The Work of WHO 1992-1993 Biennial Report of the Director-General CORRIGENDUM Page 2, column 1, line 1: Delete 1993. The increase of$ 105 523 000 or 14.46% in Insert 1993. The net increase of$ 87 165 000 or 11.86% in The Work of WHO 1992·1993 The Work of WHO 1992·1993 Biennial Report of the Director-General to the World Health Assembly and to the United Nations ~ . 'I .. ~ ~-~ ~ ~ ~""?~ World Health Organization Geneva 1994 The texts of the World Health Assembly and Executive Board resolutions referred to in this report can be found in the Handbook ofResolutions and Decisions of the World Health Assembly and the Executive Board, Volume I, 1948-1972, Volume II, 1973-1984 and Volume Ill, third edttion (1985-1992). Throughout this volume the $ sign denotes US dollars. The abbreviations used in this report include the following: ACC -Administrative Committee on Coordination OAU -Organization of African Unity ACHR -Advisory Committee on Health Research OECD - Organisation for Economic Co-operation AGFUND -Arab Gulf Programme for United Nations and Development Development Organizations PAHO - Pan American Health Organization ASEAN -Association of South-East Asian Nations SAREC - Swedish Agency for Research Cooperation CIDA -Canadian International Development with Developing Countries Agency SIDA - Swedish International Development CIOMS -Council for International Organizations of Authority Medical Sciences UNCTAD -United Nations Conference on Trade and DANIDA -Danish International Development Agency Development ECA -Economic Commission for Africa UNDCP -United Nations International Drug Control ECE -Economic Commission for Europe Programme ECLAC -Economic Commission for Latin America UNDP -United Nations Development Programme and the Caribbean ESCAP - Economic and Social Commission for Asia UNDRO -Office of the United Nations Disaster Relief and the Pacific Coordinator ESCWA - Economic and Social Commission for UNEP -United Nations Environment Programme Western Asia UNESCO -United Nations Educational, Scientific and FAO -Food and Agriculture Organization of the Cultural Organization United Nations UNFPA -United Nations Population Fund FINNIDA -Finnish International Development Agency UNHCR -Office of the United Nations High Com­ GTZ -German Technical Cooperation Agency missioner for Refugees IAEA - International Atomic Energy Agency UNICEF -United Nations Children's Fund IARC -International Agency for Research on UNIDO -United Nations Industrial Development Cancer Organization ICAO -International Civil Aviation Organization UNRWA -United Nations Relief and Works Agency for IFAD -International Fund for Agricultural Devel- Palestine Refugees in the Near East opment USAID -United States Agency for International ILO - International Labour Organisation Development (Office) WFP -World Food Programme IMO - International Maritime Organization WHO -World Health Organization ITU -International Telecommunication Union WIPO - World Intellectual Property Organization NORAD -Norwegian Agency for International Development WMO -World Meteorological Organization The World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and enquiries should be addressed to the Office of Publications, World Health Organization, Geneva, Switzerland, which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. ISBN 92 4 156165 3 © World Health Organization 1994 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol2 of the Universal Copyright Convention. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. ISSN 0509 2558 PRINTED IN SWITZERLAND 93/9852-At.r-4700 iv Contents Introduction IX 1. Governing bodies 1 2. WHO's general programme development and management 3 Constitutional and legal matters 3 WHO's programme development 3 Informatics management 4 External coordination for health and social development 4 Emergency relief operations 7 3. Strategy for health for all 11 Monitoring and evaluation 11 Regional and national activities and policies 11 Health for all and economic development 12 4. Health system development 13 Assessment of global health situation and future trends 13 Intensified cooperation with countries and peoples in greatest need 15 Technical cooperation among developing countries 16 Health systems research and development 17 Health legislation 18 5. Organization of health systems based on primary health care 21 National health systems and policies 21 District health systems 23 6. Development of human resources for health 27 Policy analysis, planning and management 27 Nursing 29 Educational development 30 Staff development 33 V THE WORK OF WHO 1992-1993 7. Public information and education for health 35 Public information 35 Education for health 35 8. Research promotion and development 39 9. General health protection and promotion 43 Women, health and development 43 Food and nutrition 44 Oral health 47 Injury prevention 49 Tobacco or health 50 10. Protection and promotion of the health of specific population groups 53 Maternal and child health and family planning 53 Health of adolescents 56 Human reproduction research 58 Occupational health 62 Health of the elderly 63 11. Protection and promotion of mental health 65 Mental health policy, and support to national programmes 65 Psychosocial and behavioural problems and relevant interventions 66 Prevention and control of alcohol and drug abuse 66 Mental and neurological services and treatment 68 12. Promotion of environmental health 71 Community water supply and sanitation 71 Environmental health in rural and urban development and housing 72 International Programme on Chemical Safety 74 Control of environmental health hazards 75 13. Diagnostic, therapeutic and rehabilitative technology 77 Clinical technology 77 Health laboratory technology and blood safety 77 Radiation medicine 78 Technology development, assessment and transfer 78 Drug management and policies 78 Pharmaceuticals 79 Biologicals 80 Traditional medicine 80 Action Programme on Essential Drugs 80 Rehabilitation 82 vi CONTENTS 14. Disease prevention and control 85 Immunization 85 Control of tropical diseases 88 Disease vector control 96 Leprosy 97 Tropical disease research 99 Diarrhoeal diseases 101 Acute respiratory infections 103 Tuberculosis 105 Zoonoses 106 AIDS and other sexually transmitted diseases 108 Other communicable diseases 113 Research and development in the field of vaccines 116 Blindness and deafness 117 Cancer 118 International Agency for Research on Cancer 120 Cardiovascular diseases 121 Other noncommunicable diseases 123 15. Health information support 125 Health literature services 125 WHO publications 126 Technical terminology 128 Distribution and sales 128 16. Support services 129 Personnel 129 Office accommodation 129 Budget and finance 130 Equipment and supplies for Member States 131 Map showing regional offices and the areas they serve 132 17. African Region 133 18. Region of the Americas 137 19. South-East Asia Region 141 20. European Region 145 21. Eastern Mediterranean Region 149 vii THE WORK OF WHO 1992-1993 22. Western Pacific Region 153 Annex 1. Members and Associate Members of the World Health Organization 159 Annex 2. Regional distribution of Members and Associate Members of the World Health Organization 161 Annex 3. Organizational and related meetings, 1992-1993 163 Annex 4. Intergovernmental organizations that have entered into formal agreements with WHO approved by the World Health Assembly, and nongovernmental organizations in official relations with WHO at 31 December 1993 164 Annex 5. Structure of the World Health Organization at 31 December 1993 (charts) 167 Index 171 viii Introduction The period 1992-1993 was marked by deep economic and social tensions as well as ethnic, religious and territorial conflicts, on a scale unprecedented since the second world war. In these difficult circumstances WHO continued to deliver its programme of work, to help countries sustain their health achievements, strengthen their human resource capabilities, and enhance their disease prevention and control activities. At the same time WHO initiated a review of its policies, management and structures in order to adapt to the challenges, constraints and opportunities of the changing global envi­ ronment. In 1993, within the overall reform process undertaken with the Executive Board and its working group on the WHO response to global change, I introduced a number of mechanisms to enhance coordination throughout WHO's worldwide network. The Global Policy Council, whose membership includes the Regional Directors, and the Management Development