatedhimself withthe CHAIRMAN stated that, in view of the highlyobservations of the ad hoc committee contained specialized nature of the work, he thought itin paragraph 3.2 of its report :he considered would be permissible for a member of the Staffthat the accounting work of WHO compared very Benefit Committee to be accompanied by anfavourably with that of other organizations. expert, provided that no expense to WHO was Mr. Brunskog had drawn attention, in the involved. He also noted that advice on legalintroduction to his report, to the unsound financial and personnel matters would be available fromposition of WHO and he, Mr. Lindsay, felt that the Organization. the ad hoc committee might have commented upon that statement. He proposed that the Decision :There being no opposition, it waswords, " and calls the attention of the Assembly agreed to recommend to the Health Assemblyto the second and third sub-paragraphs to para- thatitadopt the following New Zealandgraph 11 of the Auditor's introductory remarks, proposal : on page 10 of Official Records No. 20 " should be The Health Assembly made a part of the present committee's report DECIDES that as a matter of principle it willto the Assembly. elect the members and alternates to the Staff He wondered whether by accepting the report Benefit Committee from the membership of thehe would be debarred from raising the question Executive Board (for text of the full resolutionagain at a later date. as submitted to the Assembly, see first report, Afterfurtherdiscussion,Mr. INGRAM and section 6). M. DE LAVARENE (France) reserved the position of their delegations in regard to the working On the CHAIRMAN'S suggestion, it was agreedcapital fund. to defer the appointment of members to the Staff Benefit Committee until after the designation of The CHAIRMAN considered that it would be the new members of the Executive Board (forsufficient for the committee to note the report further discussion,see eleventh meeting, sec- tion 4). 9 OU. Rec. World Hlth Org. 17, 21 - 229 - THIRD MEETING

of the ad hoc committee. By so doing, no delega- make any comments and answer anY question tion would prejudice its position in regard to the relating to the report. working capital fund, as that question would be considered under another item of the agenda. The SECRETARY supportedtheAustralian The CHAIRMAN put to the vote the resolutiondelegate's proposal but asked him to explain in submitted by the ad hoc comMittee and thewhat respects he considered that the principles comments of the delegate of the United Kingdom.recommended by the Administrative Committee on Co-ordination differed from those proposed in Decision:It was agreed to note the report of the ad hoc committee and to recommend tothe resolution on the appointment of the External the Assembly the adoption of the resolutionAuditor of WHO which had been agreed by the prepared by that committee (for text, see firstFirst Health Assembly 11 and, moreover, were report, section 8). those governing the audit of the United Nations. The Vice-Chairman took the chair. Mr. PLIMSOLL stated that he thought the latter imposed undesirable restrictions on the External 7.Report of the Director-General on theAuditor, especially in the event of his suspecting Feasibility of using the United Nationsimproper use of funds. He proposed the deletion Board of Auditors and Appointment of theof the second sentence of paragraph 6.5,12 since External Auditor for 1950 he believed it desirable that the Auditor should Agenda, 10.14be able to make his audit at his own discretion. The provision in paragraph 6.6 18 that objections The SECRETARY said that the Executive Boardto items arising during audit should be com- had recommended to the Health Assembly thatmunicated immediately to the accounting depart- Mr. Brunskog be appointed External Auditor 12ment concerned also constituted a danger. for the year 1950. A draft resolution to that effect was submitted, laying down principles and The SECRETARY felt there was D.0 objection to procedures to govern the external audit similarthe deletion of the second sentence of paragraph to those passed by the First Health Assembly6.5. He suggested that paragraph 6.6 might be (for final text see second report, section 1). amended so as to meet the point made by the A separate resolution was also submitted byAustralian representative and at the same time which the Health Assembly would endorse theto conform almost exactly to the wording of principles to govern audit procedures as agreedparagraph (i) of the principles to govern audit by the Administrative Committee on Co-ordina-procedure recommended by the Administrative tion of the United Nations, would agree in prin-Committee' on Co-ordination, if the words " ac- ciple to the establishment by the United Nationscounting department concerned " and " account- of a panel of external auditors of the Uniteding department " were altered to read " admi- Nations and specializedagencies and wouldnistration ". authorizetheDirector-Generaltotakethe necessary action to have Mr. Brunskog placed Mr. PLIMSOLL stated that he would accept the on that panel (for final text of the resolution seeSecretary's suggestion on the understanding that second report,section1 ;theprinciplestothe auditor would be free to exercise his discretion governauditproceduresapprovedbythein the manner in which he communicated any United Nations and details of the proposed jointobjection to the Administration. system of external audit are given as appendices to the same report). The CHAIRMAN pointed out that he would have to adjourn the meeting, as the requisite quorum, Mr. PLIMSOLL considered that the principles to as defined by Rule 43 of the Assembly's Rules govern audit procedures recommended by theof Procedure, was not present. United Nations Administrative Committee on Co-ordination were in some respects much sounder The meeting rose at 5.50 p.m. than the principles in the form given in the first resolution (on the appointment of the External 11 Off. Rec. World Hlth Org. 13, 312 Auditor) to which the Secretary had referred. 18 This paragraph read : There was, however, one additional point to The Auditor should not criticize purely adminis- trative matters, but it is within his discretion to which his Government attached importance, which comment upon the financial consequence of admi- was not mentioned in the principles recommendednistrative action.Audit examination should not by the Administrative Committee on Co-ordina-be undertaken before accounting effect has been tion. He proposed, therefore, the addition of thegiven to transactions, nor should accounts and vouchers be examined until they have been duly following words to the first paragraph of therendered available by the department concerned. draft resolution on the adoption of those prin- 18 This paragraph read : ciples : Objections to any items which may arise during audit should be communicated immediately to The Auditor should attend at the Assemblythe accounting department concerned. As a when his report is being discussed and shouldgeneral rule, criticism will not be made in the Auditor's report without first affording the account- 10 Off. Rec. World Hlth Org. 17, 21 ing department an opportunity of explanation.

- 230 COMMITTEE ON ADMINISTRATION AND FINANCE

FOURTH MEETING Monday, 20 June 1949, at 3.30 p.m. Chairman: Dr. L. F. THOMEN (Dominican Republic)

1.Report of the Director-General on thethe effect that the External Auditor might not Feasibility of using the United Nationsbe removed except by the Health Assembly did Board of Auditors and Appointment of thenot cover the eventuality of gross misuse of his External Auditor for 1950 (continuation)position by the Auditor, an eventuality against which, however, it was in principle necessary to Agenda, 10.14provide. He proposed that the words " and may not be removed except by the Assembly " be Mr. SIEGEL, Secretary, recalled the proposal,amended to read " and may be removed by the made at the previous meeting, to omit, from theExecutive Board through the Director-General ". resolution on the appointment of the ExternalHe further proposed that the Executive Board be Auditor, the second sentence of paragraph 6.5,given power to appoint an auditor to replace and in paragraph 6.6 to alter the words " account- ing department concerned " and " accountinghim for the remainder of his period of duty. department " to read " administration ". Sir Arcot MUDALIAR (India) suggested that it It had also been proposed to add the followingwas also necessary to provide against the possi- clause to the first paragraph of the resolution onbility of the Auditor's being unable for one reason theprinciples recommended by theUnitedor other to carry out his functions.In that case NationsAdministrativeCommitteeonCo- the Executive Board should be given the power ordination : to appoint a substitute to replace him, subject and the followingprinciple :the Externalto review and confirmation by the Assembly. Auditor should attend at the Assembly when his report is being discussed and make any Dr. VAN DEN BERG (Netherlands) and Mr. DAVIN necessary explanations or answer any questions(New Zealand) felt that it was an important and related thereto. generally accepted principle that the External Auditor should be responsible only to the legisla- If the latter proposal were adopted, a similartive body and should be independent of the paragraph would have to be added to the resolu-executive, which it might be his duty to criticize, tion on the appointment of the External Auditor,Mr. Davin pointing out that the case of sickness namely : or other circumstances making it impossible for the auditor to carry out his functions was covered 6.11 The Auditor should attend at the Assemblyby the provision that he could designate a repre- when his report is being discussed and make anysentative to act in his absence. necessary explanation or answer any question related thereto. Mr. REELER (Union of South Africa) suggested that any eventuality requiring urgent action Decision :The committee adopted the amend-which might arise could be dealt with under ments as listed by the Secretary, and alsoArticle 28(h) or 28(i) of the Constitution. decided,atthe suggestionofMr. BRADY (Ireland), to amend paragraph 6 of the resolu- Dr. VILLARAMA could not agree that the Assem- tion on the appointment of the Externalbly, which was a legislative organ, should inter- Auditor to read : vene in the purely executive matter of removal that the audit should be carried out by theof the External Auditor for gross abuse of his Auditor in accordance with the principles toposition. The Executive Board had been elected govern audit procedure recommended by thedirectly, and the Director-General indirectly, by Administrative Committee on Co-ordination ofthe Assembly and they should surely enjoy its the Economic and Social Council and in par-confidence and be entrusted with the powers ticular the Auditor shall have full regard to the necessary to ensure efficient execution of the following :(for full text, see second report,tasks allotted to them. His amendment would section 1). ensure in fact thatthe auditor performed his duties satisfactorily.He would only point out Dr. VILLARAMA (Philippines) felt that the pro-inconclusion thatunder theparliamentary vision, in the principles recommended by thesystem the supremeand final authority rested Administrative Committee on Co-ordination, towith the legislature. - 231 - FOURTH MEETING

The CHAIRMAN put to the vote the proposal Mr. LINDSAY (United Kingdom), Rapporteur, of the Philippine representative that section (a)proposed that the words " But where an arrange- of the principles to govern audit proceduresment made for relief is not kept " in the fourth recommended by the United Nations be amendedparagraph of that draft resolution be amended to toread :" The ExternalAuditorshallberead " But if a defaulting Member does not accept appointed by the Assembly of each agency, andthe agreed terms under which relief may be may be removed by the Executive Board throughgranted. . " the Director-General.In that event, or in the Dr. DOWNES accepted the amendment pro- event of the External Auditor being unable forposed by the Rapporteur. any reason to carry out his duties, the Executive Board shall appoint a successor." Mr. GOUDSMIT (Netherlands) proposed, in the first paragraph of the draft resolution, amending The proposal of the Philippine representativethe words " the first meeting of the Executive was rejected by 25 votes to 1, with 6 abstentions.Board in the current year should instruct the Director-General to negotiate " to read " the Decision :The committee decided, by 26 votesDirector-General should negotiate ".He also to 1, with 4 abstentions, to recommend to theproposed deletion from the third paragraph of Assembly that it adopt the draft resolutions onthe words, " and, unless the Assembly, by reason the appointment of the External Auditor, onof exceptional circumstances, decides otherwise, the principles recommended by the Unitedprojects in the territory of the defaulting Member Nations, and on the proposed joint system ofshould be abandoned ", since he felt such a external audit, as amended and subsequentlypenalty was too severe for non-payment of contri- reproduced in the second report of the com-butions. mittee (section 1, and appendices). Dr. DOWNES regretted that he could not accept the amendments proposed by the Netherlands 2.Status of Contributions to the Budget for&legation. He pointed out that it would be for 1948 the Assembly to decide whether projects in the Agenda, 10.15territoryofdefaultingMembersshouldbe The SECRETARY gave particulars of the positionabandoned. with regard to contributions to the 1948 budget Sir Arcot MUDALIAR agreed that it was impor- to 31 May 1949. Up to that date 26 countriestant that contributions should be paid as promptly had failed to meet financial obligations to theas possible.It was necessary, however, to bear Organization totalling $978,956.In other words,in mind the difficulties and delays occasioned, 80% of the total amount due had been contri-for example, by parliamentary procedure. At buted.Since 1 June 1949, Costa Rica had paidthe present early stage of the Organization's in full the $853 for which it was assessed. activity it would be unwise to attempt to exert too strong a pressure on its Members. In par- Decision :The committee decided to recom-ticular, abandonment of projects on which work mend to the Assembly the adoption of the drafthad already been begun would not only be resolution submitted by the Director-Generalwasteful but would undermine the whole work (for text, see second report, section 2). of the Organization. He suggested that the final clause of the third paragraph be amended to Dr. DOWNES (Australia) proposed that theread " no fresh project in the territory of the committee also should recommend for adoptiondefaulting Member should be initiated ". Subject by the Assembly the draft resolution proposedto that amendment, he would support the draft by his delegation 14 in connexion with the sameresolution, although he would prefer the respon- sibility for negotiations to rest with the Executive item and with item 10.16 of the agenda. Board while the Organization was still in its infancy. 14 This read : The Second World Health Assembly in some other form) should be granted to the RESOLVES to adopt the following policy and Member. procedures where contributions by a Member If it is decided that the case is one in which are in arrears : no relief should be granted then the voting Where the contribution has not been paid rights of the Member should be at once sus- by any Member in full for any year prior to pended and, unless the Assembly by reason the year immediately before the current year, of exceptional circumstances decides other- wise, projects in the territory of the defaulting the first meeting of the Executive Board in Member should be abandoned. the current year should instruct the Director- If relief is granted, neither of these actions Generaltonegotiate with thedefaulting should be taken. But where an arrangement Member to determine the circumstances of made for relief is not kept, the foregoing the non-payment and what arrangements can sanctions should be applied unless the Execu- be made for payment. tive Board decides to continue a project until A report should then be furnished to the not later than the next annual Assembly, in annual Assembly by the Executive Board which case it should report to the Assembly andtheAssembly shouldthenconsider on the reasons for continuing the project and whether any relief(i.e.waiver, reduction, the Assembly should then make decisions as postponement of contributions, or settlement to future action. - 232 - COMMITTEE ON ADMINISTRATION AND FINANCE

M. BERTRAND (France) felt the draft resolution Mr. HALSTEAD (Canada) expressed his whole- to be most satisfactory in itsoriginal form.hearted support in principle of the Australian He supported itall the more in view of thedelegation's draft resolution and agreed that provision in Article 7 of the Constitution, that ifmeasures of the kind proposed were urgently a Member failed to meet its financial obligationsneeded in order to ensure that the obligations of to the Organization, the Health Assembly might, membership were met. on such conditions as it thought proper, suspend He suggested that the working party might the voting privileges and services to which theconsider the desirability of the Executive Board's Member wasentitled. The only amendmentexamining, as occasion arose, what measures necessary to the original text of the draft resolu-might appropriately be taken inrespectof tion would be to include some reference to that defaultingMembers and submittingspecific article at the head of the resolution. proposals in each case for consideration by the Assembly. Dr. ROGERS (United States of America) was not convinced that the effect of the resolution Mr. DAVIN was in general agreement with the in its present form would not be the oppositeAustralian delegation's draft resolution. He sup- of what he thought was realized by all representa-ported, however, the Rapporteur's amendment to tives to be necessary, and, by its provision ofthe fourth paragraph and also the Netherlands waivers, postponements, etc., might not actuallydelegation's amendment to the third paragraph : encourage Members to hold back their contribu-health was geographically indivisible and should tions.In other respects he agreed with thenever be made dependent on financial consi- delegate of India that the penalties envisagedderations. in the draft resolution were too severe,lt was desirable to weigh very carefully all the implica- tions of so far-reaching a proposal, and also the3.Status of Contributions to the Budget for constitutional questions it raised. He therefore 1949 proposed its reference to a joint working party Agenda, 10.16 of the Committees on Administration and Finance The SECRETARY reported that as at 31 May and Constitutional Matters. 1949, 13% of the total contributions to the 1949 budget had been collected, and an additional The CHAIRMAN suggested it would simplify$141,000 had been received since that date procedure not to bring another committee into(approximately 3%) ;on 20 June,therefore, the discussion and proposed the creation of aapproximately 16% of the total budget had been working party composed of representatives ofreceived. The governments which had paid Australia, Hungary, India, Netherlands, and the since 1 June 1949 were :Australia(halfits United States of America, to examine all aspectscontribution) ;Austria, Burma, Honduras, Ice- of the draft resolution proposed by the Australian land,Liberia, Nethe'rlands(full contribution). delegation, taking into account the extent toThe balance remaining to be paid by Yugoslavia which it related to the work of the Committeehad also been received, and France had indicated on Constitutional Matters. that its contribution was in process of being Decision : The Chairman's proposal was adoptedpaid. (for discussion of the working party's report, He stated that two countries, Argentina and see sixth meeting, section 2). Chile, had joined the Organization in 1948 after the scale of assessments had been established by Mr. LINDSAY, Rapporteur, suggested that thethe First Health Assembly. A portion of the question might profitably be discussed somewhatassessments for those two countries-amounting further in committee for the guidance of theto $22,726-would be applicable to 1949 and, working party. as a result,the other Member Governments With reference to the amendment proposed bywould receive proportionate credits.Accordingly, the delegate of the Netherlands to thefirsta new list of assessments would have to be drawn paragraph of the draft resolution, he pointed outup giving effect to those credits. that the procedure envisaged in the original resolution would only come into force a full Decision :There being no objection, it was year after the year for which the contribution agreed to recommend to the Health Assembly was due. He felt that at that stage it was the adoption of the resolution submitted by desirable that the executive body of the Organ- the Director-General(fortext,see second ization should play a direct part in, and thereby report, section 3). lend greater weight to, the action taken than if it were taken solely on the initiative of the4.Report on the Working Capital Fund and Director-General. Assessment of New Members With reference to the third paragraph of the draft resolution, he agreed that the abandonment Agenda, 10.17 of projects already begun might have very serious The CHAIRMAN noted that the resolution con- consequences, not only for the defaulting Membercerning the working capital fund contained in but also for other countries possibly not evenOfficial Records No. 18, page 25, would be discussed adjacent to it.That was only one of the consi-under a separate item of the agenda after the derations which would have to be weighed by thebudget for 1950 had been given appropriate Assembly. consideration. - 233 - FOURTH MEETING

The SECRETARY statedthat two different Dr. ROGERS said that the proposed resolution questions required discussion :(1) the status ofand the action recommended by the Director- the working capital fund and the question ofGeneral seemed to be contrary to the action taken whether it would be appropriate to divide itin the matter by the First Health Assembly. into separate funds :(2)assessments of newIn support of that statement, he cited the sixth Members. report of the Committee on Administration and Up to 31 December 1948, contributions received Finance of the First Health Assembly, section to the working capital fund represented 57% VI .19Furthermore, he was unable to follow the of the total ;as at 31 May 1949, they representedline of reasoning of the External Auditor as 80% of the total. He invited attention parti-expressed in his comments appearing in Official cularly to the fact that the figures concerning theRecords No. 20, page 8, second paragraph of status of the working capital fund did not re-section 4 and section 5, which he read. He could present cash :theywere bookfigures. Thesee no valid grounds why, in view of the action followingfigures showed the relation of theof the First Health Assembly, the working capital financial statement to the cash position of thefund should be reclassifiedinanarbitrary fund at 31 December 1948 : manner and in accordance with a new type of Financial Statement Cash financing. Position Position He therefore proposed the following resolution : Sub-fund I 1,687,497.00 Nil The Second World Health Assembly Sub-fund II 21,417.51 21,417.51 Sub-fund III 866,463.58 483,103.10 TAKES NOTE of the observation of the External Auditor 19 that action of the Health Assembly, Total 2,575,378.09 504,520.61 in converting 1948 appropriation balances to At that date, therefore, the cash position of the an increment in the working capital fund, fund was approximately one-fifth the size of the " could be interpreted to represent the estab- book position. By 31 May 1949, the cash amount lishment of a separate fund which could be used had risen to approximately one-half of the fund. in practice for the same purpose as the working The External Auditor, in his report,15 had fund, but the identity of which should continue commented, in regard to the working capital to remain distinct from the working capital fund, that the decision of the First Health fund " ; Assembly 16 to the effect that unused balances CALLS ATTENTION tO the language of the remaining from the 1948 budget should be relevant resolution of the Assembly, which transferred to the working capital fund, could be states that " the Director-General is further interpreted to represent the establishment of authorized to transfer as an addition to the aseparatefund. TheDirector-Generalhad working capital fund any balances remaining considered those comments and, to meet the point in the appropriations made for the financial raised by the External Auditor, suggested that year 1948 " ;and the working capital fund might be divided into REAFFIRMS the decision that the balances three sub-funds, and submitted a resolution to remaining in the appropriations made for the that effect." financial year 1948 should be used to increase He observed that another specialized agency the total of the existing working capital fund, of the United Nations had dealt with the matter and specifically determines that the claims of in a similar fashion.In its case, a fund known Members should be established against these as " the Unrestricted Surplus Fund " appeared to appropriation balances in order that they may correspond exactly to sub-fund III ;in both partake of the same character as the funds cases the funds would serve to pay current originally advanced by Members. expenses, if the payment of contributions should be in arrears. As a result, the working capital Dr. DOWNES stated that the Australian Govern- fund-sub-fund I-would remain intact in casesment believed there should be one working of arrears in the payment of contributions bycapital fund and he accordingly supported the Member Governments. resolution proposed by the delegate of the United States of America. 19 Off. Rec. World Hlth Org. 20, 8 16 Off. Rec. World Hlth Org. 13, 318, section VI M. BERTRAND said that on a first reading the 17 This read : United States' resolution appeared generally to The Second World Health Assembly meet the viewpoint of the French delegation on Having consideredthe comments ofthethe subject.Nevertheless, it might be preferable ExternalAuditor andtheDirector-General to defer discussion of the resolution until the with respect to the working capital fund andfollowing day, when delegates would have the other similar funds and reserve funds of the Organization, text before them. RESOLVES that each of these funds should maintain its separate identity and should not Mr. LINDSAY, while agreeing with the suggestion be intermingled one with another, and thatof the delegate of France, felt it might be useful these funds should hereafter be identified asto have information on the following points : follows : (1) whether it was intended to use sub-fund II Sub-fund I. Assessments of States Members Sub-fund II. Epidemiological Intelligence Station 19 Off. Rec. World Hlth Org. 13, 318 Sub-fund III.Reserve Fund 19 Off. Rec. World Hlth Org. 20, 8 - 234 - COMMITTEE ON ADMINISTRATION AND FINANCE for the normal working capital fund purposes, or In reply to the second question, he felt it was whether it would be reserved for the special needs necessary to take a realistic view of the situation. oftheEpidemiologicalIntelligenceStation ;As of May 1949, there remained unpaid 20% (2) whether some writing down of sub-fund IIIof the contributions to the 1948 budget-approxi- might not have to be expected in view of possiblemately $900,000. The figure of the three sub- withdrawals from the Organization and resultingfunds did not represent cash in hand :it was, defaults in payment of contributions to thein fact, a mythical figure. To increase the size working capital fund ;(3) whether sub-fund IIIof the working capital fund on paper by the would be taken into account in determining theamount of that mythical figure would be erroneous amount required to bring the working capitaland misleading. fund up to the proposed figure of $4,000,000. In reply to the third question, he pointed out In the latter connexion, the letter to his Govern-that, up to the present time, no estimate had ment from the Director-General, regarding con-been made of the additional assessments which tributions to the working capital fund, appearedwould be required in the event of the Assembly to suggest that the amount of $866,000.- odd indeciding to increase the working capital fund to that fund had not been taken into account in$4,000,000. That could be done only in the light estimating the additional contributions requiredof the decision to be made by the committee to make up the working capital fund to $4,000,000.in regard to this item of the agenda. The External Auditor was of opinion that the $866,000.- odd The SECRETARY noted that, in the Financialshould be treated as a separate fund :if the Regulations,20the words" advancestothecommittee decide otherwise, it might be taken working capital fund " appeared several times.into account. It was therefore quite clear that the working capital fund comprised advances from govern- Mr. HALSTEAD, while appreciating the clear ments.Consequently, the External Auditor hadexplanation of the Secretary and the motives of every reason for considering the unused balancesthe External Auditor in suggesting that a sub- from 1948 as a fund separate from the normalfund III be created, was still unable to agree working capital fund as this balance was notthat that action would be desirable. The Cana- composed of advances from governments. Hedian delegation strongly supported the United wished to stress the point because, if the com-States proposed resolution, and urged that one mittee or the Assembly should decide otherwise,consolidated working capital fund be preserved, a specific resolution to that effect would bein accordance with the decision of the First desirable. Health Assembly. In reply to the first question of the delegate of the United Kingdom he said that, among the Dr. ROGERS stressed that the resolution he had assets transferred to WHO from the Interimput forward dealt entirely with the administrative Commission, there had been included fundsprinciple underlying the working capital fund : representing a working capital fund for theit did not treat the question of the amount of Epidemiological Intelligence Station at Singapore. the fund and the re-allocation of estimates. That fund had been accepted by the Interim Commission from the League of Nations Liquida- tion Board on the condition that it could be used There being general agreement that the discus- only for the purposes for which it had originallysion should be deferred until the following day, been allocated.Consequently, sub-fund II couldthe CHAIRMAN declared the meeting adjourned. be used only for that function and no other. The meeting rose at 6.25 p.m. 20 Oft. Rec. World Hltli Org. 13, 353

FIFTH MEETING Tuesday, 21 June 1949, at 4.30 p.m. Chairman: Dr. B. SCHOBER (Czechoslovakia)

1.Adoption of Draft First Report of thereference to the United Nations in the draft Committee resolution. The committee examined its draft first report Decision: The committee adopted its draft section by section (for final text, see p. 336). first report, subject to amendment in the first With reference to section 2, on administrative lineof the second paragraph of the draft and financial relations with the United Nations, resolution on the election of members and Mr. LINDSAY (United Kingdom), Rapporteur, alternate members of the Organization's Staff pointed out, in reply to a question by Dr. PUNTONI Benefit Committee (section 6) to read : " Decides (Italy) that UNICEF, as a subsidiary organ of to adopt the principle that it will assign the the United Nations, would be covered by the members and alternates to the Staff Benefit - 235 - FIFTH MEETING

Committee fro'm the membership of the Execu-a Member should be applied first as a credit to tive Board " (for final text, see p. 336). the working capital fund and then to the con- tributions due in the order in which the Member 2.Report on the Working Capital Fund andhad been assessed. Assessment of New Members (continuation It had therefore been perfectly simple and from p. 235) natural to divide the budget presented to the First World Health Assembly into three distinct Agenda, 10.17 parts. The first had covered operating and Dr. ROGERS (United States of America) stated administrative expenses for the last four months that the draft resolution proposed by his delega-of 1948, for which $1,000,000 had been appropria- tion at the previous meeting (p. 234) envisagedted. The second part had been an appropriation no alteration in the special status of the specialof $1,650,000 for the working capital fund. The fund referred to as sub-fund II and containingthird part had been set aside for repayment of the assets transferred to WHO as a workingthe Interim Commission's debt to the United capital fund for the Epidemiological IntelligenceNations and had consisted of an appropriation Station inherited from the League of Nations. of $2,150,000. It might therefore be desirable to adopt a different Up to 31 May 1949 $979,000, representing name for that fund rather than to include it, asapproximately 20% of the 1948 figure, had not at present, as part of the working capital fund.been collected. By simply taking the proportion that each part of the budget bore to the total Mr. SIEGEL, Secretary, recalled that it hadamount uncollected, it would be seen that of the been pointed out at the previous meeting that$979,000 uncollected,approximately $285,000 the question of the working capital fund was ofrepresented a shortfall on the operational and vital importance for an adequate financial struc-administrative budget, approximately $330,000 ture of the Organization.The Director-Generalremained to be collected for the working capital considered that it was absolutely essential thatfund and approximately $364,000 for the fund the committee have thorough understanding offor repayment of the Interim Commission's debts all aspects of the question and of all the factorsto the United Nations. involved. He felt that it was of vital importance for the Adoption of the draft resolution submitted bycommittee to realize that if the fund at present the United States delegation would entail certainreferred to as " sub-fund III " were regarded unusual financial consequences, which he hopedas part of the working capital fund, it would be the committee would bear clearly in mind whenimpossible for the Organization to repay the considering it.In particular he drew attentionUnited Nations fully until 100% of the contribu- to the provision in the last paragraph wherebytions for the budget had been collected, and that the Assembly would specifically determine thatthere would be therefore a possibility of the the claims of Members should be establishedOrganization's having to default on its obliga- against 1948 appropriation balances in ordertions to the United Nations. that they might partake of the same character In essence, the committee had to decide whether as the funds originally advanced by Members.the $866,463 in sub-fund III should be trans- That would result in the total amounts in theferred to the working capital fund, in which case working capital fund continuing to belong to the funds could be used only for the purposes autho- Member Governments and not being availablerized in the Working Capital Fund Resolution, or for any purposes other than those for which thewhether the money should be drawn on to repay working capital fund could be used. that part of the debt to the United Nations which It was relevant to recall the form in which thecould not be met out of the contributions so far 1948 budget had been presented.In the firstreceived in respect of that part of the 1948 budget. place, the First World Health Assembly had decided that there should be included in the Dr. ROGERS felt that adoption of the Director- budget of the World Health Organization for theGeneral's suggestion, which was in effect to over- year 1948 provision for the repayment of theride the decision of the First World Health sums loaned to the Interim Commission by theAssembly, would result in funds advanced by United Nations, with the understanding that not Member Governments being used for purposes only Members of the Organization, but all thequite different from the normal purposes of a signatories to the Arrangement of 22 July 1946working capital fund.If the situation was con- establishing the Interim Commission would befused it was because the First World Health expected to bear their appropriate share of suchAssembly and the Secretariat had not envisaged loan. It had therefore been necessary to establish the present budgetary crisis. He felt it was unwise a separate schedule of contributions for thatto meet a budgetary crisis by recourse to a solu- purpose as distinct from the schedule of contribu-tion which would establish a precedent, in the tionsfor the operational and administrativepresent case that of setting up a reserve fund budget and the working capital fund. which would be distinct from the working capital In the case of the working capital fund, hefund and not under the control of Member pointed out that provision was made in the Governments. Financial Regulations 21 that payments made by He was in full agreement that the obligations assumed by the Organization must be met, 21 011. Rec. World Org. 13, 355, Reg. 20 particularly its obligations to the United Nations. - 236 - COMMITTEE ON ADMINISTRATION AND FINANCE

The committee was now in possession of therequest of the delegate of Belgium in order to necessary information for it to understand thegive members of the committee an opportunity reasonslyingbehindtheDirector-General'sto study the confidential report on the composi- suggestion. He therefore proposed the establish-tion of the Secretariat referred to in the Director- ment of a small working party which, in collabora-General's report." tion with the Secretariat, would endeavour to find an alternative procedure for meeting the Dr. STAMPAR (Yugoslavia)expressedhis present budgetary crisis without violating theappreciation of the very interesting confidential sound rules of budgetary management laid downreport, but observed that it contained no informa- at the First World Health Assembly. tion on the duration of the appointments of the members of the staff. Mr. HALSTEAD (Canada) felt that it did not fol- low from any previous decision by the Assembly that He congratulated the Director-General on his the budgetary contributions actually collectedefforts to build up efficient machinery and fully should be divided in any fixed ratio as betweenrealind how difficult it was, especially when an the operational and administrative budget on theorganization was firstset up, to achieve an one hand and the fund for repayment of the Unitedarithmetically fair geographical distribution of Nations on the other hand. That was indeed aappointments. He realized too that the Organiza- question which might be profitably discussedtion had had to take over numbers of staff from in the committee. It was, however, quite distinctthe League of Nations and from UNRRA. from the question whether the balances remain- He was bound to say, however, that there was ing in the appropriations for 1948 should orat present a very narrow geographical distribu- should not be transferred to the working capitaltion of the Secretariat.Of 333 staff members fund. He agreed with the United States representa-on 15 May, 236 were the nationals of only four tive that it would be unsound financial procedurecountries.It was natural that those members to establish a separate working capital fund forof the staff who, for their duties, needed perfect the repayment of the United Nations loan. knowledge of the Organization's two working languages, should be recruited from the countries The SECRETARY said that it was irrelevant towhere those languages were spoken.Of the 83 thepresentquestion whether theallocation among the various parts of the budget of thestaff members, however, whose salaries were budgetary contributions actually received hadbetween $6,000 and $10,000, 52 were the nationals been made correctly, since as long as contribu-of five countries, while no fewer than six of the tions were not paid in full it would be impossibleten members of the Secretariat with salaries over to repay the whole debt to the United Nations$10,000 came from four of the same countries. unless some device could be found for doing so, Moreover, some of those who claimed the nationa- i.e. from a reserve fund. lity of a country other than those most generously represented, did not reside there and in some The CHAIRMAN supported the United Statescases did not even speak its language. delegate's suggestion that a small working party He suggested that the committee might pro- be set up to consider the question, and proposedfitably consider the question of geographical that it also be instructed to examine tli.e questiondistribution and might recommend to the Assem- of the assessment of new Members,22 and inbly that it request the Director-General to bear particular the last paragraph of the draft resolu-in mind the importance of securing broader tion submitted by the Director-General (for finalgeographical distribution than at present. text,seethird report,section4). He He was opposedtohuge,overcentralized proposedthattheworkingpartycompriseorganizations and would greatly prefer a small representatives of Canada, Egypt, France, Polandorganization of a few very highly qualified staff and the United States of America as well as the Rapporteur, who would sit on it ex officio butmembers who would work with groups of experts whose opinion would be discounted should itthroughout the world.In that way, moreover, be necessary to decide what constituted a majorityit would be possible to obtain broader geographical and what a minority view. distribution of the staff. Decision :The committee adopted the Chair- Dr. VAN DEN BERG (Netherlands) said that he man's proposal to refer the question to a work-had studied the confidential report with great ing party (see eighth meeting, section 3). interest, especially from the point of view of geographical distribution. The idea of that 3.Report of the Director-General principle was to ensure that at the headquarters Agenda, 10.4of an organization were gathered a really inter- nationally-minded staff,acquainted with con- The CHAIRMAN recalled that this item hadditions and with people all over the world.It been deferred from the second meeting on thefollowed that it was unnecessary, as well as impossible, to apply the principle of geographical 22 The Health Assembly was asked to confirmdistribution to the appointment of junior staff. the following assessments to the working capital fund of two new Members, Argentina and Chile : Argentina $30,161 ;Chile $7,336. 23 Off. Rec. World Hlth Org. 16, 42 - 237 - SIXTH MEETING

It was not primarily a question of nationality.tion were being constantly paid to the nationality As the representative of Yugoslavia had pointedof those working in it ; that way lay a very real out, it was possible to have a very varied distribu-danger of discrimination. tion by nationality without achieving the purposes Similarly, he agreed that it was desirable for of real geographical distribution. the Secretariat to have a knowledge of conditions He fully agreed with the Yugoslav representa-throughout the world.That might be achieved tive that in the early months it was very difficultequally well, however, by the study of reports to secure the degree of geographical distributionand by visits to the different countries. which was desirable.But he also agreed that Moreover, the present disequilibrium to which there was no geographical distribution at all inattention had been drawn would probably be largely the higher grades of the present staff. He wouldredressed as a result of the establishment of therefore request the Director-General to giveregional offices, which would naturally draw far very careful attention to the possibility of secur-more of their staff from the region in which they ing as soon as possible a broader geographicalwere working than would a headquarters office. distribution, especially in the higher grades. The committee might examine the possibility of securing the services of the International Civil Sir Arcot MUDALIAR (India) warned the com-Service Advisory Board in the appointment of mittee against the dangers of taking a one-sideda few higher-grade officials. But in general the view of so complicated a question.He agreedDirector-General should be allowed to exercise with the principle that the Secretariat should behis discretion in the selection of his staff, although drawn from persons with the highest qualifica-he might be asked to bear in mind the general tions for their work, chosen over a wide area.feeling in the committee that the geographical But it would not serve the best interests of andistribution of the staff should be broadened. international organization such as WHO if atten- The meeting rose at 6.25 p.m.

SIXTH MEETING Wednesday, 22 June 1949, at 3.30 p.m. Chairman: Dr. L. F. THOMEN (Dominican Republic) later Dr. B. SCHOBER (Czechoslovakia)

1.Report of the Director-General (continua-and required adjustment so as to secure the tion) recruitment of officials possessing varied qualifica- Agenda, 10.4tions and a wide knowledge of different systems of health administration and medical matters. On the request of the CHAIRMAN, who wishedHe was concerned to note that some officials had to make a statement as representative of hisbeen appointed who had lost touch with their country, Dr. Thomen, Vice-Chairman, took theown countries and were unfamiliar with health chair. conditions there. Dr. SCHOBER (Czechoslovakia) said that his A problem which the committee should consider Government considered the question of personnelwas the size of the Secretariat.The tendency to be of vital importance, since it was the perma-of administrative bodies to become more and nent staff of the Organization that was respon-more bureaucratic as they expanded should be sible for the implementation of the policies laidavoided.The Czechoslovak Ministry of Health, down by the Assembly and the Executive Board.whose administrativeresponsibilities had ex- He welcomed the initiative the staff had shownpanded enormously with the recent nationalization in carrying out its duties.The scope for thatof all hospitals, was carrying out its increased initiative was so wide that the composition ofduties without any additional staff. He strongly the Secretariat required careful consideration.urgedtheDirector-Generaltoconsiderthe His Government did not feel that all countriespossibility of reducing the size of the Secretariat need necessarily be represented on the Secretariat.in the main office at Geneva. That was particu- What the Organization should strive to securelarly necessary in view of the increasing emphasis was a balance of professional competence inon regional organizations.At a later stage it various aspects of health administration andmight be desirable for the Director-General to policy. He agreed with the delegate of Yugoslaviagive a short statement on recent appointments. that the present geographical distribution of postsinthehigherl gradeswasdisturbing Dr. Schober then resumed the chair. - 238 - COMMITTEE ON ADMINISTRATION AND FINANCE

Professor DE LAIT (Belgium) stated that histo be one of primary importance and it was there- Government also attached the greatest import-fore desirable that the committee should be ance to the question of personnel, since the valueinformed of the actions taken by the Director- of any organization largely depended upon theGeneral to conform with the principles laid down efficiency of its staff and the size of its budget.in Article 35 of the Constitution. He agreed with the delegates of the Netherlands, In November 1948 'the Director-General had Yugoslavia and Czechoslovakia that the alloca-communicated with 48 Member Governments tion of posts should be governed by two considera- whose nationals were not at that time well tions, namely competence and nationality-herepresented on the staff,requesting them to used the term ' nationality ' not so much in anotify him of possible candidates for posts. Ten narrow political sense but in a sense of ensuringhad submitted recommendations and informed the necessary link between the Organization andhim that they would also advertise for applica- the peoples of Member Governments, which ittions within their countries.Six had asked for was striving to serve. He considered that whilefurther details of the posts available.Six had appointments to a small proportion of the top-informed him that publicity would be given to ranking posts need not necessarily be governedhis request. Three had replied that no personnel by special provisos, the majority of the staffwould be available. Twenty-three other Members should be recruited on the basis of the two con-had sent no reply at all. siderations he had mentioned.His delegation The geographical composition of the staff was had confidence that the Director-General wouldat the present time a problem, not of over- be guided by those principles. representation, but of under-representation, which it was hoped would be solved as the Organization Mr. HALSTEAD (Canada) stated that his Govern- expanded and as regional offices were established. ment also attached the greatest importance toAt all events, the geographical distribution of the question under consideration and was appre-staff compared favourably at the present time hensive lest in the effort to secure the widestwith that of the other specialized agencies. geographical representation possible, the para- In connexion with the enquiry of the delegate mount consideration, namely that of the efficiencyof India as to the action taken by the Interna- and integrity of the staff, as enunciated in Articletional Civil Service Advisory Board, the committee 35 of the Constitution, would be overlooked. Anwould recall that the First Health Assembly had international civil service was, afterall,notdecided that WHO should participate in, and composed of representatives of countries.Theshare the costs of, that body.24It was inter- criterion of efficiency was the only practical basis esting to note that the Board had recently for recruitment, since it would be quite impossiblediscussedmeasurestoensurethenecessary to allocate posts as between regions or countries.indepéndence of persons responsiblefor the The Director-General was to be congratulatedselection of the staff of international organiza- on the extent to which he had adhered to thetions. Its findings could be summarized as follows : desiderata laid down in Article 35.He agreed The head of any agency should be entirely with the delegate of India that the best way forindependent in the selection of staff, regardless the administration to keep in touch with theof their grade, and it was undesirable that he conditions and developments in various countriesshould be obliged to advertise or ask for govern- was forits high-ranking members to travelment nominations.He should be free to seek extensively. candidates by whatever method and in whatever country he thought best, recognizing that in Mr. LINDSAY (United Kingdom) associatedcertain instances, particularly in the case of himself with the remarks of the Canadian delegatehigh-ranking specialists, it would be necessary and said there was a danger in trying to secureto enter into direct contact with governments. officers from smaller countries. He would quote He then drew the attention of the committee an extreme case, where the most valuable healthto the fact that an increase of 109 members of officer might be employed by the Organization,the staff was envisaged for the third quarter of thereby depriving his country of essential andthe current year, and 72 for the fourth quarter. probably irreplaceable services. That expansion would be carried out in a way which would help to adjust the balance of the Dr. ROGERS (United States of America) statednational composition of the administration. The that his Government joined in the consensus ofincrease in staff numbers had been orderly and opinion that appeared to have emerged from theevery effoq had been made to secure persons discussion favouring the selection of staff in thewith the best qualifications. He emphasized that widest possible way, bearing in mind, of course,the confidential report of the Director-General, that appropriate qualifications constituted thewhich had been circulated, covered allstaff most important criterion. members of the Organization and not only those working at headquarters. Mr. SIEGEL, Secretary, stated that the Director- General also considered the matter of recruitment 24 og. Rec. World HlM (ilrg. 13, 312 - 239 - SIXTH MEETING

Mr. BRADY (Ireland) stated that his Govern- The meeting was suspended at 5 p.m. and resumed ment did not wish to criticize the Director-at 5.30 p.m. under the Chairmanship of Dr. Thomen, General in his efforts to recruit staff on the Vice-Chairman. broadestpossiblebasis,and recognized the difficulties of obtaining equitable geographical distribution in the initial stages. 2.Status of Contributions to Budgets (con- In connexion with the Secretary's reference tinued from p. 233) to the Director-General's letter to governments Agenda, 10.15, 10.16 concerning posts, he considered that it contained very little information on their nature and theReport of the W orking Party conditions attached.It would be desirable in the future, when the Director-General sought Mr. LINDSAY, Rapporteur, read the report of advice on recruitment, to provide governmentsthe working party set up to consider the draft with the fullest possible information. resolution submitted by the Australian delega- He noted that the staff had increased fromtion (see p. 232) on the status of contributions to 206 persons on 1 September 1948 to 377 at thebudgets (for text of the resolution recommended present moment.It was understandable that expansion should occur over that period ; never-bytheworkingparty,seethirdreport, theless, a note of warning should be sounded.section 3). He hoped that every effort would be made to He pointed out that the working party had keep the number of staff as low as possible,been at pains to avoid use of the word " default ", thereby reserving funds for the supply of medicalwhich necessarily suggested an element of blame, services to Member Governments. He wouldwhereas it had been pointed out that the non- be interested to know the principles governingpayment of contributions by Member Govern- recruitment of temporary staff-an importantments might often be unavoidable.Instead of point in view of the temporary nature of a greatthat term, the working party had used two number of WHO projects. distinct phrases to indicate two stages in non- payment. The SECRETARY stated, in reply to the delegate of Ireland, that the Director-General's letter to The wording of the final paragraph of the draft governmentsinNovember1948,concerningresolution submitted by the working party was recruitment, was of necessity couched in some-designed to meet two difficulties raised during what general terms as it was not at that momentthe previous discussion (at the fourth meeting). possible to give details on the posts available.In the first place, the delegate of the United It was expected that should the Director-GeneralStates had suggested that reference to the pos- in the future decide to ask governments to assistsibility of waiver or reduction of contributions in the recruitment of staff, the request would bemight encourage Member Governments to bank for specific qualifications and would be accom-on such a possibility.Secondly, a number of panied by a complete statement of conditionsrepresentatives had pointed out that the specific of service. reference made in the original draft resolution With regard to his second point, the expansionto the withdrawal of services might be considered in personnel was of necessity considerable in theas binding the Assembly to excessively drastic first year of WHO's existence, but it had beenaction, even in cases where there was some a gradual, planned expansion. adequate reasonfor non-payment ;and the Finally, as to the terms and length of contracts, the Director-General was making every effortdraft resolution submitted by the working party to take into account the time necessary for themerely stated that the Assembly could take such completion of assignments. It was not, however,action, if any, as it considered necessary and always possible to forecast their duration withappropriate by invoking all or part of Article 7 exactitude. In most instances contracts wereof the Constitution, which read as follows : from two to five years.In some cases it had been found necessary to recruit staff on a short- If a Member fails to meet its financial obliga- term basis, particularly where experts in specific tions to the Organization or in other exceptional fields were required. circumstances, the Health Assembly may, on such conditions as it thinks proper, suspend The CHAIRMAN suggested that the committee the voting privileges and services to which might request the Rapporteur to summarize in a Member is entitled.The Health Assembly the committee's report the points raised in con- shall have the authority to restore such voting nexion with the item under consideration, asking privileges and services. the Director-General to take note of them. Dr. Schober resumed the Chair. . Decision : The Chairman's proposal was adopted and thesectionoftheDirector-General's report 25 on the organization of the Secretariat Decision : The committee decided to recom- was accepted (see third report, section 2). mend to the Assembly that it adopt the draft resolution submitted by the working-party 25 off. Rec. World Huh Org. 16, 42 (for text, see third report, section 3). - 240 - COMMITTEE ON ADMINISTRATION AND FINANCE

3.Adoption of Draft Second Report of the Board at least two weeks in advance of the Committee winter meeting of the Board. (c) The Executive Boatd at its winter session Mr.LINDSAY,Rapporteur,introducedthe draft second report of the Committee on Admin- shall review the budget estimates in detail. istration and Finance. The Board's review shall include consideration of both adequacy to meet health needs and Decision : The committee adopted the draft the practicability of financing.The Board second report with a number of drafting amend- should take into account any observation ments (for final text, see p. 338). which may have been made by the United Nations with respect to the WHO adminis- 4.Financial Responsibilities of the Executive trative and budgetary matters. Board (d) The Board shall submit its comments on Agenda, 10.6 the budget estimates to the Director-General Mr. LINDSAY stated that his delegation and who will transmit them to the next Health the United States delegation had had certain Assembly at the same time as he submits discussions on the question ofthe financial his budget. responsibility of the Executive Board and as a (e)The Assembly shall consider and adopt consequence had presented a joint resolution the budget in accordance with Article 56 which read : of the Constitution and with its own rules Whereas of procedure. Article 55 of the Constitution provides that (f)The Third Assembly should consider any the Director-General shall prepare and submit proposals which the Executive Board may to the Board the annual budget estimates of have made in regard to a long-term pro- the Organization, and that the Board shall gramme and give instruction to the Executive consider and submit to the Health Assembly Board in regard thereto. such budget estimates,together with any This resolution supersedes the resolution recommendations the Board may deem advis- adopted by the Assembly on 21 July 1948 able ; and directing the Board to establish a standing Article 56 of the Constitution provides that committee on Administration and Finance. subject to any agreement between the Orga- Briefly, the United Kingdom delegation was nization and the United Nations, the Healthanxious to establish a specific point of principle Assembly shall review and approve the budgetand the United Stâtes delegation had suggested estimates and shall apportion the expensesprocedures which should follow from it. among the Members in accordance with a His Government had requested that the ques- scale to be fixed by the Health Assembly ; tion of the financial responsibility of the Executive The Second Health Assembly Board be placed on the agenda in order to call attention to, and if possible to clear up, a confu- 1.TAKES NOTE of the view expressed by the Executive Board in regard to the desirabilitysion of ideas which hampered proper financial of establishing a programme for a period cover-procedure in the Organization and which might and requestseventuallyseriouslyinjureitsprestigeand ing several consecutive years ; effectiveness. the Board to submit recommendations to the In the view of his Government, the Executive Third Health Assembly in regard to the methodBoard, in carrying out the policy of the Health and procedure ofestablishing a long-rangeAssembly, should have in its own sphere precisely programme in accordance with the provisionsthe same range of responsibility as the Assembly. of the Constitution relating to programme andIts function, in preparing a programme and in budget ; commenting on budget estimates, was primarily 2.DIRECTS that the Board's review of annualadvisory. For this purpose he considered it programmes and budgetsshouldbe bothessential that it have careful regard to the re- thorough and comprehensive, and should takesources that Member Governments were likely into account all relevant considerations includ-to be able to place at the Organization's disposal. ing financial feasibility ; For no responsible body could plan for practical action without considering whether it was likely to 3.DECIDES that with reference to the schedulehave the resources necessary to give effect to it. for the coming year : A contrary view had been expressed with (a) At its first session after the present meet-great vigour before the Executive Board during ing of the Health Assembly, the Board,the past year, namely that the Executive Board, taking into account decisions and recom-when planning a programme for a specific period, mendations of the Assembly, shall formulateas it was bound to do under Article 28 ( g) of the a general programme of work covering theConstitution, should not consider whether the year 1951 for the guidance of the Director-Organization was likely to get the money needed. General in his preparation of budget estimatesHe was bound to admit that he was so completely for that period. unable to understand that view that he might be (b) The Director-General shall prepare budgetdoing its supporters an injustice, but certainly the estimates for 1951.These estimates shouldExecutive Board had been told more than once be submitted to members of the Executivethat it was not its business, but the Assembly's - 241 - SIXTH MEETING alone, to consider what funds were likely to becompletely different point that members of the available.To make so marked a difference inExecutive Board should be experienced in health the financial outlook of the Executive Board andadministration and that they should speak as of the Health Assembly was surely very wrong.individuals, not as governmental representatives. He did not, however, propose to argue the The United Kingdom delegation stressed the technical case at the present stage. importance of this question because it felt that Two points had been made when the Unitedto restrict to the Assembly the right to consider Kingdom member had raised the question in theprobable resources was anomalous, unbusiness- Executive Board. In the first place, it had beenlike and dangerous. stated that the Constitution debarred the Execu- tive Board from considering certain financial It was anomalous because in all other specialized points.That was not true.There was not oneagencies the executive body, and not the plenary, word in the Constitution that debarred or dis-had the primary responsibility for reconciling couraged the Executive Board from consideringprogramme and likely resources.All had an or advising upon any financial aspect whateverorgan to examine and comment on estimates, of the Organization's business.It had beenincluding the total involved, before they were suggested that because Article 24 of the Constitu-referred to the Assembly. tion stated that persons designated to serve .on To withhold financial responsibility from the the Board should be " technically qualified inExecutive Board was unbusinesslike, firstly be- the field of health ", they should consider thecause as a small body it was obviously better Organization's programme purely as doctors andfittedthan the plenary todiscussfinance ; not consider the availability of funds. He wouldsecondly, because any body considering a practical at the present time only point out that Articleprogramme involving expenditure was only wast- 11 of the Constitution stated that delegates toing time if it did not, at the earliest possible stage, the Assembly should be " persons most qualifiedendeavour to gauge and to take into account the by their technical competence in the field ofamount of money likely to be at its disposal ; health ".The words were almost identical, yetno explicit authority was required for what was it had been argued that the Assembly was, andonly an essential part of the job. Before proposing the Executive Board was not, entitled under theto spend money, it was only reasonable to see Constitution to consider financial resources.Ifwhether one was likely to have the money to his interpretation of the Constitution was con-spend.Thirdly, it was unbusinesslike because tested, he suggested that the question be discussedit presented the plenary body with a fait accompli in the Committee on Constitutional Matters. in the form of a complicated and elaborate budget It had also been suggested that this questionestimate.The Assembly alone, they were told, had been discussed again and again by thehad the duty of reconciling the programme with Technical Preparatory Committee in Paris, atthe resources.That necessarily unwelcome task the International Health Conference in Newwould only be made more difficult and distasteful, York, in the Interim Commission and at thesince reduction of the programme involved the First Assembly, and that it had been the inten-waste of careful preparatory work. The Assembly tion of the two preliminary conferences to draftwould be subjected to a moral pressure which the Constitution so that the Executive Boardwas compatible neither with sound finance nor should plan unfettered by financial cares.Hewith the high purpose ofthe Organization. would reply in the first place that if such hadFinally, the procedure whereby the Executive been the intention, it was odd that the veryBoard need not consider financial resources was competent drafters had not carrieditout ;particularly unbusinesslike at the present time, certainly one of the drafters had had no ideawhen the total task confronting the world in the that such was the intention. Secondly, thefield of health could usefully absorb a practically subject had been openly discussed for the firstunlimited amount of money. It was surely time, as far as he knew, at the second session ofobvious that the question of how much of the the Executive Board ;unchallenged statementsworld's resources could in any year be set apart might have been made earlier and not been fullyfor health problems was a fundamental point understood. Thirdly, he could find no documen-that had to be taken into account from the first tary support for the view that either of the preli-stage of planning for that year. minary conferences had had any such intention, Finally, such procedure was against the interests and he was prepared to argue the case in detailof the Organization.All representatives knew if necessary.Individual members might havethat many of the world's present problems were thought the Constitution should be drafted ineconomic and that some of the most difficult of that way, but if so they had represented a minoritythose economic problems werequestionsof view. The conferences had not intended to writecurrency.They all knew that many Member such financial irresponsibility into the Constitu-States in their efforts to maintain solvency were tion and had not done so. experiencing serious difficulty in paying their What had been discussed at length and hadcontributions to the Organization in hard cur- been written intothe Constitution was therency. They all knew that in the United Nations - 242 - COMMITTEE ON ADMINISTRATION AND FINANCE serious concern had been increasingly voiced at Not only should the Assembly be aware of the the steadily rising cost of international workposition and realize how much responsibility had and that the need for economy had been expressedbeen left to it on the present occasion, but it from many quarters.If in those circumstancesshould take steps to prevent continuance of the , the World Health Organization allowed it to beconfused situation. The Assembly could remove said that its responsible executive organ needthe difficulties and dangers to which he had not consider how the money it needed was toreferred by advising the Board that the situation be raised, need feel no responsibility towardsdid not debar the Board from considering and those who had to raise the money and could beadvising on any financial questions whatever. He indifferent to the results of calling for too muchaccordingly moved that the committee recom- money, the effect on the prestige of the Organiza-mend to the Assembly adoption of the draft tion would be disastrous. Even the immense storeresolution proposed by the United Kingdom and of goodwill which it enjoyed would be dissipated.United States delegations. The present position was confused and un- With reference to that draft resolution, para- satisfactory.The working party set up by thegraph 3 of the operative part had been drafted Executive Board to consider the Programme andon the assumption that there would be only two Budget Estimates for 1950 had by the verysessions of the Executive Board annually.He nature of its task been compelled to pay somedid not, in presenting this joint resolution, com- regard to the problems of financing the pro-mit his Government to this assumption. And if gramme. But the Board itself had been preventedmore than two sessions were held, the procedure by the doctrine he was attacking from givingoutlined in paragraph 3 would have to be some- those problems sufficiently early or sufficientlywhat modified. full consideration. The meeting rose at 6.45 p.m.

SEVENTH MEETING Thursday, 23 June 1949, at 3.30 p.m.

Chairman: Dr. B. SCHOBER (Czechoslovakia)

1.Financial Responsibilities of the Executiveexecutive organ, in which case still another body Board (continuation) would probably be needed to co-ordinate the Agenda, 10.6work of the two executive organs. He could not agree that recourse to either of those expedients Dr. ROGERS (United States of America) statedwould be wise in the case of WHO. that he fullyendorsed the views expressed by the United Kingdom delegate on the question The fruits of the present policy would soon and commended for the attention of the com-become apparent when they came to examine a mittee the draft resolution presented at theprogramme drawn up involving estimated budget previous meeting (see p. 241) on behalf of his andexpenditure of $7,800,000, when the Organiza- the United Kingdom delegations. tion had had great difficulty for the present year The United Kingdom delegate had referred toin levying contributions amounting to $5,000,000. three points of signal importance. He had statedThere could be no doubt that the task of the that the procedure at present being followed wasExecutive Board and of the Assembly would be anomalous, that it was unbusinesslike and thatmade infinitely easier if the Board took financial it was against the interests of the Organizationavailabilities into account. in that it did not encourage public confidence in its administrative procedures and was likely to The DIRECTOR-GENERAL felt that it was very dissipate the goodwill it at present enjoyed. important that the committee should view the He thought it would be generally admitted byfunctions of the Assembly and of the Executive members of the committee that no responsibleBoard as being quite distinct.The Executive executive board in their countries would proceedBoard was not a smaller edition of the Assembly. on the assumption that the two functions ofThe Assembly was composed of the responsible drawing up programmes and of considering therepresentatives of the Governments Members of means of financing them could be completelythe Organization. The members of the Executive divorced.If an attempt were made to divorceBoard, however, sat as individuals, and not as them, it would be necessary to resort to one ofthe representatives of their countries. That was two expedients : either to give executive respon-clearly shown by the terms of Article 29 of the sibility in a whole field in which no decisions hadConstitution, which stated :" The Board shall been made to the staff or secretariat of theexercise on behalf of the whole Health Assembly organization in question ; or to create a furtherthe powers delegated to it by that body." - 243 - SEVENTH MEETING

He wished to make certain comments on theWorld Health Assembly.Not until then could draft resolution submitted by the United King-the nations of the world obtain a clear picture, dom and the United States delegations. through their representatives to the Assembly, In the first place, he drew attention to thèof the health needs of the world as a whole, rather request made to the Board in paragraph 1 of thethan of individual countries or regions. Not operative part that it submit recommendationsuntil then could they say how much they would to the Third Health Assembly in regard to thebe willing and able to invest in the cause of method and procedure for establishing a long-world health for any one year. range programme in accordance with the provi- If the Executive Board were to be given the sions of the Constitution relating to programmeresponsibility for determining, by some means and budget.He submitted that in fact thereso far unspecified, the amounts that the Members of the Organization would be willing and able were no provisions in the Constitution relatingto contribute a year subsequèntly, it would be to a budget for a long-range programme. More-next to impossible for the Assembly to add to over he pointed out that Article 28 (g) of thethe total programme as proposed by the Board. Constitution provided that the Board should It would be relatively simple for an Assembly to submit to the Health Assembly for considerationreduce a budget that had been produced, but and approval a general programme of workextremely difficult for it to raise it, for that would covering a specific period, not " the method andentail entering into the whole lengthy business procedure " for establishing such a programme.of costing the additional items, all within the Unless the intention was to submit an amend-space of a few weeks.The result therefore of ment to the Constitution at the Third Worlddirecting the Board to take into account considera- Health Assembly, it was clearly a responsibilitytions of financial feasibility would be that a of the Executive Board to submit actual pro-small number of governments would be enabled grammes of work to the Assembly. to place a ceiling on the Organization's work Almost the whole of paragraph 2 merelyfor the succeeding year. That was not what had repeated in effect the provisions of the Constitu-been contemplated when the Constitution had tion, and was innocuous. It was in the last threebeen drafted at the International Health Con- words that a revolutionary principle had been ference.The functions of the Executive Board introduced, at least in so far as the World Healthhad all been set out clearly in Article 28 of the Organization was concerned. The main practicalConstitution. Responsibilityfordetermining difficulty was to determine how the Executivewhat Members would be willing and able to pay Board should go about taking into account con-was such an important function that it was siderations of " financial feasibility ".By thathardly conceivable that if it had been the inten- term was presumably meant the ability andtion that the Executive Board should exercise willingness of Member Governments to contributeit, it would not have been stated in that article. to the funds of the Organization in the yearIf that function were now to be given to the following that in which the Board was examin-Board,theConstitutionshould be amended ing the programme and budget.The normalaccordingly and the proposal to do so treated method for the Board to collect information waswith the careful consideration it deserved. to obtain it through the Secretariat.He was In paragraph 3 of the operative part of the bound to say that he was aghast at the idea thatdraft resolution proposed by the United King- the Secretariat should be asked to obtain fromdom and United States delegations, (see p. 241) governments information as to the amount theyit was provided, in sub-paragraph (a), that the would be willing and able to contribute in aBoard should formulate a general programme year's time.If governments were asked for suchof work covering the year 1951 for the guidance information, he very much doubted whether theyof the Director-General in his preparation of would be able to supply figures on which anybudget estimates for that period. He suggested kind of reliance might be placed, for they wouldthat such a provision was in flagrant contradic- not have had the benefit of studying the resultstion with the Constitution, which provided in of the lengthy process which the elaboration ofArticle 28 (g) that the Executive Board should a programme and budget constituted.That" submit to the Health Assembly for considera- process, starting with groups of national expertstion and approval a general programme of work from all over the world, led through regionalcovering a specific period ". offices and regional directors to headquarters, where the different regional plans had to be The effect of sub-paragraph (b) of paragraph 3 collated and scrutinized with the help of adminis-was, he suggested, to tell the Executive Board trative experts and technical consultants. Head-how to conduct its own business. It was already quarters also received a number of direct requestsprovided for under the Constitution that the from goveniments, and these had frequently toDirector-General would prepare budget estimates be referred back to regional directors for advice.'for 1951.He submitted that it was an unwar- It was the function of the Director-General torantable encroachment on the prerogative of any reduce that mass of information and often con-executive board to give it instructions as to when flicting projects to a single programme coveringits working documents should be submitted to the whole world and to cost the items in thatit.He pointed out that the Executive Board programme in order to present it with budgethad taken the precaution before its last session estimates through the Executive Board to theof appointing a working party to scrutinize the - 244 - COMMITTEE ON ADMINISTRATION AND FINANCE

Director-General's blidget estimates before theyclose of the present Assembly, to formulate a were submitted to the Board. Surely the Execu-programme of work for 1951 which would take tive Board should be the masters of its own%into account the probable financial availabilities procedure ! for that year. He doubted if that was realistic. Sub-paragraph (c) of paragraph 3 dealt purely He repeated that to confer such powers on the with matters of routine, except for inclusion ofExecutive Board would be flatly opposed to the the phrase " the practicability of financing ",intentions of those present at the International which doubtless meant the same as " financialHealth Conference, as incorporated in the Con- feasibility ". He felt that it was essential, shoulastitution. It had been their intention that the Board be instructed to consider the practic-Members should retain financial control of the ability of financing the general programme ofOrganization's funds and its budget. work for 1951, that it should also be instructed to advise the Assembly on its sources of informa- Dr. DOWNES (Australia) said that his Govern- tion. For he assured the committee most empha-ment understood that it was the Director-Gene- tically that the Secretariat would not be able toral's contention that, in view of Articles 24, 28, obtain such information.It could, then, only29 and 55 of the Constitution, the persons serving be obtained from the governments of the memberson the Executive Board sat as individuals and not of the Board or, rather, from those governmentsas the representatives of their governments and who could and would supply such information,moreover, that, as experts in the field of health even for their own countries.In that way tooadministration, they did not need to consider the draft resolution submitted for the committee'swhether governments would be willing to pay consideration would have the effect of endowingfor the programmes they drew up. His Govern- a small number of governments with the powerment considered such a view unrealistic.Pro- to fix the ceiling for the Organization's work forgrammes for the Organization's work should be the subsequent year. formulated with due regard to all relevant con- siderations, including financial feasibility. The implementation of sub-paragraph (d) would entail an amendment to Article 55 of the Constitu- One result of the Executive Board's financial tion, which stated that the Director-Generalirresponsibility was that no proper comments should prepare and submit to the Board, and the were available for governments to consider before Board to the Health Assembly, the annual budgetthe annual Health Assemblies, and that much estimates of the Organization.He pointed outtime was thereby wasted. that such amendment could only be made at the The Board should be prepared, if necessary, Third World Health Assembly. Moreover, itto re-write the budget submitted by the Director- seemed a reversal of the normal channels ofGeneral, even if the conclusions it reached were responsibility that the Executive Board shouldsubmitted to the Assembly only in the form of submit its comments on the budget estimatescomments on the Director-General's proposal. to the Director-General, who was in fact sub- He understood that when that question had ordinate to the Board. been raised by the alternate member for Australia Sub-paragraph (e) of paragraph 3 paraphrasedat the third session of the Executive Board, the part of Article 56 of the Constitution. He pointedDirector-General and another member of the Board had made replies which were quite un- out,however,that the words " review and approve " had been altered to " consider andacceptable to the Australian Government.He adopt ".If they meant the same, the changepointed out that the Board's function of authoriz- seemed unnecessary ;if not, would there noting the Director-General to meet unforeseen have to be another amendment to the Constitu-financial demands could only be carried out if tion ? it had full control of financial policy. Sub-paragraph (f) too was merely a restatement It should be made as clear as it had been in of certain provisions of the Constitution and wasthe case of the Food and Agriculture Organiza- therefore quite superfluous. tion that members of the Executive Board were the representatives of governments, acting under There was one further question which heinstructions from governments, and that the wished to raise in connexion with the draft resolu-Board therefore carried the support of the most tion.The Organization would not be able toinfluential governments in the Health Assembly. decide to what extent contributions might beUNESCO was the only specialized agency in paid in currencies other than dollars and Swisswhich members of the executive organ sat as francs until it had agreed upon its programme.individuals. And he thought that such a system But the degree to which countries would be ablewould no longer be feasible when the operations to pay in such other currencies might appreciablyof specialized agencies expanded to the point affect their ability and their willingness to con-contemplated by recent decisions. Whatever tribute to its funds. might have been the expectation of some repre- In conclusion he pointed out that under para-sentatives at the International Health Conference, graph 3 (a) the Executive Board was expectedtheConstitution was certainly open to the at its meeting in July, immediately after theinterpretation that members of the Executive - 245 - SEVENTH MEETING

Board sat as the representatives of their govern- The DIRECTOR-GENERAL, referring to the points ments. raised by the delegate of Australia, explained His country knew from experience that underthat the instructions given by the First Wdrld the present system it was difficult for govern-Health Assembly had been carried out by the ments, even for those which were members ofExecutive Board at its first meeting.28 the Executive Board, to obtain the relevant On the question of the financial qualifications documentation to enable them to consider theof members of the Executive Board, he could not programme on a realistic basis. Under the presenttestify as to the competence of members who system,governments would continuetobeattended, but he thought that the delegations expected to digest important and highly com-of the United States and the United Kingdom plicated questions of finance during the threehad been well represented by experts. weeks of the Assembly without such questions With regard to the final point raised by the having been previously considered collectivelydelegate of Australia, there seemed to be no by a group of governments.Yet the Director-doubt that under the terms of Article 29 of the General apparently still wished to deny theConstitution, members of the Executive Board Executive Board the right to weigh financialshould not be responsible to their governments, considerations which were of the utmost impor-but that the Executive Board should exercise tance to governments. its powers in the name of the whole Assembly. He referred to General Assembly ResolutionIf members of the Executive Board were under 165 (II) 26 which drew the attention of a numberinstructions from their governments, the inten- of specialized agencies to the recommendations oftion of Article 29 would not be fulfilled. the Advisory Committee on Administrative and Budgetary Questions, and in particular to the Dr. Bj ORNSSON (Norway) said that his delega- recommendation that they make appropriatetion associated itself with the point of view of arrangements for their budget estimates to betheDirector-General and recommended that subjected to scrutiny, before submission to thethe resolution under discussion be not adopted. Assembly, by persons highly qualified in theHe was not sure that its adoption would be of fields of administration and fmance. His Govern-benefit to WHO, since Article 29 of the Constitu- ment wished to press for the establishment bytion stated that members of the Executive Board the Executive Board of a standing committeerepresented the Assembly as a whole. He could on administration and finance in accordancenot understand the criticism that had been with the resolution adopted by the First Worldvoiced in respect of the Executive Board, whose Health Assembly.27 By that resolution theprogramme as set out in Official Records No. 18 Executive Board was instructed " to establishhad, on the whole, received favourable considera- a standing committee on administration andtion. finance, whose terms of reference shall include, among other things, responsibility for examining M. VAN DER BRUGGEN (Belgium) said that his in detail budget estimates proposed to be sub-delegationsupported thedelegationsofthe mitted by the Executive Board to the HealthUnited States, the United Kingdom and Australia, Assembly, and for reporting thereon to theand wished to adopt the resolution. He thought ExecutiveBoard." AlthoughtheGeneralthat it was clear from Article 29 of the Constitu- Assembly's resolution had not been addressedtion that the powers and functions delegated to to the World Health Organization, which atthe Executive Board were exercised in the name that time had not been brought into relation-of the Assembly.But that did not alter the problem under discussion as the members of the .ship with the United Nations, WHO should not remain an anomaly in that respect. The membersExecutive Board were above all world public- of the Executive Board were not primarily financial health administrators. Although they might experts, although they had wide experience in not always have at their disposal detailed informa- the administrativefield. It hardly seemed,tion on the amount which each Member State therefore, that the standing committee envisagedmight be able to contribute, they were in a posi- by the Health Assembly was exactly the bodytion to judge on a world scale the possibilities which the General Assembly had had in mind. of the financial realization of any budget presented In general his delegation supported the proposalby the Director-General. to increase the financial responsibility of the If the Executive Board were to act in the way Executive Board. It also thought that a thoroughproposed by the Director-General, the result examination should be made of the respectivemight well be the contrary to the solution sought. responsibilities of the Board and the Assembly, Should the Executive Board present a programme as defined in the present Constitution, with arequiring a higher budget than could be met view to determining whether the Constitutionfrom available funds,it would be considered should be amended. Any amendments that wereutopian by world opinion, already too prone to found to be necessary could be made fully con-consider the programmes of specialized agencies sistent with the principle that the administra-as unrealistic.If the governments knew that the tion of the Organization should be in the handsbudget was realistic and had been carefully of persons primarily concerned with health. studied beforehand, they would probably author- ize their delegations to agree to it in its broad 26 Passed at the Second Session of the Generallines, subject to any later adjustment of detail Assembly, 20 November 1947 27.0ff. Rec. World Hlth Org. 13, 316 28 og. Rec. World Hlth Org. 14, 14 - 246 - COMMITTEE ON ADMINISTRATION AND FINANCE which might be necessary.If however they werethe Director-General. The difference between confronted with a budget which they knew tothe points of view of the Director-eneral and have been drawn up without consideration ofother delegations and that of the delegation for the financial possibilities, therewas the dangerthe United States was not as great as might that delegations would receive instructions fromappear. their governments to press for draconian and Since the committee could not deal with points perhaps excessive reductions. touching on the Constitution, the working party The DIRECTOR-GENERAL intervened at thatshould try to clarify issues and reach common point to say that he thought he had already madeground, stating the differences clearly, so that it clear that the resolution under discussion wasthe Secretariat or the Chairman could say whether unconstitutional. It entailed a contraventionthe matter was to be referred to the Committee of the Constitution of WHO, which could onlyon Constitutional Matters. be amended by the Third World Health Assembly. Mr.HALSTEAD (Canada)agreedwith the The CHAIRMAN suggested that as the committeedelegate for India that the terms of reference had no power to adopt a resolution involvingfor the working party should be clearly stated. constitutional matters, reference should be madeHe thought that the task of the working party to the Committee on Constitutional Matters. Heshould be to consider whether the principle proposed that a working party should be set upunderlying the resolution proposed by the dele- which would consider the matter together withgates for the United States and the United the Secretariat and report back to the committeeKingdom need be referred to the Committee for for consideration. Constitutional Matters. Mr. LINDSAY (United Kingdom) said that he The CHAIRMAN pointed out that the intention wished to support the Chairman's suggestion aswas to revise the resolution and try to define the regards the setting up of a working party.Thedifferences of opinion. On the basis of the result Director-General had put forward the view thatreached by the working party it could be decided the Constitution did not require the Executivewhether any amendment to the Constitution Boardtotakefinancialconsiderationsintowas entailed.If it were not, a vote would have account.The discussions of the working partyto be taken on the two opposing opinions ;if would therefore turn on two main considerations :it were, the matter would have to be referred to points of principle and points of procedure. the Committee on Constitutional Matters. He suggested, and in that matter was supported by the delegation of the United States, that the Mr. DAWN (New Zealand) agreed with the interested parties should discuss the matter withproposal for setting up a working party and the Director-General or with his representative,hoped that the issues would be clarified so that seek to reach an agreement in principle, andthe committee could express its views on the bring back to the committee either an agreementsubstance of the problem and on the working or a well-defined statement of the points ofparty's report. difference.He pointed out that he himself had The CHAIRMAN agreed that there should be never spoken at a meeting of the Executive Boardan opportunity for delegates to speak on the otherwise than as a person, whereas on the present subject after the working party had reported. committee he considered himself as a represen- tative of his Government. Mr. BRADY (Ireland) said that if the point at issue was related to the principles underlying Sir Arcot MUDALIAR (India) asked what termsthe resolution, then the matter should be referred of reference, if any, were to be given to the work-to a working party ; but if it was a matter merely ing party. of examining the constitutionality of the proposed He agreed with the Director-General thatresolution, then reference to the working party members of the Executive Board should be con-would be a waste of time. sidered as elected by the Assembly and not by He wished to have it put on record that his their governments, and referred to the difficultydelegation agreed in principle with the resolution which would arise if members had to be repre-of the United Kingdom and United States delega- sentatives of their governments. tions. He wished to correct one point :he did not believe that the Executive Board had ceased to Dr. ROGERS urged that the Director-General function as a body competent to discuss thehimself attend the meeting of the working party, budget.It had discussed both programme andas he thought that that would lead to a more budget, and he was not aware that its memberssatisfactory solution of the problem. were not familiar either with administrative or The CHAIRMAN agreed thattheDirector- financial matters ;they were not experts, butGeneral's presence at the working party was they were accustomed to budgetary work and desirable.He suggested that a working party the necessary contact with governments whichof five members should be elected and also that it entailed. the Chairman of the Executive Board should The CHAIRMAN said that the working partyattend in a consultative capacity. should take into account the remarks of the Decision: At the suggestion of the CHAIRMAN delegate for the United Kingdom who, he under- it was decided to form a working party com- stood, accepted some of the comments made by posed of delegates from the United States of - 247 - EIGHTH MEETING

America, United Kingdom, Norway, India,by the Swiss authorities for aesthetic and func.- and Hungary (for discussion of report of work-tional reasons. ing party, see eleventh meeting, section 2). The Swissauthoritiesthen presented two alternative projects (D and E), on learning from 2.ArrangementsforAccommodationforthe United Nations Secretary-General that unless Headquarters Office the " tower " project were accepted no other Agenda, 10.11 project so fa..r presented could be approved, fail- ing a decision to build outside the United Nations The SECRETARY explained that various projects perimeter,Those Projects D and E provided had been put forward with regard to the proposedalternative locations within a close radius of the building to be erected for the accommodation ofUnited Nations site. Suitable land would be made WHO's permanent headquarters at Geneva. available to WHO by the Swiss authorities. Project A was a proposal to erect a building in The Swiss Confederation had presented three the perimeter of the United Nations site inalternative plans for finishing the construction, Geneva (closing the Secretariat court on thein which it would be willing to participate. They Jura side).The project had been considered bywere : the United Nations, the Swiss authorities and the Director-General, and it had been decided by (1) A gift of 2,000,000 Swiss francs and a loan theDirector-General,afterconsultation and of the balance, viz. 3,750,000 Swiss francs at agreement with the Swiss authorities, that the 2% interest. project was not acceptable. (2) A loan of the total estimated cost, viz Under Project B the building would be in the 5,750,000 Swiss francs without interest. United Nations perimeter but in another posi- (3) A gift of 3,000,000 Swiss francs, WHO to tion (on the present car-park to the west of the find elsewhere the balance of 2,750,000 Swiss main entrance drive).That proposal had been francs. considered at length and agreed by the Director- General and the Swiss authorities, but it did not The requisite quorum not being present, the meet with the requirements of the United Nations. CHAIRMAN adjourned the meeting. Project C (known as the " tower " project) had then been submitted and found unacceptable The meeting rose at 6.15 p.m.

EIGHTH MEETING Friday, 24 June 1949, at 3.30 p.m. Chairman: Dr. B. SCHOBER (Czechoslovakia)

1.ArrangementsforAccommodationfor M. MULLER (Switzerland) explained that th Headquarters Office (continuation) study of this question undertaken by WHO, the Agenda, 10.11 United Nations and the Swiss authorities had shown that there was no suitable building in Mr. SIEGEL, Secretary, said that he had oneGeneva for the accommodation of WHO head- or two points to add to the preliminary commentsquarters and that the Palais des Nations was not he had made during the discussion of the samebig enough.It was therefore necessary to erect item on the preceding day. A cable received froma new building. In accordance with the promise the Secretary-General stated that the Unitedmade at the First World Health Assembly, the Nations was willing to give favourable considera-Swiss Authorities had put forward certain financial tion to any alternative plans to project C whichproposals set out in paragraph 1 of the letter of might be put forward. 28 March 1949 from M. Max Petitpierre (Annex The Swiss authorities were considering alterna- 9).This offer was subject to ratification by the tive projects with a view to reaching agreementSwiss Federal Chambers. on a plan for erecting a building on the United The offer, based on project B, on which (as the Nations site.The question was by no meansSecretary had stated at the previous meeting) settled, since no plan had been agreed upon. WHO and the Swiss Government were agreed, The working documents already circulated tohad been submitted to the United Nations delegates made it clear that the proposal of thesince the building was to be on United Nations Secretary-Generalofthe United Nations toground.The Secretary-General's comments on provide accommodation for WHO headquartersthis project were contained in his memorandum was made on the basis that WHO funds wouldto the Advisory Committee on Administrative be made available to the United Nations andand Budgetary Questions.29 thatthe United Nations would design and construct a building which would become the " The relevant paragraph of the memorandum property of the United Nations.In exchange,stated that Project B was unacceptable because " it would aggravate the consequences from a the United Nations would guarantee office accom-.point of view of efficient technical and adminis- modation to WHO, on terms acceptable to thetrative services of the elaborate horizontal plan Director-General. of circulation of the existing building ". - 248 - COMMITTEE ON ADMINISTRATION AND FINANCE

The Secretary-General had stated that theboth sides should consult together in the hope of " tower " project was the only acceptable solu-achieving the solution. Discussions between those tion for the United Nations.That project hadarchitects had already begun but it was as yet too been studied by the Swiss authorities but hadearly to say whether agreement could be reached : not proved acceptable for the reasons given innevertheless it was hoped that it would. the letter of 13 June from M. Petitpierre." Those In the absence of such agreement, or if WHO reasons were in themselves sufficient to justifypreferred an independent building, the Swiss the attitude of the Swiss Government, but. adelegation submitted plans for the erection of more important reason should be mentioneda building outside the United Nations perimeter. which had not been brought forward previously The Director-General of WHO had raised no owing to the fact that study of the question hadobjection in principle to a building outside the not reached a sufficiently advanced stage.TheUnited Nations perimeter, but had expressed the Swiss Federal Aviation Board had objected onfear that this would involve the Organization in the ground that the tower would be a dangeroussupplementary expenses. The local authorities of obstacle for aircraft landing at Cointrin Aero-Geneva had consequently offered a supplementary drome and that the project was contrary to thecontribution to WHO to be added to the offer regulations laid down by ICAO, one of the spe-already made by the Swiss Federal Government cialized agencies of the United Nations, for theon i't own behalf. The offer made by the authori- security of air traffic.The Palais des Nationsties of Geneva would take the following form : was in the security zone of Cointrin Aerodrome (1)The Council of State for Geneva had and the proposed tower would be too high.Itoffered to hand over gratis to WHO the land was not desirable to infringe international civilsouth of the Place des Nations of a superficial air regulations enacted by a sister agency.Inareaof approximately 33,000 square metres, view of the position taken up by the Secretary-and the value of which was assessed at approxi- General and the fact that the Swiss authoritiesmately 500,000 Swiss francs. were unable to give their approval to the tower (2)Should WHO decide to erect a building project, it seemed that there remained for con-on the site to the south-east of the Place des sideration only the construction of a building out-Nations known as " Campagne Rigot ",the side the perimeter of the United Nations. The Swiss authorities of 'Geneva would offer to WHO a authorities were desirous that a solution satis-supplementary sum of 500,000 Swiss francs, i.e., factory to all parties should be reached, and hada sum equal to the value of the other site. carried on discussions to that end with the United The Rigot land had been donated to the Nations. It had been decided that architects fromUniversity of Geneva by Mr. Rockefeller, Junior. 30 The relevant paragraphs read : It was available for the use of international The proposal to erect a tower as planned byorganizations, and the Swiss authorities proposed Monsieur Carlu, has been submitted to the Gene-to put the whole part of that land at the disposal vese committees dealing with town planning, as well as to the Administrative Council of the townof WHO free of charge. of Geneva and to the State Council of the Republic In either case the land offered would be exter- and Canton of Geneva. These bodies have notifiedritorialized as was the case with other United their unanimous dissent.They consider that anyNations lands.The project of building on the addition made today to the building of the Palais des Nations should be carried out in horizontalRigot land was only tentative and the Swiss lines in harmony with the landscape, this being theauthorities were prepared to consider any other original conception at the time of building. Theyprojects submitted. have not, therefore, been able to agree to a plan The cost of the building was estimated at which aims at the introduction of a vertical feature. In addition, the erection of a tower would not fail5,500,000 Swiss francs with an addition of 350,000 to provoke a strong reaction on the part of localfrancs should it be decided to add a hall for the public opinion. Executive Board. The architects consulted had As far as we are concerned, we note on readingbased their project on information provided by the memorandum referred to (p. 9-line 3) that the tower would not be used for the WHO butthe Secretariat of WHO. that this organization would be housed in the The Swiss delegation expressed its willingness existing buildings. In these circumstances it wouldto supply any other information desired by the seem that the WHO would not profit from anycommittee. advantages which might accrue from the adminis- trative point of view from a construction in height. The CHAIRMAN said that WHO was in great Finally you state in your letter that the costsneed of accommodation and it was regrettable of the construction, according to the estimate worked out in French francs by Monsieur Carlu,that the study of the different projects had not have been converted into Swiss francs by the Unitedreached a sufficiently advanced stage for discus- Nations at a rate which is not recognized. At thesion to be undertaken on the matter now. On conversation which you had on the 3rd June withthe question of the procedure to be adopted, he representatives of our Department in the presence of a delegate of the United Nations, it was agreedsuggested that a proposal should be made to the that the estimates of both the Carlu and the BAssembly for the matter to be referred to the plans would be subjectto somewhat similar expenses.Executive Board for consideration. The building of a tower therefore would not be of any financial advantage. Dr. ROGERS (United States of America) made For these reasons we consider that the argumentstwo comments in support of the Chairman's put forward in favour of the tower project are not (1)thepossibilityofachieving convincing, and we have come to the conclusionsuggestion : that the said plan would not offer a satisfactoryeconomies by erecting a building close to or as solution to our problem. part of the United Nations buildings should be - 249 - EIGHTH MEETING thoroughly investigated since certain essential Dr. ROGERS asked that in the proposed resolu- services could be utilized jointly ; (2) any solutiontion sufficient emphasis should be given to the reached must be entirely acceptable to the hostpoints raised by his delegation, which was less government. concerned with the architectural reasons affect- ing any decision than with the reasons affecting Mr. DAVIN (New Zealand) said that althoughoperational econbmy and the functional use of the information available was not sufficient forthe building.The resolution should be clearly governments to take decisions, his Government was in favour of the erection of a new buildingworded. away from the Palais des Nations, since they The CHAIRMAN thought that the point could could see no financial advantage in creating newbe met when the resolution was laid before the offices as part of the Palais. He thought that nocommittee. addition to the Palais could in any case be approved without reference to and the approval Decision: It was agreed that the Secretary of of the General Assembly of the United Nations. the committee should be asked to draft the resolution for consideration of the committee M. BERTRAND (France) agreed with the preced- at a later meeting (see tenth meeting, section 2). ing speakers that this important question could only be solved in Geneva by the Executive Board.2.Budget Estimates for Proposed MO Pro- He was also of the opinion that whatever solution gramme was reached must receive the approval of the Agenda, 10.18 Swiss Government. Sir Arcot MUDALIAR (India) proposed that The CHAIRMAN thought that the committeethe Committee on Administration and Finance should ask the Secretary to prepare a resolutionappoint a working party of 15 members represent- on the matter on which a vote could be taken ating the major and minor contributors to WHO, a later stage. whose duty would be to suggest to the committee The SECRETARY said that it was difficult to the budgetary ceiling that should be recommended put the resolution in specific terms at the presentto the Committees on Administration and Finance stage.It could contain the usual introductoryand on Programme, at the outset of their joint paragraphs and refer to the communicationsdeliberations. received from the Swiss Government and the Dr. ROGERS and MT. BRADY (Ireland) warmly United Nations.Since the matter had not yetsupported the proposal of the delegate of India. reached a definitive stage, it might be desirable to delegate authority to the Executive Board The CHAIRMAN pointed out, however, that that to deal with the question, asking the Board toproposal could not be considered under item 10.18 bear in mind three points :(1) any decision toof the agenda, which related only to the costing erect a construction on a United Nations siteof the programme submitted by the Committee should be subject to complete agreement withon Programme. He proposed therefore that he the Secretary-General, the Director-General andconsult with the Chairman of the General Com- the host government ; (2) if a satisfactory agree-mittee on the propriety of the committee taking ment could be reached to build on a separatethe action proposed by the delegate of India site, authorization should be granted to proceedand that he report back to the committee at the with the construction of the building ;(3) if itfollowing meeting. were considered more advantageous, other solu- tions should be considered. Decision: The Chairman's proposal was adopted. Dr. DOWNES (Australia) suggested that the proposed resolution should draw the attention3.Report of the Working Party on the Working of the Executive Board to the reasons which Capital Fund (continued from p. 237) made it necessary to erect a new building. Agenda, 10.17 Should the plans for the building be approved Mr. LINDSAY (United Kingdom), Rapporteur, and the requisite budget be passed, temporarypresented the report of the working party on the accommodation would still be necessary. Heworking capital fund. understood that the Palais des Nations housed at the moment some of the personnel of IRO, Decision: The committee adopted the report whose activities would cease within two years. of the working party on the working capital He proposed that the decisions of the Executive fund and decided to recommend to the Assembly Board should be communicated toMeinber adoption of the draft resolutions it contained Nations for their consideration before any definite (for text, see third report, section 4). engagements were entered into. 4.Currency of Contributions The SECRETARY, in thanking the delegate of Agenda, 10.21 Australia for his suggestion, said that the rooms at present occupied by the staff of IRO in the The SECRETARY recalled that provision was Palais des Nations would shortly be taken overmade in the Financial Regulations 31 for con- by WHO, but would not make a substantialtributions to the annual budgets of the Organiza- difference to the general problem of accommoda- 31 Financial Regulation 19, Off. Rec. World Hlth tion. Org. 13, 355 - 250 - COMMITTEE ON ADMINISTRATION AND FINANCE tion to be paid in United States dollars or inordination, but he was bound to say that little Swiss francs, but that the Director-General, inprogress had as yet been made.That question consultation with the Executive Boird, couldwould continue to be studied as it was one in agree to payment in other currencies which couldwhich all the agencies were interested. be utilized by the Organization.The Director- General had made every effort to devise means Dr. VILLARAMA (Philippines) pointed out that whereby the Organization could accept currenciesa further difficulty in any scheme for the collec- other than Swiss francs and United States dollarstion of contributions in currency other than but had so far been unable to do so. Swiss francs and United States dollars was that The Organization's anticipated expendituressome other currencies were not tied to the dollar to the end of the present year in a currency otheror the Swiss franc. How was it proposed to deter- than Swiss francs or United States dollars wasmine assessments on some existingrateof not large and in view of the many difficultiesexchange which might be radically altered in the that had arisen it had not been possible to acceptcourse of the year to which the budget related ? such other currencies in amounts which would result in any advantage to Member Governments. M. DE LAVARENE (France) asked whether the Only 16% of the contributions for 1949 had beenExecutive Board's resolution was only applicable received by 20 June. Yet any plan for the collec-to the contributions for 1950 or also to the con- tion of contributions in currencies other thantributions for 1949 which had not yet been paid. United States dollars and Swiss francs restedIn the latter case, he asked if it would not be pos- of necessity on the assumption that the con-sible for those Members who had paid their 1949 tributions would have been paid by the beginningcontributions in full in dollars or Swiss francs to of the year for which they were due and thatobtain a rebate on part of what they had paid funds would therefore be available in the Organiza-and pay in other currencies in exchange. tion's various bank accounts to meet expenditure as it arose.It might conceivably be possible to The SECRETARY said he interpreted the word- devise some scheme whereby the soft currencying of the Executive Board's resolution as apply- funds received would be used to defray theing to future years, beginning with 1950. expenses incurred in the last months of the year He urged the committee not to regard the only. difficulties as insuperable.He hoped the com- The Director-General was determined to findmittee would seriously consider the problem ; some means of overcoming the numerous difficul-alternatively it might prefer to refer it to the ties and he would welcome discussion of theExecutive Board for further consideration. question, whether in the committee or in a work- ing party.To give the committee a concrete Mr. DAVIN proposed that the committee simply basis for discussion, he drew attention to therecommend to the Assembly the adoption of resolution adopted at its third session by thea resolution identical in wording to that adopted Executive Board,82 which, indeed, had discussedby the Executive Board, and that the details of the question at every one of its sessions. By thatthe scheme should be worked out by the Secreta- resolution the Board had recommended to theriat in collaboration with interested countries. Second World Health Assembly that contribu- tions to the operating budget in currencies other Mr. LINDSAY suggested that the Chairman than United States dollars and Swiss francs benominate a working party composed of members accepted on the basis that all Member Govern-of the committee, to consider the problem. ments should have equal rights in paying a proportionate shareoftheircontributionin Mr. GOUDSMIT (Netherlands), Dr. NAZIF Bey such currencies as might be acceptable, those(Egypt)and Mr.STEINVORTH(CostaRica) currencies to be determined under the provisionssupported the New Zealand delegate's proposal, of Financial Regulation 19. The main importanceDr. Nazif Bey pointing out that the Executive of that resolution was in the unequivocal layingBoard, in its preamble to the resolution in ques- down of the principle that all Member Govern-tion, had expressed the opinion that it would be ments should have equal rights in paying pro-possible to use to some extent currencies other portionate shares of their contribution in otherthan United States dollars and Swiss francs. currencies.The Executive Board had opted for the principle to which the United Nations already Decision : The committee decided to recom- adhered, and not for any of the alternative prin- mend to the Assembly the adoption of a ciples governing the policy in this respect of resolution identical with -that adopted by the certain other specialized agencies. Executive Board (for text, see third report, The question had in fact been considered at section 5), and further decided to set up a a number of meetings of the Consultative Com- working party composed of the representa- mittee on Administrative Questions, a subsidiary tives of the Dominican Republic, Egypt, France, body of the Administrative Committee on Co- India, Switzerland and the United Kingdom to consider the problem and report back to 32 oll. Rec. World Hlth Org. 17, 20, item 9.1.3 the committee (see eleventh meeting, section I ). - 251 - EIGHTH MEETING

5.Proposed Amendments to the Provisional (c)thatthe Secretary-General(oragency Staff Regulations (continued from p. 228) head) should be left free to seek candidates wherever he deems best, recognizing that for Agenda, 10.9 certain purposes, such as the loan of highly specialized staff, many of whom may be in Additional Proposals by the Government of Belgium the service of governments, he may find a request addressed to governments to be desir- M. VAN DER BRUGGEN (Belgium) drew atten- tion to the Belgian delegation's proposal to able. amend Regulation 11 of the Staff Regulations Mr. HALSTEAD (Canada) endorsed the point by the addition of the following paragraph : of view expressed by the Secretary.He could not support any categorical instruction to the Lists of vacant posts, or posts for whichDirector-General which would curtail his respon- vacancies are expected, as well as new postssibility for carrying out Article 35 of the Constitu- to be conferred, are communicated to thetion, whereby the paramount consideration in governments of Member States within a suffi-the appointment of the staff should be compe- cient time-limit to permit their posting. tence. He therefore proposed the following redraft of the Belgian delegation's proposed amendment The proposal might well have been discussedto Regulation 11 of the Staff Regulations : at the fifth and sixth meetings when the question of the geographical distribution of the Secretariat Further, it is desirable that, as far as practic- had been under consideration during discussion able, vacancies for the higher grades in the of the report of the Director-General. The Secretariat should be communicated to the Belgian delegation attached importance to the Governments of Member States in order that giving of more systematic publicity by one means they might be publicized. or another to vacancies in the policy-making and higher executive grades of the Secretariat. Mr. BRADY (Ireland) agreed in principle with The proposal did not refer to the lower grades.the suggestion that as far as possible adequate UNESCO made public not only lists of vacanciesand timely information on vacancies in the staff but also the qualifications required, and heof the Organization should be supplied to govern- suggested that WHO should copy that example.ments. In view of what the Secretary had said, It would then be possible for delegations return-however, he felt that the amendment proposed ing to their countries to secure a certain publicityby the Belgian delegation was too sweeping, and for vacancies, thus giving the Director-Generalhe suggested that it would be preferable to adopt a wider choice of the best-qualified staff. a resolution embodying that principle rather than to amend the Staff Regulations.If the Staff Mr. DAVIN suggested that the words " areRegulations were to be amended, he would communicated to the governments of Membersupport the text proposed by the delegate of States within a sufficient time-limit to permit Canada. their posting " in the draft amendment proposed Mr. DAVIN said he was impressed by the by the Belgian delegation should be redraftedexplanation furnished by the Secretary, and to read " shall be communicated to the govern- ments of Member States in sufficient time toagreed that the committee should adopt a resolu- permit their publicizing such vacancies ". tion rather than amend the Staff Regulations. M. VAN DER BRUGGEN stated that he apprecia- M. VAN DER BRUGGEN accepted the Newted the points raised by the Secretary, especially Zealand delegate's suggestions. the argument that the Director-General should not be bound too strictly.He still believed The SECRETARY recalled that he had alreadyfirmly thatit was important that adequate drawnattention,duringthediscussionsonpublicity should be given to the vacancies for geographical distribution, to that part of thethe higher-grade posts, but he was prepared to minutes of the International Civil Service Advisoryagree to the suggestion of the delegate of Canada Board 33-in which, he pointed out, WHO hadthat the original proposal be remoulded in the agreed to participate-where it was stated thatform of a resolution.He would agree to the general agreement had been reached : wording proposed by the delegate of Canada (a)that it was of great importance to main-subject to addition of the words " at regular tain the principle and the fact that the Secretary-intervals " after the words " should be com- General (or agency head) is entirely independentmunicated ". in selection of his staff, regardless of grade ; (b)that a rule requiring the Secretary-General Decision : The committee decided, at the sug- (or agency head) to notify vacancies to, or seek gestion of the Chairman, to request the repre- candidates from, governments is undesirable ; sentatives of Belgium and Canada, in collabora- tion with the Secretariat, to draft a resolution 83 Extract from summary record of the first for submission to the Assembly (for text, see meeting, 16 March 1949 third report, section 6). - 252 - COMMITTEE ON ADMINISTRATION AND FINANCE

6.Report on Reimbursement by Governmentsand demonstration services to governments being forMaterials,Supplies and Equipmentdelayed or even not carried out at all. furnished by the OrganizationinCon- As was stated in the draft resolution, govern- nexion with Advisory and Demonstrationments already contributed a large share of the Services to Governments cost of demonstration projects. What such con- Agenda, 10.22tribution would be under the terms of the pro- posed draft agreement between a government The SECRETARY stated that the report by theand the World Health Organization, set out in Director-General on this subject (see Annex 21)the Appendix to the Director-General's report dealt with a problem which had arisen as a result(see p. 394) could be seen from Article IV (b) of of paragraph VI of the appropriation resolutionthat draft agreement. for 1949. That paragraph read : Replying to M. DE LAVARENE (France), the With respect to advisory and demonstrationSECRETARY stated that it was not possible to services to governments, the Director-Genera1estimate the exact amounts which the Organiza- shall, in consultation with the receiving govern-tion would forgo b'y adopting the proposed draft ments, take steps to recover such cost ofresolution, since those amounts would be con- materials, supplies and equipment furnishedditioned by the ability of governments to repay. by the Organization out of the sums appropri- He recalled in this connexion that the work- ated under this Section as these governments areing party which, at the First Health Assembly, able to repay, and shall report to the next had recommended to the Committee on Admin- Health Assembly the sums thus recovered. istration and Finance the inclusion in the Appro- priation Resolution of the paragraph in .question It had been impossible so far for any of thehad stated specifically that, in reporting on the governments concerned to reimburse WHO foraction taken, the Director-General should make the costs involved, and the difficulties that had no reference to the names of countries which had arisen might eventually handicap the work ofbeen unable or unwilling to repay, or to, those the Organization.The Director-General there-that had repaid. fore recommended that the committee reconsider the question and submit for approval by the Dr. ROGERS thought there was little doubt that Assembly a draft resolution (see p. 262) whichall delegates would agree with the delegate of would have the effect of rescinding paragraph VIIndia if they were to interpret paragraph VI of of the appropriation resolution for 1949. the 1949 appropriation resolution literally and rigidly.But as the Secretariat had indicated, Dr. ROGERS asked whether the wording ofsuch an interpretation was not the only one and, paragraph VI of the appropriation resolutionin fact, was not the one that had been placed should be interpreted as meaning that the Director-upon it by the Director-General. General must recover the cost of materials, There were other considerations that had to be supplies and equipment furnished by the Orga-taken into account, relating to the whole philo- nization or that he should endeavour to recoversophy of a demonstration programme.Such a such monies where possible. programme was quite distinct from a programme of mere assistance ; it was launched in a country The SECRETARY said the exact interpretationwhere there was a real possibility of its stimula- was open to doubt. Paragraph VI provided thating the rapid development and utilization of the Director-General should take steps to recovernational resources.It was a natural consequence such cost of services as governments were ablethat WHO would sooner or later hand over the to repay.As was stated in paragraph 3 of hisresponsibility for operating it to the authorities report (p. 394) the Director-General consideredof the country in question.It seemed obvious that he was not in a position to determine thetherefore that the beneficiary country should ability of individual governments to pay. endeavour as soon as possible not only to train The question had also arisen whether repay-the necessary personnel but also to organize the ment could be made in local currency as well asnecessary material resources.All that vitalizing in dollars and Swiss francs. The Director-Generalaspect of demonstration programmes was lost had in fact invited governments to pay in localsight of in the draft resolution under considera- currency.In every case they had replied thattion. to do so would lay an intolerable burden on their He agreed however that the Director-General budgets and that to obtain the funds by specialwas placed in a difficult position by paragraph VI appropriation would entail lengthy legislativeof the 1949 appropriation resolution.He sug- processes. It seemed then that it would be neces-gesed therefore that a working party be set up to sary for all of them to ask for delay in startingconsider, in consultation with the Secretariat, repayment, or cancellation of the requirement. some other means of solving those difficulties without prejudice to one of the fundamental Sir Arcot MUDALIAR (India) warmly supportedprinciples underlying demonstration programmes. the proposed draft resolution, without which there was a very grave danger of the advisory The meeting rose at 6.30 p.m.

- 253 - NINTH MEETING

NINTH MEETING Friday, 24 June 1949, at 8.30 p.m. Chairman: Dr. B. SCHOBER (Czechoslovakia)

1.Report on Reimbursements for Materials,Director-General.He would therefore propose Supplies and Equipment furnished by thethe insertion of the words " in his opinion " after Organization in connexion with Advisorythe word " Section " in paragraph VI of the and Demonstration Services to Governmentsappropriation resolution for the financial year (continuation) 1949.84 There seemed to be a lack of correspond- Agenda, 10.22ence between the tenor of that paragraph and the somewhat mandatory wording of Article IV, Mr. SIEGEL, Secretary, thought the committeesub-paragraph (c) of the draft agreement. would wish to consider whether it would be a sound principle to establish an inflexible arrange- Dr. CAMERON (Canada) believed that the policy ment for recovering from governments expendi-of WHO should be based on the principle that tureformaterials,suppliesand equipmentresponsibility for the administration of health furnished by WHO advisory and demonstrationprogrammes should lie with the local authorities teams.It had to be recognized that, if theconcerned.'Wherever possible the latter should Organization requiredgovernments to makebear the cost, since that would stimulate their appropriations out of their national health budgetsinterest in the continuation of the programmes for that purpose, their total funds for otherinitiated by WHO and would encourage them health programmes would be reduced. Heto take them over at an early stage. referred the committee to Article IV, paragraph (b) of the draft agreement between WHO and a Colonel AFRIDI (Pakistan), speaking as a repre- government receiving services from the Organiza-sentative of a country which had received help tion (appendix to annex 21) which containedfrom advisory and demonstration teams, stated seven main items of expenses which could bethat one of the functions of those teams was to paid in local currency for which governmentsconvince local administrations, as distinct from would be required to provide funds. The amountshealth officers, of their usefulness. After govern- involved would often exceed the sum required had seen teams in action they would to repay WHO for the materials, supplies andprobably be prepared to subsidize their opera- equipment furnished by demonstration teams. tions.However, the countries that were most urgently in need of help were undeveloped Mr. LINDSAY (United Kingdom), Rapporteur,countries where demands on national resources said he had much sympathy with the point ofwere already heavy. They might find it extremely view of the United States delegate.It had notdifficult therefore to reimburse WHO for demon- been the intention of the working party whichstration services and it would be undesirable to had considered the item at the previous Healthpress them in the matter, WHO thereby losing Assembly to reach any decision on the mattera valuable opportunity for giving assistance. He which could be interpreted in such a way as towas doubtful of the utility of the United King- hamper the importantservicesprovided bydom amendment since the Director-General had advisory and demonstration teams. The countriesalready indicated that he would be unable to in a position to do so should pay, but a largeassess the ability of governments to pay. proportion of those for whom the services were specially designed would be unlikely to be able Dr. MARTINEZ (Chile) suggested that the same to pay at least during the period of the teams'procedure might be followed as that adopted by operation. He felt strongly that the principle ofthe administrators of Rockefeller grants who requiring governments to meet the cost shouldinitiated projects which were later taken over not in any way be abandoned but that arrange-by governments. However, he felt that eventual ments should be sufficiently flexible to enableparticipation of governments in demonstration. those who were not in a position to pay at theschemes should be ensured in the initial agree- moment to enjoy the benefits of demonstrationments. programmes.He therefore supported the sug- gestion of the United States delegate that a Dr. ROGERS (United States of America) thought working party be set up, to consider the meansthat the different views expressed could be re- ofsolvingthepracticaldifficultieswithoutconciled if the resolution were redrafted and endangering the principle. repeated his proposal that a working party be It seemed to him that the responsibility forset up for the purpose. deciding whether governments were in a position to reimburse WHO should be laid upon the 34 Quoted on p. 253. - 254 - COMMITTEE ON ADMINISTRATION AND FINANCE

The SECRETARY said that, as a matter ofof the committee to which the Indian proposal principle,someassurancethatgovernmentscould be related.He, the Chairman, had raised receiving such assistance would be willing tothe question of the Indian proposal with the continue the work was desirable, and provisionPresident of the Assembly, who had agreed that for such assurance was included in the arrange-it should be allocated to the appropriate com- ments to be completed between governmentsmittee, promising that rapid action would be and the Organization. taken. Mr. GODDSMIT (Netherlands) said that it would The SECRETARY stated that the Secretariat be wise for the working party proposed by thewas uncertain as to the manner in which the United States' delegate to consider in detail thecommittee would wish to proceed in connexion articles of the draft agreement between WHO andwith the budgetary estimates. It might be useful a government receiving services from the Organiz-to recall that, whereas the programme was an ation. integrated one, the budget was arbitrarily divided The SECRETARY stated that the draft agree-into two parts :the Regular Budget and the ment had been drawn up in accordance with theSupplemental Operating Budget. The programmes policy laid down by the First Health Assembly.themselves cut across the two budgetary divisions. If the Assembly so desired, the policy could be As far as the estimates for travel and allow- amended. ances were concerned, they were based on specific data where those were available.Where posts Decision : The committee agreed to set up ahad not yet been filled, the Personnel Office had workifig party composedofrepresentativesmade estimates of home stations, taking into of Chile, India, Pakistan, the United Kingdomaccount the necessity for geographical distribu- and the United States of America to considertion.Thereafter averages for travel and allow- the resolution on the reimbursement by govern-ances had been computed.The note by the ments for materials, supplies and equipmentDirector-General on the Supplemental Operat- furnished byadvisoryanddemonstrationing Programme of Advisory and Technical Services services (for discussion on the report of theBudget (see Annex 22) was also of interest in working party, see eleventh meeting, section 3).explaining the proposed methods of financing (1) the Regular Budget, which was based on an 2.Proposed Amendments to the Provisionalappropriation resolution by the Assembly in Staff Regulations (continued from p. 252)accordance with the Constitution and (2) the Supplemental Budget, which anticipated addi- Agenda, 10.9tionalvoluntarycontributionsfrom govern- Additional Proposals by the Government of Belgiumments. Were the recommendations in the Director- General's note to be adopted, the appropriation The SECRETARY, recalling the decision reachedresolution as given in Official Records No. 18, at the previous meeting that representatives ofpage 23, would require amendment by the deletion Belgium and Canada be requested to draft aof the column headed " Supplemental Budget ". resolution in collaboration with the Secretariat insteadof proposing an amendment to the Dr. STAMPAR (Yugoslavia) stated that it was Provisional Staff Regulations, stated that theimportant to ascertain the position with regard following text of a resolution had been evolved :to the Supplemental Budget, and he would be interested in obtaining more information on that It is desirable that, as far as practicable,subject. He recalled the discussions in the First vacancies for professional and senior admin-Health Assembly on the ceiling for contributions. istrative posts in the Secretariat should beGovernments were going to be asked whether communicated to the governments of Memberthey could make such appropriations and he States in order that they may be given publicity.wondered how many replies had been received. Decision : The draft resolution as read by theAs far as his country was concerned he would Secretary was adopted (for final text, see thirdlike to state that his Government was prepared report, section 6). to contribute a sum of 10,000 dollars in hard currency and one and a half million dinars per 3.Budget Estimates for the Proposed 1950annum in local currency, which was equivalent Programme (continued from p. 250) to 30,000 dollars. Agenda, 10.18 The CHAIRMAN replied that all would join with The CHAIRMAN announced with regret that hehim in expressing appreciation for the generous could not accept the proposal to set up a workingoffer made by the Yugoslav Government.He party to consider a budgetary ceiling. Thathad, however, to rule out of order any discussion would be contrary to the decision already takenon a budgetary ceiling.The committee was on the procedure to be followed in the considera-obliged to confine itself to the costing of pro- tion of the 1950 programme and budget.85 Thatgrammes approved by the Committee on Pro- decision would have to be reconsidered in plenarygramme. meeting if the procedure was to be altered. Furthermore, there was no item on the agenda Dr. DOWNES (Australia) asked for information on the total cost of the programmes recommended 35 Resolution WHA2.1 by the Committee on Programme and its dis- - 255 - NINTH MEETING

tribution as between the Regular and Supple- Dr. ROGERS stated that a significant and mental Budgets. accurate evaluation of any programme would require data showing how the estimated cost was The CHAIRMAN replied that no answer coulddivided between the regular and supplemental be given until the Committee on Programme hadbudgets.The committee would have to decide finished its work.At all events, the matter ofbetween two courses of action ;either it could total cost and priorities could only be consideredattempt what seemed to him an impossible task, at a later stage in the joint meetings with thenamely, a real and detailed examination of the Committee on Programme. budget proposals, or it could refer back the Secretariat's proposals tothe Committee on Dr. ROGERS said that the programme as setProgramme without much comment, together forth in Official Records No. 18 had been virtuallywith some recommendation as to the advisability endorsed by the Committee on Programme withof evolving a more satisfactory procedure for little alteration. He was deeply concerned as tothe future. the procedure the committee would have to follow in considering the financial implications The SECRETARY explained in detail how the of that programme.In the time at its disposal,cost of one particular project had been determined, it would be quite impossible to fulfil the tasktaking as an example the budget estimates for conscientiously sinceitrequired examination,the maternal and child health programme in and analysis in the greatest detail would be Official Records No. 18, p. 71. As he had already required.Furthermore, he doubted whether thestated, each item was an integrated project material had been presented in the appropriatecomplete in itself.The division between the form. regular and supplementary was arbitrary. The CHAIRMAN replied that he was also in Sir Arcot MUDALIAR (India) said that it was considerable perplexity.He regretted that hisdifficult to assess the exact scope of the budgetary delegation had overlooked the importance of theestimateswithout having some comparative decision reached concerning the procedure toinformation on the nature of expenditure in be followed.However, at the present stage no 1949. Such a comparison would enable the useful purpose would be served by reopening thecommittee to determine whether the estimates discussion on the matter. were too high.He did not know whether it would be possible to prepare such information Mr. BRADY (Ireland) considered that enoughat the present stage but he felt that it should data on costing were available in Official Recordscertainly be done in the future.It would be of No.18for the committee to proceed withinterest also to know the repercussions on pro- its work as soon as all programmes had beengrammes if the Regular Budget were passed and referred to it by the Committee on Programme.how far they would be expanded if the Supple- He was, however, uncertain about the practicalmental Budget were also passed. operation of the procedure outlined in the penul- timate paragraph of the Assembly resolution, The CHAIRMAN felt that unless the committee reading : 36 was prepared to accept the budget proposals in a more or less formal way it would be unable to INSTRUCTS the Committee on Administrationmake much progress. and Finance to recommend cost estimates for the programme recommended by the Committee Dr. B J ORNSSON (Norway) did not think it on Programme, and to comment generally onadvisable for the committee to attempt to discuss the administrative and financial aspects of thethe cost of the programme in detail. The proposals proposals. should be accepted in general and the financial aspects considered at the joint meetings with the Mr. LINDSAY feared that if the financial implica-Committee on Programme. tions of programmes were considered in a piece- meal manner a decision on one item might involve Decision: The committee adopted the proposal a commitment on a question of general principle. of the United Kingdom delegate,seconded He proposed,therefore,that the committee by the delegate of New Zealand, to defer a should consider the items separately with reserva- decision on the Norwegian proposal until the tions on matters of general application. following meeting.

36 Resolution WHA2.1 The meeting rose at 10.50 p.m.

- 256 - COMMITTEE ON ADMINISTRATION AND FINANCE

TENTH MEETING Saturday, 25 June 1949, at 9.30 a.m. Chairman: Dr. B. SCHOBER (Czechoslovakia)

1.Budget Estimates for the Proposed 1950committee wished to reconsider the procedure Programme (continued) that had been adopted.He proposed that he Agenda, 10.18 should be authorized to raise the matter at the meeting of the General Committee immediately Mr. SIEGEL, Secretary, suggested that a brief and to urge that a joint meeting of the Committees explanation of the way in which the Secretariaton Programme and Administration and Finance, had approached the problem of the presentationbe held on the following Monday morning, of the budget might be useful to the committee.27 June 1949. The Secretariat had carefully studied the records of the discussions in the First World Health The first task at the joint meeting of the two Assembly, with a view to determining, as far ascommittees would be to determine the best pro- possible, the type of information which delegatescedure for solving the various difficulties that to the Assembly would wish to have before themhad arisen, including that to which the draft when studying the budget estimates. It had alsoresolution submitted by the delegate of India considered the procedure followed by the otherat the eighth meeting had related ; and he sug- international organizations, . especially by thosegested in fact that the best procedure would be, with more experience. first, to establish a list of priorities for the various The WorldHealthOrganizationwasin-programme items and, secondly, to consider the experienced.It was the Director-General's firmtotal amount that would be available to finance intent to take careful note of the discussions atthe programme. each Assembly as a guide to the preparation of If that proposal were adopted, the Committee documentation at future Assemblies ; he wouldon Administration and Finance could dispose therefore be grateful for any constructive sug-of the question for the present by considering gestions, which would be noted carefully. the proposal made by the delegate of Norway The decision taken at an early plenary meet-at the previous meeting. ing of the present Assembly 37 had been that the Committee on Programme should consider the Dr. ROGERS (United States of America) sup- programme and should subsequently refer it toported the Chairman's proposal, but suggested the Committee on Administration and Financethat he endeavour to obtain permission from for costing, and for such other comments onthe General Committee for a joint working party administrative and financialaspectsasthatof the Committees on Programme and Admin- committee might think fit to make. He suggestedistration and Finance to meet as soon as possible, that some of the difficulties with which the com-even before the first joint meeting of the com- mittee had seemed to be confronted,, at themittees themselves. previous meeting, would be resolved if it were steadily borne in mind that costing, in the present The CHAIRMAN replied that such a suggestion context, meant simply the establishment of costwould be out of order since a working party could figures for each of the programme items approved by the Committee on Programme and had, there-only be set up by a committee or by committees fore, nothing to do with approval of the totalin session.The United States delegate's point budget.Under the procedure envisaged by thecould be met, however, by placing the establish- Assembly,the Committee on Administrationment of a joint working party as the first business and Finance, once it had costed the individualitem on the agenda of the joint meeting of the programme items, would be in a position tocommittees, after consideration of which it could arrive at a single figure representing the totaladjourn so that the working party could begin cost of the programme as approved by the Com-its work. mittee on Programme. The ground would then be clear for joint meetings of the Committees on Decision : The Chairman's proposal was adopted. Programme and on Administration and Finance at which any necessary adjustments, in either Dr. Bj oRNssoN (Norway) presented the follow- direction, would have to be made to the pro-ing draft resolution for consideration by the gramme, to ensure that its total cost coincidedcommittee : with the total amount that would be available The Second World Health Assembly under the budget. TAKES NOTE of the resolution adopted in The CHAIRMAN felt it was obvious from the plenary session on 16 June 1949, which pro- discussions at the previous meeting that the vides for the Committee on Administration and Finance to cost the programme approved by " Resolution WHA2.1 the Programme Committee ; - 257 - TENTH MEETING

UNDERSTANDS that the costing of the pro- a view to recommending a more satisfactory gramme does not in any way commit the com- procedure for the Third World Health Assembly. mittee to a total budget and that consideration of the total budget will be undertaken by the Dr. ROGERS accepted thé Secretary's proposals. Committees on Programme and Administra- tion and Finance in joint session ; Mr. BRADY (Ireland) suggested that the Execu- tive Board and the Secretariat should also consider DECIDES that the costs of the programmethe desirability of arranging for a general debate provided by the Secretariat are hereby accepted. on the budget, and on the best means of consider- ing it in detail, to be held at an early stage in the M. DE LAVARkNE (France) and Dr. ROGERSAssembly. The Committees on Programme and supported the draft resolution submitted by theAdministration and Finance would thus be able delegate of Norway. to begin their examination of the budget in a Mr. LINDSAY (United Kingdom) also supported more realistic atmosphere, and not in vacuo, as the draft resolution, on the understanding thatat presefit. it meant merely that the committee agreed that M. VAN DER BRUGGEN (Belgium) suggested that the individual programme items, if carried out,the following additional paragraph be added to would cost the amounts estimated by the Secre-the draft resolution to meet the point raised by tariat. the representative of Ireland : Dr. BJ ORNSSON confirmed that that was the And HOPES that general consideration of intention of the draft resolution he had sub- total budget costs will at future Assemblies take mitted. place at the outset of the committee's work. The SECRETARY assumed that it was implicit Dr. BJØRNssoN said he could not accept the in the draft resolution presented by the delegateBelgian delegate's amendment to his proposal. of Norway that the Secretariat should submit as soon as possible to the joint meeting a summary of the financial implications of the changes made The SECRETARY suggested that the point raised by the delegate of Ireland would be met by insert- in the programme by the Committee on Pro-ing the words " to take note of the discussions gramme, and an estimate of the total cost of thein the Committee on Administration and Finance programme as approved by the Committee onand " after the words " requests the Executive Programme. Board " in the paragraph which it had been Dr. ROGERS thought all delegates were agreedproposed to add at the end of the draft resolu- that the procedure now envisaged was designedtion. only to meet an emergency situation.It should The CHAIRMAN agreed that some such vague be clearly placed on record that it was not re-statement would be preferable,sinceitwas garded as establishing a desirable precedent andimpossible to estimate the total budget cost that in future a more satisfactory procedureuntil the programme had been discussed. should be elaborated well in advance of the opening of the Assembly. Decision: The committee adopted the draft resolution submitted by the delegate of Norway, Dr. GEAR (Union of South Africa) was in entire as amended in the course of the discussion agreement with the United States delegate.It (for text, see third report, section 7). was important to place the committee's views on record, especially in view of the fact that the Committee on Programme had throughout worked 2.ArrangementsforAccommodationfor on the assumption that each of the programme Headquarters Office (continued from p. 250) items it considered would be carefully costed by the Committee on Administration and Finance. Agenda, 10.11 The CHAIRMAN read the following draft resolu- The SECRETARY proposed the insertion beforetion : the last paragraph of the draft resolution sub- Whereas the First World Health Assembly, mitted by the Norwegian representative of the after consultation with the United Nations in following additional paragraph : conformity with Article 42 of the Constitution, BELIEVES it desirable, in order to expedite selected Geneva as the permanent headquarters the consideration of the budget for 1950, to of the World Health Organization, and adopt a procedure which should not establish Whereas the Secretary-General of the United a precedent for future years, and therefore, Nations has, subject to the approval of the General Assembly, offered to place at the and also the addition, after the last paragraph, disposal of the World Health Organization, of the following paragraph : for the latter's permanent headquarters office, And further REQUESTS the Executive Board accommodation to be provided within the peri- to give special consideration to the problem meter of the United Nations grounds at Geneva which has developed at this Assembly with subject to the construction of such additions to - 258 - COMMITTEE ON ADMINISTRATION AND FINANCE the existing structure of the Palais des Nations to seek and adopt any other solution which as may be necessary for the purpose, and in its opinion will satisfy the needs of the Whereas by the letters of 28 March and World Health Organization in an adequate 1 June 1949 from M. Max Petitpierre to the and practicable manner.Finally, Director-General the Swiss Federal Council 3.REQUESTS the Executive Board to expedite, has, upon the conditions mentioned in the so far as lies within its power to do so, the said letters, proposed three alternative plans commencement of building operations at the for making available to the World Health earliest possible moment and to report to the Organization an amount up to Swiss francs Members of the World Health Organization 5,750,000 to finance the construction of a on the decisions taken for the execution of the building either within the perimeter of the present resolution. United Nations grounds or on an independent The Chairman added that the committee would, site which the Canton of Geneva has offered tohe was sure, wish him to express the Organiz- place gratis at the Organization's disposal, andation's gratitude to the Swiss Federal Council Whereas the various projects submitted forand to theSecretary-General of the United the consideration of the Health Assembly haveNations for the generous offers they had made. not yet been worked out in sufficient detail to enable a choice to be made among them at Dr. DOWNES (Australia) proposed the follow- the present stage ing amendments to the draft resolution which The Second World Health Assembly had just been read : (a) 1.THANKS the Federal Council and the Secre- the addition of the words " Canton of tary-General for the spirit of understanding in Geneva " after " Federal Council " in para- which they have approached this matter and graph 1 ; for the offers which they have made ; (b)at the end of paragraph 2, the addition of the words " up to a limit of six million Swiss 2.RESOLVES to delegate to the Executive Board, acting in concert with the Director- francs for the total cost of constructing the General and subject to the instructions men- building " ; tioned in paragraphs (1), (2) and (3) below, full (c)in paragraph 2 (3), the deletion of the powers to take in the name of the World Health words " and adopt " ;the addition of the Assembly the final decision both as to the words " for headquarters at Geneva " after selection of the site and as to the choice of the " solution " ; and the addition to the end of proposal which the Board may deem most the paragraph of the words " and to report advantageous among the three presented by the thereon to the Third World Health Assembly ". Swiss Federal Council in the above-mentioned The second amendment, imposing a limit to letters for the provision of the necessary funds,the total cost of the building was, in his opinion, a very important one, as otherwise the Executive (1)In view of the administrative facilities and economies that might accrue to theBoard would be given complete freedom in the mutual advantage of the United Nationsmatter. He wished the last amendment only to and the World Health Organization fromapply to paragraph 2 (3). the provision for the latter of headquarters The SECRETARY statedthatthe proposed accommodation in the closest possible proxi- amendments tothe resolution seemed satis- mity to the United Nations buildings infactory, with the exception of that for the dele- Geneva, the Board is instructed, in consulta-tion of the words " and adopt " in paragraph (3). tion with the Swiss Government, to acceptIf those two words were deleted the whole point the offer of the Secretary-General of theof the paragraph, which was to make it possible United Nations on condition that the needsto find another solution and to start work of the World Health Organization in thisimmediately, should the previous solutions pro- matter receive full consideration and thatposed prove unacceptable, would be defeated. acceptableand adequate accommodation Sir Arcot MUDALIAR (India) was opposed to can be made available to the World Healththe deletion of those words. In view of the extreme Organization within the United 1Itionsurgency of the matter, it was very desirable that Grounds at Geneva on terms to be agreedany delay should be avoided.Furthermore, he upon in advance with the Secretary-Generalfelt it might be easier for a smaller body, such of the United Nations and to be completelyas the Executive Board, to discuss the matter acceptable to the Director-General of theand reach a decision, and there would be an World Health Organization ; adequate safeguard in regard to the cost if the (2)should however the final offer of thesecond Australian amendment were adopted. Secretary-General fail to satisfy the condi- tions set forth above, then the Board will Dr. DOWNES could not see his way to with- accept the offer of an independent site madedrawing the amendment to which objection had by the Swiss Federal Council on behalf ofbeen taken. The financial implications involved the Canton of Geneva, were so complicated that he felt there were valid (3)should none of the offers made in accord- grounds for a thorough re-examination of the ance with paragraphs (1) and (2) above bewhole draft resolution. completely acceptable to the Board and the Mr. LINDSAY did not think that the proposed Director-General, the Board isauthorizedamendments covered the two points made the - 259 - TENTH MEETING

previous day by the delegate of Australia (seeThe Secretary-General, the Advisory Committee p.250), namely,(i)that the Executive Boardon Administrative and BudgetaryQuestions should consider whether, in fact, a need existedand the United Nations General Assembly were for a new building, and (ii) that the Organiza-all committed to the principle of co-ordination tion should not be committed to the constructionand the organization of common services with of a building until Member Governments hadthe specialized agencies. The Secretary-General been informed. would be particularly anxious to do everything He also was of the opinion that reasonablehe could to make a success of the present experi- grounds existed for reconsidering the draft resolu-ment-the first attempt at large-scale co-opera- tion.In that connexion it might prove helpfultion on a permanent basis. if the committee could be given an idea of the Up to a short time ago the Secretary-General probable date, before the holding of the Thirdhad been persuaded that the " tower project " Health Assembly, at which a definite decisionwas the most suitable.That project had met might be made. withopposition ;consequently,itwould be Dr. DOWNES, in reply to the first point raisednecessary to make further efforts to find a solu- by the delegate of the United Kingdom, statedtion.The Secretary-General had stated that he that he had satisfied himself that the accommoda-would be very ready to examine any solution tion available in the Palais des Nations, Geneva,found acceptable to all the other parties con- was inadequate for the needs of the Organiza-cerned, provided that it was not incompatible tion.The second point raised would be coveredwith his own responsibilities as the principal by the proposed addition at the end of para-custodian of the United Nations' assets in Geneva. Work was already proceeding on the elaboration graph 2 (3) of the draft resolution. of alternative plans and considerable progress The SECRETARY, in reply to the delegate of thehad been made.If equal goodwill was shown United Kingdom, stressed the impossibility ofby all sides, it should be technically possible for giving any estimate of the probable date at whichthe new accommodation required to be well on a decision might be taken in the matter.Itits way to completion before the holding of the depended largely upon how soon a plan acceptableThird Health Assembly. to the three parties interested could be found. The CHAIRMAN thanked Mr. Evans for his Mr. EVANS, Assistant Director of the Unitedclear exposé of the situation. Nations European Office, stated that the specific question of the amount of space available for In reply to a point raised by Dr. DAVIN (New WHO in the Palais des Nations, Geneva, hadZealand), Mr. EVANS stated that the Secretary- been very thoroughly studied by a number ofGeneral had so far kept the Advisory Committee experts. The result of their enquiries, whichon Administrative and BudgetaryQuestions might be taken as final and authoritative, pointedfully informed of all the exploratory work in to the fact that WHO was more crowded andconnexion with the problem. His intention, cramped than any other body at present accom-if the solution agreed upon with WHO should modated there.The accommodation at presentinvolve an addition to the United Nations' available to WHO might be increased in the nearpremises in Geneva, was to lay the proposal future by the addition of a small block of offices,before the Advisory Committee in the first place, which would bring it up to 147 offices for a staffand fmally before the General Assembly.It had of 256 strong. There was quite clearly no marginalways been the Secretary-General's hope that whatsoever for the expansion which would nosufficient progress would be made so that the doubt occur in the course of the next twelveproject, complete in all details, might be sub- months.Moreover, there was virtually nothingmitted to the Sixth Session of the General further which the United Nations could do toAssembly. Ifthe approval ofthe General add to the facilities offered to WHO in the PalaisAssembly were obtained, work could then be des Nations unless the activities in Geneva ofbegun well before the end of the year. the United Nations itself were to be substantially curtailed.The Secretary-General would be un- Dr. NAZIF Bey (Egypt) felt that the terms of willing to contemplate such curtailment andparagraph 2 (3) of the draft resolution were too furthermore, the offer made on behalf of theelastic. He therefore supported the deletion Swiss Government was contingent on thereproposed by the delegate of Australia. being no reduction in the activities at present Mr. HALSTEAD (Canada) was not certain that, going on in the Palais des Nations. WHO couldshould the alternative solutions mentioned in not therefore be accommodated adequately atparagraphs 2 (1) and 2 (2) of the draft resolution the Palais des Nations unless the building wasprove unacceptable, time would be saved by considerably extended. authorizing the Executive Board to seek and He then briefly outlined the attitude of theadopt any other solution. That was a responsi- United Nations to the problem.The terms ofbility which should rest upon the Health Assem- the resolution before the committee were entirelybly itself.Accordingly, he also supported the acceptable to the Secretary-General in so far assuggested amendment of the delegate of Australia they referred to the United Nations, and thein that respect. Secretary-General would, he was sure, particularly welcome the terms of paragraph 2 (1) of the Mr. INGRAM (United States of America) pro- proposed instructions to the Executive Board.posed that the word "may" should be substituted - 260 - COMMITTEE ON ADMINISTRATION AND FINANCE for the word " will ", in paragraph 2 (2) of thesolution which would enable WHO to be accom- draft resolution. modated in the best of conditions in Geneva. M. MULLER (Switzerland) felt that the draft The CHAIRMAN again expressed the thanks of resolution met fully the requirements of thethe committee to the Swiss Federal Government. situation.The projects so far put forward were There being no objection, the amendments not yet at a stage permitting a decision to beproposed by the delegate of Australia to the taken.Consequently, in view of the urgency ofdraft resolution, with the exception of that for the matter, authority might well be given tothe deletion of the words " and adopt " in para- the Executive Board to study the problem furthergraph 2 (3), and the amendment proposed by the and take the final decision.The Swiss Govern-delegate of the United States of America, were ment desired to see the construction of theadopted. buildings started as soon as practicable, and the On a vote being taken, the amendment pro- draft resolution and amendments thereto wereposed by the delegate of Australia to delete the fully acceptable to it. words " and adopt " from paragraph 2 (3) of the He was sure that the amendment to paragraphdraft resolution was adopted. 2 (3) providing for the presenting of a report to the Third Health Assembly would, in the event, Decision :There being no objection,it was prove unnecessary :one of the three solutions agreed to recommend to the Health Assembly already put forward would surely meet with the the adoption of the draft resolution as amended general acceptance of the three parties concerned (for final text, see third report, section 8). and give satisfaction to the Executive Board. The Swiss Government, for its part, would do The meeting rose at 11.45 a.m. everything possible to help in the finding of a

ELEVENTH MEETING Tuesday, 28 June 1949, at 9.45 a.m. Chairman: Dr. B. SCHOBER (Czechoslovakia)

1.Currency of Contributions (continued from Dr. GEAR (Union of South Africa) was satisfied p. 251) that an acceptable resolution had been adopted Agenda, 10.21but, in view of the implication in paragraph 9 Mr. LINDSAY (United Kingdom) Rapporteur,of the report 39 that the mechanism in question said a working party had been convened tohad not been given a sufficient trial, he suggested discuss the problems concerning the currency inthe following additional paragraph to the resolu- which contributions should be paid, but as it tion : was meeting during the afternoon, it would be RECOMMENDS that the position be reviewed impossible for the present meeting of the com- at not later than the Fifth World Health mittee to make any decision. He suggested there- fore that the Executive Board be authorized to Assembly. deal with the matter at Geneva with the help Decision: The report of the working party was of the Swiss representative on the working party. adopted with the above amendment (for text Decision: The Rapporteur's suggestion was of resolution, see fourth report, section 1). accepted(for resolution,see fourth report, section 4). Dr. DOWNES (Australia) said he could not vote in favour of the report of the working party 2.Financial Responsibilities of the Executivesince his Government believed that the members Board (continued from p. 248) of the Executive Board should be exclusively Agenda, 10.6government representatives. Report of the Working Party Mr. LINDSAY, Rapporteur, invited attention 89 This read : to the report of the working party on the financial The working party, in considering all of these responsibilities of the Executive Board.38 The questions,suggests that thedifficultieswhich topic under discussion had been the subject ofoccurred during the first year of the Organization should not be taken as indicative of 'difficulties in dispute for some time and he was satisfied thatfuture years.Once the full machinery provided a suitable resolution had been elaborated whichfor in the Constitution is set in motion-and this embodied the opposing views that had beenwill take from two to three years-there is reason expressed. to believe that, with the interpretations which the working party has included in this report, the 88 Unpublished working document same difficulties are not likely to arise in future. - 261 - ELEVENTH MEETING

3.Report on Reimbursement by Governments The delegation of Canada had been alarmed forMaterials,Supplies and Equipmentat the formidable contracts which had been furnished by the Organization in connexiondrawn up between the Organization and the with Advisory and Demonstration Servicescountries receiving services.Those seemed to to Governments (continued from p. 255) imply that there was something wrong, not with Agenda, 10.22the regulations themselves, but with the imple- Retort of the W orking Party mentation of the regulations. Countries should meet at least some of the Mr. LINDSAY, Rapporteur, said paragraph (c) of Article IV of the draft agreement betweencost of professional services rendered by WHO WHO and a government receiving services frombut not necessarily all of it, nor necessarily in the Organization (see Appendix 1 to Annex 21)hard currency. The best method of reimbursing had been considered as likely to interfere withsuch services would seem to be the maintenance the work on demonstration services to govern-of the expert concerned in the area with the help ments and had therefore been deleted. Moreoverof local currency.If the committee were willing there had been two modifications to paragraph VIto agree, he would suggest that the matter be of the appropriation resolution for the financialreviewed after three years. year 1949 which was quoted at the eighth meet- ing (p. 253). Those modifications had been embo- died in the revised text of paragraph VI set forth Mr. SIEGEL, Secretary, replied that the two in the resolution proposed by the working party.4°questions raised by the delegate of Canada were The first modification was that the Director-interrelated.The paragraph of the resolution General should, in consultation with the receiv-referred to was in line with Article IV, section ing governments, take stepsto recover the(b) of the draft agreement (see Appendix 1 to depreciationvalueofnon-expendableequip-Annex 21) which stated that governments should ment which might be left in the country after amake provision for such of the costs of the ser- demonstration team had completed its work.vices provided for in the agreement as might be The second was that governments were not tomet in their own national currency. Seven clauses be bound by contract to reimburse part of thewere added stating what those costs would cover. cost of expendable materials, but should do so only if they were willing.Such a procedure would have a beneficial psychological result. Dr. DOWNES proposed the following additional paragraph to the resolution in order to avoid Dr. CAMERON (Canada) thought two pointsembarrassment to governments in the matter were not clear in the resolution proposed by theof reimbursement : working party :(1) the paragraph of the resolu- tion beginning " Recognizing that governments " ; The Director-General, prior to the furnish- (2) the omission in the last paragraph of any ing of these services, should, if possible, reach reference to the reimbursement for services. agreement in advance as to willingness of governments to make such payments under the provision of this paragraph. 40 This read : The Second World Health Assembly Having reconsidered paragraph VI of the appropriation resolution for the financial year Mr. GOUDSMIT (Netherlands)proposed the 1949 as approved by the First World Healthdeletion from the last paragraph of the phrase Assembly, and in brackets, and suggested that the Secretary Recognizing that governments receiving advi-examine the agreements made with governments sory and demonstration services from the Orga-in implementation of the resolution. nization already contribute a large share of the cost of demonstration projects, and Having considered that the provisionsof paragraph VI of the appropriation resolution Sir Arcot MUDALIAR (India) thought some for the financial year 1949 represent a seriousamendment to paragraph VI of the appropriation obstacle to providing these services to someresolution for 1949 would be necessary if WHO of the countries where the greatest need exists,was to continue successfully its demonstration RESOLVES that paragraph VI of the appropria-services.In that field WHO had to prove its tion resolution for the financial year 1949 be rescinded, and replaced by the following text :usefulness not only to the medical services of the With respect to advisory and demonstrationcountry concerned but more particularly to the services to governments, the Director-Generalgeneral public.In order to do so, materials and shall,inconsultationwith thereceivingsupplies were essential.However, if countries governments, take steps to recover the depre- ciated value of non-expendable equipmenthad to state in advance whether or not they which may be left in the country after acould pay for the supplies, there might be con- demonstration team completes its work andsiderable delay in their being granted. such part of the cost of expendable materials and supplies as the governments are willing On the other hand he agreed that reimburse- to repay (either before, during or after thement for unexpendable articles was a sound pro- work is completed), which repayment may be made by governments in their own cur-position as it would save money to the Organiza- rencies. tion, and approved the Canadian proposal to , - 262 - COMMITTEE ON ADMINISTRATION AND FINANCE have the whole matter reviewed after three Decision : The resolution proposed by the work- years. ing party set up to consider the question of reimbursement by governments was adopted with the above amendments (fourth report, Dr. ROGERS (United States of America) sup- section 2). ported the Australian amendment if it were under- stood to be merely as an attempt to speed up the 4.Election of Members and Alternates to provision of equipment to governments. theStaff BenefitCommittee(continued Secondly, as regards the paragraph of the from p. 229) resolution beginning " Recognizing that govern- Agenda, 10.10 ments ", he had assumed that the Constitution of WHO contained some authorization for a The SECRETARY, recalled that the committee policy whereby governments would provide localhad already decided to recommend to the Assem- services as a form of reimbursement. However,bly that the Staff Benefit Committee 4°a be com- he had failed to find any such authorization. Heposed of nine members, three to be appointed by therefore agreed that some additions were neces-the Assembly, three by the Director-General and sary to the resolution, particularly those suggestedthree to be elected by the participants of the by the Canadian delegate, and that more preciseFund, and that, as a matter of principle, the instructions should be given to governmentsthree to be appointed by the Assembly should with regard totheir responsibilityforlocalbe elected from the membership of the Executive services. Board. That had been deemed a practical solu- tion, since meetings of the two bodies could be arranged to coincide, and, in addition, members Dr. WICKREMESINGHE (Ceylon) approved theof the Executive Board would be more familiar principle that no kind of assistance should bewith the internal work of the Organization. A given free by WHO but rather that at least partproposed resolution establishing this principle of it should be reimbursed by governments. Hehad already been submitted to the Assembly. therefore supported the draft agreement andIt had been decided in plenary meeting that the the resolution submitted by the, working party.latter part of the resolution should be deleted as it was felt undesirable to establish too rigid a principle."However, it was understood that Mr. LINDSAY speaking to the Australian amend-the deletion would not preclude that procedure ment, said that in the modified resolution thebeing followed.The committee was now called idea of willingness to pay had been substitutedupon to nominate the three members and their for that of a contract to pay, because his experi-alternates for appointment by the Assembly. ence tended to show that sometimes more money could be obtained with less legal formality if the The CHAIRMAN suggested that the committee former idea were adopted. should first reach a decision on the substantive part of the resolution which read as follows :

The SECRETARY suggested the following changes The Second World Health Assembly, in the text of the resolution to cover the objec- Noting the resolution adopted by the Execu- tive Board at its third session, as regards the tions raised in the discussion : adhesion of WHO to the United Nations Joint (1)the insertion after the first paragraph of Staff Pension Plan, a new paragraph reading, " Taking note of the RESOLVES that, when the WHO Staff Benefit draft form of agreements submitted by the Committee is first constituted, one-third of the Director-General, and " ; members and their alternates shall be appointed for a period of one year, one-third for a period (2)in the following paragraph, the substitu- of two years, and one-third for a period of tion of the words " will normally " for the word three years. " already " and the insertion after the words " demonstration projects " of the following clause : It could then proceed to the nomination of the " by providing for these expenditnres of the members. project which can be met in local currency, " ; Decision : The resolution as read was adopted. (3)to meet the Canadian proposal the inser- tion of an additional paragraph : " Requests the Mr. DAVIN (New Zealand) emphasized that it Director-General to submit a report reviewingwas understood that if a member of the Executive this policy to the Fifth World Health Assembly ".Board were replaced by his Government he would still continue to serve on the Staff Benefit Com- The Australian amendment would be insertedmittee because he had been elected thereto in at the end of the resolution. his personal capacity, and would not be affected by any change of the representative of his country on the Executive Board. Dr. ROGERS agreed to the changes proposed by the Secretary except that the additional second 40a Since called Staff Pension Committee paragraph seemed to him unnecessary. 41 Ninth plenary meeting

--:263 ELEVENTH MEETING

He then proposed the following members andhad reached a compromise solution.There was, alternates : therefore, no need for WHO to reopen the ques- Member Dr. Zozaya tion. His Government thought it undesirable (Mexico) that WHO should adopt a policy fundamentally for one year different from that adopted by the General Alternate:Professor Parisot Assembly of the United Nations and accordingly (France) proposed the following resolution : Member :Sir Arcot Mudaliar (India) The Second World Health Assembly for two years Alternate:Dr. Kozusznik ADOPTS as its basic objective that in normal (Poland) times no one Member State should contribute Member :Dr. Hyde more than one-third of the ordinary expenses (USA) for three years of the Organization and Alternate:Dr. Höjer (Sweden) DECIDES that the principle that the per capita contribution of any Member shall not exceed Dr. WICKREMESINGHE seconded the proposals the per capita contribution of the Member which submitted by the delegate of New Zealand. bears the highest assessment shall be observed, and in interpreting the words " in normal Dr. NAZIF Bey (Egypt) thought it desirable times " the World Health Organization should to nominate Member Governments, leaving them follow the practice established by the General to designate their representatives. Assembly of the United Nations.

The CHAIRMAN pointed out that the resolution Dr. SCHEELE (United States of America) said which had been adopted in principle requiredthat there was no reason why the WHO scale of nominations of persons. assessments should follow that of the United Nations. The membership and functions of WHO Mr. GOUDSMIT was of opinion that the proposalwere entirely different. Conformity with the made by the delegate of Egypt would necessitateUnited Nations practices was neither necessary reopening discussion on the resolution itself. nor desirable.It was not followed by any other permanent specialized agency.He quoted the Decisions : It was agreed not to reopen discus-following figures representing the maximum con- sion on the resolution and to reaffirm its adop-tribution of any member of certain specialized tion. agencies : FAO 25%, ICAO 18.66%, ILO 18.35%, The nominations submitted by the delegateITU 7.76%, the Universal International Postal of New Zealand for members of the StaffUnion 4.37%. Up to the previous year UNESCO Benefit Committee were approved (for texthad also used the United Nations scale and of full resolution, see fourth report, section 3).because of the small membership of the Organiza- tion the United States had been assessed at 41.48 per cent.However, at the UNESCO con- 5.Scale of Assessments for 1950 ference the previous winter it had been decided to reduce the United States' contribution to one Agenda, 10.21 third of the total, in three stages beginning in The SECRETARY drew the attention of the1949. WHO was thus the only specialized agency committee to the resolution adopted by thewhose scale was at the moment based on that of Executive Board 42 following the request madethe United Nations, and he felt there was every by the First Health Assembly 43 that it shouldreason to reconsider it at the present session. study the scale of assessments and report to the present Assembly. A resolution had also been Sir Arcot MUDALIAR was in agreement with submitted by the United Kingdom on the subject.the proposal of the Executive Board that no Member State should contribute more than one Mr. LINDSAY stated that his Government'sthird of the regular budget.It would, of course, objection to the Executive Board's resolutionaffect only the United States and all Members was based on two considerations.In the firstwere extremely grateful for the assistance already place, the whole problem was one of extreme com- However, it would plexity and the revision proposed by the Executivegiven by that government. Board would require very detailed considerationbe in the best interests of the Organization to with the help of experts.It was a task whichestablish that ceiling.The time had come to could not be undertaken at the present stage ofrevise the scale accordingly, particularly as the the Assembly. Secondly, the matter had alreadyaccession of new Members demanded a redistribu- been discussed by the Fifth Committee of thetion of the quota of contributions. The question General Assembly of the United Nations whichof contributions from Associate Members also required consideration. He was in favour of the 42 011. Rec. World Hlth Org. 17, 20, item 9.1.1 matter being considered at the present Assembly 43 Off. Rec. World Hlth Org. 13, 337 so that the 1950 contributions could be adjusted - 264 - COMMITTEE ON ADMINISTRATION AND FINANCE on the basis of the ceiling suggested by thewould be made to the second paragraph after the Executive Board. words " for any year " : " provided that the per capita contribution of any Member State shall Mr. LINDSAY said that his government hadnot exceed the per capita contribution of the never suggested that the United Nations scaleMember paying the highest contribution."The should be followed exactly, but merely that thefollowing paragraph would be substituted for the principle adopted by the General Assembly con-third paragraph of the Executive Board's resolu- cerning per capita contributions should be safe-tion : guarded. DECIDED that this principle be made effective Dr. SCHEELE observed that it appeared to him in gradual stages starting in 1950. to be inconsistent for WHO to have a scale of He was not altogether certain as to the practical assessments different from that of other specializedpossibilities of establishing a ceiling to per capita agencies. contributions but he felt it was a desirable prin- ciple to be followed. Mr. HALSTEAD (Canada) stated that his Govern- ment had expressed the view at the United Mr. DAVIN saidthattheresolutionsub- Nations General Assembly that the scale ofmitted by the delegate of Ireland did not differ assessment was open to improvement.Never-materially from that of the delegate of Canada. theless, he believed that WHO might use theHe preferred the text as proposed by the delegate United Nations scale as a starting point andof Canada, but felt that the second paragraph profit by the expert experience of the Unitedas proposed by the delegate of Ireland was better Nations Committee on Contributions,takingexpressed. into account world economic conditions. Canada had supported in the General Assembly the pro- Mr. HALSTEAD accepted the amendment of the posal that a ceiling should be placed on the con-delegate of Ireland to the second paragraph but tributions of any one Member on condition thatwas anxious that his own wording for the third the reduction should be gradual and related toparagraph should be maintained, since it would the improvement in the world economic situa-be desirable for the findings of the United Nations tion and should be accompanied by a reductionCommittee on Contributions to be taken into in per capita contributions. account in the revision of the scales of assess- He supported the second paragraph of the ment. draft resolution submitted by the Executive Board but proposed that it should be expanded The SECRETARY said that some provision would by the addition of the words " on condition thathave to be included in the resolution for dealing a comparable per capita ceiling be placed onwith the scale of assessments for 1950, on which contributions of other Member States " afterthe Executive Board had made no recommenda- the words " for any year ". tion. He also proposed the insertion in the third paragraph after the word " effective " of the Dr. SCHEELE, seconded by Sir Arcot MUDALIAR words " in gradual stages as world economic and Dr. NAZIF Bey, proposed that a working party conditions improve, taking into account thebe established to consider the draft resolution. recommendations of the United Nations Com- mittee on Contributions ". Decision : The proposal made by the United States delegate to establish a working party was adopted and it was agreed thatit should Mr. LINDSAY, in reply to the CHAIRMAN, said consist of delegates from the following coun- that his delegation found the amendments pro- tries : Australia, Bulgaria, Brazil, Canada, Iran, posed by the delegate of Canada acceptable. Poland, Thailand, United Kingdom, United States of America (for discussion of the work- Dr. SCHEELE quoted some figures of United ing party's report,see thirteenth meeting, States foreign assistance as evidence of the large section 2). share his country was bearing in international health programmes. He assured the committee that if the percentage of the United States con-6.Adoption of Draft Third Report of the tribution was reduced, it would be easier to Committee persuade the United States Congress to raise the Mr.LINDSAY,Rapporteur, introducing the ceiling on its maximum contribution. report, drew attention to a number of drafting amendments, and a further drafting amendment Mr. BRADY submitted a resolution on behalfwas suggested by M. MULLER (Switzerland). of his delegation which he felt might require further detailed study by a small working party. Decision: The draft third report of the com- It was based on the resolution submitted by the mittee was adopted as amended (see p. 341). Executive Board, the first paragraph of which would be maintained.The following addition The meeting rose at 1.25 p.m.

- 265 - TWELFTH MEETING

TWELFTH MEETING Tuesday, 28 June 1949, at 4.30 p.m. Chairman: Dr. L. F. THOMEN (Dominican Republic)

Working Capital Fund Resolution financial situation and consequently feel under no urgent pressure to pay their contributions. Mr. SIEGEL, Secretary, pointed out that by theHe therefore supported the proposal of the draft resolution proposed by the Director-Generaldelegate of New Zealand. and approved by the Executive Board," the Health Assembly would establish the working capital fund for the financial year 1950 in the Dr. DOWNES (Australia) felt that the working amount of $4,000,000. capital fund should not be more than a third of It was important to bear in mind that the sumthe budget. His government did not wish to see of approximately $2,500,000 which, on paper, thethe Organization carrying those Members who working capital fund at present contained, wasdid not pay their contributions.He proposed largely a book figure, which included funds yetthat the sums of $500,000 and $1,000,000 referred uncollected. to in paragraph (2) (b) of the draft resolution be On the somewhat optimistic assumption that,reduced to $250,000 and $500,000 respectively. Together with the $300,000 which the Executive by the end of 1949, 85% of the contributionsBoard could use under paragraph (3), those sums both to the 1949 and to the 1948 budget wouldshould be quite sufficient to meet any unforeseen have been received, the Secretariat had estimatedor extraordinary expenditure, as well as current that on 1 January 1950 the working capital fund of contributions. might contain as much as $1,100,000.If thereexpenditure pending receipt was the same delay in the receipt of contributionsIf more was needed, a special session of the to the 1950 budget as had been experienced inAssembly could be convened. the present year, the Organization would be It was his government's view that ail advances unable, under the provisions at present govern-made by the Director-General under paragraph ing use of the working capital fund, to meet its(2) (b) of the draft resolution should be reported obligations during the first part of 1950. ft there-to the Executive Board as well as to the Health fore seemed essential to increase the capital ofAssembly. the working capital fund. The committee would also have to consider the Colonel AFRIDI (Pakistan) said that, after care- procedure to govern the assessment of Membersful consideration, his government had come to for such additional contributions and the Execu-the conclusion that the working capital fund tive Board's proposals in paragraphs (2) (a) andshould be five-twelfths of the regular budget. He (2) (b) of the draft resolution for increasing thetherefore supported the proposal of the delegate use that could be made of the fund. of New Zealand.

Mr. DAVIN (New Zealand) considered that the Mr. LINDSAY (United Kingdom) also supported Assembly should determine that the workingthat proposal. capital fund should not exceed a certain percent- Moreover, he considered that, in present circum- age of the Regular Budget ; that percentage should stances, the amount which the Executive Board not be subject to annual review, but should onlywas authorized to use under paragraphs (2) (b) be considered periodically in the light of theand (3) of the draft resolution, amounting to Organization's activities.The Assembly should$1,300,000, was twice as much as it should be. consider annually the minimum requirements for the working capital fund for the succeeding In conclusion, he did not understand why what year in the light of the programme for that year.were, in effect, two separate funds should be set In his Government's view, the working capitalup under the terms of paragraphs (2) (a) and fund should be nearer a third than a half of the(2) (b) of the draft resolution, since the purposes regular budget. He therefore proposed that it befor which those funds would be used were so established for the financial year 1950 in the similar. amount of $3,000,000. M. VAN DER BRUGGEN (Belgium) supported the Dr. CAMERON (Canada) agreed that the work- proposal of the delegation of Australia. He con- ing capital fund should be increased substantiallysidered that a working capital fund of one-third above the present figure.It should not be madeof the regular budget (that being the same pro- so large, however, that governments might tendportion as provided for 1949) would be quite tofeelcomplacent about theOrganization'sappropriate, and as the Organization developed such a proportion would prove sufficientfor 44 og. Rec. World Hlth Org. 18, 25 future requirements. - 266 - COMMITTEE ON ADMINISTRATION AND FINANCE

M. DE LAVARÈNE (France) said that his delega- capital funds and he considered that that tendency tion had voted for the budget at the previousshould be fought. meeting under the impression that the amount of the working capital fund would be considered Dr. WICKREMESINGHE (Ceylon) considered it in relation to the Regular Budget on similar linesonly reasonable that the working capital fund to those adopted in other specialized agencies ofshould be reduced, as the budget had been reduced the United Nations.In most of those organiza-by $1,000,000. He supported the proposal of the tions, the working capital fund was for a muchdelegate of Pakistan that it should be five-twelfths smaller amount in proportion to the budget thanof the budget : this was approximately 42% and the amounts under consideration for WHO. Forwould amount to almost $3,000,000. example, in ICAO it was considerably less than He moved closure of the debate. half the budget ; in ILO it was $900,000 against a budget of $6,000,000.The intention of the The SECRETARY was given permission to clarify French delegation had been to propose a maximumthe position prior to voting.If the working of $2,000,000 but in view of the opinions expressedcapital fund were fixed at $3,000,000, there would by other delegations, and taking into accountbe little increase in its present size. If the mythical that the total effective regular budget would bereserve fund of $866,000 were added to the present roughly $7,500,000 his delegation would proposeworking capital fund of $1,650,000, the size of a working capital fund of $2,500,000. the fund would be $2,500,000, on paper. Was it the intention to increase it by $1,350,000, or by The sums necessary to meet unforeseen or$500,000 ? extraordinary expenses, provided for in clause He emphasized that the working capital fund (2) (b), should also be on a similar basis to thatwould be quite inadequate to enable the Organiza- of other specialized agencies. The United Nationstion to meet its obligations in the coming year : had limited such provision to 10% of its workingmoney would have to be borrowed from outside capital fund. In the case of WHO the provisionsources. All the contributions from Members had should in no case exceed $300,000. not come in and the estimated amount for 1948 and 1949 which would not have come in by the Dr. ROGERS (United States of America) desiredend of the current year would be about $1,500,000: to place on record a reminder of his Government's that would have to come out of the working position, which was that, under the presentcapital fund. ceiling imposed by Congress, the total amount which could be made available for the WHO In view of the suggestion of the Secretariat budget was $1,920,000. Their share was apparent-that the matter had not been sufficiently clarified, ly already oversubscribed and, if the workingDr. WICKREMESINGHE withdrew his motion for capital fund were to be increased-even with aclosure of the debate. slight reduction in the United States share-he did not know where the additional money would Dr. KLosI (Albania)considered$4,000,000 come from. excessively high :it would mean that countries would have to pay this year a higher contribu- The SECRETARY believed it necessary to correcttion ;that would affect their national budgets, the impression given by the delegate of Francewhich had already been voted ;further, some in regard to the proportion between workingcountries would have to pay in foreign currency, capital fund and budget of the United Nationswhich made matters still more difficult. The and other specialized agencies.The figures indelegation of Albania would therefore urge that his possession showed the following position : the working capital fund should be kept as low as possible. ILO :working capital fund $2,200,000 = 42% of the budget. Mr. LINDSAY proposed a compromise :that the working capital fund should be increased to FAO :working capital fund $1,500,000, plus$3,000,000, leaving out of account the reserve reserve fund of $1,000,000 totallingfund which the present committee had proposed $2,500,000 -- 50% of the budget. should be transferred to it, and which was very ICAO : working capital fund = 36% of thelargely mythical.The possible effect would be budget. to increase the working capital fund from its present figure to something like one half of the United Nations :$20,000,000 = 46% of thebudget which had been voted, and that would budget. seem to be in proportion to the working capital funds of other specialized agencies in relation Practically all the specialized agencies exceptto their budgets. WHO had a working capital fund of from one- third to half of their annual budgets. The CHAIRMAN asked whether the proposal of the delegate of the United Kingdom would be M. DE LAVARENE said that the figures he hadacceptable to the delegations of New Zealand quoted were those in the possession of his delega-and Pakistan. tion, but he accepted the correction of the Secre- tariat. He would add that all specialized agencies Mr. DAVIN could not accept the compromise showed a tendency to increase their workingsuggestion. The working capital fund should not - 267 - TWELFTH MEETING be more than $3,000,000 but the actual cashExecutive Board or even an emergency meeting position rather than thefinancial statementof the World Health Assembly itself. should be taken into account, i.e. the real cash surplus of approximately $500,000 should be In reply to a question by Dr.ROGERS,the taken into account which, with $2,500,000 from SECRETARYexplained that the figure of $866,463.58, current contributions, would make a total ofshown in Official Records No. 20, p. 12, as " Balance $3,000,000. transferred to Working Capital Fund in accord- ance with appropriate resolution, paragraph VI " was the book figure to which reference had been ColonelAFRIDIsaid it was difficult for him tomade.On page 17 of the same document, in accept the compromise suggestion ; the instruc- Schedule C, the same figure appeared under " Sub- tions of his Government were to propose a work-Fund III ".The Schedule showed that, of this ing capital fund of $2,500,000 based on an ac- figure, the available cash at the end of last year was cepted budget of about $6,000,000: but, since hisonly $483,103.10 and the balance of $383,360.48 Government had also given a ratio to five-twelfths,was a claim against the working capital fund, all he had raised the figure to $3,000,000. of which had been completely exhausted at the end of December. Therefore, the working capital Dr.NAZIFBey (Egypt) urged the committeefund did not have sufficient money to transfer to face facts : they had been informed that onlythe $383,000 odd to this Sub-Fund III.That was further evidence that the size of the working 16% of the 1949 contributions had been collectedcapital fund, when the reserve fund was added up to 20 June : also, that unless a working capitalto it, was a mythical figure. fund was established in an amount equal to half of the budget, the Organization would not be Mr.GOUDSMITasked what was the minimum able to meet its financial obligations.Contribu-estimate that the Secretariat thought necessary tions for 1950 had been fixed at $7,000,000. Hefor its purposes. would support the proposal of the United King- dom which would provide a fund of approximately TheSECRETARYsaw, no possibility of being half the budget total. able to give an assurance that the Organization couldmeetitsobligationswithlessthan Mr.HALSTEAD(Canada) said his delegation$4,000,000. Obviously $3,500,000 would come had understood that the decision of the workingcloser to the Secretariat's estimated requirements party on the working capital fund, which hadthan $3,000,000 but he could not guarantee that been accepted by the committee, was that thatthat would meet the requirements. fund was one : therefore, in suggesting $3,000,000, his delegation intended this to be the inclusive Mr.GOUDSMITsaid that, taking into considera- fund. To be realistic one must realize that thattion the fact that the working capital fund was a book figure, but to increase the book figureremained the property of contributing countries of the fund to over half the budget would be justand the confidence his delegation felt in the as mythical as was the reserve fund figure. Secretariat, they would support the Director- The delegation of Canada therefore could notGeneral's proposal of $4,000,000. accept the compromise suggested by the delegate of the United Kingdom and reaffirmed their In reply to a question by Mr.HALSTEAD proposal that the fund, including the amount(Canada), theSECRETARYsaid that the committee had already decided (see third report, section 4) added as a result of the decision of the Firstthat a single working capital fund should be World Health Assembly," should be $3,000,000established and thereforethe respective sug- which was slightly less than half the budget.If,gested figures of $4,000,000 and $3,500,000 were at a later date, the Organization found that thiseach intended to include the book figure of was not sufficient, a further increase could be$866,000 odd already referred to. considered. Mr.BRADY(Ireland) said that, according to TheSECRETARYreminded the committee thatthe statement contained in the second paragraph regardless of the agreed size of the working capitalof page 25 of Official Records No. 18, it seemed fund, it would be of no use unless all the govern-that the Secretariat would be satisfied with a ments paid their contributions.He read para-working fund of 50% of the budget. A Regular graph 7 of the report of the External Auditor,Budget of $7,000,000 having been adopted, it from Official Records No. 20, page 9, and repeatedwould therefore appear that a working capital that it was obvious that the Organization wouldfund of $3,500,000 would be satisfactory, and the have great financial difficulties unless the work-delegation of Ireland would support the creation ing capital fund were substantially increased.of a fund of that amount. Regarding the Canadian suggestion, no further increase could be asked for during the year, TheSECRETARYexplained that normally such except by convening a special meeting of thean amount should be adequate, but the present situation was not normal. When the Secretariat 45 Off. Rec. World Hlth Org. 13, 318, sectioh VIrecommendation had been made it had not been - 268 - COMMITTEE ON ADMINISTRATION AND FINANCE envisaged that the $866,000 odd would be con-tute$250,000 ;for US $1,000,000 substitute sidered as part of the working capifal fund. $500,000. As indicated by Mr. GOUDSMIT, the working capital fund remained the property of the con- Colonel AFRIDI (Pakistan) proposed that the tributing governments and should it subsequentlyvote be taken first on paragraph (1) (b), taking be found that the fund was higher than necessary,into consideration the contributions of Member the World Health Assembly by resolution couldStates according to whether the fund were decide to reduce its size and to credit against theestablished at $4,000,000, $3,500,000 or $3,000,000. following year's contribution the amount of the Dr. EJERCITO (Philippines)asked leave to credit of each Member Government. Each Healthmake a proposal which might enable all the Assembly would be given information whichamendments to be incorporated into one, but would enable it to determine whether the fundthe CHAIRMAN regretted that he was unable to was too large or too small and to take appropriateaccept further proposals, a motion for closure action ; any decision taken by the present com-having been adopted. mittee would not preclude this. Mr. GOUDSMIT made it clear that his delega- Sir Arcot MUDALIAR (India)said that thetion's support of the Secretariat proposal of amount suggested by the Secretariat had seemed$4,000,000 presumed that that sum included to the Executive Board perfectly reasonable.the budget balance available from 1948. It had since been suggested that it be decreased to $3,000,000.Some delegations perhaps feared After discussion on the order in which the that the fund would be used in such a mannerproposals were to be presented, the vote was that ultimately the contributions of the countriestaken by show of hands with the following would not come in.The remedy for that wouldresults : be to put moral pressure on governments to subscribe in sufficient time so that it would not The amendment that the working capital be necessary for the Secretariat to draw on the fund for the financial year 1950 be established working capital fund to more than a very limited at $3,000,000 was defeated by 22 votes to 3, extent. He stressed the point made by the Nether- with 4 abstentions. lands delegation that the amounts subscribed The amendment that the working capital remained the property of the contributing coun- fund for the financial year 1950 be established tries. at $3,500,000 was defeated by 21 votes to 5, The committee should pause to consider how with 6 abstentions. far the activities of the Secretariat would be The amendment that the working capital limited if their proposal was not accepted.The fund for the financial year 1950 be established whole of the expenditure contemplated was less at $3,000,000 plus the unappropriated balance than a single day's expenditure of some nations from 1948 was defeated by 15 votes to 10, during the recent world war and that was a with 7 abstentions. thing which the members of the medical profes- The original motion of the Director-General sion, at any rate, in considering health problems (Official Records No. 18, page 25) that the work- of a global nature, might bear in mind. ing capital fund for the financial year 1950 be established at $4,000,000 was adopted by 14 Dr. Bj ORNSSON (Norway) moved the closure votes to 5 with 13 abstentions. of the debate. The CHAIRMAN pointed out that the amount The vote on the closure of the debate wasof the additional advances to be made by members carried by a majority. to the working capital fund provided for in Before the vote on the resolution was takenclause (1) (b) of the resolution should be left the CHAIRMAN summarized the position as follows : blank. The first vote to be taken would deal with The SECRETARY, replying to a question by paragraph (1) (a)of the resolution inOfficial Dr. ROGERS, said that the amount of these Records No. 18, page 25.The proposals beforeadvances would be governed by the number of the committee were : new Members joining the Organization :such admissions would have the effect of lessening The Secretariat resolution that the workingthe contribution required from each Member capital fund be established for the financial yearState.The maximum amount of the total ad- 1950 in the amount of US $4,000,000 ; vances would be about $1,500,000. an amendment reducing it to $3,000,000 ; an amendment reducing it to $3,500,000 ; Dr. ROGERS said he was fully satisfied with this explanation. an amendment thatitbeestablishedat $3,000,000 with a proviso that it should not Decision : The resolution as a whole was then include the balances carried forward from 1948. put to the vote by show of hands and adopted by 15 votes to 2 with 12 abstentions (for text, A vote would then be taken on the proposal see fourth report, section 5). of the Australian delegation that paragraph (2) (b) be amended, as follows : for US $500,000 substi- The meeting rose at 7.5 p.m.

- 269 - THIRTEENTH MEETING

THIRTEENTH MEETING Wednesday, 29 June 1949, at 5 p.m. Chairman : Dr. L. F. THOMEN (Dominican Republic)

1.Adoption of Draft Fourth Report of thecontribution of the United States of America Connnittee at 36% of the total budget, and he moved its adoption. Decision: The committee adopted itsdraft fourth report (see p. 343). The CHAIRMAN pointed out that apart from the draft resolution dealing with the general 2.Scale of Assessments for 1950 (continuedproblem ofassessmentofcontributions,the from p. 265) working party had presented a draft resolution Agenda, 10.20dealing with the assessment of the State of Report of the Working Party Israel. Dr. AVERY (Iran), Chairman of the working Decision: The committee decided to recom- party set up to consider the scale of assessments mend to the Health Assembly the adoption for 1950, expressed his thanks to the members of the draft resolution on the method of assess- of the working party for their co-operation and ment to be applied to the State of Israel (for to the Director-General and the secretary of the text, see fifth report, section 1). committee for the lucid information which they had provided and which had been largely instru- With reference to the draft resolution pre- mental in enabling the working party to makesented by the working party on the general prob- a single recommendation (subject only to thelem of assessment of contributions, Dr. DOWNES reservation of two of its members) rather than(Australia) requested that the penultimate para- a set of three or four conflicting proposals. Thegraph of that resolution, namely " Decides that draft resolution on the general problem of assess-the unit scale of assessments be continued ; and " ment of contributions 46expressed agreementbe also included as the penultimate paragraph with the United Nations principle that it wasof the alternative draft resolution proposed by undesirable for any one Member State to contri-his delegation which amended the third and later bute more than one third to the regular expensesparagraphs of the resolution submitted by the of an international organization in any one yearmajority of the working party to read : and that the per capita contribution of any Member State should not exceed the per capita DECIDES that this principle be made effective contribution of the Member paying the highest in gradual stages as world economic conditions contribution.On that paragraph of the draft improve, based on the scale of assessments resolution there had been unanimous agreement accepted by theUnitedNationsGeneral among the eight members of the working party. Assembly ; and He felt that it was an eminently practical out- DECIDES that the scale of contributions for come to a very difficult question to establish the 1950 be the same as that for 1949 unless the United Nations scale of assessment be varied 46 This read : prior to the end of 1949 by the United Nations The Second World Health Assembly, General Assembly, in which event appropriate in considering the several questions referred to adjustments shall be made in the World Health it under resolutions adopted by the First Health Organization scale for 1950. Assembly concerning the scale of assessments for 1950 and future years, RECOGNIZES that it is in the best interests of Mr.LINDSAY (UnitedKingdom)formally WHO that no one Member State should con-supported the Australian representative's amend- tribute more than one-third to the regularment to the draft resolution on the general prob- expenses of WHO for any year, provided that the per capita contribution of any Memberlem of assessment of contributions. State shall not exceed the per capita contribution of the Member paying the highest contribution ; Mr. GOUDSMIT (Netherlands) asked whether it DECIDES that this principle be made effectivewas intended, under the last paragraph of the as world economic conditions improve, in gradualdraft resolution proposed by the working party, stages, starting in 1950 ; that if it was found that the per capita contribu- DECIDES that the unit scale of assessments betion of any Member State would exceed the per continued ; and capita contribution of the Member making the DECIDES that the scaleof assessments be based on that for 1948 and 1949 with appropriatehighest contribution, its contribution would be adjustments to establish the contribution of theaccordingly reduced, or whether the contribu- United States of America at thirty-six per centtion of the Member making the highest contribu- of the total, providing that the per capita con-tion, in the present case the United States of tribution of any Member State shall not exceed the per capita contribution of the MemberAmerica, would be pegged at the present level making the highest contribution. and not reduced as proposed. - 270 - COMMITTEE ON ADMINISTRATION AND FINANCE

The SECRETARY stated that the former pro-in deciding on a contribution of approximately cedure was intended.He suggested that thisone-third for the United States of America was might be made more clear by amendment of thean example that should be followed.In other words " providing that " in the paragraph referredwords, the French delegation supported the draft to by the Netherlands representative, to readresolution proposed by the working party. " and that ". Mr. DAVIN (New Zealand) supported the draft Mr. GOUDSMIT accepted the Secretary's sug-resolution proposed by the delegate of Australia. gestion. Implementation of the draft resolution proposed by the working party would raise a number of Dr. Pozzo (Argentina) supported the draftdifficulties ; for example, the calculation of per resolution presented by the working party ascapita contributions supposed exact knowledge amended by the Australian delegation. of the populations of the various countries. While assessment per capita might be a satisfac- The SECRETARY said no difficulty was envisaged tory criterion from the financial point of view, itin that respect. Member States whose per capita was necessary, in the field of health, to take intocontribution would approximate to or might account various demographic and economic factorsexceed the per capita contribution of the United which were irrelevant in the case of contributionsStates probably did not include any countries paid, for example, to the United Nations. for which the size of the population was not The United Nations had set up a special com-known. mittee to draw up a permanent scale of assess- ments for that organization. It would be illogical Dr.SCHEELE(UnitedStatesofAmerica) not to take the findings of that committee iutoexpressed his appreciation of the working party's account. He therefore agreed with the delegateproposal to reduce the United States' contribu- of Australia that WHO should await the resulttion to 36%. Since he had already clearly ex- of its deliberations and should then agree uponpressed his attitude with regard to the United a criterion whereby contributions could be as-States' contribution and it was set out again in the sessed each year. last paragraph of the working party's report,47 he intended to support the draft resolution proposed The DIRECTOR-GENERAL feltthere was anby the working party. impression that WHO had in the past adhered strictly to the scale of assessments in force in the Dr. BAKAcs (Hungary) did not understand the United Nations.In fact the United Statesreasons for the proposal to reduce the United contributed rather more to the United NationsStates' contribution, thereby increasing the con- tributions of other countries. He thought there budget than to the World Health Organization'shad been no economic or demographic changes budget. which could justify such a proposal. He recalled that the United States' contribution to UNICEF Dr. DOWNES pointed out that every Memberwas 42% of that agency's budget. of WHO which was also a Member of the United He could not understand why the United Nations contributed less to WHO than to theStates of America was unwilling to accept the United Nations because of its larger membership.assessment of its contribution to the Regular Budget at 39%, but stated that it was prepared M. BERTRAND (France) agreed with the delegateto make an additional contribution to the Supple- of Australia that the scale of assessments shouldmental Budget. be considered within the framework of the policy He proposed that the scale of assessments for of the United Nations as a whole. A co-ordinated1949 should remain in force for 1950. policy, however, would also result from the second paragraph of the draft resolution proposed by Dr. SCHEELE pointed out that assessments for the working party.For throughout the Unitedthe Regular Budget were part of the obligation Nations there was at present a general tendencyof membership of a permanent organization.In to stabilize the United States' contribution athis government's opinion, they should be more approximately one-third of the total contribu-equally shared than might be possible in the tions.The International Labour Organization,case of joint temporary projects which entailed for example, to which the United States' contri-none of the obligations of membership. bution had previously beenless than 30%, had recently increased it to approximately that This read figure. The member of the working party from the The example was not taken at random.United States of America views with great satis- The Australian representative had proposed thatfaction the inclusion in the report of the working the principle that no one Member State shouldparty of a provision for some reduction of the contribute more than one-third to the regularpercentage contributionof the USA in1950. liowever, inasmuch as a percentage contribution expenses of WHO for any one year should beof thirty-six per cent when applied to a budget of made effective in gradual stages as world eco-$7,000,000 would carry the contribution of the nomic conditions improved. No agency was in aUSA above the amount at present authorized, the member of the working party from the United better position than ILO to appreciate prevail-States of America must reserve the position of ing economic conditions. The action it had takenhis Government. - 271 - THIRTEENTH MEETING

Dr. MARTINEZ (Chile) stated that his Govern- The Second World Health Assembly ment would take steps in the General Assembly RESOLVES that the State of South Korea of the United Nations to have the present very shall make an advance to the working capital high assessment of Chile reduced. He therefore fund and contribute fo the budgets for 1949 supported the proposal of the delegate of Australia. and 1950 of the World Health Organization at a rate to be fixed by the Third World Health Mr. BRADY (Ireland), Dr. OLCAR (Turkey) and Assembly ; and further Dr. NAZIF Bey (Egypt) supported the draft resolu- tion proposed by the working party, Dr. Nazif RESOLVES that an interim assessment for Bey, observing that the actual contribution made South Korea shall be made of five units, to be by the United States Government to the cause replaced by the definitive assessment, when of world health left no room for doubt as to the established. sincerity of its feelings on the question. Dr.KLOSI(Albania),and Dr. STOYANOFF Dr. TOGBA (Liberia) also supported the draft(Bulgaria), felt that no action should be taken resolution proposed by the working party.Hepending the Assembly's decision on the admission felt the question had been sufficiently consideredof South Korea to the Organization. and moved closure of the debate. The CHAIRMAN pointed out that there would be no further meeting of the committee after There being no speakers against closure, thethe consideration of the admission of South CHAIRMAN declared the debate closed. Korea in plenary session, and on the proposal of The proposal of the delegate of Hungary thatMr. LINDSAY, seconded by Dr. MARTINEZ, declared the scale of assessments for 1949 should remainthe debate closed. in force for 1950 was put to the vote and rejected Decision: The draft resolution submitted by by 29 votes to 5, with 2 abstentions. the Secretariat was put to the vote and adopted The draft resolution presented by the working by 33 votes to 5 with 1 abstention (see fifth party as amended by the Australian representa- report, section 1). tive, was put to the vote and rejected by 19 votes to 15, with 8 abstentions. Assessment of Associate Members Decision: The draft resolution presented by Mr. LINDSAY drew attention to the note pre- the working party was put to the vote andsented by his delegation on the financial obliga- adopted by 20 votes to 7 with 11 abstentions,tions of Associate Members.He recalled that subject to the amendment of the words " pro-the First World Health Assembly 48 had resolved vided that " in the last paragraph to readthat Associate Members should be subject to the " and that ", as agreed during the discussionsame obligations as Members except that the (for text, see fifth report, section 1). difference in their status would be taken into account in determining the amount of their contributions to the budget of the Organization. The CHAIRMAN expressed his gratitude and that His Majesty's Government believed that the of the committee to the working party for theassessment of Associate Members should be 60% contribution it had made to their work. of what it would have been, if they had been full Members, except that the minimum rate of Assessment of South Korea in the Event of its beingassessment should be three units.He regretted admitted to Membership by the World Healththat it was impossible for reasons of time for the Assembly question to be fully examined at the Second World Health Assembly. He therefore proposed The SECRETARY said that the draft resolutionthat the Executive Board be authorized to deter- submitted by the Secretariat for the committee's mine a scale of assessment for Associate Members, consideration was almost identical with thatsubject to confirmation by the Third World adopted in the case of Israel, except that forHealth Assembly. South Korea the assessment clearly could not be based on a contribution paid to the United Decision: The committee adopted the proposal Nations. of the delegate of the United Kingdom (for textofresolution,seefifthreport,last The draft resolution read as follows : resolution). Whereas Financial Regulation No. 18 pro- vides that " Members shall be required to 3.Proposal of the United Kingdom Delegation make a contribution for the year in which their to refer the Question of Administrative membership becomes effective, and an advance Costs to the Executive Board to the working capital fund, at rates to be Mr. LINDSAY suggested that it was fair neither determined by the Health Assembly " ;andto the Secretariat nor to those delegates who had Whereas the First World Health Assemblyreferred,in the course of the Second World did not include a determination for the StateHealth Assembly, to the high costs of administra- of South Korea in establishing the unit scale of assessments for 1948 and 1949 ; 48 Oft. Rec. World Filth Org. 13, 337 - 272 - COMMITTEE ON ADMINISTRATION AND FINANCE tion and the size and salaries of the Secretariat, number of staff, the scales of salaries and to leave the matter there. administrative costs generally, and to do their He recalled that when the delegate of Norway best to ensure that these costs are kept to the had, at the tenth meeting, proposed the adoption minimum, consistent with efficiency. of the costs estimates supplied by the Secretariat, he, Mr. Lindsay, had suggested, and the Norwegian Mr. BRADY supported the proposal presented representative had agreed, that the committeeby the delegate of the United Kingdom. was not thereby debarred from further considera- tion of questions of staffing, salaries and adminis- Sir Arcot MUDALIAR (India) suggested that trative expenses generally. the United Kingdom proposal could be considered He therefore proposed that the committeemore properly and profitably at the following recommend to the Health Assembly the adoptionjoint meeting with the Committee on Programme of the following draft resolution : in conjunction with the report of the working party on the 1950 Programme and Budget The Second World Health Assembly estimates. DESIREStheExecutive Board andthe Director-General to take note of the views Mr. LINDSAY accepted that suggestion. expressed at the Second World Health Assem- bly by a number of Members in regard to the The meeting rose at 6.50 p.m.

FOURTEENTH MEETING Thursday, 30 June 1949, at 9.30 p.m. Chairman: Dr. L. F. THOMEN (Dominican Republic)

1.Adoption of the Draft Fifth Report of thestances the Executive Board met only twice a Committee year and that if the Australian amendment were adopted, the matter would have to be handled Decision: The draft fifth report of the com-by correspondence-a long and more costly mittee was approved (see p. 345). procedure. 2.Adoption of the Draft Sixth Report of the Dr. ROGERS (United States of America) sup- Committee :AppropriationResolution ported the Australian amendment subject to the Dr. DOWNES (Australia) made two suggestionsdeletion of the words " with respect to Part II " in with regard to paragraph II of the draft appro-the final clause, as he considered that the Director- priation resolution which read.: General should be authorized, with the concur- rence of the Executive Board, to transfer credits The Director-Generalisauthorized, withbetween sections and chapters of the whole budget. respect to Part II of the budget, to transfer If the original wording of paragraph II were credits between chapters and, with the con-maintained, it would give the Director-General currence of the Executive Board, or of anycomplete control over the operating budget.It committee to which it may delegate authority,seemed normal to have some additional control to transfer credits between sections. by the Executive Board before transfers were made. Moreover a similar procedure was followed His proposed amendments were to delete thein the United Nationsand other specialized phrase " with respect to Part II of the budget " agencies. and to add at the end of the paragraph, the words " and chapters with respect to Part II of the Dr. DOWNES, after accepting the United States budget ". amendment, thought the objections raised by the Secretary as to the difficulty of negotiations Mr. SIEGEL, Secretary, said the effect of thebetween the Director-General and the Executive Australian amendment would be to make itBoard, when the latter was not in session, were impossible for the Director-General to transferinvalid, since all that was required was eighteen credits between chapters of Part II without thereply-paid telegrams. authority of the Executive Board.In effect, under the terms of paragraph III, the Director- The SECRETARY questioned the statement by General was required to report to the subsequentthe United States delegate that the adoption of session of the Executive Board all transfers madeparagraph II as it stood would give the Director- under the authority of paragraph IL The com-General complete control over the operating mittee should realize that in normal circum- budget.That paragraph stated expressly that - 273 - FOURTEENTH MEETING the Director-General needed the concurrence of Dr. GEAR (Union of South Africa) proposed the Executive Board or of any committee tothat in the footnote to the Appropriation Resolu- which it might delegate authority, for the transfertion the words " provides for a " should be sub- of credits between sections. stituted for the words " leaves a net ". M. DE LAVARENE (France) proposed the Com- Decision: The appropriation resolution as a promise solution of authorizing the Director- whole with the Egyptian amendment and that General to make transfers between the articles proposed by the delegate of the Union of South of the same chapter without the authority of the Africa was adopted (for text, see sixth report, Executive Board. p. 346).

The DIRECTOR-GENERAL said the procedureAddition of a new paragraph to the Appropriation suggested by the Australian delegate would be Resolution possible but only at the expense of additional complications and work for the Secretariat.If Mr. HALSTEAD (Canada) proposed the follow- the Secretariat merely sent telegrams to eaching additional paragraph VI to the Appropriation member of the Executive Board, it would beResolution : impossible to explain all the circumstances which might justify the transfer of credits. The Execu- In approving the expenditure of the above- tive Board would therefore either have to rubber mentioned amounts in the Regular Administra- stamp the proposals or indicate that it had no tive and Operating Programme Budget for the confidence in the proposed transfer. On the other official year 1950, the Health Assembly empha- hand, if every circumstance were explained in sizes that it in no way commits the third or writing to each member of the Executive Board, subsequent World Health Assemblies to any considerable delay and expense would ensue. particular levels of expenditure. Many statements had been made at the present Assembly as to the necessity of keeping down Such an addition contained an unexceptionable administrative expenses. Throughout the session,principle and would leave subsequent Health however, instructions had been given to theAssemblies full discretion in the drawing up of Secretariat which entailed additional expensetheir budgets. and work.The proposal now before the com- mittee was a case in point. The DIRECTOR-GENERAL said the insertion of He would stress that the Constitution of thethe proposed new paragraph in the appropriation World Health Organization provided that theresolution was a drastic procedure which, as far Director-General was the chief technical andas he knew, had no precedent in any other inter- administrative officer of the Organization. How-national organization. Moreover the question ever, there seemed to be a tendency to surroundraised was so important that it would be better both him and the Secretariat with controls andnot to discuss it at the present late state, but to red tape of which this particular proposal wasdefer it till the next Assembly. an example. It seemed that the Canadian proposal was The fact was that the Executive Board wouldinspired by the fact that the First World Health find it quite impossible, without actually meet-Assembly had adopted a programme larger than ing,to judge whether certain transfers werethe budget. Such a situation could not be expected necessary in the budget. The Australian amend-to recur. ment would consequently serve merely to com- The committee should also realize that the plicate the work of the Secretariat and to instituteproposal, with its implication that there was no a control by the Executive Board, which in prac-continuity in the policy of the World Health tice might be ineffective. Organization, would have a very adverse psycho- logical effect on the staff of the Secretariat. M. DE LAVARENE said he had made his pro- posal in an effort to find a compromise, but in view of the remarks of the Director-General, he Sir Arcot MUDALIAR (India) thought the Cana- would withdraw it. dian proposal went further than limiting the financial responsibility of the Third World Health Dr. NAZIF Bey (Egypt) thought there wereAssembly.It meant in fact that it would be certain circumstances in which the Director-impossible for WHO to lay down any stable pro- General should be authorized to transfer creditsgramme or policy for the future, or inspire its between chapters without the concurrence ofSecretariat to implement such a policy. The the Executive Board. He therefore proposed thecommittee should realize that WHO was an insertion of the words " in urgent circumstances "international organization and not a national after the word " budget " in the second line ofadministration representing different parties and the original paragraph H. changing policies.However, even such a body as the latter would never consider any break in On being put to the vote, the Australianthe continuity of general policy without carefully amendment was rejected by 17 votes to 15, withconsidering the consequences. 2 abstentions. He would, therefore, suggest that the Secretariat The Egyptian amendment was adopted byand the Executive Board should be instructed to 26 votes to 3, with 7 abstentions. consider the problem in all its aspects and make - 274 - COMMITTEE ON ADMINISTRATION AND FINANCE

proposals to the Third World Health Assembly.it would be unfortunate if, on being put to the If the Canadian proposal were hastily adopted atvote, the Canadian proposal were rejected 'merely this late stage it would only hamper the Secre-because it seemed out of place in the appropria- tariat's work in preparing for the Third Healthtion resolution. Such a step might be interpreted Assembly. as a repudiation by the committee of a principle with which it agreed. He would therefore request Mr. HALSTEAD regretted that the Director-the Canadian delegate to withdraw his proposal. General and the Indian delegate had ascribed to him a hidden intention of limiting the field of Mr. HALSTEAD respecting the arguments of the action of future assemblies. He could only repeatDirector-General and agreeing with the point of that the principle contained in his proposal wasview expressed by the New Zealand delegate, unexceptionable and should therefore be readilysaid he would withdraw his proposal as an amend- ment to the appropriation resolution but would acceptable by the committee. request it to be put to the vote as a separate The DIRECTOR-GENERAL, while making it clearresolution. that he had by no means sought to attribute The SECRETARY said in that case he would ulterior motives to the Canadian delegate, stressedsuggest the following rewording to the begin- that his proposal would be quite out of place inningofthe resolution :" In approving the the appropriationresolution now before theappropriation resolution for the Regular Adminis- committee. trative and Operating Programme Budget ".

Dr.SCHEELE(UnitedStatesofAmerica) Mr. HALSTEAD agreed to the above amend- thought the objections against the insertion ofment. the Canadian proposalintheappropriation Decision: On being put to the vote as a separate resolution were unconvincing and saw no reason resolution, the Canadian proposal was adopted why it should be out of place. by 28 votes to 2, with 4 abstentions (for text, see sixth report, p. 346). Mr. DAVIN (New Zealand) while agreeing with the principle of the Canadian proposal, thought The meeting rose at 11.15 a.m.

- 275 - FIRST MEETING

JOINT MEETINGS OF THE COMMITTEES ON PROGRAMME AND ADMINISTRATION AND FINANCE

FIRST MEETING Monday, 27 June 1949, at 9.50 a.m. Chairman: Dr. H. HYDE (United States of America)

1.Programme and Budget for 1950 United States of America, had considered the granting of an enlarged programme of technical Agenda, 8.23, 10.19 assistance to governments. The information The DIRECTOR-GENERAL said the present jointconcerning the discussions, and the resolutions meeting was an experiment in order to avoid theadopted, was contained in document A2/82 Rev. 1 difficulties which had arisen in the consideration(Annex 22). The programme of assistance, which of the budget at the First World Health Assembly.would be under the general supervision of the That Assembly had approved a programme,Economic and SocialCouncil,contained the costedat$7,500,000,and had subsequentlySupplemental Budget of WHO.That budget approved for this programme a budget whichwould be financed by direct and voluntary con- amounted only to $5,000,000. Hence, in order totributions from governments to WHO. He remain within the budget it had been necessarystressed, therefore, that when any item was placed to postpone certain programmes till later in theon the Supplemental Budget it did not mean year and the consequent difficulties had beenthat it was rejected, but that it would be covered considerable. The present joint meeting wasby the extensive resources available under the therefore an attempt to resolve the problem byprogramme recommended by the Economic and providing the Assembly with one answer to its Social Council. budgetary problems instead of two incompatible The full title of that programme was Technical answers as had been the case before. Assistance for Economic Development and it The background to the budget should first bewas important that the matters to be covered thoroughly understood. The programme andby the Supplemental Budget should come under budget had been prepared by the Secretariatthat heading. However, it was assumed that any with the assistance of expert committees, regionalmeasure designed to improve the health of the offices, requests from governments and advicepeoples of the world could be considered as part from experts, and were then submitted for theof a programme for economic development. consideration of the Executive Board. The The relation of WHO to that programme would Executive Board examinedtheSecretariat'sdepend on the decisions to be taken at the forth- proposals and made recommendations concern-coming ninth session of the Economic and Social ing them to the Assembly. Those recommenda-Council as regards co-ordination between the tions were contained in OfiEcial Records No. 18. United Nations and the specialized agencies. He The total budget figure was $17,450,530 andwould therefore suggest that the Executive Board would cover a programme which the Executivebe given the authority to deal with the matter, Board had considered both desirable and possible. taking into consideration the decisions made by However, as the Board had recognized that itthe Council.One of the most important recom- was unlikely that that figure could be met bymendations it would have to make would con- government contributions, it had recommendedcern the use of local currency in programmes. that the budget be divided into two parts, oneThe degree to which local currency could be paid forfromthe regularcontributionsof accepted affected considerably theabilityof Members aud the other paid for by voluntarycountries to contribute tothe Supplemental contributions from governments and implementedBudget.If such authority were not delegated accordingly. to the Executive Board, a special meeting of the The Committee on Programme had examinedAssembly would have to be convened-a difficult the programme for 1950 in some detail and hadand costly proceeding. recommended slight additions to it :$16,000 to It was essential, therefore, that the Assembly, the Regular Budget and $500,000 to the Supple-if it could not approve the total budget, should mental Budget. reach a decision as to the regular budget at the Earlier in the present year a meeting of thepresent session.That budget might bear no Economic and Social Counci1,1 as a result ofrelation to the programme for 1950, but whatever representations from the Government of themight be left over would be placed in the Supple- mental Budget and arranged for in a different 1 4 March 1949 manner, according to the recommendations of - 276 - J OINT MEETINGS the Economic and Social Council with regardAssembly at its third regular session (reproduced to the technical assistance to be given to govern-in the United Nations volume entitled " Technical ments. Assistance for Economic Development ") which read as follows : The CHAIRMAN thought the committees should first discuss the question of the Regular Budget. Thetechnicalassistancefurnishedshall The figure of $7,893,000 had now, with the addi- (i) not be a means of foreign economic and tions approved by the Committee on Programme, political interference in the internal affairs of become approximately $8,000,000.At its tenth the country concerned and shall not be ac- meeting, the Committee on Administration and companied by any considerations of a political Finance had recommended the setting-up of a nature ;(ii)be given only to or through working group by the joint meeting to examine governments ;(iii) be designed to meet tne the matter, but as the question concerned all needs of the country concerned ;(iv) be pro- governmentsitmightbetterbediscussed vided, as far as possible, in the form which immediately in the present meeting. that country desires ;(v) be of high quality and technical competence. Dr. GEAR (Union of South Africa) said the Committee on Administration and Finance had There was a further safeguard on page 40 of recommended that the Executive Board shouldthe same volume a which read as follows : reconsider the whole matter of the procedure for examining the budget (third report of Committee Each organization would make agreements on Administration and Finance, section 7).The with its member Governments as to the cur- Assembly should endorse that recommendation. rencies in which their contributions toits He was in full agreement with the Director- special budget would be made, and as to any General's suggestion that the committees should conditions to be attached to them. immediately deal with the Regular Budget. Gifts and bequests to the Organization were The CHAIRMAN opened discussion on the pro-further subject to the provisions of Article 57 of posal that the Regular Budget for 1950 shouldthe Constitution of WHO. be $8,000,000. The third safeguard was contained in the deliberations of the Administrative Committee Dr. BABECKI (Poland) said that contributions on Co-ordination and its working parties, which to the Supplemental Budget would presumablyhad considered the technicalassistancepro- be dependent on the goodwill of the countriesgramme and stated that no conditions would apply making them and might be subject to conditionsto the voluntary contributions. The administra- which would influence the work of the Executivetion of the total sum for the use of WHO would Board or the Director-General.Therefore thebe in the hands of the Organization. Polish Government was opposed in principle to the double budget. If two separate budgets were voted, the resolution should provide that the Dr. BABECKI was satisfied with the Director- States offering additional funds should not pre-General's statement but wished it to be included sent conditions and that the Director-Generalin the resolution on the Supplemental Budget. and the Executive Board should be free to ad- minister those funds in the way they considered The CHAIRMAN asked the delegate of Poland, appropriate. in conjunction with the Secretariat, to prepare a With regard to the ceiling of the budget, manyresolution for submission to the joint meeting of Members had had difficulty in paying the 1949the Committees on Programme and Administra- contributions in hard currency.The raising oftion and Finance. contributions for the larger budget proposed Referring to the second point raised by the for 1950 would entail proportionately increaseddelegate of Poland, he recalled that the Com- difficulties and might cause delay in the paymentmittee on Administration and Finance had in of contributions. its third report already accepted the ceiling on the Countries that had suffered from the war werebasis of the costing prepared by the Secretariat, making heroic efforts towards their own recovery,although there might, however, be an opportunity and WHO also should make efforts to reduceof reconsidering the costing of the Regular Budget. unnecessary expenditure. He thought that 15% of the budget could be saved by reducing ad- ministrative expenses, the number and salaries Dr. STAMPAR (Yugoslavia) expressed satisfac- of staff, and perhaps by reducing the number oftion with the statement of the Director-General. the expert committees. Only $4,000,000 of the 1948 contributions had yet been collected. The External Auditor had given The DIRECTOR-GENERAL said three safeguards a warning that the financial situation of the governed voluntary contributions to the Supple- Organization was unsound ;although WHO was mental Budget. The first was contained in Resolu-yet young and financial conditions should improve, tion 200(III) (d) 2adopted by the Generalthe warning could not be ignored. The budget

2 UN doc. E/1327, Add. 1, p. 18 UN doc. E/1327 Add. 1, p. 40, section B(2) - 277 - FIRST MEETING of $8,000,000 represented an increase of 100%should instead be a reasonable increase over that over the amount collected for 1948. passed by the First Health Assembly. On behalf of his Government, he expressed With regard to the proposed Regular Budget gratitude for the help received from WHO, whichof $8,000,000, he asked the Secretariat to furnish had contributed greatly to the improvement ofan estimate of the revenue for 1950. The com- public-health administration in his country. Hismittees could then consider the way of meeting Government was willing to help the Organizationthe deficit between the expected revenue and the by paying its contribution on time-even anbudget of $8,000,000. increased contribution. He would make a pre- He was au-thorized to inform the committees cise statement on the amount of that at a laterthat Ceylon had made a .50% increase in the stage. national budget allocation for use in the Supple- Yugoslavia was satisfied with the safeguardsmental Programme.If a further increase on an governing the Supplemental Budget. equitable and reasonable basis were suggested, the Yugoslavia was willing to contribute $40,000 toGovernment would support itin Parliament. the Supplemental Budget, of which $10,000 wouldHe expressed his country's wholehearted support be in hard currency and the remainder in localfor increase in the Regular Budget. currency. Those statements showed thathis country was willing to support the aims of the The CHAIRMAN referred the delegate of Ceylon Organization, in the hope that some of theto Article 56 of the Constitution. The size of the mistakes committed in the past would be remediedbudget was determined by the Health Assembly in the future.It was difficult to discuss theand therefore by the governments themselves. ceiling of the budget without knowing how muchHe questioned the value of an estimate of revenue governments were willing to subscribe. He ap-at the present stage, since that revenue would pealed to those Members who had made reserva-depend on the commitments entered into by tions regarding their financial contributions togovernments as a result of their decision on the withdraw the reservations.Yugoslavia was will-budget for1950. The Organization's income ing to support WHO, in spite of the shortage ofcame from the contributions by governments hard currency, as his Government consideredaccording to the scale adopted by the Health co-operation in international health to be anAssembly, except for about $500,000 derived important contribution to peace. from UNRRA and other sources. Mr. DAWN (New Zealand) said his Government considered a Regular Budget of $8,000,000 too Dr. DOWNES (Australia) recalled two contri- great an increase over the budget for the currentbutory causes of the unsatisfactory state of the year. The tendency of international organiza- financesoftheOrganizationmentioned by tions to raise their budgets annually had theseveral delegates. The first was the unsettled combined effect of absorbing an increasing pro-state of China, whose contribution amounted to portion of national revenue ;small countries5.8% of the total budget of the Organization ; wishing to meet their international obligationsthe second was the fact that no contributions promptly and who wished to play a part in inter-had been received in 1948 and 1949 from the national affairs were particularly affected. Thethree Eastern countries whose combined con- necessity of paying contributions in hard currencytribution amounted to 7.16% of the Organiza- was a further reason for restricting the level oftion's budget. Only six countries made a greater expenditure.His Government appreciated thecontribution to WHO than Australia, in spite of value of WHO and regretted that its work wasitssmall population.His country hadalso difficulty in finding sufficient hard currency and hampered by financialdifficulties.The New Zealand Government had been prepared for aunless the special unilateral variation from the budget of $6,000,000 and his delegation had beenUnitedNationsscaleofcontributionswere instructed to support all reasonable proposals toremoved by one great nation, it was the opinion reduce the Regular Budget and to restrict theof his Government that the budget should remain programme to practical projects of high priority.at the same level as in 1949. If restrictions of that nature were not sufficient to reduce the budget to $6,000,000, it could be The CHAIRMAN saidthatthedelegateof done by the transfer of some operational ap-Australia had amended the original proposal for propriations from the Regular to the Supplementala budget of $8,000,000 and had proposed instead Budget. a budget of $5,000,000.

In answer to a question by the CHAIRMAN, Sir Arcot MUDALIAR (India)said that his Mr. Davin agreed that his statement be consideredGovernment, having considered the programme as a formal prbposal to confine the budget forand budget as set out in Official Records No. 18, 1950 to $6,000,000. was prepared to pay its share of the contribution to the Regular Budget proposed in that volume. Dr. WICKREMESINGHE (Ceylon) did not agree The small increase made as a result of the delibera- with the proposal to reduce the budget. Theretions in the Programme Committee did not alter - 278 - JOINT MEETINGS that position.His Government was prepared tothe Regular Budget of $8,000,000 was acceptable. take this action as they were convinced that noSympathetic consideration would be given to tangible results could be achieved on the basisproposals for a Supplemental Budget. of an inadequate budget of $5,000,000. He was of the opinion that the Regular Budget should be The CHAIRMAN, in summing up the discussion, supported without a reduction, as the programmerecalledthatthere was an initialproposal, of the Organization benefited the world as a whole emanating from the Director-General and modified and all countries would stand to gain from anby the Committee on Programme, for a Regular extension of its work. Budget of $8,000,000 ;there had then been a His Government viewed with sympathy theproposal from the delegate of New Zealand for a proposals for a Supplemental Budget and wouldRegular Budget of $6,000,000 ;and thirdly an be prepared to make some contribution to it,amendment from the delegate of Australia for a although a statement on the precise amount ofRegular Budget of $5,000,000. that contribution could only be made at a later stage. 2.Announcement by the Director-General Dr. THOMEN (Dominican Republic) expressed The DIRECTOR-GENERAL said that the General satisfaction with the work of the Organization.Committee, having considered representations He was not in a position to make any definitefrom the delegate of Iran on its decision taken statement on the amount his Government wouldon 24 June to publish in the Journal the names contribute to the 1950 budget since the finalof delegates present at the Committee on Admini- amount would have to be voted in Parliament,stration and Finance when there was no quorum, but the Government had promised to study anyhad decided that delegations present at working proposals submitted by the World Health Organ-parties should be included on the list in the ization with the sympathy always given toJournal as being present. internationalorganizations with humanitarian interests.Subject to the decision of Parliament, The meeting rose at 12 noon.

SiCOND MEETING Monday, 27 June 1949, at 3.30 p.m. Chairman: Dr. L. F. THOMEN (Dominican Republic)

1.Programme and Budget for 1950 (continu-participate wholeheartedly in matters requiring ation) co-operation between countries.El Salvador's Agenda, 8.23, 10.19contributionstointernationalorganizations formed a high proportion of the national budget. Colonel AFRIDI (Pakistan) said that his Govern- He was unable to express an opinion on the ment greatly appreciated the assistance receivedproposed increase in the Regular Budget as the from WHO and had paid the full ,contributionrelevant documentation had not been available in 1948 and 1949;It felt the budgetary increaseto his Government before the departure of his to be essential, but was disturbed by the size ofdelegation. the increase. His delegation was willing to study the implications of the Supplemental Budget and his Government would contribute to it to The DIRECTOR-GENERAL stated that the docu- the best of its ability. mentation had been despatched to Member Governments six weeks in advance and pointed Dr. Pozzo (Argentina) stated that the proposedout that cases had occurred of documents arriv- budgetary increases were chiefly on personneling but not reaching the persons for whom they account, which was perfectly normal.However, were intended. they required close examination.The absence of China and the Soviet Union meant that WHO Dr. DE PAULA SOUZA (Brazil) considered the could not rely on their contributions.A 12% Regular Budget to be satisfactory from a technical increase would, therefore, have to be borne bypoint of view. His Government had already sub- the remaining Members, the majority of whommitted proposalstoCongress concerningits were experiencing currency difficulties owing tocontribution for 1950 equivalent to the contribu- a shortage of dollars. He therefore proposed thattion for 1949.Adequate steps would be taken the Regular Budget should not be increasedto inform his Government of the proposals to until world economic conditions were such as toincrease the contribution to the Regular Budget enable governments to bear the additional cost.and he assured the committees that his delega- tion would do its best to obtain approval of the Dr. ALLWOOD-PAREDES (El Salvador) said thattotal. He was not authorized to make any state- although his country was a small one, its firmment concerning the Supplemental Budget but policy was to fulfil international obligations andundertook to stress its value to his Government. - 279 - SECOND MEETING

Mr. LINDSAY (United Kingdom) said that hisRegular Budget at the current operating level Government was convinced that some increaseof $5,000,000. He also urged that action be taken in the Regular Budget was necessary, but feltto reduce the percentage of the budget assessment that an increase to $8,000,000 was too high. Heof the United States of America. The Executive therefore supported the New Zealand proposalBoard had recognized the advisability of such a for an increase to $6,000,000, but his delegationreduction, which would certainly assist in persuad- had been briefed with some latitude and woulding Congress to lift the ceiling on the maximum consider arguments put forward in the debate.United States contribution in the future.He It was necessary to consider not only worldrecalled the argument put forward by the United health needs but also the position of small andStates delegate at the First World Health Assem- war-devastated countries and those experiencingbly to the effect that no nation should pay over exchange difficulties who could not support a25% of the entire budget.' Moreover, his country budget involving contributions which they wouldhad already borne a very large percentage of the be unable to meet. A large increase over 1949cost of post-war rehabilitation programmes and would also be undesirable since it might give theat the present moment it was proposed to render United States Congress the impression that thesupplementary aid to public-health programmes Organization was being somewhat over-ambitious. both through international organizations and He would be interested to learn whether heby direct assistance.The principle of capacity was right in assuming that the withdrawal of ato pay should be balanced with the principle of Member from the Organization would necessitatethe sovereign equality of all Member States.In a revision of the scale of assessments, but thatconclusion, he seconded the proposal of the failure to pay by a State remaining a Memberdelegate of Australia that the Regular Budget meant less money for the Organization but nobe maintained at $5,000,000 for 1950. additional charge on the remaining Members. He agreed with the delegate of Ceylon that distinction should be drawn between budget and The DIRECTOR-GENERAL recalled that a pro- income. That was a question which would havegramme had been approved at the First Health to be raised when they were considering theAssembly which, if put into operation at the budget in relation to the programme. beginning of 1949, would have cost $7,000,000. The programme had then been adjusted to a In connexion with the enquiry from the delegatebudget of $5,000,000 but it had been accepted of the United Kingdom, the DIRECTOR-GENERALthat at the end of 1949 the Organization would drew attention to Regulation 14 of the Financialbe operating at a level of about $7,000,000. For Regulations : that reason many projects such as the develop- ment of regional offices, fellowships, etc., had The appropriations, subject to the adjust-been postponed until later in the year. ments to be effected in accordance with the provisions of Regulation 16, shall be financed Dr. MARTINEZ (Chile) said that the Chilean by contributionsfrom Members accordingcontribution was smaller than that of other to the scale of assessments determined bycountries of the same size and his Government the Health Assembly. Pending the receipt ofwould pay in full.He would, however, require such contributions, the appropriations may besome additional information from the Secretariat financed from the working capital fund. so that the necessary steps could be taken in order to secure Parliamentary approval. He had Dr. SCHEELE (United States of America) statedto state with regret that if the Chilean contribu- that his country would continue to support thetion were increased his Government would have aims and programme of WHO. He welcomedto withdraw from WHO.He supported the the wide range of activities undertaken andproposal of the delegate of Australia that the agreed with the delegate of India that the budgetbudget should be maintained at $5,000,000. was too small in terms of real world health needs. However, the programme would have to be matched with resources and it could not be Dr. AL-WAnsI (Iraq) said that his Govern- ignored that some Members had not paid theirment, though fully aware of the heavy responsi- contributions in full in the past and might notbilitiesof the Organization, could not accept do so in the future.His Government could notany increase in its contribution owing to its own at the moment commit itself to a contributiondifficult economic situation. to the 1950 Regular Budget in excess of $1,920,000 since no change had been authorized by Congress. Dr. SIGURJONSSON(Iceland)saidthathis However, it was hoped that a substantial sumcountry was heavily assessed on a per capita might be forthcoming for technical assistance inbasis. He had no instructions to oppose an increase supplementary programmes.It was essential toin the Regular Budget but had to state his Govern- avoid the position that had arisen in 1948 whenment regretted not being able to promise any a regular programme had been voted the costcontribution to the Supplemental Budget. of which was higher than the actual income from government contributions.He therefore urged the committeestoconsider maintaining the Oft. Rec. World Huh Org. 13, 101 - 280 - JOINT MEETINGS

Dr. BJØRNSSON (Norway) said that he was The CHAIRMAN said that the scale of assessments authorized to vote for a budget of approximatelywould be considered at forthcoming meetings $8,000,000, in spite of the difficulties experiencedof the Committee on Administration and Finance in meeting commitments in dollars. His country(see eleventh and thirteenth meetings). fully recognized that WHO would be operating on a basis of a $7,000,000 budget by the end of Dr. CLAVEAUX (Uruguay), observing that the the year. It would be unfortunate if the Organiza-present occasion was the first on which a repre- tion were unable to carry out its work owingsentative of Uruguay had spoken in the World to lack of funds. WHO should reduce administra-Health Assembly, supported a budget for 1950 tive expenses rather than restrict the scope ofamounting to $8,000,000, which sum he thought its programmes.He was unable to make anywould be needed if the programme planned were commitment with regard to the Supplementalto be carried out in full.All recognized the Budget. importance of the work that the Organization could do in the field of world health, but the diffi- Dr. DUJARRIC DE LA RIVIÈRE (France) statedculties of obtaining the necessary funds could not that, from a strictly technical point of view, hisbe denied. In view of WHO's expanding activity country entirely approved of the proposed pro-and increasing need for funds, the budget for 1950 gramme, but keen as was the desire of France toshould be considered in the light of the Organi- promote the work of the Organization, it wouldzation's future aims. be compelled to restrict its financial commitment. If the Organization was compelled from lack He could not give defmite figures at the presentof funds to curtail its activities-which were not stage but he doubted whether the maximumonly of an advisory but also of a more direct contribution which his country would be ablenature-it would forfeit the interest of govern- to pay could be reconciled with a budget ofments. Similarly, a reduction in the funds $8,000,000.However, he felt that if the budgetgovernments placed at its disposal would neces- were to be maintained at the 1949 level thesarily result in a decrease in the services they activity of the Organization would be restricted.would receive. It had now passed the organizational stage and Those representatives who had expressed serious needed to proceed to effective action. The meansreservations had doubtless had good reasons for would have to be found of ensuring that thedoing so.He suggested, however, that if there programmes went forward on the basis of budget-was a real desire for the work of the Organiza- ary provisions which Member Governments wouldtion to develop, the means could be found, as be able to finance.Any reduction found to beindeed they must. necessary should be applied to administrative expenses rather than to the programme. Dr. NAZIF Bey (Egypt) considered that cogent reasons could be produced not only in support M. STEINVORTH (Costa Rica) felt that the budgetof a proposal that the budget for 1950 should be presented by the Director-General was not onlyfixed at $8,000,000, or even below that figure, but acceptable, but modest, if compared with thealso in support of a proposal that it be increased sums allocated by governments formilitaryabove $8,000,000.It should be borne in mind purposes.The Costa Rican Government hoped,that WHO, which had begun activities only the however, that the Director-General would makeprevious year, should be given the means whereby every effort to achieve substantial economies andit could develop steadily. The Health Assembly would take into account the very limited financialhad had the opportunity of reviewing with resources of the smaller countries. He thereforesatisfaction the humanitarian work done by the supported those representatives who urged aOrganization in the past year, but the Director- more realistic budget. General had told the committees that that pro- gramme had been based on a budget expenditure Dr. BAKÁCS (Hungary) pointed out that therunning, at the end of the year, at $7,000,000 proposal of the delegate of the United States ofannually. Any decrease in that level of expendi- America, that the contribution of that countryture would place the Organization's achievements to the budget be reduced below the 39% recom-in a very different light. His Government, there- mended by the working party set up at the Firstfore, supported a Regular Budget for 1950 of Health Assembly, would result in a larger con-$8,000,000 and would, at the proper time, con- tribution being required from the smaller coun-sider the question of a contribution to the Supple- tries, many of which, like his own, had beenmental Budget. devastated by the war.While Hungary fully realized the importance of the Organization's Mr. BRADY (Ireland) stated that he recognized programme, she had been unable to pay herthe desirability of a gradual and regular increase contribution for 1949, and it was likely that shein the Organization's budget.His Government, would have to increase her indebtedness in 1950.however, considered a jump from $5,000,000 to He did not understand why the United States $8,000,000 in a single year as excessive. He would delegation stated that its country was unwillingnot support adoption of a Regular Budget in to continue to contribute the agreed share of theexcess of $7,000,000, although of course he would Regular Budget, but at the same time expressedagree to a budget somewhat below that figure. a willingness to contribute to the SupplementalOf the proposals before the committees, he sup- Budget. ported that made by the delegate of New Zealand ; - 281 - SECOND MEETING detailed calculation of the actual figure could bebudget of $7,000,000 in accordance with the left until later. decision taken by the First World Health Assem- The Assembly must be most careful to ensurebly.If the Second World Health Assembly fixed that its accounts for 1950 would relate to revenuea budget ceiling of $5,000,000 a year the result that could actually be expected to accrue to thewould be that the Director-General would im- Organization. mediately have to curtail many of the Organiza- His Government considered that details of thetion's activities.Such action would, of course, programme which would be covered by theundermine WHO'sprestigeininternational Supplemental Budget had not yet been elaboratedaffairs. sufficiently, and was therefore not prepared at It was true that present economic conditions the present time to enter into any commitmentswere difficult.It was, however, highly significant in connexion with the payment of a supplementalthat the smaller countries, which did not possess contribution. much hard currency, had in general expressed Dr. BRISKAS (Greece) stated that althoughtheir agreement to an increased budget. Greece followed with great interest the important Dr. VAN DEN BERG (Netherlands) stated that activity of the Organization, it would, as a smallhis delegation had no instructions to oppose the country with a precarious economy, find it veryRegular Budget estimates presented for 1950. difficult to contribute in the same proportion toHe realized that the adoption of a $5,000,000 an increased Regular Budget.As regards theceiling would place the Director-General in a Supplemental Budget, his Government could nothighly unenviable position. He would be expected enter into any future commitments for theto cut down activities from a level corresponding present. to an annual budget rate of $7,000,000 without Dr. GONDA (Czechoslovakia) pointed out thatinjuringtheOrganization. The committees many countries had to practise strict economies,might consider limiting the 1950 budget to even to the point of making cuts in very important$7,000,000, the basis on which WHO would be national budget items, in order to meet theirworking at the end of 1949, but should not even international financial obligations. He thereforeconsider any lower figure. proposed that the World Health Organization His Government was unable for the present to alsoshould practiceeconomies which wouldenter into any commitments for the Supplemental enable it to meet the obligations imposed on itBudget. by the programme of operations it had adopted. That should be done, first, by reducing the total Replying to Dr. Scheele (United States of of the 1950 budget, as had been proposed by theAmerica), the DIRECTOR-GENERAL stated that delegate of Poland ; secondly, by cutting downit was not possible to make an accurate estimate administrative expenses by means of a reductionof the annual operating cost at the present level in non-essential staff and in the salaries of higherof employment.The figure was approximately officials and through a limitation to an absolute$5,000,000.That did not, however, take into minimum of the number and size of expert com- account further commitments for 1949 in respect mittees ; thirdly, by establishing a scale of priori- of services offered to governments and other ties for the 1950 programme and reducing thecommitments entered into vis-à-vis the United programmes which had not been given topNations and other specialized agencies, nor did priority. it take into account the development of regional offices. Dr. OLCAR (Turkey) stated that his country The South-East Asia office had been set up but wished to contribute all it could to the cause ofit was as yet too small to be on a functional basis. world health and had accordingly paid its con-The Eastern Mediterranean office would be set tribution in full up to the present.Althoughup on 1 July ; no staff had yet been engaged and Turkey was not opposed to the idea of a voluntary no funds expended. In the Americas only a small Supplemental Budget, he had to state that fornumber of staff had been transferred from the the present it could not increase its contributionOrganization's New York officeto the Pan above the present figure. American Sanitary Bureau ; almost no expendi- Dr. STAMPAR (Yugoslavia) admitted that heture had been involved. Apart from those regional had been depressed by the statement of theoffices, provision was made in the 1950 budget delegate of the United States, although he recog-estimates for the establishment of regional offices nized that each country must decide for itselfin Africa and the Western Pacific. the size of the contribution it could make. He recalled thattheFirst World Health It had to be frankly stated that the procedureAssembly 5 had authorised the Director-General the Assembly had followed had been unhappy.to set up regional offices in all the regions to It was illogical that the same people who hadwhich he had referred as soon as a majority of spent a considerable time in drawing up whatthe Members in those regions intimated a desire they believed to be a good programme shouldfor this to be done.Only two more favourable state only at the present stage that it could notreplies were required before the Director-General be carried out. was bound, under the decision of the First Health The Director-General had drawn attention toAssembly, to set up a regional office in Europe. the fact that by the end of 1949 the Organiza- tion would be operating on the basis of an annual 5 011. Ric. World Hlth Org. 13, 331 - 282 - JÓINT MEETINGS

It would be impossible to do this or to set upAmerican regions would have to be cancelled. any of the other regional offices if the budgetIt would in fact, be necessary , to reverse the were frozen at $5,000,000. The regional meetingsOrganization's stated policy of decentralization. which had been organized for September in the Eastern Mediterranean,South-East Asia and The meeting rose at 6 p.m.

THIRD MEETING Monday, 27 June 1949, at 9.30 p.m. Chairman: Dr. H. HYDE (United States of America)

1.Programme and Budget for 1950 (continu-$7,000,000 to the end of 1949, in view of the ation) health needs of the world, particularly in devas- Agenda, 8.23, 10.19tated and under-developed and non-developed areas, of the achievements of the Organization to The CHAIRMAN said that the General Committeedate, and of the discussion in the Committee on had asked the committees to reach a decision onProgramme, his Government believed that an the budget that evening.The discussion wouldincrease of $1,000,000 above the rate for the continue and then votes would be taken begin-end of 1949 was reasonable and justified.He ning with the proposal most remote from thetherefore supported the budget as presented by original proposal.He stressed the importancethe Director-General. of the matter under discussion. M. VAN DER BRUGGEN (Belgium) did not wish Dr. BHAYUNG (Thailand)agreed with theto see too rapid an increase in the budget as his Director-General that the budget passed by thecountry was striving to regain economic stability. First Health. Assembly had only been sufficientHe hoped it would be possible to reduce new to establish the office of the Organization. non-priority undertakings in order to restrict In the coming year work would be undertakenthe budget to the $6,000,000 proposed by the which would be of benefit to the health of thedelegate of New Zealand. He reserved his posi- world and therefore an increase in the budgettion with regard to the Supplemental Budget. was essential.His Government was prepared to If a small Regular Budget were adopted, the contribute to a Regular Budget of $7,000,000.Belgian Government would be in a better posi- He could enter into no commitment regardingtion to support before Parliament an allocation the Supplemental Budget at the present stage.for the Supplemental Programme.

The CHAIRMAN said that the proposal of the The CHAIRMAN said the Director-General would delegate of the Netherlands at the previous meet-be placed in a difficult position if he were asked ing for a Regular Budget of $7,000,000 had beento suggest reductions in the programme he had taken as an amendment to the original proposal.planned.If the budget adopted were less than that originally proposed, it would be the function M. MÜLLgx (Switzerland)said the budgetof the Assembly to decide where the reductions should be established on the basis of what wasshould fall. practicable and not what was desirable.While a budget of five million dollars was small in Mr. DAVIN (New Zealand), referring to the comparison with the needs of the world, tooSupplemental Budget, said it was the view of rapid an increase was to be avoided.Contribu-his Government that all Members should con- tions to international organizations placed atribute to that programme, and New Zealand's heavy burden on small countries : many had notaction in the matter would depend on the readi- paid the 1948 contribution ;others had statedness of others to contribute.He was unable to that they would be unable to increase their con-make any precise statement at the present stage tributions ;one Member had said his countrybut two conditions would govern any contribu- would be obliged to leave the Organization if itstion from New Zealand :all contributions would contribution were increased.As contributionshave to be to a central fund and the contribu- to a larger budget might further delay the pay-tion of his Government would be in non-conver- ment of contributions, the increase might betible sterling. only nominal. His country appealed for moderation and hoped Dr. GEAR (Union of South Africa) felt that the the reductions would be on the administrativeacceptanceofthe1949budget,authorizing side only. expenditure at the rate of $7,000,000 by the end of 1949, carried with it an obligation to increase Dr. RADJI (Iran) said that in view of the factthe budget for 1950. The economic position must, that the First Health Assembly had authorizedtherefore, be taken into account. Progress during the Director-General to spend at the rate ofthe early years should be prudent as many - 283 - THIRD MEETING aspects of the work of WHO were on trial.He The Chairman then put to the vote the proposal hoped a readjustment would be made in theof the delegate of Australia for a Regular Budget spale of assessment so that one large countryfor 1950 of $5,000,000. would no longer be responsible for too great a At the request of the delegate of Australia, a proportion of the budget of the Organization.vote was taken by roll call.The result of the His delegation therefore supported the proposalvote was as follows : of the delegate of the Netherlands for a regularIn favour : Australia, Austria, Chile, Costa Rica, budget of seven million dollars. That was a net Greece, Iraq, Portugal, Switzerland. figure, after allowance had been made for addi-Against: Afghanistan, Belgium, Ceylon, Den- tional income from UNRRA, casual income and mark, Dominican Republic, Finland, Iceland, estimated contributions from new Members. India,Iran,Israel,Netherlands, Norway, Mr. SIEGEL, Secretary of the Committee on Sweden, Thailand, Union of South Africa, Administration and Finance, in connexion with United Kingdom, Yugoslavia. the last point raised by the delegate of the UnionAbstained: Albania, Brazil, Bulgaria, Canada, of South Africa, referred to Annex II of document Czechoslovakia, France, Hungary, Ireland, A2/Prog/32 6 showing the proposed budget for Italy, New Zealand, Poland, El Salvador. 1950 of $8,410,925 to which some $73,000 should United States of America. be added for the increase in the tuberculosis pro- gramme, giving a total of $8,500,000.Revenue The proposal of the delegate of Australia for from other sources amounted to $501,500, leavinga Regular Budget of $5,000,000 was lost by 17 about $8,000,000 to be contributed by govern-votes to 8, with 13 abstentions. ments. The proposal of the delegate of the Union of South Africa meant that governments should A vote was taken by roll call on the proposal contribute $7,000,000 to the 1950 budget toof the delegate of New Zealand that the 1950 which would be added about half a million dollarsRegular Budget should be $6,000,000 net.The from other sources.The total budget of theresult of the vote was as follows : Organization for the year would then be $7,500,000.In favour: Albania, Australia, Belgium, Bulgaria, The CHAIRMAN said that the figures under Canada, Costa Rica, France, Greece, Hungary, discussion would not take into account the half Ireland, New Zealand, Switzerland. million dollars received from other sources whichAgainst: Afghanistan, Ceylon, Dempark, Domini- would be additional to any amount agreed by can Republic, Finlând, Iceland, India, Iran, the committees. Iraq, Israel, Netherlands, Norway, Sweden, Thailand, Union of South Africa, United Sir Arcot MUDALIAR (India) supported the Kingdom, Yugoslavia. proposal of the delegate of the Union of SouthAbstained: Austria, Brazil, Chile, Czechoslovakia, Africa and suggested that priority on the Supple- Italy, Portugal, El Salvador, United mental Programme should be given to the items States of America. transferred from the Regular Programme. The proposal of the delegate of New Zealand The CHAIRMAN drew attention to Article 56for a Regular Budget of $6,000,000 was lost by of the Constitution and emphasized thatall17 votes to 12, with 9 abstentions. governments becoming Members of WHO accepted responsibility for making contributions according A vote was taken by roll call on the proposal to the estimates and assessments adopted by theof the delegate of the Netherlands that the 1950 Assembly. Therefore a decision by the AssemblyRegular Budget should be $7,000,000 net.The on the budget and the scale of assessment auto-result of the vote was as follows : matically committed governments to contribute accordingly.Discussion, in the Committee onIn favour:Afghanistan,Australia,Belgium, Administration and Finance of the First Health Canada, Ceylon, Denmark, Dominican Repu- Assembly, on the majority required for the vote blic, Finland, Greece, India, Iran, Ireland, on the budget had resulted in Regulation 9 of Israel, Netherlands, El Salvador, Sweden, theFinanceRegulations,under which that Switzerland, Thailand, Union of South Africa, important decision was to be taken by a simple United Kingdom, Yugoslavia. maj ority. Against: Albania, Iraq. Four proposals were before the committees : Abstained: Austria, Brazil, Bulgaria, Chile, Costa the original proposal from the Committee on Rica, Czechoslovakia, France, Hungary, Ice- Programme for a Regular Budget of $8,000,000 ; land, Italy, New Zealand, Norway, Poland, the Australian amendment of $5,000,000 ;the Portugal, United States of America. New Zealand amendment of $6,000,000 ;the Netherlands amendment of $7,000,000. Decision: The proposal of the delegate of the Under the Rules of Procedure, it was the duty Netherlands for a Regular Budget of $7,000,000 of the Chair to present the proposals in order net was adopted by 21 votes to 2, with 15 starting with the proposal that was furthest abstentions (for text of resolution, see first from the original. report, p. 347). 6 Unpublished working document The meeting rose at 11.30 p.m.

- 284 - JOINT MEETINGS

FOURTH MEETING Tuesday, 28 June 1949, at 3.30 p.m. Chairman: Dr. L. F. THOMEN (Dominican Republic)

1.Regional Offices but was already entering on itsoperational Agenda, 8.19phase." Special Nice for Europe No action was required from the joint meeting of the committees on the item. The CHAIRMAN recalled that a Special Office for Europe had been established in Geneva onEastern Mediterranean 1 January 1949, following a conference of war- devastated countries, on 15 and 16 November Dr. GOODMAN said that the item again was of 1948.7Since its establishment, the Special Officea purely informational nature. A note submitted had pursued three main typesofactivity :by the United Kingdom delegation had been administration of the regular WHO programmewithdrawn. of advisory and demonstration programmes, in He recalled that theFirst World Health Europe ;co-operation with the Economic Com-Assembly had resolved to integrate the Alexandria mission for Europe on medical supply problems ;Sanitary Bureau for epidemiological intelligence and developmentofproblemsofparticularwith the World Health Organization as soon as interest to war-devastated countries.8 He pointed possible.1-3 At its third session, the Executive out that at its nineteenth meeting the CommitteeBoard had noted that the majority of Members on Programme had considered the Special Office'sin the region had expressed a desire for a regional co-operation with ECE and had approved aoffice to be established and had considered a resolution whereby theDirector-General wasreport on the first session of the Regional Com- requested to continue co-operation with ECEmittee for the Eastern Mediterranean Area." with a viewtoincreasingtheavailability The Board had approved the selectionof of medical supplies, particularly for the warAlexandria as the site of the Regional Office, damaged countries of Europe.8 subject to the agreement of the United Nations No action was required from the joint meeting-which had subsequently been obtained. It had of the committees on the item. expressed its appreciation to the Egyptian Govern- ment for placing the site and buildings of the South East Asia Alexandria Sanitary Bureau at the disposal of the Organization for a nominal fee.The Board Dr.GOODMAN, ActingAssistantDirector-had further approved the establishment of the General, recalled that at itsfirst session theRegional Office on or about 1 July 1949 and had Executive Board had noted that a majority ofapproved the Regional Committee's resolution the Members in the South-East Asia region hadthat the functions of the Alexandria Sanitary agreed to the establishment of a regional officeBureau be integrated within those of the Regional in South-East Asia." At its second session, theOrganization.Finally, it had appointed Sir Aly Board had considered and endorsedcertainTewfik Shousha, Pasha, as Regional Director. recommendations made by the Regional Com- mittee for South-East Asia at its first session : namely, the establishment of a South-East Asia The Americas office on or about 1 January 1949, with site at The CHAIRMAN said that the item was being New Delhi, subject to the agreement of the Uniteddealt with in the Committee on Constitutional Nations-which had subsequently been given ;Matters (see ninth meeting of that committee, and the nomination as Regional Director ofp. 308). Dr. C. Mani," who was available for any ques- tions the joint committees wished to put to him. At its third session, the Executive Board hadEurope noted that the South-East Asia office had in fact The CHAIRMAN pointed out that the Executive been set up on 1 January 1949, and that it hadBoard had approved and referred to the Second experienced certain accommodation difficultiesHealth Assembly a proposal for the establish- ment of a regional organization for Europe. The og. Rec. World Hlth Org. 13, 331 ;14,9, Board asked the Assembly to note that the Special item 2.1 and 18, item 1.5 ;17, 13, item 3.6 Office for Europe would be dissolved on the 8 og. Rec. World Hlth Org. 17, 13, item 3.6 ;creation of a full regional organization.18 and report by the Director-General on Co-operation with ECE (see p. 213, footnote 83). 9 See eighth report of Committee on Prograirhne, 12 05. Rec. World Hlth Org. 17, 16, item 6.1 section 2. 13 og. Rec. World Hlth Org. 13, 331 19 Off. Rec. World Hlth Org. 14, 12, item 6.1 14 Off. Rec. World Hlth Org. 17, 16, item 6.2 11 Off. Rec. World Hlth Org. 14, 27, item 4.2 14 Off. Rec. World Hlth Org. 17, 16, item 6.5 - 285 - FIFTH MEETING

In view of a possible misunderstanding of theas set out in Official Records No. 18, page v, decisions of the First World Health Assembly,items 2.1 and 2.2 but had referred point 2.2.1 it might be advisable for the Second Assemblyfor further consideration by the joint meeting to affirm that a regional organization should beof the two committees. The decision of the Com- set up for Europe as soon as the majority ofmittee on Programme (see nineteenth meeting, Members in the region desired it. He drew atten-p. 211, section 2) had been subject to the under- tion therefore to a draft resolution submitted bystanding that the policy as laid down by the the Director-General. Executive Board did not exclude points 1.2.8 Decision : It was agreed to recommend to the and 1.2.9 on page 5 of Official Records No. 18, and Assembly the adoption of the draft resolutionthat provision for those two points could be made suggested by the Director-General (for text,in such provisions as would be made in connexion see secondreportofjointmeetings,sec- with item 7.6.1. on page 169 of Official Records tion 2). No. 18. Decision :The committee decided that the 2.Medical Supplies Section decisions of the Committee on Programme in Agenda, 8.18 connexion with points 2.1 and 2.2 on page v Programme for 1950 of Official Records No. 18, would apply equally Dr. FORREST, Secretary, recalled that the Com- to point 2.2.1 on that page. mittee on Programme at its nineteenth meeting had endorsed the policy of the Executive Board The meeting rose at 4.30 p.m.

FIFTH MEETING Wednesday, 29 June 1949 at 9.30 a.m. Chairman: Dr. H. HYDE (United States of America)

1.Programme and Budget for 1950 of Medical and Auxiliary Personnel programme be restored and that the sum be deducted from Agenda, 8.23, 10.19the appropriation made for the Advisory and Mr. SIEGEL, Secretary, introduced the proposedDemonstration Services to governments. revised budget estimates prepared by the Secre- tariat at the request of the committees (see Dr. GEAR (Union of South Africa), on behalf Annex 23) and explained that there had notof the delegations of Australia, Ceylon, Canada, been enough time to make detailed calculations Ireland, the Netherlands, and the Union of South on the reductions to be made in the RegularAfrica introduced the following note on the pro- Budget and the transfers between the Regularcedure to be followed in considering the 1950 and Supplemental Budgets. He drew attentionbudget estimates : to the transfer to the Regular Budget of the 1.The importance of a detailed discussion by estimated cost of the tuberculosis research office the Committee on Programme of each item of to ensure that its activities should not be inter- the proposed programme for 1950 has been rupted. In 1949 it had been financed from the shown during the present session. UNRRA Special Fund. The committees would 2.However, it appears to our delegations that note that it was expected that $400,000 would be an opportunity for a discussion of the broad available for the following year's budget from scope and the general balance of the proposed programme is necessary.This will be essential that fund. as a guide to the Committee on Administration At the request of the Committee on Programme and Finance and to the joint committees in (seetwenty-first meeting of that committee, determining the administrative and financial section 1) $50,000 had been allocated to meet the arrangements to be made. estimated expenditure on Palestine refugee pro- 3.It is recognized that any examination of gramme. the relative importance of the subjects of the proposed 1950 programme is likely to be difficult. Dr. STAMPAR (Yugoslavia), after recalling that This difficulty will nevertheless be considerably he had on several occasions drawn attention to diminished if the following criteria be applied the fact that the administrative machinery was to each subject : too large, expressed his anxiety that the fellow- (a) Is there a need for urgent international ships and technical training programmes should action ? not be reduced. That was one of the most (b) Is the subject suitable for international important means of assisting governments and he co-operation and action at this stage ? would prefer any reduction that had to be made (c) Are acceptable international techniques to fall upon Advisory and Demonstration Services and procedures now available ? to Governments. He therefore suggested that the (d) Are suitable technical and administrative proposed cut of $202,000 in the Technical Training personnel available for recruitment ? - 286 - JOINT MEETINGS

(e) Are tangible results of any international Sir Arcot MUDALIAR (India) supported the ' action likely to be early, comprehensive andproposal to set up a working party with terms worldwide ? of reference as suggested by the delegate of the 4.Conversely itisconsidered that careis Union of South Africa.He was not, however, needed to avoid the inclusion of subjects which entirely convinced of either the necessity or are more appropriately the primary responsi-practicabilityof thecriteria which were to bility of individual governments.It is a funda-govern the examination of the 1950 programme, mental principle that self-reliance and localas listed in the note introduced by the delegate responsibility be fostered inalllocal healthof the Union of South Africa. administrations and communities. 5.Bearing the above considerations in mind Mr. BRADY (Ireland) was anxious that staff our delegations recommend that the Committeecosts should be kept to a minimum and noted on Programme examine and make broad pro-with concern that the 1950 appropriation for posals on the relative importance of the variousregional offices amounted to nearly $1,000,000. subjects included in the proposed 1950 pro-Members had been led to expect by the trend of gramme outlined inOfficial Records No. 18.discussion in the First Health Assembly that We feel that initially this objective can best beregional offices would be of a modest character approached by setting up a working party. with small establishments. He would favour the reduction of the appropriation by about $250,000. Dr. Gear continued to explain that the authorsIf that should leave regional offices short of funds, of the note felt that the adjustments to be madecountries in the area concerned should make in the regular budget and general policy directives supplemental contributions to close the gap. to be given to the Executive Board for theMoney thus saved in the central budget could implementation of supplemental programmes werethen be spent on such valuable programmesas very complex matters which could best be dealtfellowships and advisory and demonstration with by a working party. There appeared to be services. considerable support for that working party being set up as soon as possible. Colonel AFRIDI (Pakistan) considered that the working party should be established at once The CHAIRMAN agreed that such a proceduresince most of the figures in the document under would yield valuable results but considered thatdiscussion were of a composite character.It was a preliminary general discussion was necessaryimpossible to tell what was included in columns in order to guide the deliberations of the working1 and 2 or how transfers from the Regular to the party. Supplemental Budget would affect programmes. A working party was the only possible method Dr. RAE (United Kingdom) agreed wi-th theof examining the proposals in detail.He was Chairman's remarks and stated that his Govern-extremely disturbed about the block transfers ment would support the proposal made by theas between the two budgets and felt that the delegate of Yugoslavia that the cut of $202,000matter was one which required close examina- be transferred from cttapter 3.5 to chapter 3.4 tion. (Appendix 2 to Annex 23, Section 3). The CHAIRMAN agreed that it would be darfr Decision :There being no objection,it wasgerous to endorse block transfers without due decided that the working party should beconsideration of their implications.He therefore instructed to make the transfer proposed bysuggested that the committees might wish to the delegate of Yugoslavia. revise their foregoing decision concerning the pro- posal of the delegate of Yugoslavia (chapters Dr. ROGERS (United States of America) agreed3.4 and 3.5) and allow the working party some that a working party should be set up and feltlatitude in the matter. it was particularly important that its terms of reference should include the consideration of the Dr. Holm (Denmark) considered that any general policy to be followed by the Executivereductions that had to be made should fall upon Board in administering the Supplemental Budget.new programmes so that priority programmes His delegation had had little time to study thealready under way would not be endangered. details of the proposed revised budget estimates but it was concerned to note the reductions made Dr. Ki.osi (Albania) noted with concern the inthe malaria and environmental sanitationsmall appropriation made for supplies to govern- programmes. ments. That item was one of the most effective, means of assisting national programmes and Dr. NAZIF Bey (Egypt) agreed that the establish-particularly those of devastated countries.The ment of a working party was the most expeditiousneed for technical advice and the provision of method of dealing with the matter.He hopedtechnicians was not, in his opinion, so great. it could start work as soon as possible so thatHe therefore proposed that the appropriations valuable time would not be lost in general debate.for supplies to governments be increased. - 287 - SIXTH AND SEVENTH MEETINGS

Dr. BABECKI (Poland) supported the proposal Czechoslovakia, Denmark, Egypt, Hungary, made by the delegate of Albania. India, Ireland, Philippines, Union of South Africa, Turkey and the United States of America M. VAN DER BRUGGEN (Belgium) agreed with to consider the proposed revised budget esti- the delegateof Denmark that thepriorities mates and to submit suggestions for the general established by the First Health Assembly should guidance of the Executive Board in administer- be safeguarded and that reductions should as ing the Supplemental Budget and adjusting far as possible be avoided in the funds allocated programmes to the available funds (for discus- to those programmes.Cuts could much more' sion of report of the working party, see seventh conveniently be made in new programmes which meeting, section 2). had not yet been put into operation. Decision: It was decided to set up a working The meeting rose at 11 a.m. party composed of delegates of Brazil, Ceylon,

SI XTH MEETING Wednesday, 29 June 1949, at 4.45 p.m. Chairman: Dr. L. F. THOMEN (Dominican Republic)

1.Programme and Budget for 1950 (conti-discussion. Paragraph 4 (1)of the proposed nuation) resolution contained a reference to the same text. Agenda, 8.23, 10.19Moreover, a new paragraph (the last of the pre- At the request of the CHAIRMAN, Dr. FORREST,amble) and an addition to paragraph 4 (2) had Secretary, introduced a revision of the draftbeen introduced at the request of the United resolution submitted in the Director-General'sNations representative. note on the Supplemental and Operating Pro- gramme of Advisory and Technical Services On the suggestion of Mr. LINDSAY (United Budget (see Annex 22 ; for final text of resolutionKingdom), Rapporteur, and to meet a point raised by Dr. SCHEELE (United States of America) see third reportofthejointmeetings, sec-it was agreed that the word " directs " in para- tion1)containingalterationsrequestedby the delegates of Poland and the United Statesgraph 4 of the draft resolution be altered to of America during previous discussion by the" empowers ". joint committees (see first meeting).The prin- Decision: The joint committees adopted the cipal change was the inclusion, in the preamble resolution submitted by the Director-General to the proposed resolution, of the text of Resolu- with the drafting amendment suggested by the tion No. 200 (III), paragraph 4 (d) adopted by Rapporteur (fortext,seethirdreport, the United Nations General Assembly atits section 1). third session on 4 December 1948 and quoted by the Director-General during the previous The meeting rose at 5 p.m.

SEVENTH MEETING Wednesday, 29 June 1949, at 10 p.m. Chairman: Dr. H. HYDE (United States of America)

1.Adoption of the Draft First Report of theextremely complex task entrusted to it. He then Joint Meetings read the report.16 Decision: The draft first report was adopted Dr. RAE (United Kingdom) congratulated the (see p. 347). working party on having reached unanimous agreement and moved the immediate adoption 2.Programme and Budget for 1950 (continu-of the report. ation) Agenda, 8.23, 10.19 Dr. VAN DEN BERG (Netherlands) asked why mental health had been omitted from sub-para- Report of the Working Party graph (4) of the resolution on the instructions to Dr. MACCORMACK (Ireland), Chairman of the be given to the Executive Board for the imple- working party, introducing the report, suggested 16 The substance of this report is contained in the that the working party had achieved in a verythird report of the joint meetings, section 4, and short space of time a reasonable solution of the in appendices 1 and 2 to Resolution WHA 2.78. - 288 - J OIN T MEETINGS mentation of the supplemental operating pro- The CHAIRMAN said that part of the programme gramme.17 He also felt that the clause " and notwould be financed under the Regular Budget and by eliminating any portion of the programme forthe remainder under the machinery of technical the year inquestion "inthe preambleto assistance. The only question remaining was the resolution should be deleted. whether the whole programme could be financed. In answer to the first point raised by the delegate of the Netherlands, Dr. MACCORMACK Colonel AFRIDI (Pakistan) seconded the proposal stated that the items listed in sub-paragraph (4)of the delegate of the United Kingdom to adopt had been given first priority at the First Healththe report of the working party. Assembly. Mental health had not been given the Decision: The report of the working party was same priority. adopted. 17 Last resolution in the third report of the joint meetings. The meeting rose at 11.30 p.m.

EIGHTH MEETING Thursday, 30 June 1949, at 9.15 a.m. Chairman: Dr. L. F. THOMEN (Dominican Republic)

1.Adoption of Draft Second and Third Reports of the Joint Meetings The draft second and third reports of the joint meetings were adopted (see p. 347). The meeting rose at 9.20 a.m.

- 289 - FIRST AND SECOND MEETINGS

COMMITTEE ON CONSTITUTIONAL MATTERS

FIRST MEETING Tuesday, 14 June 1949, at 10.20 a.m. Acting Chairman : Dr. K. EVANG (Norway) later Chairman : Dr. P. VOLLENWEIDER (Switzerland)

1.Election of Chairman There were no other nominations and Dr. Vol- Agenda, 9.1 lenweider was accordingly elected Chairman. In accordance with the decision taken at the Dr. V ollenweider took the Chair. third plenary meeting (see p. 72), it was agreed that the President of the Assembly should act The CHAIRMAN said that his election was a as temporary chairman of the committee untilgreat honour both for his delegation and his it had elected its own chairman. country.He would endeavour to do his best, and would try to deal expeditiously and tho- The ACTING CHAIRMAN pointed Out that Dr. roughly with all the matters on the committee's Vollenweider (Switzerland) had been nominated agenda. as Chairman of the committee and asked whether there were any other proposals for the office. The meeting rose at 10.25 a.m.

SECOND MEETING W ednesday, 15 June 1949, at 3.30 p.m. Chairman : Dr. P. VOLLENWEIDER (Switzerland)

1.Election of Rapporteur complied with. The application came under Agenda, 9.2 Article 6 of the Constitution, since the Republic The CHAIRMAN informed the committee that of San Marino was not at present a member of the election of the Vice-Chairman would havethe United Nations or of any specialized agency. to be postponed until the next meeting.The committee could therefore proceed immediately Dr. VAN DEN BERG (Netherlands)recalled to the election of the Rapporteur. In view of thethat an excellent procedure had been adopted nature of the committee's work, he consideredat the First Health Assembly in the appointment that a lawyer should be selected, and he proposedof a small committee to consider requests for Mr. Calderwood (United States of America). admission to the Organization. He would strongly advocate the continuation of that procedure. SirAly SHOUSHA, Pasha(Egypt),and Dr. FRÓES (Brazil)seconded the Chairman's Dr. STAMPAR (Yugoslavia)supportedthe proposal. Netherlands proposal. Decision:There were no further nominations On theChairman'sinvitation,Dr.Suzzi- and Mr. Calderwood was unanimously elected VALLI (Observer,RepublicofSanMarino) Rapporteur of the committee. stated that although his country was a small one its sovereignty and independence had always 2.Admission of New Members been recognized. His Government was extremely Agenda, 12 anxious to become a Member of WHO since it On the invitation of the Chairman, Dr. MANI,was an international organization with a humani- Secretary, briefly outlined the history of thetarian purpose. It was not the political standing application for membership in WHO made byof Member States that was important, but the the Republic of San Marino.The applicationachievement of genuine co-operation. had been rejected by the First Health Assemby as the requisite 30 days' notice had not been Mr. BANDARANAIKE (Ceylon)was doubtful given.' The necessary conditions had now beenas to the necessity of referring the application of the San Marino Republic to a working party, I Off. Rec. World Hlth Org. 13, 332 as suggested by the Netherlands representative, -- 290 - COMMITTEE ON CONSTITUTIONAL MATTERS since the case had already been considered at the Miss SWITZER (UnitedStatesof America) First Health Assembly. There could be no doubtsupported the proposal of the delegate of the that San Marino was a fully sovereign StateNetherlands for a working party to consider the responsible for its own foreign relations.Thereapplications from both the Republic of San could therefore be no objection to its immediateMarino and South Korea.She pointed out the admission to the Organization.He was not invalue of this procedure to ensure full consideration principle opposed to the creation of a workingof all points. party to consider further applications. That was a question which might be dealt with later, but Rajkumari AMRIT KAUR (India) supported the Netherlands proposal on condition that the work- at the present stage he was anxious not toing party should report to the committee within postpone theadmission of theSan Marinoa very short time. Republic. The CHAIRMAN then closed the debate and put Mr. LINDSAY (United Kingdom) agreed withto the vote the Netherlands proposal for the the delegate of Ceylon. creation of a working party to consider all appli- cations for membership. Professor PANTALEONI (Italy) was also in favour Decision : The Netherlands proposal was of the immediate admission of the San Marino adopted. Republic. The CHAIRMAN then proposed the following Dr. VAN DEN BERG explained that his proposalcountries for membership of the working party : related not only to the application for membershipCeylon, Denmark, the Netherlands and South by the San Marino Republic, but to all appli-Africa. He asked whether it was the wish of the cations. Experience bad shown that they requiredcommittee that the applications from both the very careful consideration. Republic of San Marino and South Korea should be referred to that working party. Dr. VILLARAMA (Philippine Republic) pointed out that the credentials of the delegation of the Dr. VAN DEN BERG pointed out that his proposal San Marino Republic had been accepted by thewas thatallapplications, without exception, Committee on Credentials. He was thereforeshould be considered by the working party. unable to understand what technical objections could be raised to its admission to the Organiza- Mr. BANDARANAIKE observed that when he had voted in favour of the Netherlands proposal tion. he had not realized that it involved the reference to the working party of the San Marino appli- Dr. STAMPAR, while in no way wishing tocation, as well as future applications.He had restrict the admission of new Members, consideredcast his vote under a misapprehension. that all applications should be very thoroughly examined so as to establish the status of appli- M. GEERAERTS (Belgium) did not consider that cants. For instance, the position of South Koreaany exception should be made in the case of the was extremely complicated and would certainlyRepublic of .San Marino. The procedure adopted require the expert knowledge of internationallast year of referring all applications to a working lawyers.It was for that reason that he was inparty was the most satisfactory solution.The favour of the Netherlands proposal. anxiety expressed by the delegate of Ceylon that delay would occur over the admission of Sir Aly SHOUSHA, Pasha, said that presumablythe Republic of San Marino should be allayed by the Secretariat had fully studied the questionthe fact that if there were no technical objections the working party could dispose of the case with of the status of the Republic of San Marino, andgreat dispatch. he doubted whether there could be any technical objections to its immediate admission. However, Dr. STOYANOFF (Bulgaria) proposed that the a working party might be set up to considerworking party should be enlarged by the addition future applications. of Czechoslovakia and Yugoslavia. In reply to the delegate of Egypt, M. ZARB, Dr. VAUCEL (France) could see no objection Legal Secretary, pointed out that the Secretariatto increasing the number of the working party, could not express any opinion on the statusbut felt that its geographical composition should of any applicant for membership, since there wasbe balanced by the inclusion of a representative a question of political recognition involved. from one of the South American Republics. He In connexion with the point raised by thetherefore proposed that Uruguay should be delegate of the Philippine Republic, he observedincluded. that the Committee on Credentials had very Decision: It was agreed that the working limited terms of reference.The acceptance of party should consist of Ceylon, Czechoslovakia, credentials could in no way affect the question Denmark, the Netherlands, Union of South at issue. Africa, Uruguay, and Yugoslavia. - 291 - THIRD MEETING

The CHAIRMAN announced that the workingthe committee would be able to report to the party would start work at once in order to reportAssembly at its next meeting, so that the neces- to the comnlittee as quickly as possible. sary steps could be taken at Lake Success by the governments concerned.The position of their The DIRECTOR-GENERAL urged that a decision delegations at the present Assembly could then be reached without delay as to the admissionbe regularized. of new Members, for which the present meeting had specifically been convened. He hoped that The meeting rose at 5 p.m.

THIRD MEETING Friday, 17 June 1949, at 9.30 a.m. Chairman: Dr. P. VOLLENWEIDER (Switzerland) later Dr. L. S. DAVIS (New Zealand)

1.Election of Vice-Chairman to serve on the Executive Board. He hoped that Agenda, 9.1 there would be no objection to the taking-up of that item immediately in spite of its being the The CHAIRMAN drew the attention of the com-last on the agenda of the present meeting. mittee to the nomination of Dr. Davis (New Zealand) for the office of Vice-Chairman, sub- Dr. SCHOBER (Czechoslovakia) asked that the mitted by the Committee on Nominations. order of consideration of items of the agenda Decision: There were no further nominationsshould, so far as possible, not be altered without and Dr. Davis was unanimously elected Vice-due notice ;otherwise small delegations might Chairman of the committee. experience difficulties.

2.Admission of New Members (continuation) Dr. MANI, Secretary, reminded the committee that six new members of the Executive Board had to be elected.As the opening date of the Agenda,12next session of the Board had been fixed for The DIRECTOR-GENERAL, recalling his state-8 July in Geneva, it was essential that the elec- ment at ,the end of the previous meeting, statedtion should take place as early as possible in that the Secretariat apologized for the misunder-order to enable the new members to obtain their standing that had arisen. The problem of member- credentials and make the necessary arrangements. ship was a matter of international law involvingThe debate was likely to be very lengthy and complex political factors and it had thereforeevery delegation would have an opportunity of been assumed that delegates would be briefedexpressing its views.He therefore hoped that in advance by their foreign ministries so as tothe committee would accept the alteration in enable them to cast their votes without furtherthe order of the agenda. substantive discussion.Indeed, few delegations included the necessary legal experts for such Dr. VAN DEN BERG (Netherlands), while realiz- discussions.The Secretariat now realized thating the need for speed, suggested that the item it had been labouring under a misapprehension,might be postponed until the following day if a and it was in process of assembling as muchmeeting of the committee would be held then. information as possible on the legal aspectsThus delegations would have an opportunity to involved in the two applications for membershipconsider the matter in advance. at present before the committee. Sir Dhiren MITRA (India) agreed with the 3.Amendments to the Rules of Procedure ofsuggestion of the delegate of the Netherlands. the World Health Assembly Agenda, 9.5 M. GEERAERTS (Belgium)recalled thathis Government had expressed disapproval of the Nomination and Election of Members entitled toprocedure for nominations followed last year, designate Persons to serve on the Executive Boardand had proposed that nominations should be considered by a special committee composed of The CHAIRMAN announced that the Generalthe heads of delegations. He hoped that solution Committee had expressed the desire that themight now be adopted. Committee onConstitutionalMattersmight proceed without delay to the consideration of The SECRETARY stated that the Executive item 9.5.2, procedure for the nomination andBoard had carefully considered the objections election of Members entitled to designate persons raised at the First Health Assembly to the - 292 - COMMITTEE ON CONSTITUTIONAL MATTERS procedure for nominations.Its recommendationsa list of nine Members was to be drawn up by were now presented .to the committee.2 the General Committee, out of which six would be selected by the Assembly to designate persons Dr. GEAR (Union of South Africa) proposedto serve on the Board, asked whether suc-h a that, in order to save time, the question of nomi-procedure would preclude Members from sub- nating should be referred to a working party. mitting further nomiriations in plenary meetings. It was important to know whether election would The SECRETARY pointed out that the normalbe confined to Members named in the list. procedure was for all items on the agenda to be discussedfirstinfull committee ;thereafter The SECRETARY replied that it was the intention points of detail might be referred to ad hoc work-of the Executive Board that the choice be made ing parties. It was not useful to submit importantfrom the list of names submitted by the General items of the agenda to working parties withoutCommittee. If there was any lack of clarity in the such preliminary general discussion. draft Rules 79 and 80, the Secretariat would welcome any proposal for their amendment. Mr. BANDARANAIKE (Ceylon) agreed with the Secretary that the matter was of vital importance Dr. TOGBA (Liberia) congratulated the Execu- and should first be discussed by the committee.tive Board on the valuable work performed, but It could not be referred immediately to a work-expressed concern with regard to paragraphs 1 (b) ing party, the terms of reference of which wouldand (c) of Annex 20. He felt that they ignored, necessarily be restricted. by implication,the principleofa balanced geographical distribution of seats. Mrs. WRIGHT (UnitedStatesofAmerica) Dr. Davis, Vice-Chairman, took the Chair. agreed with the delegate of Ceylon that a working party could not achieve anything useful until a The CHAIRMAN assured the delegate of Liberia general debate had been held. She congratulatedthat full account would be taken of the need for the Executive Board on itslucidproposals, an equitable distribution of seats, a principle which the United States delegation felt had beenwhich was explicitly recognized in Article 24 presented in a form practicable for trial at theof the Constitution and in paragraph 1(a)of present Assembly. Annex 20. Dr. VAN DEN BERG observed that it was not Miss GREEN (United Kingdom) supported the clear to him whether the discussion had alreadyNetherlands proposal. been opened on item 9.5.2, as he was not aware Dr. DAVIS (New Zealand), while generally of the committee's having reached any decisionin agreement with the proposal, observed that on the question of that item being taken up atparagraph 2 (b) of Annex 20 seemed to place once. an invidious responsibility on the General Com- mittee ; however, while he would not vote against The CHAIRMAN then put to the vote the proposalthe adoption of the proposal for that reason, he that discussion be opened immediately on itemthought the views of members of the Executive 9.5.2 of the Agenda. Board might be helpful. Decision: It was agreed to proceed immediately The SECRETARY replied that the list of nine to the consideration of item 9.5.2 of the Agenda.Members had been drawn up by the Executive Board merely to start discussion and to ensure, The SECRETARY drew the attention of the com-in the first instance, the concept of equitable mittee to the resolution and recommendationsgeographical distribution.He emphasized that of the Executive Board on pages 29 and 66 of theit was not a list of appointments, but a list of report ofitssecondsession,OfficialRecordsrecommendations. No. 14. Sir Dhiren MITRA observed that, while out of Dr. VAN DEN BERG stated that the wholethe list of nine Members, six were recommended problem was one of great complexity.It hadby the General Committee, the Assembly was received very careful study by the Executivefree to vote for any of the remaining three if they Board, which had achieved unanimous agreementwished.He felt the difficulty involved by the on the proposals formulated. He hoped it wouldGeneral Committee's recommending six Members be possible to avoid a repetition of those dis-out of the nine was that they would be prescribing cussions, since he doubted whether the committeeto the Health Assembly the Members to be would, in fact, be able to improve on the work elected.Thus the Assembly would be left with of the Executive Board.For the purpose ofno discretion in the matter.It was preferable expediting their business, he moved the imme-to give to the Assembly a list of nine names out of diate adoption of the proposals submitted by thewhich six Members would be elected.He sug- Executive Board. gested that, in the interests of clarity, Rule 80 should be prefaced with the words : " From Sir Dhiren MITRA, referring to the proposedamongst the nine Members aforesaid...". draft Rules 79 and 80, contained inOfficial Records No. 14, Annex 20, by the terms of which The SECRETARY replied that it had been the opinion of the Executive Board that the nine 2 See Off. World Hlth Org. 14, 66 names should be reduced to six by the General - 293 - THIRD MEETING

Committee, who would submit that list to thefully considered by the Executive Board and Assembly.There was, however, no compulsionits working party.The suggestion of elections on the Assembly to accept the list, and he directedmade on a regional basis had been dropped after attention to paragraph 2 (c) of Annex 20. Thatconsideration because of possible harmful reper- would be one method of procedure, and thecussions. Paragraph2(b)could,ifdesired, suggestion of the delegate' of India would con-be modified by the committee to read : " Although stitute another, to which the Secretariat would notseats should not be allocated according to regions, object if it found more favour with the committee.the needs of regions of the World Health Orga- nization should be borne in mind while making Dr.TOGBAwondered whether it might sufficerecommendations ". It was the responsibility to delete sub-paragraphs (b), (c) and (d) of para-of the committee to decide that matter.The graph 1 of Annex 20, in order to avoid confusion.delegate of Ceylon might like to propose that M.GEERAERTSsaid the delegate of the Nether-amendment. The Executive Board had considered lands had reminded the committee of the carethat regional representation might lead to an with which the Executive Board had examinedundesirable rivalry between regions :that was the question, and had proposed the adoptionwhy they had proposed allocation of seats on a of the suggestions of the Board. He did not seeglobal basis. any objection to that, but pointed out that paragraph 2 (a) of Annex 20 stated that " The Mr.HALSTEAD(Canada) said the Executive Assembly, prior to any nomination or election,Board had struck a fine balance between giving should solicit the views of Members ", Henecessary discretion to the Assembly and ensuring wondered if the best and quickest method ofequitable geographical distribution, and he sup- procedure would not be to call together the headsported the proposals before the committee. He of delegations for discussion, after which a listfelt, however, that the list of nine names should of nine Members might more easily be drawn up.go to the Assembly without recommendations He thought that discussion in the Committeefrom the General Committee, and he suggested on Constitutional Matters would take more timethe deletion of the second paragraph of Rule 79. than reference of the question to the GeneralRegarding the suggestion of the delegate of Committee. Ceylon, he thought the main objection to regional representation was that the regional organizations TheSECRETARY,citingRule78,thought complete discussion by heads ofdelegationswere not equal as regards membership numbers, would be tantamount to suggestions from thepopulation or resources.The Executive Board floor, which they had tried to avoid.He saidshould be representative of the Organization as paragraph 1 (g) of Annex 20 had been drawn upa whole and not become a collection of repre- precisely to avoid this discussion of proposalssentatives of regional organizations. and counter-proposals from the floor. TheSECRETARYsaid the Executive Board, in Dr.VAUCEL(France) said that his delegation,considering the matter, had not intended to put in common with those of the United Kingdoma brake on the suggestions made to the Assembly and the Netherlands, realized the difficultiesfor its consideration, but they had feared that with which the Executive Board had had toan open list of nine Members might adversely contend in framing the resolution. While admit-affect equitable geographical distribution. ting that it was only a compromise, he thought it a happy one, well drafted and permitting the Mani's Assembly to exercise its rights.Although the Dr.VAN DEN BERGconfirmed Dr. General Committee would recommend six Mem-account of the discussion in the working party bers from the list of nine, the Assembly wasof the Executive Board. free to choose as it thought fit.The French delegation therefore supported the adoption of ProfessorCANAPERIA(Italy) recalled that, at the resolution. the First World Health Assembly, his delegation had proposed that membership of the Executive Mr.BANDARANAIKEsaid he was in favour of theBoard should be composed of one-third of the adoption of the draft rules submitted by theMember States.That would not only ensure Executive Board, but he wanted to emphasizeequitable geographical distribution but also equit- one point :in interpreting the phrase " equitableablerotationamongtheMembers. 3 The geographical distribution " the Assembly shouldExecutive Board had rejected the proposal, but not neglect the growing importance of regionalultimately it would be for the Committee on organizations. Such neglect might lead to compli-Constitutional Matters to decide on the question. cations such as over- or under-representation ofHe supported the proposal of the Belgian dele- certain regions.He suggested they should shiftgation because it was preferable that the Assembly the emphasis in paragraph 1 (b), particularly initself should decide on the nomination of the the phrase " it will not be necessary to allocatemembers of the Executive Board. seats...".It was necessary to emphasize the needsof regionalorganizations,without necessarily being bound by them. TheSECRETARYsaid the Italian proposal had beencarefullyconsidered by the Executive TheSECRETARYreplied that the question of geographical representation had been very care- 3 09. Rec. World Illth Org. 13, 93

- 294 - COMMITTEE ON CONSTITUTIONAL MATTERS

Board, but the principal reasons for its rejectionvaried, it might become necessary for the Health were that rotation was contrary to the electoralAssembly to review periodically the size of the system required by the Constitution and thatExecutive Board. since the total membership of the Organization The meeting rose at 11.55 a.m.

FOURTH MEETING Saturday, 18 June 1949, at 9.30 a.m. Chairman: Dr. P. VOLLENWEIDER (Switzerland) later Dr. L. S. DAVIS (New Zealand)

1.Amendments to the Rules of Procedure ofdid not correspond to the concept of a world the World Health Assembly (continuation)organization.He proposed that the recommen- Agenda, 9.5 dations of the Executive Board be forwarded to the Assembly. Nomination and Election of Members entitled to designate Personstoserve on the Executive Mr. PLIMSOLL (Australia) said his delegation Board (continuation) believed that the Executive Board should be Dr. VILLARAMA (Philippines) said his countryelected by the Assembly as a whole, but he was believed that, while equitable geographical dis-prepared to accept the proposals of the Executive tribution was advisable, it was a policy whichBoard as a practical compromise.The main could not be followed to the letter.It was pre-criterion should be the securing of an equitable sumed that the persons designated to serve on thegeographical distribution, as laid down in the Board would setve the legitimate interests ofConstitution.There were also other considera- all Members of the Organization, and that thetions which should be kept in mind, some of policy adopted by the Executive Board wouldwhich had been referred to in the report of the always reflect the interests of the OrganizationExecutive Board.For example, the Executive as a whole. Discussion on equitable geographicalBoard should always include members from those distribution was therefore academic. two or three countries which made the largest contribution, not only because of the size of their M. MULLER (Switzerland) recalled the proposalsfinancial quotas, but also because of the assistance of his Government to the First Health Assembly :they could give to the Organization, and because first, that all delegations should be consultedof their worldwide responsibilities. This selection before the election of members of the Executivecould be done within the principle of equitable Board ;secondly, that delegates should havegeographical distribution. time to study the list submitted by the General He supported the amendment proposed by the Committee ; and thirdly, that the General Com- delegate of Canada, which allowed the Assembly mittee should put forward more candidates thanfree scope to choose six out of the nine names the number of seats to be filled so that somesubmitted.It might be left to the good judg- choice might be left to the Assembly. Thement of the Assembly not to choose those mem- Executive Board had. taken these views intobers of the Board in a way which was incompatible account and had done excellent work.Never-with equitable geographical distribution. A free theless he supported the proposal of the delegatechoice in the Assembly was fairer to the other of Canada, put forth at the previous meeting, tothree Members on the list and to the Assembly delete the second paragraphof Rule 79 ofitself.In this matter he agreed completely with Annex 20, Official Records No. 14. For the Generalthe observations of the delegate of Switzerland. Committee to recommend six out of the nine In regard to the remarks by the delegate of names submitted to the Assembly might leadCeylon onsatisfyingtheneedsofregional to difficulties and trouble within the committee :organizations,he supported theobservations it was wiser for the General Committee to stibmitmade on the previous day by the S6cretary. The nine names without qualification.With thatkey word of paragraph 1 (b)of Annex 20 was amendment, he supported the adoption of the" allocate " ;the proposalofthe Executive recommendations. Board did not contemplate allocation of seats to specificregions,thoughtheirclaimswould Dr. AVERY (Iran) said that paragraph 1 (b) ofnaturally be borne prominently in mind. But the Annex 20, although it had been criticized, con-needs of regional organizations were not the tained a point of principle :representation ofsame thing as equitable geographical distribution, regional organizations on the Executive Boardparticularly since the regional organization was still incomplete, and some important countries 4 Off. Rec. World I11th Org. 13, 84 had not, so far, elected to join any region. - 295 - FOURTH MEETING

His delegation would support the appendix totaking into account the principle of equitable Annex 20 with the amendments proposed by thegeographical distribution and any other factors. representatives of India and Canada. He would have preferred a list of only six Members to be submitted to the Assembly, but Sir Aly SHOUSHA, Pasha (Egypt), summarizedsince nine names were to be proposed it was the the trend of opinion expressed in the Executiveduty of the General Committee to indicate the Board during discussions of the proposals. Almostsix most suitable.If the amendment of the every point raised in the present committee haddelegate of Canada were pressed, he would ask been thoroughly discussed there. An amendmentfor the reduction of the list to six names only. He to the Constitution to conform to the Italiansupported the adoption of the report on the proposal had been discussed but rejected on theunderstanding that the General Committee would grouhds that it was unwise to alter the Constitu-consider the needs of regional organizations. tion at such an early stage, and before all coun- The CHAIRMAN pointed out that the Committee tries had ratified it.Later it could be modifiedon Constitutional Matters was not competent to in the light of experience, and at that time all change the views of the Executive Board, although nations of the world would have an opportunitythe Assembly could make the modifications it to present their views. The Board had consideredthought fit.The proposed amendment of the that the best body to submit nominations to thedelegate of Canada to the appendix to Annex 20 Assembly would be the General Committee, which was nominated from the floor and was thuswas permissible. representative of the Organization.The recom- Sir Dhiren MITRA (India) said that the second mendation of six out of the nine names placedparagraph of Rule 79 served a useful purpose ; no commitment on the Assembly, which would beit did not purport to make any invidious dis- free to choose among all names submitted ;ittinction on the basis of merit.The Assembly had been made with the idea that the Generalwould appreciate a recommendation from the Committee might relieve the Assembly of some General Committee for an equitable geographical of its burden in the matter. distribution which would take into account the Equitable geographical distribution would auto-existence and importance of regional organiza- matically give regional representation. The tions. He agreed with the proposal of the dele- Executive Board was an executive body of thegate of Ceylon.He had been informed by the Assembly as a whole and its members did notSecretariat that it was implicit in the Rules represent their respective countries. He supportedthat election would be confined to the nine names the proposal that the report of the Executiveon the list and he therefore withdrew his earlier Board be accepted and submitted to the Assembly.amendment to that effect.

Mrs. WRIGHT (UnitedStatesofAmerica) Dr. MANI, Secretary, said that the proposal of supported the adoption of the report in itsthe delegate of Canada would involve a conse- entirety on the understanding that the procedurequential change in Annex 20, paragraph 2 (b). would be tried for the following year, after which Dr. GEAR (Union of South Africa), on a point there should be a further opportunity to makeof order, asked whether Rule 80 would also be any necessary changes. In forwarding its recom-affected, because it appeared that the method mendations to the Assembly, the committeeof election was based on that Rule. should ask the General Committee to take note of the various suggestions made during the course The SECRETARY stated that no consequential of the discussion. change would be necessary in Rule 80, which required the Assembly to elect six Members Mr. BANDARANAIKE (Ceylon), referring to hiswithout stipulating whether those six were to be statement at the previous meeting, proposed theelected from a list of nine or of only six names. following amendment to paragraph 1 (b): The CHAIRMAN put to the vote the proposal of While ensuring equitable geographical distri-the delegate of Canada, which was rejected by bution, the needs of regional organizations will23 votes to 8. be borne in mind, although itwill not be The CHAIRMAN then put the recommendations necessary to allocate seats either to the geo-of the Executive Board 5 to the vote. graphical areas which have been defined for purposes of regional organization or to other Decision: Therecommendationsofthe regions which might be delineated for this Executive Board were adopted unanimously. particular purpose. Dr. 'Davis, Vice-Chairman, took the Chair.

If paragraph 1 (b) had not been included in the2.Rights and Obligations in Regional Orga- report and it had been left to the interpretation nizations of Article 24 of the Constitution, the difficulty Agenda, 9.11 would not have arisen, but since it had been mentioned he was anxious that the needs ofAssociate Members and Other Territories regional organizations should not be neglected. The SECRETARY recalled that the rights and He opposed the proposal of the delegate of Canada, obligations of Associate Members in the central since the object .was that the General Committee should recommend Members with the best claims, 5 OD% Roc: World Hlth Org. 14, 29, 66 - 296 - 7111.

COMMITTEE ON CONSTITUTIONAL MATTERS organizations had been defined by the Firstresponsible for the external relations of certain Health Assembly. The rights and obligations ofterritories ; nevertheless, sight should not be lost Associate Members in regional organizations andof -the fact that WHO was not a political, but a of the third category of States which were neitherhealth organization. In all matters of fundamental Members norAssociateMembers had beenpolicy, that should be the guiding criterion. Since referred to the Executive Board. 6The subjectthe purpose of regional committees was to further had been fully discussed at its second session 7health programmes in countries falling within and general agreement had been reached that thetheir boundaries, he doubted whether any valid rights and obligations of Associate Members inobjections could be raised to the definition he regional organizations should be as wide ashad put forward. Even in the main organization, possible, so as to ensure their fullest participation.the interests of Associate Members were safe- The main point of divergence in the Executiveguarded by Article 8, whereby their representa- Board, upon which it had ultimately divided, wastives to the Health Assembly had to be chosen the question of voting rights in the main regionalfrom the native population. committees,itbeingagreedthatAssociate Members should have equal voting rights in the technical committees.Another difficulty which Sir Aly SHOUSHA, Pasha, stated that complex the Board had encountered was the definitionconstitutional questions were involved,parti- of the term " Member States in the region "cularly in view of certain changes which had referred to in Article 47 of the Constitution. Therecently occurred in the relations between so- Board had been unable to reach a decision oncalled parent States and their dependants.It the definition and had instructed the Secretariatwas, however, clear to his Government that the to ask governments for their views. Repliesexpression " Member States in the region " in so far received were to be found in documentsArticle 47 of the Constitution referred to the A2/47 and A2/47 Add. 1 (See Annex 24).Thejuridical politicalentities whose metropolitan Executive Board had reopened the discussionterritory and seat of government were to be on the whole problem at its third session, andfound in the region concerned. the results were summarized in Official Records No. 17, page 17, item 6.8.It would be seen that Dr. VAUCEL (France) hoped that the recom- the Executive Board had referred the mattermendation of the Executive Board that Members back to the Assembly.The committee mightand Associate Members should enjoy equal rights find it advisable to deal with the question of thewould be adopted,since that would ensure definition of " Member States in the region,"maximum co-operation.In view of the difficult before it proceeded to the general considerationproblems involved, he moved that the matter of the rights and obligations of Associate Members.be referred to a working party. Sir Aly SHOUSHA, Pasha, considered that the committee should first reach agreement on the Dr. DUREN (Belgium) seconded the proposal of definition of a Member State. the delegate of France.

Mr. BANDARANAIKE agreed with the view of the Mr. CALDERWOOD (United States of America) delegate of Egypt, but said that a general dis-was doubtful of the utility of setting up a working cussion should help in reaching a decision on theparty before any definite opinions had been definition. The committee should avoid tying itsformulated in the committee. He noted that the hands in advance to a rigid procedure precludingviews of the United States Government which such general discussion. had been forwarded to the Secretariat had not Decision : The proposal of the delegate of Egyptyet been circulated.He would therefore briefly was adopted. outline them. It seemed quite clear to his Government that, In the light of that decision Mr. BANDARANAIKE in view of the distinction made in the last sentence asked for the committee's indulgence since he wasof Article 47 between " Member States in the going to touch on matters of general implication.region " and Member, etc., the words " Member In trying to establish a definition of " MemberStates in the region " could apply only to those States ", the obvious purpose of the regionalMembers which had their seat of government in committees should be borne in mind. There couldthe regkal. The action of the First Health Assem- surely be no doubt that the whole emphasis ofbly in defining the geographic areas for purposes Article 47 was on the geographical aspects.Itof regional organization supported that inter- therefore followed logically that the Memberspretation. The Assembly had defined five of the envisaged were thoseterritories which weresix areas by listing the countries which composed located in the regions concerned. The same heldthem, and in no instance was the same country true for Associate Members. He was aware thatlisted in more than one area. 8 that interpretation raised a number of difficulties regarding the position of so-called metropolitan The questionofparticipationinregional States which, to some degree or another, wereorganizations of Members which were responsible fortheinternationalrelationsofterritories 6 011. Rec. World Hlth Org. 13, 337 7 011. Rec. World Hlth Org. 14, 26, 54 8 011. Rec. World Hlth Org. 13, 330 - 297 - FOURTH MEETING

situated in the region and which were not Memberand Associate Members proposed by the Execu- States in the region was a separate question. Thetive Board would be, confirmed. Constitution providedfortheir participation, but left the question of the extent of their parti- Dr. GABALDÓN (Venezuela) stated that the cipation to be determined in consultation withviews of his Government entirely accorded with the Member States in the region. those expressed by the Executive Board. The resolution in the eighth report of the Legal Committee 9 provided that any comments Mr. BRADY (Ireland) drew the attention of the from regional organizations, as well as those fromcommittee to the views of his Government, which Members, concerning the rights and obligations were to be found in document A2/47 (see Annex 24). of Associate Members in regional organizationsIt felt that the words " Member States in the should be transmitted to Members.If, say, suchregion " could only be construed as meaning comments had been made by regional organiza-thoseStates whose nationalterritories were tions, could they be circulated before that ques-located in the region concerned. Any extension of tion was discussed by the committee ? that definition would in its view require an amend- ment of the Constitution. His Government The SECRETARY stated that regional committeesconsidered that Associate Members should enjoy were comparatively young organizations.Thethe same voting rights as Members on regional only one that had yet submitted any views wascommittees. He felt that the committee had now that of South-East Asia, and these would soondevoted enough time to the general discussion, be circulated.He noted that no definition of aand should proceed to refer the whole matter to Member State was given in that reply, but thata working party. organization did express the view that the rights and obligations of Members and Associate Mem- Mr. GOUDSMIT (Netherlands) observed that bers should be equal, except as regards voting inthe meaning of Article 47 was not as plain as the regional committee. some delegates had suggested. He therefore supported the proposal of the delegate of France Dr. DA SILVA TRAVASSOS (Portugal) said that, for the establishment of a working party to in view of the complexity of the problem, bediscuss the matter in detail. waiinly supported the motion of ,the delegate of France. Professor PANTALEONI (Italy) also supported the French proposal. Dr. TOGBA (Liberia) agreed with the United States delegate that the problem of definition Decision:It was unanimously agreed to refer should be disposed of in the committee itself. He both the definition of " Member States in the pointed out that, according to 4 region " and the question of the rights and of the Constitution, Members were defined as obligations of Associate Members in regional signatory States. He was unable to understand organizations to a working party. why such a definition could not be extended to Members of regional committees. The CHAIRMAN proposed that the working party should consist of the following members : Mr. MORETON (United Kingdom) favoured theBrazil, Bulgaria, Egypt, France, India, Nether- proposal of the delegate of France to refer thelands, Philippines; Union of South Africa, United matter to a working party.The definition ofKingdom. membership and rights and duties of Associate Members were two closely interdependent ques- Dr. DA SILVA TRAVASSOS asked that his country tions.The first could be approached from twoshould also serve on the working party. differentangles,theonestrictlylegal and constitutional, the other taking into account the Dr. TOGBA proposed that its composition would interests of the regional committees concerned. Ifbe better balanced if it were expanded to include the second approach were adopted his Governmentthe following countries : Belgium, Portugal, the felt that metropolitan Powers should participate inUnited States of America, and Liberia. such regional committees since they could make a valuable contribution to their work. From the Dr. FRÓES (Brazil) supported the request of the legal point of view metropolitan Powers wouldPortuguese delegate and seconded the nomina- in the first instance have to be responsible fortions submitted by the delegate of Liberia. theinternationalrepresentationofnon-self- governing territories which by definition did not Dr. GABALDÓN pointed out that the Western control their own foreign relations.Such metro-Hemisphere was represented by only one member politan governments would probably automati-and suggested that a higher proportion would be cally become members of regional organizations.more appropriate. For its part his Government would not necessarily wish to sit on all of them. He hoped that the Dr. SCHOBER (Czechoslovakia) said that the principle of equality of status between Memberssuggested composition of the working party was not very happy.There was too great a 9 Off. Rec. World Hlth Org. 13, 337 preponderance of States with dependent terri- - 298 -- COMMITTEE ON CONSTITUTIONAL MATTERS tories and too few' disinterested countries.He M. GEERAERTS (Belgium) rthanked the repre- considered that the list should be revised andsentative of Liberia for his proposal to include moved the adjournment of the meeting for thatBelgium on the working party but stated that purpose. as the working party threatened to become very large his delegation was prepared to stand down. Sir Dhiren MITRA supported the proposal of the delegate of Czechoslovakia. Decision: It was agreed to adjourn the meeting and to postpone the decision on the membership Dr. VAUCEL seconded the nominations sub- of the working party. mitted by the delegate of Liberia. The meeting rose at 12.40 p.m.

FIFTH MEETING Monday, 20 June 1949, at 9.30 a.m. Chairman : Dr. L. S. DAVIS (New Zealand) later Dr. P. VOLLENWEIDER (Switzerland)

1.Rights and Obligations in Regional Orga-zations. The committee should therefore be nizations (continuation) careful not to restrict arbitrarily the size of the Agenda, 9.11 workingparty,therebyexcludingmembers directly interested in the question.He would Associate Members and Other Territories (continua-prefer it to consist of at least nine members. tion) Rajkumari AMRIT KAUR (India) proposed that Dr. TOGBA (Liberia) felt that it would be diffi- the working party which the committee hadcult to achieve balanced representation even with decided to set up for the consideration of thea working party of nine members. rights and obligations of Associate Members in regional organizations be limited to the following Mr. KAM (Pakistan) and Professor PANTALEONI seven Members :Brazil, Czechoslovakia, France, (Italy) both agreed with the delegate of India India, Iran, Mexico and the United Kingdom. that the working party should be restricted to seven members. Dr. SCHOBER (Czechoslovakia) thanked the delegate of India for proposing his country for Dr. ALLWOOD-PAREDES (El Salvador) proposed membership of the working party, but statedthat it should consist of three representatives that as his delegation was too small to attend allfrom each geographical region. meetings it would prefer to stand down in favour of Bulgaria. Mr. MORETON (United Kingdom) considered that the working party should be kept to manage- Rajkumari AMRIT KAUR replied that she would able proportions and felt that seven was a reason- have no objection to the Czechoslovak proposal.able number. Dr. GARZA-RAMOS (Mexico) stated that his Dr.PEREIRA(Portugal)pointedoutthat delegation would also be unable to accept nomi-Portugal by her history and geographical position nation for the same reason. was fully qualified to participate in such a work- ing party,sinceitwas to deal with highly Dr. VAUCEL (France) noted that there was nospecialized matters. He would therefore strongly representative from the African continent onadvocate that his country be represented on it. the list submitted by the delegate of India, and proposed that it should include the Union Dr. VAN DEN BERG asked what precisely was of South Africa. meant by the term " region " in the proposal of The committee decided todisposeof thethe delegate of El Salvador. question of the size of the working party before nominating its members. Dr. MANI, Secretary, replied that the regions referred to were the six geographical areas as Dr. VAN DEN BERG (Netherlands) pointed outdelineated by the First Health Assembly. The the danger of deciding in advance on the size ofacceptance ofthatproposal wouldentail a the working party without first being certainworking party of 18 members. that it would ensure a well-balanced represen- tation. The CHAIRMAN put to the vote the proposal of the delegate of El Salvador, which was rejected. Mr. BANDARANAIKE (Ceylon) stated that the The amendment, proposed by the delegate of item under discussion was of vital importanceCeylon, that the working party should consist to the efficient operation of the regional organi-of nine members was also rejected. - 299 - FIFTH MEETING

Decision:The proposal of the delegate ofcommittee, as his delegation was still in consul- India that the working party should consisttation on the subject. of seven members was adopted. Decision: The proposal of the delegate of Dr. VILLARAMA (Philippines) suggested that Canada to defer consideration of the item was the Chairman should be asked to appoint the adopted by 32 votes to 2. working party. Dr. SCHOBER (Czechoslovakia) considered that5.Report on Situation with regard to OIHP it would be more expeditious to adopt the list Agenda 9.12 suggested by the delegate of India, with certain Dr. VILLARAMA asked if the transfer of the alterations. functionsof OIHP would involve additional Mr. MORETON (United Kingdom) felt that theexpenses for WHO, and if so, to what extent. committee would be more likely to achieve balanced representation in the working party The SECRETARY asked Dr. Morgan, observer on the basis of the list submitted bY the Indianfor OIHP, to reply. delegate, rather than by asking each delegation to present its nominations. Dr. MORGAN, Observer, OTHP, stated that the only expenses involved would be those connected Dr. GARZA-RAMOS stated that, contrary towith the study-group work being undertaken his earlier statement, his country would now beduring 1949 and possibly 1950. He was not prepared to serve on the working party. aware of further obligations, apart from the Mr. BANDARANAIKE pointed out that it couldactual winding-up of the Paris Office at the end not be taken for granted that the list of the of 1950. Indian delegate had been accepted by all mem- Professor PANTALEONI(Italy)askedifthe bers.It was important to achieve as represen-third paragraph of the resolution before the tative a composition as possible so that thecommittee (see second report of the committee, decisions of the working party would be accept-section 3) should be interpreted as meaning that able to the committee as a whole ; that wouldthe Bulletin, previously published by OIHP, avoid the danger of reopening the whole discus-would be discontinued. sion at a later stage. The best procedure would be to request the Chairman to nominate members The SECRETARY replied that all the information of the working party, taking into account theformerly contained in the Bulletin was already proposal of the Indian delegate and the viewssplit up among the appropriate publications of expressed in the course of the discussion. WHO. Dr. STAMPAR (Yugoslavia) proposed the closure of the debate. Mr. DAVIN (New Zealand) suggested that some The motion for closure of the debate wasprovision should be made for a share in the assets carried by 24 votes to 8. of OIHP by those nations which were not pre- pared to denounce the 1907 Rome Agreement. Decision: The proposal that the Chairman be entrusted with the task of the final selection of The SECRETARY stated that this matter was the seven members of the working party wasexclusively within the province of OIHP, and the adopted by 34 votes to 10. Secretariat of WHO could only bring it to the Dr. V ollenweider took the Chair. notice of the Paris Office. Mr. DAVIN withdrew his amendment in the 2.Agreement with the Government of Indialight of that explanation. Agenda, 9.7 Decision:The Agreement with the Govern- Decision:The report on the situation with ment of India (see Annex 11) was adopted regard to OIHP was adopted unanimously with- without amendment. out amendment (see second report, section 3).

3.Agreement with the Government of Egypt 1° 6.Adoption of draft First Report of the Com- mittee Agenda, 9.8 Decision: The resolution before the committee Dr. VAN DEN BERG suggested that the resolu- was adopted without amendment (for text,tion contained in paragraph 2 of the report be amended to read" whichdefinesthe prin- see second report, section 2). ciples to govern ... " instead of " which defines certain principles to govern ... 4.Agreement with the Pan American Sanitary Organization Mr. CALDERWOOD, Rapporteur, said he was Agenda, 9.9prepared to accept the amendment. Mr. HALSTEAD (Canada) requested that this item be deferred until the next meeting of the Mr. BANDARANAIKE said the words " regarding the principles defined by the Board ... " con-

10 Off Rec. World Hltli Org. 17, 45, item 10 . tained in the following paragraph covered the - 300 - COMMITTEE ON CONSTITUTIONAL MATTERS point raised by the delegate of the Netherlands, The RAPPORTEUR asked whether the delegate and he proposed the adoption of the reportof the Netherlands was willing to accept the without amendment. originalwordinginthereport,towhich Dr. FRÓES (Brazil) seconded the proposal ofDr. VAN DEN BERG agreed. the delegate of Ceylon. Decision:The draft first report was adopted Mr. KAZI supported the proposal to adopt the unanimously without amendment(forfinal report, but pointed out that the amendment of text, see p. 350). the delegate of the Netherlands had already been accepted by the Rapporteur. The meeting rose at 11.30 a.m.

SIXTH MEETING Tueday, 21 June 1949, at 9.30 a.m. Chairman: Dr. L. S. DAVIS (New Zealand) later Dr. P. VOLLENWEIDER (Switzerland)

E. Rights and Obligations in Regional Orga- submitted by the Executive Board were adopted nizations (continuation from p. 300) unanimously. Agenda, 9.11 3.Policy on Invitations to appoint Members Associate Members and OtherTerritories (con- to Governing Bodies of Health Organiza- tinuation) tions (Request from London School of Hygiene and Tropical Medicine) The CHAIRMAN announced that he had now completed the delicate and difficult task of nomi- Agenda, 9.14 nating members to the working party.He was Dr. HAFEZI (Secretariat) informed the com- aware that it would be impossible to satisfy allmittee that the London School of Hygiene and members of the committee.He had given theTropical Medicine had requested that WHO question extremely careful consideration, takingappoint a representative to the Court of Gover- into account the list proposed by the Indiannors of the School. The matter had been referred delegation and the views expressed in the courseto the Executive Board, which had discussed of the debate. He hoped that his proposal wouldit in detail and directed that the principle involved be regarded as constituting the nearest possiblein the request should be submitted to the Second approach to a representative group, and thatWorld Health Assembly."In the first place it it would be accepted in a spirit of goodwill andconstituted a precedent ;secondly, it had to be co-operation.It should be noted that whateverdecided whether such a representative should the findings of the working party, its suggestionstake instructions on the policy of the School would in no way commit the committee.It wasfrom the Executive Board.It was felt by the at liberty to réopen the subject, after which itDirector-General that were he to do so he might would be referred to the Assembly. be placed in an embarrassing position in the He accordingly invited the following Membersevent of any controversial discussions, and were to participate in the working party :Brazil, he to abstain from taking part in such discussions Bulgaria, France, India, Iran, Liberia and thehis role would be reduced to that of an observer. United Kingdom. Furthermore, it was not in general the practice of the United Nations to establish relations with Dr. Vollenweider took the Chair. national non-governmental organizations. Should the Assembly consider, in view of the above- 2.Amendments to the Regulations and thementioned questionofprinciple,that WHO Rules of Procedure for Expert Committeesshould not accept the invitation, it might wish to and their Sub-Committees adopt the draft resolution before the committee. Agenda, 9.6 Decision:The draft resolution was adopted M. ZARB, Legal Secretary, explained that the unanimously(fortext,seethirdreport, object of the amendments to the Regulations section 2). and the Rules of Procedure for Expert Commit- tees and their Sub-Committees, adopted by the4.Committee on the Hygiene of Housing of Executive Board and now submitted to the the American Public Health Association Assembly for approval, was simply the improve- Agenda, 9.15 ment of working procedure. Mr. PINCUS (Secretariat) informed the com- Decision:The additions and amendments tomittee that, in accordance with the action taken the Regulations and Rules of Procedure forby the Executive Board, second session, the Expert Committees and their Sub-Committees"-Director-General had established relations with 11 OD'. Rec. World Hlth Org. 17, 40 12 Off. Rec. World Hlth Org. 14, 27, item 5.1.3 - 301 - SIXTH MEETING the Committee on the Hygiene of Housing of theperformed, and hoped that the full picture would American Public Health Association. It wasbe presented to the Economic and Social Council. expected that as soon as the small panel of expert She was also concerned to note that there was correspondents in the hygiene of housing hadno mention of collaboration with UNESCO in been set up, active co-operation with that com-Haiti and in China. She suggested that UNESCO inittee would take place. The matter of enteringoffered a particularly fruitful field for co-Operation. into relationshipwith national housing com- mittees had had to be deferred as the organi-WHO would be interested to learn of the special zation of these committees by the Social Com-measures being taken by that organization to mission of the Economic and Social Council hadfacilitateprocurementofbooksfromhard been referred to the fifth session of the Socialcurrency areas by means of the coupon system. Commission. Dr. HAFEZI reminded the committee that the Dr. VAN DEN BERG (Netherlands) stated that,Director-General's Report only covered the last since WHO was an international organization,four months of 1948.Further developments in he would have thought that relations shouldthe field of co-ordination would therefore be re- first be established with international rather thanported to the next Health Assembly. Some infor- national organizations, and he asked what stepsmation on co-ordination with UNESCO could be had been taken in that direction, particularly asfound elsewhere in the Report and at all events regards the International Housing and Townit would be considered in the Committee on Planning Organization. Programme. He assured the United States delegatethatdaily contactwas maintained Mr. PINcus replied that the matter would bewith other specialized agencies, and with refe- taken up as soon as the panel of expert corre-rence to her special mention of the UNESCO spondents had been established. scheme for obtaining books, he said that the Decision : The committee took note of thematter had been studied by the Secretariat, action taken by the Executive Board.13 with a view to adopting it for implementation of the medical literature and special teaching 5.Relations with Specialized Agencies programme. Agenda, 9.16 Mr. PLIMSOLL (Australia) stated that he had The DIRECTOR-GENERAL drew the attentionhimself been witness of the valuable work done of the committee to the brief exposition of co-by representatives of the Director-General in ordination activities in Official Records No. 16,the field of co-ordination at the eighth session page 39.It had been thought preferable to omitof the Economic and Social Council. His Govern- detailed information on the large amount ofment was particularly anxious that the Execu- work which had devolved upon the Secretariattive Board should take definite action on the in that connexion. Representatives of WHOapplications from non-governmental organiza- were attending numerous meetings of varioustions to enter into relationship with WHO. The organs of the United Nations and specializedmatter had twice been deferred and required agencies and that work had become increasingly decision. His Government realized that the heavy with the growing appreciation of themain difficulty was the question of sectional importanceofhealthfactors. Each itemorganizations, but it hoped that the Board would involving co-ordination with other agencies would be guided by the criterion outlined in Official be considered by the Committee on Programme. Records No. 17, page 50, namely " the desirability A small correction should be noted in the secondof imposing no more restrictions than are neces- paragraph of the section " Non-governmental Organizations " on page 40 of Official Recordssary to ensure that organizations which are No. 16. The number of non-governmental organi-' brought into relationship with WHO are resPon- zations admitted to relationship with WHO atsible, representative, and able to contribute to the first two sessions of the Executive Boardthe work of WHO in a specific field ". was 16 and not 18. Some bodies (such as the International Com- mittee of Catholic Nurses) were sectional in their Mrs. WRIGHT (UnitedStatesofAmerica) composition but universal in their interests and congratulated the Director-General and the Secre-in the contribution which they made to the tariat on the degree of co-ordination which hadsolution of health problems. Such bodies should been achieved. Her Government hoped that thebe admitted to a relationship with WHO imme- co-ordination at Secretariat level, already welldiately. He drew a distinction between the advanced, would in the near future be extendedadmission of bodies, and the further definition to the planning of programmes, so as to obviateof their relationship to WHO : a decision on the the danger of duplication as the number offirst should not await the Executive Board's programmes increased.She regretted that thefuture consideration of the latter. Director-General's Report did not contain enough detail to do full justice to the valuable work Mr. BANDARANAIKE (Ceylon) asked for clarifi- 13O. Rec. World Hlth Org. 14, 20, item 1.12.2 cation on the relationship between UNICEF and - 302 - COMMITTEE ON CONSTITUTIONAL MATTERS

WHO and in particular as to what progressInternational Trade Organization had been made in the assumption of respon- Dr. HAFEZI stated that the Director-General sibility by WHO for the health programmes ofhad been requested by the First Health Assembly UNICEF. He felt that that was a question whichto study the question of entering into relationship should futtingly be dealt with by the Committeewith ITO and report to the Executive Board.15 onConstitutionalMatterssinceitinvolvedThe latter had adopted a resolution on the matter questions of status. He doubted whether thewhich was to be found in Official Records No. 14, Committee on Programme would be concernedpage 28. with that aspect. Decision: The committee approved the reso- Dr. SCHOBER (Czechoslovakia) was also anxious lution of the Executive Board. that the committee should have another oppor- tunity of discussing the relationship betweenIntergovernmental Maritime Consultative Organi- WHO and UNICEF. zation Dr. HAFEZI said that as UNICEF was not a Dr. HAFEZI stated that at the moment contact specialized agency the matter would be comingwas being maintained with the Intergovern- up in connexion with another item on the agendamental Maritime Consultative Organization at at a later stage.The absorption by WHO ofthe secretariat level. certain UNICEF responsibilities would be dis- Decision:The committee took note of the cussed by the Committee on Programme. Director-General's report 16 on relations with Rajkumari AMRIT KAUR (India) feltit was the Intergovernmental Maritime Consultative imperative to clarify the position with regard Organization. to UNICEF so as to avoid any danger of over- lapping in programmes. The meeting rose at 11 a.m.

Mr. HALSTEAD (Canada)congratulated the 16 Off. Rec. World Hlth Org. 13, 326 Secretariat on the degree of co-ordination already 16 The report (document A2/42) read as follows : achieved and stressed the necessity for its con- The Director-General has the honour to inform tinuation, in particular with the United Nationsthe Assembly that he has explored informally with Statistical Office and UNESCO. the Executive Secretary of the Preparatory Com- mittee of the Intergovernmental Maritime Con- Dr. MANI, Secretary, informed the committeesultativeOrganization the establishment of a working arrangement similar to the arrangements that the Secretary-General of UNICEF waswhich have been concluded with ICAO and the expected in Rome shortly.The question of theInterim Commission of ITO. relationship between WHO and the Fund would In view of the limited functions of the Prepara- be placed on the agenda so as to coincide withtory Committee, the Executive Secretary con- siders that the establishment of relations should be his visit. postponed until the first Assembly of IMCO. A Decision:The committee took note of thesimilar decision has been taken by the Preparatory Director-General'sreport on relationswithCommittee with respect to the establishment of relations with ILO and IC. ITO. In the interval, specialized agencies.14 contact will be maintained at the secretariat level for the exchange of documents and the study of 14 Off. Rec. World Hlth Org. 16, 39 common problems.

SEVENTH MEETING W ednesday, 22 June 1949, at 9.30 a.m. Chairman: Dr. P. VOLLENWEIDER (Switzerland)

1.Adoption of Draft Second Report of the2.Action taken by certain Countries with Committee regard to Membership of WHO Sir Aly SHOUSHA, Pasha (Egypt), suggested Agenda, 9.4 that the word " organizations " in the third line of sub-paragraph (2) of the proposed resolution The DIRECTOR-GENERAL, summing up the in Section 2 should be in the singular. action detailed on page 19 of Oticial Records No. 17, item 8.1, said opinion was divided on The CHAIRMAN stated that there was a mis-whether formal legal withdrawal from the Organi- print in the English text, and the word shouldzation were possible and whether communi- be " organization ". cations from Deputy Ministers of Public Health of the USSR, the Ukrainian SSR and the Byelo- Decision:With that modification, the draftrussian SSR could be consideredasofficial second report was adopted for transmissioncommunications from those governments. There to the Assembly (for final text, see p. 350). was no provision for withdrawal in the Constitu- - 303 - SEVENTH MEETING tion, and the three States were still regarded byto secure collaboration with those nations. Be the Assembly as Member States with full rights.said the fundamental issue before the Organi- All the Assembly ,could do, under its Constitu-zation should be resolved, as other cases might tion, was to suspend services in the event ofarise in the future. Article 75 of the Constitution default of contributions, but whether that was provided that any question or dispute concerning desirable was another matter. He thought sus-the interpretation or application of the Consti- pension of services necessary for the control oftution which was not settled by negotiation or diseases was not permissible in any circum-by the Health Assembly should be referred to stances. If the Assembly so decided, the questionthe International Court of Justice, and he pro- of withdrawal from the Organization could beposed that the draft resolution submitted by the referred to the International Court of Justice. delegation of India should include such a recom- mendation for transmission to the Assembly. Rajkumari AMRIT KAUR (India) introduced theHe pointed out that Rule 80 of the Rules of draft resolution submitted by her delegationProcedure laid down that the Director-General which read as follows : had to report to the Assembly should any Member 'Whereas the Vice-Minister of Health of thefail to be represented at two consecutive meetings Union of Soviet Socialist Republics, the Vice-of the Executive Board, and proposed that the Minister of Health of the Ukrainian Sovietcommittee should make a recommendation to SocialistRepublic and the Vice-Ministerof the Assembly that the two seats on the Board Health ofthe ByelorussianSovietSocialist Republic, expressing their dissatisfaction withleft vacant by the action of the States in question certain aspects of WHO work, have notified thebe filled temporarily. Director-General that their States no longer He suggested that paragraph 2 of the draft consider themselves Members ofthe Worldresolution of the delegation of India be amended Health Organization ;and to read :" Whereas the objective of the World Whereas the objective of the World Health Organization is the attainment by all peoples ofHealth Organization is the attainment by all the highest possible level of health, necessitating peoples of the highest possible level of health, it thereby the universal co-operation of all coun-implies or involves the co-operation of all coun- tries ; and tries or States in the world in order to ensure Whereas this principle has been proclaimedits achievement." He proposed that the penulti- by these States at the First World Healthmate paragraph be amended to read : " to Assembly ; and continue their endeavours to secure the continu- Whereas the Constitution of the World Health Organizationdoesnot makeprovisionfor ance of theseStatesinthe World Health withdrawal from the Organization, and in anyOrganization ". With those amendments, he case notification of withdrawal should properlywas in favour of the draft resolution submitted come from the Minister for Foreign Affairs ofby the delegation of India. a Government ; The Second World Health Assembly, The DIRECTOR-GENERAL said that attendance Regretting deeply the absence of represent- atives of these States from the Assembly andof members at sessions of the Executive Board the Executive Board ; was irrelevant to the question of membership of Recognizing the consequent loss to the workthe World Health Organization. of the Organization ; and Hoping that these States will in the near Dr. VAN DEN BERG (Netherlands) waS not in future wish to reconsider their position ; favour of referring the question to the Interna- INVITES them to reconsider their intentiontional Court of Justice, because only a unanimous and join if possible the present sessions of the Health Assembly and those of the Executivedecision would be satisfactory to the Organization Board immediately following ; and in any eventand there could be no certainty that the Inter- REQUESTS the Chairman of theExecutivenational Court would reach unanimity. He Board and the Director-General to continuestressed the importance of the fact that the negotiations with the saidStates and their responsible authorities, and to report to thecommunications had come, not from the res- Third World Health Assembly on the results ofponsible authorities, but from Deputy Ministers such negotiations ; and of Public Health. He agreed with the Director- RECOMMENDS that States Members of theGeneral that the Committee should not confuse Organization take such steps as they may deemattendance at sessions of the Executive Board suitable in order that the said States may recon-with membership of the World Health Organi- sider their decision. zation, and thought any attempt to replace Rajkumari Amrit Kaur declared that hermembrs, even temporarily, on the Executive delegation had been motivated solely by theBoard would detract from the effectof the desire to induce the USSR, the Ukranian SSRproposed resolution by the delegation of India, and the Byelorussian SSR to return to the Organi-with which he generally concurred. He proposed zation, to the work of which they had madethat the eighth paragraph be amended to read " ... valuable contributions. She appealed to thethe present and following sessions of the Health committee to transmit the resolution to theAssembly and those of the Executive Board ", Assembly and thus make a unanimous gesturewith the deletion of the words " immediately of goodwill to the three nations. following ". Further discussion was deferred until the follow- Mr. BANDARANAIKE (Ceylon) associated him-ing meeting. self with the attempt by the delegation of India The meeting rose at 11.30 a.m. - 304 - COMMITTEE ON CONSTITUTIONAL MATTERS

ErGHTH MEETrNG Thursday, 23 June 1949, at 9.30 a.m. Chairman: Dr. P. VOLLENWEIDER (Switzerland)

1.Action taken by certain Countries withwhole, and also supported the delegate of Czecho- regard to Membership of WHO (continu-slovakia in proposing the deletion of the fourth ation) paragraph of the draft resolution.He did not Agenda, 9.4consider it was necessary or desirable for the Dr. VAN DEN BERG (Netherlands) repeated theAssembly to commit itself to any legal views at the present session, because the Assembly was statement he had made at the close of the pre-basing its action on the general desire to keep vious meeting. the three States concerned in the Organization, Dr. VAUCEL (France)supported thedraftirrespective of any legal considerations. resolution submitted by the delegation of India. He thought the proposal of the delegate of Dr. PAOLINI (Italy) supported the proposal Ceylon to replace those members absent fromof the delegate of India and the steps taken by the Executive Board was premature and shouldthe Director-General in communicating with the not be considered by the committee, but feltthree States.He said it was too early to pass that some mention might be made in the draftjudgment on the work of the Organization, but proposal to the effect that the Assembly hadfeltit was necessary to make every effort to taken note of the statement of the three countriessecure the collaboration of those States, whose concerning certain aspects of the work of theparticipation in the work was very important. World Health Organization. He hoped the committee would be unanimous in its approval of the draft resolution submitted Sir Aly SHOUSHA, Pasha (Egypt), agreed withby the delegation of India. the Director-General that it was not appropriate to discuss in the present committee the legal Mr. BANDARANAIKE (Ceylon) said his proposal aspects of the problem. He supported the pro-to submit the question to the International Court posal of the delegation of India, which he saidof Justice was based on the fourth paragraph of had already been formulated in Annex 22 ofthe draft resolution submitted by the delegation Official Records No. 17, pages 52 and 53, sinceof India, but as he felt that the document should the Director-General had sent a letter toallbe restricted to an appeal by the Assembly to Member States asking them to use their influencethe three States to continue their co-operation to induce the three countries to reconsider theirwith he would support the decision.His Government had sent such a noteproposal of the delegation of Czechoslovakia to to the Soviet Republics. He thought an endorse-delete the fourth paragraph.Furthermore, he ment of the action previously taken by thefelt it would be useful if the general question of Director-General and the Executive Board wouldwithdrawal by Member States were submitted strengthen the resolution,and proposedtheto the International Court of Justice for future insertion,after" Invites them to reconsiderreference.As the Director-General had notified their intention and join if possible the presentthe Assembly of the absence of two of ,those sessions of the Health Assembly and those ofStates from two consecutive meetings of the the Executive Board," of the words " and endorsesExecutive Board, he withdrew his amendment the action taken by the Director-General andmade at the previous meeting regarding their the Executive Board ". temporary replacement. Dr. VILLARAMA (Philip`pines) said that while He proposed that an amendment be made to he supported the proposal of the delegation ofthe last paragraph but two of the draft resolution India, he felt that inquiry should be made, withsubmitted by the delegation of India, since only dignity,into the dissatisfaction of the threetwo of the three States in question were members States. Without that, even a ruling by the Inter-of the Executive Board.His amendment would national Court of Justice to the effect that noread :" Invites them to reconsider their inten- withdrawal was possible would not be efficacioustion and join if possible the present session of in inducing the Soviet States to return. the Health Assembly and, in the case of the USSR and the Byelorussian SSR, those of the Dr. SCHOBER (Czechoslovakia) asked the dele-Executive Board immediately following." There gate of India to agree to the deletion either ofwould be a consequential amendment in the para- the whole of the fourth paragraph or of thegraph beginning, " Regretting deeply the absence words " and in any case notification of with- ofrepresentativesoftheseStates from the drawal should properly come from the MinisterAssembly and the Executive Board." for Foreign Affairs of a Government ", in order He suggested that the penultimate paragraph to avoid any discussion. should be amended to express approval of the action taken by the Director-General and the Mr. PLIMSOLL (Australia) associated himselfExecutive Board, and should commence, " Fully with the delegate of India on the question as aapproves the action already taken by the Exe- - 305 - EIGHTH MEETING cutive Board and the Director-General in this She did not agree with the proposal of the connexion ..." delegate of Pakistan to omit reference to the Chairman of the Board and the Director-General M. DE RHAM (Switzerland), thanking the dele-continuing their negotiations, as it would vitiate gation of India for taking the initiative in invit-the resolution if no further action were taken. ing the three States to reconsider their decision,Nor did she agree with the proposal of the dele- said the draft resolution had raised three legalgate of the United Kingdom to delete mention of questions :(1) whether a Member of the Organi-the Executive Board, since it was a fact that two zation had the right to withdraw from it ;(2) since of the three States had been elected as members the communications had been received from theof that Board and their absence was regretted. Deputy Ministers of Public Health of the threeShe did not see any reason to mention that only States, whether the States had, in fact, withdrawntwo of the three States were members of the from the Organization ;(3)if there were with-Executive Board, as suggested by the delegate drawal on the part of the three States, whetherof Ceylon, but she would leave it to the discretion the two members absent from the Executiveof the Director-General to clarify that point Board should be replaced-although the expla-as he thought fit. nations of the Director-General had clarified that last point. Miss GREEN thought the inclusionin the In the light of the draft resolution submittedpresent resolution of a request to the States to by the delegation of India, it did not appearattend future meetings of the Executive Board necessary for a ruling to be given on the threemight prejudice consideration of document A2/7717 legal questions during the course of the Secondunder item 14 of the Agenda. Assembly.Although his delegation was of the Dr. SCHOBER (Czechoslovakia), said no dele- opinion that any Member of the Organizationgation could regret more than his own the absence had the right to withdraw from it, in the case inof the three Soviet States, who were pioneers question he thought it was preferable to concen-in socialist health services.He was grateful to trate on securing the future co-operation of thethe delegate of India for the draft resolution, three States.Since the aim of the Organization and to the other delegations who had supported was to raise the general level of health of allit, but he reminded the committee that Czecho- peoples in the world, he supported the proposalslovakia had criticized some of the policies of the of the delegation of India, agreeing at the sameOrganization at both the First and Second World time with the proposal of the delegate of Czecho-Health Assemblies, and could therefore under- slovakia to delete the fourth paragraph. stand the dissatisfaction of the Soviet States and the action they had taken. He thought the Soviet Mr. KAZI (Pakistan) pointed out that no infor-States would reconsider their decision only if mation was available about the request of thethere were a change in certain policies of the Chairman of the Executive Board and the Director-Organization. General to be invited to Moscow for consultations. In order to avoid misunderstanding about the In view of that fact, while supporting the draftposition of his delegation, he would abstain from resolution submitted by the delegation of India,voting on the resolution. he felt that all reference should be omitted to the Chairman and the Director-general continuing Mr. BANDARANAIKE reminded the committee theirnegotiations,as that would not be inthat he had also proposed at the previous meeting conformity with the dignity of the Organization.that the word " negotiations " in the penulti- He agreed that the fourth paragraph shouldmate paragraph should be amended to " endea- be deleted, suggesting that the resolution shouldvours ", an amendment on which the delegate be as simple as possible. of India had not commented. Miss GREEN (United Kingdom) proposed the The DIRECTOR-GENERAL said that every amend- deletion in the last paragraph but two of refer-ment proposed would be submitted to the com- ence to the Executive Board, as that was irre-mittee for acceptance or rejection. levant and would be considered under item 14 Dr. VILLARAMA (Philippines) said that unless of the Agenda. the three States were informed that the Organi- zation was willing to investigate their complaints, Rajkumari AMRIT KAUR (India) accepted thethe efforts of the Executive Board and the Direc- proposal of the delegate of the Netherlands totor-General would not meet with success. add in the eighth paragraph the words " and future " after " the present ".She also accepted The DIRECTOR-GENERAL replied that that was the proposal to preface the penultimate para-a matter to be considered by the Committee graph with the words, " Fully endorses theon Programme and the Committee on Administra- action taken by the Director-General and the 17 This document read as follows : Executive Board in that regard ".She agreed The Director-General has the honour to inform with the proposal of the delegate of Czechoslo-the Assembly, in accordance with Rule 80 of the vakia, supported by other delegations, to deleteRules of Procedure of the Assembly, that the the fourth paragraph of the draft resolution. UnionofSovietSocialistRepublics and the Byelorussian Soviet Socialist Republic failed to She suggested the omissionof the wordsbe represented, in accordance with the provisions " thereby " and " universal "inthe secondof Rules 77 and 79 at the second and third sessions paragraph. of the Executive Board. - 306 - COMMITTEE ON CONSTITUTIONAL MATTERS tion and Finance.It was within the province of The first paragraph was approved without the Committee on Constitutional Matters onlyamendment by the committee. to recommend to the other two committees that The following compromise wording was ac- the criticisms of the three States should be con-Cepted for the second paragraph : sidered and appropriate action suggested to the Assembly. Whereas the objective of the World Health Organization is the attainment by all peoples Dr. VILLARAMA said that was satisfactory as of the highest possible level of health, which far as the Committee on Constitutional Matters involves the co-operation of all countries. was concerned, but asked what would be the The third paragraph was accepted without recommendation of that committee regarding theamendment. appeal to be made to the Soviet States. The deletion of the fourth paragraph was agreed upon. The DIRECTOR-GENERAL replied that all infor- The fifth and sixth paragraphs were accepted mation regarding the deliberations of the Com-without amendment. mittee on Administration and Finance was for- After the sixth paragraph it was agreed to warded to the Soviet States as to all other Membersinsert a new paragraph reading : of the Organization. The question of programme was a longer process, developing from meetings Taking note of the observations in the of regional committees, the Special Office for communications sent to the Director-General. Europe and various expert committees which would meet in the summer and early autumn. The seventh paragraph was approved without From those meetings a programme and budget amendment. was devised which was discussed by the Execu- The eighth paragraph was approved with the tive Board.The Soviet States were invited inamendments suggested by the delegates of Ceylon the draft resolution submitted by the delegationandtheNetherlands,theparagraphbeing of India to participate in those discussions. Thereworded to read : only way to change the programme of the Organi- zation was by resolution of the Assembly or at Invites them to reconsider their intention some stage in the development of the programme. and foin if possible the present and following The Soviet States were repeatedly invited to sessions of the Health Assembly and, in the participate in every stage of the development case of the USSR and the Byelorussian SSR, of the programme, and he felt it was not possible the sessions of the Executive Board. to go beyond that. The United Kingdom proposal to delete from this paragraph the reference to the Executive Mr. RETTA (Ethiopia) said the draft resolutionBoard was rejected. called for two lines of action : one by continuation The committee approved the ninth paragraph, of the efforts of the Executive Board and theamended as follows : other by action by Member States, both of which he thought suitable. While agreeing with amend- Fully approves of the steps already taken ments to the last paragraph but two, lib thought in this regard by the Executive Board and the that might have been left to the discretion of the Director-General and requests them to continue Administration, which would be responsible for their endeavours to prevail upon the said the suggested action. States and their responsible authorities to If withdrawals were allowed to continue without change their decision and report to the Third protest, it might have bad effects on the Organi- World Health Assembly on the results of such zation, as in the case of the League of Nations. endeavours. It was a matter of principle that it was better for States to present their points of view to the The last paragraph was approved without Organization and strive to have them accepted amendment. rather than to withdraw altogether. The CHAIRMAN said the committee would vote Mr. BRADY (Ireland) endorsed the draft reso-on the entire resolution in principle. lution submitted by the delegate of India, but Decision: The resolution was adopted by stressed that his support of that resolution was 31 votes to nil, with 5 abstentions. in support of the principle of universality.The fact that the resolution was an appeal to those The DIRECTOR-GENERAL said a revisedtext States to return to the Organization should notwould be circulated at the following meeting, be taken as acceptance by his delegation of thewhen the committee would vote on the drafting criticisms made by those States. of the resolution, the substance having been The following decisions were taken on theaccepted. draft resolution submitted by the delegation of India (see p. 304) : The meeting rose at 12 noon.

- 307 - NINTH MEETING

NINTH MEETING Friday, 24 June 1949, at 9.30 a.m. Chairman: Dr. P. VOLLENWEIDER (Switzerland)

1.Adoption of draft Third Report of thetuted an important step in the implementation Committee of the provisions of the charter concerning regional arrangements. His Government was confident Decision: The draft third report was adoptedthat the Agreement would stand the acid test unanimously (for text, see p. 352). of day-to-day co-operation, and hoped that it would serve to promote the widest possible co- 2.Adoption of draft Fourth Repott of theoperation in the Western Hemisphere. The pro- Committee visions of Article 2 whereby the Pan American Mr. CALDERWOOD, Rapporteur, recalled theSanitary Conference, through the Directing Coun- decision on principle reached at the last meeting,cil of the PASO and the PASB, should serve and moved the adoption of the resolution in therespectively as the Regional Committee and the report before the committee which the Secre-Regional Office of WHO for the Western Hemis- tariat had been authorized to prepare on thephere within the provisions of the WHO Consti- basis of the text submitted by the delegation oftution, would be acceptable if interpreted in such India. a way as to allow any Member of WHO from the Western Hemisphere who was not also a member Mr. GOUDSMIT (Netherlands) asked whetherof the PASO to participate in the work of the the words " these States " in the third paragraphWestern Hemisphere Regional Committee on of the resolution referred to the Soviet Union,terms mutually agreeable to the Directing Coun- the Ukrainian and Byelorussian Soviet Socialistcil of the PASO and the interested Member.It Republics or to all members present at the Firstwas still for his Government to decide what Health Assembly. action it would take in the matter. His Govern- ment also wished to endorse the statement made Rajkumari AMRIT KAUR (India) stated thatin the Director-General's letter of 24 May 1949 it was quite clear from the text of the first para-to the Director of the PASB (see Annex 12, graph that reference was to those three Statesappendix 2) stating that the adoption of the only. Agreement, although representing a further step Mr. GOUDSMIT said that, if there was no dangerin the implementation of Article 44 of the WHO of misinterpretation, he would not insist onConstitution, did not yet constitute " integra- revision of the text. tion " in accordance with that Constitution. His Government looked forward to the time when Dr. STOYANOFF (Bulgaria) asked for the inser-representation in WHO of all the American nations tion of the words " by 35 votes with 5 absten-would make that integration possible. tions " after the words " the committee decided " in the first paragraph of the draft fourth report. Dr. SCHOBER (Czechoslovakia) asked whether the PASO had other funds apart from the appro- The RAPPORTEUR asked the Secretary whetherpriations from the WHO budget. it was customary to include a record of the vote He expressed the regret of his Government that in reports of committees. regional offices were being established on grounds of geographical proximity rather than on those M. ZARB, Legal Secretary, replied that it wasof common health problems.All would agree not usual to quote voting figures unless the votethat health problems of Canada and the United had been taken by roll-call.A record of theStates were quite different from those of the voting could always be found in the minutes.Latin-American countries.

Dr. STOYANOFF stated that he reserved his The LEGAL SECRETARY referred the delegate of right to raise the question again when the matterCzechoslovakia to Article 6 of the Agreement was discussed in the plenary meeting. with the PASO and to the temporary working arrangement, Official Records No. 17, Annex 17, Decision: The draft fourth report was adoptedpage 47, signed by the two organizations and (for text, see p. 353). which included budgetary and financial pro- visions. 3.Agreement with the Pan American Sanitary Organization (continuation from p. 300) Dr. SOPER, Director of the PASB, stated, in Agenda, 9.9reply to the delegate of Canada, that a resolution MT. HALSTEAD(Canada)statedthatthehad been adopted at the twelfth session of the Agreement with the PASO (see Annex 12) consti- Pan American Sanitary Conferencein1947 - 308 - COMMITTEE ON CONSTITUTIONAL MATTERS

recognizing Canada as a conference member.of the Constitution, since the latter provided According to the Constitution of PASO, all self-that the Regulations should come into force governing countries of the Western Hemispheretwelve months after due notice had been given were entitled to membership. of their adoption.It was obviously impossible to provide, as laid down in the original Article 20 The LEGAL SECRETARY Stated that the twoof the Nomenclature Regulations, for a period of organizations in question had suggested 1 July12 months during which a State, which had not 1949 as the date on which the Agreement wouldbeen a Member at the time of the adoption of the come into force. Regulations, could consider them. Therefore, it had been felt necessary to amend Article 20 Decision : The proposal to forward the textin accordance with Articles 21 and 22 of the of the Agreement (see Annex 12) to the Assembly Constitution.Article II of the Supplementary inserting the date 1 July 1949, was adopted.Nomenclature Regulations (see Annex 13) pro- vided a short period of notice of 60 days, after 4.Relations with Specialized Agencies (con-which the Supplementary Regulations would come tinuation from p. 303) into force if approved by the Assembly. Agenda, 9.16 Mr. jou.. (United Kingdom), while associat- Accessions to the General Convention on the Privi-ing himself with the general principle of the leges and Immunities of the Specialized Agenciesproposed Supplementary Regulations, observed that those States which had joined the Organiza- The LEGAL SECRETARY said the purpose oftion after the First Health Assembly, but before the resolution was to emphasize to all States thethe date of the adoption of the Supplementary urgency of their acceding to the Coñvention, Regulations, should be deemed to have had due which had been approved by the first Worldnotice from the date on which they joined the Health Assembly." Organization.It was reasonable to assume that those Member States had had due notice of the Dr. PAOLINI (Italy) pointed out that it wasRegulations,especially having regard to the not a question of ratification as stated in theterms of the original Article 20. French text, but of accession to the Convention. He suggested the following proviso be added to Article I of the Supplementary Regulations : The LEGAL SECRETARY explained that that Provided that in the case of such of the States modificationaffectedonly theFrenchtext, aforesaid as shall have become Members before since the English text used the word " acceded " the date of the adoption of these Supplementary -the term used in the Convention itself. Regulations the notificationreferred toin Article 20 of the Nomenclature Regulations 1948, M. GEERAERTS (Belgium) proposed that, in as amended by these Supplementary Regula- order to clarify the intention of the committee, tions, shall be deemed to have been given on governments should be invited to ratify the the date on which those States became Members. Convention because of the internal legislative measures which would result, and to notify the Mr. GUTTERIDGE pointed out that, although Director-General that they adhered to it. that amendment might be legally sound, a consi- derablecorrespondence had been exchanged After the LEGAL SECRETARY had explainedwith States which were Members at the time of that it was left to each country to decide on itsthe adoption of the Regulations concerning the internal measures for ratification, M. GEERAERTSapplication and the technical aspects of the said he agreed with this explanation. Regulations, but the exchange of correspondence had not been extended to those States which Mr. GOUDSMIT agreed with the remarks of themight be covered by the provisions of the Supple- Legal Secretary. mentary Regulations and that those States might Decision : The resolution, with the amendmentthus find themselves unable to carry out the to the French text proposed by the delegateNomenclature Regulations, although in law the of Italy, was adopted (for text, see fifth report,Regulations might be binding on them. section 2). Mr. Pm. Withdrew his amendment following that explanation, but asked if the Secretariat Nomenclature Regulations 1948 : Proposedhad been wise in omitting the dispatch of such Amendments to Article 20 information to those States.He felt that it Agenda, 9.17could be assumed that new Members would normally acquaint themselves with the Regula- Mr. GUTTERIDGE (Secretariat) said that aftertions and with the obligations of Members. the Nomenclature Regulations had been adopted," a discrepancy had. appeared between Article 20 Decision : The proposed amendment to Article 20 of the Nomenclature Regulations and Article 22 of the Nomenclature Regulations 1948, together with the Nomenclature (Supplementary) Regu- 19 Off. Rec. World Hlth Org. 13, 332 lations 1949 (see Annex 13), was adopted for 19 Off. Rec. World Hlth Org. 13, 335, 349 submission to the Assembly. - 309 - NINTH MEETING

6.Amendments to the Rules of Procedure ofment to Rule 19 be accepted, he thought ,it would the World Health Assembly (continuation)be advisable to increase the number of Members of the Committee on Nominations (in Rule 18) Agenda, 9.5from 12 to 18, since the task of that committee Other Amendments would consequently be greater. The LEGAL SECRETARY said that the amend- The amendment to Rule 27 was to add a clause ments, which had been accepted in principle atat the end of the rule to the effect that the Com- the first plenary meeting of the Second Healthmittee on Nominations would submit names to Assembly, modified Rules 3, 6, 14, 25 and 33 ofthe Assembly, which would then elect chairmen the Rules of Procedure.It remained for theof committees.The rule would then read : Committee on Constitutional Matters to report The chairmen of these committees shall be to the Second Health Assembly on the substance elected by the Health Assembly after considera- of Annex 23 to item 8.3 of Official Records No. 17. tion of the report of the Committee on Nomina- tions. Mr. GOUDSMIT suggested the deletion in the second paragraph of Rule 25 of the words " pro- The amendment to Rule 29 was a consequential vided that the vice-chairman shall not have thechange if the amendment to Rule 19 were ac- right to vote if he is of the same delegation ascepted : to replace the words " a chairman and a another member of the committee," since thatvice-chairman ", by " a vice-chairman and a point was covered in the first paragraph of therapporteur ". rule by the words, " provided that no delegation After further consideration of the proposed may have more than one representative on theamendment to Rule 74, to omit the words " If committ ee ". the Health Assembly so decides... ", his delega- tion had decided to withdraw that proposal as The LEGAL SECRETARY pointed out that it wasthe deletion might lead to difficulties for the sometimes useful to have reiteration of such aAssembly. clause to avoid misinterpretation. The new rule proposed by his delegation was as follows : Mr. DAVIN (New Zealand) agreed with the Secretary, addirrg that the right deductions were Whenever practicable, the General Committee not always made from given premises. shall make known a few days in advance the date and hour of meetings of the Assembly and Mr. GOUDSMIT withdrew his proposal in the of the committees. light of those explanations. This rule was designed to cover the needs of Decision : The committee adopted the proposedStates with small delegations who required to amendments to the Rules of Procedure forknow well in advance the times and dates of transmission to the Assembly." meetings in order to dispose their personnel to the best advantage, but it would also be of help to Additional Amendments proposed by the Govern-other delegations. ment of Belgium Dr. VILLARAMA (Philippines) suggested that M. GEERAERTS explained that he proposed the a working party should be set up to study the addition of the words " for the posts of Chairmanimrilications of the principles involved. of each of the main committees " to Rule 19 since they were important enough to be entrusted to the Nominations Committee.He thought the The LEGAL SECRETARY thought it would be choice of rapporteurs, however, might be leftpossible to dispose of any such difficulties by to the committees themselves as they were tasksgoing through the document paragraph by para- of a more technical nature. To give delegationsgraph. time to examine the lists, he proposed the addi- tion of a paragraph allowing for communication Dr. VILLARAMA said he could accept that pro- of the proposals of the Committee on Nomina-posal if he could receive assurance that protracted tions to the Assembly or the principal committeesdebate on those amendments would not take -two hours before the meeting during which theplace in the Assembly. The formation of a work- election would take place.21 Should the amend-ing party would obviate such debates.

each of the main committees, and for the mem- 22 OD% Rec. World 111th Org. 17, 19, 53 bers of the General Committee to be elected 21 The amended text of Rule 19, as proposed under Rule 25, and (b)to each of the main by the Belgian delegation, was as follows : committees, set up under Rule 27, nominations The Committee on Nominations, having regard from among the delegates for the officesof to an equitable geographic distribution and to vice-chairman and rapporteur. experience and personal competence, shall pro- The proposals of the Committee on Nomina- pose (a) to the Health Assembly from among tions shall be communicated to the Assembly the delegates nominations for the offices of the or to the main committees respectively, two President and threeVice-Presidentsofthe hours at least before the meeting during which Health Assembly, for the offices of chairmen of the election is to take place. - 310 - COMMITTEE ON CONSTITUTIONAL MATTERS

The LEGAL SECRETARY pointed out that the Decision: The proposal was adopted without amendments proposed did not concern questions amendment (for text, see fifth report, section 6). of principle.It Was desirable for the committee to finish its work as soon as possible, preferably8.Regional Offices by the following Monday, and the creation of a Agenda, 8.19 working party would retard progress. Proposal by the Delegation of the Philippines for M. GEERAERTS Stated he was ready to with- the Establishment of a Regional Office for the draw his amendment to Rule 18 if that would Western Pacific Region facilitate the work of the committee. Mr. MOORE (Secretariat) said the normal pro- Mr. HALSTEAD agreed with the delegate of thecedure was for the States concerned to consult Philippinesthat unnecessary debatesin theinformally with each other to see if the majority Assembly should be avoided, but in the light ofwas in favour of the establishment of a new the proposal made by the delegate of Belgiumregional organization.Until three of the four to withdraw his amendment to Rule 18, heStates in the Western Pacific Region consented seconded the suggestion of the Legal Secretaryto the establishment of such a regional organiza- to discuss the document paragraph by paragraph. tion, no action could be taken by the Director- It was agreed to adopt that procedure. General. Concerning Rule 19, Mr. HALSTEAD suggested the future tense might be employed throughout Dr. VILLARAMA said he had been privately the English text in accordance with the otherinformed that New Zealand and Australia were Rules of Procedure. not in favour of a new regional organization ; China was occupied in civil war ; Japan, which It was agreed that the wording of the amend-would normally come within that region, was ments would be regulated by the Rapporteur. still occupied territory, and he did not know if Sir Dhiren MITRA (India) did not see the neces-Southern Korea had yet been admitted to the sity for amendment to the first paragraph ofWorld Health Organization. His purpose in Rule 19,as that principle had already beensubmitting the document was to sound the adopted. He also felt that fixing a time limit ofreaction of other countries in the region. two hours before the meeting for submission of the proposals of the Committee on Nominations Dr. STOYANOFF said that although the region might result later in the work of the Assemblycontained a large population whose needs should being held up on a point of order. He suggestedbe considered, most of that population lived in the rule should be left in its original form. the three countries whose consent could not yet be gained.Japan was an occupied territory ; The CHAIRMAN proposed that the ExecutiveChina was in a state of civil war ; and in , Board be asked to consider the suggestions ofthe internal situation was obscure. He proposed the Belgian delegation and report to the Thirdthat the question should be studied by the Health Assembly. In any case the amendmentsDirector-General and placed on the agenda of would not affect the work of the present Assembly. the Third Health Assembly.

M. GEERAERTS, tO meet the point of the delegate Mr. PLIMSOLL (Australia) said that his Govern- of India, said he was willing to change the word-ment was prepared to co-operate with the Philip- ing of his amendment to "... are communicatedpines and other governments of the region in all to the Assembly or to the main committeesmatters of common concern in the field of health, respectively, before the meeting... "He didjust as it had done in the past.Further discus- not object to the proposal of the Chairman tosion would be necessary on such questions as the submit the amendments to the Executive Board.definition of matters of common concern, the best and most fruitful forms of co-operation Decision: The proposal to submit the amend-(e.g., was a regional organization the most suit- ments of the Government of Belgium to theable form), the proper timing of any steps taken, Executive Board for consideration and reportand the actual membership of regional organiza- to the Third Health Assembly was adopted.tions.Australia was concerned not only with the Western Pacific, but with South East Asia, 7.Request for Reconsideration of AssigmnentIndia, and other countries further afield, and to Geographical Region (Greece) all these matters would have to be discussed in detail. Agenda, 9.13 The LEGAL SECRETARY explained that that Mr. DAVIN said the remarks of the delegate item concerned the request of Greece to beof Australia were applicable to his own Govern- included,notinthe EasternMediterraneanment. He supported the suggestion of the dele- Region, but in the European Region. The Execu-gate of Bulgaria that the matter be referred tive Board had framed a resolution providingto the Director-General for study and that a for the inclusion of Greece in Area (4), compris-report should be made to the Third Health ing countries of the European continent. Assembly. - 311 - TENTH MEETING

Dr. VILLARAMA was gratified to hear that hereferred to the Executive Board, provided it had been misinformed about the unwillingness ofwas understood that each of the interested coun- Australia and New Zealand to join his countrytries in the region would be given an opportunity in a new regional organization. to be present at the discussions of the Executive Board. Mr. DAVIN replied that his Government was willing to co-operate on problems of health, but Mr. MOORE repeated that the Director-General he could give no undertaking thatit wouldand the Executive Board could take no action participate in a regional organization for theuntil a majority of the States concerned was in Westèrn Pacific Region. agreement.They could only consult Member States in that area. Mr. PLIMSOLL said that his position was the The CHAIRMAN said the proposal would be same as that of the delegate of New Zealand. noted by the Director-General and the Secretariat. He was agreeable to the matter being taken up by the Director-General and,ifappropriate, The meeting rose at 12.25 p.m.

TENTH MEETING Monday, 27 June 1949, at 9.30 a.m. Chairman: Dr. P. VOLLENWEII)ER (Switzerland)

1.Adoption of Revised Agenda San Marino had in fact made a reservation in The CHAIRMAN explained that the agenda ofrespect of its financial contribution, and this the committee had been altered. Two items onreservation not being withdrawn, the working the Agenda formerly assigned to the Committeeparty was not in a position to recommend the on Programme had now been assigned to theacceptance of the application of San Marino. Committee on Constitutional Matters :Regional Decision: It was agreed that the recommenda- Offices-items8.19.1.5(Africa)and8.19.1.6 tion contained in section 1 of the report of the (Western Pacific). working party (regarding the application of San Decision: The agenda as amended was adopted. Marino) should be submitted to the Health Assembly (see sixth report, section 1). Adoption of draft Fifth Report of the Dr. VAN DEN BERG said that the study of the Committee request of the Republic of Korea (South) for Decision: The draft fifth reportwas adoptedmembership of WHO had raised a very important (for text, see p. 353). question with regard to the actual international position of the Republic.The working party 3.Admission of New Members(continuationhad been informed that until now only a few from p. 292) States had recognized the State of South Korea Agenda, 12and for this reason it had decided not to propose acceptance of the application. 22 He had to add, Report of the Working Party however, that he had that morning received information to the effect that an error existed The CHAIRMAN asked Dr. van den Berg, Chair- man of the working party, to deal separatelyon this point and that Korea (South) had been with the two questions raised in the report sorecognized by a large number of Members of the that each could be discussed. United Nations. Dr. CHoI (Observer, South Korea) stated that Dr. VAN DEN BERG explained that the workinghis Government wished to be admitted as a party had studied the applications of San MarinoMember of WHO and to be informed of the and of South Korea for admission to membershipobstacles to admission. of WHO. This study had proved the necessity of careful examination of all requests for member- 22 The draft resolution submitted by the working ship and of all the documents concerned. party read as follows : The report made it clear that, with regard to In view of the fact that the Republic of the application of San Marino, there existed two Korea (South) does not yet command a sufficient degree of recognition amongst the international problems :(a) that of the international status community of States of San Marino, and (b) the question of the reserva- The Second World Health Assembly tion with regard to the financial obligation to be REGRETS not being able to accept Korea's undertaken by San Marino.The conclusion at application for membership in the World Health which the working party had arrived was that Organization at the present time. - 312 - COMMITTEE ON CONSTITUTIONAL MATTERS

The CHAIRMAN referred to the report of the The international and political nature of the working party, which he thought indicated thequestion was complicated. The Allies had pro- reasons for non-admission. The Republic ofmised to liberate Korea and now there was one South Korea was not sufficiently recognized ongovernment in South Korea and another in an international basis and many States had noNorth Korea ; consequently, it might be advisable diplomatic relations with it. to wait until the whole question of the recogni- tion of Korea had been considered on an inter- Dr. AVERY (Iran)expresseddissatisfactionnational scale. with the report of the working party on the Miss SWITZER (UnitedStatesofAmerica) admission of South Korea.He was not awaresupported the view of the delegate of Canada of the number of States which recognized Korea,and urged that the report be not accepted. She but he suggested that the report should not bethought thattheresolutionoftheGeneral adopted until that point had been clarified. Assembly of12 December 1948 23indicated clearly that South Korea was an independent M. ZARB, Legal Secretary, explained that innation having effective control over its internal order to obtain the necessary information to helpadministration and competent to conduct its the working party in its deliberations, the Secre-own foreignrelations. She emphasized the tariat had telegraphed to the Secretary-Generaldesirability of the widest possible membership of the United Nations for information on thefor WHO and pointed out that the United States number of countries which had recognized Korea.had always stood for this principle.She further The reply received by cable three or four daysstated that the question of North Korea, raised ago was as follows : by the delegate of Yugoslavia, was irrelevant since that question was not before the committee. SECOND PART REPORT UNITED NATIONS COM- MISSIONON KOREA CONTAINING PAGE23 Mr. PLIMSOLL (Australia) was in favour of the CONSTITUTION OF REPUBLIC OF KOREA BEINGadmission of the Republic of Korea. He stressed AIRMAILED. ACCORDING INFORMATION IN SECRE- that the resolution of the General Assembly, TARIAT FOLLOWING GOVERNMENTS RECOGNIZE quoted by the delegate of the United States, had REPUBLIC KOREA UNITED STATES CHINA PHILIP- been adopted by 50 votes to 6 and was in itself PINES UNITED KINGDOM FRANCE CHILE BRAZIL. sufficient justification for the admission of South Korea to WHO. Mr. HALSTEAD (Canada)thoughtthat,in Dr. ELICAÑo (Philippines) was also in favour considering the question, the working party hadof the admission of Korea, and his delegation was failed to take account of the action and discus-of the opinion that the admission of Korea formed sions of the United Nations on the subject. Thean important, part of the committee's programme. overwhelming majority of the Security Council,He did not think that it was necessary that a which had considered the matter first-since thecertain number of nations should recognige a General Assembly could not deal with it withoutState before admission, but that it was desirable the assent of the Security Council-had been inthat a nation making application for membership favour of the admission of this State to theof WHO should be recognized by as many States United Nations, and implementation had onlyas possible. been prevented by the use of the veto in the Security Council. Dr. MARTINEZ (Chile) expressed the support His delegation wished to support the admis-of his delegation for the views expressed by sion of South Korea for two reasons :(a) CanadaCanada, the Philippines, the United States of had already supported the membership of SouthAmerica and Australia, and said that he was in Korea in the United Nations and (b)it wasfavour of the admission of South Korea. generally desirable that, from a world health Dr. TOGBA (Liberia)also agreed with the point of view, as many States as possible shoulddelegate of Canada.Disease knew no national belong to WHO. boundaries,and membership should notbe refused on political grounds. Dr. STAMPAR (Yugoslavia) said that whilst he also thought that it was desirable that as many Dr. STOYANOFF (Bulgaria) was in agreement countries as possible should be admitted towith the report of the working party for the membership of WHO, the question of Koreafollowing reasons :(a) Korea and its people were was difficult. divided in two ; (b) the Security Council had not The point at issue seemed to be whether therecognized South Korea ;(c) if South Korea were request for admission to membership of theadmitted as a Member of WHO, it would be tantamount to making a political decision before United Nations had or had not been refused.the United Nations had taken up a position'on Only seven governments out of 64 Members hadthe matter. He felt that WHO, could not take established diplomatic relations with the Govern-this line of action, and therefore he was in favour ment of the Republic of South Korea, and as heof the report. deemed this recognition to be insufficient, he thought that the working party was justified in 28 Resolution 195 (III) of the General Assembly deferring the application. of the United Nations. - 313 - TENTH MEETING

Dr. DAVIS (New Zealand) said that, in hisWHO on the one hand and UN, ILO and UNESCO Government's opinion, South Korea should beon the other.The English text conformed with admitted. the original agreements but unfortunately the French texts had been translated separately Dr. AVERY pointed out that WHO was awith the result that there were two different strictlynon-politicalorganization whose aimFrench versions. should be to bring health to all parts of the world. He requested the admission of a country which Decision: It was agreed that the original French had been recognized by an overwhelming majority texts of the Agreements between WHO and in the United Nations as being capable of adminis- the United Nations, WHO and ILO, and WHO tering its own affairs, and he moved that the and UNESCO be approved (see Annex 25, first part of the report (relating to San Marino) French edition only). be approved, but that the second part be rejected and South Korea's admission accepted. Agreement between the International Labour Orga- nization and WHO : Amendment to Article VII The LEGAL SECRETARY pointed out that the The LEGAL SECRETARY said that last year when committee had already unanimously adopted thethe Assembly had voted the Agreement with report with reference to San Marino. The com-ILO it had been agreed that a slight amendment mittee now was considering the admission ofin the text of Article VII was desirable, this South Korea. amendment affecting the form but not the sub- Dr. GONDA (Czechoslovakia) supported thestance of the article.24The reply of ILO was views put forward by the delegates of Bulgariacontained in the document before the committee. and Yugoslavia, and thought that it would be Dr. GRUT (Observer, ILO) summarizing the better not to create a precedent by acceptingreply of his organization, said that if the original Korea until that country was recognized as atext were to be changed there was a possibility Member of the United Nations. that similar changes would have to be made in Dr. AVERY moved, and Dr. TOGBA seconded,the case of agreements already concluded with the closure of the debate. several other international organizations. His organization did not consider that there would The motion for closure was adopted. be any advantage in modifying the text of the The LEGAL SECRETARY explained that thereAgreement and it suggested that the Assembly were two proposals for consideration by theshould not stress the amendment but should committee :(a) the rejection or the adoption ofadopt the original Agreement. the working party's report concerning the admis- Mrs. WRIGHT (United States of America) was sion of South Korea to membership of WHO, andin agreement with the point of view expressed (b) the following proposal by the delegate of Iran :by ILO. The additional clarification of the text The Committee on Constitutional Matterswas not commensurate with the complications having considered the report of the workingthat might ensue therefrom. party concerning the request of admission to Decision: The committee decided in favour of the World Health Organization of South Korea the original text being retained without any decides not to accept the resolution set forth modification, by 21 votes to nil, with 7 absten- therein and recommends to the Second World tions. Health Assembly that the request for admis- sion presented by the Government of South5.Amendments to the Rules of Procedure of Korea be accepted by the Assembly. the World Health Assembly Decision: Proposal (b) being considered first, Agenda, 9.5 the resolution as moved by the delegation ofConcerning Status of Associate Members 25 Iran was adopted by 20 votes to 3, with 7 The LEGAL SECRETARY introduced the item abstentions. and the proposal was adopted for transmission The LEGAL SECRETARY stated that the Secre-to the Assembly without amendment. tariat would work with the Rapporteur of the working party in the elaboration of a new resolu- 6.Rights and Obligations in Regional Orga- tion for submission to the Assembly (for final nizations (continuation from p. 301) text, see sixth report, section 1). Agenda, 9.11 Associate Members and Other Territories (continu- 4.Relations with Specialized Agencies (con- ation) tinuation from p. 309) Sir Dhiren MITRA (India) introduced the report Agenda, 9.16of the working party (For text of the report as Inter-OrganizationAgreements:Correctionof adopted by the committee, see sixth report, p. 355) French Texts which he said was consistent with both interpre- The LEGAL SECRETARY explained that thetations of the words " Member States ". He drew committee had to pronounce on an amendmentattention to footnotes 2 and 3, the first suggested for a formal regularization.In the precedingby the delegation of Liberia concerning agree- year the First World Health Assembly had 24 Off. Rec. World Hlth Org. 13, 322 approved draft agreements concluded between 26 Off. Rec. World Hlth Org. 14, 64 - 314 - COMMITTEE ON CONSTITUTIONAL MATTERS ment by other Member States having their seatmust necessarily be a compromise solution, of government in the region, and the second anproposed the adoption of the report of the work- amendment proposed by the delegation of theing party as this would ensure that areas such United Kingdom, which had not been acceptedas Africa were not left without regional organiza- by the delegations of Bulgaria and Liberia, em-tion for a further year. phasizing the difference in status between States Members on the one hand and States Members Dr. AVERY seconded the proposal. of other territories or groups of territories not responsible for the conduct of their international Dr. VAUCEL (France) requested that discus- relations on the other. sion on that item be adjourned until the French Regarding the draft resolution submitted bytranslation of the United States proposal was the United States delegation, he said that thatavailable. proposal was based entirely on the interpreta- tion that Member States in the region meant Dr. PEREIRA (Portugal) seconded the proposal. only Member States having their capitals in the It was accordingly decided to adjourn the region. discussion on that item until the following meet- ing, to be held at 3.30 p.m. that day. Dr. VAN DEN BERG, while recognizing that any solution adopted by the Second Health Assembly The meeting rose at 11.55 a.m.

ELEVENTH MEETING Monday, 27 June 1949, at 3.30 p.m. Chairman: Dr. L. S. DAVIS (New Zealand)

1.Rights and Obligations in Regional Orga- The United States delegation would accept nizations (continuation) the draft resolution submitted by the working party with the modifications she had proposed. Agenda, 9.11 Dr. DUREN (Belgium) stated that the Belgian Associate Members and Other Territories (continu-delegation fully supported the conclusions of ation) the working party. Dr. PEREIRA (Portugal) said the problem was Mrs. WRIGHT (United States of America) stated one of the most complex and difficult facing the that,after consideration, her delegation hadAssembly.The hesitation of the First Health decided to withdraw the alternative, submittedAssembly and of the Executive Board, the atthe previousmeeting,to theresolutiondocumentation before the committee and the contained in the report of the working party. Shedebates all indicated the difficulties inherent in stressed the interest of the United States in thethe question. development of regional organizations.It should The report of the working party did not entirely be recognized, however, that the various regionsaccord with the point of view which the Portuguese differed greatly insize,economic and socialGovernment had never ceased defending since development, etc., and the form of organizationthe question was raised at the First Health would have to be adapted to those differences.Assembly. Portugal considered as Member States not only States directly represented in the Health While agreeing in general with the draft resolu-Assembly as part of the region, but also States tion proposed by the working party, she feltpossessing territories in that region which con- that it did not give sufficient consideration tostituted an integral part of the nation and which the Member States in the regions. She accordinglywere subject to the same political constitution. proposed that the words " with ,the consent ofHowever, the Portuguese delegation could sub- the majority of the Member States in the Region "mit the case for consideration by its Government, should be inserted in paragraph 2, between theprovided that the suggestion put forward was words " Region " and " may elect ".The lastnot fundamentally contrary to the basic point sentence in that paragraph appeared to be un-of view of Portugal. It had not yet been possible necessary and should be deleted. for the report, even in outline, to be communicated The provisions with regard to voting laid downto the Portuguese Government, and in con- in paragraph 3 did not entirely meet the viewsequence the delegation must adhere to the view of her delegation : she was, however, willing tohe had just outlined. accept that paragraph on the understanding It should also be recalled-and WHO was not that the matter would be subject to review inqualified to introduce any modification whatso- the light of experience. ever in the political status of the Member States - 315 - ELEVENTH MEETING

-that the Portuguese Constitution, which wasreview of the matter, in the light of experience, approved by a national plebiscite on 19 Marchby a future Health Assembly. 1933 (a plebiscite which took place throughout the Portuguese territories both in Europe and . Mr.MORETON(United Kingdom)saidhis overseas), laid down in Article 1 that the territorydelegation agreed in general with the recom- of Portugal included :(1) in Europe, Continentalmendations contained in the working party's . Portugal and the Archipelagoes of the Azoresreport.As had been noted by the Chairman of and Madeira ;(2) in West Africa, Cape Verdethe working party, Article 47 of the Constitution Islands, Guinea, Sao Tomé and Principe withwas capable of two interpretations ;since the their dependencies, S. Joao Baptista de Gyuda,compromise offered by the working party would Cabinda and Angola ;(3) in East Africa, Mozam-give the essentials necessary to allow of the bique ;(4) in Asia,Portuguese India, Macaosetting-up of regional organizations represent- and their dependencies ;(5) in Oceania, Timoring all interests in the area, his delegation accepted and dependencies.The rights which Portugalit without thereby committing themselves on had, or which it might have in the future inthe legal interpretation of Article 47.He was respect of any other territory were also main-in complete accord with the observations of the tained. delegate of South Africa. Thus, Portugal represented a population of He suggested the following modifications to about 20 million persons, all Portuguese citizens, the draft resolution submitted by the working scattered over four continents, and all enjoyingparty :(1) the substitution of the words " shall the same rights and subject to the same obliga-be " for " may elect to become " in paragraph 2 ; tions. (2) the deletionof the last sentence of para- Under those circumstances it was indispensablegraph 2 ; and (3) the inclusion in the first sentence that the criteria of his country should be respectedof paragraph 3of the words " in accordance and its Constitution observed if it was to collabor- with Articles 8 and 47 of the Constitution ". ate in the regional committees. Paragraph 3 could then be divided into two to allow of the application of these rights and Dr.GEAR(Union of South Africa) also pointedobligations to the " third category " to be subject out the complexity of the problem. The Unionto the consultation provided for in the last of South Africa desired to see every Power in asentence of Article 47. region participating in the regional organization : There were, in his view, serious objections to only in that way would the organization bethe United States proposed amendment to para- strong and comprehensive. graph 2 :it would affect the whole substance The resolution adopted by the committee wouldof the draft resolution and would be contrary lay down rules for the establishment of regionalto the provisions of Article 47 of the Constitution. organizations : therefore, great care was necessary in drafting it. He was not quite happy about the The constitutional difficulty in connexion with phrase " may elect to become Members " inthe PASO might be overcome by adding the paragraph 2 :he doubted its value both fromfollowing paragraph to the draft resolution : a legal and a practical viewpoint.The rights and obligations of States were clearly defined In view of the statement made by the Director in the Constitution, and the adoption of such of the Pan American Sanitary Organization, aprovisionmightleadtounconstitutional and the fact that integration between PASO practices. and WHO is still in process, the application of Two vital factors were not taken into account the above recommendation in the American in paragraph 3.First, it did not mention that Region shall await the completion of these territories or groups of territories in the region negotiations. which were not responsible for the conduct of their international relations should be admitted The United Kingdom delegationfelt most to the regional organization through the Memberstrongly that a decision on the matter should not Stateshavingresponsibilityfortheirinter-again be deferred. A solution should be found national relations.Secondly, the rights definedat the present Assembly, and that solution should were global and did not take into account Articlebe subject to review in the light of experience, 47 of the Constitution, which stated : " The natureas had been proposed by the delegates of the and extent of the rights and obligations of theseUnited States and the Union of South Africa. territories or groups of territories in RegionalHis delegation had always thought that Associate Committees shall be determined by the HealthMembers should be granted full rights in regional Assembly in consultation with the Member orcommittees, and at a later stage when the number other authority having responsibility for theof Associate Members was known he hoped such international relations of these territories anda solution might still be possible.He thought with the Member States in the Region. '-' the delay should be not less than three years. While the delegation of South Africa agreed He proposed that the committee should adopt in general with the intent of the draft resolution,the report of the working party with the amend- he felt it required redrafting both from the legalments he had suggested. and practical standpoints. In conclusion, he suggested that a provision Dr.VAUCEL(France) said that his delegation should be included in the draft resolution forwas unable to accept the United States amend- - 316 - COMMITTEE ON CONSTITUTIONAL MATTERS ment providing for the consent of the majority Requests the Executive Board to keep under of Member States in the region before certain review implementation of these decisions and territories could obtain equal rights in the regional to submit to the Fifth World Health Assembly organization. at the latest a report thereon in order that that Although the draft resolution presented by Assembly might determine what, if any, modifi- the working party represented a compromise, he cations are required in the above decisions in welcomed it as providing for the maximum parti- the light of experience. cipationof Member Statesinthe proposed In conclusion, he hoped the United States regional organizations, which was, in his opinion,delegate would be able to accept the amendment the main issue.Members of the committee whoto paragraph 2 proposed by the United King- had held the same views as himself appeared todom delegate. have resigned themselves toaccepting para- graphs 1 and 2,dealing with Members of the Dr. FRÓES (Brazil) stated that his delegation first and second categories.The amendmentwas unable to accept the United States amend- suggested by the United Kingdom delegate inment : it was contrary to the definition of Member that connexion would be acceptable to his delega-States which he had given to the committee at tion. It was also prepared to accept the definitiona previous meeting. The United Kingdom given by the working party of " Member States ",amendment to paragraph 2, was on the other amended as proposed by the United Kingdomhand, acceptable to his delegation. delegate, as well as the proposed additional para- Mrs. WRIGHT (United States of America) agreed graph referring to the PASO. that regional organizations could not be effective He believed that agreement could be reachedwithout the participation of the metropolitan on the draft resolution submitted by the work-countries concerned in the region : neither could ing party, which had been the result of goodwillthey be effective without the full co-operation on the part of all its members. of Member States in the region. In the interests of securing agreement, her delegation would be Dr. PEREIRA supported the United Kingdomprepared to alter its amendment to paragraph 2 amendment to paragraph 2 of the draft resolu-to read as follows, subject to acceptance of the tion. altered wording by the United Kingdom delegate : " may participate as members of the Regional Mr. HALSTEAD (Canada) stated the view ofCommittee ".26 the Canadian Government in regard to the matter. She supported the Canadian proposal that the In regional organizations there should be nomatter should be re-examined by the Fifth Health distinction of rights and responsibilities, includ-Assembly, and the United Kingdom proposal ing voting rights and proportionate financialwith regardtothe Pan AmericanSanitary liabilities,betweenMembersandAssociate Organization. Members. Associate membership should be Mr. MORETON accepted the wording of the granted sparingly and only to territories whererevised United States amendment. a fair level of public-health standards had been attained and where the size of the population The CHAIRMAN put to the vote successively warranted special consideration.Territories notthe United Kingdom proposal to add a paragraph responsible for the conduct of their internationaldealing with the Pan American Sanitary Organiza- relations but which formed a democratic entitytion at the end of the draft resolution, and the United States proposal to alter the wording of should be permitted and encouraged to sendparagraph 2. representatives to regional meetings.The Cana- The United Kingdom and the United States dian Government would like to see the widestproposals were adopted. possible participation and assumption of respon- sibility in regional meetings of WHO.In that The CHAIRMAN put to the vote the United connexion, it was assumed that representativesKingdom proposal to delete the last sentence in of dependent territories would be appointed byparagraph 2 and to add the words " in accord- their respective administrations in consultationance with Articles 8 and 47 of the Constitution " with the metropolitan Power concerned, whereafter " Regional Committees " in Paragraph 3. appropriate. The proposal was adopted. The working party's draft resolution was a worthy compromise, offering a starting point for M. GEERAERTS (Belgium) stated that he had voted against the proposal, not because he opposed the setting-up of regional organizations, and theit in principle, but because it contained expres- Canadiandelegation supportedit,withthesions in contradiction to expressions used in the amendments proposed by the United KingdomConstitution. That might give rise to difficulties delegate. of interpretation. To meet the point as to the necessity for review of the present decision, already stressed by the The CHAIRMAN then put to the vote the United delegates of the United Kingdom and SouthKingdom proposal to add the following para- Africa, he proposed that a further paragraph 26 The United States delegation later agreed should be added to the draft resolution, readingthat this should read, " shall participate... " (see as follows : minutes of the thirteenth meeting). - 317 - TWELFTH MEETING

graph after the penultimate paragraph of the The proposal was adopted. draft resolution : The CHAIRMAN finally put to the vote the In the case of territories not responsible forCanadian proposal to add a further paragraph the conduct of their international relationsto the draft resolution. and not Associate Members, the above rights and obligations shall be subject to consulta- The proposal was adopted. tion between the States Members in a region Decision: On a vote being taken, the report as defined in paragraph 1above, and the of the working party was adopted, as amended Members or other authority having responsi- (see sixth report, section 5). bility for the international relations of these territories. The meeting rose at 6 p.m.

TWELFTH MEETING Tuesday, 28 June 1949, at 3.30 p.m. Chairman: Dr. L. S. DAVIS (New Zealand)

1.Regional Offices establishmentofaregionalorganizationfor Agenda, 8.19 Africa would be greatly facilitated by consulta- Africa tion between all the Member States in the region, whether or not their seat of government was in Mr. MOORE (Secretariat) recalled the decisions Africa. of the Executive Board and the First Health He proposed that a similar procedure to that Assembly concerning the establishmentofa followed in establishing the Eastern Mediter- regional organization for Africa.27 The Executiveranean Regional Organization should be followed, Board had agreed that a necessary preliminarynamely, the convening of a meeting of all Member would be the defining of the status of MemberStates of the Region with the object of obtain- States in the region and the rights and obliga-ing their agreement to the setting-up of the tions of Associate Members and other territories.Regional Organization. The First Health Assembly had provided that the consent of the majority of Member States of Dr. VAN DEN BERG (Netherlands), M. GEERAERTS the region should be obtained. The former point (Belgium), Mr. TALJAARD, Dr. TOGBA, Dr. DA SILVA had been covered by the decision of the com-TRAVASSOS (Portugal) and Sir Aly SHOUSHA, mittee taken at its previous meeting. That deci-Pasha (Egypt), all spoke in support of the sug- sion did not in any way modify the definition ofgestion of the delegate of France. Member States as such, and it would therefore be necessary to obtain the consent of the majority The CHAIRMAN noted that, following upon the of the Member States in the African Region,committee's decision in regard to the definition namely Liberia and the Union of South Africa.of " Member States in the Region ", no obstacle now existed to the establishment of regional Dr. TOGBA (Liberia) stated that he would likeorganizations.It was simply a matter of ad- very much to see a regional organization estab-ministrative procedure following the wishes and lished for Africa. desires of members within the region concerned. The suggestion of the delegate of France. would Mr. TALJAARD (Union of South Africa) recalledtherefore be brought to the notice of the Director- that his Government had some time ago signifiedGeneral. its desire that a regional organization for Africa Decision: The committee noted the position should be established as soon as possible.He in regard to the establishment of a regional assumed that, following upon the previous day's organization for Africa. decision in regard to the status, rights and obliga- tions of Associate Members and other territories Western Pacific dependent uponmetropolitancountries,the matter would be referred to the governments Mr. MOORE recalled that the question had concerned. already been discussed under another item (see p. 311) of the agenda and a decision taken. The Dr. VAUCEL (France),while agreeing thatcommittee might therefore wish to consider that Liberia and the Union of South Africa were,it had dealt with the item. according to the Constitution, the only Member States of the African Region, considered that the Decision: There being no observations, the position in regard to the establishment of a 27 011 Rec. World Hlth Org. 17, 16, item 6.3 ; regional organization in the Western Pacific 13, 330 Area was noted. - 318 - COMMITTEE ON CONSTITUTIONAL MATTERS

2.General Convention on the Privileges and Following a point raised by Dr. VAN DEN BERG Immunities of theSpecialized Agencies(Netherlands),it was agreed to delete as in- (continuation) appropriate the words : " but only iiso far as Agenda, 9.10the activities of the Associate Member or its Its Application in Territories of Associate Membersrepresentatives were to be connected with any and in Non-Self-Governing Territories or Groups activity of WHO " in paragraph 4 of Annex B.31 of Territories Mr. GUTTERIDGE(Secretariat)outlined the M. ZARB, Legal Secretary, called attention tocomplicated procedure which would be necessary the relevant documentation." At the Firstfor the amendment of the Convention, should Health Assembly two important acts had beenthe suggestion of the United Kingdom delegate adopted in regard to the matters under considera-be accepted. A simpler procedure to give effect tion : the General Convention on the Privilegesto that suggestion would be to adopt an amend- and Immunities of Specialized Agencies and ament to Annex VII to the Convention, which resolution establishing the rights and obligationswould then be transmitted through the normal of Associate Members and of territories or groupschannels to the States signatories to the Conven- of territories not having the responsibility fortion. the conduct oftheirinternationalrelations. Document A2/47, Annex 13,22 might serve as a The CHAIRMAN suggested that it might be wise basis for discussion. to refer the question to the Executive Board for Mr. MORETON (United Kingdom) stated thatstudy, a report to be made to the Third World the United Kingdom Government had recentlyHealth Assembly. passed legislation whereby it would be enabled to accede to the Convention on Privileges and In reply to a point raised by M. GEERAERTS, Immunities of Specialized Agencies in respectthe LEGAL SECRETARY stated that the Director- of WHO. In signing the Convention the UnitedGeneral had already signed agreements with the Kingdom Government had signed on behalf ofStates (called " Host States ") in the territories all territories for the international relations ofof which the Organization and its regional orga- which it was responsible, and the privileges andnizations had been established, providing for immunities provided for would be afforded toprivileges and immunities for those organizations WHO by all such territories. He suggested thatand defining their local rights and obligations. paragraph 3 of Annex B to document A2/47 3°Further agreements would be drawn up and was unnecessary. No provision had been madesigned as occasion demanded. for signing the Convention with reservations : accordingly, governments having therespon- Decision : After further discussion and on a sibility for the conduct of the international rela- vote being taken, it was agreed :(1) to accept tions of any other territory would, in signing the in principle the United Kingdom proposal that Convention, sign automatically on behalf of such application of the Convention on Privileges territ ories. and Immunities of Specialized Agencies should The provisions of the Convention did not apply be extended to representatives of Associate to Associate Members. He was of opinion, how- Members in the World Health Assembly, and ever,thatAssociate Members and non-self- in regional committees, to representatives both governing territories should be entitled to similar of Associate Members and of other territories privileges and immunities in their own right. or groups of territories not having the respon- He therefore suggested that a resolution might sibility for the conduct of their international be adopted extending the privileges and immuni- relations, participating under the terms of ties of the Convention to the representatives of Article 47 of the Constitution ;(2) to request Associate Members in the Health Assembly and the Executive Board to submit a report to the to the representatives of Associate Members and Third World Health Assembly making recom- all other territories or groups of territories not mendations as to how the acceptance of that having the responsibility for the conduct of principle might be put into effect. theirinternationalrelationsparticipatingin regional organizations under the terms of Article The meeting rose at 5.5 p.m. 47 of the Constitution.

28 IVRec. World Hlth Org. 13, 337, 364 ;14, 14, 26 21 This paragraph read : 29 Unpublished working document. Should the application of an Associate Member " This paragraph read : be accepted, the States Members of the Organization In submitting the application of an Associateshould indicate that they would be prepared to Member, the competent political Power concerned accord to the said Associate Member or its repre- should at the same time declare on behalf of thesentatives the benefit of the provisions of the potential Associate Member that the provisionsGeneral Convention in question on an equal footing oftheGeneral Convention on Privileges andwith the Member States, but only in so far as the Immunities ofSpecializedAgencies would beactivities of the Associate Member or its repre- applied within the territory of that Member andsentatives were to be connected with any activity that steps would immediately be taken to that end. of WHO.

- 319 - THIRTEENTH MEETING

THIRTEENTH MEETING Wednesday, 29 June 1949, at 9.30 a.m. Chairman : Dr. P. VOLLENWEIDER (Switzerland)

1.Adoption of draftSixth Report of thefelt unable to vote in favour of the resolution Committee requesting the admission of Korea (South) to Mr. CALDERWOOD, Rapporteur, introduced themembership of WHO, and in relation to the rights draft sixth report and said that it covered theof Associate Members. work accomplished by the committee at its tenth, Decision: The draft sixth report of the Com- eleventh and twelfth meetings. mittee on Constitutional Matters was approved, There were two modifications to be made in the as amended (for text, see p. 355). draft report which would bring it into conformity with the action approved at these meetings. In section 5, paragraph II of the resolution,2.Adjournment of the Committee the word " may " before " participate " should The CHAIRMAN, in closing the final meeting be replaced by the word " shall ". of the committee, said that the work accomplished In paragraph III of the resolution, sub-para-would be a constructive contribution to the work graph (iv), the words " the above rights andof WHO as a whole. He felt that thanks were obligations ", should be changed to read " thedue to all members of the committee and to the rights and obligations in (ii) above " ; and theSecretariat, who had co-operated in a friendly words " shall be ", immediately following, shouldand conciliatory spirit, and in particular to the be replaced by the words " shall apply ". Vice-Chairman, the Rapporteur, the chairmen of the two working parties, and also to the After some discussion, in which the delegatesdelegate of Iran for his work in connexion with of Iran, Belgium, the Union of South Africa,the question of Associate Members. Liberia, the Netherlands and the United States of America took part, these amendments were Dr. ELIcAÑo (Philippines) moved a vote of approved by 24 votes to nil, with 4 abstentions.thanks to the Chairman which was carried by acclamation. The CHAIRMAN took note of a statement by the delegate of Yugoslavia to the effect that he The meeting rose at 10.30 a.m.

- 320 - COMMITTEE REPORTS

'The " WHA " serial numbers appearing in brackets after the resolutions of the committees correspond with those in the list of Decisions and Resolutions (Part I of this volume) and have been added to facilitate reference.

COMMITTEE ON CREDENTIALS CA2/59] 13 June 1949 FIRST REPORT

The Committee on Credentials met on 13 June Burma Mexico 1949.Representatives of the following Members Canada Netherlands were present :2 Ceylon New Zealand Dominican Republic, Egypt, France,Italy, Costa Rica Norway Pakistan, Philippines, Portugal, Union of South Denmark Pakistan Africa, Uruguay, Venezuela. Dominican Republic Philippines Egypt Portugal Professor G. A. Canaperia (Italy) was elected El Salvador Saudi Arabia Chairman, Dr. E. M. Claveaux (Uruguay) Vice- Ethiopia Sweden Chairman, and Dr. F. U. Kazi (Pakistan) Rappor- Finland Switzerland teur. France Thailand The committee examined the credentials depo- Greece Turkey sited by the delegations taking part in the Assem- Iceland Union of South bly. India Africa Iran United Kingdom The credentials presented by the delegations Iraq United States of listed below were found to be in order, thus Ireland America entitling these delegations to take part in the Italy Uruguay work of the Assembly, as defined by the Constitu- Lebanon Venezuela tion of the World Health Organization.The Liberia Yugoslavia Committee therefore proposes that the Assembly Luxembourg should recognize the validity of the credentials presented by the following delegations : Certain credentials transmitted by telegraph Afghanistan Belgium were considered by the committee to be valid, Australia Brazil provided they are confirmed by transmission Austria of the documents to which the telegrams referred. Bulgaria The committee has also taken due note of the 1 Adopted by the Health Assembly at its seconddocuments accrediting to the Assembly observers plenary meeting. sent by governments which have not yet fully 2 Roumania was also appointed to this com-completed the formalities of ratification of the mittee but was not represented at the Assembly.Constitution of the World Health Organization

[A2/61] 15 June 1949 SECOND REPORT 2

The Committee on Credentials met on 15 The committee accepted the credentials of the June 1949, under the chairmanship of Professordelegations of G. A. Canaperia (Italy). Representatives of the following countries were present : Czechoslovakia Monaco Egypt, France, Italy, Pakistan, Philippines, Hungary Poland Portugal,UnionofSouthAfrica,Uruguay,entitling the members to take part in the work Venezuela. of the Assembly asdelegates, and proposes 3 Adopted by the Health Assembly at its seventhto the Assembly that the validity of these creden- plenary meeting. tials should be recognized. - 321 - COMMITTEE REPORTS

[A2/76] 21 June 1949 THIRD REPORT

The Committee on Credentials met on 21 June The committee accepted the credentials of the 1949, under the chairmanship of Professor G. A.delegations of Canaperia (Italy).Representatives of the follow- ing countries were present : Albania Chile Ethiopia Dominican Republic, Egypt, Italy, Pakistan,entitling the members to take part in the work Portugal, Union of South Africa, Venezuela. of the Assembly as delegates, and proposes to 4 Adopted by the Health Assembly at its eighththe Assembly that the validity of these creden- plenary meeting. tials should be recognized.

[A2/90] 25 June 1949 FOURTH REPORT 5

The Committee on Credentials met on 25 Juneentitling the members to take part in the work 1949,underthechairmanshipofProfessorof the Assembly as delegates, and proposes to G. A. Canaperia (Italy).Representatives of thethe Assembly that the validity of these credent- following countries were present : ials should be recognized. Since the last meeting of the committee, the France, Italy, Pakistan, Philippines, Portugal,Secretary-General of the United Nations has Union of South Africa, Uruguay, Venezuela. stated that he has received the instrument of The committee accepted the credentials ofratification of the Constitution of the World the delegations of Health Organization by the StateofIsrael. The credentials presented by the delegates of Argentina Syria the State of Israel having been found in order, theCommittee onCredentialsproposesto 5 Adopted by the Health Assembly at its ninththe Health Assembly thattheirvalidity be plenary meeting. recognized.

COMMITTEE ON NOMINATIONS

[A2/57] 13 June 1949 FIRST REPORT

The Committee on Nominations, consisting of Raj kumari Amrit Kaur was elected Chairman, Brazil, Dr. H. P. Fróes ;Bulgaria, Dr.S. and Dr. J. N. Togba Rapporteur. Stoyanoff ;Canada, Mr. J. G. H. Halstead ; The committee presents the following nomina- Czechoslovakia, Dr. B. Schober ; El Salvador,tions for the consideration of the Second World Dr.J. Allwood-Paredes ;India,RajkumariHealth Assembly : Amrit Kaur ;Liberia, Dr. J. N. Togba ; New Zealand, Dr. L. S. Davis ; Saudi Arabia, Dr. Honorary President: Professore on. Mario Cotel- R. Pharaon ;Sweden, Dr. R. K. Bergman ;lessa, chief delegate of Italy ; Switzerland,Dr.P.Vollenweider ;Turkey, President: Dr. Karl Evang, chief delegate of Dr. E. Tok, Norway ; met on 13 June 1949. Vice-Presidents: Mr. S. W. R. D. Bandaranaike, chief delegate of Ceylon ;Dr. Naguib Scander, 1 Presented to the Health Assembly at its third Pasha, chief delegate of Egypt, and Dr. J. Zozaya, plenary meeting. chief delegate of Mexico ; - 322 - GENERAL COMMITTEE

Chairman oftheCommittee on Programme:and the following eight delegates as members Dr. H. Hyde, member of the United Statesof the General Committee :Rajkumari Amrit delegation ; Kaur (India), Dr. D. A. Dowling (Australia), Dr. H. P. Fróes (Brazil), Mr. F. U. Kazi (Paki- Chairman of the Committee on Constitutionalstan), Dr. Melville Mackenzie (United Kingdom), Matters :Dr. P. Vollenweider, chief delegate ofDr. A. Stampar (Yugoslavia), Dr. J. N. Togba Switzerland ; (Liberia), Médecin-General Inspecteur M. Vaucel Chairman of the Committee on Administration (France). and Finance : Dr. B. Schober, member of the Czechoslovak delegation ; [A2/64] 16 June 1949 SECOND REPORT 2

The Committee on Nominations met on 16 Vice-Chairman of the Committee on Constitu- June 1949, at 3 p.m., under the chairmanshiptional Matters : Dr. L. S. Davis, chief delegate of Raj kumari Amrit Kaur (India). of New Zealand ; Vice-Chairman of the Committee on Administra- The committee proposes the following nomina-tion and Finance: Dr. L.F. Thomen, chief tions : delegate of the Dominican Republic. Vice-Chairman of the Committee on Programme : 2 Presented to the Health Assembly at its seventh Dr. Irène Domanska, chief delegate of Poland ;plenary meeting.

GENERAL COMMITTEE [A2/79] 22 June 1949 FIRST REPORT 1

The General Committee held five meetings on Agreement between theCommittee on 15, 16, 17, 20 and 21 June 1949. The programme International Labour Or- Constitutional for the main committees was laid down as an- ganizationand WHO : Matters nounced in the Journal of the Health Assembly. Amendment of Article VII. The general Committee agreed to recommendRatifications of the GeneralCommittee on the allocation of the following new items proposed Convention on the Privi- Constitutional for inclusion in the agenda (under Rule 26 (d) of leges and Immunities of Matters the Rules of Procedure) as follows : the Specialized Agencies. NomenclatureRegulations,Committee on Subject Main Committee 1948 :Proposed amend- Constitutional Leprosy :Proposal by the Committee on ments to Article 20. Matters. Government of India. Programme Proposed amendments to theCommittee on Staff Regulations :Propo- Administration Draft Proposal by the delega-Committee on sal by the Government of and Finance. tion of Greece, relating to Programme. Belgium the assistance to be given todisplacedpersonsin Report on reimbursement byCommittee on that country. Goverments for materials, Administration suppliesandequipment and Finance. Proposal by the delegationCommittee on furnished by the Organiza- of the Philippine Republic Constitutional tioninconnexionwith for the establishment of a Matters. advisory and demonstra- regional organizationfor tionservicesto govern- the Western Pacific Region. ments. Additional amendments toCommittee on The first report of the Committee on Constitu- Rules of Procedure of the Constitutional tional Matters, and the first and second reports of World Health Assembly : Matters. the Committee on Programme, were submitted Proposal by the Govern- by the General Committee to the Assembly for ment of Belgium. consideration. The General Committee agreed that the Health 1 Adopted by the Health Assembly at its ninthAssembly should aim at concluding its proceedings plenary meeting. by 2 July 1949. - 323 - COMNHTTEE REPORTS

[A2/94 Rev. 1] 28 June 1949 SECOND REPORT 2

The General Committee held its sixth, seventh,by a majority vote a nomination listto the eighth, ninth and tenth meetings on 22, 23 (twoAssembly of Members entitled to designate a meetings), 24 and 25 June 1949. The programmeperson to serve on the Executive Board.3 for the main committees was laid down as an- Continued difficulty in maintaining quorums nounced in the Journal of the Health Assembly.at committee meetings was discussed by the The General Committee proposed to the HealthGeneral Committee at its ninth and tenth meet- Assembly the re-allocation of the following itemsings, and it was finally decided that, if at any on the Agenda of the Assembly as approved attime during the meeting of a main committee its third plenary session : a quorum is not present, there would be published in the Journal of the Assembly the names of Subject Main Committee delegations present at the committee meeting, Regional Offices: From Committee ontogether with those concurrently engaged in a Africa (item 8.19.1.5)Programme to Com-working party. Western Pacific mitteeonConstitu- The General Committee noted and referred to (item 8.19.1.6) tional Matters. the Assembly information that Israel, in deposit- ing an instrument of ratification of the Constitu- The first report of the General Committee, thetion, had attained full membership of the World first and second reports of the Committee onHealth Organization. A request from Israel for Administration and Finance, the second, thirdassignment to the Eastern Mediterranean Region and fourth reports of the Committee on Constitu-was referred to the Assembly. tional Matters and the third and fourth reports of the Committee on Programme were referred In order to expedite the remaining business of to the Assembly for consideration. the Assembly as much as possible, the General After careful consideration at its ninth andCommittee proposed to the Assembly the sus- tenth meetings, the General Committee adoptedpension of Rule 10 of the Rules of Procedure during remaining plenary sessions. 2 Adopted by the Health Assembly at its tenth plenary meeting. See Annex 1.

[A2/106 Rev. 1] 30 June 1949 THIRD REPORT 4

The General Committee helditseleventh,second and third reports of the General Com- twelfth and thirteenth meetings on 27, 28 andmittee ; fifth and sixth reports of the Committee 30 June 1949.The programme for the mainon Constitutional Matters ;third, fourth, fifth committees was laid down as announced in theand sixth reports of the Committee on Admin- Journal of the Health Assembly. istration and Finance ;first, second and third The General Committee fixed the date ofreports of the Joint Meetings of the Committees adjournment of the Second World Health Assem- on Programme and Administration and Finance. bly for Saturday, 2 July 1949. The General Committee recommended to the The following reports were submitted by theAssembly that the Third World Health Assembly General Committee to the Health Assembly forshould be held in Geneva commencing on 8 May consideration : 1950. Fifth, sixth, seventh, eighth, ninth, tenth and 4 Adopted by the Health Assembly at its tenth eleventh reports of the Committee on Programme ; plenary meeting.

- 324 - COMMITTEE ON PROGRAMME

COMMITTEE ON PROGRAMME [A2/63 Rev. 1] 21 June 1949 FIRST REPORT

The Committee on Programme held its first Dr. A. H. Radji (Iran) was elected Rappor- meeting on Tuesday morning, 14 June 1949, andteur. after consideration of the report of the Com- The procedure for the examination of the Pro- mittee on Nominations elected Dr. H. Hydegramme and Budget for 1950 was fully discussed, (United States of America) as Chairman. and the committee decided to recommend to the The committee held its second meeting onAssembly the adoption of the resolution as pro- Wednesday, 15 June, at 3.30 p.m. posed by the Executive Board.2 1 Adopted by the Health Assembly at its eighth plenary meeting. Resolution WHA2.1

1A2/71 Rev. 1] 21 June 1949 SECOND REPORT 3

The Committee on Programme at its third Whereas the Assembly recognizes the import- meeting, held on 16 June 1949, took the follow- ance of the World Health Organization under- ing decisions : taking as rapidly as possible measures to assist governments, as requested, to develop their 1.Election of Vice-Chairman maternal and child health programme, After consideration of the report of the Com- The Second World Health Assembly mittee on Nominations, Dr. Irène Domanska (Poland) was elected Vice-Chairman. NOTES the report of the Expert Committee on Maternal and Child Health on itsfirst session,withtherecommendationofthe 2.Maternal and Child Health Executive Board thereon.5 Report of Expert Committee [WHA2.2] The Committee on Programme recommendsJoint Activities to the Health Assembly the adoption of the The Committee on Programme took note of following resolution :4 the activities of the United Nations and specia- lized agencies in this field and the co-operative 3 As adopted by the Health Assembly at itsarrangements with WHO:3 eighth plenary meeting. 4 The Assembly deleted from this resolution a final clause which read :" REQUESTS the Director- 5 011. Rec. World Hlth Org. 19, 35 General to take appropriate action." 6 Off. Rec. World Hlth Org. 16, 15; 18, 68 ; 19, 37

[A2/83] 24 June 1949 THIRD REPORT 7

The Committee on Programme at its fourth The Second World Health Assembly and fifth meetings, held on 17 June 1949, took NOTES the report of the Expert Committee the following decisions : on Venereal Diseases on its second session 8 and the action taken thereon by the Executive 1.Venereal Diseases Board and the Director-General. Report of Expert Committee [WHA2.3] The committee recommends to the SecondJoint Activities World Health Assembly the adoption of the The committee recommends to the Second following resolution : World Health Assembly the adoption of the following resolution : 7 Adopted by the Health Assembly at its ninth plenary meeting. 8 Off. Rec, World Hlth Org. 15, 18 - 325 - COMMITTEE REPORTS

The Second World Health Assembly expenses for the secretariat (of the Council), NOTES technical services(of the congresses) and publication of their proceedings, or where (1) the activities with the United Nations and possible, by direct participationin such specialized agencies, in particular with regard technical services by the staff of the World to WHO and UNICEF participation in venereal- Health Organization ; disease control programmes with governments in implementation of the recommendations (4) that adequate justification of the use of the Joint Committee on Health Policy, made of any funds allocated to the Council UNICEF/WHO ;and by the World Health Organization should be regularly furnished by the Council ; (2) the full support of the programme proposals for 1950 given by the International Union (5)that the World Health Organization against Venereal Diseases, representing non- designate priorities for some of the Council's governmental organizations in more than 40 activities or sponsor some selected congresses. countries. 9 In such cases, the Council should use the [WHA2.4] funds provided by the World Health Orga- nizationinconformity with thelatter's decision ; 2.Training, Education and Fellowships (6) that arrangements for collaboration be Joint Activities reviewed every year and set up in accord- The committee took note of the activities ance with the policy and budgetary appro- with the United Nations, specialized agencies priations of WHO, with a view to the Council and non-governmental organizations in this field becoming eventually financially independent, and the co-operation arrangements with WHO. and 2.REQUESTS the Director-General to imple- Co-ordinationofInternationalCongresses of ment the above by making arrangements for Medical Sciences: Proposed Collaboration with collaboration with the Council on the basis of the Permanent Council this resolution and within the limits of annual The committee recommends to the Second budgetary appropriations. World Health Assembly the adoption of the [WHA2.5] following resolution : Co-operation with UNESCO in the Co-ordination The Second World Health Assembly of International Congresses of Medical Sciences 1.APPROVES the principles laid down by the In view of UNESCO's responsibilities in the Executive Board for collaboration of the World Health Organization with the Permanent Coun- field of sciences basic to medicine, and cil for Co-ordination of International Congresses Considering that the resolution of the Third of Medical Sciences, i.e. : General Conference of UNESCO 10 emphasizes its interest in the co-ordination of international (1) that the Council be recognized as a non- governmental organization to be brought congresses of medical sciences, intoofficialrelationship with the World The Second World Health Assembly Health Organization ; DECIDES that UNESCO be consulted on any (2) that a senior staff member of the Secre- question of common interest in this field, in tariat of the World Health Organization be the spirit of Article 1 of the Agreement between assigned by the Director-General to represent UNESCO and WHO,11 each organization being the World Health Organization in an ad- free to follow its own policy regarding relation- visory capacityatthe meetingsofthe ship with non-governmental organizations. Council ; [WHA2.6] (3) that the World Health Organization assist the Council in its task by giving advice, upon 10 " Jointly with the World Health Organization, request, to selected congresses of interest toto assist in the establishment of a Permanent the World Health Organization and by supply-Bureau [Council] for the co-ordina tion of Inter- national Congresses of IVIedical Sciences, and to ing them with material support in the formprovide appropriatefinancial and otheraid." of reimbursement of a part of the actual(UNESCO Third General Conference, Resolution 3.421). ° Og. Rec. World Hlth Org. 15, 27 ;16, 13 11 off. Rec. World Hlth Org. 10, 76

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[A2/84] 24 June 1949 FOURTH REPORT12

At its sixth, seventh, eighth and ninth meet-3.Co-ordination of Research and Therapeutic ings, held on 18, 20 and 21 June 1949, the Com- Substances mittee on Programme took the following deci-Reports of the Expert Committee on Biological sions : Standardization and of its Sub-Committee on Fat-Soluble Vitamins 1.Technical Training of Medical and Auxiliary The Committee on Programme recommends Personnel to the Health Assembly the adoption of the following resolutions : The Committee on Programme recommends to the Second World Health Assembly the adop- The Second World Health Assembly tion of the following resolution : (1)NOTESthe report of the Expert Committee on BiologicalStandardization on itsthird Having considered the policies to be followed session and the report of its Sub-Committee in implementing the programme of technical on Fat-Soluble Vitamins ;13 training of medical and auxiliary personnel as (2)REFERSthese reports to the Executive set out in Official Records of the World Health Board for consideration and action. Organization No. 18, pages 118 to 127, Wishing to join in the homage rendered to the memory of Mr. P. Bruce White by the The Second World Health Assembly Expert Committee on Biological Standardiza- RE QUESTSthe Director-General : tion, (1) to arrange fellowships on a group basis as The Second World Health Assembly far as possible (this should not be interpreted RE QUESTSthe Director-General to convey as excluding individual fellowships) ; and to the family of Mr. Bruce White the sympathy (2) to encourage the establishment and develop- of the Assembly. ment by governments of national educational [WHA2.9] institutes in the field of health, and to encourage the development of courses having an inter-Reports of the Expert Committee on the Unification nationalcharacteratexistingeducational of Pharmacopoeias institutes or institutes to be created, by the The Committee on Programme recommends to provision of assistance in personnel and material. the Health Assembly the adoption of the follow- ing resolution : [WHA2.7] The Second World Health Assembly 2.Publications (1)NOTESthe reports of the Expert Committee International Digest of Health Legislation on the Unification of Pharmacopoeias on its third14and fourth15sessions ; and The Committee on Programme recommends (2)REFERSthese reports to the Executive to the Health Assembly the adoption of the Board for consideration and action. following resolution : [WHA2.10] Whereas the publication of the International Digest of Health Legislation involves difficultReport of the Expert Committee on Habit-Forming problems of selection of material and of the Drugs relative prominence to be given to it, The Committee on Programme recommends to the Health Assembly the adoption of the follow- The Second Wo.rld Health Assembly ing resolution : RESOLVESthattheDirector-Generalbe The Second World Health Assembly requested to submit to the Third World Health NOTESthe report of the Expert Committee Assembly a report on the methods considered on Habit-Forming Drugs on its first session.16 to be most satisfactory of making available information on health legislation and of pre- [WHA2.11] sentationand publicationofsuchhealth la Both reports to be published. See also report legislation as is considered to be of internationalof the ad hoc committee of the Executive Board, importance. Part II, Annex 2. [WHA2.8] 14Off. Rec. World Hlth Org. 15, 39 " To be published. See also report of the ad hoc committee of the Executive Board, Part II, 12Adopted by the Health Assembly at its ninthAnnex 2. plenary meeting. 12Off. Rec. World Hltlt Org. 19, 29 -- 327 - COMMITTEE REPORTS

4.Nutrition on Nutrition the question of the establishment of joint FAO/WHO national nutrition com- Joint Activities mittees ; and The committee took note of the activities with (2)AUTHORIZES the Executive Board to make the United Nations and specialized agencies, in appropriate recommendations on this subject particular with FAO, and recommends to the to the Third World Health Assembly after Second World Health Assembly the adoption of consideration of the report of the joint com- the following resolution : mittee. The Second World Health Assembly [WHA2.13] (1)NOTES the harmonious relations which haveProduction of Synthetic Vitamins been established with FAO ; The committee recommends to the Assembly (2)REQUESTS the Director-General to continuethe following resolution : the policy of close co-operation with FAO on nutrition problems and projects. The Second World Health Assembly (1)REQUESTS the Director-General to bring to [WHA2.12] the attention of the FAO/WHO Joint Com- National Nutrition Committees mittee on Nutrition the question of the manu- The committee recommends to the Assembly facture of synthetic vitamins in under-developed the following resolution : countries ; and The Second World Health Assembly, (2)AUTHORIZES the Executive Board to make appropriate recommendations on this subject Considering the importance of national nutri- to the Third World Health Assembly after tion committees, consideration of the reportofthe above- (1)REQUESTS the Director-General to bring to mentioned committee. the attention of the Joint FAO/WHO Committee [WHA2.14]

[A2/89] 25 June 1949 FIFTH REPORT "

The Committee on Programme at its tenth, Epidemiology and Quarantine for re-examina- eleventh and twelfth meetings held on 21 and tion in the light of the report of the Expert 22 June 1949, took the following decisions : Committee on Insecticides, together with the observations of the Committee on Programme 1.Epidemiological Services on the subject ; 21 Sanitary Conventions and Quarantine (4)REQUESTS the Director-General to call the attention of national health administrations Report of the Expert Committee on International to the need for eliminating quarantine restric- Epidemiology and Quarantine tions of doubtful medical value which interfere The committee recommends to the Second with international trade and travel, and to the World Health Assembly the adoption of the present unsatisfactory tendency to multiply following resolution : the number of immunization certificates re- quired from travellers. The Second World Health Assembly [WHA2.15] (1)NOTES the report of the Expert. Committee on International Epidemiology and Quarantine Report of the Section on Quarantine of the Expert on its first session ; 12 Committee on International Epidemiology and (2)APPROVES the principles to govern WHO Quarantine Sanitary Regulations contained therein and The committee recommends to the Second in the memorandum of the expert committee'sWorld Health Assembly the adoption of the Rapporteur 22 with the exception of that sec-following resolution : tion covering the sanitary inspection of sea and air craft ; 22 The Second World Health Assembly (3)REFERS the above-mentioned section back NOTES the report of the Quarantine Section to the Expert Committee on International of the Expert Committee on International Epidemiology and Quarantine onitsfirst 17 Adopted as amended by the Health Assembly session. 22 at its tenth plenary meeting. [WHA2.16] 18 Off. Rec. World Hlth Org. 19, 5' 12 Off. Rec. World Hlth Org. 19, 12 21 See minutes of the tenth meeting, section 1. 28 Section 2.5.3, Off. Rec. World Hlth Org. 19, 14 28 Off. Rec. World Hlth Org. 19, 16 -328 - COMMITTEE ON PROGRAMME

International Epidemic Control economic benefits to be expected from their The committee recommends to the Second use on a large scale ; and World Health Assembly the adoption of the (4)RECOMMENDS tO all governments that they following resolution : require from manufacturersofinsecticidal The Second World Health Assembly products the correct labelling of such products as regards their content in active ingredients. NOTES the reports of the following study- Such requirement need not, however, be im- groups : posed in those countries where the national Second session of the Joint ()MP/WHO Study- authorities have developed a machinery whereby Group on Cholera,23 and the field research work insecticidal products are tested for efficacy for on the factors of cholera endemicity being specific purposes and are officially " approved " carried out by the Government of India as a for the said purposes. result of the recommendations of the study- [WHA2.18] group ; Second session of the Joint OTHP1WHO Study-2.Co-ordination of Research Group on Plague24and the offer made by the The Committee on Programme, having studied Government of India to set up a training centrethe memorandum on research submitted by the for field plague-control personnel in the Haff- delegation of the Government of India29endorses kine Institute, Bombay ; the views contained therein, and recommends Second session of the Joint OMPIWHO Study-to the Health Assembly the adoption of the Group on Smallpox25 following resolution : First session of the Joint OMPIWHO Study- Whereas the development of planned pro- Group on Trachoma26 grammes requires continuous application of Expertconsultationonactiveimmunization research and investigation on many problems, against common communicable diseases of child- the solution of which may be found essential hood." for the diagnosis, treatment and prevention [WHA 2.17] of disease, and for the promotion of positive health ; Insecticides The committee recommends to the Second 'Whereas research includes field investiga- World Health Assembly the adoption of the tions as well as those conducted in laboratories, following resolution. The Second World Health Assembly The Second World Health Assembly RESOLVES that the following guiding prin- (1)NOTES the report of the Expert Committee ciples should be applied in the organization on Insecticides on its first session ;28and of research under the auspices of the World Health Organization : Considering that the report contains technical information and advice for the Expert Com- (1) research and co-ordination of research mittee on Malaria and the Expert Committee are essential functions of the World Health on International Epidemiology and Quarantine, Organization ; (2)REFERS this report to the above-mentioned (2) first priority should be given to research expert committees, together with the observa- directly relating to the programmes of the tions contained in the summary records relat- World Health Organization ; ing to the discussions on the subject ; (3) research should be supported in existing (3)RE QUESTS the Director-General to refer institutions or should form part of the duties to the attention of the Economic and Social of field teams supported by the World Health Council at its next sessiou the serious considera- Organization ;36 tionof the proposal that countries waive (4) all locally supported research should be customs duties on material for insect control so directed as to encourage assumption of in view of the very important sanitary and responsibility for its continuance by local agencies where indicated ; 23Off. Rec. World Hlth Org.19,24 (5) the World Health Organization should 24Off. Rec. World Hlth Org.19,18.This study- not consider at the present time the establish- group also considered rickettioses and sanitary measures appropriate for merchandise in inter- ment, under its own auspices, of international national traffic. research institutions. 25Off. Rec. World Hlth Org.19,22 [WHA2.19] 26Off. Rec. World Hlth Org.19,27 29See Annex 15. 27To be published. 39The Assembly amended this clause by the 28 To be published. substitution of the word " and " for " or ".

- 329 - COMMITTEE REPORTS

[A2/91] 27 June 1949 SIXTH REPORT 81

The Committee on Programme, at its thirteenth,Joint Activities fourteenth and fifteenth meetings held on 23 and The committee took note of the activities with 24 June 1949, took the following decisions : the United Nations, specialized agencies and non- governmental organizations, particularly in co- 1.Malaria operation with UNICEF and the International Joint Activities Union Against Tuberculosis, and recommends The committee took note of the activities withto the Second World Health Assembly the adop- the United Nations and specialized agencies, intion of the following resolution : particular with the Economic and Social Council, The Second World Health Assembly FAO and with UNICEF, and recommends to the Health Assembly the adoption of the following NOTES with satisfaction the arrangements resolution : outlined for co-operation with UNICEF and the International Union Against Tuberculosis The Second World Health Assembly in the field of tuberculosis.35 (1)NOTES the joint activities carried out by [WHA2.23] WHO with the Economic and Social Council, FAO and UNICEF, and 3.Joint Committee on Health Policy, UNICEF/ (2)REQUESTS the Director-General to continue the policy of close co-operation with these WHO organizations in regard to methods of malaria The committee recommends to the Second control. World Health Assembly the adoption of the [WHA2.21] following resolution : Expert Committee on Malaria Whereas the First World Health Assembly The committee recommends to the Health recommended the establishment by the World Assembly the adoption of the following resolu- Health Organization and by the United Nations tion : International Children's Emergency Fund of a The Second World Health Assembly joint committee on health policy, to regulate the (1)NOTES the resolution proposed by the health programmes and projects of UNICEF ; 38 Italian delegation concerning the transforma- Whereas this Joint Committee on Health tion of the Expert Committee on Malaria into Policy was established and has laid down an expert committee on malaria and other principlesandpoliciesgoverningtheco- insect-borne diseases,32 operative relations of WHO and UNICEF, (2)NOTES the comments thereon expressed which have been approved by the respective by the delegation of the Philippines," Executive Boards of WHO and UNICEF ; (3)RESOLVES that this question be referred Whereas the WHO members of the Joint to the Executive Board for consideration with Committee on Health Policy have submitted a request to report on the subject to the Third a report to the Second World Health Assembly World Health Assembly. on certain aspects of these relationships ; 37 [WHA2.20] 2.Tuberculosis The Second World Health Assembly Report of Expert Committee (1)NOTES with satisfaction the progress made The committee recommends to the Second in improving co-operation with UNICEF, as World Health Assembly the adoption of the shown in the report of the WHO members of following resolution : the Joint Committee on Health Policy ; The Second World Health Assembly (2)APPROVES this report,38 and (1)NOTES the report on the third session of (3)REAFFIRMS the resolution adopted by the the ad hoc Expert Committee on Tuberculosis ; 33 First World Health Assembly,33 that the health and projects of UNICEF fall within the competence of the World Health Organization, and that (2)ENDORSES the decision of the Executive the World Health Organization is ready and Board at its third session 34 that the report be willing to handle these projects. further considered by the enlarged expert [WHA2.24] committee. [WHA2.22] 35 Off. Rec. World Hlth Org. 18, 100 ;see also 31 Adopted by the Health Assembly at its tenthminutes of the fourteenth meeting, section 3. plenary meeting. 36 Off. Rec. World Hlth Org. 13, 327 82 See Annex 3. " See Annex 4. 38 Off. Rec. World Hlth Oyg. 15, 5 38 See Annex 4. 34 Off. Rec. World Hlth Org. 17, 11 39 Off. Rec. World Hills Org. 13, 327

- 330 COMMITTEE ON PROGRAMME

[A2/92] 27 June 1949 SEVENTH REPORT 40

The Committee on Programme at its fifteenthJoint Activities and sixteenth meetings, held on 24 June 1949, The committee recommends to the Second took the following decisions : World Health Assembly the adoption of the following resolution : 1.Mental Health Retort on the Nuclear Committee on Mental Health The Second World Health Assembly The committee recommends to the Second NOTES World Health Assembly the adoption of the (1) the activities with the United Nations, and following resolution : specialized agencies, in particular with regard The Second World Health Assembly to the prevention of crime and treatment of NOTES the action of the Director-General in offenders and the study of tensions affecting convening a meeting of the nuclear committee international understanding, and on mental health, to be held during 1949. (2) the full support of the programme proposals [WHA2.25] for 1950 given by the World Federation for 4° Adopted by the Health Assembly at its tenth Mental Health. plenary meeting. [WHA2.26]

rA2/93] 26 June 1949 EIGHTH REPORT 41

At its eighteenth and nineteenth meetings, held Commission for Europe, of assisting the Govern- on 25 and 26 June 1949, the Committee on Pro- ments of Czechoslovakia, Poland and Yugo- gramme took the following decisions : slavia in the modernization of their UNRRA- donated penicillin plants ; 1.Medical Supplies Section (2)RE QUESTS the Director-General to con- After taking note of the report of the Director- tinue co-operation with the Secretariat of the General on this subject 42 the committee recom- Economic Commission for Europe with a view mends to the Health Assembly the adoption of to increasing the availability of other essential the following resolution : medical supplies,particularlyforthe war The Second World Health Assembly damaged countries of Europe. (1)NOTES the report of the Director-General [WHA2.28] on the study of the supply of insulin which shows that present and future world supplies of 3.Public-Health Administration insulin are adequate in quantity and quality to meet the normal requirements, and Physical Training (2)REQUESTS the Director-General to advise governments, upon request, concerning the The committee recommends to the Second means of obtaining the necessary requirementsWorld Health Assembly the adoption of the of insulin and to explore the possibilities offollowing resolution : manufacture in various countries. The Second World Health Assembly [WHA2.27] RE QUESTS the Director-General to proceed 2.Co-operation with the Economic Commis- with the collection of information on physical sion for Europe training and to hold consultations with experts The committee noted the report of the Director- with a view to submitting a programme to the General on this subject 42 and recommends to the Third World Health Assembly. Assembly the adoption of the following resolu- [WHA2.29] tion : Joint Activities The Second World Health Assembly The committee recommends to the Second (1)APPROVES the provisional programme ofWorld Health Assembly the adoption of the action,evolved jointly with the Economicfollowing resolution : 41 Adopted by the Health Assembly at its tenth plenary meeting. The Second World Health Assembly 42 See minutes of the nineteenth meeting, sec- tion 2. NOTES the activities carried on in co-opera- 42 See minutes of the nineteenth meeting, p. 213, tionwith the United Nations,specialized f ootnote 83. agencies and non-governmental organizations,

- 331 -- COMMITTEE REPORTS

and in particular the report on the Joint ILO/ The Second World Health Assembly WHO Committees on Occupational Hygiene (1)NOTES the report of the Director-General and Hygiene of Seafarers." on co-ordination, and [WHA2.30] (2)REQUESTS the Director-General to continue 4.GeneralCo-ordinationwiththeUnited collaboration with the Secretary-General of the Nations,SpecializedAgenciesorNon- United Nations and the Directors-General of Governmental Organizations other specialized agencies through the mecha- The committee recommends to the Health nism of the Administrative Committee on Assembly the adoption of the following resolution : Co-ordination and its subsidiary bodies, and by appropriate representation at the meetings " Seeminutesofthenineteenthmeeting, of other United Nations bodies. section 4. [WHA2.31]

[A2/101] 29 June 1949 NINTH REPORT "

At its twentieth meeting, held on 28 June 1949, Economic and Social Council communicate such the Committee on Programme took the following recommendations asit may be considering decisions : within the field of health to WHO, which, under its Constitution and the Agreement, is required 1.Activities with the United Nations, Spe- toconsider such recommendations and to cializedAgenciesor Non-Governmental report to the Council on the steps taken by Organizations WHO to give effect to them. [WHA2.32] United Nations Proposals to create International Research Laboratories 2.Assistance to Displaced Persons The committee recommends to the Health The committee recommends to the Second Assembly the adoption of the resolution proposedWorld Health Assembly the adoption of the by the Executive Board at its third session, read-followingresolution : ing as follows : Considering the disastrous consequences of The Second World Health Assembly the situation of displaced persons in different parts of the world as regards its health aspects (1)NOTES resolutions 22 (III) and 160 (VII) as well as the risks of epidemics in their respec- of the Economic and Social Council regarding the establishment of United Nations research tive regions, laboratories, and the report of the Secretary- The Second World Health Assembly General on this subject (UN document E/620) ; DRAWS THE ATTENTION of the Economic and (2)CONFIRMS the resolution concerning this Social Council of the United Nations to this subject which was adopted by the Interim situation,and recommendsitsimmediate Commission of WHO on 11 November 1946,46 examination at a meeting of the Economic and and the views of the Interim Commission as Social Council to be held in Geneva on 5 July stated to the Secretary-General of the United 1949. Nations by the Executive Secretary of the [WHA2.33] Interim Commission on 4 December 1946 ; (3)CONSIDERS that research in the field of 3.United Nations Library, Geneva health is best advanced by assisting, co-ordinat- The committee recommends to the Second ing and making use of the activities of existingWorld Health Assembly the adoption of the institutions and that the Health Assembly andfollowing resolution : the expert committees of WHO provide an adequate mechanism for the implementation The Second World Health Assembly of such a policy ; RE QUESTS theDirector-Generaltocom- (4)RE QUESTS that, in view of the responsibility municate to the Secretary-General of the United and authority placed upon WHO in respect of Nations its appreciation of the action taken international research in the field of health by the Secretary-General in placing before the and in implementation of the Agreement be- ninth sessionof the Economic and Social tween the United Nations and WHO, the Council proposals for the loan to WHO by the United Nations Library, Geneva, for an in- " Adopted by the Health Assembly at its tenth definite period, of certain medical and health plenary meeting. material needed by WHO. " Oft. Rec. World mui Org. 4, 139 [WHA2.34] - 332 - COMMITTEE ON PROGRAMME

4.World Health Day Whereas most schools in many countries are closed on 22 July and therefore cannot serve The committee recommends to the Second in such manner ; World Health Assembly the adoption of the Whereas the date of 7 April, the day when following resolution: the Constitution of WHO officially entered Whereas it was decided by the First Health into force in 1948, provides a suitable alterna- Assembly that the Organization should sponsor tive without such disadvantages, the observance of World Health Day on 22 July ' The Second World Health Assembly each year by all States Members ; RESOLVES that, beginning in 1950 and each Whereas in every country the schools and year thereafter, World Health Day should other educational institutions could and should appropriately be observed on 7 April by all act as important focal points for the observ- States Members. ance of this day ; [WHA2.35]

[A2/102] 29 June 1949 TENTH REPORT 47

The Committee on Programme, at its various The Second World Health Assembly meetings, took the following decisions : RESOLVES (1) that the Director-General be requested to 1.Venereal Diseases refer to the Executive Board the proposal that an International Health Y earbook be published, Bejel and other Treponematoses and to obtain the comments of the Board on The committee recommends to the Second its possible form, content, periodicity and use- World Health Assembly the adoption of the fulness ; following resolution.48 (2) that the Director-General be requested to The Second World Health Assembly report further on this proposal to the Third (1)APPROVES the action taken by the Execu- World Health Assembly. tive Board and the Expert Committee on [WHA2.37] Venereal Diseases as regards bejel ; 3.Health Statistics (2)REALIZES the importance of treponema- toses other than syphilis, such as yaws and The committee recommends to the Second bej el ; World Health Assembly the adoption of the (3) AUTHORIZES the Executive Board to establishfollowing resolutions : an expert group on treponematoses, consisting of the experts on syphilis of the Expert Com-Report of Expert Committee mittee on Venereal Diseases and six experts The Second World Health Assembly on other treponematoses, to study these diseases NOTES the report of the Expert Committee and make recommendations for further action on Health Statistics on its first session.5° concerning them. [WHA2.36] RESOLVES (1) to request the Executive Board to establish 2.Editorial and Reference Services during its next session : (a) a temporary sub-committee of the Expert Programme of Publications Committee on Health Statistics to study the The committee recommends to the Second uestion of the definition of stillbirth and World Health Assembly the adoption of the abortion ; following resolution : (b) a sub-committee of the Expert Committee Whereas the character and usefulness of the on Health Statistics to initiate the proper proposed International Health Y earbook require action to be taken by the committee in the further careful consideration, field of hospital statistics, primary attention to be given to the application of the new 47 Adopted by the Health Assembly at its tenth InternationalStatisticalClassificationof plenary meeting. Diseases, Injuries, and Causes of Death and 48 The budgetary implications of the proposal related subjects, appropriate questions being contained in this resolution would be : decentralized for study by national com- Expert Advisory Committee . . $9.000 mittees on health statistics ; Total of project $9,000 48 off. Rec. World 1-11th Org. 17, 11 ;15, 29 " To be published. - 333 - COMMITTEE REPORTS

(c) a sub-committee of the Expert Committee of implementing the recommendations con- on Health Statistics entrusted with the study tained in the report of the Expert Committee of problems concerning the registration of on Health Statistics. cases of cancer as well as their statistical [W H A2.39] presentation ; Use of Statistical Methods Having consideredthe memorandum on (2) to request the Director-General to establish Health Statistics by the United Kingdom a unit for maintaining relationship with national Delegation," committees on vital and health statistics (or their national equivalents) ; The Second World Health Assembly (3) to request the Director-General to set up RESOLVES a clearing centre for problems arising in the (1) that in the field and laboratory investiga- application of the Manual of the International tions and action carried out by WHO or with Statistical Classification of Diseases, Injuries, its assistance, the fullest possible use of avail- and Causes of Death, including arrangements able statistics and modern statistical methods for the use of such national skills as might be should be made in the planning and execution necessary to supplement those available in the of such investigations and action and in the Organization ; evaluation of their results ; (4) to request the Director-General to arrange (2) that it is desirable that, wherever suitable for a handbook or handbooks to be prepared health statistics exist or can be made avail- able within a reasonable time, they should be summarizing the present position in different examined in order to make a preliminary countries with regard to the collection of health assessment of the need for the investigation statistics ; or action contemplated ; (5) pending the result of the studies to be carried (3) that although it is recognized that, in many out by the sub-committee on cancer statistics countries, such suitable statistics may not be referred to in (1)(c), to request the Director- readily available, the absence or insufficiency General to make arrangements for the publica- of these statistics should not prevent investiga- tion in 1950 of the Annual Report on the Results tions and necessary action being undertaken of Radio-therapy on Cancer of the Uterine Cervix, in those countries where prima facie considera- at present in operation, the sub-committee to tions necessitate such investigations or action ; consider the modifications to be made in the (4) that it is essential in any event that con- presentation of further possible editions of this tinuous statistical control and analysis of the Annual Report with a view to adapting it to investigations and action should in every case the new conditionsof international cancer be provided for and carried out to the fullest statistics, which will have been studied by it ; extent practicable ; and (5) that the Director-General be requested to (6) with the aim in view of initiating the estab- submit to an early meeting of the Executive lishment of vital and health statistics systems Board a report on the present administrative or services in underdeveloped areas or of better- arrangement in the World Health Organiza- ing those already in existence in them, even tion in the sphere of statistics (health, epidemio- if still in a primitive state, and also of making logical, medical and vital) and to indicate any possible the evaluation of the effectiveness of changes he thinks necessary or has carried out. projects carried out for improving health and nutrition in such areas, to request the DireCtor- [WHA2.40] General to undertake the study of such questions4.Malaria by means of conferences, within the regionJoint Programme of Co-operation between FAO concerned,betweenspecialistsorqualified and WHO to increase World Food Production representatives of the areas and one or more and to raise Standards of Health 52 experts in health statistics from WHO, in co- The committee recommends to the Second operation with other United Nations agencies,World Health Assembly the adoption of the if necessary. following resolution : [WHA2.38] Whereas the Economic and Social Council at its sixth session (2 March 1948) " invited Registration, Compilation and Transmission the specialized agencies concerned and the In view of the value of health statistics in regional economic commissions, in consulta- the proper understanding of epidemiological tion with FAO, to study suitable measures to and other medical and public-health problems, bring about an increase in food production " ; The Second World Health Assembly Whereas the present necessity of increasing food production in the world requires develop- DRAWS THE ATTENTION Of Member Govern- ment of tropical and subtropical areas where ments to the great importance to be attached to the registration, compilation and trans- 51 See Annex 6. mission of health statistics, and to the means 52 See Annex 7. - 334 -- COMMITTEE, ON PROGRAMME

standards of health in general should be raised of regional consultant tuberculosis officers to and in particular where malaria must be con- the Executive Board ; and trolledbeforeany schemeofagricultural (2)APPROVES an increase in personnel avail- development and settlement can be started ; able for Field Services in 1950 from 27 to 37 Whereas FAO has already given favourable in the Regular Budget for tuberculosis. consideration to joint WHO/FAO broad-scale projects aiming at increasing food production, [WHA2.42] at raising standards of living and at achieving malaria control in fertile areas, 6. Leprosy The committee recommends to the Second The Second World Health Assembly World Health Assembly the adoption of the (1)RESOLVES that the 1950 programme shouldfollowing resolution : include provision to enable WHO to carry out, in collaboration with FAO, general surveys for The Second World Health Assembly the selection of the areas where operations will be undertaken in the following five years ; RESOLVES (1) that an expert committee with the 'maximum (2)RECOGNIZES that such provision will involve the obligation to provide in the programme of number of nine be established and that provi- WHO for the following five years for the opera- sion be made for a meeting of this committee tion of the various projects ; and in 1950 ; (2) that provision be made for the exchange, (3)RECOMMENDS to FAO that similar action be taken with a view to enabling the two during 1950, of four selected leprosy workers organizations to plan the projects in 1949 and from among the existing leprosy institutes in to initiating joint surveys in 1950. different countries ; (3) that provision be made for making available [WHA2.41] three experts for an average period of eight 5.Tuberculosis months in each case to countries requiring guidance in the development of anti-leprosy The committee recommends to the Second work ; World Health Assembly the adoption of the (4) that provision be made for the supply of following resolution : sulfones and other new leprosy drugs for control trials by selected leprosy workers under The Second World Health Assembly the conditions to be laid down by the expert (1)REFERS the question of the services of committee. temporary consultants and the appointment [WHA2.43]

[A2/103] 29 June 1949 ELEVENTH REPORT 53

1.Availability of Technical Knowledge of The Second World Health Assembly Production Processes of Antibiotics : Peni- cillin,Streptomycin,Chloromycetin, Au- CONSIDERS that any withholding of scientific reomycin or technical information on essential thera- peutic and prophylactic drugs, in selling or At its twenty-first meeting held on 29 June otherwise supplying nations with the means 1949, the Committee on Programme considered for their production, or withholding the free the proposal submitted by the Polish delegation, exchange of medical scientists, is not compatible and recommends the following resolution for with the ideals of the World Health Organiza- adoption by the Health Assembly : tion and is against the interests of humanity. " Adopted by the Health Assembly at its tenth plenary meeting. [WHA2.44]

- 335 - COMMITTEE REPORTS

COMMITTEE ON ADMINISTRATION AND FINANCE

[A2/72] 21 June 1949 FIRST REPORT 1

The Committee on Administration and Finance the seat of central administration of the Member held three meetings on 14, 16 and 17 June 1949. or Associate Member to the place of the meet- ing, and not to include the payment of subsist- ence, except where this is included as an integral 1.Election of Officers part of the regUlar posted schedule for first-class Dr. B. Schober (Czechoslovakia) was elected accommodation for recognized public transport. Chairman of the committee, Dr. L. F. Thomen [WHA2.46] (Dominican Republic) was elected Vice-Chairman and Mr. T. Lindsay (United Kingdom) was elected4.Insurance against Travel Accidents of Dele- Rapporteur. gatestotheHealth Assembly and of Members of the Executive Board 2.AdministrativeandFinancialRelations The committee agreed to recommend to the between the United Nations and SpecializedHealth Assembly thatitadopt the following Agencies resolution Considering that, in virtue of the decision of The committee agreed to recommend to the the World Health Assembly 2 the Organization Health Assembly that it adopt the following hasacceptedtoreimbursethetravelling resolution : expenses to the Health Assemblies of one delegate or representative of each Member or The Second World Health Assembly Associate Member of WHO and of the members (1)APPROVES the action taken by the Director- of the Executive Board to meetings of the General to achieve co-ordination on budgetary, Board, administrative and financial practices between the World Health Organization, the United The Second World Health Assembly Nations and other specialized agencies ; (1)STATES that the Organization does not accept any liability for travel risks incurred (2)REQUESTS the Director-General to continue participation in the Administrative Committee by this provision ; and on Co-ordination and to take such other action (2)REQUESTS the Director-General to com- as he believes necessary to achieve more com- municate this decision to the governments of plete co-ordination, providing always that due Member States, notifying them that WHO recognition be given in each case to the prob- assumes no responsibility to provide insurance lems inherent in the individual requirements cover for persons travelling to meetings of the of each of the agencies concerned. Health Assembly and of the Executive Board. [WHA2.47] [WHA2.45] 5.Proposed Amendments to the Staff Regul- 3.Transportation and/or per diem Allowance ations for Delegates to the Third and Subsequent The committee decided to recommend to the Health Assemblies Health Assembly that it adopt the following The committee agreed to recommend to theresolution : Health Assembly thatit adopt the following The Second World Health Assembly resolution : RESOLVESthatthefollowingregulations should be added totheProvisionalStaff The Second World Health Assembly Regulations : AUTHORIZESthereimbursementtoeach Regulation 29 Member and Associate Member of WHO of the The Director-General, by virtue of the actual travelling expenses of one delegate or authority vested in him as the chief technical representative only to the Third and subsequent and administrative officer of the Organiza- Health Assemblies, the maximum reimburse- tion, may delegate to other officers of the ment to be restricted to the equivalent of first- Organization such of his powers as he con- classreturnaccommodation by recognized siders necessary for the effective implementa- public transport via an approved route from tion of these regulations. 1 Adopted as amended by the Health Assembly 2 First World Health Assembly, Off. Rec. World at its ninth plenary meeting. Hlth Org. 13, 314, 317 - 336 - COMMITTEE ON ADMINISTRATION AND FINANCE

Regulation 30 the Organization, as mentioned in paragraphs 7 and 8 of the report of the External Auditor. In case of doubt as to the meaning of any The committee wishes to underline particularly of the foregoing regulations, the Director- the necessity for Members to pay their con- General is authorized to rule thereon, subject tributions at the earliest possible date, in order to confirmation of the ruling by the Board that the work of the Organization may not be at the next meeting. jeopardized. The committee recommends that [WHA2.48] the Assembly give particular attention to the reports submitted to it on the present status 6.Election of Members and Alternate Mem- of contributions. bers of the Organization's Staff Benefit Committee 3.2The committee noted with gratification the comments contained in paragraph 10 of The committee decided to recommend to the the report concerning the proper accounting Health Assembly the adoption of the following of funds made available to the Organization resolution : by governments to facilitate the work of the Organization's operations in the country. The Second World Health Assembly 3.3 The committee fully endorses the com- DECIDES ments of the External Auditor regarding the (1) that the WHO Staff Benefit Committee necessity for an adequate working capital fund shall be composed of nine members (and nine as contained in paragraph 11 of the report, alternate members), three to be appointed by and invites careful attention of the Assembly the Health Assembly, three to be appointed to the proposal concurred in by the Executive by the Director-General, and three to be elected Board to increase the working capital fund to by the participants of the Fund ; $4,000,000.6 (2) to adopt the principle that it will appoint 3.4 The committee noted with satisfaction the members and alternates to the Staff Benefit that the External Auditor carried out a com- Committee from the membership of the Execu- plete audit, as referred to in paragraph 12. tive Board. 3 3.5 The committee takes great pleasure in [WHA2.49] calling the attention of the Assembly to para- graph 13 of the report of the External Auditor, 7.Financial Reports and Accounts of the and expresses the hope that the administrative Interim Commission for the Financial Period policies and procedures of the World Health 1 January to 31 August 1948, and the Organization will continue to merit commenda- Report of the External Auditor 4 tion. The committee agreed to recommend to the 3.6 The committee wishesparticularlyto Assembly that it adopt the following resolution : recognize the excellent report of the External Auditor, and commends Mr. Brunskog's work The Second World Health Assembly, as being of outstanding assistanceto the Organization. Having examined the final report of the External Auditor on the accounts of the Interim The committee, having considered the report, Commission covering the period from 1 Januarydecided to call the attention of the Assembly 1948 to 31 August 1948, and having consideredto the second and third sub-paragraphs of para- the recommendation of the Executive Boardgraph 11 of the Auditor's introductory remarks,7 with regard thereto, and to recommend to the Health Assembly that it adopt the following resolution : ACCEPTS the report. [WHA2.50] The Second World Health Assembly, Having examined the annual financial state- 8.Financial Reports and Accounts of the ment and the report of the External Auditor, World Health Organization for the Financial on the audit of the accounts of the World Period 1 September to 31 December 1948, Health Organization for the financial period and the Report ot the External Auditor 5 1 September 1948 to 31 December 1948, as The committee considered the report of the contained in Ogicial Records No. 20, and having ad hoc committee acting on behalf of the Execu- considered the recommendation of the ad hoc tive Board, reading as follows : committee acting on behalf of the Executive Board, 3.1The ad hoc committee considered parti- cularly the problem of adequate financing for ACCEPTS the report. [WHA2.51] 3 This clause was deleted by the Assembly at its ninth plenary meeting. 4 Off. Rec. World Hlth Org. 17, 60 6 oil. Rec. World Hlth Org. 18, 25 5 Ofl. Rec. World Hlth Org. 20 7 011. Rec. World Hlth Org. 20, 10 - 337 - COMMITTEE REPORTS

[A2/81] 22 June 1949 SECOND REPORT 8

The Committee on Administration and Finance, 4. that the Auditor, subject to budgetary pro- at its fourth meeting, held on 20 June 1949, took vision made by the Health Assembly for the the following decisions : cost of the audit, and after consultation with the appropriate committee of the Executive 1.Report of the Director-General on the Board relative to the scope of the audit, may Feasibility of using the United Nations conduct the audit under the provisions of this Board of Auditors, and Appointment of resolution in such manner as he thinks fit and the External Auditor for 1950 may engage commercial public auditors of international repute ; The committee reviewed the report and agreed to recommend that the following resolution be 5. that the Auditor shall submit his report, adopted by the Assembly : together with the certified accounts and such other statement as he thinks necessary, to the The Second World Health Assembly Health Assembly, to be available to the Execu- tive Board not later than 1 May following the (1)RESOLVESthat it endorses the principles end of the financial year to which the accounts to govern audit procedures as agreed by the relate ; Administrative Committee on Co-ordination of the United Na.tions and Specialized Agencies, 6. that the audit should be carried out by the and in addition the following principle :the Auditor in accordance with the principles to External Auditor should attend the Assembly govern audit procedure recommended by the when his report is being discussed and make Administrative Committee on Co-ordination any necessary explanationor answer any of the Economic and Social Council and that question related thereto ; in particular the Auditor shall have full regard to the following : (2)RESOLVESthat it agrees in principle to the establishment of a panel of external auditors 6.1The Auditor should satisfy himself of the United Nations and specialized agencies," 6.1.1 that theaccounts,includingthe and balance sheet, represent a correct record (3)REQUESTStheDirector-General,ifthe of duly authorized financial transactions proposed joint system of external auditis of the financial year ; adopted, to initiate such action as may be 6.1.2 that money has not been expended necessary to have the External Auditor of the or obligated for other than the purpose or World Health Organization placed on the panel purposesfor which theappropriations of external auditors of the United Nations and voted by the Assembly were intended to the specialized agencies. provide, except in so far as the Director- [WHA2.52] General has authorized transfers within the budget acting upon his authority con- The committee further agreed to recommend tained in the Appropriation Resolution to the Health Assembly the adoption of the and that expenditures conform to the following resolution : authority which governs them ; 6.1.3 thattransfers from the working The Second World Health Assembly capital or other funds have received the RESOLVES necessary authority. 1. that Mr. Uno Brunskog be appointed as 6.2 The Auditor, after satisfying himself External Auditor of the accounts of WHO for that the vouchers have been examined and the financial period ending 31 December 1950. certified as correct by the accounting orga- Should the necessity arise, Mr. Brunskog may nization, may, in his discretion and having designate a representative to act in his absence ; regard to the character of the examination 2. that in the year of the last financial period within the department, in any particular to be audited by the Auditor appointed under case admit the sums so certified without 1 above, the Health Assembly shall appoint further examination, provided, however, that an Auditor of the accounts of WHO ; if the Health Assembly or the appropriate 3. that the Auditor shall adopt his own rules committee of the Executive Board on behalf of procedure ; of the Health Assembly requests that any accounts be examined in greater detail, the Auditor shall do so. 8 Adopted by the Health Assembly at its ninth plenary meeting. 6.3 The Auditor shall examine at least once 9 See Appendix 1 to this report. a year such stock or store accounts as are " See Appendix 2 to this report. maintained by the Organization. -- 338 - COMMiTTEE ON ADMINISTRATION AND FINANCE

6.4 The Auditor shall have free access at 6.8.4 the accuracy or otherwise of the all convenient times to the books of account stores records as determined by stock- and all information relevant to the accounts taking and examination of the records. of the Organization.Requests for official In addition, the reports may contain refer- files which may deal with matters of policy ence to : should be made only through the official 6.8.5 transactionsaccountedforina designated for that purpose by the Director- previous year concerning which further General. information has been obtained, or trans- 6.5 The Auditor should not criticize purely actions in a later year concerning which administrative matters, but it is within his it seems desirable that the Health Assem- discretion to comment upon the financial bly should have early knowledge. consequences of administrative action. 6.9 The Auditor, or such of his officers as 6.6Objections which may arise during audit he may delegate, should certify each account to any items should be communicated imme- in the following terms : " The above accounts diately to the administration. As a general have been examined in accordance with my rule, criticism will not be made in the Audi- directions.I have obtained all the informa- tor's report without first affording the admin- tion and explanations that I have required istration an opportunity of explanation. and I certify, as the result of the audit, that, in my opinion, the above account is correct " 6.7 Documentary or other information ob- adding, should it be necessary, " subject to tained from a department should not be the observations in my report. " published by the Auditor without reference to the duly authorized official of the Orga- 6.10 The Auditor shall have no power to nization. disallow items in the accounts, but shall recommendtotheDirector-Generalfor 6.8 The Auditor certifying the accounts appropriate action such disallowances as he should prepare a report of each account is prepared to recommend to the Health certified, in which he should mention : Assembly based on his audit of the accounts 6.8.1 the extent and character ofhis and records. The Auditor shall bring to the examination or any important changes attention of the Health Assembly any cases therein ; where his recommendations for disallowances have not been acted upon by the Director- 6.8.2 matters affecting the completeness General. or accuracy of the accounts, such as : 6.11The Auditor should attend the Assem- (1) informatipn necessary to the correct bly when his report is being discussed and interpretation of the accounts ; make any necessary explanation or answer (2) any amounts which ought to have any question related thereto. been received but which have not been [WHA2.53] brought to account ; (3) expenditures not properly vouched ;2.Status of Contributions to the Budget for 6.8.3 othermatterswhichshouldbe 1948 brought to the noticeof the Health The committee agreed to recommend to the Assembly, such as : Health Assembly that it adopt the following (1) cases of fraud or presumptive fraud ;resolution : (2) wasteful or improper expenditure of The Second World Health Assembly, the Organization's money or stores (not- Having in view the necessity of financing withstanding that the accounting for the the programmes of the Organization, and recall- transactions may be correct) ; ing the resolution adopted at the First Health (3) expenditurelikelyto commit the Assembly urging the prompt payment of Organization to further outlay on a large contributions, scale ; AGAIN CALLS UPON States in arrears with (4) any defect in the general system or their 1948 contributions to make payment detailed regulation governing the control thereof without further delay. of receipts and expenditure, or of stores ; [WHA2.54] (5) expenditure not in accordance with the intention of the Health Assembly,3.Status of Contributions to the Budget for after making allowance for duly authorized 1949 transfers within the budget ; The committee agreed to recommend to the (6) expenditure in excess of appropria-Assembly that it adopt the following resolution : tions,as amended by duly authorized The Second World Health Assembly, transfers within the budget ; Conscious of the necessity of prompt pay- (7) expenditure not in conformity with ment of contributions to enable the Organiza- the authority which governs it ; tion to carry out its programmes, - 339 - COMMITTEE REPORTS

(1)DRAWS THE ATTENTIONOf Members- of the to the administrative head of the agency and the Organization to their responsibility of financially Assembly on tbe efficiency of the internal audit. supporting the Organization, and (h) Notwithstanding that the accounts as such (2)URGESMembers to pay their 1949 con-may be correct, the external auditor shall be entitled to report on the efficiency and economy tributions without further delay. of operations of the organization, but not including general policy matters.He may comment upon [WHA2.55] financial procedure, the accounting system, internal financial control and the financial consequences of administrative procedure. Appendix 1 (i) In no case, however, shall the auditor include criticism in his audit report without first affording PRINCIPLES TO GOVERN AUDIT the Administration an opportunity of explanation to him of the matter under observation.Audit PROCEDURES 11 objections to any item arising during the examina- (a) The external auditor shall be appointed bytion of the account shall be immediately communi- the Assembly of each agency, and may not becated to the Administration. removed except by the Assembly. (b) The external auditor shall report to the Assembly. (c) The external auditor shall perform such an audit as he deems necessary to certify : Appendix 2 (i) that the statements of financial position are in accord with the books and records of thePROPOSED JOINT SYSTEM OF EXTERNAL Organization, AUDIT (ii)that the cash on deposit and on hand has been verified by certificate received direct from the Organization's bankers and by actual count, (a) In principle there should be a panel of external auditors of the United Nations and the specialized (iii)that the statements of financial transac- tions reflected in the statements have been inagencies, composed of persons having the rank of accordance with the rules and regulations, theAuditor General (or its equivalent in the various budgetary provisions and other applicable direc- Member States) ; tives of the Assembly. (b) Such a panel should consist of the auditors appointed by the United Nations and the specia- (d) The external auditor shall not be restrictedlized agencies, chosen by common consent for a in any way in carrying out the audit. period of three years in such a manner that the (e) The external auditor shall be free to see anymembers of the panel would not exceed six in of the books and records of the Organizationnumber, and bearing in mind the location of the necessary for the performance of his audit. Con-specialized agencies, the ability of the govern- fidential information required by him for themental audit staffs to undertake the total audit purposes of his audit shall be made available toload within the appropriate time limits, and the him on application to the official designated bydesirability of securing continuity of audit ; the administrative head of the Organization. He (e) Each Organization should select one or more shall use discretion in his treatment of confidentialmembers of the panel to perform its audit.Pay- information. ments of salaries, fees or honoraria should be a (f) In the performance of the audit the externalmatter for settlement between the parties directly auditor shall be the sole judge as to the acceptance concerned ; in whole or in part of certifications by the Adminis- (d) Each auditor(or auditors) performing an tration and may proceed to such detailed examin-audit should sign his(or their) own report or ation and verification as he chooses, including thereports ; physical verification of stocks. (e) Members of the panel selected to perform (g) The external auditor may affirm by test theaudits should be requested to take appropriate reliability of the internal audit and he may reportsteps, in particular by meeting together annually, to co-ordinate their audits and to exchange infor- li In each case throughout these proposed prin-mation on methods and findings ; ciples the term " Assembly " should be interpreted as the supreme legislative conference of the organ- (f) Costs of the annual meeting of active members ization or a body to which the Conference hasof the panel should be borne by the participating delegated such authority. organizations.

- 340 - COMMITTEE ON ADMINISTRATION AND FINANCE

rA2/98] 28 June 1949 THIRD REPORT 12

1.Director-General's Contract with respect to is made, that Member shall be considered the Representation Allowance as Discussed to be in arrears for one year, warranting at the Second Session of the Executive consideration by the next convened meet- Board ing of the World Health Assembly. The committee decided, since it is clear that A full report on the circumstances of the the representation allowance of the Director- case shall be furnished by the Executive General is intended to cover normal allowances Board to the World Health Assembly and authorized to staff members, as well as representa- the Health Assembly may, after considera- tion in connexion with his official duties, not to tion of that report, take such action, if any, recommend to the Health Assembly that any as it considers necessary and appropriate, change be made in the contract of the Director- by invoking all or part of Article 7 of the General at the present time. Constitution. [WHA2.56] 2.Report of the Director-General 4.Report on Working Capital Fund and The committee considered the report of the Assessment of New Members Director-General and the confidential staff list The committee agreed to accept the report of which had been distributed to the chief delegateof the working party, and to recommend to the of each Member Government.The committeeAssembly the adoption of the following resolu- agreed that Article 35 of the Constitution requires tion : that the personal qualifications of staff members must be the paramount consideration.It further The Second World Health Assembly agreed that every effort should be made to obtain a wider geographical distribution of staff, parti- (1)RESOLVES cularly in the more senior posts. The committee (a)that the working capital fund of the agreed to request the Director-General to take Organization shall be constituted as a single note of the points raised in the discussion on this fund ; item and to recommend to the Health Assembly (b)that the interests of each Member of the that it accept the section of the Director-General's Organization in the working capital fund report that deals with matters of Administration shall be maintained ; and Finance. (c)that the funds transferred to the World Health Organization from the League of 3.Status of Contributions to Budgets Nations Liquidation Board for the Epidemio- The Committee agreed to recommend to the logical Intelligence Station shall be main- Assembly that it adopt the following resolution : tained as a separate fund ; (d)that a separate fund shall be set up for The Second World Health Assembly the assessments of States not Members of RESOLVES to adopt the following policy and the Organization for the repayment of the procedure when the contribution to be paid loantothe World Health Organization by a Member is in arrears : Interim Commission by the United Nations. When the contribution has not been paid (2)CONFIRMS the action taken by the Director- by any Member in full by the end of the General in making the assessment of new year for which the assessment is made, that Members in the Organization during 1948 for Member shall be considered to be in arrears. the working capital fund, and When any Member is in arrears, the Director- (3)DECIDES that, notwithstanding the amount General shall communicate with the Member established from time to time by the Health concerned to ascertain the reasons for the Assembly as the size of the working capital delay in payment and what arrangements can fund, a new Member of the Organization shall, be made for payment. He shall submit to upon its membership becoming effective, con- the next session of the Executive Board a tribute to the working capital fund an amount report on the result of his enquiries. equal to that which it would have been required When the contribution has not been paid to contribute had it been a Member of the by any Member in full by the end of the year Organization from its inception. following the year for which the assessment [WHA2.57] 5.Currency of Contributions 12 Decisions taken at the third, fourth, fifth, sixth, eighth, ninth and tenth meetings of the The committee agreed to recommend to the committee. Adopted by the Health Assembly atHealth Assembly that it adopt the following its tenth plenary meeting. resolution : - 341 - COMMITTEE REPORTS

The Second World Health Assembly, (5)REQUESTS the Executive Board to take Having considered the matter of currency note of the discussion in the Committee on of contributions to the operating budget of Administration and Finance and give special WHO ; and consideration to the problem which has deve- loped at this Assembly with the view of re- Recognizing that it will be possible to use, commending a more satisfactory procedure for to some extent, currencies other than US dollars the Third Health Assembly. and Swiss francs in carrying out the operating [WHA2.60] budget of the Organization, DECIDES that contributions to the operating budget in currencies other than US dollars8.ArrangementsforAccommodationfor and Swiss francs be accepted, on the basis that Headquarters Office all Member Governments shall have equal The committee agreed to recommend that the rights in paying a proportionate share of theirHealth Assembly adopt the following resolution : contribution in such currencies as may be Whereas the First World Health Assembly, acceptable, these currencies to be determined after consultation with the United Nations in under the provisions of Financial Regulation 19. conformity with Article 42 of the Constitution, [WHA2.58]. selected Geneva as the permanent headquarters of the World Health Organization ; Whereas the Secretary-General of the United 6.Proposed Amendments to the Staff Regu- Nations has, subject to the approval of the lations General Assembly, offered to place at the The committee decided not to recommend the disposal of the World Health Organization, adoption of the proposed staff regulation,13 but for the latter's permanent headquarters office, decided to recommend to the Health Assembly accommodation to be provided within the that it adopt the following resolution : perimeter of the United Nations grounds at Geneva subject to the construction of such The Second World Health Assembly additions to the existing structure of the Palais RECOMMENDS that itis desirable that, as des Nations as may be necessary for the far as practicable, vacancies for professional purpose ; and senior administrative posts in the Secreta- Whereas by the letters of 28 March and 1 June riat should be communicated to the govern- 1949 from M. Max Petitpierre to the Director- ments of Member States in order that they General the Swiss Federal Council has, upon may be given publicity. the conditions mentioned in the said letters, [WHA2.59] proposed three alternative plans for making available to the World Health Organization an amount up to Swiss francs 5,750,000 to 7.Budget Estimates for the Proposed 1950 finance the construction of a building either Programme within the perimeter of the United Nations The committee agreed to recommend to the grounds or on an independent site which the Assembly the adoption of the following resolu- Canton of Geneva has offered to place gratis tion : at the Organization's disposal ; and Whereas the various projects submitted for The Second World Health Assembly the consideration of the Health Assembly have (1)TAKES NOTE of the resolution adopted in not yet been worked out in sufficient detail to plenary session on 16 June 1949 which provides enable a choice to be made among them at the for the Committee on Administration and present stage, Finance to cost the programme approved by The Second World Health Assembly the Committee on Programme ; 1. THANKS the Federal Council, the Canton (2)UNDERSTANDS that the costing of the pro- of Geneva and the Secretary-General for the gramme does not in any way commit the com- spirit of understanding in which they have mittee to a total budget and that consideration approached this matter and for the offers which of the total budget will be undertaken by the they have made ; Committees on Programme and Administra- 2.RESOLVES to delegate to the Executive tion and Finance in joint session ; Board, acting in concert with the Director- (3)BELIEVES it desirable in order to expedite General and subject to the instructions men- the consideration of the budget for 1950, to tioned in paragraphs (1),(2) and (3) below, adopt a procedure which should not establish and to the proviso that the total cost of con- a precedent for future years and, therefore, struction of the building shall not exceed (4)DECIDES that the costs of the programme 6,000,000 Swiss francs, full powers to take in provided by the Secretariat are hereby ac- the name of the World Health Assembly the cepted ; and further final decision both as to the selection of the site and as to the choice of the proposal which 18 See minutes of the tenth meeting, p. 257, the Board may deem most advantageous among section 1. the three presented by the Swiss Federal Council - 342 - COMMITTEE ON ADMINISTRATION AND FINANCE

in the above-mentioned letters for the provi- (2)Should, however, the final offer of the sion of the necessary funds : Secretary-General fail to satisfy the con- ditions set forth above, then the Board may (1)In view of the administrative facilities accept the offer of an independent site made and economies that might accrue to the by the Swiss Federal Council on behalf of mutual advantage of the United Nations the Canton of Geneva ; and the World Health Organization from (3)Should none of the offers made in accord- the provision for the latter of headquarters ance with paragraphs (1) and (2) above be accommodation in the closest possible proxi- completely acceptable to the Board and the mity to the United Nations buildings in Director-General, ,the Board is authorized Geneva, the Board is instructed, in consulta- to seek any other solution for headquarters tion with the Swiss Government, to accept at Geneva which in its opinion will satisfy the offer of the Secretary-General of the the needs of the World Health Organization United Nations on condition that the needs in an adequate and practicable manner, of the World Health Organization in this and to report thereon to the Third World matter receive full consideration and that Health Assembly ; and acceptable and adequate accommodation 3.REQUESTS the Executive Board to expedite, can be made available to the World Health so far as lies within its power to do so, the Organization withintheUnited Nations commencement of building operations at the grounds at Geneva on terms to be agreed earliest possible moment, and to report to the upon in advance with the Secretary-General Members of the World Health Organization on of the United Nations and to be completely the decisions taken for the execution of the acceptable to the Director-General of the present resolution. World Health Organization ; [WHA2.61]

[A2/1041 29 June 1949 FOURTH REPORT 14

1.Financial Responsibilities of the Executive 2.DIRECTS that the Board's review of the Board annual budget estimates in accordance with The committee agreed to recommend to the Article 55 of the Constitution shall include Health Assembly that it adopt the following consideration of : resolution : (1) the adequacy of the budget estimates to meet health needs ; Whereas Article 28 (g) of the Constitution provides that the Executive Board shall sub- (2) whether the programme followsthe mit to the Health Assembly for consideration general programme of work approved by and approval a general programme of work the Health Assembly ; covering a specific period ; and (3) whether the programme envisaged can be carried out during the budget year ; and Whereas Article 55 of the Constitution pro- vides that the Director-General shall prepare (4) the broad financial implications of the and submit to the Board the annual budget budget estimates with a general statement estimates of the Organization, and that the of the information on which any such con- Board shall consider and submit to the Health siderations are based ; and Assembly such budgetestimates,together 3.RECOMMENDS that the position be reviewed with any recommendations the Board may not later than the Fifth World Health Assembly. deem advisable ; and Whereas Article 56 of the Constitution pro- [WHA2.62] vides that subject to any agreement between the Organization and the United Nations, the 2.Reimlmrsement by Governments for Health Assembly shall review and approve the Materials,Supplies and Equipment fur- budget estimates and shallapportionthe nished by the Organization in connexion expenses among the Members in accordance with Advisory and Demonstration Services with a scale to be fixed by the Health Assembly ; to Governments The Second World Health Assembly The committee agreed to recommend to the 1.REQUESTS the Board to submit recommenda- Health Assembly that it adopt the following tions to the Third World Health Assemblyresolution : pursuant to Article 28 (g) of the Constitution, The Second World Health Assembly, and Having reconsidered paragraph VI of the 14 Decisions taken at the eleventh and twelfth appropriation resolution for the financial year meetings of the committee. Adopted by the Health 1949 as approved by the First World Health Assembly at its tenth plenary meeting. Assembly ; and - 343 - COMMITTEE REPORTS

Recognizingthatgovernmentsreceiving (a)for a period of one year : advisory and demonstration services from the as member, Dr. J. Zozaya Organization will normally contribute a large as alternate member, Professor J. Parisot share of the cost of demonstration projects by providing for those expenditures of the projects (b)for a period of two years : which can be met in local currency ; and as member, Sir Arcot Mudaliar as alternate member, Dr. B. Kokusznik Having 'considered that the provisions of (c)for a period of three years : paragraph VI of the appropriation resolution for the financial year 1949 represents a serious as member, Dr. H. Hyde obstacle to providing these services to some as alternate member, Dr. J. A. Hiijer of the countries where the greatest need exists, [W H A2.64] (1)RESOLVES that paragraph VI of the appro- priation resolution for the financial year 19494.Currency of Contributions be rescinded, and replaced by the following The committee agreed to recommend to the text : Health Assembly that it adopt the following " With respect to advisory and demonstra- resolution : tion services to governments, the Director- General shall, in consultation with the receiv- The Second World Health Assembly ing governments, take steps to recover the REQUESTS theDirector-General and the depreciated value of non-expendable equip- Executive Board to attempt to solve the prob- ment which may be left in the country after lems involved in accepting part of the con- a demonstration team completes its work tributions to the operating budget in currencies and such part of the cost of expendable other than US dollars and Swiss francs, in materials and supplies as the Governments order to find a means whereby a portion of are willing to repay, which repayment may contributions can be accepted in such currencies. be made by governments in their own cur- [W HA2.65] rencies.The Director-General, prior to the furnishing of these services should, if possible, reach agreement in advance as to the willing-5.Working Capital Fund for 1950 ness of governments to make such payments The committee agreed to recommend to the under the provisions of this paragraph ; "Health Assembly that it adopt the following resolution : (2)REQUESTS the Director-General to submit a report reviewing this policy to the Fifth World The Second World Health Assembly Health Assembly. [W H A2.63] (1)RESOLVES (a)that the working capital fund shall be established for the financial year 1950 in 3.Appointment of Members and Alternates the amount of US $4,000,000 ; to the Staff Benefit Committee (b)that Members shall make additional The committee agreed to recommend to the advances to the working capital fund, in Health Assembly that it adopt the following accordance with the scale adopted by the resolution : First Health Assembly for contributions of Members to the budgets of the World Health Organization for the financial years 1948- The Second World Health Assembly, 1949 ; Noting the resolution adopted by the Execu- (2)AUTHORIZES the Director-General tive Board at its third session, as regards the (a)to advance from the working capital adhesion of WHO to the United Nations Joint fund such sums as may be necessary to Staff Pension Plan, finance the appropriations for the financial year 1950, pending receipt of contributions RESOLVES from Members ; sums so advanced shall be (1)that, when the WHO Staff Benefit Com- reimbursed to the working capital fund as mittee isfirst constituted, one-third of the soon as contributions are available ; members and their alternates shall be appointed (b)to advance such sums in 1950 as may for a period of one year, one-third for a period be necessary to meet unforeseen or extra- of two years, and one-third for a period of three ordinary expenses, providing that not more years ; than US $500,000 may be used for such purposes, except that with the prior con- (2) that the following persons be appointed currence of the Executive Board a total of to represent the Health Assembly on the WHO US $1,000,000 may be used.The Director- Staff Benefit Committee General shall report to the next convening - 344 - COMMITTEE ON ADMINISTRATION AND FINANCE

Health Assembly all advances made under the discretion of the Board to meet emergencies this clause and the circumstances relating and unforeseen contingencies, this authorization thereto, and shall make provision in the being made to comply with Article 58 of the estimates for reimbursement of the working Constitution.Any amounts used under this capital fund except when such advances are authorization are to be replaced by making recoverable from some other source ; specific provisions therefor in the next year's annual budget, except when expenditures made (3)AUTHORIZES the Executive Board to use, under this authority are recoverable from some not to exceed, US $300,000 of the working other source. capital fund as the special fund to be used at [WHA2.66]

[A2/105] 29 June 1949 FIFTH REPORT 15

1.Scale of Assessments for 1950 State shall not exceed the per capita contribu- tion of the Member paying the highest con- Contribution of Israel to the Budgets of 1949 and tribution ; 1950 (2)DECIDES that this principle be made effec- The Committee on Administration and Finance tive as world economic conditions improve, in agreed to recommend to the Health Assembly gradual stages, starting in 1950 ; that it adopt the following resolution : (3)DECIDES that the unit scale of assessments Whereas Financial Regulation, 18 provides be continued ; and that " Members shall be required to make a contribution for the year in which their member- (4)DECIDES that the scale of assessments be ship becomes effective, and an advance to the based on that for 1948 and 1949 with appro- working capital fund, at rates to be determined priate adjustments to establish the contribu- by the Health Assembly " ; and tion of the United States of America at thirty- Whereas the First World Health Assembly six per cent of the total, and that the per capita did not include a determination for the State contribution of any Member State shall not of Israel in establishing the unit scale of assess- exceed the per capita contribution of the ments for 1948 and 1949, Member making the highest contribution. [WHA2.68] The Second World Health Assembly RESOLVES that the State of Israel shall makeContribution of the State of South Korea to the an advance to the working capital fund and Budgets of 1949 and 1950 contribute to the budgets for 1949 and 1950 of the World Health Organization at a rate The committee also agreed to recommend to to be fixed by establishing the number of unitsthe Health Assembly that it adopt the following corresponding to the contribution of Israel toresolution : the United Nations for the year 1950. Whereas Financial Regulation 18 provides that " Members shall be required to make a [WHA2.67] contribution for the year in which their member- ship becomes effective, and an advance to the Determination of the Maximum Contribution to working capital fund, at rates to be determined the Regular Expenses of the Organization by the Health Assembly " ; and The committee also agreed to recommend to Whereas the First World Health Assembly the Health Assembly that it adopt the following did not include a determination for the State resolution : of South Korea in establishing the unit scale of assessments for 1948 and 1949, The Second World Health Assembly, In considering the several questions referred The Second World Health Assembly to it under resolutions adopted by the First RESOLVES Health Assembly concerning the scale of assess- (1) that the State of South Korea shall make ments for 1950 and future years, an advance to the working capital fund and (1)RECOGNIZES that it is in the best interests contribute to the budgets for 1949 and 1950 of WHO that no one Member State should of the World Health Organization at a rate contribute more than one-third to the regular to be fixed by the Third World Health Assem- expenses of WHO for any year, provided that bly ; and further the per capita contribution of any Member (2) that an interim assessment of South Korea shall be made of five units, to be replaced by 15 Decisions taken at the thirteenth meeting of the definitive assessment, when established. the committee. Adopted by the Health Assembly at its tenth plenary meeting. [WHA2.69] - 345 - COMMITTEE REPORTS

Financial Obligations of Associate Members budget of the Organization be referred to the The committee also agreed to recommend to Executive Board ; and the Health Assembly that it adopt the following (2)DELEGATESto the Executive Board author- resolution : ity to establish provisional scales of assessments for Associate Members to be confirmed or revised The Second World Health A.ssembly by the Third World Health Assembly. (1)RESOLVESthat the question of the financial obligations of Associate Members towards the [WHA2.70]

[A2/109 Rev. 1] 30 June 1949 SIXTH REPORT 16

I. Appropriation Resolution II.The Director-General is authorized, with The Committee on Administration and Finance respect to Part II of the budget, in urgent circumstancestotransfercreditsbetween decided to recommend to the Health Assembly chapters and, with the concurrence of the the adoption of the following resolution : Executive Board, or of any committee to which I.The Second World Health Assembly resolves it may delegate authority, to transfer credits that for the financial year 1950 the Regular between sections. AdministrativeandOperatingProgramme III. The Director-General shall report to the Budget is as follows : next subsequent regular session of the Execu- tive Board all transfers made under the author- Appropriation US $ Section Purpose of Appropriation ity of paragraph II hereof, together with the PARTI- ADMINISTRATIVE BUDGET circumstances relating thereto. 1 Organizational Meetings. 229,000 IV. Notwithstanding the provisions of Finan- 2 Administrative Expenses 1,188,875 cial Regulation 13, the Director-General is Total PART I 1,417,875 authorized to transfer to the ensuing year the unexpended balancesofallotments(made PART II - OPERATING PROGRAMME under the provisions of Financial Regulation BUDGET 10) made to countries for Fellowships, under chapter 3.5 of section 3 of Part II, and for 3 Operating Programmes Medical Literature and Teaching Equipment, Chapter chapter 3.6 of the same section. 3.1 Operating Supervisory Staff 266,850 V. With respect to advisory and demonstra- 3.2 Regional Offices 902,535 tion services to governments, the Director- 3.3 Other Offices 71,925 General shall, in consultation with the receiv- 3.4 Advisory and Demonstration ing governments, take steps to recover the Services to Governments. . 1,819,870 depreciated value of non-expendable equip- 3.5 Technical Training of Medi- ment which may be left in the country after cal and Auxiliary Personnel 779,380 a demonstration team completes its work and 3 . 6 Medical Literature an d such part of the cost of expendable materials Teaching Equipment . . 75,000 and supplies as the governments are willing 3.7 Technical Services . 1,373,470 to repay, which repayment may be made by 3.8 Expert Committees . . . 253,815 governments in their own currencies. The 3.9 Supplies to Governments 115,000 Director-General, prior to the furnishing of 3 .10Common Services for Part II, these services should, if possible, reach agree- except chapters 3.2, 3.3 and ment in advance as to the willingness of govern- 3.4 425,780 ments to make such payments under the pro- Total Section 3 6,083,625 visions of this paragraph.

TOTAL ALL PARTS. . 7,501,500 17 The committee agreed to recommend to the Health Assembly that it adopt the following Amounts not exceeding the above shall be resolution : available for the payment of obligations in- The Second World Health Assembly curred during the period 1 January 1950 to 31 RESOLVESthat in approving the appropria- December 1950. tion resolution for the Regular Administrative 16 Decision taken at the fourteenth meeting of and Operating Programme Budget for the the committee. Adopted by the Health Assembly financialyear1950,the Health Assembly at its tenth plenary meeting. emphasizes that itin no way commits the 17 The estimated income to be available in 1950 Third or subsequent World Health Assemblies is $501,500, which, after being applied to this appropriation, provides for a contribution to be to any particular levels of expenditure. made by governments of $7,000,000. [WHA2.71] -- 346 -- JOINT MEETINGS OF THE COMMITTEES ON PROGRAMME AND ADMINISTRATION AND FINANCE

JOINT MEETINGS OF THE COMMITTEES ON PROGRAMME AND ADMINISTRATION AND FINANCE

[A2/107] 29 June 1949 FIRST REPORT

The Joint Meeting of the Committees onrecommends to the Second World Health Assembly Programme and Administration and Finance 2the adoption of the following resolution : The Second World Health Assembly 1 Adopted by the Health Assembly at its tenth RESOLVES that the contributions from Member plenary meeting. nations to the regular operating budget for 1950 shall be seven million dollars. 2 See minutes of the first, second and third joint meetings. [WHA2.72]

[A2/100] 29 June 1949 SECOND REPORT 3

The Joint Meeting on 28 June of the Committees2.Regional Organization for Europe on Programme and Administration and Finance The joint meeting recommends to the Second took the following decisions : World Health Assembly the adoption of the following resolution : 1.Programme Medical Supply Services The Second World Health Assembly, The joint meeting, having considered the re- Having noted the resolution of the third commendation of the Committee on Programme, session of the Executive Board concerning the recommends to the Second World Health Assem- establishment of a Regional Organization for bly the adoption of the following resolution : Europe ; (1)AUTHORIZES the Executive Board to estab- The Second World Health Assembly lish a Regional Organization for Europe as ENDORSES the policy of the Executive Board soon as the consent of the majority of Member as contained in Official Records of the World States situated within the European area shall Health Organization No. 18, page v, paragraph 2 have been obtained ; and (Supplies). (2)NOTES that the Special Office for Europe [WHA2.73] would automatically be dissolved upon the establishment of a Regional Office for Europe. 3 Adopted by the Health Assembly at its tenth plenary meeting. [WHA2.74]

[A2/108] 29 June 1949 THIRD REPORT

At the Joint Meetings of the Committees on The Second World Health Assembly, Programme and Administration and Finance on Having considered the operating programme 29 June the following decisions were taken : of advisory and technical services to govern- ments prepared by the Director-General and 1.SupplementalOperatingProgrammeof forwarded by the Executive Board ; Advisory and Technical Services Budget Having noted with interest and approval The Cominittee on Programme and the Com- Resolution No. 200 (III) adopted by the United mittee on Administration and Finance recom- Nations General Assembly at its third regular mend to the Second World Health Assembly the session on 4 December 1948 with particular adoption of the following resolution : reference to paragraph 4 (d)thereof, which reads : 4 Adopted as amended by the Health Assembly " The technical assistance furnished shall at its tenth plenary meeting. (i) not be a means of foreign economic and - - 347 - COMMITTEE REPORTS

political interference in the internal affairs (2) to consider appropriate resolutions of of the country concerned and shall not be the Economic and Social Council and the accompanied by any considerationofa General Assembly of the United Nations in political nature ;(ii) be given only to or connexion with (1) above ; through governments ;(iii) be designed to (3) toauthorize the Director-General to meet the needs of the country concerned ; negotiate agreements with Member Govern- (iv) be provided, as far as possible, in the ments concerning the amounts and currencies form which that country desires ;(v) be of of their contributions in accordance with (1) high quality and technical competence " ; above. [WHA2.75] Having noted with interest and approval Resolution No. 180 (VIII) adopted by the2.Joint Activities Economic and Social Council on 4 March 1949, and that, by virtue of the above resolution,United Nations Project for Reliefof Palestine a comprehensive plan for an expended co- Refugees operative programme of technical assistance The Committee on Programme and the Com- for economic development through the Unitedmittee on Administration and Finance recommend Nations and the specialized agencies has beento the Second World Health Assembly the adop- prepared by the Secretary-General of the Unitedtion of the following resolution :5 Nations in consultation with the Executive Heads of the specialized agencies through the Whereas the Executive Board at its second Administrative Committee on Co-ordination, sessionauthorized the Director-General,in and is to be submitted to the Economic and consultation with the Chairman of the Execu- tive Board, within the limits of any resources Social Council at its ninth session, made available for this purpose, to take the necessaryemergencymeasures,underthe 1.APPROVES that part of the programme con- terms of Article 2& (i) of the Constitution, to tained in Official Records No. 18, as amended deal with events requiring immediate action by this Assembly and which, for budgetary in connexion with the health situationof reasons, is called the Supplemental Operating Palestine refugees ; Programme of Advisory and Technical Services, Whereas the Executive Board at its third subject to arrangements having been completed session approved the action of the Direct or- to provide funds for its implementation ; General under this authority ; And further, as there is no financial provision Whereas the health situation of the refugees in the 1949 budget for more than one meeting in the Palestine area continues to cause anxiety, of the Health Assembly, and may, if measures are relaxed, lead to epidemics which could be a threat to other 2.DELEGATES to the Executive Board author- countries ; ity to authorize the Director-GeneraI to under- Whereas the United Nations relief to Pales- take appropriate negotiations concerning the tine Refugees is to be continued beyond the provision of funds to implement the Supple- original termination date of 31 August 1949, mental Operating Programme of Advisory in order to provide time for the fourth regular and Technical Services ; and further session of the General Assembly to take new action ; 3.AUTHORIZES the Executive Board to act on behalf of the World Health Assembly until Whereas the Secretary-General of the United its next meeting in approving the results of Nations has requested,ina letter to the Director-General dated 10 June 1949, that such negotiations, and the World Health Assembly consider the 4. EMPOWERS the Executive Board : feasibility of making provision in the budget for 1950 for a substantially larger allocation (1)toauthorize the Director-General to towards the medical care provided among these accept and administer such funds as will be refugees than was possible for 1949, and has made available for the purpose of implement- stated that any such favourable action would ing all or part of the Supplemental Operat- be warmly welcomed by the United Nations, ing Programme of Advisory and Technical Services approved by the Health Assembly 6 Budgetary implications contained in proposal provided that any conditions attached tosubmitted for consideration : Estimated Expenditure the provision of such funds or any other 1949 1950 conditions except those established by the US $ US $ Grants to UNRPR : 50,000 50,000 Executive Boardorthe World Health Construction of latrines Assembly are consistent with the principles (i)and pits containedinUnited NationsResolution (ii)Fly and malaria control No. 200(III) withspecificreference to (iii)Development and control paragraph 4 (d) thereof and with Article 57 of water supply of the Constitution ; Total of project 50,000 50,000 - 348 - JOINT MEETINGS OF THE COMMITTEES ON PROGRAMME AND ADMINISTRATION AND FINANCE

The Second World Health Assembly and Estimates for 1950 to meet a ceiling of Recognizing that continued assistance for$7,501,500 were made by transferring items or the prevention of epidemics is required toportions of items to the Supplemental Operating prevent their outbreak among Palestine refu- Programme. gees, and their spread to surrounding countries ; In addition to the adjustments made which and have resulted in the revised 1950 Programme and Desiring to respond to the appeal of theBudget now presented, given in Annex 1,8 the Secretary-General of the United Nations, in sojoint meeting discussed generally the matter of far as the financial resources of the Worldthe administrative estimates. It noted with Health Organization will allow ; satisfaction the comments of the External Auditor as given in Official Records No. 20, as an index (1)RESOLVES that technical assistance in this ofthegeneralfinancialandadministrative field be rendered by the World Health Organiza-efficiency of WHO.However, it requests the tion in 1950 through the United Nations as anExecutive Board to examine the organizational emergency measure, and that an amount bestructure in greater detail, so that it may assist provided for in the budget for 1950 to meetthe Health Assembly to ensure the administrative this expenditure ; and further efficiency of the Organization, and to establish (2)CONSIDERS that the best solution of thisgeneral lines of policy in this respect. problem as regards its health aspects lies in the The joint meeting recommends to the Health rapid re-settlement of the refugees, and Assembly the adoption of the following resolu- (3)REQUESTS the Director-General to trans-tion : mit to the Secretary-General of the United The Second World Health Assembly Nations its views in this regard. [WHA2.76] (1)ADOPTS the programme and budget as set out in Official Records No. 18, as revised by the 3.Establishment of Expert Committee on resolutions of this Assembly ; 9 Nursing (2)NOTES with satisfaction the comments of The Committees on Programme and Admin- the External Auditor as given in Official Records istration and Finance recommend to the Second No. 20 ; and World Health Assembly the adoption 6f the (3)REQUESTS the Executive Board to examine following resolution :6 the organizational structure so that the Third World Health Assembly may be assisted in Whereas the role of nurses is proving more ensuring the administrative efficiency of the and more important in the protection of public Organization and establishing general lines of health ; policy in this respect. Whereas it is necessary to ensure recruitment [WHA2.78] of these assistants in proportion to the needs of each country ; The Joint Meeting of the Committees on Pro- Whereas it is necessary in all countries togramme and Administration and Finance, hav- give these assistants the training in keepinging considered the instructions to be given to the with the numerous and complicated tasksExecutive Board in implementing the Supple- which will devolve upon them ; mental Operating Programme, recommends to Whereas the First World Health Assemblythe Health Assembly the adoption of the follow- decided that the question of establishing aning resolution : Expert Committee on Nursing be examined The Second World Health Assembly by the Second World Health Assembly ; INSTRUCTS the Executive Board, in imple- The Second World Health Assembly menting theSupplemental OperatingPro- REQUESTS the Director-General to establish gramme, to give major consideration to : an expert committee on nursing. (1) those items transferred from the Regular [WHA2.77] Operating Programme and such part of the administrative provisions therefor as may 4.Programme and Budget for 1950 be appropriate ; The Joint Meeting of the Committees on Pro- (2) strengthening or augmenting technical gramme and Administration and Finance, having services ; consideredtherelevantdocuments including (3) technical training of medical and aux- Official Records No. 18, the reports and minutes iliary personnel ; of the Committee on Programme and the Joint (4)malaria,maternal andchildhealth, Meetings of the Committees on Programme and environmental sanitation, venereal diseases, AdministrationandFinance,anddocument tuberculosis and nutrition ; A2/Prog/40-A2/AF/30,7 and the general discus- sion thereon, decided to emphasize that the (5) programme supply advisory services. adjustments to the Regular Budget Programme [WHA2.79] 6 For drafting amendments made by the Health 8 This annex is reproduced as Appendix 1 to Assembly, see final text in Resolution WHA2.77.Resolution WHA2.78 (p. 47). 7 Report of the working party set up at the fifth 9 See Appendices 1 and 2 to Resolution joint meeting (see p. 288). WHA2.78. - 349 - COMMITTEE REPORTS

COMMITTEE ON CONSTITUTIONAL MATTERS

[A2/73] 20 June 1949 FIRST REPORT 1

The Committee on Constitutional Matters heldto the attention of the General Committee the four meetings on 14, 16, 17 and 18 June 1949.minutes of the meetings of the committeein The following decisions were taken : which this subject was discussed. The committee therefore recommends to the 1.Election of Officers Assembly the adoption of the following resolu- tion : Dr. P. Vollenweider (Switzerland) was elected Chairman, Dr. L. H. Davis (New Zealand) Vice- The Second World Health Assembly Chairman, and Mr. H. B. Calderwood (United (1)ADOPTS the report of the Executive Board States of America) Rapporteur. in which it is recommended that Chapter VI of the Constitution be preserved and which defines certain principles to govern the selec- 2.Procedure for the Nomination and Election tion of Members entitled to designate persons of Members entitled to designate Persons to serve on the Executive Board ; 5 to serve on the Executive Board (2)ADOPTS also the amended and supplemen- In pursuance of the resolution adopted by the tary Rules of Procedure of the Health Assembly, First Health Assembly,2 the committee considered which are appended to the Board's report ; the report of the Executive Board and the Rules and of Procedure recommended to govern the nomina- (3)INVITES theGeneral Committee, when tion and election of Members entitled to designate nominating Membersforelectionby the persons to serve on the Executive Board.3 Assembly, to take into account the views After a full discussion, during which various expressed during the discussion in the Com- delegations expressed views on the principles set mittee on Constitutional Matters regarding forth in this report and the Rules of Procedure the principles defined by the Board and the amended by the Executive Board, the committee interpretation of Articles 79 and 80 of these approved the Board's report.The committee Rules of Procedure.6 also decided to request the Assembly to bring [WHA2.80] As adopted by the Health Assembly at its 4 Minutes of the third and fourth meetings of eighth plenary meeting. the committee, pp. 292, 295. 2 Off. Rec. World Hlth Org. 13, 336, 345 5 011. Rec. World Hlth Org. 14, 29, 66 3 Off. Rec. World Hlth Org. 14, 66 Minutes of the third and fourth meetings.

[A2/78] 20 June 1949 SECOND REPORT 7

The Committee on Constitutional Matters, at The Second World Health Assembly, its fifth meeting, held on 20 June 1949, took the Acting in pursuance of Chapter XV of the following decisions : Constitution, (1)APPROVES the draft Agreement between 1.Agreement with the Government of India the Government of India and the World Health The committee unanimously approved the Organization concerning theprivileges and draft Agreement with the Government of India 8 immunities and facilities to be granted by the extending privileges and immunities in India to Government of India to the World Health the Regional Organization for South-East Asia. Organization with regard to its arrangements The committee therefore recommends to the in the South-East Asia Region ; Assembly the adoption of the following resolu- (2)AUTHORIZES the Director-General or his tion : representative to sign the said Agreement on behalf of the World Health Assembly ; 7 Adopted by the Health Assembly at its ninth plenary meeting. (3)REQUESTS theDirector-Generalorhis 8 See Annex 11. representative in furtherance of Article XII, - 350 - COMMITTEE ON CONSTITUTIONAL MATTERS

Section 33 of the said Agreement to notify thefor the protection of the interests of certain States Government of India of the approval of theMembers of the League of Nations, but not said Agreement by the World Health Assembly. Members of the United Nations, consequent on the winding-up of the League, might be followed [WHA2.81] by the OIHP. The committee therefore recom- mends to the Assembly the adoption of the 2.Agreement with the Government of Egyptfollowing resolution : Pending the approval by the Government of Whereas forty-nine States have accepted the Egypt of an agreement extending privileges and Protocol of 1946 regarding the OIHP ; immunities to the Regional Organization in the Whereas a certain number of parties to the Eastern Mediterranean Region, the committee Rome Agreement of 1907 have not yet accepted recommends to the Assembly the adoption of the the Protocol or have not otherwise taken steps following resolution : to denounce the said Agreement ; Whereas, itis desirable to terminate the The Second World Health Assembly Rome Agreement of 1907 and to transfer to RESOLVES WHO, after the complete liquidation of the (1) that the Director-General be invited to Office, all its tasks and functions as well as continue negotiations with the Government of the assets and liabilities concerned ; Egypt in order to obtain an agreement extend- Whereas, certain governments, parties to ing privileges and immunities to the Regional the Rome Agreement of 1907, may be unable Organization of WHO in the Eastern Mediter- to proceed to the denunciation of the said ranean Area, including those persons properly Agreement ; taking part, in order to carry out its functions, For these reasons having regard to the proper interests of the Government of Egypt and having regard to The Second World Health Assembly agreements of the same nature which are in INVITES force and which have been concluded between (1) those parties to the Agreement of 1907 the " host " governments and international which have not already done so, to denounce organizations in several countries ; ,the said Agreement, and if possible, to accept (2) that as a provisional measure, and until the Protocol of 1946 ; such agreement comes into force, the Govern- (2) those governments which are competent ment of Egypt be invited to extend to the to act on behalf of any party not now in a Regional Organization established on its terri- position to act for itself, to denounce the Agree- tory, including those persons properly taking ment of 1907 and to agree to the dissolution part, the privileges and immunities contained of the Office on behalf of that party ; in the general Convention on the Privileges and Immunities of the Specialized Agencies, (3) those governments which are responsible including Annex VII ; for the conduct of the international relations of any non-self-governing territories and which (3) that the Director-General be requested to acceded to the Agreement of 1907 on behalf report on the results of negotiations at the of any such territories, to denounce the Agree- next session of the Executive Board. ment of 1907 and agree to the dissolution of the Office on behalf of any such territories ; [WHA2.82] (4) the Executive Board and the Director- General of WHO to keep in touch with the 3.Report on the Situation with regard to OIIIP Office International d'Hygiène Publique and The committee discussed the report of the to give their assistance if required in settling Executive Board concerning the situation of the the situation which might arise should certain Office International d'Hygiène Publique.9The Governments, parties to the Rome Agreement committee further took note of a suggestion that of 1907, be unable to denounce the said Agree- in the case where certain parties to the Rome ment ; Agreement of 1907 should be unable either to (5) the Director-General of WHO to inform denounce the Rome Agreement or to become without delay all interested governments of parties to the 1946 Protocol, the precedent created the text of the present resolution, for such purposes as they may deem fit. 9 Ofl. Rec. World HlthOrg. 14, 30 ;17, 20, item 8.7 [WHA2.83]

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(A2/85] 24 June 1949 THIRD REPORT 10

The Committee on Constitutional Matters, atsecond session, relations had been established its sixth meeting, held on 21 June 1949, took thewith the Committee on the Hygiene of Housing following decisions : of the American Public Health Association, and that the organization of a panel of expert cor- respondents in the hygiene of housing was under 1.Amendments to Regulations and Rules ofway. The committee was in agreement with the Procedure for Expert Committees and theirproposal to take up the matter of relations with Sub- Committees the International Housing and Town Planning The committee approved the additions andOrganization and other similar international and amendments to the Regulations and Rules ofnational organizations. It accordingly recom- Procedure for Expert Committees and their Sub-mends to the Health Assembly the adoption of Committees submitted to the Assembly by thethe following resolution : Executive Board. The committee therefore recommends to the The Second World Health Assembly Assembly the adoption of the following resolu- (1)NOTESthe activities begun by WHO in tion : the field of the hygiene of housing ; and The Second World Health Assembly (2)REQUESTSthe Director-General tocon- tinue these activities. ADOPTSthe additions and amendments to the Regulations and Rules of Procedure for [WHA2.86] Expert Committees and their Sub-Committees as approved by the Executive Board at its4.Relations with Specialized Agencies of the third session.0 United Nations [WHA2.84] The committee discussed that part of the report of the Director-General concerning rela- tions with the specialized agencies of the United 2.Policy on Invitations to appoint Members Nations14and accordingly recommends to the to Governing Bodies of Health Organiza-Health Assembly thatit adopt the following tions :Request from London School ofresolution : Hygiene and Tropical Medicine12 The committee recommends to the Assembly The Second World Health Assembly the adoption of the following resolution : (1)EXPRESSESits satisfaction with the work achieved by WHO during the past year in its The Second World Health Assembly relations with the specialized agencies of the (1)ADOPTSthe policy that the World Health United Nations ; and Organization cannot accept any invitation to (2)REQUESTSthat full co-operation in this appoint members to the governing bodies of fieldshould be continued,with particular health institutions or national health organiza- attention to the further development of such tions ; co-operation at the secretariat level during (2)REQUESTSthe Director-General to thank the planning stage. the London School of Hygiene and Tropical [WHA2.87] Medicine for its invitation, and to inform the School that, in view of the principles involved, the World Health Organization cannot accept5.RelationswiththeInternational Trade the invitation to appoint a member to the Organization Court of Governors of the School. The committee noted the recommendation of [WHA2.85] the Executive Board with regard to relations with the Interim Commission of ITO, and recom- mends to the Assembly the adoption of the follow- 3.Committee on the Hygiene of Housing ofing resolution : the American Public Health Association13 The committee took note of the statement by The Second World Health Assembly the Director-General that, in accordance with APPROVESthe continuation of relations with the resolution of the Executive Board at its the Interim Commission of the International Trade Organization on the basis of the letters 10 Adopted by the Health Assembly at its ninth exchanged by the Director-General of WHO plenary meeting. and the Executive Secretary of the Interim 11011. Rec. World Hlth Org. 17, 40 Commission of IT0.15 12Off.Rec. World Hlth Org. 14, 27. See also [WHA2.88] minutes of the sixth meeting of the committee, section 3, p. 301. 14oil. Rec. World Hlth Org. 16, 39 13011. Rec. World Hlth Org. 14, 20 15Cll. Rec. World Hlth Org. 14, 28, 60 - 332 - COMMITTEE ON CONSTITUTIONAL MATTERS

6.Relations with the Intergovernmental Ma- The Second World Health Assembly ritime Consultative Organization DECIDES tha. t for the time being, until the The committee, after examining the report of convening of the First Assembly of the Inter- the Director-General on the establishment of national Maritime Consultative Organization, relations with the Intergovernmental Maritime contact with this organization shall be main- Consultative Organization," recommends to the tained at the secretariat level, for the exchange Health Assembly the adoption of the following of documents and the study of common prob- resolution : lems. [WHA2.89] 18Minutes of the sixth meeting of the com- mittee, p. 303, footnote 6. [A2/86] 24 June 1949 FOURTH REPORT 17

The Committee on Constitutional Matters held The Second World Health Assembly, its seventh and eighth meetings on 22 and 23 June Regretting deeply the absence of representa- 1949. tives of these States from the Assembly and, in the case of the Union of Soviet Socialist 1.Action taken by Certain Countries with Republics and the Byelorussian Soviet Socialist regard to Membership of WHO Republic, of members of the Executive Board ; Recognizing the consequent loss to the work After discussing this question, the committee of the Organization ; and decided to recommend the following resolution, based on a proposal from the delegation of India,18 Taking note of the observations in the com- for adoption by the Second Health Assembly munications sent to the Director-General ; and Hoping that these States will in the near Whereas the Vice-Minister of Health of the future wish to reconsider their position, Union of Soviet Socialist Republics, the Vice- (1)INVITES them to reconsider their intention Minister of Health of the Ukrainian Soviet and join if possible the present and following Socialist Republic and the Vice-Minister of sessions of the Health Assembly and, in the Health of the Byelorussian Soviet Socialist case of the Union of Soviet Socialist Republics Republic, expressing their dissatisfaction with and the Byelorussian Soviet Socialist Republic, certain aspects of the work of WHO, have those of the Executive Board ; and in any event notified the Director-General that their States no longer consider themselves Members of the (2)Fully APPROVES the steps taken in this World Health Organization ;and regard by the Executive Board and the Director- General ; Whereas thé objective of the World Health (3)REQUESTS the Chairman of the Executive Organization is the attainment by all peoples Board and the Director-General to continue of the highest possible level of health, which endeavours to prevail upon the said States involves the co-operation of all countries ; and and their responsible authorities to change Whereas this principle has been proclaimed their decision and to report to the Third World by these States at the First World Health Health Assembly on the results of such en- Assembly ; deavours ; and (4)RECOMMENDS that States Members of the Organization take such steps as they may deem 17Adopted by the Health Assembly at its ninth plenary meeting. suitable in order that the said States may 18See minutes of the seventh meeting, p. 303, reconsider their decision. section 2. [WHA2.90]

[A2/96] 24 June 1949 FIFTH REPORT19

The Committee on Constitutional Matters, atSanitary Organization20and recommends to the its ninth meeting, held on 24 June 1949, took theAssembly the adoption of the following resolu- following decisions : tion : The Second World Health Assembly 1.Agreement with the Pan American Sanitary Acting in pursuance of Chapter XI of the Organization Constitution of the World Health Organization, The committee approved the text of the Agree- (1)APPROVES the Agreement between the ment between WHO and the Pan American World Health Organizationand the Pan 19Adopted by the Health Assembly at its tenth plenary meeting. 20See Annex 12. - 353 - COMMITTEE _REPORTS

American SanitaryOrganizationsignedin The conimittee therefore recommends to the Washington by the Director-General of theAssembly the adoption of the following resolu- World Health Organization and the Directortion : of the Pan American Sanitary Organization on 24 May 1949 ; The Second World Health Assembly, ADOPTS (2)DECLARESthat the said Agreement shall the additions and amendments to have effect from 1 July 1949. the Rules of Procedure of the World Health [WHA2.91] Assembly as approved by the Executive Board at its third session. [WHA2.94] 2.Accessions to the General Convention on the Privileges and Immunities of the Spe- 5.Additional Amendments to the Rules of cialized Agencies 21 Procedure of the World Health Assembly : The committee recommends to the Assembly Proposal by the Government of Belgium 24 the adoption of the following resolution : The committee recommends to the Assembly The Second World Health Assembly, the adoption of the following resolution : Considering the desirability of the applica- The Second World Health Assembly, tion of the Convention on the Privileges and REQUESTSthe Executive Board to examine Immunities of the Specialized Agencies and the additional amendments to the Rules of its Annex VII to the World Health Organiza- Procedure of the World Health Assembly, tion, and, in particular, proposed by the Government of Belgium and Having regard to the necessity of conferring to report to the Third World Health Assembly. its benefits on the Organization and its staff while engaged on the programme of the Orga- [WHA2.95] nization throughout the world, RECOMMENDSthat Members should as soon6.Request for Reconsideration of Assignment as possible accede to this convention and, if to Geographical Region (Greece) necessary, take such legislative measures as The committee, having approved the proposal may be necessary in order to extend its pro-put forward by the Executive Board," recom- visions to the World Health Organization. mends the following resolution for adoption by the Health Assembly : [WHA2.92] The Second World Health Assembly, 3. WHO Regulations on Nomenclature, 1948 : Having considered the request of the Greek Proposed Amendment to Article 20 Government for inclusion of Greece in Regional Organization Area 4, The committee approved the amendment to RESOLVESthat Greece shall from now on Article 20 of WHO Regulations on Nomenclature, form part of Regional Organization Area 4, 1948,22 and recommends to the Assembly the which comprises countries of the European adoption of the following resolution : continent. The Second World Health Assembly, [WHA2.96] Acting in pursuance of Article 23 of the Nomenclature Regulations,1948, 7.Establishment of a Regional Organization for the Western Pacific Region : Proposal ADOPTS,this day of .... by the Delegation of the Philippine Republic 1949, the Supplementary Regula- tions on Nomenclature (including the compila- The committee, after discussing this proposal, tion and publication of statistics) with respectsubmits the following resolution to the Assembly to diseases and causes of death. for adoption : [WHA2.93] The Second World Health Assembly, Having consideredthe proposal by the 4.Amendments to the Rules of Procedure Delegation of the Philippine Republic for the of the World Health Assembly establishment of a Regional Organization for The committee approved the additions and the Western Pacific Region," amendments to the Rules of Procedure of the NOTESthis proposal. Health Assembly, submitted to the Assembly by [WHA2.97] the Executive Board." 24 See minutes of the ninth meeting of the com- mittee, p. 310, section 6. 21 011. Rec. World Hlth Org. 10, 111 ;13, 364 25 011. Rec. World Hlth Org. 17, 17, item 6.5.2 22 See Annex 13. 26 See minutes of the ninth meeting of the com- 23 og. Rec. World mot Org. 17, 19, 53 mittee, p. 311, section 8.

354 -- COMMITTEE ON CONSTITUTIONAL MATTERS

[A2/99] 29 June 1949 SIXTH REPORT 27

The Committee on Constitutional Matters, at Noting that the texts of these agreements in its tenth, eleventh and twelfth meetings, held on the French language are not in conformity 27 and 28 June 1949, took the following decisions : with the texts as previously approved by the General Assembly of the United Nations on 1.Applications for Membership of WHO 15 November. 1947, by the Governing Body of ILO on 15 December 1947 and by the 1.1San Marino 28 Executive Board of UNESCO on 15 July 1948, The committee, having considered the report RESOLVES that these texts be replaced by of the working party, approved the following the texts which are annexed 31 which will be draft resolution and recommends it to the Health considered to have had effect as from 10 July Assembly for adoption : 1948. In view of the fact that the Republic of San [WHA2.100] Marino has announced that it cannot withdraw its reservation concerning the question of its3.Agreementbetween theIntel national financial contribution to the World Health Labour Organization and WHO : Article VII Organization, should its application for member- ship be accepted, The committee, after considering this matter The Second World Health Assembly and hearing the views of the representative of ILO, submits to the Health Assembly the follow- REGRETS not being able to accept San Marino'sing resolution for adoption : applicationformembershipofthe World Health Organization with such reservation. The Second World Health Assembly, [WHA2.983 Having reconsidered the substitution of the 1.2Korea (South) 29 words " involves or would involve " for the The committee, having considered the report words " would involve ",32 of the working party, approved the following draft Noting that the substitution would make resolution and recommends itto the Health little difference to the Agreement, and would Assembly for adoption : probably requiresimilar amendments to a number of other agreements to which ILO The Second World Health Assembly is a party, RESOLVES that the request for admission DECIDES not to urge the proposed alteration to the World Health Organization presented of Article VII. by the Government of Korea (South)be accepted. [WHA2.101] [WHA2.99] 4.Amendments to Rules of Procedure of the 2.Inter-Organization Agreements : Correction World Health Assembly concerning the of French Texts Status of Associate Members The committee approved the French texts of The committee approved the amendments to inter-organization agreements as corrected, andthe Rules of Procedure of the World Health recommends for adoption by the Health AssemblyAssembly concerning the statusof Associate the following resolution submitted by the Execu-Members 33 and submits the following resolution, tive Board : 30 put forward by the Executive Board,34 to the The Second World Health Assembly Health Assembly for adoption : Having regard to the resolution of 10 and The Second World Health Assembly, 17 July 1948 of the First Health Assembly, Having regard to the resolution of the First approving the draft agreements between the World Health Assembly of 21 July 1948 con- World Health Organization on the one part cerning the rights and obligations of Associate and the United Nations, the International Members, Labour Organization and the United Nations Educational, Scientific and Cultural Organiza- ADOPTS the amendments to the Rules of Procedureofthe World Health Assembly tion on the other part ; concerning the Status of Associate Members.33 27 Adopted by the Health Assembly at its tenth [WHA2.102] plenary meeting. 28 See minutes of the tenth meeting of the com- 31 011. Rec. World Hlth Org. 17, 17 mittee, p. 312, section 3. 32 Off. Rec. World Hlth Org. 13, 322 29 See footnote 2, p. 9. 33O. Rec. World Hlth Org. 14, 64 39 See Annex 25, French edition only. 34O. Rec. World Hlth Org. 14, 29

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5.The Rights and Obligations of Associate Committee, nor in sub-divisians dealing Members and Other Territories in Regional with finance or constitutional matters ; Organizations (3) Representatives of Associate Members The committee considered the report of the should be qualified by their technical com- working party 35 concerning the interpretation petence in the field of health and should be of the expression " States Members in the Region " chosen from the native population in accord- in Article 47 of the Constitution and the question ance with Article 8 of the Constitution ; of the rights and obligations of Associate Members and other territories in Regional Organizations. (4) In the case of territories not responsible The committee also took note of a statement for the conduct of their international rela- made by the representative of Bulgaria " and a tions and not Associate Members, the rights statement concerning the Pan American Sanitary and obligations in(2) above shall apply Organization (Annex 12). subject to consultation between the States The committee finally approved the following Members in a region as defined in 1 above resolution and recommends its adoption by the and the Members or other authority having Health Assembly : responsibility for the international relations of these territories ; The Second World Health Assembly, Having regard to Articles 8 and 47 of the (5) In recommending any additional appro- priation under Article 50 (/) of the Constitu- Constitution ; tion, the Regional Committee shall take Having regard to paragraph 4 of the resolu- account of the difference in status between tion of the First World Health Assembly con- States Members on the one hand and As- cerning the rights and obligations of Associate sociate Members and other territories or Members ; 37 and groups of territories not responsible for the Having regard to the reports of the Executive conduct of their international relations on Board at its second and third sessions ; 38 and the other ; Having regard to a statement concerning thePanAmericanSanitaryOrganization 4.In view of the statement made by the (Annex 12) Director of the Pan American Sanitary Orga- nization (Annex 12) and of the fact that integra- RESOLVESas follows : tion between PASO and WHO is still in process, 1.For the purposes of Article 47 of the Consti- the application of the above recommendation tution, States Members in a region shall be in the American Region shall await the comple- deemed to be those States Members having tion of these negotiations for such integration ; their seat of government within the region ; 5.The Executive Board should keep under 2.Those States Members not having their review the implementation of these decisions seat of government within the region, which and submit to the Fifth World Health Assembly (a) either by reason of their Constitution con- at the latest, a report thereon in order that sider certain territories or groups of territories that Assembly might determine what, if any, in the region as part of their national territory, modifications might be required in the above or (b) are responsible for the conduct of the decisions in the light of experience. international relations of territories or groups of territories within the region, shall participate [WHA2.103] as Members of the Regional Committee, in which case they shall have all the rights, privileges and obligations of Member States6.Regional Organization : Africa 39 in the region, but with only one vote for all the territories or groups of territories in the The committee recommendsthefollowing region, as defined in (a) and (b) above ; resolution to the Health Assembly for adoption : 3.(1) Territories or groups of territories in The Second World Health Assembly, the region which are not responsible for the conduct oftheir international relations, Havingconsideredthequestionofthe whether Associate Members or otherwise, establishment of a Regional Organization for may participate in Regional Committees, Africa ; and in accordance with Articles 8 and 47 of the Having regard to its decision relating to the Constitution ; definition of Member States in Regional Orga- (2) Associate Members shall have all rights nizations and the rights and obligations of and obligations in the Regional Organiza- Associate Members and other territoriesin tions, with the exception that they will have Regional Organizations, no vote in plenary meetings of the Regional NOTESandDRAWS TO THE ATTENTIONOf the 38 See minutes of the tenth and eleventh meetings Director-General the discussion concerning con- of the committee, pp. 314, 315. sultation with Member States in the Region " See appendix to this report. and with Member States which may participate 37 Off. Rec. World Hlth Org. 13, 337 38 Off. Rec. World filth Org. 14, 54 ;17, 17 " Ofi. Rec. World Hlth Org. 13, 330 ;17, 16 - 356 - COMMITTEE ON CONSTITUTIONAL MATTERS

as Members in the Regional Committee, in the provisions of Article 47 of the Constitu- regard to the establishment of a Regional tion ; and Organization for Africa. (2)REQUESTS the Executive Board to study [WHA2.104] the implementation of this principle and to submit a report with recommendations to the 7.Regional Organization :Western Pacific Third World Health Assembly. The committee noted that this subject had [WHA2.105] already been discussed and a decision taken (fifth report, section 7). Appendix 8.Convention on the Privileges and Immun- ities of the Specialized Agencies : Its Appli- STATEMENT BY THE REPRESENTATIVE cation in Territories of Associate Members OF BULGARIA and in Other Territoriesor Groups of Territories not Responsible for the Conduct In the Preamble of the Constitution it is stated of their International Relations and not as f ollows : Associate Members 40 " The enjoyment of the highest attainable standard of health is one of the fundamental After a discussion of the principles involved, rights of every human being without distinction the committee decided to recommend the follow- of race, religion,political belief, economic or ingresolutiontotheHealth Assembly for social condition." adoption : It is furthermore stated : The Second World Health Assembly " The extension to all peoples of the benefits of medical, psychological and related knowledge (1)AGREES in principle that the application is essential to the fullest attainment of health." of the Convention on the Privileges and Im- munities of the Specialized Agencies, together Taking into account the principles of the Con- stitution, I am of opinion that all peoples are equal with its Annex VII, should be extended toand have the same rights, and that therefore there representatives of Associate Members in the should not exist some peoples possessing all rights World Health Assembly, and in Regional Com-while others have only limited rights. In Regional mittees, to representatives both of AssociateCommittees all Members should have the same Members and of other territories or groups ofrights and obligations.Considering, however, that territories not responsible for the conduct ofArticles 8 and 47 of the Constitution recognize a their international relations, participating understate of fact which exists in international affairs, that is to say the non-self-governing territories, 40 011. Rec. World Hlth Org. 10, 111 ;13, 337, I have put forward certain amendments to the 364 ;14, 14, 26.See also minutes of the twelfthresolution presented to the committee by the meeting of the committee, p. 319, section 2. working party.

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PART III

ANNEXES

ANNEX 1 [A2/88] 24 June 1949 NOMINATIONS BY THE GENERAL COMMITTEE OF MEMBERS ENTITLED TO DESIGNATE A PERSON TO SERVE ON THE EXECUTIVE BOARD 1

In accordance with Rule 79 of the Rules of Procedure as amended during the eighth plenary meeting of the Second World Health Assembly, the General Committee submits herewith for con- sideration a nomination list of Members entitled to designate a person to serve on the Executive Board. The name of each of the six Members was placed on the nomination list by a majority vote of the members of the General Committee, as recorded below : Members present In alphabetical order Votes received and voting Italy 9 15 Philippines 11 15 Turkey 13 15 United Kingdom 9 15 United States of America 11 15 Venezuela 13 15

The General Committee considers that these six Members would provide, if elected, a balanced distribution of the Executive Board as a whole, and it recommends their acceptance by the Assembly. The General Committee submits also for consideration the following three Members who were added to the list by separate majority votes : Members present Votes received and voting Australia 7 12 Pakistan 10 15 Sweden 10 15 I See Decision (ix) and ninth plenary meeting, section 43.

ANNEX 2 AD HOC COMMITTEE OF THE EXECUTIVE BOARD 1

Part 1 [A2/55] 11 June 1949 REPORT ON THE EXTERNAL AUDITOR'S REPORT AND ON THE AUDIT OF THE ACCOUNTS OF THE WORLD HEALTH ORGANIZATION FOR THE FINANCIAL PERIOD 1 SEPTEMBER TO 31 DECEMBER 1948 2

1.The Executive Board atitsthird session tween the time of the receipt of the report of created this ad hoc committee of the Board by the External Auditor on the accounts of the the following resolution : Organization for the period 1 September 1948 to 31 December 1948 and the date of the con- The Executive Board, vening of the Second Health Assembly ; and Considering the fact that there will not be Considering the requirement that the com- a formal session of the Executive Board be- ments, if any, of the Board on such report be made to the Second Health Assembly ; 1 See Decision (xii) 2 See Resolution WHA2.51 and minutes of the RESOLVES that an ad hoc committee of the third meeting of the Committee on Administration Executive Board, consisting of Professors Parisot and Finance, section 6. and Stampar and Dr. van den Berg, is author- - 361 - ANNEX 2

ized to meet one day before the date of the3.3 The committee fully endorses the comments convening of the Second Health Assembly, toof the External Auditor regarding the necessity consider the report of the External Auditorfor an adequate working capital fund as contained (on the accounts of the Organization for thein paragraph 11 of the report, and invites careful period 1 September 1948 to 31 December 1948)attention of the Assembly to the proposal con- and to submit to the Second Health Assemblycurred in by the Executive Board to increase on behalf of the Board such comments, if any,the working capital fund to $4,000,000.4 as it deems necessary.3 3.4 The committee noted with satisfaction that 2.The committee met at 10 a.m. on 10 Junethe External Auditor carried out a complete 1949 at the Palazzo Venezia.The meeting wasaudit, as referred to in paragraph 12. attended by Dr. van den Berg, Professor Stampar3.5 The committee takesgreatpleasurein and Dr. Dujarric de la Rivière, who attended incalling the attention of the Assembly to para- place of Professor Parisot. Dr. van den Berg wasgraph 13 of the report of the External Auditor, elected Chairman.Dr. Dujarric de la Rivi&-eand expresses the hope that the administrative was elected Rapporteur. policies and procedures of the World Health Organization will continue to merit commenda- 3.The ad hoc committee considered the reporttion. of the External Auditor on the audit of the3.6 The committee wishes particularly to recog- accounts of the World Health Organization fornize the excellent report of the External Auditor, thefinancialperiod 1 September1948toand commends Mr. Brunskog's work as being 31 December 1948 as set out in Official Records No. 20. of outstanding assistance to the Organization. 3.1The ad hoc committee considered particu-4. The ad hoc committee recommends to the larly the problem of adequate financing for theSecond World Health Assembly that the report Organization, as mentioned in paragraphs 7 andof the External Auditor be accepted and suggests 8 of the report of the External Auditor.Thethe adoption by the Health Assembly of a resolu- committee wishes to underline particularly thetion along the following lines : necessity for Members to pay their contributions The Second World Health Assembly, at the earliest possible date, in order that the work of the Organization may not be jeopardized. Having examined the annual financial state- The committee recommends that the Assembly ment and the report of the External Auditor, give particular attention to the reports submitted on the audit of the accounts of the World to it on the present status of contributions. Health Organization for the financial period 1 September 1948 to 31 December 1948, as 3.2 The committee noted with gratification the contained in Official Records No. 20, and comments contained in paragraph 10 of the report concerning the proper accounting of funds Having considered the recommendation of made available to the Organization by govern- the ad hoc committee acting on behalf of the ments to facilitate the work of the Organization's Executive Board, operations in the country. ACCEPTS the report. 8 Off. Rec. World Hlth Org. 17, 21 4 Off. Rec. World Hlth Org. 18, 25

Part 2 [A2/55] 11 June 1949 REPORT ON EXPERT COMMITTEE REPORTS

In accordance with the instructions of the ReportofSub-CommitteeonFat-Soluble third session of the Executive Board,6 the ad hoc Vitamins committee considered the following reports of those expert committees 7 which had met after Expert Committee on the Unification of Phar- the third session of the Board : macopoeias :Report on the fourth session Expert Committee on Health Statistics : Report Expert Committee on Biological Standardiza- on the first session tion :Report on the third session Expert Committee on Insecticides : Report on the first session 5 See Resolutions WHA2.9 ; WHA2.10; WHA2.18 and WHA2.38, and minutes of the eighth meeting The ad hoc committee, considering that the (section 4) and twelfth meeting (section 3) of thework done by the expert committees had been Committee on Programme. most valuable from an international point of 6 Off. Rec. World Hlth Org. 17, 13 view, desired to place on record its appreciation 7 To be published. of the reports presented. - 362 -- ANNEX 3

It also suggested that in selecting members of Expert Committee on Health Statistics : Report expert committees, every effort should be made on the first session.9 to secure equitable geographical distribution as far as possible. having noted the report of the Expert Committee In the course of commenting on the various on Biological Standardization, as instructed by reports, the ad hoc committee consideredit the third session of the Executive Board, en- necessary to draw the attention of the Second dorsed the committee's expression of regret on World Health Assembly to the advisability of the loss of Mr. P. Bruce White, outstanding bacte- riologist and serologist, who had been closely suggesting that governments sponsoring inter- connected with the work of the committee. national conferences on subjects related to public The ad hoc committee commented on this health and medicine should, so far as possible,report as follows : consult WHO in order that such conferences The ad hoc committee of the Executive Board, might be co-ordinated. having noted the report of the Expert Committee These reports were referred by the ad hoc on Health Statistics, as instructed by the third session of the Executive Board, committee to the Second World Health Assembly In view of the value which health statistics and their comments on individual reports will have for the proper understanding of epidemio- be found in the following documents : logical and other medical and public-health problems, Expert Committee on Biological Standardiza- Draws the attention of the Second World tion : Report on the third session ; 8 Health Assembly to the desirability of impressing upon Member Governments the great importance to be attached to the compilation and trans- 8 The ad hoc committee commented on this mission of health statistics, and to the means of report as follows : implementing the recommendations contained The ad hoc committee of the Executive Board, in the report. (WHA2.39.)

ANNEX 3 [A2/68] 18 June 1949 MALARIA : SCOPE OF THE EXPERT COMMITTEE

Part 1

NOTE SUBMITTED BY THE ITALIAN DELEGATION

The Italian delegation wishes to call the atten-reference and be constituted as a committee on tion of the committee [on Programme] to the fact malariaandotherinsect-bornediseases,to that, in its opinion, malaria should be consideredadvise WHO on all activities in relation to the as ranking among insect-borne diseases. control of insect-borne diseases. Every nation in the world has a permanent The advantage of this proposal is clear when problem in relation to diseases transmitted byit is considered that in many malarious countries domestic insects.With the existence, now, ofthe prevention of malaria may be of insignificant po werful means such as contact insecticides, itcost if and when house-insect-borne diseases are would seem that the time has come for attack- controlled. ing domestic insects on a wide scale in order to If the suggestion of the Italian delegation is prevent the diseases for which they are respon-adopted, the corollary would be that training sible.Experience in the last few years has showncourses in malaria should be integrated with that domestic insect control is greatly welcomedtraining in the control of insect-borne diseases. by all populations ;its cost is very low in com-This is already being done in connexion with the parison with the immense benefits derived.Itcourses which are now being held in the Institute appears, therefore, evident that this is a mostof Public Health in Rome, under the auspices important task for WHO to assume in assistingof WHO. governments to undertake large-scalecontrol Therefore, the Italian delegation submits the programmes against house insects. following draft resolution : The Italian delegation suggests that the Expert Committee on Malaria be given wider terms of Whereas malaria control by modern contact insecticides has often brought about control of insect-borne diseases other than malaria ; 1 See Resolution WHA2.20 and minutes of the fourteenth meeting of the Committee on Programme, Whereas such diseases represent a problem section 2. for all countries, -- 363 - ANNEX 3

The Second World Health Assembly (2)RECOMMENDS that malaria training courses (1)RESOLVES that the Expert Committee on in different countries be integrated with the Malaria be henceforward changed into an training in insect control as a measure of public expert committee on malaria and other insect- health. borne diseases, and

Part 2 [A2/68/Add.1] 20 June 1949

COMMENTS BY THE DELEGATION OF THE PHILIPPINES ON THE NOTE SUBMITTED BY THE ITALIAN DELEGATION

The following is the text of a letter received matters.This is therefore not in consonance from Dr. Antonio Ejercito,delegateofthe with the implications of the words "... malaria Philippines. and other insect-borne diseases ", which suggest Allow me, Sir, to congratulate the Italian that malaria control means only the control delegation on its good intention in suggesting of mosquitoes. an extension of the activities of WHO to other 3. In the control of mosquitoes as a phase insect-borne diseases-to that end proposing of malariology there is recognized the so-called that the Expert Committee on Malaria be " species sanitation or species control ", mean- henceforward changed into an expert committee ing that out of so many anopheles species in on malaria and other insect-borne diseases. a region or locality, the control is only directed This proposal has apparentlyarisen from to the particular species that transmits malaria. observations on the success of house-spraying This is evidently to reduce the cost of mosquito with contact insecticidesin the control of control, as otherwise the amount of money malaria ;and this is because the anopheles might be unnecessarily great and needlessly vector species is domesticated, i.e., it has the spent. Now then, while the policy in the control habit of living and breeding in houses. Hence, of malaria is for judicious expense within the attack on this species will also involve the an- realm of anophelism, is it logical to go beyond nihilation of other house insects. this and attack other insects ? Believing that the Italian delegation is invit- ing constructive criticisms to its proposal, I 4. The proposed additional phrase in the have to offer the following comments : title " ... and other insect-borne diseases " 1. Bionomics of anopheles transmitters of might be taken, in a universal concept, to malaria differ not only indifferent regions, cover even yellow fever, dengue fever and but also in different countries of the same ffiariasis. Therefore,the nine-man expert region.Thus, while it is true that in some committee on malaria will not only lose its countries the anopheles vector is domesticated, specialized identity, but its membership will it is equally true that in other countries the be insufficient to handle diseases other than speciesis wild-after getting human blood malaria.As a matter of fact, the number of meals, it leaves the house and returns to its members, in my humble opinion,is hardly natural habitg in the field.While contact enough for an advisory body to the WHO insecticide is effective in the former, it is not administration on matters pertaining to malaria. so in the latter case. How then can we apply I earnestly hope that the Italian delegation, the isolated concept of contact insecticides as a body of scientists, will welcome the fore- affecting the domestic malaria mosquitoes and going comments, for they have been offered other insects to a worldwide concept to make as constructive criticisms, and that the Com- the proposal logical ? mittee on Programme will take them as food 2. The control of malaria is not merely the for thought in considering the proposal sub- use of contact insecticides ;it involves other mitted.

- 364 - ANNEX A

ANNEX 4 [A2/351 27 May 1949 REPORT BY WHO MEMBERS ON THE ASSUMPTION BY WHO OF RESPONSIBILITY FOR UNICEF HEALTH PROJECTS, AND ON THE FUNCTIONING OF THE JOINT COMMITTEE 1

1.Authority ever, some concern over the expansion of technical By resolution of the third session of the Execu-staff and health activities within UNICEF. tive Board, the WHO members of the Joint Com- 3.Report mittee on Health Policy, UNICEF/WHO were requested to report to the Second World HealthCo-operative Policies Assembly on the plan developed for the assump- At the third session of the Joint Committee tion by WHO of responsibility for UNICEFon Health Policy, consideration was given to the health projects 0.nd on the functioning of the" development of a plan for the assumption by joint committee.2 WHO of the responsibility for UNICEF health projects."In the discussion of this item, it 2.Background became apparent that a distinction could be drawn between the supply and the technical The First Health Assembly passed a resolution health phases of the UNICEF health programmes. in which it found that " the health projects ofOn the basis of this distinction, an agreement UNICEF fall within the competence of WHO ",was reached which appears to the WHO members and declared that " the World Health Organiza-of the joint committee to provide the framework tion is ready and willing to handle these projectswithin which a proper relationship can be estab- as soon as suitable arrangements can be made ".lished, with WHO carrying the full technical In the meantime, the Joint Committee on Health responsibility.This agreed policy statement is Policy was established as " a temporary body to as follows : operate only until all health activities of UNICEF shall have been taken over by the World Health For the purpose of carrying out the intent Organization or are terminated." 3 of paragraph 4 (c) of the Charter of UNICEF 4 At the request of the Executive Board, the the following principles will immediately govern third session of the joint committee considered the co-operative relationship between WHO, the agenda item, " Development of a plan for as the UN specialized agency recognized as the the assumption by WHO of responsibility for directing and co-ordinating authority on inter- UNICEF health projects." national health work, and UNICEF, with The WHO members of the joint committee regard both to health programmes approved consider that the actions cited above were taken by the Joint Committee on Health Policy and by the Health Assembly and the Executive Board any new health programmes which may be because of a concern that a second United Nations developed for its consideration : agency, operating in the field of responsibility (a) When international health experts are defined in the Constitution of WHO, might required for assisting governments in draw- develop from UNICEF. This concern has grown ing up plans of operation for UNICEF health as the health programmes of UNICEF have programmes, it will be the responsibility of expanded into new geographical areas and into WHO to make available to governments such the activities concerned with age-old problems experts, upon the invitation of the countries requiring long-range action for their solution. concerned. The agreements reached at the first and second (b) The Director-General of WHO will study sessions of the Joint Committee on Health Policy and approve plans of operation for all health resulted in increasingly intimate relationships programmes which fall within the policies between the organizations, with the recognition laid down by the Joint Committee on Health of WHO as the organization responsible for the technical health aspects of UNICEF programmes. 4 Paragraph 4 (c) of UNICEF Charter reads as Following these meetings, there remained, how- follows : To the maximum extent feasible, the utili- zation of the staff and technical assistance of I See Resolution WHA2.24 and minutes of the specialized agencies, in particular the World fifteenth meeting of the Committee on Programme, Health Organization or its Interim Commission, section 2. shall be requested, with a view to reducing to a minimum the separate personnel require- 2 Off. Rec. World Hlth Org. 17, 18 ments of the Fund.Resolution 57(I)of 3 011. Rec. World Hlth Org. 13, 328 11 December 1946, of the General Assembly. - 365 - ANNEX 5

Policy and for which countries may request The Joint Committee on Health Policy recom- supplies from UNICEF. mended that the Executive Director of UNICEF (c)All international expert health personneland the Director-General of WHO consider the agreed with governments as necessary forusefulness of joint UNICEF/WHO missions in the implementation of any health programmeareas in which health programmes constitute the will be made available by WHO. predominant UNICEF supply activities. The WHO members of the joint comtnittee feel that (d) UNICEF's role in health programmesthis administrative arrangement provides a parti- is, in accordance with its charter, to furnishcularlydesirablemethodforadministrative under its agreements with governments thedevelopment. required supplies and services, and through its staff to observe that the principles of the Executive Board are maintained in theirCommittee Procedure utilization. At the third session of the Joint Committee (e) WHO's role in carrying out the foregoingon Health Policy, the procedures of the Com- arrangements is subject to the provisionsmittee were reviewed.Particular emphasis was of its Constitution and the limitations oflaid on the desirabilityof consideration and its resources, but beyond this it will provideapproval by the joint committee of programmes the services which will be reimbursed byinvolving new technical policies prior to action UNICEF. on such programmes by the Programme Com- mittee and the Executive Board of UNICEF. (/) UNICEF will inform governments ofIt was recognized that under unusual circum- the foregoing arrangements. stances due to the difficulties of convening inter- The WHO members of the Joint Committeenational meetings at short notice in emergency on Health Policy attach particular importancesituations, exceptions might be required at times. to paragraph (b) of the above policy statement.The joint committee approved a document setting In view of the temporary emergency characterforth the agreed procedures.This document is of UNICEF, it is felt that the above policy pro-appended.5 vides a framework within which the Director- General of WHO and the Executive Director of 5 The annex to the report printed above entitled UNICEF can develop working arrangements" Consideration of the Procedure of the Joint Health Policy Committee " was a reproduction of satisfactory to both organizations. The develop-section B of the report of the third session of the Ments under this policy should be kept underjoint committee and is printed in Official Records review by the Executive Board of WHO. No. 22 in the third part of the supplement.

ANNEX 5 [From A2/19] 28 April 1949 CO-ORDINATION - GENERAL 1

1.The World Health Organization has taken anfrom 4 April to 20 April to discuss the resolution active part in the work of co-ordination which of the Economic and Social Council on technical is carried out, with respect to policy, by theassistance to underdeveloped countries. A deputy Administrative Committee on Co-ordination (ACC)of the Director-General will attend the eighth and its Preparatory Committee and, with respectsession of the Preparatory Committee at Lake to the execution of programmes, by the subsidiarySuccess on 16 May 1949.The World Health bodies of the ACC. Organization has been represented at all the meet- 2.The Director-General attended the specialings of subordinate bodies of the Administrative session of the Administrative Committee on Co-Committee on Co-ordination which have been ordination held in Geneva on 9 March 1949, andheld to date. will attend the seventh regular session of the committee at Lake Success on 21 May. Deputies3. The Director-General considers that the best of the Director-General have attended the seventhguarantee of co-ordination is to be found in effectiveworking relationswiththe United session of the Preparatory Committee held atNations and with the other specialized agencies. Lake Success on 15 February 1949, and the meet- Such relations have been developed, in particular, ings of the working groups held in Washingtonwith FAO, ILO, UNESCO, the Secretariat of from 31 March to 2 April and in Lake Successthe United Nations, the Economic Commission I See Resolution WHA2.31 and minutes of thefor Europe and, through the Joint Committee nineteenth meeting of the Committee on Pro-on Health Policy with UNICEF. It is proposed gramme, section 5. thattheserelationsshall be continued and - 366 - ANNEX 6

expanded.The mechanism of the ACC and itsgreater part of this work is accomplished, at the subordinate bodies is giving good results for thesecretariat level, by technical working groups, co-ordination of policy, and the development ofand there appears to be no danger that the comparable administrative procedures and con-machinery of co-ordination will expand unduly, sultation regarding activities in which severalor that the working groups will be perpetuated United Nations bodies are collaborating. Thewhen their functions have been completed.

ANNEX 6 [A2/6] 11 April 1949 HEALTH STATISTICS 1

NOTE SUBMITTED BY THE UNITED KINGDOM DELEGATION

At the First World Health Assembly Sir Wilsonproject that appears to lend itself to international Jameson, the chief delegate of the United King- effort. dom, said, " It seems to me that the World Health The United Kingdom delegation is convinced Organization should concentrate itsefforts inthat, if wasteful expenditure and futile effort are attacking where the most generally useful resultsto be reduced to a minimum, the programmes will be achieved. There is certain to be a tempta-of the Organization must be guided by scientifi- tion to tackle the big scourges of mankind ; butcally sound information and that tests should be before embarking on any such undertaking weapplied to determine the need for, and value of, must be sure that the problem really does lendinternational action in particular fields before itself to international effort...I look forwardsuch action is embarked upon. to the provision by the Organization of a first- A consequence of this general proposition is class information service and of expert guidancethat statistical material and methods should be over a wide range of subjects." 2 fully and expertly used in all suitable cases. The The delegate of the Union of South Africanumerical measurement of a problem is in itself planning " 3a great safeguard against hasty and confused and the delegate of Canada emphasized that " wethought.In planning, in implementation and must be very careful not to dissipate our limitedin judging results for future guidance, health resources on a vast variety of projects, not allprogrammes should be founded upon, and guided of which may be of crucial importance.Theby, good statistics. Canadian delegation will lend its support to the For these reasons the United Kingdom delega- adoption of projects for which sound scientifiction hopes that the Organization will encourage data are available." 4 the full use of health statistics as an important In the view of the United Kingdom delegation,means of ensuring the successful pursuit of the it is a necessary corollary to these views that,objectives set forth in its Constitution. The where statistical information isavailable anddelegation also suggests that it would be worth statistical methods appropriate, they should bewhile to examine whether the administrative fully used to test the desirability of any suggestedarrangements so far made by the Organization in the sphere of health statistics are those best 1 See Resolution WHA2.40 and minutes of thecalculated to achieve such objectives and to twelfth meeting of the Committee on Programme,further the principles set out above.With this section 3. purpose in view, it is suggested that the Assembly 2 Off. Rec. World filth Org. 13, 35 should request the Director-General to draw up a Oft. Rec. World 111114 Org. 13, 39 a paper for consideration at the next session of 4 Og. Rec. World MA Org.13, 62 the Executive Board.

- - 367 -- ANNEX T

ANNEX 7 [From A2/54] 10 June 1949 JOINT PROGRAMME BASED ON CO-OPERATION BETWEEN GOVERNMENTS, FAO AND WHO TO INCREASE WORLD FOOD PRODUCTION AND RAISE STANDARDS OF HEALTH 1

NOTE BY THE DIRECTOR-GENERAL

1.Need for Joint Action increaseworld foodproductionandraise The General Assembly of the United Nations, standards of health ; and on 11 December 1946, adopted a resolution on (2)REQUESTS the Director-General to continue the " World Shortage of Cereals and other Food- collaboration with FAO in order to prepare stuffs ",2 requesting the international organiza- plans for the implementation of this programme tions concerned with food and agriculture to in 1950. publish full information in their possession on the world food position and the future outlook, and to intensify efforts to obtain as full informa- II.The Executive Board tion as possible on this subject, in order to assist REQUESTS the Director-General, in consulta- governments indeterminingtheirshort-term tion with FAO, and long-term agricultural policy. Having in mind the General Assembly resolu- (1)to present to the Economic and Social tion, the Economic and Social Council, during Council at its eighth session the proposal for a its sixth session, on 2 March 1948, invited " the jointaction programme of FAO/WHO to specialized agencies concerned and the regional increaseworldfoodproductionandraise economic commissions, in consultation with the standards of health ; FAO, to study suitable measures to bring about (2)to request the Council to consider the an increase in food production " and requested means, by which such a proposal might best be " the FAO to make a report to the seventh session implemented. of the Council on progress achieved in co-ordina- tion of these studies ", and " to present a factual report to the first session of the Council following III.The Executive Board the 1948 annual conference of FAO, on the RECOMMENDS that the proposal for a joint measures which have been taken by Member action programme of FAO/WHO to increase States, regional commissions and the specialized the world food production and raise standards agencies to alleviate the world food crisis, and of health, together with the Board's approval to recommend specifically what further action and the recommendations of the Economic might appropriately be taken in this field." 3 and Social Council, be brought to the attention During its seventh session, the Economic and of the Second Health Assembly. Social Council in its resolution of 27 August 1948 noted " with satisfaction the progress recorded in This resolution was circulated to the eighth the report of the Food and Agriculture Organiza-session of the Economic and Social Council for tion with regard to co-ordination of the work ofinformation. No action was taken by the Council the specialized agencies concerned and of theat that time. regional commissions to bring about an increase In view of the interest repeatedly expressed in food production throughout the world " and by the General Assembly, the Economic and Social requested " the'se organs to continue their effortsCouncil and other bodies on the agricultural deve- to that end in the closest co-operation." 4 lopment of territories in order to increase world The Executive Board of the World Healthfood .production ; because of the view taken by Organization, at its third session, adopted the the First World Health Assembly that " economic following resolutions : development without adequate health measures is necessarily incomplete and it is the right of the I.The Executive Board people to expect that proper health measures be (1)NOTES with approval the proposal for ataken concurrently with such economic effects " ;2 jointaction programme of FAO/WHO toand because a prerequisite to development in many undeveloped territories situated in the 1 See Resolution WHA2.41 and minutes of the tropics or sub-tropics is the improvement of the thirteenth meeting of the Committee on Pro-health of the inhabitants, including the elimina- gramme, section 2. tion of malaria and other preventable diseases, 2 Resolution 45 (I) the following plan is submitted. 3 Resolution 103 (VI) 4 Resolution 140 (VII) 5O. Rec. World Hlth Org. 17, 10 Off. Rec. World Hlth Org. 10, 65 ;13, 321 - 368 - ANNEX 7

2.The Proposed Plan policy of the World Health Organization to insist upon full preliminary consultations with Objective the other organization or organizations concerned, and that a satisfactory joint survey shall be Joint government, FAO and WHO co-operativerequired before any such joint projects may be action to increase food production in areas suscep-considered by the Executive Board of the Health tible of agricultural development, and in whichAssembly ".8 ill-health (particularly severe endemic malaria) Joint " area selection survey teams " will be is the primary obstacle to such development, willsent to these areas for a period of not less than contribute towards a solution of the problemthree months in order to investigate the circum- posed in the General Assembly and the Economicstances on the spot and furnish the data on which and Social Council resolutions by helping tothe final choice will be made. Six areas in all will decrease the deficit in world food production andbe surveyed, and on the basis of the report, three at the same time improving the health of millionswill be selected jointly by the two organizations. of people. The total acreage which will be covered This joint survey will be carried out with the by the plan must be of a magnitude adequate tofull co-operation of the governments concerned, bring about an increase in agricultural productionwhich will be expected to provide auxiliary which will have a significant effect.? personnel and assistance in kind or in local currency, including the provision of accommoda- Programme tion, laboratories, offices, stores, etc.Provision The programme will extend over a minimumfor assistance will be covered by an agreement of five years (i.e., 1951 to 1955).This excludeswith the government before the survey begins. the period required for the preliminary selectionSuch a survey will, in itself, be valuable to the and the joint area selection survey.Preparationcountry concerned. for operations, including initial staffing and the It will be necessary to ensure that funds are provision of supplies and equipment, will com-made available for the completion of the whole mence in the fourth quarter of 1950. Operationsprogramme involving at least five years' operation, will reach full scale in 1951. before the area selection surveys are authorized. The timetable will be broadly as follows : Final selection of areas Late 1949 :Preliminary selection of six areas by FAO/WHO The final selection of the three areas will require the fullest co-operation of the governments con- 1950 : Joint area selection surveys of six areas,cerned and their agreement (a)to collaborate at appropriate seasons technically and financially as far as possible, and Fourth quarter 1950 : Final selection of threeto give complete assistance to WHO and FAO areas and start of procurement of suppliesin the operations ;and (b)to maintain the and the recruitment of personnel measures of control and the level of development attained in the areas when the assistance of the First quarter 1951 :Pre-operational detailedtwo organizations is withdrawn. survey, merging into The three areas finally selected should belong Second quarter 1951 :Operations. to different regions. Recruitment of personnel and procurement of supplies and equipment will be started during Preliminary selection of areas the last quarter of 1950. As the choice of areas will of necessity be based upon their agricultural potential, the preliminaryPre-operational detailed survey selection will be made by FAO. WHO will then screen the chosen areas, concentrating on those This phase of the plan is of the greatest import- where(a)poor health,particularlymalaria, ance and the success of the operation as a whole constitutes a major obstacle to development ;may well depend upon the care with which it is (b) malaria would be amenable to control ; anddone. (c) such control would be economically feasible. The personnel necessary for the pre-operational A number of areas meeting these requirementssurvey, to which a minimum of three months will then be selected provisionally by agreementshould be devoted, will be required to be in the between the two organizations, according to thearea during the first quarter of 1951 (Northern resolution of the First Health Assembly " that,Hemisphere).The survey team will : except in cases of emergency, it shall be the (1)Carry out a detailed malaria survey of the area with the view of planning the control operations ; 7 In the proposal for a joint action programme to increase world food production and raise stan- (2)Carry out a general public-health survey, dards of health, presented by FAO and WHO at the Central Committee of UNRRA in 1948, it paying proper attention to nutrition and other was stated that the total area for such a joint major public-health problems.Priority will project was expected to cover " at least ten million acres of agricultural land inadequately worked by disease-ridden people." 8 Off. Rec. World Hlth Org. 13, 324 - 369 - ANNEX 7

be given to those problems which might beport which cannot be provided locally.It will affected by the anti-malaria campaign ; be the responsibility of the government concerned (3)Plan the operation for the five-year period.to arrange for provision of mechanical and other The projectis designed for underdevelopedequipment necessary for carrying out programmes territories and from the health standpoint, itof agricultural development with such consulta- will aim not only at controlling malaria buttion and advisory assistance from FAO as may also at a simultaneous raising of general stan-be desirable and feasible. dards of health. The survey group will therefore be required to place the several health prob-Estimates (WHO only) lems in an order of priority.Malaria will It is impossible to foresee the actual size of the probably be placed in top priority, not onlyareas to be selected.To give an illustration of because itis likely to be the most seriousthè budgetary implications, however, a unit area obstacle to the development of the area, butof two million acres has been considered for the because it is likely that, in the first year ofpurpose of drafting the following estimates. operation, transmission of malaria may be interrupted by insecticides and a large partArea Selection Surveys of the health problems solved ; 1950 (4)Negotiate with the government an agree- For three-month surveys, on the basisof ment on the basis of such a plan, specifying the2,000,000 acres (8,000 sq. km) per area : commitments of the government in implement- ing the plan. The governments concerned will Estimated cost per area selectionsurvey : be expected to recruit and pay all local per- sonnel, to furnish accommodation for the WHO Personnel services 20,000 staff members, for laboratory, offices, surgeries,Travel and transportation 12,000 stores, etc., to supply drivers and as muchSupplies and material 1,350 transportation as possible, to make the con-Fixed charges and claims 500 tinuing local investments necessary for theAcquisition of capital assets 11,500 success of the scheme, and to make provisions Total for one team $45,350 for agricultural development programmes in Total for six teams :$272,100 consultation with FAO ; (5)Train local personnel for the 1951-1955 Increase in personnel of the malariasection campaign. at headquarters, Geneva :one Class 1 officer, one Class 3 secretary. Operations These will be timed in accordance with the 1951-1955 seasonalimplicationsofagriculturalmalaria The first year of operation will include capital transmission, and will start in the second quarterexpenditure which will not be repeated in the of 1951 in the case of areas in the Northernfollowing years.Moreover, considering that the Hemisphere, and in the third quarter in the caseinternational personnel will devote a large part of areas of the Southern Hemisphere. of their activities to training national personnel, The pre-operational detailed surveys will beit is expected that in the latter years the expenses arranged so that they will merge into the opera-related to WHO staff members willfall. A tional phase, using the same personnel and equip- minimum figure for a single area of some two ment and transport as much as possible. million acres would imply an average yearly The type of operation which will be undertaken expensefor WHO amountingto$489,540. by WHO in the selected areas will vary accordingThus, as an illustration, if three areas of some to the diseases to be controlled, the priority intwo million acres each are selected, the total cost which they will have been placed and the parti-for WHO's participation in this project in 1951 cular approach to health decided upon. It seems,is estimated at $1,468,620. however, that during the first year of operations As it will be necessary for WHO to build up emphasis should be placed upon malaria, environ-a stockpile of supplies during 1950 for the timely mental sanitation and on health education ofimplementation of this programme, as well as the public. The types of soil and the local possibili-to commence initial staffing towards the end of ties for agricultural development will probablythefourthquarter,supplementary provision govern their choice of operation. WHO will place amounting to $229,200, should be made in the a number of technically equipped officers in each1950 budget to meet this end. To this must be of the selected areas to advise and assist, as faradded the cost of the surveys, indicated above. as circumstances permit, in the facilitiesfor Thus the total supplementary estimate to provide procurement of equipment, supplies and trans-for this project for 1950 amounts to $501,300.

-- 370 - ANNEX 8

ANNEX 8 [From A2/9] 10 May 1949

ADMINISTRATIVE AND FINANCIAL RELATIONS BETWEEN THE UNITED NATIONS AND SPECIALIZED AGENCIES 1

Following the policy adopted by the Firstnumber of staff, terms of appointment, classifica- Health Assembly,2theDirector-General hastion of positions and nationality distribution, participated in meetings of the Administrativefor the use of the Expert Committee on Salaries Committee on Co-ordination of the United Nationsand Allowances which was established by the and the specialized agencies with a view to pro-Third General Assembly of the United Nations. moting the development of similar budgetary, It is understood that the committee will give administrative and financial practices.In addi-consideration to the problems and needs of the tion, WHO has participated in other joint activi-specialized agencies. ties designed to result in co-ordination of these The findings of the committee, which will hold practices. its first meeting in July, will be communicated to the session of the Executive Board next follow- 1.Reciprocal Arrangements on Personnel ing its report and to the subsequent Health Assembly. WHO Staff Regulations and Staff Rules contain provisions facilitating the transfer of staff be- 3.ParticipationintheInternationalCivil tween WHO and the United Nations and other Service Advisory Board Activities specialized agencies.Vacant positions in WHO are filled by transfer of staff from the United At the invitation of the Secretary-General of Nations and the specialized agencies in preferencethe United Nations, the Interim Commission of to appointments from outside. Service withWHO was represented on the working party another organization is taken into considerationwhich drew up a scheme for an International when fixing the period of probation for thoseCivil Service Advisory Board. Subsequently, staff members who, prior . to their appointmentthe First Health Assembly decided that WHO in WHO, served in a similar position with theshould participate in the Advisory Board and United Nations or another specialized agency.agreed to assume its proportionate share of the Such staff members may be exempted from thecost.2 By agreement between the organizations, normal period of probation. Moreover, servicethis share has been fixed for 1949 at US $1,250. for seniority is accorded on a reciprocal basis to WHO supplied,for submission to the first staff recruited from the United Nations and thesession of the Advisory Board, information on specialized agencies. Staff members so transferredthe size of WHO staff, local and international retain certain rights acquired under the contractrecruitment, geographical distribution, the num- with the releasing organization. ber of staff transferred from UN and specialized Formal transfer agreements have been enteredagencies to WHO and vice versa, staff seconded into with the United Nations and most of thefrom Member Governments, and vacancies to specialized agencies. Under these agreements,be filled during the remainder of 1949. staff members transferred between WHO and WHO was represented at the first session of any of these organizations may retain such ofthe Advisory Board. Reports of the Board, when their acquired rights under the rules of theavailable, will be submitted to the Health Assem- releasing agency as are compatible with the rulesbly, and to the Executive Board, as appropriate. of the receiving agency (annual leave, sick leave, homeleave,providentfund,pensionfund,4.United Nations Advisory Committee on repatriation rights, etc.), the transfer not being Administrative and Budgetary Questions considered as an interruption of service. The second session of the Executive Board decided that the fifth report of the United Nations 2.Co-operation with the United Nations Ex- Advisory CommitteeonAdministrativeand pert Committee on Salaries and AllowancesBudgetary Questions should be submitted to the At the request of the United Nations, WHO Second Health Assembly.4 The Director-General, has supplied detailed information on its salary,as requested by the Executive Board, sent the allowance and leave systems, as well as thefollowing letter to the Secretary-General of the United Nations : I See Resolution WHA2.45 and minutes of the second meeting of the Committee on Administra- tion and Finance, section 6. 3 Off. Rec. World Hlth Org. 13, 312 2 00. Rec. World Hlth Org. 13, 316 4 OU. Rec. World Hlth Org. 14. 31, item 7.2.4 - 371 -- ANNEX 8

Geneva, 19 November 1948the United Nations and the specialized agencies. It is expected that it will be possible to submit The Executive Board of the World Healthfor the consideration of the World Health Assem- Organization at its second session discussedbly a proposed system jointly recommended by the fifth report of the United Nations Advisorythe specialized agencies and the United Nations committee on Administrative and Budgetaryfollowing its consideration and possible approval Questions in which reference is made to theby the General Assembly of the United Nations. programme and budget of WHO for 1949. The Board questioned whether certain com- ments and recommendations made in the report 7.Addendum were within the terms of reference of that 11 June 1949 Committee. It was disturbed at the rather Since the above document was distributed liberal view which the committee has takenadditional progress has been made in the co- of its functions with respect to the specializedordination of administrative and financial prob- agencies. lems between the United Nations and specialized The Board decided that the entire report,agencies. The attention of the Health Assembly with the comments of the Board as recordedis invited to that portion of the fifth report of in the minutes, should be submitted to thethe Administrative Committee on Co-ordination Second Health Assembly, and that in the mean-to the Economic and Social Council 6which time the Director-General should indicate toreflects the following recommendations :7 the Secretary-General of the United Nations the general feeling of the members of the Board .1. Common Collection of Contributions in this regard. With regard to the studies on the possibility This message was acknowledged by the Secre- of common collection of contributions, it was tary-General as follows : found that no significant savings could be expected from common collection, while delays 10 December 1948 in the payment of contributions to certain In your letter of 19 November you informed agencies might even be caused where in the me of the general feeling expressed, and the past special arrangements had been made for action taken, by the Executive Board of the early payment of contributions. The Committee World Health Organization in regard to the accordingly agreed to recommend that, as an comments and recommendations concerning alternative, each agency might supply to the the programme and budget of the World Health United Nations early in December each year Organization for 1949 contained in the fifth re- a schedule showing the amounts requested from port of the United Nations Advisory Committee each government for the following year, so that on Administrative and Budgetary Questions. the Treasuries in each year could be informed at I referred your letter to the Chairman of the that time of the total contributions to be made Advisory Committee and received from him, by each government for the work of the various under date of 27 November, a communication international agencies of which it is a member.8 on behalf of the Committee,8 the text of which Full details of the results of the above studies has been brought to the attention of the will be placed before the fourth session of the President of the General Assembly. The Presi- General Assembly by the Secretary-General dent has requested me to transmit that com- in his report on administrative and budgetary munication to you and to inform you that co-ordination. he concurs in the statement of the functions and competerice of the Committee set out 2. Personnel problems therein. The Committee wishes to call attention to the difficulties experienced by a number of 5.Standard Form of Budget Presentation organizations in recruiting, on a wide geogra- phical basis, senior personnel of the calibre Agreement has been reached among the United required to carry the increasing responsibilities Nations and the specialized agencies on the which are being placed upon them.In this standard form in which the budget summaries connexion the work undertaken by the Inter- will be submitted by specialized agencies to the national Civil Service Advisory Board...is United Nations General Assembly. Further clearly of great significance.The work of the study is being made of such related problems as financial policies and standard objects of expendi- 6 Document E/1340, p. 11 ture, and it is expected that general agreement 7 The Administrative Committee on Co-ordi- on these matters will be reached within the nextnation also agreed to recommend to the appro- several months. priate body in each agency (a) a set of principles to govern audit procedures in the United Nations and specialized agencies and (b) the establish- 6.Common System of External Audit ment of a panel of external auditors of the United Nations and specialized agencies (see Appendices 1 Considerable progress has been made in deve-and 2 to the second report of the Committee on loping a common system of external audit forAdministration and Finance). 8 The provisions are not applicable to the Bank 5 See appendix to this annex. and the Fund. - 372 - ANNEX 8

Committee of Experts on Salaries, Allowances Nations and specialized agencies, studies have and Leave Systems, established by the Secre- been made which revealed certain basic assump- tary-General by direction of the General Assem- tions underlying these staff regulations that bly, which includes study of the salary systems would be useful as a guide for further studies. of the specialized agencies, will likewise be With regard to cost-of-living surveys and the followed with the greatest interest. fixing of salary differentials applicable to areas The agencies were duly consulted through where United Nations and specialized agencies the Consultative Committee on Administrative offices are located, arrangements were made Questions on the possible membership, plan of for the computation and collation of data by work and areas of studies for this committee, the United Nations Statistical Office, with the and their assistance was obtained in the pre- agencies concerned sharing in any extra costs paration of comparative data for the salary agreed to be necessary ;further studies are study. With a view to achieving greater proceeding with regard to the application of uniformity in the staff regulations of the United the results of these surveys.

Appendix

LETTER FROM THE CHAIRMAN OF THE ADVISORY COMMITTEE ON CO-ORDINATION TO THE SECRETARY-GENERAL OF THE UNITED NATIONS

27 November 1938. May I, on behalf of the Advisory Committee, add that no such criticisms as those embodied Dear Mr. Secretary-General, in the letter of the Director-General of the new organization have ever been levelled in the past The Advisory Committee on Administrativeagainst the Committee's interpretation of its own and Budgetary Questions, having taken note offunctions and procedures.Indeed, they seem the communication addressed to you on 19 No-to imply cristicism of the General Assembly for vember 1948 by the Director-General of thehaving though fit to bestow on the Committee World Health Organization (a copy of which youits present jurisdiction, and for having adopted were good enough to forward to me), has instruc-its Report on the Budgets of the Specialized ted me to communicate to you the following views :Agencies for 1949 (A/675). The Advisory Committee is a body set up by the General Assembly and its terms of reference have You will no doubt wish to communicate to the been established by the 'latter.It is accountablePresident of the General Assembly a copy of this solely to the Assembly for ist actions. Examina-letter together with the text of the communication tion of the administrative budgets of the specia-from the Director-General of WHO. lized agencies is included in the terms of reference of the Advisory Committee (General Assembly Yours sincerely, resolution 14 (I) in implementation of the relevant provision of the Charter, Article 17 (3)).Its (signed) Th. AGHNIDES, reports thereon are to be submitted to the General Chairman. Assembly. It is for the General Assembly to decide whether its Advisory Committee acted within its termsThe Secretary-General, of reference.Short of a contrary intimation byUnited Nations, the Assembly, the Committee must, of necessity,Palais de Chaillot, continue to perform its difficult task as in theParis XVIe, past. France.

-373 - ANNEX 9

ANNEX 9 [From A2/7 and Add. 1] 7 April and 17 June 1949 HEADQUARTERS OFFICE : ARRANGEMENTS FOR ACCOMMODATION

The two letters reproduced below were received by the Director-General from M. Max Petitpierre, Federal Councillor, Chief of the Federal Political Department of Switzerland :

Berne, 28 March 1949. In reply to your letter dated 25 March 1949, and with reference to the conversations which I had with the Secretary-General of the United Nations and yourself, I have the honour to inform you that the Federal Council, desirous of facilitating the establishment of the World Health Organi- zation in Geneva, is in a position to make certain financial proposals in this regard. These proposals, if accepted, will have to be submitted to the Federal Chambers for approval. The proposals are based on the estimate for the architects' plan known as " Project B ", which contemplates a new building, in the form of an addition to the Palais des Nations, at a cost of Frs. 5,750,000. Any other acceptable project, the cost of which would not exceed this amount, could also be taken as a basis of computation. Upon the conditions set forth above, the Federal Council considers that the Confederation might participate in one of the following ways : 1. A gift of Frs. 2,000,000 and a loan of the balance, viz., Frs. 3,750,000 at 2% interest, amortisa- tion and interest to be set off by the Swiss annual contribution to WHO. 2.A loan of the whole amount, viz., Frs. 5,750,000 without interest, to be reimbursed within a period of thirty years, Switzerland's contribution to be appropriated to the repayment. 3. A gift of Frs. 3,000,000, the World Health Organization to find elsewhere the balance of Frs. 2,750,000.

Needless to say, the above-mentioned offer is open to the United Nations as well as to the World Health Organization, on the understanding that it is associated with the definitive establish- ment of the last-named agency in Geneva. With regard to the plans for the building, I have already indicated the Swiss authorities' preference for Project B. This does not mean that we reject any other practicable and adequate solution. With special reference to the proposal for constructing in height (the tower), the Federal Council, at the express request of the Genevese authorities, would reserve its opinion. In any case, one or more town-planners of repute would have to be consulted. The plans for a construction to be put up outside the perimeter of the " Parc des Nations " could be considered subsidiarily, but such a building, besides making it impossible to take full advantage of the services already existing in the Palais, would probably entail a greater outlay than would Project B. The Swiss authorities, for their part, are convinced that any other solution, particularly that involving more or less important transformations in the Palais des Nations, is not to be recommended. The Federal Council is in entire agreement with the opinion of the Secretariat of the United Nations, that it is essential that no measure be taken which might hamper the development of the European Office of the United Nations as such, or detract from Geneva's importance as a centre of international conferences. I hope that the suggestions made above will help to hasten the solution of the problem of establishing the World Health Organization. (signed) Max PETITPIERRE.

Berne, 1 June 1949. We have the honour to refer to the letter of 1 April by which you communicated to us your observations on the method of repayment of any advance that might be made by Switzerland with a view to facilitating the establishment of the headquarters of the World Health Organization. Our Department has examined your observations, in conjunction with the Federal Department for Finance and Customs. Both departments have reached the conclusion that they can accept 1 See Resolution WHA2.61 and minutes of the eighth meeting of the Committee on Administra- tion and Finance, section 1. - 374 - ANNEXES 10 AND 11

the principle of repayment by equal annual amounts, as suggested by you. We therefore propose the following alternatives : (a)In the case of our first proposal (gift by the Confederation of Frs. 2,000,000, and loan of the balance, viz. Frs. 3,750,000 at 2% interest), repayment would be made by annuities of Frs. 200,000 over 23 Y2 years, the annuities to include interest. (b)In the case of our second proposal (loan by the Confederation of the whole amount, viz. Frs. 5,750,000, with interest) repayment would be made by annuities of Frs. 191,666 over a period of 30 years. (signed) Max PETITPIERRE.

ANNEX 10 [A2/66] 18 June 1949 RELIEF OF PALESTINE REFUGEES 1

The following is the text of a letter sent to the Director-General of WHO by the Secretary-General of the United Nations on 10 June 1949 : The United Nations is deeply appreciative of the work done by the World Health Organization in helping to implement the United Nations program for relief to nearly one million homeless and destitute Palestine refugees under the terms of the General Assembly Resolution 212 (III). I believe you know already that the United Nations Relief for Palestine Refugees is to be continued beyond the original termination date of 31 August 1949 so as to provide time for the Fourth Regular Session of the General Assembly to take new action. While it is hardly possible to anticipate the scope or character of any program which the General Assembly may establish, the facts would indicate that a sizeable need for international provision of assistance to refugees probably will exist in 1950, particularly while any measures for permanent rehabilitation are first being implemented. Certainly protective measures with respect to sanitation and medical care will continue to be needed. I would like to suggest, therefore, that the attention of the forthcoming World Health Assembly be drawn to the question of the possibility of continuing and extending WHO's Palestine refugee program in the coming year. The total sums available for sanitation and health services from UNRPR resources have been very small, of course, in comparison with actual needs as assessed by the WHO representative serving as UNRPR's Chief Medical Officer and the medical officers of the International Committee of the Red Cross, the League of Red Cross Societies, and the American Friends Service Committee. On this account, your Assembly might wish to consider the feasibility of a provision in the 1950 budget of WHO which would permit a substantially larger allocation toward a medical care program among the refugees than was possible for 1949. Any such favorable action would be warmly welcomed by the United Nations.

1 See Resolution WHA2.76.

ANNEX 11 [From A2/51] 9 June 1949 AGREEMENT WITH THE GOVERNMENT OF INDIA 1

In accordance with the request of the Executive Board at its second session,2 a draft agreement extending privileges and immunities in India to the Regional Organization for South-East Asia was submitted to the Government of India by the Director-General through the Director of the South-East Asia Regional Office. By letter of 20 May 1949,3 the Regional Director was informed of the approval by the Indian Government of the draft agreement. 1 See Resolution WHA2.81 and minutes of the fifth meeting of the Committee on Constitutional Matters, section 2. 2 011. Rec. World Hlth Org.14, 26 3 Appendix 2 to this Annex. - 375 - ANNEX 11

Appendix 1

AGREEMENT BETWEEN THE WORLD HEALTH ORGANIZATION AND THE GOVERNMENT OF INDIA

THE GOVERNMENT OF INDIA of the one part, and THE WORLD HEALTH ORGANIZATION of the other, DESIRING to conclude an AGREEMENT for the purpose of determining the privileges, immunities and facilities to be granted by the GOVERNMENT OF INDIA tO the WORLD HEALTH ORGANIZATION, tO the representatives of its Members and to its experts and officials in particular with regard to its arrange- ments in the SOUTH-EAST ASIA REGION, and of regulating other related matters,

HAVE AGREED as follows :

Art. I :Definitions Section 1 In the present Agreement : (i) The word " Organization " shall mean the World Health Organization ; (ii)For the purposes of Article IV the words " property and assets ", " funds, gold or currency ", or " assets, income and other property " shall be deemed to include property, assets, and funds administered by the Organization under Article 57 of its Constitution and/or in furtherance of its constitutional functions ; (iii) The words " representatives of Members " shall be deemed to include all delegates to the World Health Assembly ;all persons designated by Members to serve on the Executive Board of the Organization ;all representatives on the Regional Committees in the South-East Asia Region ;as well as all delegates, alternates, advisers, technical experts who are members of delegations, and secretaries of delegations ; (iv) The word " Member " shall be deemed to include a Member or an Associate Member of the Organization as well as a territory or group of territories which, without being an Associate Member, is represented and participating in the Regional Committee of the South-East Asia Region of the Organization, in accordance with Article 47 of its Constitution ; (v) The words " principal or subsidiary organs " shall be deemed to include the World Health Assembly, the Executive Board, the Regional Committee in the South-East Asia Region and any of the subdivisions of all these organs as well as the Secretariat and the Regional Office in New Delhi ; (vi) For the purposes of Sections 4, 6, 16 and 17 the words " freedom of meeting " or " meeting of the Organization " shall be deemed to include all meetings of the principal or subsidiary organs of the Organization as well as all conferences or meetings convened by, or under the authority or auspices of, the Organization in India. Art. II: Juridical Personality Section 2 The Organization shall possess juridical personality and legal capacity and, in particular, capacity (a) to contract, (b) to acquire and dispose of immovable and movable property, and (c) to institute legal proceedings.

Art. III :Freedom of Action Section 3 The Organization and its principal or subsidiary organs shall have in India the indepen- dence and freedom of action belonging to an international organization. Section 4 The Organization, its principal or subsidiary organs, as well as its Members and the representatives of Members in their relations with the Organization, shall enjoy in India absolute freedom of meeting, including freedom of discussion and decision.

Art. IV :Property, Funds and Assets Section 5 The Organization and its property and assets located in India shall enjoy immunity from every form of legal process except in so far as in any particular case this immunity - 376 - ANNEX 1 1

is expressly waived by the Director-General of the Organization or the Regional Director as his duly authorized representative.It is, however, understood that no waiver of immunity shall extend to any measure of execution. Section 6 (1)The premises of the Organization in India or any premises in India occupied by the Organization in connexion with a meeting of the Organization shall be inviolable. (2)Such premises and the property and assets of the Organization in India shall be immune from search, requisition, confiscation, expropriation, and any other form of interference, whether by executive, administrative, judicial or legislative action. Section 7 The archives of the Organization, and in general all documents belonging to it or held by it in India shall be inviolable. Section 8 (1)Without being restricted by financial controls, regulations or moratoria of any kind :(a) the Organization may hold funds, gold or currency of any kind and operate accounts in any currency ;(b) the Organization shall be free to transfer its funds, gold or currency to or from India or within India and to convert any currency held by it into any other currency. (2)This section shall also apply to Members of the Organization in their relations with the Organization. Section 9 The Government of India shall provide for the Organization, at the most favourable rate officially recognized, its national currency to the amount required to meet the expenditure of the Organization in India or other parts of the South-East Asia Region. Section 10 In exercising its rights under Sections 8 and 9, the Organization shall pay due regard to any representations made by the Government of India in so far as the Organization considers that effect can be given to such representations without detriment to its interests. Section 11 The Organization, its assets, income and other property shall be :(a) exempt from all direct and indirect taxes.It is understood, however, that the Organization will not claim exemption from taxes which are, in fact, no more than charges for public utility services ;(b) exempt from customs duties, prohibitions and restrictions on imports and exports in respect of medical supplies, or any other goods or articles imported or exported by the Organization for its official use. It is understood, however, that such medical supplies, goods, or articles, imported under such exemption will not be sold in India except under conditions agreed with the Government of India ; (c) exempt from customs duties, prohibitions and restrictions on imports and exports in respect of their publications. Section 12While the Organization will not, as a general rule, in the case of minor purchases, claim exemption from excise duties and from taxes on the sale of movable and immovable property which form part of the price to be paid, nevertheless, when the Organization is making important purchases for official use of property on which such duties and taxes have been charged or are chargeable, the Government of India shall make appro- priate administrative arrangements for the remission or return of the amount of duty or tax. Art. V :Facilities in respect of Communications Section 13 The Organization shall enjoy in India for its official communications treatment not less favourable than that accorded by the Government of India to any other govern- ment including its diplomatic mission, in the matter of priorities, rates and taxes on mails, cables, telegrams, radiograms, telephotos, telephone and other communications, and Press rates for information to the Press and radio. Section 14 (1) No censorship shall be applied to the official correspondence and other official communications of the Organization. (2)The Organization shall have the right to use codes and to despatch and receive correspondence by courier or in sealed bags, which shall have the same immunities and privileges as diplomatic couriers and bags. Art. VI: Representatives of Members Section 15 Representatives of Members of the Organization on its principal or subsidiary organs and at conferences or meetings convened by the Organization, shall, while exercising their functions and during their journeys to and from the place of meeting, enjoy the following privileges and immunities :(a) Immunity from personal arrest or detention and from seizure of their personal baggage, and, in respect of words spoken or written and all acts done by them in their official capacity, immunity from legal process of every kind ;(b)Inviolability for all papers and documents ; (c)The right to use - 377 - ANNEX 11

codes and to despatch or receive papers or correspondence by courier or sealed bags ; (d)Exemption in respect of themselves and their spouses from immigration restric- tions, aliens' registration or national service obligations in India ;(e) The same facilities in respect of currency or exchange restrictions as are accorded to representatives of foreign Governments on temporary official missions ;(f)The same immunities and facilities in respect of their personal baggage as are accorded to members of diplomatic missions of comparable rank ;(g)Such other privileges, immunities and faciitfes not inconsistent with the foregoing as members of diplomatic missions of comparable rank enjoy, except that they shall have no right to claim exemption from customs duties on articles imported (otherwise than as part of their personal baggage) or from indirect taxes or sales taxes. Section 16 In order to secure for the representatives of Members of the Organization at a meeting of the Organization complete freedom of speech and independence in the discharge of their duties, the immunity from legal process in respect of words spoken or written and all acts done by them in discharging their duties shall continue to be accorded notwithstanding that the persons concerned are no longer engaged in the discharge of such duties. Section 17 If the incidence of any form of taxation depends upon residence in India, periods during which the representatives of Members of the Organization are present at a meeting of the Organization in India for the discharge of their duties shall not be considered as periods of residence. Section 18 Privileges and immunities are accorded to the representatives of Members of the Organization not for the personal benefit of the individuals themselves, but in order to safeguard the independent exercise of their functions in connexion with the Organiza- tion.Consequently, a Member not only has the right, but is under a duty to waive the immunity of its representatives in any case where, in the opinion of the Member, the immunity would impede the course of justice, and it can be waived without prejudice to the purpose for which the immunity is accorded. In any such case in which one of the persons designated to serve on it is concerned, the Executive Board of the Organiza- tion shall be under the same duty.

Art. VII : Experts on Missions for the Organization Section 19 Experts and consultants other than those under Section 1 (iii) or as officials come within the scope of Articles VI or VIII respectively and who perform missions for the Organization shall be accorded such privileges and immunities as are necessary for the independent exercise of their functions during the period of their missions, including the time spent on journeys in connexion with their missions.In particular, they shall be accorded :(a)Immunity from personal arrest or detention and from seizure of their personal baggage and in respect of words spoken or written and acts done by them in the course of the performance of their mission, immunity from legal process of every kind. This immunity from legal process shall continue to be accorded notwith- standing that the persons concerned are no longer employed on missions for the Organiza- tion ;(b)Inviolability for all papers and documents ;(c) For the purpose of their communications with the Organization, the right to use codes and to despatch or receive papers or correspondence by courier or in sealed bags ;(d) Exemption in respect of themselves and their spouses from immigration restrictions, aliens' registration or national service obligations in India ;(e) The same facilities in respect of currency or exchange restrictions as are accorded to representatives of foreign governments on temporary official missions ; (f)The same immunities and facilities in respect of their personal baggage as are accorded to members of diplomatic missions. Section 20Privileges and immunities are granted to experts in the interests of the Organization and not for the personal benefit of the individuals themselves. The Director-General shall have the right and the duty to waive the immunity of any expert in any case where, in his opinion, the immunity would impede the course of justice and can be waived without prejudice to the interests of the Organization.

Art. VIII :Officials Section 21 The Director-General or the Regional Director as his duly authorized representative, shall from time to time communicate to the Government of India the names of those officials to whom the provisions of this Article and Article IX shall apply. Section 22Officials of the Organization shall :(a) be immune from legal process in respect of words spoken or written and all acts performed by them in their official capacity ; (b) be exempt from taxation in respect of the salaries and emoluments paid to them

378 ANNEX' 11

by the Organization ;(c) be immune, together with their spouses and relatives dependent on them, from immigration restrictions and aliens' registration ;(d) be accorded the same privileges in respect of exchange facilities as are accorded to officials of comparable rank of diplomatic missions to India ;(e) be given, together with their spouses and relatives dependent on them, the same repatriation facilities in time of international crises as officials of comparable rank of diplomatic missions ;(f) have the right to import free of duty their furniture and effects at the time of taking up their post in India or upon their permanent appointment to it ;(g) once every three years have the right to import free of duty a motor-car it being understood that the duty will become payable in the event of the sale or disposal of such motor-car to a person not entitled to this exemption within three years upon its importation. Section 23 (i) The officials of the Organization shall be exempt from national service obligations in India provided that, in relation to officials who are Indian nationals, such exemption shall be confined to officials whose names have, by reason of their duties, been placed upon a list compiled by the Director-General or the Regional Director as his duly authorized representative and communicated to the Government of India. (ii)Should other officials of the Organization be called up for national service, the Government of India, shall, at the request of the Director-General or the Regional Director as his duly authorized representative, grant such deferments in the call-up of such officials as may be necessary to avoid serious dislocation in the continuation of essential work. Section 24 In addition to the immunities and privileges specified in Sections 22 and 23, the Director- General, the Deputy Director-General, the Assistant Directors-General, the Regional Director in India and, if the Director-General should so desire and communicate their names to the Government of India, certain officials of a director's status, shall be accorded in respect of themselves, their spouses and minor children, the privileges and immunities, exemptions and facilities accorded to diplomatic envoys in accordance with inter- national law. Section 25 Privileges and immunities are granted to officials in the interests of the Organization and not for the personal benefit of the individuals themselves.The Director-General shall have the right and the duty to waive the immunity of any official in any case where, in his opinion, the immunity would impede the course of justice and can be waived without prejudice to the interests of the Organization. Section 26 The Organization shall co-operate at all times with the appropriate authorities of the Government of India to facilitate the proper administration of justice, secure the observ- ance of police regulations and prevent the occurrence of any abuses in connexion with the privileges, immunities and facilities mentioned in this Article.

Art. IX :Visas, Permits of Residence, United Nations Laissez-passer Section 27 (1)The Government of India shall take all measures required to facilitate the entry into, residence in, and departure from India of all persons having official business with the Organization, i.e,(a) representatives of Members, whatever may be the relations between India and the Member concerned ;(b) experts and consultants on missions for the Organization, irrespective of nationality ;(c)officials of the Organization, (d) other persons, irrespective of nationality, summoned by the Organization. (2) Any police regulation calculated to restrict the entry of aliens into India or to regulate the conditions of their residence, shall not apply to the persons provided for in this section. (3)The Government of India shall issue to the embassies, legations and consulates abroad general instructions in advance to grant visas to any applicant on production of a valid identity and travel document and of a document establishing his official relationship to the Organization, without any delay or waiting period and without requiring his personal attendance or the payment of any charges. (4)The provisions of this Section shall apply to the spouse and dependents of the person concerned if they live with him and do not exercise an independent profession or calling. Section 28 The Government of India shall recognize and accept as valid travel documents the United Nations Laissez-passer issued to the officials of the Organization under admin- istrative arrangements concluded between the Director-General of the Organization and the Secretary-General of the United Nations. - 379 - ANNEX 11

Section 29 The Director-General, the Deputy Director-General, the Assistant Directors-General, the Regional Director of the Organization in India and the Directors of the Organiza- tion travelling on its official business shall be granted the same facilities as are accorded to diplomatic envoys.

Art. X :Security of Government of India Section 30 Nothing in the present Agreement shall be construed to preclude the adoption of appro- priate security precautions in the interests of the Government of India which shall be determined by agreement between the Governmeat of India and the Director-General.

Art. XI :Settlement of Disputes Section 31 The Organization shall make provision for appropriate modes of settlement of : (a) disputes arising out of contracts or other disputes of a private law character to which the Organization is a party ;(b) disputes involving any official of the Organiza- tion who, by reason of his official position, enjoys immunity, if immunity has not been waived by the Director-General in accordance with the provisions of Section 25. Section 32Any difference between the Organization and the Government of India arising out of the interpretation or application of the present Agreement or of any supplementary arrangement or agreement which is not settled by negotiation shall be submitted for decision to a Board of three arbitrators ; the first to be appointed by the Government of India, the second by the Director-General of the Organization, and the third, the presiding arbitrator, by the President of the International Court of Justice, unless in any specific case the parties hereto agree to resort to a different mode of settlement.

Art. XII :Final Provisions Section 33 The present Agreement shall enter into force upon an exchange of notes between the authoriied representatives of the Government of India and the Organization stating respectively that it has been approved by the Government of India and adopted by the World Health Assembly. Section 34On the coming-into-force of the present Agreement, it will be communicated for registra- tion to the Secretary-General of the United Nations by the Director-General of the Organization, in pursuance of Article 1 of the Regulations, to give effect to Article 102 of the Charter of the United Nations adopted by the General Assembly of the United Nations on 14 December 1946. Section 35The present Agreement may be revised at the request of either party.In this event the two parties shall consult each other concerning the modifications to be made in its provisions.If the negotiations do not result in an understanding within one year, the present Agreement may be denounced by either party giving two years' notice. Notice of denunciation to the Government of India may be given to the representative of that Government in the Organization and notice to the Organization may be given to the Director-General.

IN FAITH WHEREOF the present Agreement wa done and signed at on the day of ,194., in six copies, three in French and three in English, the texts in both languages being equally authentic, of which two texts, one copy in French and one in English, were handed to the representatives of the Government of India and the four remaining copies to the Director-General of the World Health Organization.

FOR THE GOVERNMENT FOR THE WORLD HEALTH OF INDIA : ORGANIZATION :

Director-General

- 380 - ANNEXE 12

Appendix 2

LETTER FROM THE UNDER-SECRETARY TO THE GOVERNMENT OF INDIA TO THE REGIONAL DIRECTOR OF WHO FOR THE SOUTH EAST ASIA REGION

New Delhi, 20 May 1949 From : P. S. Doraswami, Esquire, B.A., Under-Secretary to the Government of India, To : The Director, Regional Office of the World Health Organization for South East Asia, 12, Hardinge Avenue, New Delhi. Subject :Draft Agreement between the Government of India and the World Health Organization.

Sir, With reference to your letter No. 11-3/48, dated the 10th February, 1949, I am directed to convey the approval of the Government of India to the draft agreement regarding the privileges, immunities and facilities to be granted by the Government of India to the World Health Organization. It is not clear how " comparable rank " mentioned in article 22 (d) in the draft agreement is to be determined. While the Government of India have no objection to the retention of the phrase " comparable rank ", it is requested that they may kindly be informed of the procedure suggested for determining " comparable rank ". Yours faithfully, (signed) P. S. DORASWAMI, Under-Secretary

ANNEX 12 [From A2/45] 7 June 1949

AGREEMENT WITH THE PAN AMERICAN SANITARY ORGANIZATION 1

Pending the conclusion of an agreement withfourteenth Americanrepublictoacceptthe the Pan American Sanitary Organization, andConstitution. in accordance with the instructions given by the In accordance with Article 10 of the proposed First World Health Assembly,2 the Executivedraft Agreement between the World Health Board approved a temporary working arrange-Organization and the Pan American Sanitary ment at its third session,3 signed by the Director-Organization,4 and in accordance with the instruc- General and the Director of the Pan Americantions of the First World Health Assembly, an Sanitary Bureau. agreement,as appended tothisannex, was On 22 April 1949, the Government of Uruguaysigned in Washington on 24 May 1949 by the deposited an instrument of acceptance of theDirector-General and the Director of the Pan Constitution of the Organization with the Secre-American Sanitary Bureau. Minor drafting tary-General of the United Nations, being thechanges were made in Article 2, and a new Article 11 added, providing that in case of doubt or difficulty in interpretation, the English text 1 See Resolution WHA2.91 and minutes of theshall govern. A copy of a letter from the Director- ninth meeting of the Committee on Constitutional General to the Director of the Pan American Matters, section 3. Sanitary Bureau concerning the implementation 2 Ofl. Rec. World Hlth Org. 13, 329 of this Agreement is also appended. 3 Ofl. Rec. World Hlth Org. 17, 16 4 Off. Rec. World Hlth Org. 14, 37 - 381 - ANNEX 12

Appendix 1

AGREEMENT BETWEEN THE WORLD HEALTH ORGANIZATION AND THE PAN AMERICAN SANITARY ORGANIZATION

Whereas Chapter XI of the Constitution of the Article 4 World Health Organization provides that the When this Agreement enters into force, the Pan American Sanitary Organization representedDirector of the Pan American Sanitary Bureau by the Pan American Sanitary Bureau and theshall assume, subject to the provisions of para- Pan American Sanitary Conference shall in duegraph 2, the post of Regional Director of the course be integrated with the World HealthWorld Health Organization, until the termina- Organization and that such integration shall be tion of the period for which he was elected. There- effected as soon as practicable through commonafter, the Regional Director shall be appointed action based on mutual consent of the competentin accordance with the provisions of Articles 49 authorities expressed through the organizationsand 52 of the World Health Organization Consti- concerned ; and tution. Whereas the World Health Organization and Article 5 the Pan American Sanitary Organization have agreed that measures towards the implementa- In accordance with the provisions of Article 51 tion of such action by the conclusion of an agree- of the Constitution of the World Health Organiza- ment shall be taken when at least fourteention, the Director-General of the World Health American countries shall have ratified the Consti- Organization shall receive from the Director of tution of the World Health Organization ; andthe Pan American Sanitary Bureau full informa- tion regarding the administration and the opera- Whereas on the twenty-second of April 1949tions of the Pan American Sanitary Bureau as this condition was satisfied, the Regional Office for the Western Hemisphere.

IT IS HEREBY AGREED AS FOLLOWS : Article 6 An adequate proportion of the budget of the 1 World Health Organization shall be allocated The States and territoriesof the Westernfor regional work. Hemisphere make up the geographical area of a regional organization of the World Health Article 7 Organization, as provided in Chapter XI of its The annual budget estimates for the expenses Constitution. of the Pan American Sanitary Bureau as the Regional Officefor the Western Hemisphere Article 2 shall be prepared by the Regional Director and The Pan American Sanitary Conference, throughshall be submitted to the Director-General for the Directing Council of the Pan American Sani-his consideration in the preparation of the annual tary Organization and the Pan American Sanitarybudget estimates of the World Health Organiza- Bureau shall serve respectively as the Regionaltion. Committee and the Regional Office of the World Article 8 Health Organization for the Western Hemisphere, The funds allocated to the Pan American within the provisions of the Constitution of theSanitary Bureau, as Regional Office of the World World Health Organization. In deference to tradi-Health Organization, under the budget of the tion, both organizations shall retain their respec-World Health Organization, shall be managed tive names, to which shall be added " Regionalin accordance with the financial policies and Committee of the World Health Organization "procedures of the World Health Organization. and " RegionalOfficeofthe World Health Organization " respectively. Article 9 Article 3 This Agreement may be supplemented with The Pan American Sanitary Conference maythe consent of both parties, on the initiative of adopt and promote health and sanitary conven-either party. tions and programmes in the Western Hemi- sphere, provided that such conventions and pro- Article 10 grammes are compatible with the policy and This Agreement shall enter into force upon its programmes of the World Health Organizationapproval by the World Health Assembly and and are separately financed. signature by the Director of the Pan American -- 382 - - ANNEX 13

Sanitary Bureau, acting on behalf of the PanIN WITNESS WHEREOF this Agreement was done American Sanitary Conference, provided thatand signed at Washington on this twenty-fourth fourteen of the American Republics have at thatday of May nineteen hundred and forty-nine time deposited their instruments of acceptancein four copies, two in English and two in French. of the Constitution of the World Health Organiza- tion. For the World Health For the Pan American Article 11 Organization Sanitary Conference In case of doubt or difficulty in interpretation, Brock CHISHOLM Fred SOPER the English text shall govern. Director-General The Director

Appendix 2

LETTER FROM THE DIRECTOR-GENERAL TO THE DIRECTOR OF THE PAN AMERICAN SANITARY BUREAU

24 May 1949 constitute" integration "inaccordance with Sir, the Constitution. Under the provisions of Article 10 the Agree- I have the honour to inform you that notifica-ment will enter into force upon final approval by tion was received by me from the Secretary-the World Health Assembly and signature by General of the United Nations that on the 22 Aprilthe Director of thé Pan American Sanitary Bureau 1949 fourteen American States had ratified theacting on behalf of the Pan American Sanitary Constitution of the World Health Organization.Conference. I am therefore to present to you the original I have the honour to be, texts of an Agreement between the World Health Sir, Organization and the Pan American Sanitary Your obedient Servant, Organization for signature by the duly appointed (signed) Brock CHISHOLM, M.D. representatives of each organization. Director-General. I am further to state that, in accordance with the Dr. F. L. Soper, resolution of the Executive Board at its secondDirector of the session, the adoption of this initial Agreement,Pan American Sanitary Bureau, although representinga further step in the2001 Connecticut Avenue N.W., implementation of Article 54 of the ConstitutionWashington 8, D.C. of the World Health Organization, does not yet U.S.A.

ANNEX 13 [From A2/44] 3 June 1949 SUPPLEMENTARY REGULATIONS TO WORLD HEALTH ORGANIZATION REGULATIONS No. 1 REGARDING NOMENCLATURE (INCLUDING THE COMPILATION AND PUBLICATION OF STATISTICS) WITH RESPECT TO DISEASES AND CAUSES OF DEATH 1

The Second World Health Assembly, Article I Acting in accordance with Article 23 of the In Article 20 of the Nomenclature Regulations Nomenclature Regulations 1948 1948 there shall be made the amendments specified ADOPTS, this thirtieth day of June one thou-in the Schedule to these Supplementary Regula- sand nine hundred and forty-nine the followingtions, being amendments which facilitate the SupplementaryRegulationson Nomenclaturegiving of notice under Article 22 of the Constitu- (including the compilation and publication oftion to such States as shall have become Members statistics) with respect to diseases and causes ofof the Organization subsequent to the date of death which may be cited as the Nomenclaturethe adoption of the Nomenclature Regulations (Supplementary) Regulations 1949. 1948 by the World Health Assembly, and accord- 1 See Resolution WHA2.93 and minutes of theingly the said Article 20 of the Nomenclature ninth meeting of the Committee on ConstitutionalRegulations 1948 shall have effect as amended Matters, section 5. by these Supplementary Regulations. - 383 -- ANNEXES 14 AND 15

Article II to each Member within sixty days of the notifica- Without prejudice to Article 22 of the Constitu-tion of their adoption by the World Health tion these Supplementary Regulations shall apply Assembly.

Schedule

AMENDMENT OF THE NOMENCLATURE REGULATIONS 1948

Amendment of Article 20 In line 3 after the words " the date of " there shall be inserted the words " the notification of the ". IN WITNESS WHEREOF we have set our hands this first day of July one thousand nine hundred and forty-nine. The President of the The Director-General of the World Health Assembly World Health Organization (Signed) Karl EVANG (Signed) Brock CHISHOLM

ANNEX 14 RIGHTS AND OBLIGATIONS IN REGIONAL ORGANIZATIONS : STATEMENT BY THE DIRECTOR OF THE PAN AMERICAN SANITARY BUREAU

The Agreement between the World Healthconstituted under the Pan American Sanitary Organization and the Pan American SanitaryCode (Treaty Havana 1924) and the Constitution Organization, the terms of which were approvedof the PASO (Buenos Aires 1947). Action by the by the First World Health Assembly, has beenCouncil itself or by the Pan American Sanitary signed on 24 May 1949, by the Director-GeneralConference is required to alter its membership. and by the Director of PASB and will come into Such action has been taken by the XII Pan force upon approval by the Second World HealthAmerican Sanitary Conference (Caracas 1947) Assembly.Article 2 of this Agreement providesin the case of Canada, which was specifically that the Pan American Sanitary Conference,recognized as a member of future Pan American through the Directing Council of the Pan AmericanSanitary Conferences. Sanitary Organization, shall serve as the Regional The Directing Council of the PASO opened Committee of the World Health Organizationmembership to all self-governing nations of the for the Western Hemisphere. Western Hemisphere (Constitution, Buenos Aires The Directing Council of the PASO is duly 1947). Similar action would be required before other See Resolution WHA2.103 and minutes of thenations, not members of the Pan American Sani- eleventh meeting of the Committee on Constitu-tary Organization, could exercise full rights in tional Matters. the Directinc, Council.

ANNEX 15 [A2/Prog/10] 21 June 1949 A MEMORANDUM ON RESEARCH

PAPER SUBMITTED BY THE DELEGATION OF THE GOVERNMENT OF INDIA

The planned development of health programmeslems and into those relating to the practical requires the continuous application of research.application of the fruits of research. The nature The term " research " is used here in a wide senseand extent of the field and laboratory studies so as to include field investigations as well asrequired in respect of specific subjects would those conducted in laboratories into basic prob-naturally vary. The purpose of this memorandum is not therefore to consider the requirements in 1 See Resolution WHA2.19 and minutes of the twelfth meeting of the Committee on Programme,individual fields of study but to put forward section 5. certain suggestions regarding the manner in - 384 - ANNEX 15 which WHO may promote actively the develop- with the expansion of the programme of studies ment of research in relation to the health pro- undertaken by WHO it will be necessary to grammes it undertakes in association with govern- createa corresponding numberofexpert ments or other bodies as well as in relation to committees or study-groups. the study of the many problems, the solution of It is considered that one of the essential which may from time to time be found essential things which such study-groups should do is for the diagnosis, treatment and prevention of to put forward suggestions for ensuring that disease and for the promotion of positive health. the results as recorded at the different centres of The following suggestions are put forward for research are comparable, and that the data are consideration : considered satisfactory from the statistician's point 'Of view.In this connexion the memo- (a) Two methods of approach seem possible randum on health statistics submitted by the whereby WHO may promote the development British delegation is of particular interest.It of research.The first is for WHO to provide is essential to ensure that adequate statistical itself with adequate organizations to deal with control is provided for the planning and execu- field and laboratory studies.The other is to tion of all investigations as well as for the utilizeexistinghealthadministrations and evaluation of their results.It may also be research centres in different countries and to mentioned that the demonstration programmes assist them with expert personnel and equip- initiated by WHO should be preceded by field ment and other physical facilities in order to studies which are designed to provide adequate enable them to undertake the investigations data to determine the health conditions of the that are required from time to time. The second population groups that are involved, in order appears to be the more satisfactory method. that these data may form the basis for the The number of experts available in the different periodical assessment of the success or failure fields of study is limited and those required for of the scheme in each case. institutions established by WHO will naturally have to be drawn from existing national (c)Progress in research on sound lines will institutesorhealthadministrations. The require provision for mutual consultation and extent to which experts will become available exchange of information between workers in for WHO to establish a number of international specific fields.Individual workers will also organizations directly under its control seems require to be given opportunities to study newer therefore to be limited.Further, as WHO's methods that may have been evolved at scales of pay are generally much higher than particular institutes.These purposes can be those of national institutes, the competition served by WHO's making itself responsible that will be set up for the services of outstand- for the convening of periodical conferences, ing workers will naturally be to the detriment for the exchange of workers between institutes of the countries from which such workers will and for the grant of fellowships for special study, be taken away by WHO.It is doubtful too wherever necessary. whether, under existing conditions, this orga- nization with itslimited resources will be (d)The war years have produced, in the case justified in embarking on a programme for of many institutes, a gap in the regular supply equipping itself with international research of medical journals essential for their work. centres in many fields.On the other hand, a In the circumstances it will be helpful if WHO scheme for assisting national organizations to can provide an organization for the supply of undertake such work has many advantages, photographic copies of special articles that including a smaller scale of expenditure, the may be required by individual workers in their speed with which such a programme can be respective fields of study. brought into being, and above all, the fact that the active collaboration of many countries These are only some of the lines on which WHO with WHO in a task of common interest willcan profitably enter the field of research.There have been secured.It is therefore for seriousare no doubt other measures also which should consideration whether the second method ofbe undertaken, and it is anticipated that refer- approach is not the one to be adopted on theence to these measures will be made during the present occasion.The possibility of WHO'sdiscussion on this memorandum by the Committee developing in due course certain specializedon Programme. agencies for research under its own auspices, It is felt that this is not the place to consider if the need for such agencies is felt, is not ofthe specific programmes of investigation that course ruled out. should be undertaken in particular fields of study. Certain suggestions for such investigations have (b)It is desirable that, if research on the samealready been put forward by different expert subject is undertaken in a number of centres,committees and further suggestions will no doubt there should be a central body to co-ordinatebe forthcoming from the health ministries of and guide the work.The expert committeesdifferent countries as well as from individuals and which deal with specific subjects are fulfilling thisorganizations interestedin the promotion of function in their respective fields.Side by sidehealth activities in particular fields.

- 385 - ANNEX 16

ANNEX 16 [A2/56] 13 June 1949

ORIGIN AND PROGRAMME OF THE TUBERCULOSIS RESEARCH OFFICE 1

NOTE BY DR. CARROLL E. PALMER, CHIEF OF THE OFFICE

1.Creation of the Office The compilation and analysis of these data Recognizing the need for scientific research indeserve the greatest Care and attention.There connexion with the mass' BCG-vaccination pro-should result not only an adequate documenta- gramme of UNICEF and theScandinaviantion of the work of the campaign but a permanent voluntary organizations, and the unparalleledrecordof the findingsof the prevaccination opportunity such a campaign offers for the world-tuberculin-testingsforvariouscountries and wide study of tuberculosis, the Executive Boardareas according to age and sex.The tabulation of the World Health Organization created aof the statistics on vaccination will be useful for Tuberculosis Research Office at its second session, later follow-up of the campaign. It is also planned in November 1948, and appropriated US $100,000to include the results of post-vaccination testing. for its 1949 activities. Last February, the Tuber- The responsibility of the Research Office is not culosis Research Office was established in Copen-merely to analyse the materials being collected hagen in order to permit close working co-opera-but also to make suggestions regarding suitable tion with the headquarters office of the BCGsystems of filing these records for future follow- campaign. up and comparison.

2.The Programme Investigations of the techniques and procedures used A possible research programme for the Office in the campaign. had been outlined in a prospectus previously There is not general agreement on what degree submitted to the Executive Board.2 With certainof tuberculin sensitivity should be the basis for moditcations, deemed necessary in the light ofseparating persons into those needing and those experience gained during the past few months,not needing vaccination.At the present time, the research programme may be summarized atseveral 'different products are being used by this time under four major headings. several different methods and combinations of Documentation, analysis and appraisal of the massmethods. BC G-vaccination campaign. In the mass BCG -campaign, the Moro Patch test is used for children under 12 years of age The BCG campaign includes plans to tuberculin- and the Mantoux test for older persons. Recently test 50,000,000 children and young adults inthe procedure has been changed ; 10 rather than Europe and estimates that 15,000,000 persons33 or 100 TU are being employed for the final Will be vaccinated with BCG. By May, aboutMantoux test. In addition, it is not known whether 9,000,000 had been tested and 4,000,000 vaccina-the criteria for selecting persons for vaccination ted in Finland, Poland, Czechoslovakia, Yugoslavia,should be varied with age, tuberculinization of Hungary, Greece, Bulgaria, Austria, and Italy.the population, country or nationality group, The campaign has also been started in India, etc.For these reasons, it is essential and urgent Ceylon and North Africa and plans are ready forto undertake certain studies which may be ex- the Middle East countries.It is expected that before long the work will be extended to Eastpected to furnish more precise as well as practical Asia and Central and South America. The widemethods for prevaccination testing. geographical coverage, the large numbers to be It is assumed that the best vaccine and :the tested and vaccinated, and the uniformity ofmost successful vaccination are those which procedures and materials used in the campaignproduce the highest degree of allergy for the are unique and unprecedented.An enormouslongest period of time.This assumption, based number of observations on tuberculin sensitivityon the premise that immunity in tuberculosis as well as records of vaccination have alreadyand tuberculin sensitivity are inherently related, been collected. may or may not be warranted. There is also the qUestion of revaccination, the effect and value 1 See minutes of the fourteenth meeting of theof which are little known.All these problems Committee on Programme, section 3. need to be studied under long-range, extensive 2 Og. Rec. World Hlth Org. 14, 50 projects in suitable places and in different areas. - 386 - ANNEX 17

Investigations of the effectiveness of BC G vaccina-culinsensitivity,especiallyofschoolchildren tion in the prevention of tuberculosis. between 6 and 14 years of age, can be utilized with great advantage. Average annual rates for During recent years much information has beenschoolchildren may be the best single index of accumulating which suggests that BCG vaccina-tuberculosis that can be obtained for many tion affords some protection against the develop-countries today, since morbidity and mortality ment of tuberculosis, but decisive proof of thisstatistics are not available or reliable.For these and of the exact degree of protection is lacking.countries and local areas accurate yearly infec- The only way this question can be answered is totion-rates should be of great value both immedi- set up a controlled experiment in which part ofately and in the future, and may be made the the population is vaccinated and another part notfoundation for planning practical programmes of vaccinated, the two gwoups being chosen entirelytuberculosis control. at random.The study would have to be done Similarly, the campaign opens the way for on such a large scale that follow-up could besampling surveys of tuberculosis morbidity and effected through utilizing existing facilities ofmortality. It is highly important that such surveys vital statistics registration. This could be accom-be started as soon as possible, with the introduc- plished by carrying out the investigation in ation of bacteriological and x-ray facilities, and total area, either a geographical unit such as anmore uniform methods of diagnosis and report- island, or a small country.Total area coverageing.Sooner or later, most countries in the BCG that would permit identification of individualscampaign will want to measure the effect of the in the denominator as well as in the numeratorvaccination work in terms of changes of tuber- would open enormous possibilitiesforotherculosis morbidity and mortality. long-term studies. If the epidemiology of tuberculosis is to be It is recognized that such a study may not beclearly obtained, there is required the type of easy to organize or carry through, but this doesresearch activity that will identify diseases which not lessen the responsibility of the medical pro-cause pathological changes resembling tuber- fession, particularly of those of its members who culosis. are in high governhient posts, to try to provide Because of the difficulties inherent in a dif- an answer to this important question. ferential diagnosis of tuberculosis it is most impor- tant for each country to know aCcurately the Studies of the epidemiology of tuberculosis on aconditions which may simulate the disease, and worldwide basis to know how frequently such conditions occur. In certain parts of the United States, subclinical The present BCG campaign has created aninfection with Histoplasma capsulatum is very opportunity that has never existed before forcommon, and for many years the failure to the study of the epidemiology of tuberculosis.recognize this condition was a great stumbling The first and most important study that shouldblock in the understanding of both the clinical be undertaken is the investigation of the ratesand epidemiological manifestations of tuberculosis. of tuberculosis infection in different countriesIt seems very likely that other diseases, in other and in many widely separated areas.Obviously, areas, may be complicating and confusing the the observations made on prevaccination tuber-tuberculosis problem.

ANNEX 17 [A2/Prog/14] 21 June 1949 TUBERCULOSIS PROGRAMME PROPOSALS 1

NOTE SUBMITTED BY THE DELEGATIONS OF CZECHOSLOVAKIA DENMARK, FINLAND AND INDIA

The Annual Report of the Director-General 2 ascertain needs more precisely.It is planned, states : therefore, that consultants of wide experience During 1949, it will be a major function of should visit as many countries as possible, WHO, in its antituberculosis campaigns, to advise authorities where advice is needed, and See minutes of the fifteenth meeting of the ascertain indetail what particular service, Committee on Programme, section 3. demonstration or other, might best suit the a 09. Rec. World Hlth Org.16, 13 needs of the countries. - 387 - ANNEX 17

In Official Records No. 18, page 100, sectionis in accordance with the recommendation of the 7.4.7.4.2, it is stated : third session of the Expert Committee on Tuber- Consequently, it will not be before the middle culosis.3 of 1950 that we shall be in a position to know what the reaction of many countries may be3. We are strongly of the opinion that there to the services which WHO is in a positionshould be more adequate financialprovision to provide. in the 1950 budget of WHO for tuberculosis, in view of the fact that tuberculosis has been given It would seem that until the middle of 1950 theone of the highest priorities by the First World main work in tuberculosis for WHO would beHealth Assembly. the collecting of information.This is done by4. We are further of the opinion that the nature sending out specialist short-term consultants toof the problem is such that work in the field visit a large number of countries.We believeon the lines suggested is urgently needed, and that in view of the needs of certain countries,should be put into operation at the earliest this programme is inadequate. It is an expensivepossible moment. way of collecting information and it is not neces- sary for planning the work for which information5. We therefore recommend that the Committee could be obtained in a more effective and eco-on Programme should propose to the Health nomical manner. Furthermore, valuable timeAssembly the following resolution : is wasted before the real tuberculosis programme can be worked out and its implementation can The Second World Health Assembly, begin. We feel that temporary consultants visiting Having considered theDirector-General's countries which are unfamiliar to them cannot Report for 1949 and the proposed plans for get the necessary detailed information and can 1950, give only limited service to the country concerned. REQUESTS the Director-General to limit the 1. We therefore recommend that : these services services of temporary consultants in tuber- be provided by highly qualified specialists em- culosis to a minimum ; ployed full time in the regional offices.This RECOMMENDS that in each Regional Office would give the specialist time to familiarize him- of WHO a full-time tuberculosis officer be self with the special conditions in the region, and employed ; and further thus enable him to render much better service RECOMMENDS that the personnel available to the countries in the region. for field services in 1950 be increased in accor- 2. We consider the tuberculosis problem impor- dance with the proposals submitted in the tant enough to justify taking the immediate step Appendix to this note. of employing a full-time tuberculosis officer in each region of WHO. We wish to stress that this 3 Off. Rec. World Hlth Org. 15, 6, item 2.2

Appendix

REVISED BUDGET FOR 1950-TUBERCULOSIS PROGRAMME

Presented by the Delegations of Czechoslovakia, Denmark, Finland and India

The above delegations recommend the follow- 3.Field Services -The field service budget ing alterations in the tuberculosis programme should be alteredto include the following budget for 1950. personnel : 1.Threefull-timetuberculosisconsultants Number of Posts (grade 16) to be appointed on 1 January, and Category Regular Supplemental three full-time tuberculosis consultants (grade 15 2 16) to be appointed on 1 July 1950.Each II 16 10 consultant should be provided with a secretary III 6 3 (grade 5) and one stenographer (grade 4). Total 37 15 2.In the Regular Budget provision should be made for four part-time consultants, and in the Supplementary Budget for two part- 4.With regard to the question of supplies the time consultants. delegations above-mentioned propose that the - 388 - ANNEX 18

amount for supplies and equipment for teams 5.The delegations recommend that $4,000 in the Regular Budget should be increased to should be available in the Regular Budget for $58,000 and that the amount in the Supple- special literature, and that $2,000 should be mental Budget should be reduced to $33,900. provided in the Supplemental Budget.

ANNEX 18 [A2/Prog/3] 17 June 1949 MENTAL HEALTH PROGRAMME PROPOSALS 1

NOTE SUBMITTED BY THE DELEGATIONS OF DENMARK, ITALY, SWEDEN, SWITZERLAND AND THE UNITED STATES OF AMERICA

The mental health expert advisers of the Since these recommendations may be of assist- delegations of Denmark, Italy, Sweden, Switzer-ance to the Committee on Programme in consider- land and the United States of America haveing these items, they are attached as an Appendix met informally to consider the Director-General'sto this document. programme proposals in the fieldof mental After considering the views put forward in this health.2 Appendix, the committee, in adopting the Director- They have submitted totheirdelegationsGeneral's programme proposals for mental health, agreed recommendations for certain modifica-may wish to recommend that the collection of tions of the programme. information, the expert committee meetings and the consultant services should be carried out 1 See minutes of the sixteenth meeting of theunder the regular programme and that all other Committee on Programme, section 1. items should be incorporated in the supplemental 2 Off. Rec. World Hlth Org. 18, 77 programme.

Appendix

JOINT RECOMMENDATIONS BY THE MENTAL HEALTH ADVISERS OF FIVE DELEGATIONS ON THE DIRECTOR-GENERAL'S PROPOSED MENTAL HEALTH PROGRAMME

The mental health technical advisers to thetion of control of habit-forming drugs is adequate- delegations of Denmark, Italy, Sweden, Switzer- ly cared for elsewhere, the phenomenon of drug land, United States of America, together withaddiction in all its forms as a psychiatric problem the President of the World Federation for Mentalmerits the early attention of the expert committee Health have informally considered in concert theconvened for the study of the problems of mental Director-General's programme proposals in thehealth. field of mental health.After carefully studying The advisers consider that, although, as they this programme proposal and hearing detailedhave made plain, all the activities mentioned in explanations from the Secretariat of this item,the programme are worth undertaking, it might they would like to comment on the various pro-be helpful if they expressed their views on the posals to their delegations before the matter isrelative importance of the items in the pro- discussed in committee. gramme as put forward. The advisers feel that the general orientation With this in view they wish to put forward and objectives of the programme are carefullysuggestions for modifications in the content of thought out and excellent in content, particularlythe regular programme, to ensure that within because of its emphasis on the preventive aspectsit are contained those activities which are con- of mental-health work, which is in line with thesidered most essential. general policy of WHO. The technical advisers Of premier importance in the development of any were unanimous that all the activities proposedhealth programme is adequate and accurate in- in the programme merit action by WHO. Theyformation concerning the problem to be attacked. also wish to point out that the problem of drugIn thefieldof mental health the necessary addiction has been omitted, and while the ques-data are not at hand upon which can be based - 389 - ANNEX 19 a detailed long-term, and carefully thought-outof the consultant services have been relegated. public-health programme.For that reason, weto the supplemental programme. At the present consider the item of first priority in the mental-stage of development of international mental- health programme of WHO to be the assemblinghealth work, consultant services appear to us to centrally of data concerning mental-health prob-be of paramount importance ; therefore without lems and facilities throughout the world. intending to give the impression of belittling the The advisers are in agreement with the pro-importance of the survey work, we recommend posals for the collection of information set out inmost strongly that the consultant services pro- Official Records No. 18, page 80, section 7.4.5.3.2.1, gramme be transferred in toto to the regular but are doubtful whether the secretariat staffprogramme and the whole-time surveys of rural, proposed in the regular programme would beindustrial and student mental health activities adequate to undertake the task that must bebe transferred in toto to the supplemental pro- done.They therefore propose the transfer of agramme. proportion of that part of the secretariat proposed The technical advisers feel that if these pro- in the supplemental programme to the regularposals were adopted the hard essential core of programme to ensure that this work can bethe Director-General's proposals would be placed efficiently carried out.The effect of this wouldwithin the regular programme. be to increase the secretariat staff proposed in We therefore recommend that the items men- the regular programme by Grade 14 (1), Gradetioned above,viz,collectionof information, 10 (1) and Grade 8 (1), with consequent reduc-expert committees and consultant services, be tions in the supplemental programme. In makingincorporated in the regular programme, and all this proposal they also have in mind the growingother items be incorporated in the supplemental obligations of WHO towards the other agencies, programme. particularly in respect of the work proposed by the Social Commission of the United Nations Dr. A. C. CLEMMESEN, Adviser to on the prevention of crime and treatment of the delegation of Denmark offenders. Professor Carlo DE SANCTIS, Ad- The technical advisers note that the meetings viser to the delegation of Italy of the expert committee have been divided be- Dr. G. LUNDQUIST, Adviser to tween the regular and supplemental programme. the delegation of Sweden They feel that this arrangement is quite undesir- Dr. A. REPOND, Adviser to the able, since all action programmes must necessarily delegation of Switzerland stem from the best available technical advice.It is therefore recommended that all the activities of Dr. R. H. FELIX, Adviser to the the technical committee should be considered delegation of the United States as part of the regular programme. of America The technical advisers note that the whole- Dr. J. R. REES, Observer, Presi- time surveys are divided between the regular and dent of the World Federation the supplemental programmes and that the bulk for Mental Health.

ANNEX 19 [A2/40] 1 June 1949

LEPROSY 1

MEMORANDUM SUBMITTED BY THE DELEGATION OF THE GOVERNMENT OF rNDIA

1.Incidence of the Disease 102,000 in Japan, 100,000 in Indonesia and The incidence of leprosy is high in a number of 121,000 in other Asian countries. countries in the tropical and sub-tropical regions These are undoubtedly crude estimates of the of the earth and the disease therefore constitutesprevalence of leprosy in the countries concerned. a public-health problem of great importance inA reasonably correct assessment of its incidence such countries.The total number of leprosyin any area requires a detailed survey undertaken patients in the world is estimated at five millions ;by medical practitioners with special training and, of this number, it is considered that approxi-in the diagnosis of the disease, but in all the mately 1,200,000 are in India, 1,000,000 in China, countries mentioned above, witli the probable exception of Japan, there exist only skeleton I See minutes of the seventeenth meeting of thepublic-health services. The leprosy surveys that Committee on Programme, section 1. might have been undertaken in the past could - 390 - ANNEX 19 not therefore have been sufficient to yield .an1948) 2 and it was agreed that leprosy was a overall picture of the situation which might bemajor scourge and that it would be wrong to accepted as satisfactory.Even so, the figurespostpone its study. The Interim Commission in quoted above have some value in that theyits report to the First World Health Assembly demonstrate the importance ofdealing withrecommended that WHO should consider the leprosy as a community problem. continuance of international studies oh leprosy, It will be seen that 20% of the total incidenceincluding its epidemiology, treatment and pro- of the disease is in India and that Asian countriesphylaxis, in co-operation with the International can together claim some 2.5 million cases orLeprosy Association and other organizations.3 about half the total number of leprosy patientsOn the recommendations of the Committee on in the world. Among the countries besides India,Programme, which considered the report, the which are included under the South-East Asiasubject was entrusted to the Epidemiological Bureau of WHO, Siam reports that a surveyDivision of the Secretariat by the Assembly.4 carried out in 1916 revealed 7,300 cases and that When the actual preparation of the budget a later investigation in 1934 showed that thecame to be considered it was found that no funds number had increased to 17,042.Ceylon hasor staff had been made available for leprosy reported 3,150 cases.It is known that thereresearch and surveys. It was however considered exists in Burma a wide central belt of high inci-that leprosy research should be one of the first dence of leprosy, the rate being over 2.5% of theitems to be entrusted to an epidemiologist for population in this area. No definite informationapreliminarystatisticalandbibliographical isavailable regarding the prevalence of thesurvey when budget provision made his appoint- disease in Afghanistan. ment possible. Estimates of the incidence of leprosy in other parts of the world include Africa with 875,0003.The Need for co-ordinated International cases, Europe with 21,000, America with 111,000 Action to control Leprosy and South Pacific with 10,000. The figures given in the preceding paragraphs Much useful light has been thrown in the past on are sufficient to show that leprosy must be reck-the epidemiology of leprosy and on the measures oned as an international health problem. Further,to be taken for its control.For instance, it is in certain countries in Asia and Africa the preval-well known that close personal contact with an ence of the disease is so high in specific areas asinfective patient of the disease over a relatively to justify the conclusion that measures to deallong period is required for the transmission of with it in as comprehensive a manner as possibleinfection, that leprosy spreads much less rapidly should receive the highest priority in the nationalthan the common epidemic diseases such as health programmes. cholera, smallpox and plague, that children are much more susceptible to infection than adults and that segregation of the infective patient is 2.International Action undertaken so far the most effective method of controlling leprosy. International study of leprosy has been carriedEven so, there are many gaps in our knowledge out by : of its epidemiology which have to be filled before adequate control over the disease can be estab- (a) four international conferences, lished. For instance, the actual mode of transmis- (b) the Commission for the Study of Leprosysion of infection is not fully understood. Further, appointed by the League of Nations, and while many encouraging forms of treatment have (c)the International Centre for Research onbeen brought forward in the past, none of them Leprosy established at Rio de Janeiro underhas been shown to be so effective as to sterilize the auspices of the League of Nations. the patient completely.Indeed, as periods of quiescence and of exacerbation are characteristic There is also an International Leprosy Associa-of certain forms of the disease, it is by no means tion. easy to make a true assessment of the therapeutic The International Centre forResearch onvalue of particular drugs. More knowledge than Leprosy, which was set up at Rio de Janeiro withis at present available regarding the aetiology the help of a private donation, did not produceand pathology of the disease is necessary before any outstanding technical findings, and its con-a sound programme of action can be formulated. nexion with the League of Nations was severed On the administrative side also the leprosy at the beginning of the Second World War. Theproblem presents many difficulties. The disease Leprosy Committee of the League of Nationsis mainly prevalent among the poorer sections was established in 1929 and functioned untilof the people who live under conditions of great 1932 with Professor Burnet of the Pasteur Insti-overcrowding and insanitation and whose practice tute, Paris, as its secretary. He made a surveyof personal and communal hygiene is far from of the incidehce of the disease in Europe, Southsatisfactory. Effective isolation of infective cases America and to a less extent in Asia.Clinicalwould therefore necessitate their segregation in and statistical data were collected and the Com-institutions or special leprosy colonies.In view mittee laid down certain broad principles regard- ing the administrative approach to the problem of dealing with the disease. 2 Ofl. Rec.World Hlth Org. 7, 39 The subject of leprosy was discussed at the fifth 3 Ofl. Rec.World Hlth Or g.31.0, 13 session of the Interim Commission (on 31 January 4 Oft. Rec.World Hlth Org. 13, 310 - 391 - ANNEX 20 of the long periods of isolation that individualnational action should be taken on the following cases may require, the financial burden becomes lines great, and prolonged separation of patients from (a) creation of an expert committee to guide their own people and homes introduces various and co-ordinate anti-leprosy work in the differ- social difficulties. The countries in which leprosy ent countries and to assist in the investigation constitutes an important public-health problem of problems relating to therapy, epidemiology, are those with meagre financial resources and pathology, surgery, social assistance, rehabilita- ill-developedhealthservices. Therefore the tion, occupational therapy and social welfare ; magnitude of the task to be undertaken becomes so formidable that, in the presence of other and (b) establishment of a world centre for research equally pressingproblems,anti-leprosy work in leprosy and dissemination of information tends to become relegated to the background. about various branches of leprosy including Attention is drawn to these complicating factors scientific, social welfare and educational aspects; in order to emphasize the fact that considerable (c)assignment of experts to countries where researchis required in order to evolve anti- technical guidance and assistance are required leprosy programmes which are in accord, as far in the development of anti-leprosy work ; as possible, with the economic and social back- ground of the people among whom such work (d) provision of fellowships for the training of is to be undertaken. personnel ; It is considered that from all these points of (e) procurement of supplies of drugs at cheap view, instead of relegating the subject of leprosy rates in order that the present high cost of for consideration at a future date, WHO should sulfone or any other form of treatment that begin to concentrate attention on this disease may be brought into existence may be reduced as early as possible and to promote international in the interests of leprosy patients all over studies on a large scale. It is suggested that inter- the world.

ANNEX 20 [A2/Prog/23] 24 June 1949 HEALTH DEMONSTRATION AREAS

PAPER PREPARED BY THE US AND INDIAN DELEGATIONS IN CONSULTATION WITH THE DIRECTOR-GENERAL

The following criteria were adopted by the Committee on Programme at its nineteenth meeting, in substitution for those presented on page 56 of Official Records, No. 18, under section 7.4.1.3, " The Work to be established in 1950 ".

(1)Careful selection of the areas in which these tive structure and financial resources of the health demonstrations are to be carried out, area and government concerned.The entire giving consideration to the following principles : project will be developed to meet the needs of (a) A demonstration operation will not be set the area to be served. up without due regard for the financial and (2)Assessment of the health needs and the technical ability of the country or jurisdictionavailable resources. to carry on the work after the demonstration has been withdrawn. (3)Assessmentoftheenvironment-health, cultural, social and economic factors being taken (b)It will be carefully ascertained that thereinto account. is acceptance of the contemplated procedure by the government concerned and the people (4)Development ofa programme ofaction of the region, before establishing a demonstra-designed to fit the context. tion operation.Demonstration must not be a service that is superimposed by an outside (5)Commencement ofoperations with both agency, and operated from the outside. Thereshort- and long-term objectives. should be desire for an improvement in condi- (6)Continuous analysis and appraisal of progress tions by the people themselves or at least bymade and results obtained. This information will the administration responsible. show gains in health, attendant economic advan- (c)Regard will be paid,in establishing atages, and new organizational techniques involved, demonstration, to the economic and administra-with evaluations. - 392 - ANNEX 21

(7)Adaptation and application of this experiencedifferent from the usual advisory and demonstra- and information for the benefit of other areas,tions project.The difference made is necessary countries and health administrations. to provide estimates for the basic cost of the project from WHO funds. These additional (8)Throughout the entire demonstration, seriousexpenditures are necessary because, while many attention will be given to informing the peoplecountries will contain areas ideal for projects in the area and to encouraging them to participatesuch as those envisaged, many of them might personallyinwhatever healthpracticesarenot be in a financial position to make a contribu- indicated.This presupposes a thorough know-tion to the project.Also, since this programme ledge of the mental attitudes and culture of theis a departure from those hitherto sponsored by people in the area by some member of the demon-WHO, it must be started in areas where the best stration team.Considerable attention should beresults are expected to be obtained, exclusive given to stimulating and motivating the peopleof any other considerations concerning its location. of the area to want to improve their health situa- The value and importance of each of these areas tion, and to maintain the improvement after therests as much in its capacity to provide know- demonstration ends.This is a pre-requisite toledge, experience and tangible results for the securing their interest in and support of thebenefit of all analogous countries with similar programme. problems, as in its capacity directly to benefit (9)In operating these areas, the work will bethe country in which the area is situated. carried out in co-operation with the health staff At least the government concerned, and so far of the area and country concerned ; fellowshipsas possible the local area, should provide some will be granted, not only to members of theseresources for the demonstration, such as by staffs in order that they may be well fitted toproviding some of the technical personnel and work on the project, but also to medical andin facilities of institutions, if any, situated in auxiliary personnel from countries where compar-proximity to the area, as well as by placing able conditions exist, so that they will be ableindividuals in training to replace the WHO to observe and participate in the demonstrationstechnical personnel in a reasonable period of time. in progress, and become familiar with the tech-In other words, there must be some assurance niques applied and evolved and with the resultsthat the country will help itself very shortly achieved within the demonstration area.Theyafter the start of the demonstration. will then be in a position to carry that knowledge back to their own areas or countries. (11) The requirements in terms of personnel, supplies and equipment for each health demon- (10) The budget estimates for the health demon-stration area cannot be accurately determined at stration areas have been developed on the theorythis time, and will vary essentially according to that this completely integrated type of approachthe circumstances in the area selected and the to the health problems of the world is somewhatplans made to meet these circumstances.

ANNEX 21 [From A2169] 18 June 1949

REIMBURSEMENT BY GOVERNMENTS FOR MATERIALS, SUPPLIES AND EQUIPMENT

FURNISHED BY THE ORGANIZATION IN CONNEXION WITH ADVISORY AND DEMONSTRATION SERVICES 1 REPORT BY THE DIRECTOR-GENERAL

1.The attention of the Second Health Assembly With respect to advisory and demonstration is invited to paragraph VI of the appropriation services to governments, the Director-General resolution for the financial year 1949,2 which shall, in consultation with the receiving govern- reads : ments, take steps to recover such cost of materials, supplies and equipment furnished by the Organization out of the sums appro- See Resolution WHA2.63 and the minutes of the eighth (section 6), ninth (section 1) and the priated under this Section as these govern- eleventh (section 3) meetings of the Committee on ments are able to repay, and shall report to Administration and Finance. the next Health Assembly the sums thus 2 011. Rec. World Ma Org. 13, 319 recovered. - 393 - ANHEk 21

2.The action taken so far to effect the recoveryno agreement has been signed and reports so far of costs as required in paragraph VI of the appro-received indicate that countries requiring advisory priation resolution for 1949 is as follows : and demonstration services are not in a position, 2.1Letters notifying individual governments,either because of economic reasons or because to whom such advisory and demonstration servicesof legislative processes, to reimburse the Organiza- could be made available, drew attention to para-tion even in local currency. graph VI of the appropriation resolution and 3.It is therefore suggested that consideration requested an indication as to whether the govern-be given to the effect of paragraph VI of the ment would be able to repay such costs.Theappropriation resolution on the programmes and replies from governments accepting demonstra-finances of the Organization.Experience thus tion services have not in any case indicated thatfar has indicated that the resolution is an obstacle repayment could be made for materials, suppliestoprogrammedevelopmentandthatfew and equipment furnished by the Organization.financial resources will be developed from it. 2.2 ThestandarddraftoverallagreementFurthermore, the Director-General considers that (appendix) between governments and the Worldhe is not in a position to determine the ability Health Organization, governing the conditionsof individual governments to pay for materials, under which services are made available tosupplies and equipment as required under para- individual governments, and the standard draftgraph VI of the appropriation resolution for letters of arrangement proposed for signature by1949. Attention is invited to the fact that govern- the World Health Organization and the appro-ments receiving services, under the terms of the priate national health administrations for theoverall agreement and the letters of arrangement implementation of specific projects, include pro-for individual projects, will pay approximately vision for the recovery of costs as established inall of the local expenses which can be met in the paragraph VI of the appropriation resolution.currency of the country. This contribution may, This agreement is being presented to govern-in some instances, approximate or exceed the ments through regional directors, where regionalcost of personnel, supplies and equipment fur- offices have already been established.To datenished by the Organization.

Appendix

DRAFT AGREEMENT BETWEEN A GOVERNMENT AND THE WORLD HEALTH ORGANIZATION FOR THE PROVISION OF SERVICES BY THE WORLD HEALTH ORGANIZATION

The Government of (c)Staff may be assigned by the Organization of the one part and to perform technical and advisory or other duties deemed necessary to facilitate the execution of The World Health Organization of the otherthe programme in " the territory " and such part office or offices established in " the territory " BEING DESIROUS of regulating the conditionsas may be necessary. which shall govern services to be provided by the World Health Organization in " the territory ", .Article II HAVE AGREED as follows : Duration of Operations and Services Article I The Organization shall provide such assistance Provision of Services or services for such period as may be mutually agreed in accordance with Article VIII, having (a) On the request of the Government of regard to the particular requirements of the pro- and in accordance with the policiesgramme in each instance. adopted by the World Health Assembly and the Executive Board, the World Health Organiza- tion (hereinafter called the Organization) shall, Article III within its determination of requirements and Assistance by the Government of resources and subject to its budgetary limita- The Government of shall assist tions, render in " the territory " technical andby providing such office or other accommodation advisory assistance or other services. as may be required with water, light, telephone, (b)The Organization shall, if necessary, providepower (and heating) and by providing any other the whole or part of such supplies, materials andmaterials, supplies, equipment, facilities or person- equipment as may be required for the executionnel which may be agreed upon in accordance with of the said assistance or services. Article VIII. -- 394 - ANNEX 21

Article IV dollars or Swiss francs. All such payments shall be deposited in such bank or banks as may be Expenses designated by the Organization. (a)The Organization shall make provision for the following expenses : Article V (i)The salaries and allowances of its staff Privileges and Immunities assigned to perform duties in " the territory ", (a)For the purposes of this Agreement the but not including installation, subsistence andGovernment of shall extend cost of living provisions within " the territory ";to the Organization for the attainment of its (ii)Travel costs to and from " the territory " ;aims and for the performance of its duties in " the territory " and to its staff while engaged in the (iii)Subject to the provisions of paragraph (c)business of the Organization in " the territory " below the cost of materials, supplies and equip-the privileges and immunities set forth in Chapter ment required for demonstration purposes andXV of the Constitution of the Organization and transportation costs for such materials, suppliesin the General Convention on the Privileges and and equipment to and from " the territory " ;Immunities of the Specialized Agencies together with its Annex VII, as approved by the World (b)The Government of shallHealth Assembly on 17 July, 1948, and such other make provision for those costs of the servicesprivileges and immunities as may be set forth provided for in this agreement as may be met inin any separate instrument concluded between its own national currency, including : the parties hereto. (i)Salary and expensesofstaff provided (b)The provisions of Article VI Section 19 (b) under the provisions of Article III, including (c)(d)(e) and (f) and Section 20 of the afore- technicalpersonnel andclericalorothermentioned Convention shall not apply to personnel auxiliary personnel ; provided by the Government of (ii)Office and other accommodation, facilitiesunder Article III of this Agreement. and supplies, including public services such as telephone, electricity, power, heating etc., Article VI office équipment and stationery supplies ; Rates of Exchange (iii)Transportation and travel expenses within " the territory " ; For the purposes of this Agreement rates of exchange shall be calculated at the most favour- (iv)Allowances for the staff of the Organiza-able rate officially recognized by the Govermnent tion due in connexion with their assignment of to" theterritory ",includinginstallation, subsistence and cost of living provisions ; Article VII (v)Operational and administrative expenses or costs with respect to the reception, unloading, Taxation warehousing, transportation and operation or(a) Any sums payable to the Organization under use within " the territory " of the materials,Article IV (c) of this Agreement shall be exempt supplies and equipment furnished by the Orga-from taxation. nization ; (b)Staff of the Organization, irrespective of (vi)Workman's compensation, industrialnationality, assigned to " the territory " shall insurance or other obligatory insurance forbe exempt from taxation on their salaries and staff provided under Article III in accordanceother emoluments. with the municipal or local legislation in " the (c)The Government of will territory " ; take such action as may be necessary to ensure (vii)Loss, damage, accidentor injury tothat any materials,supplies and equipment persons or property arising out of the imple-furnished, used or operated by the Organization, mentation of any programme under this agree-and the personal effectsof the Staff of the ment, provided that this shall not apply toOrganization are exempted from any tax, fee, accident or injury incurred by any member oftoll or other duty in " the territory ". the WHO staff ; Article VIII (c)The Government of under- takes to reimburse the Organization for the cost, Implementation of the Agreement including transportation, of any materials, sup- For the requirements of each programme this plies and equipment furnished in accordance withAgreementwillbe implemented by special arrangements concluded under Article VIII toarrangements to be concluded between(the " the territory " by the Organization. Reimburse-national health administration 8) of the Govern- ment may be payable in the national currencymentof and the of the Government of , providedOrganization. that the Government of shall have notified the Director-General of the Organiza- 8 The titleof the administration should be tion that it is unable to pay in United States specified. - 395 - ANNEX 22

Article IX (b)This Agreement may be terminated by either party on 31 December of any year by notice given Settlement of Disputes to the other party not later than 30 September Any difference between the Government ofof that year, provided that in the event of such and theOrganizationtermination the Organization reserves the right arising out of the interpretation or applicationto discontinue any programme in course of execu- of this Agreement or of any supplementary agree-tion under this Agreement and to withdraw any ment or arrangement thereto which is not settledstaff or facilities provided by virtue of Articles I by negotiation shall be submitted for decision toand VIII thereof. a board of three arbitrators ;the first to be appointed by the Government of Article XI the second by the Director-General of the Orga- niiation, and the third, the presiding arbitrator, Entry into force by the arbitrators duly appointed by the parties, This Agreement shall enter into force as from unless in any specific case the parties hereto agree (date) to resort to a different mode of settlement. IN FAITH WHEREOF this Agreement was done and signed at on this Article X day of 19 ....in three Revision and Termination copies in English. (a)This Agreement may be revised at the request For the Government of of either party. In this event the two parties shall consult each other concerning the modifications For the World Health Organization to be made in its provisions. Regional Director

ANNEX 22 [From A2/82Rev.1] 28 June 1949 FINANCING OF THE SUPPLEMENTAL OPERATING PROGRAMME OF ADVISORY AND TECHNICAL SERVICES 1

NOTE BY THE DIRECTOR-GENERAL

This note is submitted to the Assembly in180 (VIII) requesting " the Secretary-General, in order to provide information which may assistconsultation with the executive heads of the in consideration of the Supplemental Operatinginterested specialized agencies through the Admin- Programme of Advisory and Technical Services.istrative Committee on Co-ordination, and taking The Programme and Budget Estimates forinto consideration the suggestions of Member 1950 2 were prepared by the Director-GeneralGovernments, to prepare a report for the ninth and were forwarded by the Executive Board withsession of the Council setting forth : its endorsement to the Second World Health Assembly. This presents a programme of advisory " 1. A comprehensive plan for an expanded and technical services for the year 1950. co-operative programme of technical assistance The budget which reflects this programme com- for economic development through the United prises the Regular Budget and the budget for the Nations and its specialized agencies, paying Supplemental Operating Programme of Advisory due attention to questions of a social nature and Technical Services. With regard to the latter which directly condition economic development ; the Board invited " governments in a position " 2.Methods of financing such a programme to do so to indicate to the Second World Health including special budgets ; and Assembly their willingness to make additional contributions to WHO to finance the Supple- " 3. Ways of co-ordinating the planning and mental Operating Programme of Advisory and execution of the programme." Technical Services." 3 On 4 March 1949 the Economic and Social In implementationofthisresolutionthe Council of the United Nations adopted resolutionDirector-General of the World Health Organiza- tion took part in consultations with the Directors- 1 See resolution WHA2.1 and minutes of theGeneral of the other specialized agencies, includ- ninth meeting of the Committee on Administration and Finance (section 3), the first joint meetinging the International Bank and the International (section 1), and the sixth joint meeting. Monetary Fund, and the Secretary-General of the 2 011. Rec. World Hlth Org. 18 United Nations. A working party of their experts 3 011. Rec. World Hlth Org. 18, p. vi prepared a report which is the co-operative pro- --- 396 - ANNEX 23 duct of the secretariats of all the United Nationsbly to approve such d. supplementary operating organizations.4 programme as it may deem technically advisable The World Health Organization, in carryingand internationally feasible and to approve such out the Supplemental Operating Programme ofpolicies and delegations of authority as may be Advisory and Technical Services in such formappropriate to provide for financing such a pro- and to such an extent as may be approved by the gramme. Second World Health Assembly, will have a basis Probably the most effective method would be on which it can co-operate in this new programmefor the Second World Health Assembly, after of technical assistance. It would appear, in orderdeciding upon a supplemental programme, to that the World Health Organization may be inempower the Executive Board to put this pro- a position to play its full part in this very impor-gramme into operation on a scale corresponding tant new programme of technical assistance-to the funds which will be made available, taking and the part to be played by the health agencyinto consideration the relevant decisions of the in such a programme is a vital one-that it willEconomic and Social Council. be necessary for the Second World Health Assem- It would also appear necessary to delegate to the Executive Board certain powers with respect 4 UN document E/1327/Add. 1. May 1949. to the financing of the programme.

ANNEX 23 [A2/Prog/39 A2/AF/27] 28 June 1949 PROPOSED REVISED BUDGET ESTIMATES

PAPER SUBMITTED TO THE FIFTH JOINT MEETING OF THE COMMITTEES ON PROGRAMME AND ADMINISTRATION AND FINANCE

At the request of the joint meeting of the Committees on Programme and Administration and Finance, the Director-General presents as Appendix 1 a proposal for transferring part of the Regular Budget to the Supplemental Budget in order to meet a ceiling of $7,501,500. This proposal provides for the transfer to the Regular Budget of the estimated cost of the Tuberculosis Research Office amounting to $297,280. At the request of the Committee on Programme, an amount of $50,000 has been provided in the Regular Budget to meet the estimated expenditure on Palestine refugees.All other increases proposed by the Committee on Programme have been included under the Supplemental Estimates. There is also attached as Appendix 2 a summary of the proposed revised budget estimates for the financial year 1 January-31 December 1950.

Appendix 1

DIRECTOR-GENERAL'S PROPOSALS FOR TRANSFERRING PART OF REGULAR BUDGET TO SUPPLEMENTAL BUDGET

1. 2. s. Decreases from Regular Col. 1 and Revised Estimates Transfer to Regular Shown in Supplemental Estimates Off. Rec. 18 Estimates Uss US $ US $ PART I - ADMINISTRATIVEBUDGET World Health Assembly 190,000 12,500* 177,500 Executive Board 64,000 12,500* 51,500 Administrative Expenses 1,403,995 190,120 1,213,875 TOTAL DECREASE,PART 215,120 * This amount has not been transferred to the Supplemental Budget ; decrease from regular estimates only. - 397 - ANNEX 23

1. 2. a. Decreases from Regular Col. 1 and Revised Estimates Transfer to Regular Shown in Supplemental Estimates Off. Rec. 18 Estimates PART II - OPERATING BUDGET US $ US $ US $ Maternal and Child Health 331,050 46,660 284,390 Malaria ** 439,255 94,600 344,655 Environmental Sanitation 268,235 51,600 216,635 Venereal Diseases 429,415 92,400 337,015 Tuberculosis 363,040 47,600 315,440 Public-Health Administration ** 161,080 6,000 155,080 Nutrition 72,440 9,000 63,440 Mental Health 217,180 22,500 194,680 Technical Training of Medical and Auxiliary Personnel 868,080 202,200 665,880 Publications 483,255 39,600 443,655 Epidemiological Studies 95,515 25,000 70,515 Co-ordination of Research 101,060 36,800 64,260 Medical Literature, Teaching Equipment and Pro- gramme Medical Supplies 309,875 50,000 259,875 Common Services (Operating) 505,480 29,700 475,780 Expert Committees 303,815 50,000 253,815 TOTAL DECREASE, PART II 803,660 TOTAL DECREASE, PARTS I AND II 1,018,780 ** Provision has been made under these headings for estimated expenditure of $50,000 for Palestine refugee programme.

Appendix 2

SUMMARY OF PROPOSED REVISED BUDGET ESTIMATES FOR THE FINANCIAL YEAR 1 JANUARY - 31 DECEMBER 1950

PART I - REGULAR AND SUPPLEMENTAL ADMINISTRATIVE Estimated Expenditure 1950 BUDGET ESTIMATES Regular Supplemental SECTION 1 ORGANIZATIONAL MEETINGS US IS US t4 Chapter 1.1World Health Assembly 177,500 Chapter 1.2Executive Board and Committees 51,500 TOTAL SECTION 1 229,000 SECTION 2ADMINISTRATIVE EXPENSES 1,213,875 315,120 TOTAL PART I 1,442,875 315,120 PART II - REGULAR AND SUPPLEMENTAL OPERATING PROGRAMME BUDGET ESTIMATES SECTION 3 Chapter 3.1Operating Supervisory Staff 279,850 - Chapter 3.2Regional Offices 952,535 - Chapter 3.3Other Offices 71,925 - Chapter 3.4Advisory and Demonstration Services to Governments 1,807,845 6,857,795 Chapter 3.5Technical Training of Medical and Auxiliary Personnel 653,405 2,159,880 Chapter 3.6Medical Literature and Teaching Equipment 100,000 150,000 Chapter 3.7Technical Services 1,348,470 369,370 Chapter 3.8Expert Committees 253,815 263,825 Chapter 3.9Supplies to Governments 115,000 385,000 Chapter 3.10 Common Services for Part II except Chapters 3.2 and 3 3 475,780 123,420 TOTAL PART II 6,058,625 10,309,290 TOTAL ALL PARTS 7,501,500 10,624,410 Deduct: Available from UNRRA Fund 400,000 Casual Income 47,500 Estimated Contributions for 1949 from New Members 54,000 501,500 Regular Budget - Health Assembly Appropriation 7,000,000 - 398 - ANNEX 24

ANNEX 24 [From A2/47 and Adds. 1, 2, 3 and 4] 7 June 1949 PARTICIPATION OF ASSOCIATE MEMBERS AND OTHER TERRITORIES IN REGIONAL ORGANIZATIONS : INTERPRETATION OF ARTICLE 47 OF THE CONSTITUTION 1

The Director-General was requested by the Executive Board, at its third session, to obtain the views of Member Governments on the interpretation of the words " Member States in the region" in Article 47 of the Constitution in order that he might placa these views with full documentation and data before the Second World Health Assembly. A circular letter was accordingly sent to Member Governments on 17 March 1949, and the replies are reproduced below.

Austria having clearly defined the terms used in the The words " Member States and Associatewording of this article and without having defined Members in the region concerned " are to bethe rights of the different categories of members understood in connexion with the regulationsfor which provision is made in the same article. of Chapter III," Membership and Associate Consequently, the Belgian Government is of Membership ". This chapter distinguishes be-the opinion that it is not desirable to undertake tween Members and Associate Members, that isthe creation of the central African Regional Members with full and Members with limitedOffice, nor is it desirable to decide on the head- rights. quarters without having fully explored these The term " Members " (Members with fullquestions. rights) evidently covers States in possession of In order to clarify this problem, the Belgian their full sovereignty, i.e., States which possessGovernment wouldliketo communicate the the unrestricted right of self-government, subjectinterpretation which it believes should be given only to the principles of the law of nations. to Article 47, as well as the position which it The Associate Members are, according t6 theexpects to take, in accordance with the opinions view held by the Austrian Ministry of Socialexpressed by its legal and medical advisers, basing Affairs, Members with limited rights.The termitself above all on the very special situation df " Associate Members "covers such territoriesterritories which are to be found in tropical or groups of territories which are not in possession Africa. of sovereignty or of their full sovereignty and 1.Definition of the term " Member State in the which in all important affairs depend on theregion ". protectingState,e.g.,colonies,protectorates, " Member State in the region " should be inter- trusteeship territories and so on. preted as meaning any Member State of the World Therefore, only the right of being representedHealth Organization (central organization) which at the World Health Assembly and its committeesfalls into one of the following categories : and at the regional organizations of WHO should be conceded to the Associate Members, subject (a) that the State itself is situated in the region to the provision that they shall be authorized concerned, either all or in part ; only to make recommendations and proposals (b) that the State owns in the region concerned -in a word, that they shall participate in an one or more dependent territories which are advisory capacity only and without right of not responsible for the conduct of their inter- voting. national relations ; On the other hand, the Associate Members (c)that the State has been entrusted or is should, provided that the protecting State agrees, effectively entrusted with the trusteeship of be engaged to accomplish all resolutions taken one or more territories situated in the region by the World Health Assembly or the regional concerned. committee of WHO, in the same manner as the2.Rightsof Associate Members in regional " Members ". organizations. In WHO regional organizations where practical Belgium and technical questions override questions of The Belgian Government attaches a great dealprinciple, there is no need for creating between of importance to the interpretation of Article 47Member StatesandAssociate Members the of the Constitution.In fact, it is of the opiniondistinction which prevails in the central organiza- that it is difficult to create any regional organiza-tion. tion and that it is even impossible to create a The rights of Member States and those of central African Regional Organization withoutAssociate Members or of groups of territories comprising together an Associate Member, must 1 See minutes of the fourth meeting of thebe equal in all respects in WHO regional organiza- Committee on Constitutional Matter, ssection 2. tions. - 399 - ANNEX 24

3.Rights of so-called " participating " Members ;Ceylon that is, those which, without being Member States or Associate Members of the central organization, (I)Definitions are, however, authorized to take part in regional Members are those States which possess sove- organizations. reignty including control over their international With respect to these Members, the differencerelations. Associate Members are those territories existing between Member States and Associatewhich do not possess this power and are dependent Members in the central organization would prevailon some other State or States. This definition is within regional organizations. based on an interpretation of Articles 3 to 8 in the Constitution where, although it is stated that 4.The Belgian Government reserves the right to be represented at any time as a Member Statemembership shall be open to all States (Article 3), in the regional organizations to be establishedthe term " State " is not defined except by in regions where it exercises authority. implication arising from a definition of territories which areeligibleforassociate membership However, it would not necessarily contemplate(Article 8). availing itself of this right if, in regional organiza- Although it would appear from Article 8 that tions, the rights of Member States and of Asso-any territory which is not responsible for the ciate Members were recognized as equal in accord-conduct of its international relations should be ance with paragraph 2 of the present paper. entitled to associate membership and no other 5.The Belgian Government will at the propercategoryiscontemplated under thatarticle, moment examinetheadvisabilityofbeingunder Article 47 a third category is visualized represented in a regional organization of tropicalin the case of regional organizations, i.e., terri- Africa as a group of territories or by two distincttories which are not responsible for the conduct territories. of their international relations and which are not Associate Members but which have the right to be represented and to participate in regional Brazil committees. In reply, I have the honour of informing Your Excellency that the Brazilian Government con- (II)Meaning of words " in the region" in first siders as Member States of a specified region sentence of Article 47 those States whose territory is situated in the It would appear from the spirit underlying the said region, including their colonies, protectorates,formation of regional organizations and indeed or mandated territories. from the wording of Article 47 itself, where it is stated, " territories ... within the region which are not responsible for the conduct of their inter- Canada national relations ... shall have the right to be It is the opinion of the Canadian Governmentrepresented and participate in Regional Com- that the words in question refer to sovereignmittees ", that what is really contemplated are States (i.e., those responsible for the conduct ofthe actual territories situated in those regions international relations), whose territory is includedrather than the metropolitan Powers situated in a geographical area defined by the Healthoutside, but exercising control over territories Assembly under Article 44, provided that thewithin the region. States fall into one of the three following cate- Itissuggested that this interpretation be gories : accepted. (a) a Member of the United Nations, which has become a Member of the Organization by(III)Duties, powers and obligations of Associate signing or otherwise accepting the Constitution Membérs in accordance with the provisions of Article 79 On an analysis of the actual position in the (see Article 4) ; various regions that have been set up already, (b) any State whose government was invitedor are likely to be set up in the future, it would to send observers to the International Healthappear that it is not necessary to have more than Conference held in New York, 1946, which hasone type of membership.In all regions except become a Member of the Organization byAfrica, countries, which would normally qualify signing or otherwise accepting the Constitu-for associate membership are so few and in such tion in accordance with the provisions ofa minority that from a practical point of view the distinction is not necessary.In the case of Article 79, before the first session of the HealthAfrica too it will be seen that such a distinction Assembly (see Article 5) ; will not be needed because a large majority of (c) any other State whose application forterritories would be those that would qualify for membership has been approved by a simpleassociate membership. For regional organiza- majority of the Health Assembly, providedtions, therefore, it is suggested that only member- that its membership does not contravene theship should be recognized, but such membership conditionsof any agreement between theshould be subject to the above interpretation of United Nations and the Organization, approved" region " in Article 47 with the further qualifica- pursuant to Chapter XVI (see Article 6). tions contemplated in the second sentence of - 400 - ANNEX 24

Article 8 in the case of Member territories notdirect repercussions in the law of nations, which possessing full sovereignty. cannot disregard them. If any proof were needed, it would suffice to mention the evolution of the China political-juridical system of the former British According to the stipulations of the Constitu-Dominions, which today are considered entirely tion (Articles 4, 5, 6) the Organization is composedasinternational Stateentities,and even as of Member States of the following categories :independent and sovereign States. 5.The question which arose hitherto was whether 1.Members of the United Nations which become Members of the Organization by sign-a given possession was an ordinary colonial ing or otherwise accepting this Constitution interritory or an entity with a status of its own, accordance with the provisions of Chapter XIXsufficiently independent to enable it to be treated of the Charter of the United Nations and inas a person under the law of nations. accordance with their constitutional processes ; Certainconstitutional innovations seem to give rise to a new problem in the opposite sense, 2.States whose governments were invited towhich is that of the juridical status of a colonial send observers to the International Healthpossession united with thepossessingState. Conference held in New York, 1946, whichFrom the point of view of international law should become Members by signingorotherwise such a possession be considered in the same accepting this Constitution in accordance with" juridical-political position " as the parent State ? the provisions of Chapter XIX of the CharterOr, in other words, when confronted with this of the United Nations ; and phenomenon of integration, are we not dealing 3.States which apply to become Memberswith one and the same Power, with one and the subject to the conditions of any agreementsame independent State having multiple and between the United Nations and the Organiza-incorporated territories, with one and the same tion and which are admitted as Members when " State entity ", both from the constitutional their application has been approved by aand from the international point of view ? simple majority vote of the Health Assembly. Interesting as the problem may be, one is necessarilyobligedtoscrutinizecloselythe Regarding the interpretation to be given toconstitutional system which gives rise to it and the words " Member States in the region ", asto consider whether the international conditions each one of the regional organizations shall be an integral part of the Organization, as mentionedfor recognizing this new state of affairs are fulfilled. in Article 45, it is indispensable that the Member6. But there is no doubt at the present time that States in the region comprise the three categoriesthe practice of the European States concerned is of countries mentioned above. However, Articleto continue to admit the distinction between the 47 of the Constitution states that territories or" parent State " and its " overseas territories " groups of territories in a region often rely on thein the various manifestations of international State which is responsible for the conduct of theirlife, whatever the constitutional link between internationalrelations when their rights andthem might be. obligations are concerned.It follows from this7. And it is clear that the expression " Member state of affairs that the Member States in a regionStates...in the region " contained in the first must comprise the Member States responsiblesentence of Article 47 of the WHO Constitution can for the conduct of the international relations ofonly have reference to juridical-political entities territories or groups of territories in a region. whose metropolitan territory, together with its capital (seat of its government) and its public Egypt State powers, are to be found or are established 1.Article 47 of the WHO Constitution stipulates :in the region concerned. [text of Article 47]. Any other interpretation would be inadmissible from the Egyptian Government's point of view. 2.The question raised by the letterof the Director-General of the World Health Organiza- 8.Moreover, it should be pointed out that in tion, dated 17 March 1949, Ref. C. L. 15-1949,the spirit of the WHO Constitution, the region 900-1-6, regarding the creation of the Africanmust comprise a limited group of States which, region,deals with the determination of thewith their central administrations, reside as it " Member States.. . in the region ", to whichwere in the regional area. This is a proper method reference is made in the first sentence of Article 47.of considering the question, which takes account of the harmony of the conceptions, the traditions 3.It would seem that the question has arisenand, in general, the social conditions which link because of the fact that certain European Powerstogether the States forming the group concerned. have territories in Africa which, as the result ofThe interpretation given by Egypt to the words certain constitutional changes, have passed from" Member States " can therefore only be a con- the stage of ordinary colonies and been endowedfirmation of thisspirit and ensure the said with a status which, in the opinion of some, makes harmony. it possible to consider them as a more or less integral part of the parent State and as being more or less completely united with it. France 4.It is obvious that the constitutional changes 1.TheFrenchGovernmentconsidersthat in the status of the colonial possessions have" Member States in the region " should be under- - 401 - ANNEX 24 stood to mean all the States whose territory liesArticles 3 to 8 of the Constitution. The Govern- within the geographical area, either for the wholement are advised that as the Constitution stands or for a fraction forming an integral part of theseat present there is nothing to prevent a State States within the terms of their Constitution.being situated in two regions and thereby being a member in two regional committees.While 2.In the opinion of the French Government,this is the strict legal interpretation of the Consti- Associate Members should be entitled to the same tution as it stands now, the Government of India rights, on the regional plane, as the Memberare of the view that ordinarily the regions them- States. selves should be so demarcated by the World 3.Concerning territories placed under the trustee-Health Assembly that in practice a Member ship system, their representation on the regionalState will come exclusively within one region. plane should be ensured by the administeringIt is also desirable to make a provision in the Power in virtue of the authority conferred uponConstitution that no Member State should have it by the trusteeship agreements. representation as a full Member in more than one In application of the provisions constitutingregion. The Government of India are also of the the Organization and of the above-mentionedview that while Associate Members and terri- principles, the French Government, in so far astories or groups of territories of the type men- it is specially concerned, has reached the follow-tioned in the second sentence of Article 47 of the ing conclusions : Constitution may be given full power to participate in discussions in regional committees they should (a)France will ensure the representation ofnot have the power to vote.In other words, the overseas departments and territories of theAssociate Members and other territories which French 'Republic which are included withinare not full Members of the World Health Organiza- the geographical area of the various regionaltion should not have greater powers in the regional committees.France is unable, owing to thecommittees than Associate Members have in the constitutional structure of the State, to con-World Health Assembly. If this creates difficulties template autonomous representation for thesein special regions like Africa, the question of integral parts of the Republic.The Frenchvarying the rights of Associate Members and Government, moreover,intends toincludeother dependent territories in the regional com- native persons and experts in the delegationsmittees of those regions can be considered. to these regional committees. (b)Since certain elements of the French Union,Iraq such as the Associated States of and The interpretation of " Member States in the Cambodia for example, enjoy a national orga-region ", in the opinion of the competent Iraqi nization distinct from that of the Republic,authorities, is as follows : it is for France to submit their candidatures They are the countries connected with each as Associate Members. other by neighbourhood relations, by different (c)It is the duty of the French Government tomeans of communication, thus forming a con- organize appropriate representation on thenected region, enabling full co-operation in mat- regional committees of the trust territóriesters of health. under itsadministration. Itintends this representationto be composed ofofficials Ireland belonging to the administering Power and of advisers and experts from the territories con- In view of the distinction drawn in the final cerned.The participation of the trust terri-sentences of Article 47 between Members having tories would take place under conditions to beresponsibility for the international relations of determined, in accordance with Article 47, forterritories within the region and Member States territories which are not responsible for thein the region, it is the view of the Irish Govern- conduct of their international relations andment that the words " Member States in the which are not Associate Members. region " can only be construedas meaning Member States whose national territoriesare Hungary located in the region concerned. Hungary, in view of its geographical site, doesLebanon not seem to be concerned in the question.Con- sequently we on our part do not find it necessary The words " Associate Members ", which are to form an opinion on this matter. defined inArticle8,apply to non-sovereign countries.The words " Member States " apply India 2 to sovereign States as defined in Article 3 and those following. The Government of India are advised that under the ordinary rules of interpretation the termsMexico " Member " and " Associate Member " have the same meaning in Article 47 as they have in 1.The words " Member States and Associate Members in the region ", which appear in lines 2 This reply was received on 18 July 1949, afterone and two of Article 47 of the Constitution of the close of the Health Assembly, but is includedthe World Health Organization, should be inter- for convenience. preted in the light of Article 47, Article 44 and, -402 - ANNEX 24 more particularly, Article 8 of the aforementionedNetherlands Constitution. The expression " Member States in the region " The first of the above-mentioned articles states : includes not only States which are Members of [Text of Article 47] the Organization and which, in accordance with Article 44 reads : their constitutions, possess territories of which [Text of Article 44 (b)] . the whole or a part is situated in the area in Finally, Article 8 stipulates : question, but also States Members which are [Text of Article 8] responsible for the conduct of the international relations of territories situated in that region. 2.It thus appears necessary that the countries According to Article 8 of the Constitution of concerned should be admitted first of all to thethe World Health Organization, States Members Health Assembly as Members or as Associatemay make application for territories which are Members, so that they may give their majoritynot responsible for the conduct of their interna- approval, according to the terms of Article 44,tional relations to be admitted as Associate for the establishment of the regional organiza-Members of the Organization.It follows that in tion. drawing up the Constitution it was desired to The legal status of Member States of a region isgive States Members an important task in view, already set down in the Constitution of the Worldof the work to be accomplished in the regions, Health Organization.With regard to the legalA similar conclusion may be drawn from Article status of Associate Members, the last part of47. It is, moreover, inconceivable that in the Article 8 lays down that the rights and obliga-African Region the expression " Member States... tions of such Members shall be determined byin the region concerned " should only apply to the Health Assembly, and Article 47 states that Members possessing territories of which the whole the rights and obligations of non-self-governingor a part is situated within the region, since in territories or groups of territories which are notthat case only very few States could be considered Associate Members shall be fixed by the Healthas being Member States in the region, which was Assembly in consultation with the State havingcertainly not intended by the Constitution. responsibility for the international relations of For these reasons, in the opinion of the Govern- the said territory or group of territories, and withment of the Kingdom of the Netherlands the Member States in the region. words " Member States in the region " must be In consequence, it may be considered that nointerpreted in the sense defined above. problem exists here in respect of the legal status of Member States, but merely a question ofNew Zealand determining the rights and obligations of other territories, which can be settled by the Assembly The correct interpretation of " Member States itself. in the region " in Article 47 includes States In view of the foregoing, the Mexican Govern-Members of WHO having responsibility for the ment believes that : conduct of the international relations of a territory in the region which is the concern of the regional (a)For the establishmentofthe Africanorganization. Regional Organization, the Associate Members will have to be admitted previously according to the form prescribed in Article 8. Pakistan (b)Once this has been done, the creation of The Government of Pakistan are of the view the regional organization should. be voted asthat the words " Member States in the region " in prescribed by Article 44 of the ConstitutionArticle 47 of the Constitution of the World Health of the World Health Organization. Organization mean States which are admitted (c)The Health Assembly itself will be ableto the membership of the Organization under to define the scope of the obligations and rightsArticles 4, 5 and 6 of the Constitution, and which of the Associate Members in the form laid downare situated in the region constituted under in Article 8 ; and the powers and duties, in theArticle 44 of the Constitution. regional committees, of the territories or groups of territories which are not responsible forSyria the conduct of their international relations The Syrian Government interprets the above- and which are not Associate Members, will bementioned words as meaning that distinction is able to be fixed also by the Assembly itself inmade in the Constitution between Member States consultation with the Member or authorityand Associate Members ; and as within a given responsible for the conduct of the internationalregion there may be Member States and Asso- relations of those territories and with theciate Members, the committee of the region in Member States in the region, following thequestion will be composed of representatives from procedure established in Article 47. these two categories. (d)In any case, the burden of the obligations The problem is to find a criterion in the Consti- must rest on the State conducting the inter-tution which makes it possible to distinguish be- national relations of those countries withouttween the two above-mentioned categories. full status in accordance with international From examination of Articles 3 to 8 of the law. Constitution,it appears that the qualification - 403 - ANNEX 24 of Member State is attributed to sovereign Stateshealth regional organization ". In the case of the enjoying allthe prerogatives attendant uponAfrican Region, it should include all States or such sovereignty and which have complied withassociate States that lie between 20° latitude the conditions laid down in the said articles.north and Cape Town, excluding States included In accordance with Article 8,territories orin the Eastern Mediterranean Region. groups ofterritories not responsible for the conduct of their international affairs may beTurkey admitted as Associate Members by the Health In the opinion of the Government of the Assembly. Republic, it would be relevant to assign to the Such admission is subject to a request madeword " Region " its usual geographical meaning. for the territory or group of territories by theBesides, this meaning is corroborated by the Member State or by another authority responsibleuse in the text of the resolution of the Executive for the conduct of their international affairs.Board mentioned in your above-mentioned letter This is to say that the qualification of Associateof the expression " establishment of the African Member is reserved to territories or groups ofRegion ", and of the term " geographical areas " territories having their own sanitary organizationappearing in Article 44 of the Constitution of the and internal administrative services but whichWorld Health Organization. do not yet enjoy the prerogatives of sovereignty, Regarding the words " Member States and especially with regard to the conduct of theirAssociate Members ", it would be advisable to international affairs. interpret them within the framework and in the There remains the question of the rights andspirit of Articles 4, 5 and 8 of the said Constitution obligations of Member States, Associate Members and Chapters XI and XII of the United Nations and other territories. With regard to the rights and obligations ofCharter. Member States, they have been set down in the Constitution. United Kingdom The right of the Assembly to determine the With reference to your letter of 17 March, in rights and obligations of Associate Members isdocument EB3/76 8 the Executive Board at its recognized in the Constitution. third session expressed the view that the decision Associate Members do not make up the Healthon the interpretation of the words " Member Assembly (Article 10) nor the Executive BoardStates in the region " in Articles 47 and 44 (b) (Article 24) ; they have no voting rights in theof the Constitution should be based on the prac- Health Assembly (Article 59). ticalrequirementsforco-operationand the But taking into consideration the interests ofeffective functioning of regional organizations. the Organization, and in order to render theirIn the view of His Majesty's Government in the participation in regional committees more usefulUnited Kingdom, responsibility for the conduct and effective, the Syrian Government is of the, of the international relations of non-self-governing opinion that it would be advisable that Asso-territories must inevitably include responsibility ciate Members in a given region have the samefor questions arising from the association of such rights and obligationsas Member Statesinterritories with the work of international organiz- regional committees. ations.It follows from this statement of the With regard to other territories, in order toconstitutional position that itis the duty of determine their rights and obligations, the follow-His Majesty's Government in the United Kingdom ing points should be taken into consideration : to represent the interests of any territories for whose foreign relations it is responsible in any 1. Area of the territory regional committee covering an area in which 2.Population His Majesty's Government has territorial respon- 3.Sanitary organization of the territory itselfsibilities. It is accordingly the view of His Majesty's 4.Importance to other countries of the terri-Government that the phrase " Member States tory's health situation in the region " in line 1of Article 47 of the 5.Extent of autonomy with regard to internalConstitution of WHO must be interpreted to affairs. include States Members possessing the whole or partoftheirmetropolitanterritorieswithin Thailand the region and States Members responsible for His Majesty's Government are of the opinionthe conduct of the international relationsof that the Member States in the region should beany territories situated within the region. the States which are Members of the World His Majesty's Government would not however Health Organization and tertitories of which areof necessity wish to exercise this right in every situated entirely or predominantly within theinstance. region concerned. United States of America Transjordan 1.The words " Member States in the Region " in Article 47 of the Constitution of the World " Member States in the region " is interpretedHealth Organization are to be interpreted as by my Government as " any State or associate State that lies within the boundaries of any 3 See O. Rec. World Hlth Org. 17, 1'7 - 404 - ANNEX 24 meaning Member States which have their seat of under Article 75 of the World Health Constitution, government within the region.Thus a Member ofthe Health Assembly has the duty to interpret WHO whose seat of government is in Europethe meaning of " Member States in the region " would be a Member State in the geographicalin Article 47. Obviously, this is a " question . . area of Europe which the Health Assembly hasconcerning the interpretation "of the WHO defined for purposes of regional organization, and Constitution as stated in Article 75 ;and the would not be a Member State in any otherclear intent of that article is that such questions geographical area. should be settled wherever possible by the It seems clear that this meaning was theHealth Assembly itself in preference to some intent of the parties since the final sentence ofother international body such as the International thisarticle makes a distinction between theCourt of Justice. Member havingresponsibilityfortheinter- national relationsofterritoryinthe regionOther Countries and Member States in the region. Acknowledgements of receipt only were sent 2.It is also the view of the United States that,by Argentina, El Salvador and Venezuela.

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SUBJECT INDEX

AND NAME INDEX

SUB JECT INDEX

Abortion, 28, 333 Assessment Abstracting, Interim Co-ordinating Committee on of Israel, 270, 345 Medical and Biological, 157, 165 resolution on, 40 Abstracts, medical and biological, 157, 165, 168 of South Korea, 272, 345 Administration and Finance resolution on, 41 Committee on, Assessments Chairman, election of, 225 of Associate Members, 272, 346 joint meetings of, with Committee on resolution on, 42 Programme, reports of, 347-9 of new Members, for working capital fund, Rapporteur, election of, 225 237, 341 reports of, 336-46 resolution on, 36 adoption of, 116, 120 scale of, for 1950, 264, 270-2, 345 Vice-Chairman, election of, 225 resolution on, 41 Standing Committee on, 241 See also Contributions Administrative Committee on Co-ordination, see Associate Members under United Nations assessments of, 272, 346 Advisory and demonstration services to govern- resolution on, 42 ments, 39, 253-5, 262, 343, 393 rights and obligations of, in regional organ- draft agreement with regard to, 394-6 izations, 296-300, 301, 314-8, 356, 399-405 resolution on, 55 Advisory and Technical Services, Supplemental Audit Operating Programme of, 396 procedure, 33, 230-2, 340 adoption of, 44, 347 proposed joint system of, 33, 230-2, 340, 372 priority items, 48, 349 Auditor, External See also Budget for 1950, Supplemental appointment of, 33-35, 230-2, 338 on AdvisoryCommittee Administrativeand reportsof,32, 229, 337 Budgetary Questions, see under United NationsAuditors, United Nations Boardof,seeunder Agc les aegypti, 176 United Nations Africa, Regional Organization for,see RegionalAureomycin, 105, 209, 214, 223 Organization See also Antibiotics Agenda, 61-66 Austria adoption of, 16, 72 health conditions in, 93 Agreement health legislation in, 93, 94 with Egypt, negotiations for, 300, 351 tuberculosis control in, 93 resolution on, 49 venereal-disease control in, 93 with ILO, Article VII of, 314, 355 Auxiliarypersonnel,seeTechnicalpersonnel ; resolution on, 55 Medical and auxiliary personnel, training of, with India, 300, 350, 375-81 approval of, 49 with Pan American Sanitary Organization,BCG vaccination, 150, 171, 193, 194, 195, 386 308, 353, 381-3 in Brazil, 125 approval of, 52 Finland, 90 with United Nations, ILO, UNESCO, correc- Israel, 109 tion of French texts, 314, 355 Philippines, 88, 150 resolution on, 54 Bejel, 154, 155, 192, 333 Aircraft, disinsectization of, 176, 183, 184 resolution on, 27 Albania, malaria control in, 191 Bibliographies, 155, 181 Allowance Biological standardization, 171, 195 of Director-General, 227, 341 Biological Standardization, Expert Committee on, to Health Assembly delegates, 226, 336 report on third session, 20, 171, 327, 362 resolution on, 31 Birth control, 84, 139 American Leprosy Foundation, 204 Blood groups, 171 Brazil American Public Health Association, 301, 352 BCG vaccination in, 125 Americas,Regional Organizationfor,see Pan five-year plan in, 125 American Sanitary Bureau ; Regional Office malaria control in, 94 Amidone, 179 public health in, 95 Annual Report on the Results of Radio-Therapy on training of technical personnel in, 95 Cancer of the Uterine Cervix, 28, 334 Brucellosis, 182 Anophelines, 183, 189, 193 Budget for 1950, Regular report on quarantine regulations concerning, 188 amount of, 276-84, 286-9, 347 Antibiotics, Expert Committee on, 172 resolution on, 44 Antibiotics,productionof,98,105,208,214, appropriation resolution, 42, 346 222-4, 335 discussion on, 273-5 resolution on, 30 revised estimates for, 47 See also Aureomycin, Chloromycetin, Peni- transfers from, 47 cillin, Streptomycin See also Programme and Budget for 1950 - 409 - SUBJECT INDEX

Budget for 1950, Supplemental Contributions discussion on, 276-284, 286-9, arrears in, 232, 233, 240, 341 financial support of, resolution on, 35 by Ceylon, 278 currency of, 250, 261, 341, 344 by Yugoslavia, 278 resolutions on, 36, 40 resolution concerning, 44, 347 to 1948 Budget, 232, 339 revised estimates for, 47 resolution on, 35 statement by France on, 121 to 1949 Budget, 233, 339 transfers to, 47 resolution on, 35 See also Programme and Budget for 1950 ; See also Assessments Advisory and Technical Services, Supple- Co-ordination mental Operating Programme of AdministrativeCommitteeon, see under Bulletin of the World Health Organization, 167 United Nations See also Publications with UN and specialized agencies, 26, 31, 216, Bulletin of Tropical Medicine and Hygiene, 181 302, 332, 366 Byelorussian Soviet Socialist Republic, 52, 114,Credentials, Committee on, 138, 303-7, 353 membership of,11,15, 70 reports of, 321-2 adoption of, 70, 104, 108, 109 Cancer, 84 Credentials, verification of, 15, 321, 322 of the Uterine Cervix, Annual Report on theCrime, prevention of, 25 Results of Radio-Therapy on, 28, 334 Criminology, Congress on, 199 statistics, 28, 334 Czechoslovakia Ceylon assistance to, 96 cancer in, 84, 160 health needs of, 96 fellowshipsin,156 financial support for Supplemental Budget from, 278 health needs of, 84 Darling Foundation, 188 malaria control in, 86 Decisions of the Second World Health Assembly, Chemotherapy, 194, 204, 205 see under World Health Assembly, Second Child, Declaration of Rights of, 151 Declaration of Rights of the Child, 151 Child welfare, 151, 155, 156 Demonstration areas,see Health demonstration reports on, 151, 166 areas See also Maternal and child health Demonstration teams Child Welfare, International Union for, 151, 152, environmental sanitation, 171 174 malaria-control, 190 Chlordane, 184 maternal and child health, 151, 152 Chloromycetin, 105, 209, 214, 223 nutrition, 174 See also Antibiotics venereal-disease, 153, 154 Cholera programme for 1950, 178 tuberculosis training-courses in, 161 research on, 99 Dental hygiene, 215 in India, 22, 178, 329 DDT, 183, 184, 191, 192, 208, 209 Cholera, Joint OIHP/WHO Study-Group on, 175 See also Insecticides report on second session, 22, 178, 329 Diphtheria, 183 Chronicle of the World Health Organization, 167 Director-General See also Publications contract of, 227, 341 Coca leaves, 179 Report of Communicable diseases of childhood, immunization against, adoption of, 17, 124 programme for 1950, 182 discussion on, 78-106 expert consultation on, 22, 182, 329 Disinfestation, 192 Congress on Criminology, 199 Disinsectization, 176, 183, 184 Congresses, medical, see International congresses Displaced persons of medical sciences assistance to, 89, 90, 119, 120, 140, 220, 332 Constitution of WHO resolution on, 27 acceptance of, by Israel, 109 Dolantin, 179 Article 47 of, interpretation of, 55, 297-300,DominicanRepublic,public-health programme 314-8, 356 in, 106 views of governments on, 399-405 Drug addiction, see Habit-forming drugs Constitutional Matters, Committee on Drugs, synthetic, 179 Chairman, electionof, 290 Rapporteur, election of, 290 reports of, 350-7 Eastern Mediterranean Area adoption of, 107, 113-5, 121-4 assignment of Israel to, 17, 109 Vice-Chairman, election of, 292 memorandum from Members of, 125 Consultants environmental sanitation, 170 Eastern Mediterranean Regional Office, see under malaria, 190 Regional Office maternal and child health, 151 Economic and Social Council, see under United nutrition, 174 Nations technical training, 160 Economic Commission for Europe, see under United tuberculosis,195 Nations venereal-disease, 153, 154 Editorial services, 164-8, 222 - 4W - SUBJECT INDEX

Education, health, see Health education of theFood production, joint FAO/WHO programme, public 188, 334, 368-70 Education, medical, 79, 99, 157, 160, 161 resolution on, 29 international centres of, 162 Forlanini Gold Medal, presentation to WHO of, 125 SeealsoTeaching,medical ;Medical and auxiliary personnel, training of ;Technical personnel General Committee Egypt election of, 16, 75 proposed agreement with, 300, 351 nominations for, 73, resolution on, 49 reports of, 323-4 Environmental sanitation, see Sanitation, environ- adoption of, 16, 113, 124 mental Greece Epidemic control, international, 178, 180-4 assignment of, to European Region, 311, 354 Epidemiological resolution on 53 notifications and information, 177 BCG vaccination in, 194 broadcasting of, 177 displaced persons in, 89 services, 175-8, 180-4, 203-6 statistics, 29, 187 studies, revised budget estimates for, 47 Habit-forming drugs, 179 Epidemiological Intelligence Station,Singapore,Habit-forming Drugs, Expert Committee on 36, 234, 235, 236, 341 report on first session, 21, 172, 327 .Epidemiological and Vital Statistics Report, 164Haffkine Institute, 180 See also Publications Haiti special project, 171 Epidemiology and Quarantine, Expert CommitteeHeadquarters of WHO, accommodation for, 248- on International 250, 258-261, 342, 374 report on first session, 22, 175-7, 328 resolution 'on, 37 Ethics, medical 208 Health conditions and needs, see under names of Europe countries Regional Organization for, see Regional Organ-Health demonstration areas, 80, 170, 201-3, 211 ization principles for, 392 Special Office for, 103, 209, 213, 222-4, 285 Health education of the public, 151, 155 European Region programme for 1950, 163 assignment of Greece to, 311, 354 UN seminars for, 163 resolution on, 53 Health Inspectors, Venezuelan Association of, 108 Executive Board Health organizations,policy on invitations to ad hoc committee of, report of, 229, 361 appoint members to governing bodies of, 301, 352 budget estimates for, 47 resolution on, 51 financial responsibilities of, 241-8, 261, 343 Health statistics, see under Statistics resolution on, 38 Heroin, 179 insurance of members of, 227, 336 Housing, 79, 168-70 resolution on, 31 hygiene of Members, designating panel on, 302 geographical distribution of, 110-3, 125, resolution on,51, 352 132 national committees, 302 election of, 16, 110-3, 117, 144 Hungary procedure for, 292-6, 350 assistance to, 97 resolution on, 49 health conditions in, 98 nominations of, 361 Hygiene Expert Committee on... see under subject dental, 215 Expert Committees, budget estimates for, 47 occupational, 26, 203, 215, 332 Expert Committees and their Sub-committees, of housing, see Housing Regulations and Rules of Procedure for, of seafarers, 26, 215, 332 rural,see Sanitation, environmental adoption of amendments to, 50, 301, 352 urban, see Sanitation, environmental Hygiene, Occupational, Joint ILO/WHO Expert FAO, 170, 173, 188, 328, 334, 366, 368-70 Committee on, 26, 215, 332 resolutions on co-operation with, 21, 29 Hygiene of Seafarers,Joint ILO/WHO Expert Committee on, 26, 215, 332 - Standing Advisory Committee on Nutrition,Hylean Amazon project, 171 173 working capital fund of, 267 Fellowships, 80, 99, 156, 159, 170, 205, 206 collaboration on, with UN and other organ- ICAO, 175, 176 izations, 157 Quarantine Committee of, 176 working capital fund of, 267 programme for 1950, 20, 160-3, 327 ILO, 157, 158, 162, 200, 203, 215, 366 Filariasis, 181 Agreement with, correction of French text of, Finance, see Administration and Finance 54, 314, 355 Finland Article VII of agreement with, 314, 355 assistance to, 90 resolution on, 55 BCG vaccination in, 90 working capital fund of, 267 health needs of, 90 India " WHO Committee " in, 90 Agreement with, 300, 350, 375-81 Flies, control of, 184 approval of, 49 See also Insect control ; Insecticides cholera research in, 22, 178 - 411 - SUBJECT INDEX

India (contd.) International Union of Child Welfare, 151, 152, 174 college of nursing in, 160 Iran, malaria control in, 99 tuberculosis training centres in, 161 IRO, 157, 220, 221 Industrial hygiene, see Occupational hygiene Iron lungs, 182 Infant mortality studies, 156 Isotopes, radioactive, 98, 105 Influenzá, 173 Israel Inoculation certificates, see Plague, Typhus, Yellow assessment of, 270, 345 Fever resolution on, 40 Insect-borne diseases, 192 assignment of, to Eastern Mediterranean Area, Insect control, 189, 192, 329 17, 109 resolution on material for, 23 BCG vaccination in, 109 See also Insecticides ;Flies, control of seated as Member, 17, 109, 141 Insecticides, 183, 192, 208, 209, 329 Italian Anti-Tuberculosis Federation, 125 resolution on labelling of, 23 Italy Insecticides, Expert Committee on, 188, 193 control of cutaneous leishmaniasis in, 181 report on first session, 23, 183, 329, 362 health conditions in, 68, 69 Institute of Public Health, Rome 192 malaria campaign in, 69 Insulin, supply of, 212, 331 maternal and child health in, 155 resolution on, 25 ITO, 209 Insurance relations with, 303, 352 social, 90 resolution on, 51 travel, for delegates, 227, 336 resolution on, 31 Intergovernmental Maritime Consultative Organ-Joint Committee on Health Policy, UNICEF/WHO, ization, relations with, 303, 353 119, 146, 153, 196, 366 resolution on, 51 report of WHO members of, 196, 330, 365 Interim Commission, financial report and accounts resolution on, 24 of, 32, 337 See also UNICEF report of Executive Board on, 229 Interim Co-ordinating Committee on Medical and Biological Abstracting, 157, 165 Korea, South International Air Travel Association, 176 admission to membership of WHO, 121-4, International Association of Microbiologists, 194 312-4, 355 International Bank of Reconstruction and Develop- resolution on, 54 ment, 210 assessment of, 272, 345 InternationalChildren'sEmergency Fund,see resolution on, 41 UNICEF statement by observer of, 129 InternationalCivilAviationOrganization,see ICAO International Civil Service Advisory Board, 226, Laboratories 238, 239, 252, 371, 372 establishment of international research, 210, International Committee of Catholic Nurses, 302 332 International Committee of the Red Cross, 220 resolution on, 26 International Congress for Children, 172 national, 153 International congresses of medical sciences, co- Leishmaniasis ordination of, 157, 326 control of, 181, 192 resolution on co-operation with UNESCO programme for 1950; 181 in, 19 Leprosy, 80, 203-6, 335 See also Permanent Council for Association, International, 203, 204 International Council of Nurses, 157, 206 expert committee on, 30, 204, 205, 335 International Council of Universities, 158 fellowships, 205, 206 International Court of Justice, 304, 305 Foundation, American, 204 International Dental Federation, 215 memorandum on, 204-6, 390-2 International Digest of Health Legislation, 165, 166, resolution on, 30 167, 327 world centre for research on, 204, 205 resolution on, 20 Library See also Publications of Office International d'Hygiène Publique, 165 International Health Year Book, 47, 166, 167, 333 of United Nations, Geneva, 165, 168, 222, 332 resolution on, 28 resolution on, 27 See also Publications services, 167 International Labour Organization, see ILO Literature, medical, 44, 84, 208, 211 International League of Red Cross Societies, 194 exchange of, 158, 165 International Leprosy Association, 203, 204 indexing of, 165 International Medico-Scientific Federation, 215 programme for 1950, 212 International Monetary Fund, ' 210 revised budget estimates for, 47 International Refugee Organization, see IRO London School of Hygiene and Tropical Medicin e, International Salmonella Centre, 173 51, 301, 352 International Sanitary Conventions, see Sanitary Conventions, International International Telecommunications Union, 178 Malaria International Trade Organization, see ITO conference in Equatorial Africa, 190 International Union against Tuberculosis, 194 control, 69, 86, 89, 94, 99, 191 resolution on activities with, 24 ' collaborationin,with UN and other International Union against Venereal Diseases, organizations, 188, 330, 334, 368-70 19, 152, 153 resolutions on, 24, 29 - 412 - SUBJECT INDEX

Malaria (contd.) Nomenclature Regulations, Supplementary, 309, programme for 1950, 189-93 354, 383 revised budget estimates for, 47 adoption of, 53 Malaria, Expert Committee on Nominations, Committee on report on second session, 188 membership of,11,15, 71 scope of, 192, 330, 363 reports of, 322-3 resolution on, 23 Non-governmental organizations Manual of the International Statistical Classification participation of, in committees, 138, 148 of Diseases, Injuries and Causes of Death, 28, 165, relations with, 302, 303 167, 334 See also under names of organizations See also Publications Non-self-governing territories Manuals, treatment and control, 167 rights and obligations of, in regional organ- Maternal and child health izations, 296-300, 301, 314-8, 356, 399-405 collaboration in, with UN and other organ- resolution on, 55 izations, 151, 325 survey on facilities for technical training in, 157 programme for 1950, 151 Nurses, 156, 157 revised budget estimates for, 47 International Committee of Catholic, 302 See also Child welfare ;Maternal and child International Council of, 157, 206 welfare training of, 159, 161 Maternal and Child Health, Expert Committee on, Nursing, Expert Committee on, 162, 206, 349 report on first session, 18, 150-2, 155, 325 resolution on, 46 Maternal and child welfare, 155 Nutrition, 79, 173-5, 193 See also Maternal and child health ;Child collaboration in, with FAO and other organ- welfare izations, 173, 328 Medical andauxiliarypersonnel,trainingof, resolution on, 21 156-63, 168, 327 committees, national,174, 328 collaboration in, with UN and other organ- resolution on, 21 izations, 157-9 of children and pregnant women, 152, 155 group, 20, 161, 162, 168 programme for 1950, 174 programme for 1950, 159-163 revised budget estimates for, 47 revised budget estimates for, 47 NutritionCommittee,Joint FAO/WHO,173, regional centres for, 162, 171, 202 174, 328 resolution on, 20 See also Technical personnel Medical ethics, 208 Medical congresses, see International congresses of Occupational hygiene, 26, 203, 215, 332 medical sciences Offenders, treatment of, 25 Medical literature, see Literature, medical Office International d'Hygiène Publique, 50, 300, Medical supplies, 44, 80, 84, 97, 153, 191, 347 351 Bureau of, 100, 104, 208, 209, 210 library of, 165 for Europe, 213, 331 Bulletin of, 300 resolution on, 26 Official Records of the World Health Organization, programme, 208-13, 286 164, 167 revised budget estimates for, 47 See also Publications reimbursement for, by governments, 253-5, Onchocerciasis, 1.81 262, 343, 393-6 resolution on, 39- See also Insulin Membership of WHO Paediatrics, 156, 157, 161 action taken by certain countries with regardPalestine Conciliation Commission, see under United to, 114, 138, 303-7, 353 Nations resolution on, 52 Palestine refugees, assistance to, 217-9, 286, 348, admission of Israel to, 17, 109, 141, 142 375 admission of South Korea to, 121-4, 312-4, 355 resolution on, 45 resolution on, 54 Pan American Sanitary Bureau, 94, 181, 282, 308, application of San Marino for, 290-2, 312, 355 381-3 resolution on, 54 statement by Director of, 55, 384 Mental health, 128 See also Pan American Sanitary Organization collaboration in, with UN and other organ-Pan American Sanitary Organization izations, 180, 199, 200, 331 ' Agreement with, 308, 353, 381-3 resolution on, 25 approval of, 52 programme for 1950, 199-201 See also Pan American Sanitary Bureau memorandum on, 200, 389 Para-aminosalisylic acid, 194 revised budget estimates for, 47 Penicillin, 98, 105, 172, 208, 209, 214, 223, 224 World Federation for, 25, 180, 199 Mental Health, Nuclear Expert Committee on, plants, 25, 213, 223, 331 25, 199, 331 Pension Committee, see Staff Benefit Committee Midwives, 156, 157 Permanent Migration Committee, 215 Migration, Permanent Committee, 215 Permanent Council for the Co-ordination of Inter- Milk, supply of, 155, 174 national Congresses of Medical Sciences, 157 proposed collaboration with, 158, 326 resolution on, 19 Neomycin, 223 Pestilential diseases, 99 See also Antibiotics See also under specific disease Nitrogen mustard, 194 Pharmacopoeias, unification of, 172 - 413 - SUBJECT INDEX

Pharmacopoeias, Expert Committee on UnificationRed Cross of International Committee of, 220 reports on third and fourth sessions, 21, 172, Societies, International League of, 194 327, 362 Reference services, 164-8, 222 Philippines See also Library health conditions in, 89 Refugees, see Palestine refugees ; Displaced persons tuberculosis control in, 88 Regional committees, rights and obligations in, Physical training, 215, 331 55, 296-301, 356, 357 resolution on, 26 Regional Office Plague, 169 for Americas, 308 inoculation certificates, 95 See also Pan American Sanitary Bureau programme for 1950, 180 for Eastern Mediterranean, 282, 28-5 training centre in India, 22, 180, 329 for South East Asia, 205, 282, 285, 375 Plague, Joint OIHP/WHO Study-Group on, 175 See also Regional offices report on second session, 22, 180, 329 Regional offices, 80, 99, 103, 282 Podbielniak extractors, 97, 223 revised budget estimates for, 48 Poland, tuberculosis control in, 194 See also Regional Office ;Regional Organ- Poliomyelitis, 182 ization ;Regional organizations ;Europe, Presidential address, 75-8 Special Office for Privileges and Immunities of Specialized Agencies,Regional Organization General Convention on, for Africa, 318, 356 accessions to, 309, 354 resolution on, 56 resolution on, 52 for Europe, 285, 347 extension of, to Associate Members and other resolution on, 44 territories, 319, 357 for Western Pacific, 88, 311, 318, 354 resolution on, 56 resolution on, 54 Programme and Budget for 1950, 276-84, 286-9, 349 See also Regional Office ; Regional organizations adoption of, 46 Regional organizations, 78, 85, 88, 92, 99, 101, 161 rightsandobligationsin,296-300,301, procedure for examination of, 37, 128, 137, 314-8, 356, 384, 399-405 149, 150, 286, 325 resolution on, 55 adoption of, 107 See also Regional Office ; Regional Organization resolutionon,18 See also Budget, Regular ;Budget, Supple-Research, co-ordination of, 172, 196, 329 mental ;Programme 1950, memorandum on, 187, 384 for budget programme for 1950, 173 estimates for revised budget estimates for, 47 Programme for 1950, budget estimates for, 250, resolution on, 23 255-8, 286-9, 342, 397 Resolutions of the Second World Health Assembly, resolution on, 37 see under World Health Assembly, Second revised, 47 Rickettsioses, 180 See also Programme and Budget for 1950 Rockefeller Foundation, 169, 181 Programme, Committee on Rome Agreement of 1907, 50, 351 Chairman, election of, 148 Rules of Procedure of the Health Assembly, see joint meetings with Committee on Administra- World Health Assembly tion and Finance reportsof,347-9 Rapporteur, election of, 149 Salmonella, 173 reports of, 325-35 Centre,International,173 adoption of, 108, 116, 118-20 San Marino, see under Membership of WHO Vice-chairman, election of, 150 Sanitary Conventions, International Publications, 164-7, 186 administration of, 177 distribution and sale of, 167 application and interpretation of, 177 exchange of, 158, 165 revision of, 175-7 revised budget estimates for 1950 programme See also Sanitary Regulations, WHO of, 47 Sanitary Regulations, WHO, 175-7, 328 statistical, 28, 166, 186 resolution on principles for, 22 See also under names of individual publications See also Sanitary Conventions, International Public Health Sanitation, environmental, 80, 168-71 Association, American, 301 collaboration in, with UN and other organ- Institute of, Rome, 192 izations, 168-70 Public-health administration, 95, 206, 214-6 programme for 1950, 169-71 collaboration in, with UN and other organ- revised budget estimates for, 47 izations, 214, 331 Sanitation, Expert Committee on Environmental, resolution on, 26 168 programme for 1950, 216 Sardinia, anophelines in, 183 revised budget estimates for, 47 Schistosomiasis, 182 Seafarers, hygiene of, 215, 332 Secretariat, composition of, 237-40, 341 Quarantine regulations, see Anophelines ; Sanitary See also Staff Conventions, International ; Quarantine, Section Services, advisory and demonstration, to govern- on ments, see Advisory and demonstration services Quarantine, Section on, of Expert Committee on to governments Epidemiology and Quarantine Ships report on first session, 22, 177, 328 disinsectization of, 184 Rabies, 182 inspection of, 177 - 414 - SUBJECT INDEX

Smallpox Syphilis, 154, 156 programme for 1950, 180 See also Venereal diseases vaccination, 180 Smallpox, Joint OIHP/WHO Study-Group on, 175 report on second session, 22, 180, 329 Teaching material, 208, 211 Social Affairs Department, see under United Nations programme for 1950, 212 Social Commission, see under United Nations revised budget estimates for, 47 Social insurance, see Insurance Teaching, medical, 20, 95 South East Asia, Regional Office for, see Regional See also Education, medical Office Technical assistance, 157, 366 South Korea, see Korea, South programme of, 44, 217, 276, 277, 396 Specialized agencies Technical personnel administrative and financialrelations with training of, 80, 92, 95, 99, 157 UN of, 226, 336, 371-3 proposed conference on, 79 resolution on, 31 SeealsoMedical and auxiliarypersonnel, relations with, 302, 352 training of ; resolution on, 51 Tensionsaffectinginternationalunderstanding, See also under name of agency 25, 199 Spirochaetal infections, 154 Town and country planning, 169 See also Venereal diseases Trachoma, 182 Staff, 78, 226, 237-40, 252, 255, 341, 342 371, 372Trachoma, Joint OIHP/WHO Study-Group on, 175 resolution on vacancies for, 36 report on first session, 22, 182, 329 SeealsoStaffBenefitCommittee ;Staff Translation service, 164 Regulations Training,technical,seeMedical and auxiliary Staff Benefit Committee, 116, 117 personnel ;Teaching, medical ;Technical per- composition of, 229, 337 sonnel resolution on, 32 Treatment and control manuals, 167 election of, 228, 263, 344 Treponematoses, 155, 333 resolution on, 39 resolution on, 27 Staff Regulations Trusteeship Council, see under United Nations additions to, 228, 336 Trypanosomiasis, 181, 190 approval of, 32 Tuberculosis, 88, 93, 127, 161, 193-6, 197-9 proposed amendments to, 252, 255 collaboration with UNICEF and other organ- See also Staff izations, 194, 330 StandingCommitteeonAdministrationand resolution on, 24 Finance, 241 consultants, resolution on, 30, 335 Statistical Classification of Diseases, Injuries and group training in penmark, 161 Causes of Death, International, 28, 333 International Union against, 24, 194 See also Manual of the personnel, resolution on, 30, 335 Statistical handbooks, 28, 186, 334 programme for 1950, 195, 197-9 Statistical methods, resolution on, 29, 334 - proposals for, 197-9, 387 Statistics, 28, 29, 166, 185-7, 333 revised budget estimates for, 47 cancer, 28, 334 proposed demonstration area, 80 epidemiological, 29, 334 See also Tuberculosis Research Office programme for 1950, 187 Tuberculosis, Expert Committee on health, 175-7, 333 report on third session, 24, 193-5, 330 collaborationin,with UN and otherTuberculosis Research Office, 195, 286, 386 organizations, 186 Typhus handbooks, 28, 186, 334 inoculation certificates, 95 memorandum on, 185, 367 programme for 1950, 180 national committees, 28, 185, 334 personnel, 187 registration, compilation and transmission Ukrainian Soviet Socialist Republic, 52, 114, 138, of, 29, 334 303-7, 353 resolutions on, 28, 29 UNESCO, 157, 165, 168, 170, 199, 302, 326, 366 teaching of, 187 Agreement with, correction of French text of, hospital, 28, 333 54, 314, 355 medical, 29, 334 resolution on co-operation with, in co-ordina- vital, 29, 334 tion of medical science congresses, 19 See also Statistical UNICEF, 119, 146, 150, 157, 193-7, 211, 302, Statistics, Expert Committee on Health 330, 365 report on first session, 28, 186, 333, 362 resolution on activities with, 24 sub-committees of, 28 See also Joint Committee on Health Policy, Stillbirth, 28, 333 UNICEF/WHO Stomatology, 215 Unification of Pharmacopoeias, see Pharmacopoeias Streptomycin, 93, 98, 104, 127, 193, 194, 208, 209,Union of Soviet Socialist Republics, 52, 114, 138, 214, 223 303-7, 353 See also Antibiotics United Nations, 151, 157, 163, 166, 168, 170, 179, Sulfones, 30, 204, 335 216-20, 226, 302, 368, 371-3 Supplemental Operating Programme of Advisory administrativeandfinancialrelationsof, andTechnicalServices,seeAdvisoryand with specialized agencies, 226, 336, 371-3 TechnicalServices,SupplementalOperating resolutionon,31 Programme of Administrative Committee on Co-ordination, Supplies, medical, see Medical supplies 26, 31, 166, 216, 226, 230, 231, 277, 332, Synthetic drugs, 179 366, 372 - 415 - SUBJECT INDEX

United Nations (contd.) Working capital fund (contd.) Advisory Committee on Administrative and for 1950, 266-9, 344 Budgetary Questions, 226, 246, 371-3 resolution on, 40 Agreement with, correction of French text of, of United Nations, FAO, ICAO, ILO, 267 54, 314, 355 resolution on, 36 Board of Auditors, 230-2, 338 World Conference of Universities, 160 resolution on, 33 World Federation for Mental Health, 25, 180, 199 Economic Commission for Europe, 172, 209, World fund for health defence, 126, 127 213, 285, 331, 366 World Health Assembly resolution on co-operation with, 25 amendments to Rules of Procedure of,69, Economic arid Social Council, 209, 210, 217, 292-6, 310, 314, 354, 355 219, 220, 221, 276, 277, 302, 366, 368 adoption of, 49, 53, 55 See also Technical assistance proposed by Belgium, 310, 354 Expert Committee on Salaries and Allowances, resolution on, 53 226, 371, 373 delegates to InternationalChildren's Emergency Fund, allowances for,226, 336 see UNICEF resolution on, 31 library, 165, 168, 222, 332 insurance of, 227, 336 resolution on, 27 resolution on, 31 loan, 36, 236 revised budget estimates for, 47 Palestine Conciliation Commission, 217-9 World Health Assembly, Second project for relief of Palestine refugees, 217-9, Agenda, 61-66 286, 348, 375 adoption of,16, 72 resolution on, 45 committees, membership of, 11 Social Affairs Department, 157, 199, 214 decisions and resolutions, 15-57 Social Commission, 151 adoption of, 127-9 Trusteeship Council, 214 Honorary Presided, election of, 15, 71 working capital fund of, 267 Journal of, 15, 70 See also Specialized agencies membership of,3-10 UNRRA, 105, 170, 212, 369 President penicillin plants, 25, 213, 223, 331 address by, 75-8 Special Fund, 278, 286 election of, 15, 71 Uruguay, ,health conditions in, 87 Vice-Presidents, election of, 15, 72 World Health Assembly, Third, time and place of, 17, 118, 146 Vaccines, anti-tubercular, standardization of, 195World Health Assembly, Fourth, invitation by Venereal diseases, 93 USA, 118 collaboration with UN and other organizations,World Health Day, 222, 333 152, 325 resolution on, 27 resolution World Health Organization programme for 1950, 153-5 financial report and accounts of, 32, 337 revised budget estimates for, 47 report of the ad hoc committee on, 229, See also International Union against 361 Venereal Diseases, Expert Committee on Headquarters of, see Headquarters of WHO report on second session, 18, 152, 325 Regulations No. 1, see Nomenclature Regula- Venezuelan Association of Health Inspectors, 108 tions Vitamins Sanitary Regulations of, see Sanitary Regula- standardization of, 171, 172 tions, WHO synthetic, 175, 328 World Influenza Centre, 173 resolution on, 21 World Medical Association, 157, 208 Vitamins, Sub-Committee on Fat-soluble report of, 20, 171, 327, 362 Yaws, 154, 192 resolution on, 27 Yellow fever Weekly Epidemiological Record, 164 incubation period for, 176 See also Publications inoculation certificates, 95 Western Pacific, Regional Organization for,see programme for 1950, 181 Regional Organization Yellow-Fever Panel, 175, 180 Whooping-cough, 183 Yugoslavia Working capital fund, 233-5, 236, 250, 341 assistance to, 78 assessments of new Members for, 237, 341 financial support of, for Supplemental Budget, resolution on, 36 278

- 416 - NAME INDEX

Abdel Azim Bey, M. (Egypt), 4Begg, N. D. (Secretariat), 172,Caronia, G. (Italy), 5 Affonso Costa, F. (Brazil), 3 209 Carta, M. (Italy), 5 Afridi,M. K.(Pakistan),7, Benjamin, P. V. (India), 5, 195Carvalho Dias, A. A. de (Por- 149, 153, 155, 161, 178, 181,Berg, C. van den (Netherlands), tugal),7,177 184, 187, 190, 198, 213, 254, 6,116,117,123,199, 231, Castillo Plaza, A. (Venezuela), 8 266, 268, 269, 279, 287, 289 237, 282, 288, 290, 291, 292, Cattan, S. (Italy), 6 Ago, R. (World Federation of 293, 294, 299, 300, 301, 302, United Nations Associations), 304, 305, 312, 315, 318, 319 Chaussinand, R.(International 10 Bergami, G. (Italy), 5 Leprosy Association), 10, 203 Akbani, O. M. (Pakistan), 7 Bergman, R. (Sweden),7,111 Cherubini, L. (Republic of San Marino), 9 Allwood-Paredes, J.(El Salva-Bernard, L. (France), 4, 165, 213 dor),4,149, 154, 172, 180,Bertrand, P.(France), 4,233, Chisholm, Brock (Director- 279, 299 234, 250, 271 General), Secretary of the Assembly,11,74,91,112, Alsted, G. (League of Red CrossBhayung, L. (Thailand), 7, 283 113, 122, 123, 124, 136, 137, Societies), 10, 194 Biraud, Y. M. G. (Secretariat), 138, 139, 140, 141, 142, 143, Alvarez de la Cadena, J. (Mexico), 175, 176, 182, 183 144, 145, 243, 246, 247, 271, 6 Bjørnsson, J. (Norway), 6, 246, 274, 275, 276, 277, 279, 280, Al-Wahbi, S. (Iraq), 5, 280 256, 257, 258, 269, 281 282, 292, 302, 303, 304, 306, Amrit Kaur, Rajkumari (India), Bocaranda, V. M. (Venezuela), 8 307 Chairman, Committee on Nomi- Boeri, E. (Monaco), 6 Choi, Chang-Soon (South Korea), nations, 5, 11, 71, 79, 107, 112, 9, 129, 312 Boidé, D. (France), 4 114, 136, 137, 139, 140, 145, Churchard, M. B. A.(United 168, 291, 299, 303, 304, 306,Brady, T. J.(Ireland), 5, 231, Kingdom), 8 308 240, 247, 250, 252, 256, 258, Churchill, Alix J. (International Andersen, O. (Denmark), 4 265, 268, 272, 273, 281, 287, 298, 307 Association for-the Prevention Angeles, M. C. (Philippines), 7Bridges, Miss D. C. (International of Blindnes), 10 Annecke, D. H. S.(Union of Council of Nurses), 10, 206 Client),SirRaphael(United South Africa), 8 Briskas, S. (Greece), 5, 119, 161, Nations), 9, 151, 163, 166 Arends, J. R. (Netherlands), 6 172, 174, 221, 282 Clark G.(International Union Armand Ugón, V. (Uruguay), 8Bruggen, C. van der (Belgium), a gainst the Venereal Diseases), 3, 205, 226, 228, 246, 252, 258, 10, 152 Ascoli, M. (Italy), 6 266, 283, 288 Claveaux,E. M. (Uruguay), Avery, B. F. (Iran), 5, 191, 270,Brunskog, U. (External Auditor), Vice-Chairman, Committee on 295, 314, 315 229 Credentials, 8, 11, 74, 86, 281 Aykroyd, W. R. (FAO), 9, 173,Bucht, S. F. V. (Sweden), 7 Clements,F. W. (Secretariat), 174, 189 Bustamante, M. E. (PASO), 10 174 Buurman, O. (Germany, BritishClemmesen, A. C. (Denmark), 4 Babecki, V. J. (Poland), 7, 191, zone), 9 Cocchi, C. (Italy), 6 194, 198, 208, 214, 216, 222, 224, 277, 288 Cochrane, R. G. (India), 5, 204 Babione, R. W. (United St'ates of Calderone, F., Adviser to Assem-Coigny, R. L. (IRO), 9 bly Secretary, 11 America), 8, 153, 154 Corradetti,A.(ItalY),6,181, Bahar, H. (Pakistan), 7 Calderwood, H. B. (United States 183, 189, 192 of America), Rapporteur, Com- Bakács, T. (Hungary), 5,123, mittee on Constitutional Matters, Cotellessa, M. (Italy), Honorary 271, 281 8, 11, 107, 114, 290, 297, 300, President, 5, 11, 68, 131 Ba Maung, (Burma), 3 308, 320 Cramarossa, S. (Italy), 5, 170 Bandaranaike,S.W.R.D. Calseyde,P.J.J.vande (Belgium), 3 (Ceylon), Vice-President, 4, 11, Dausset,F. (World Federation 83, 136, 137, 138, 139, 140, 144,Cambournac, F. J. (Portugal), 7 of United Nations Associa- 290, 291, 293, 294, 296, 297,Cameron, G. D. W. (Canada), tions), 10 299, 300, 304, 305, 306 3, 117, 149, 187, 195, 209, 254, Barkhuus, A. (United Nations), 262, 266 Davidson, Sir Andrew (United 9, 157, 214 Canaperia, G. A. (Italy) (Inter- Kingdom), 8, 170, 198 nationalUnionagainstthe Davin,T.P.(New Zealand), Barrett, R. H. (United Kingdom), Venereal Diseases), Chairman, 6, 227, 229, 231, 233, 247, 250, 8, 158, 159, 161, 166, 167, 172, Committee on Credentials,5, 251, 252, 260, 263, 265, 266, 212 10, 11, 70, 101, 107, 165, 167, 267, 271, 275, 278, 283, 300, Bastianelli, G. (Italy), 5 294 310, 311, 312 - 417 - NAME INDEX

Davis,L.S.(New Zealand),Frandsen, J. (Denmark), 4 Hafezi, M. (Secretariat), 301 Vice-Chairman, Committee on Hakim, A. (Syria), 7 Constitutional Matters, 6,11, Fraschina, F. (Switzerland),7, 293, 296, 299, 301, 314, 318 162 Halstead,J.G. H.(Canada), 4, 233, 235, 237, 239, 247, 252, Diesen, A. (Norway), 6 Fróes,H.P.(Brazil),3,94, 136, 290, 298, 301, 317 260, 265, 268, 274, 275, 294, Domanska, Irène (Poland), Vice- 300, 303, 308, 311, 313, 317 Chairman, Committee on Pro-Frontali, G. (Italy), 5, 155 Hargreaves, G. R. (Secretariat), gramme, 7, 11, 103, 122, 178,Frugoni, C. (Italy), 5 199, 201 193, 196, 211, 221 Hedley, O. F. (United States of Donna, P. di (Italy), 6 America), 8 Gabaldán,A.(Venezuela),8, Dowling, D. A. (Australia), 3, 71, 73, 298 Hertzog, R. P. (Bolivia), 9 137, 144, 149, 153, 156, 161, 163, 164, 166, 168, 186, 201, Galeazzi-Lisi, R. (Vatican State), Hessling, H. C. (Netherlands), 6 205, 207, 209, 216, 217, 218, 9 Hill, W. Martin (United Nations), 9, 217 219, 221 Garza-Ramos, M.(Mexico),6, Downes, H. E.(Australia),3, 299, 300 Hoffer, O. (International Dental Federation), 10 128, 232, 234, 245, 250, 255, Gasperi, A. de (Italy), 67 259, 260, 261, 262, 266, 270, Htijer,J. A. (Sweden),7, 264 271, 273, 278 Gaud, M. (OIHP), 9 Holm, J. H. (Denmark), 4, 112, Dujarric de la Rivière, A. R.Gautier, R. (Assistant Director- 161, 195, 199, 287 (France), 4, 121, 131, 154, 155, General), Adviser to AssemblyHolma, H. (Finland), 4, 222 Secretary, 11, 171, 173 171, 173, 177, 185, 193, 204, Holt, G. P. (United Kingdom), 8 225, 281 Gear, H.S.(Union of South Africa), 8, 149, 159, 162, 166, Howard- Jones, N. (Secretariat), Duren, A. N. (Belgium), 3, 297, 164, 165, 166, 167 315 168, 175, 202, 205, 210, 258, 261, 274, 277, 283, 286, 293, Hyde,H.(UnitedStatesof 293, 296, 316 America), Chairman, Committee Ejercito, A. (Philippines), 7, 122, Geeraerts, L. A. D. (Belgium), 3, on Programme, 8, 11, 137, 138, 162, 163, 170, 174, 190, 191, 124, 291, 292, 294, 299, 309, 139, 141, 143, 144, 146, 147, 193, 216, 269 310, 311, 317, 318, 319 148, 150, 152, 155, 159, 164, 167, 172, 175, 178, 184, 188, El-Chorbachi, A. R. (Iraq), 5, 217 Gerin, C. (International Academy 192, 196, 200, 203, 208, 211, Elicafio, T. (Philippines), 7, 150, of Legal Medicine and of Social 218, 222, 264, 276, 283, 288 Medicine), 10 313, 320 Hylander, F. B. (Ethiopia), 4 Eliot, Martha (Assistant Direc-Glaser, K. S. (Germany, British tor-General), Adviser to Assem- Zone), 9 bly Secretary, 11 Ingram, G. M. (United States El lender, Allen J. (United States 172, 195, 220, 282, 314 of America), 8, 228, 229, 260 of America), 8 Goodman, N. (Acting Assistant L'Eltore, G. (Italy), 6, 125, 126 Director-General), Adviserto Johnson, H. G. ( Japan), 9 El Zahawi, S. (Iraq), 5, 154, 155, Assembly Secretary,11,196, 197, 201, 202, 217, 285 Joll, A. E. (United Kingdom), 182 8, 185, 186, 309 Engler, G. (Panama), 9 Goodwin, G. L. (UNESCO), 9 Jones, C. (IRO), 9 Enna Is, J. A. F. (World Federa-Goossens, J. F. (Belgium), 3, 164 tion of United Nations Associa- Goudsmit, C.J.(Netherlands), tions), 10 6, 227, 232, 251, 255, 262, 264, Kadury, B. (Israel), 5 Evang, K. (Norway) President ; 268, 269, 270, 271, 298, 308, Karabetsos,S.(Greece),5, 89 Chairman, General Committee, 309, 310 6, 11, 72, 75, 86, 91, 102, 107, Kaul, P. M. (Secretariat), 178, 205 109, 118, 125, 136, 137, 138, Grasset,E.(Switzerland),7, Kazi, F. U. (Pakistan), Rappor- 139, 141, 142, 143, 144, 145, 149, 154, 165, 173 teur, Committee on Credentials, 146, 148, 225, 290 Green, Kathleen V. (United King- 7, 11, 70, 91, 107, 108, 109, Evans, A. D. Meurig (United dom) 8, 293, 306 299, 301, 306 Nations), 9, 260 Grégoire, J. (Canada), 4 Khaum, A. (Austria), 3, 92 Grisolia, M. (Italy), 6 Khoury, E. (Lebanon), 6 Farouk, G. (Afghanistan), 3 Grut, A. (ILO), 9, 158, 162, 200, Khoury, N. (Lebanon), 6 Faville,Katharine E.(United 203, 314 Klosi, S. (Albania), 3, 115, 122, States of America), 8 Grzegorzewski, E. (Secretariat), 191, 201, 203, 208, 212, 221, Felix, R. H. (United States of 157, 158, 159, 160 267, 272, 287 America), 8, 201, 202, 203 Guidi di Bagno, R. (Italy), 6 Knack,A.(Germany,British Forest, W. R. de(Germany, Guthe, Th.(Secretariat),152, Zone), 9 American Zone), 9 153, 154 Koekebakker, J. (UNESCO), 9 Forrest, W. P. Secretary, Com- Kota, F. (Albania), 3 mittee on Programme, 11, 149,Gutierrez Osorio,J.J.(Vene- 151, 154, 158, 163, 166, 171, zuela), 8 Kozusznik, B. (Poland), 264 184, 187, 194, 203, 209, 215, Gutteridge, F. (Secretariat), 309, Krikos, A. (International Dental 219, 286, 288 319 Federation), 10 - 418 - NAME INDEX

Ladt, M. de (Belgium)(Inter- Miller, J. R. (United States ofPlimsoll, J. (Australia), 3, 227, national Academy ofLegal America) (World Medical Asso- 228, 230, 295, 302, 305, 311, Medicine and of Social Medi- ciation), 8, 10, 221 312, 313 cine), 3, 10, 126, 239 Mitra,SirDhiren(India),5, Plojhar,J.(Czechoslovakia), 4, Latsky, J. M. (FAO), 9 292, 293, 296, 299, 311, 314 95 Lavarène,C.de(France),4, Moore C. (Secretariat), 311, 318 Plunkett, J. E. (Canada), 4 229, 251, 253, 258, 267, 274Morelli, E. (Italy), 6 Polman, A. (Netherlands), 6, 221 Leclainche, X. (Secretariat), 206, Moreton,J.O. (United King-Pozzilli, P. (Italy), 6 207, 214, 215 dom), 8, 298, 299, 300, 316, Pozzo, A. A. (Argentina), 3, 130, Lee, D. B.(United States of 317, 319 271, 279 America), 8, 169 Morgan, M. T. (OIHP), 9, 300Pulcher, F. (International Hos- Lewen stein, H. (Germany, Mudaliar, Sir Arcot Lakshmana- pital Federation), 10 British Zone), 9 swami (India), 5, 130, 149, 161, Puntigam, F. (Austria), 3 Lifshitz,B.(Republic of San 166, 228, 231, 232, 238, 247, Marino), 9 250, 253, 256, 259, 262, 264,Puntoni, V. (Italy), 5, 182, 235 Lindsay, T. (United Kingdom), 265, 269, 273, 274, 278, 284 Rapporteur, Committee on Miller, C. (Switzerland), 7, 248, Radcliffe,W.D.(Germany, Administration and Finance, 8, 261, 265, 283, 295 American Zone), 9 11, 121, 226, 227, 228, 229, 232, 233, 234, 235, 239, 240, Radji, A. H. (Iran), Rapporteur, 241, 247, 250, 251, 254, 256,Nazif Bey, M. (Egypt), 4, 120, Committee on Programme, 5, 258, 259, 261, 262, 263, 264, 122, 175, 251, 260, 264, 268, 11, 99, 108, 149, 160, 222, 283 265, 266, 267, 272, 273, 280, 272, 274, 281, 287 Rae, A. M. W. (United Kingdom), 288, 291 Noack, F. (Israel), 5, 109, 218, 8, 154, 180, 181, 190, 202, 205 Livadas, G. (Greece), 5 219 Raffaele, G. (Italy), 6 Lopes da Costa, O. (Brazil), 3 Raja, K. C. K. E. (India),5, Lundquist, G. A. R. (Sweden), 7 151, 152, 153, 154, 159, 163, CEconomopoulos, N. (Greece), 5, 164, 169, 171, 175, 176, 178, 193, 194 180, 182, 184, 185, 186, 187, MacCormack, J. D. (Ireland), 5, Olcar, K. (Turkey), 7, 272, 282 195, 196, 197, 200, 202, 203, 149, 150, 154, 158, 167, 169, 205, 207, 209, 210, 213, 218, 175, 203, 207, 219, 288, 289 219, 221 Palmer, C. E. (Secretariat), 195 Mackenzie, Melville (United Rajendram, S. (Ceylon), 4, 191 Kingdom), 8, 81, 121, 136, 137, Pampana, E.J.(Secretariat), Reeler, N. A. G. (Union of South 139, 146 188, 190 Africa), 8, 231 Mac lay, W. S. (United Kingdom), Pantaleoni, M. (Italy),6,228, Rees, J. R. (World Federation for 8, 200 291, 298, 299, 300 Mental Health), 10, 180 Madsen, T. (UNICEF), 9 Paolini, R. (Italy), 5, 220, 305, Repond, A. (Switzerland) (World Maisin, J. (Permanent Council for 309 Federation for Mental Health), theCo-ordinationofInter-Parisot, J. (France), 264 7, 10, 200 national Congresses of MedicalPascua, M. (Secretariat), 11, 186Retta, A. (Ethiopia), 4, 170, 307 Sciences), 10, 159 Pasricha, C. L. (India), 5 Rham, M. J. de (Switzerland), Ma llick,S. M. K.(Pakistan), 7, 306 7, 198 Pate, M. (UNICEF), 196, 197Riddoch, J. H. (United King- Mani, C. Secretary, Committee on Paula Souza, G. H. de (Brazil), dom), 8 Constitutional Matters, 11, 290, 3, 160, 185, 202, 205, 279 Rizk, E. A. (Lebanon), 6 292, 296, 299, 303 Penso, G. (Italy), 6, 154, 163,Rodhain, J. A. H. (Belgium), 3, Maxi, A.S.(Union of South 164, 194, 195, 199, 213 154, 181, 183, 190, 205 Africa), 8 Pereira,A.R.(Portugal),7, Rogers, E. S. (United States of Marinho, I. P. (Brazil), 3 299,315, 317 America),8,149,233,234, Perez, M. C. (Costa Rica), 4 235, 236, 239, 243, 247, 249, Markowski, E. (Poland), 7 250, 253, 254, 256, 257, 258, Petrov-Mevorach, V. (Bulgaria), 263, 267, 268, 269, 273, 287 Marotta, D. (Italy), 5 3 Martin, W. Strelly (Germany,Pfeifer, Joseph L. (United StatesRoozendaal, N. A. (Netherlands), British Zone), 9 of America), 8 6 Rowland, J. R. (Australia), 3 Martinez, P. (Chile), 4, 254, 272,Pharaon, R. (Saudi Arabia), 7 273, 280, 313 Piacentini, G. (International Mattei, P. di (Italy), 5 Union for Child Welfare), 10,Sahibzada, A. K. (Pakistan), 7 Maystre, J. (World Medical Asso- 152 Sakkaf, O. (Saudi Arabia), 7 ciation), 10, 208 PignatellidellaLeonessa,L. Salvadori, M. G. (Inter-American (Italy), 6 McDougall, J. (Secretariat), 193, Association of Sanitary En- 194, 195, 199 Pincus, M. S. (Secretariat), 168, gineering), 10 301 Salveraglio, F. J. (Uruguay), 8 Me lls, F. A. (United Kingdom), 8 Pinho, B. A. V. de (Portugal),Sanctis,C.de(Italy)(World Mer, G. G. (Israel), 5 7,174, 216 Federation for Mental Health), Mile'inski, J. (Yugoslavia), 9 Play Ai6, C. (Yugoslavia), 9 6, 10 - 419 - NAME INDEX

Sandberg, H. Th. (Norway), 6Spallicci, A. (Italy), 5 Togba, J. N. (Liberia), Rappor- Santos, R. (Brazil), 3, 124 Stampar,A.(Yugoslavia),9, teur,Committee on Nomina- Savoie, A. M. (Canada), 4 67, 70, 78, 137, 144, 146, 211, tions, 6, 11, 71, 73, 111, 123, 136, 139, 145, 272, 293, 294, Savonen, S. (Finland), 4, 90 221, 237, 255, 277, 282, 286, 290, 291, 300, 313 298, 299, 313, 314, 318 Scander,Pasha,N.(Egypt), Tok, E. (Turkey), 7, 98 Vice-President of the Assembly, Steinberg, L. (Israel), 5 4, 11, 118 Steinig, L. (United Nations), 9,Tommasi, L. (Italy), 6 Scheele, L. A. (United States of 179 America), 8, 102, 118, 119, 122, Steinvorth, E. (Costa Rica), 4,Unger, A. (Germany, American 129, 165, 201, 207, 209, 210, 251, 281 Zone), 9 223, 224, 264, 265, 271, 275, 280, 282, 288 Steinvorth, O. {Costa Rica), 4 Valpakon, M. C. (Thailand), 7 Schmol, P. (Luxemburg), 6 Stock, P. G. (United Kingdom), Varela Fuentes, B. (Uruguay), 8 Schneiter, P. (France), 4 8, 177, 182, 183, 184 Stowman, K. (United States ofVaucel, M. A. (France), 4, 137, Schober,B.(Czechoslovakia), America), 8, 176, 185 291, 294, 297, 299, 305, 315, Chairman, Committee on Admi- 316, 318 nistration and Finance, 4, 11, Stoyanoff, S.(Bulgaria), 3, 99, 115, 116, 117, 129, 136, 140, 115, 119, 121, 123, 124, 212,Vernoni, G. (Italy), 6 143, 197; 225, 227, 235, 238, 216, 272, 291, 308, 311, 313 Veronese, P. (Italy), 6 243, 248, 254, 257, 261, 292, Strobl, K. (Austria), 3 Villarama, A.(Philippines),7, 298, 299, 300, 303, 305, 306, Stuart, G. (Secretariat), 177, 181, 73, 87, 123, 221, 222, 226, 227, 308 182 228, 231, 251, 291, 295, 296, Scola Camerini, G. (Italy), 6 300, 305, 306, 307, 310, 311, Suwadji Prawirohardjo, R. 312 Seiffert, G. (Germany, American (Netherlands),6 Zone), 9 Vollenweider,P.(Switzerland), Suzzi-Valli, E. (Republic of San Chairman, Committee on Con- Sen, S. C. (India) (World Medical Marino), 9, 290 Association), 5, 10 stitutional Matters, 7, 11, 136, Sweilim, S. (Egypt), 156 290, 292, 295, 300, 301, 305, Shah, M. H. (Pakistan), 7 308, 312, 320 Shousha, Pasha, Sir Aly TewfikSwitzer, M. E. (United States of (Egypt), 4, 75, 217, 218, 219, America), 8, 291, 313 220, 290, 291, 296, 297, 303,Szapiro, J. (United Nations), 9Watt,Katherine C. (United 305, 318 Kingdom), 8, 207 Shu, Y. Ch. (Secretariat), 208, Wickremesinghe, W. G. (Ceylon), 212 Tagaroff, P. (Bulgaria), 3, 127, 4, 112, 156, 160, 169, 176, 192, 162, 199, 208, 209, 221 197, 209, 213, 222, 263, 264, Sidky, M. M. (Secretariat), 181 267, 278 Siegel, M. P.,Secretary, Com- Tahitu, D. P. (Netherlands), 6 mittee on Administration andTaljaard, C. H. (Union of South Williams, Cicely (Secretariat), 151 Finance, 11, 225, 227, 231, 236, Africa), 8, 318 Wright, Louise (United States 239, 248, 254, 257, 262, 266, of America), 8, 293, 296, 302, Tejera, E. (Venezuela), 8 314, 317 271, 273, 284 Telesio di Toritto, G. (Italy), 5 Sigurjonsson, J. (Iceland), 5, 280 Yamaguchi, M. (Japan), 9 Silva Travassos, A.da(Por- Thélin, G. (International Union tugal), 7, 298, 318 for Child Welfare), 10, 174 Zahir, A. (Afghanistan), 3 Simonovits,I.(Hungary);5, Thomen, L. F. (Dominican Re- 97, 113, 120, 123, 161, 164, public), Vice-Chairman, Com- Zarb,A.H.LegalSecretary, 182, 201, 209, 216, 220 mittee on Administration and Committeeon Constitutional Finance, 4, 11, 72, 73, 106, 154, Matters,11, 291, 301, 308, 313, Solar,A.U.(Inter-American 227, 231, 238, 266, 270, 273, 319 Association of Sanitary Engi- 279, 285, 288 neering), 10 Zhukova, Irina M. (UNESCO), 9, Timmerman, W. Aeg. (Nether- 157 Soper, F. L. (PASO), 10, 308 lands), 6, 149, 155, 171, 193, Zozaya, J. (Mexico), Vice- Sorensen, B. (Denmark), 4 195 President, 6, 11, 264

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