,,,IS:- PAN AMERICAN HEALTH ORGANIZATION g_11, . 3 (;¿,N:I.( ) J1,1 LA,K-,j,. 1 annual report of the director 1979 Cover design by 1. Ellauri (Frontispiece photos- top row: World BankIR. Witlin, J. Martin, and E.G. Huffman; second row: World Bank/l. Pickerell and E.G. Huffman, PAHO/CFNI, and World BankiT. Sennett; third row: World BanklE.G. Huffman; bottom row: World Bank/I. Pickerell and 1. Martin) 4, PAHO/WHO INTEROFFICE MEMORANDUM Date: 4 May 1981 From: Herbert H. Ortega, Chief To: Those mentioned below* Information & Public Affairs Our Ref: IPA/057/81 Attention: Your Ref: Subject: NCIH 1981 International Health Conferenc Orígíinator: I bring to your attention the attached pamphlet in regard to the above mentioned subject, which NCIH has requested that we make them available to our technical staff° Please be informed that the following staff members will be participating: Speaker Topic Date & Time Ms. Janice Jaeger-Burns Case-Studies for Regular Jun.16/81 9;10:30 am In-Service Training Dr. Jorge Osuna Technical Management and Jun.16/81 11-12:30 pm Supervision of Primary Health Care Workers Dr. Ciro De Quadros Special Problems in the Jun.17/81 11-12:30 pm Supply of Vaccines for Control of Communicable Diseases ~. Att. *Dr. Sumedhn Khannn, CUS Dr. Jorge Litvak, DPC Mr. Frank Butrico, EHP Dr. J. Roberto Ferreira, HRR Dr. Mario Fernandes, AH 1)r. José M. Salazar-Bucheli, LO ce: D DD AD OM annual report of the director 1979 Official Document No. 171 August 1980 PAN AMERICAN HEALTH ORGANIZATION Pan American Sanitary Bureau * Regional Office of the WORLD HEALTH ORGANIZATION 525 Twenty-third Street, N.W. Washington, D.C. 20037, U.S.A. ISBN 92 75 17171 8 © Pan American Health Organization, 1980 Publications of the Pan American Health Organization enjoy copy- right protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. For rights of reproduction or translation of PAHO publications, in part or in toto, application should be made to the Office of Publications, Pan American Health Organization, Washing- ton, D.C. The Pan American Health Organization welcomes such appli- cations. 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 Pan American Health Organization con- cerning the legal status of any country, territory, city, or area of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' prod- ucts does not imply that they are endorsed or recommended by the Pan American Health Organization in preference to others of a similar nature that are not mentioned. CONTENTS Introduction vii 1. GENERAL DIRECTION OF THE ORGANIZATION 1 Health for all by the year 2000 4 Study of WHO's structure in light of its functions 6 Governing Bodies 6 The Directing Council 7 The Executive Committee 10 Reorganization of the Pan American Sanitary Bureau 10 Relations with other organizations 13 PAHO and the international cooperation system 13 United Nations Development Program 13 United Nations Environment Program 14 United Nations Children's Fund 15 United Nations Fund for Population Activities 15 United Nations Disaster Relief Office 16 United Nations Economic Commission for Latin America 16 United Nations Food and Agriculture Organization 16 World Food Program 16 World Bank 17 League of Red Cross Societies 17 European Economic Community 17 PAHO and the inter-American system 17 Organization of American States 17 Inter-American Development Bank 18 Inter-American Institute of Agricultural Sciences 18 Subregional groups 19 Conference of Ministers Responsible for Health in the Caribbean 19 Caribbean Community 19 Caribbean Development Bank 19 Ministers of Health of Central America and Panama 19 Ministers of Health of the Andean Pact Countries 20 Bilateral agencies 20 Canadian International Development Agency 20 Canadian International Development Research Center 21 United States Agency for International Development 21 German Agency for Technical Cooperation 21 Swedish International Development Authority 21 Foundations 22 W. K. Kellogg Foundation 22 iii 2. DEVELOPMENT OF HEALTH SERVICE SYSTEMS 24 National policies and strategies 25 Planning 28 Medical care systems 30 Physical and financial resources 34 Maintenance of health care facilities 35 Rehabilitation services 37 Health education 38 Management systems 38 National health information systems 40 Maternal and child health and family planning 41 Latin American Center for Perinatology and Human Development 42 Nutrition 43 Caribbean Food and Nutrition Institute 44 Institute of Nutrition of Central America and Panama 46 3. HUMAN RESOURCES AND RESEARCH 48 Manpower planning and administration 49 Development of human resources 52 Technologic resources 62 Regional Library of Medicine and the Health Sciences 63 Educational technology 65 Latin American Centers for Health Education Technology 65 Educational technology in nursing 67 Fellowships 67 Research promotion and coordination 71 Research grants program 73 Advisory Committee on Medical Research 73 Fields of research 74 4. DISEASE CONTROL 83 Communicable diseases 87 Expanded program on immunization 87 Tuberculosis 92 Mycoses 93 Influenza 93 Diarrheal diseases 93 Rotaviruses 94 Leprosy 95 Sexually transmitted diseases 97 Hepatitis 97 Bacterial diseases 98 Prevention of blindness 98 Malaria 99 Other parasitic diseases 103 Chagas disease 104 Schistosomiasis 104 Filariasis 105 Leishmaniasis 105 Aedes aegypti eradication 106 Yellow fever 111 Dengue 111 Mental health 112 iv Dental health 113 Noncommunicable diseases 114 Cancer 114 Other noncommunicable diseases 115 Hospital infections 116 Laboratory services 116 Epidemiologic surveillance 118 Caribbean Epidemiology Center 118 Biologicals 120 Emergency preparedness and disaster relief coordination 124 5. ENVIRONMENTAL AND ANIMAL HEALTH PROGRAMS 127 Environmental health 127 Water supply and basic sanitation 131 Solid wastes 133 Institutional development 134 Pan American Center for Sanitary Engineering and Environmental Sciences 135 Pan American Center for Human Ecology and Health 139 Radiation health 141 Fluoridation 142 Traffic accident prevention 143 Control of toxic substances 145 Food protection 145 Zoonoses and animal health 146 Foot-and-mouth disease and the Pan American Foot-and-Mouth Disease Center 148 Zoonoses and the Pan American Zoonoses Center 151 6. SUPPORTING SERVICES 155 Information collection and dissemination 155 Development of statistical methodology 156 International Classification of Diseases 156 Microcomputers in health 158 Health and biomedical publications 159 Periodical and special publications 159 Journals 159 Scientific publications and official documents 160 Distribution 163 Filmstrips 163 Visual aids 164 Public information 164 Expanded textbook and educational materials program 165 Bibliographic and health information office 166 7. ADMINISTRATION AND MANAGEMENT 168 American Region Programming and Evaluation System 169 Budget and finance 169 Procurement 171 Personnel 172 Conference services 172 Management and computer services 173 Index 175 Acronyms and Corresponding Bodies or Programs 188 v tif 0 :i International Year of the Child 1 1 Introduction As the 1970s drew to an end, so did the Ten-Year Health Plan for the Americas promul- gated at Santiago, Chile, in late 1972. Since 1975 the Plan, which has guided the activities of the Region's health ministries and the Pan American Health Organization, has empha- sized specific improvements in health status and the delivery of health care as well as technical cooperation from international and bilateral agencies. In the middle and late 1970s the social and economic thinking of the Region's develop- ing countries began to change. No longer could specific disease control programs go un- related and often in conflict with each other; no longer could events in the health sector be isolated from those in other developmental spheres; no longer could technical assis- tance from abroad be a satisfactory substitute for efforts by the developing countries individually and collectively. The need for change in the way the Region's countries try to advance their health status found ever clearer expression toward the end of the decade. This evolution in strategies for improving the health of the developing world culmi- nated in the IV Special Meeting of Ministers of Health of the Americas in 1977 and the International Conference on Primary Health Care at Alma-Ata, U.S.S.R., the following year. Primary health care, as defined at the Conference, implies rnt merely basic health care but also technical cooperation among developing countries, community participa- tion in health activities, the use of appropriate technology to achieve universal health care coverage, and articulation of health with other developmental sectors. Thus, health for all people by the year 2000 is now the fundamental goal of the Region's'nations. Technical cooperation means that the developing countries guide their own advance- ment in all spheres including health, instead of relying on the external guidance implicit in the now outdated concept of technical assistance. Community participation, which is the community-scale equivalent of technical cooperation among developing countries, expresses the new awareness of planners that progress in health cannot be decreed from above but will only come about if the citizens for whom health programs