WORLD I-IEALTH ORGANIZATION REGIONAL OFFICE FOR SOUTH-EAST ASIA 'I'W1:NTY-ISIGIITIl ANNIJ \L I~I~l'Ol~~ OF THE REGION \L DIRECTOR TO TIIE: REGION 11, (:O~lMI'lTb~EFOR SOI"r11-EAST /\St 1 1 JULY 1975 - 30 JUNE 1976 SEA/RC29/2 Page iii CONTENTS Pase INTRODUCTION vii PART I - GENERAL REVIEW OF ACTIVITIES 1 STRENGTHENING OF HEALTH SERVICES Planning and Development of Health Services Health planning, programme formulation and evaluation Organization of basic health services Medical care Operational studies Rehabilitation Family Health Nursing Health Education Nutrition Oral Health Mental Health Drug Dependence Quality Control of Pharmaceutical and Biological Products Medical Stores Management 2 DISEASE PREVENTION AND CONTROL - COh?WNICABLE DISEASES Epidemiological Surveillance Malaria Tuberculosis Diseases Subject to the International Health Regulations Smallpox eradication Cholera and other enteric diseases Plague Bacterial Diseases Leprosy Sexually-transmitted diseases Diphtheria, pertussis and tetanus Meningococcal meningitis Virus Diseases Trachoma Poliomyelitis Haemorrhagic fever Influenza and other virus diseases Parasitic Diseases Schistosomiasis Filariasis Veterinary Public Health Expanded Programme of Immunization Immunology Vector Biology and Control SEAIRC29 12 Page iv Page 3 DISEASE PREVENTION AND CONTROL - NON-COMNUWICABLE DISEASES 37 3.1 Cancer 3.2 Cardiovascular Diseases 3.3 Blindness 4 HEALTH LABORATORY SERVICES 40 4.1 Reference Laboratories 4.2 Quality Control 4.3 Laboratory Animals 4.4 Laboratory Instrumentation 5 PROMOTION OF ENVIRONMENTAL HEALTH 4 3 5.1 Environmental Health 5.2 Occupational Health 5.3 Radiation Health 5.4 Hazards to Man from Pesticides 6 HEALTH STATISTICAL SERVICES AND INFORMATION SYSTEMS 4 7 DEVELOPMENT OF HEALTH MANPOWER Medical Education Paediatric and Obstetric Education Teaching of Human Reproduction, Family Planning and Population Dynamics Nursing Education Education in Sanitary Engineering Training of Auxiliaries Group Educational Activities Fellowships The Regional Office Library 8 BIOMEDICAL RESEARCH 6 3 9 TECHNICAL INFORMATION AND REFERENCE SERVICES 64 PART I1 - ORGANIZATIONAL AND ADMINISTRATIVE MATTERS 1 THE REGIONAL COMMITTEE 67 2 REGIONAL PROGRAMME PLANNING AND DIRECTION 69 3 ADMINISTRATION 3.1 General 3.2 Organizational Structure 3.3 Personnel 3.3.1 Staffing SEA/RC29/2 Page v Page 3.3.2 Briefing 3.3.3 Staff training 3.3.4 Employment conditions 3.4 Finance, Budget and Accounts 4 PROCUREMENT OF SUPPLIES AND EQUIPMENT COLLABORATION WITH OTHER AGENCIES United Nations United Nations Development Programme (UNDP) United Nations Children's Fund (UNICEF) United Nations Fund for Population Activities (UNFPA) Economic and Social Commission for Asia and the Pacific (ESCAP) World Food Programme (WFP) International Atomic Energy Agency (IAEA) United Nations Industrial Development Organization (UNIDO) Specialized Agencies Food and Agriculture Organization of the United Nations (FAO) International Labour Organisation (ILO) United Nations Educational, Scientific and Cultural Organization (UNESCO) International Bank for Reconstruction and Development (IBRD) Non-governmental Organizations in Official Relations with WHO Bilateral and Other Agencies 6 PUBLIC INFORMATION PART 111 - ACTIVITIES UNDERTAKEN BY GOVERNMENTS WITH THE HELP OF WHO PROJECT LIST Bangladesh Bhutan Burma Democratic People's Republic of Korea India Indonesia Maldives Mongolia Nepal Sri Lanka Thailand Inter-country Inter-regional (Projects Within the Region) Inter-regional (Projects Outside the Region with Participants from the South-East Asia Region) ANNEXES 1 Organizational Structure 2 Geographical Distribution of International Staff Assigned to the South-East Asia Region as of 30 June 1976 SEAIRC29 12 Page vi Page 3 Meetings and Courses Organized by WHO and Held in the South-East Asia Region (1 July 1975 - 30 June 1976) 219 4 Conferences and Meetings in the South-East Asia Region Called by the United Nations and Its Related Specialized Agencies at which WHO was Represented (1 July 1975 - 30 June 1976) 223 5 Conferences and Meetings of Governmental. Non-governmental and Other Organizations Held in the South-East Asia Region at which WHO was Represented (1 July 1975 - 30 June 1976) 224 6 Fellowship Tables 225 7 List of Technical Reports Issued by the Regional Office (1 July 1975 - 30 June 1976) 8 Budget Performance 255 GRAPHS 1 Population at Malaria Risk and Detected Malaria-Positive Cases in Areas Under Different Categories of Anti-malaria Operations in the South-East Asia Region (1967-1976) 2 Fellowships Awarded by WHO in the Last Five Years (1971-1975). South-East Asia Region 3 Obligations Incurred on Field Activities in the South-East Asia Region (1971-1975) The following abbreviations are used in the Annual Report: DANIDA Danish International Development Agency ESCAP Economic and Social Commission for Asia and the Pacific FA0 Food and Agriculture Organization of the United Nations FUNDWI Fund of the United Nations for the Development of West Irian IAEA International Atomic Energy Agency IARC International Agency for Research on Cancer IBRD International Bank for Reconstruction and Development ILEP International Federation of Anti-leprosy Associations ILO International Labour Organisation NORAD Norwegian Agency for International Development SIDA Swedish International Development Authority UNADI United Nations Asian Development Institute, Bangkok UNDP United Nations Development Programme UNEO United Nations Emergency Operations UNEP United Nations Environment Programne UNFDAC United Nations Fund for Drug Abuse Control UNFP A United Nations Fund for Population Activities UNICEF United Nations Children's Fund UNIW United Nations Industrial Development Organization US AID United States Agency for International Development WFP World Food Programme SMALLPOX ZERO ! Three-year old Rahima Banu of Kuralia village, Bangladesh: the last ease of smallpox in South-East Asia. 16 October 1975. (Photo by P. Claquin) SEA/RC29/2 Page vii INTRODUCTION This year has seen unprecedented success with the elimination of smallpox from the Region, but this achievement continues, unfortunately, to be overshadmed by the fact that most countries are still persevering to meet merely the minimal health needs of the people. This task is, moreover, of such magnitude and the resources are so meagre that it has become difficult to make really significant progress in finding solutions to the varied health problems facing our countries. The resources of WHO also are limited, and the recent financial crisis faced by UNDP has added to the problem. To maintain some of the on-going priority projects hitherto supported by UNDP, funds from the WHO ~cgular budget had to be diverted, with the result that some of the programnes under the regular budget had to be adjusted. Country Health Programming It is now quite evident that to solve the health problems of the millions of people in the countries of the Region who are still underserved, the attitude to health development must undergo a change. Priorities and strategies must be rearranged and reoriented to overcome or circwnltent the existing constraints on resources. We must develop down-to-earth, broad, action programnes,rather than isolated vertical projects,to meet the basic health needs within the limits of available resources. There is.an urgent need for the application of modern management methods and scientific techniques of planning. These can help in the sharper definition of priority health problems, in the more careful setting of attainable goals and objectives, in developing more realistic health programmes and ensuring their effective implementation in order to achieve these goals. The old, stereotyped approaches to solving complex problems haue to be modified or replaced by innovative ideas to suit the needs of the times. As far as practicable the health programnes should not only be for the people but also of the people and by the people. We must realize that the success of a progrme will greatly depend on the participation of the people through its integration into the social fabric. Sophistication may thus have to be partly sacrificed, but the desired degree of effectiveness will be more easi ly achieved. In this context, the Sixth General Programne of Work of WHO for the period 1978-1983 is certainly an improvement over the previous five General Programnes in its more precise definition of priorities and targets, approaches and activities, and output indicators. This programme, which has been approvedby the 29th World Health Assembly, reflects and complements the national priority goals, as it has been formulated in close consultation with Member countries. To facilitate its implementation,a &tai led progrme for the medium term (also 1978-1983/, elaborating the programne activities, is also under preparation. In these activities, there is a shift from isolated vertical projects to composite programmes, with a view to broadening scope, increasing viability, and enhancing effectiveness and efficiency. This shift will plrther open the way to innovative approaches for sharpening the existing strategies and at the same time stimulating newer ones. SEA/RC29/2 Page viii It has become clearer that health development efforts cannot succeed in isolation but must be seen and planned in the context of total socio- economic development. Moreover, in view of the insufficiency of resources to satisfy all health needs, there is an urgent need for judicious investment of what is available. Systematic planning and efficient