W O R L D H E A L T H

ORGANIZATION

REGIONAL OFFICE FOR THE Ljll &JJl .. ,<'I osj &'&I BUREAU REGIONAL DE LA

EASTERN MEDITERRANEAN MEDITERRANEE ORIENTALE

REGIONAL C O M M I m FOR THE EASmN MEDITERRANEAN

Eighteenth Session ORIGINAL: ENGUSH

MINUTES OF THE FIRST MEETING

Held a t the Cyprus Hilton Hotel, Nicosia on Tuesday, 20 August 1968, a t 9.30 am

CHAIRMAN: Dr V . Vassilopoulos ( ~ y p r u s )

1. Opening of the Session

2. Address by the Acting President of the Republic of Cyprus

3 . Address by the Minister of Health of the Republic of C y p m

4 t Election of Officers

5. Address by Elected Chairman (Dr V. Vassilopoulos)

6. Address by Regional Director

7. Address by Deputy Director-General -

8. Hours of Work

9. Adoption of the Agenda

10. Appointment of the Sub-Division on Programme and elect ion of Chairman

11. Election of Chairman of Technical Discussions

12. Statement by the Deputy Director-General (cancellation of the meeting of Sub-committee B of the Eighteenth Session of - -. the .- . .

i6- - . Regional Committee f o r the Eastern ~ed i t e r r anean)

. Annual Report of the Reglonal Director t o the Eighteenth Session of the Regional Committee;

Statements and Reports by Rerjresentatives of Member S ta tes 17

Representatives of Member States

Government

CYPRUS

FRANCE

IRAN

IRAQ

J O r n N

KUWAIT

m3ANON

m Y A

PAKISTAN

Representative, Alternate or A2viser

Dr V, Vassilopoulos Dr Z . Panos Dr M. Economopoulos Dr D. Fessas D r M, HadJiMinas Dr H. Menelaou

Dr A . Tekle

Dr J. Malaspina

Dr H. Murshed

Dr Mardan A l i

Dr A. Nabilsi

M r Yousef Jassim H i j j i Dr Abdulrahman A 1 Awadi

Dr Hosni Ja l loul

D r Taher Dahan

Brigadier C .K . Hasan Dr S. Hasan - Dr Osman Ibrahim Osman

SYRIAN ARAB REPUBLXC Dr BahJat Rabbat

TUNISIA DT M. R a h r i Dr M.T. Hachicha

UNITED ARAB REPUBLIC D r Hashem E l Kadi

YEMEN Mr Mohammed E l Zofri

Representatives of Associate Member States

BAHRAIN Dr Ibrahim Yacoub

QPTAR D r M. Farid A l i

World H e a l t h Organization - .-. - -- -

Secretary t o t he Sub-Committee (ex-officio) Dr A .H. Taba, Regional Director

Representative of the Director- D r P. Dorolle, Deputy Director-General General

Representatives of United Nations Organizations

UNITED NATIONS Dr V.J. Ram

UNITED NATIONS DEVELOPMENT PROGRAMME (UNDP ) Dr E a r l C. Hald

UNITED NATIONS CHILlX3N'S FUND (UNICEF) M r Gurdial S. Dil lon

UNITED NATIONS RELIEF AND WORKS AGENCY FOR PALESTINE REFUGm (UNRWA D r M. Sharif

Representatives and Observers of In te rna t iona l Non-Governmental and In t e r - Governmental Organizations

LEAGUE OF ARAB STATES D r N. Nabulsi

INTERNATIO?JAL DENTAL FEDERA'ITON Dr S t . Ph. u s s i o t i

IKCEBNATIONAL STATISTICAL EDUCATION C E m (ISEC ) M r Fxiz E l Khouri

US NAVAL MEDICAL WEARCH UNIT No. 3 (NAMRU 3 ) D r L.G. Dickson

1. OPENING O F THE SESSION: Item 1 of the Provisional Agencla

The RFX;IONAL DIRECTOR, i n the absence of the Chairman of Sub-committee A

of the Seventeenth Session of the Regional Committee fo r the Eastern Medi-

terranean, declared the meeting open.

He invited H.E. M r Glafcos Clerides, Acting President of the Republic

of Cyprus, to inaugurate the Session.

2. ADIBESS BY THE ACTING PRESIDENT OF THE REFUBLIC OF CYPRUS

M r GLAFCOS CLERIDES sa id he had p e a t pleasure i n inaugurating Su5-

C m i t t e e A iif the Eighteenth-.Sessi.dn of the Regional- Committee f o r the Eastern

Mediterranean and i n extending t o the representatives, on behalf of H i s

Beatitude the President of the Republic, the people of Cyprus, the Government

and himself, a warm welcome t o the island. It was gratifying tha t the Member

S ta tes of the Eastern Mediterranean Region, with which Cyprus was bound by

strong t i e s of mutual respect and friendship, had been able t o accept his

Government's invitation.

His Government had always attached great importanoe t o the United Nations,

not only fo r i ts ro le i n tackling the po l i t i ca l problems of the world, but

a lso fo r the work of the specialized agencies, w h i c h had been entrusted w i t h

the task of solving many of the complex problems tha t confronted humanity.

Those agencies had, with zest and ab i l i t y and i n a constructive manner, f o a l t i

m a n y ba t t l e s against disease, pestilence, shortage of food and other impor4mt

issues. I n so doing, they had helped the world, and particularly the develop

ing countries, i n a most s ignif icant manner, and had succeeded i n promoting

international co-operation and understanding, thus contributing greatly towards

peace and s t a b i l i t y i n the world.

He was fu l ly aware of the work accomplished by WHO i n the many f i e l d s of

international health and w a s greatly impressed by the signif icant contribution

the Organization had made i n helping developing countries t o plan and strengthen

thei r health services.

The Government of Cyprus was fu l ly conscious of the f a c t t ha t the health

of the c i t izens of a nation constituted a paramount source of strength and a

necessary prerequisite for progress arld development. The health of the

younger generations, on which the future of the world depended, was r ight ly

considered an important subject to which W H O devoted its attention.

He did not f e e l qualified t o address a Committee of experts on such a

specialized subject as "world ~ e a l t h " . He would tnerefore confine himself

t o expressing the wish tha t the deliberations of the session would be fruitful

and tha t representatives would have a pleasant stay i n his country.

H.E. M r TASSOS PAPADOPOULOS, Minister of Health of the Republic of C y m ,

wished on behalf of h i s Government and himself t o extend a very cordial welcome

to all the Rcprcscntatives. His Government and people considered it a great

honour tha t the Sub-Committee should be meeting i n h i s country, and also saw

i n it a big opportunity fur Cyprus to play it3 modest role in fostering inter-

national health co-operation.

Of a l l the United Nations specialized agencies, perhaps none was doing

more t o unify mankind than WHO; i n no f ie ld , perhaps, was the need f o r in te r -

national co-operation more important and more self-evident than i n tha t of

health. I n the world of to-day, when modern technolorn was eliminating the

geographical boundaries of nations and expanding the horizons of the universe,

no country could wage the ba t t l e against disease i n i so la t ion or ignore the

health s i tua t ion among i ts neighbours: a danger t o health anywhere was a

l a t e n t SOIPCF? of danger everywhere. Today more than ever before i n history

the struggle fo r be t te r health had ceased t o be a national a f f a i r and become

an international concern. Health for all countries depended on the in t r i ca t e

system of international control, reporting and co-operation. It was i n t h a t

field that the unifying inflnecce of WHO proved the solid foundation on which

international co-operation i n other f i e l d s was a l so bu i l t .

The countries of the F ~ q t e r n Mediterranean Region were fortunate i n

having found in the person of tns Regional Director, DP Taba, an extremely

able and devoted international functionary who fervently believed in, and

unremittingly pursued the cause of ever-expariding international co-operation

i n the many fie-cls of concern to WHO. He hoped he was not offend-

Dr Taba's well knows modesty by taking the present opportunity of payirg

public t r ibute t o h i m .

If he l a i d so much s t r e s s on the ro le of WHO i n promoting international

co-operation, it was because he sincerely believed tha t the cause of be t te r

health for a l l humanity did i n f ac t encompass alaost every aspect of the

ac t iv i ty of organized society as it existed nowadays. There was p rmt ica l ly

no facet of sc ien t i f ic , cultural , educational, f inancial and soc ia l planning

which did not touch upon or was not influenced by the s t a t e of heal th of the

people of each and every country.

For WHO the f ight t o preserve and improve heal th was not limited t o com-

bating disease and creating more hygienlc cv~lditions of l iving. To attain

"a s t a t e of complete physical, mental and soc ia l well-being and not merely

the absence of disease of infirmity", it was not enough t o care f u r the sick

and invalid, t o replace mal~unctioning limbs, t o create and operate c l in i c s

and heal th centres: it was necessary t o co-ordinate every plan of the organized

comrmity, t o u t i l i z e every achievement of modern technology, t o mobilize a l l

the f inancial and human resources of a country.

I n order t o achieve the environment i n which alone such a s t a t e of com-

plete health could be attained, a dynamic and balanced r a t e of economic @;rowth

was neaessary, ar.d conversely, a satisfactorly l eve l of public heal th was a

pre-requisite f o r sustained economic well-being. It was, therefore, very

aptly pointed out by Dr Taba i n h i s report t o the present session t ha t " ~ e a l t h

improvement is part of a much larger complex and cannot be considered i n vacuo..

long-term heal th plans form an intricate part of programming f o r socio-economic

development" .

That statement alone gave an idea of t.he complexity -cad magnitude of the

problem. The f u l l dimensions of the task ahead could be real ized only when

the same problem was put i n i t c international perspective. I f "complete

health" i n any one country could be achieved only by integration of i t s ' h e a l t h

planning in to i ts economic p l a ru l i r~ , a universal improvement i n hea l t h con-

di t ions could be achieved only through international co-operation and co-

ordination of' e f for t s .

I n sp i t e of marl's fan tas t ic achievements i n science and technology, the

most formidable and most ancient problems were still besetting the human

family. Many of i ts members l ived i n poverty, misery and despair. More

than one i n three suffered from malnutrition. One i n eight suffered from

trachoma or l ived i n an area where malaria was s t i l l a threat . Ten million

suffered from leprosy. I n many countries of Africa, Asia and Latin America

the vas t majority of infants had a l i f e expectancy of only 25 years. Cancer

was claiming its t e r r i b l e t o l l of human l ives , and cardiovascular diseases

s t i l l ranked f i r s t a s a cause of death i n Europe and the TJnited States. No

one country had the economic resources, the expert knowledge or the time t o

face thvse problems alone; it w a s necessary f o r many oountries t o pool their

resources and r a l l y the campaigners i n a l l the different spec ia l i t ies t o the

crusade against disease i n a l l i t s forrns.

It was normal, when considering the struggle against disease, t o think

f i r s t of a l l of the doctor. He of course played a unique and perhaps the

fundamental ro le i n the health team, but his efficacy depended on the co-

operation of many of i ts other members: the laboratory technician, the nurse,

the paramedical s t a f f , the health educator, the sanitary engineer, the welfare

worker, the research worker and the s t a t i s t i c i a n . How t o t r a i n a l l those

experts and achieve a balance between suplsly and demand f o r them, how t o co-

ordinate and finance t h e i r e f for t s , were problems tha t WHO was called upon

t o tackle and which constantly r e e m e d i n regional and world-wide meetings

of the Organization. Some of them with special bearing on loca l conditions,

formed the important fiubJects of the agenda of the present session.

It was only through'the exchange of experience, the co-ordination of

e f for t s , the pooling of resources and regional planning t h a t those formidable

tasks could be tackled. Although over-all patterns could be discerned,

heal th problems differed according t o region, climate and local conditions,

and also the wealth an& stage of develoment of each country.

No one could deny the importance of good public health t o the welfare

of a population, nor the significance of sat isfactory levels of health in pro-

gramming economic development. The success of any programme of economic

development depended on the mobilization and f u l l u t l iza t ion of the manpower

of each country, and hence any investment which aimed a t keeping a country's

manpower healthy, vigorous and productive must be considered a sound one.

On the other hand, no grandiose scheme f o r rapid heal th improvement could

survive fo r long without a sound infrastructure t o finance and sustain a

steady improvement i n the health services. The great challenge t o any

government was t o establ ish a balance bwbween the r a t e of economic gPoWth and

the r a t e of development of health services.

How man, and h is organized society, was t o solve the problem of uti l izing

every available resource, within h i s limited capabili t ies, in the service of

a be t t e r s t a t e of health f o r a l l , and how he was t o make be t te r health the

too l and the foundation of h i s sustained economic growth, was the biggest

challenge which nowadays faced humanity. WHO had accepted t h a t challenge;

meetings such as the present one provided a unique opportunity t o review i t s

past e f fo r t s and plan its strategy fo r tomorrow. And i n heal th matters 1' t;omorrowt' of course meant the next ten or twenty years.

Health w a s no exception t o the economic ru le tha t the sa t i s fac t ion of one

need created others more d i f f i c u l t t o sa t i s fy . The struggle f o r be t te r health

w a s univeral and probably eternal . The challenges facing humanity i n the

f i e l d of health were formidable. To paraphrase the words of a great states-

man: "~11 of them w i l l not be tackled here; a l l th5c w i l l not be attempted

i n this meeting. Nor w i l l it be tackled i n the next meeting, nor in our

generation, nor even perhaps i n our l ifetime on t h i s planet. But l e t us

begin. Let us not only maintain our e f for t , but a lso persevere together;

l e t us not only endure, but a lso prevail i n our wish t o co-operate; and I

am confident, i f w e maintain the pace, we sha l l i n due season reap the kind

of world we deserve and deserve the kind of world we sha l l create".

4. ELECTION O F OFF'ImS: Ttem 2 of the Provisional Agenda

The REGIONAL DIRECTOR invited nominations fo r the Office of Chaiman of

the Sub-committee.

Dr NAEILSI ( J ~ r d a n ) proposed Dr Vassilopoulos, Director-General of Health

of the Republic of Cypms.

Ur OSMAN (Sudan) and D r EL KADI (United Arab Republic) seconded the

proposal.

Decision: Dr Vassilopoulos was unanimously elected Chairman.

Dr Vassilopoulos took the Chair.

The C~'inWN invited nominations fo r the two posts of Vice-Chairmen.

Dr N A B I I S I ( ~ o r d a n ) , seconded by D r OSMAN (Sudan), proposed Dr Morshed

(1ra.n) , and Dr OSMAN (~udan) , seconded by Mr JASSIM KCJJI ( ~ u w a i t ), proposed

D r Nabilsi ( ~ o r d a n ) .

Decision: D r Morshed and I>r Nabilsi were unanlrnously elected Vice-Chairmen;

5. ADRFESS BY ELECTED CHAIRMLAN

The C-N sa id tha t the Committee's gesture i n appointing him Chairman

conferred on him a great honour which he took t~ be ref lected on the country

that had the privilege of acting as host f o r the present session.

He wished t o congratulate the two Vice-Chairmen on t h e i r election. With

the i r assistance he hoped he would be able t o guide the discussions on the

items of the Agenda t o a successful conclusion. He alsa wished t o pay a warm

t r ibute t o the out-going Chairman, the Minister of Health of Iran, H.E. D r Shahghol.

E M / R c ~ ~ A / M ~ ~ . 1 page 10

The presence of the Deputy Director-General of WHO was a special privilege

and honour f o r the Sub-Committee. Everyone kbew Dr Dorolle's outstanding

contributions i n a l l f i e l d s of public health and h i s e f fo r t s t o improve the

heal th of the peoples i n a l l par ts of the world.

He alrso took the opportunity t o ~ongratulate the Regional Director and

h i s s t a f f fo r the very comprehensive annual report i n which WHO'S willingness

t o continue its assistance t o Member Sta tes f o r formulating t h e i r long-term

heal th plans and co-ordinating t h e i r health programmes was reaffirmed.

The emphasis l a i d by the Organization on such important subjects as educa-

t ion and t raining - which was the'&ey t o any health developnent - the control

of communicable diseases, with special reference t o the eradication of malaria

and smallpox, public heal th services and environmental heal th was highly com-

mendable.

He would not Lake much uf the Sub-Committee's valuable time t o report on

the heal th s i tua t ion i n Cyprus and on what had been achieved, as he had had

an opportunity t o do so during previous sessions, but he would take the l iber ty

of referr ing t o some of the highlights. Reflecting the concept of heal th as

an important element in any programme f o r economic development, a second five-

year heal th plan had been integrated in to the country's second five-year socio-

economic plan. The main objectives of tha t development programme were: the

development of a community heal th service, the strengthening of the existing

public heal th services, the organization of the public health services i n the

r u r a l areas, and the fur ther improvement of environmental hygiene.

With regard t o the f i r s t objective, the government had given serious con-

sideration t o the possibi l i ty of int.roducing some s o r t of community health ser-

vice, and t o tha t end an expert adviser had been invited t o study the problem

on the spot. According t o tha t cxpert ' s recommendations, two approaches were

possible, e i ther through the development of an idependent national health

service or through the exter~sion of the exis t ing soc ia l insurance scheme so as

t o include medical care among the benefits already provided. The problem

was, however, more complex than it might appear a t first glance and require

very ca re fu l consideration of a l l the f ac to r s involved. The most important of

those factors , which were comrnon t o e i t h e r type of scheme, were f i r s t l y t he

economic implications and secondly the shortage of medical and paramedical

personnel. Hence the introduction of e i t h e r type of service had had t o be

postponed, but meanwhile a l l liecessary preparatory measures f o r a t t a in ing the

goal a t a l a t e r date would be pursued with determination.

For fu r ther improvement of the public hea l th services it would be necessary

t.o ensure t h a t a higher standard of medical care w a s avai lable t o a l l sections

of t he community, t o accelera te post-graduate t r a in ing of medical and para-

medical pcrsonncl, md t o increase hosp i ta l accommodation i n the general and

specia l ized hospi ta ls . To t h a t end a new 600-bed General Hospital was t o be

b u i l t i n Nicosia.

I n conclusion, he wished on behalf of the people of Cyprus t o express his

grat i tude t o the World Health Organization, and i n pa r t i cu l a r t o t he Regional

Director, Dr Taba, f o r h i s un t i r ing e f f o r t s t o improve the health of the

people of Cyprus. He a l so wished t o give an assurance t h a t his country was

constantly endeavouring t o make the best possible use of t he ass is tance given

t o it by the Organization.

6 . ADDREsS BY THE REGIONAL DIRECTOR

The REGIONAL DLRECTOR s a i d It was a p e a t pr ivi lege t o welcome a l l the

Representatives t o the annual session of Sub-committee A of the Regiona) Com-

mittee and t o express the deep appreciat ion of the World Health Organization

t o H i s Beatitude Archbishop Makarios, the President of t he Republic, and t o

the Government of Cyprus, f o r t h e i r generous hosp i ta l i ty . The meeting would

no doubt benef i t from the added stimulus of H i s Beat i tude 's i n t e r e s t i n the

Organization's a c t i v i t i e s a s expressed during t h e audiences he had been

privileged t o be granted when v i s i t i n g Cyprus.

E M / R C ~ ~ A / M ~ ~ . 1 ' page 12

The present meeting was a sui table occasion fo r a brief assessment of 1

the joint ac t iv i t i e s of Member countries as WHO was passing the twenty-year i mark. M a n y successes had been achieved i n the f ight against disease since

the countries of the area had! gdtogether t c j s e t up the WHO Eastern Medi-

terranean Region with a programme far out-reaching anything previously

attempted. And tangible progress had bee;? recorded i n the Regian during ,

the past twenty years: a three-fold increase i n medical manpower; a th i r ty

percent drop i n the infant mortality r a t e s of several countries; definite

advances i n the all-out malaria eradication drive which already protected

100 million -ople i n the region; s tenc ly progress towards the eradication of :

smallpox, whose annual occurrence was dropping sharply i n most countries;

experimental break-throughs i n the struggle against trachoma and schistosorniasis.~

Health was indeed gaining on disease. But the task ahead, accentuated

as it was by the 2ressure of a soaring population, did not allow any lessening

of e f for t . Communicable diseases were s t i l l r i f e i n large areas. Most

Eastern Mediterranean countries were s t i l l short of doctors and medical

auxi l iar ies . And the new s t resses and s t r a ins of modern l i f e confronted them

with more commitments i n f i e lds long unexplored.

Problems of growing concern t o the countries of the Region included industri.

a l izat ion with i ts occupational hazards; urbanization with its possible squalor,

a i r pullution, soc ia l maladjustment and disease; t r i b a l disintegration and

its impact on mental health - t o mention but a few of the problems now being

i n c r e a s i n g l ~ tackled i n t h e i r local or region21 context.

But whatever the problems approached, whether old or new, past experience

gave mounting evidence of the two-fold need f o r investment i n human resources

through education, and fo r long-range planning of heal th a c t i v i t i e s within the

wider framework of overall development schemes.

While the building up of a rredical and auxiliary task force w a s every-

where imperative t o s e t the stage f o r fur ther progress, long-term planning

of health programmes with well-dosed p r io r i t i e s was of utmost importance if

the ear ly gains achieved were t o #be consolidated and benefits from the large

investments in money and manpower were t o be reaped.

page 13

I n the countries of the Region, emergin3 with such forced rapidi ty in to

the mid-twentieth century, health programes ought t o be as closely related

as possible t o plans aimed a t reducing poverty through increased agricul tural

protiuction, or a t rais ing l iving s t a ~ d a r d s t h r ~ u g h industr ia l izat ion.

With tha t i n mind, health policy makers of several countries - inc ludiw

Cyprus, as the Sub-committee had just heard - ha2 r ight ly launched long-term

health plans, mostly of c. five-year duration, as an integral p a r t of t h e i r

programmes f o r socio-economic development. Similar plans were being drafted

i n other cvuntries as mure health planners realized t h a L such a lorig-term

policy, with its l e s s immediate but more las t ing resul ts , was the key t o

success i n health promotion.

The l a s t World Health Assembly's resolution drawing the at tent ion of

Member States t o the importance of national long-term health planning a lso

stressed the need f o r regional and inter-regional long-range programming - a

point of par t icular relevance t o the Eastern Mediterranean Region whose com-

plex geographical pattern, and position a t the crossroads of three other

regions, called fo r close co-ordina-tion of health a c t i v i t i e s across borders.

WHO was well-suited t o pl8y a guiding ro le i n tha t respect, and t o help

countries i n the establishment of the i r planning uni t s and the formulation of

t h e i r plans. And the Regional Office was ready t o provide fur ther assistance

i n tha t f i e ld .

The task was not an easy one. Reliable s t a t i s t i c s , and essent ia l too l

i n planning, were scarce. The formulation, operation and evaluation of health

programmes were a l l too often based on sample surveys and conjectural estimates.

Another widely-felt handicap t o planning i n the region was the dearth of

trained personnel. It impeded the two processes of planning and implementation,

f o r even the most modest plans, once established, could not be f u l f i l l e d without

the minimum of s t a f f .

Health planning was indeed a.11 arduous administrative exercise cal l ing

f o r expertise, paLierlce and ingenuity. It w a s also a h i m y rewarding one,

leading t o a more effective use of health personnel and resources.

Several countries, including Cyprus, had gained experience i n tha t field,

result- i n a more e f f i c i en t deployment of heal th ac t iv i t i e s . And in teres t

i n long-range planning had increased among other Eastern MeOiterranean countries.

Such a trend away from piecemeal and dispersed effor ts , towards a co-

ordinated and integrated approach t o health work, within the framework of

overall developnent scl~emes, augured well for the future. He f e l t confident

tha t t ha t sound approach t o health problems would prove an important fac tor in

spading up health progress I n the Regiun.

7. , ADrWEss BY THE DEPUTY DIKECTOR-GENERAL

The I B P W DIREEPCB-GENERAL wished, through the Chairman, t o convey t o

the Acting President and t o the Minister of Health of the Republic of Cyprus

the Organization's deep grati tude fo r t h e i r attending and addressing t h e

meeting. It was a fur ther token of the friendly and co-operative s p i r i t

t ha t Cyprus had always displayed towards WHO, and which was fur ther evidenced

i n the warmly hospitable welcome extended t o those attending the session.

H i s f i r s t duty was t o convey t o the Sub-Committee the greet ing and zood

wishes of WHO'S Director-General, Dr Candau. The Director-General was sure

tha*,. as usual, the session would be a successful and useful one and under

the Chairman's expert guidance the Sub-committee would carry out i ts responsi-

. b i l i t i e s , whether statutory or delegated t o it by the Health Assembly, of

making a searching review of the past y e a r ' s work and a detai led scrutiny of

the estimates prepared by the Regional Director for the next f inancial period.

Those two functions of the Regional Committees were essent ia l t o the work of

WHO. It was i n the Regions tha t the a c t i v i t i e s of the past year could be

examined i n d e t a i l by experts conversant with loca l conditions, and tha t

budgetary proposals could be discussed by the people closest t o the problems

and best able t o judge whether or not a project was sound. One of the

greatest achievements of WHO had been t o make regionalization part of its

essent ial structure. Other organizations also held various regional

meetinas which were indeed extremely useful, but WHO'S advantage was that

regionalization had been bu i l t in to i ts Constitution and made possible a

very w i d e met6ure of decentralizatioii from t he start.

What he had said would show the importance attached t o the meetings

of the Regional Committees by the Health Assembly and the Director-General.

He was sure tha t i n the beautiful island of Cyprus the present Sub-committee

would once again hold a successful, constructive and useful session.

8. HOURS OF WORK

D r NmILSI (~ordan) proposed tha t the Sub-committee should meet from

9.30 a.m. t o 1.30 p.m.

It was so agreed.

9. ADOPTION OF THE AGENDA: Item 3 of the Provislonal Agenda (document EM/RC 181 1 )

The CHAIRMAN invited comments on the provisional agenda,

There were no comments.

The Provisional Agei~da was adopted.

10. APPOINTMENT OF THE SUB-DMSION ON PROGRAMME: Item 4 of the Provisional Agenda

The REGIONAL DIRECTOR suggested t h a t the Sub-Division on Programme, com-

posed of the Sub-committee as a whole, should meet on Thursclay morning.

Dr NORSHED (1ra.n) proposed tha t Dr Mardan A l i ( l raq) should be appointed

Chairman of the Sub-Division on Programme.

EM/RC 1 8 ~ / ~ i n . 1 ' page 16

Dr LJABILSI (~ordan) secorldetl the proposal.

D r Mardan A l i was unanimouslv elected Chairman of the Sub-Division.

11. ELECTION OF THE CHAIIiMAN OF THE TECHNICAL DISCUSSIONS

Dr OSMAN (Su6.a;i) groposed that Dr Jalloul (~ebanon) should be appointed

C h a i r m a n of the Technical Discussions.

D r W B A T (Syrian Arab Republic) seconded the proposal.

D r Ja l loul was unanimously elected Chairman of the Technical Discussions.

12. STATEMENT BY THE DEPUTY DIRECTOR-GENERAL (cancellation of the meeting of Sub-committee B of the Eighteenth Session of the Regional Committee f o r the Eastern Mediterrarean)

D r DOROLLE, Deputy Director-General, said tha t on 14 July 1968, the .

Government of I s r a e l had informed the Ilezii.nr?l Directo-rof WHO tha t it did not

propose i n the future t o participate in the meetings of Sub-Cornlittee B of

the Regional Committee. A s no other Member Government had expressed a desire

t o participate i n the meeting, the Regional Director had had 110 a l ternat ive

but t o cancel it,. In accordance with World Health Assembly resolution WHA .11.2:

the Director-General would have t o report t ha t occurrence t o the World Health

Assembly. The decision of the Government of Israel not t o participate in

future meetings of Sub-committee B created a new si tuat ion, and the Executive

Board and the W u r l d Health Asse1nbI.y would have t o seek a solution t o it. The

Executive Boar6 would be informed of the s i tua t ion before the next Assembly

met, and i n accordance with i ts Rules of Procedure, representatives or Member

S ta tes of the Eastern Mediterranean Region could appear a t i t s meetings as

observers.

The f resh s i tua t ion created by the decision of the Government of I s r a e l

should not i n any way af fec t the work of the Regional Committee. The views

expressed during the meeting and the Report of the Sub-committee would, i n due

course go t o the Director-General.

D r NABILSI (Jordan), commenting on what was said by Dr Dorolle, Dep~ty

Director-General of WIW s ta ted tha t he unc?.erstood tha t I s r a e l did not wish t o

attend the meeting of Sub-committee B i n order t a be able t o Join t h i s Sub-

committee. A s representative of the Hashemite Kingdom of Jordan he declared

his categorical refusal t o the participation of I s r a e l i n t h i s Sub-committee.

A nation which had violated a l l moral values and completely disregarded the

resolQtions adopted by the biggest international organization, the United

Nations, as well as the Security Council resolutions; a nation which had

recently attacked the c i ty of Sa l t , k i l l i n & and wounding tens of innocent

inhabitants and farmers, regardless of age and sex, using i ts Skyhawks t o spread

destruction and desti tution; a nation which disrespected human values and

violated human r igh t s should not be allowed t o joing t h i s august Committee.

He therefore declared i i i advance, refusal of h is Government t o the participation

of I s r a e l i n t h i s Sub-Conmittee. He wished those words t o be recorded

l i t e r a l b i n the minutes of the meeting.

13. ANNUAT, REPORT O F THE REGIONAL D I R E W R TO THE EIGHTEENTH SESSION OF THE REGIONAL COMMITTEE; STJ4TEMEPSrS AND REPORTS BY REPRESENTATIVES OF lvIEMf3ER STATES: Item 6 of the Provisional Ageilda (document E M / R C ~ ~ / ~ )

Dr TABA, Regional Ciiector, sa id that , before introducing h i s annual

report , he wished t o welcome two new members of WHO, the Peoples' Republic

of Southern Yemen as a f u l l Member and Bahrain as an Associate Member. He

r emet t ed tha t there were no representatives of Southern Yemen a t the meeting,

because of circumstances beyond t h e i r colitrol, but he hoped tha t they would

participate i n future meetings.

Turning t o the report , he said tha t it covered the period from 1 Juljr 1967

t o 30 June 1968. The report i t s e l f contained de ta i l s of a l l the a c t i v i t i e s

of the Regional Office, and he would only re fer t o the more important subjects

i n his introduction. The year, although -it had begun i n inauspicious circum-

stances because of the Micidle East c r i s i s , which had caused a considerable

disruption of the health programmes i n cer tain countries, had returned re la -

t ive ly t o normal. WHO had provided considerable assistance t o the Governments

concerned i n dealing with the health problems tha t had been created, and most

of the staff had returned t o t h e i r duty s tat ions.

E M / R c ~ ~ A / M ~ ~ . I page 18

An important point stressed i n the repopt was long-term health planning,

which he had discussed i n e a r l i e r annual reports. Various countries i n the

Region had long-term plans, and some countries had even embarked on t h e i r

second five-year plan. Other countries were preparing s i m i l a r plms, and

the Regional Office rras givlng ess i s tmce , 3r would be prepared t o give

assistance, i n thai? p~epera t ion , An a l l i ed ~2oblem was tha t of co-ordination,

not only with other countries, but also with other Regions. Plans had already

been made f o r co-ord ina t i~n between the coimtl-ies i n the Region and with

countries i n other Regions.

He proposed t o submit t o the Regional Committee a t its Nineteenth Session

a detai led p??ogramme covering Llie nttxt few years of the a c t i v i t i e s of the

Regional Office, indicating the areas of ac t iv i ty which, i n h i s opinion, should

receive increasing attention. Any advice and guidance frorrl the Sub-committee

would be welcome and would be borne i n mind in preparing the programme.

The present year was the l a s t one i n which the United Nations Development

Programme Technical Assistance component would operate on a biennial basis,

as new procedures, incorporating continuous prograrnmiiig, would take effect

f r o m 1969. Under the new system, requests for assistance covering a period

of up t o four yeLr;: ~ : h i c l I222 been accep5er1 % t h e Government co-ordinating

body could be submitted t o UNDP on an individual basis, a t m y time as and

when the need occurred. It was exceedingly important tha t countries i n the

Region should put the case f o r the health component a s strongly a s possible

so tha t the health programmes should not suffer . Approval by the United

Nations depended v e r y largely un the presentation of the projects .

What he had sa id about the Technical Assistance component applied equally

t o the United Nations Special Fund, which financed large projects i n various

sectors of the econow, including the f i e l d of health. I f any of the countries

i n the region wished t o apply t o the Special Fund fo r assistance i n such

f i e lds as, fo r example, environmental health or water supplies, the Regional

Office would be glad t o provide any assistance required i n preparing the

requests.

The expaisidn of the health services i n many countries had made it essent ia l

t o t r a i n more and more diversif ied health persdanel a t a l l levels. A t the

l a s t meeting of the Regional Committee he had referred t o the new medical

schools established i n Tunisia and Ethiopia. Kuwait and Libya were now

planning new schools and the Regional Office was helping i n the preparation of the

plans. A school had also been opened a t Aleppo, Syria, with assistance from

WHO.

A Special Group Meeting on Medical Education held i n Baghdad i n November

1967 had oonstitutcd an Interim Orgaiiizing Cummittee fu r the estafslishnent

of an Association of Medical Schools i n the Middle East. A meeting of tha t

Interim Committee had been held ir~ Lhe Regional off ice from 24 t o 26 June 1968

and the Draft Constitution of the Association was prepared. It would be

fur ther studled a t the forthcoming Hegional Woup Meeting on Medical Eclucation

t o be held i n Khartoum i n December 1968. I n a related f ie ld , another Interim

Committee ha6 been organized, through a recommendation of a Conference of

Directors or Representatives of Schools of Public Health held i n Manila i n

November 1367, t o consider the establishment of an Association of Schools of

Public Health pertaining t o four WHO Regions (AFRO, EMRO, SEAR0 and WPRO).

He f e l t t h a t the two Associations would provide fur ther collaboration betwean

the various ins t i tu t ions and also promote standards and policies.

The charts and figures beginning on page 26 of the Annual Report showed

the extent t o which the fellowship programme was expanding. The number c;f

fellowships awarded had increased t o 457 i n 1967, and they covered a l l cate-

gories of health personnel - ducturs, teclr r l iuiar~s , rlwses, and others, - de-

pending on the needs of countries. There was much emphasis a t present on

111edical educators who could convey t o teachers the recent developments on the

subject, and on nursing, since nursing was s t i l l weak i n the Region. Apart

from the aid WHO gave t o nursing ins t i tu t ions within the individual countries,

it also awarded fellowships. The whole problem of education and t ra ining was,

i n h i s view, of enormous importance i n the work of WHO, because of the shortage

of heal th personnel.

~ l v I / ~ ~ 1 8 ~ / ~ i n . 1

page 20

The m u a l report gave de ta i l s "n the cantrol and eradication of com-

municable discnses. On the whole, in spite o f problems m.d technical

obstacles, the malaria eradication programme was progressing sat isfactor i ly .

The problem of vec to r resistance h d cropped up in southern parts of Iran

and Iraq and WHO, along with the Iranian Government, had t r i e d out new insect-

ic ides with success; t ha t finding was of irrlportance for other Regions as well,

A programme f o r malaria eradication hacl been begun i n Tmis ia and, because

of the planned iiitegration of the programme in to the heal th services, the

prospects were good.

Much had been achieved i n the campaign against tuberculosis since it had

been real ized that BCG vaccination could be carried out without a previous

tubercul in ' tes t . Another important advance was the rea l iza t ion that ECG

vnccination could be carried out simultaneously with other vaccinations such

as smallpox. The Regional Office would be very gl8d t o help i n the planning

of programmes for simultaneous vaccination.

Smallpox was s t i l l endemic i n the Region; there had been over 1C 000

cases l a s t year. Governments within the region had embarked on active cam-

paigns against the disease, with WHO help i n the form of advice and supplies.

Smallpox vaccination had been greatly f ac i l i t a t ed , with economical resul ts ,

by the use of jet injectors and bifurcated needles. Freeze-dried vaccine

also constituted an important advance, of obvious value within the Eastern

Mediterranean Region, and WHO was helping with the improvement of the quality

of vaccines.

The laboratury services in most countries of the Region were developtng

i n a sat isfactory way, but there was s t i l l much room for improvement. The

Regional Office was prepared t o give every assistance to countries wishing to

improve such services.

The subject of ionizing radiat ion had been discussed i n d e t a i l a t the

pnevious session of the Regional Committee. The protection of the population

was s t i l l unsatisfactory, and practically no oountiirg had enacted adequate

E M / R C ~ ~ A / M ~ ~ . I page 21

legis lat ion layinp d o ~ m the responsibi l i t ies of the health authori t ies . The

largest amounts of racliation received by the population s t i l l came from medi-

cal uses and it was obviously a public health responsibilitjr t o control them.

There was now an adviser on r~dia . t ion i n the Regional Offide, and any as s i s t -

ance would gladly be ~ i v e a t o countries requiring it.

I n the f i e l d of nutr i t ion, much remained t o be done within the Region,

the younger age groups, espcially children st the stage of weaning, being

the most affected by malnutrition. I n some countries, but by no means a l l ,

milk substitutes that were zcceptable in presentation and in taste were pro-

duced cheaply f o r the population, but it was desirable tha t they should be

produced in all countries. A seminar would take place in 1969 and would deal

with the question of nutr i t ion.

I n re la t ion t o community water supply programmes, a number had begun i n

the Region. He stressed the f a c t that , it a programme was properly con-

ceived, it would be en t i t l ed t o help from the United Nations Special Fund.

The Regional Office would be prepared t o help with plans fo r such projects.

Often, though well planned and well instal led, waterworks were not properly

maintained because of the lack of trained s t a f f . A valuaSle project i n the

f i e l d of t ra ining of wacerv~orks personnel was tha t s ta r ted i n October 1.966

i n Sudan and completed i n March 1968. Another such course was be- planned.

The Tweiltieth Anniversary of ~IJHO had been widely covered i n the Region

by a l l the cornrnunication media. An excellent book had been published by the

Regional Office en t i t l ed en and Medicine i n the Middle ~ a s t " , which covered

a l l the ac t iv i t i e s of WHO i n the Region aild also mentioned some h i s to r i ca l

events i n the Region i n re la t ion t o the medical sciences. It had t o be re-

membered tha t the science of medicine had largely originated i n the Region.

Arabic and French versions of the book would be published shortly and he hoped

tha t they would be widely disseminated. Any comments on the book would be

very welcome .

EM/RC 1 8 ~ / ~ i n . 1 page 22

It was a source of pleasure tha t i n 1968, f o r the f i r s t time, the

Shousha Foundation Prize Medal hzd been awarded within the Region, t o

Dr A . Kamal of the United Arab Republic, an outstanding public health worker,

and also a personal fi2iend of zhe l a t e Dr Shausha.

I n conclusion, hc expressed h is sincere thanks t o a l l the Governments

of the Region for t h e i r effect ive and close collaboration with WHO. Without

such collabor*aLior~ the Regiunal off ice would not have achieved a l l tha t it had

done so f a r . Amons the m F L w c o l l ~ b o r a t o r s had been D r E l Mahandes, Minister

of Health, United Arab Republic, whose recent dealh had caused great sorrow

t o WHO and the health c i r c l e s i n the Region.

DP EL KADI (united Arab Republic) thanked the President and Government

of Cyprus for t h e i r hospi tal i ty and congratulated the Chairman and Vice-

Chairmen on t h e i r appointment. The Iiegional Director 's annual report was

excellent and had r ight ly placed great importance on medical education, since

most countries i n the Region were short of health s t a f f .

Like the Jordanian Representative, IE wisher? tu s t a t e categorically that

no representative of h i s Government would s i t a t the same table with any

representative of the Government of I s r a e l i n a regional meeting. The Israeli

Government had been gui l ty of a continuous ser ies of aggressive ac ts against

the Arabs tha t were marked by unbelievable a t roc i t ies , and there was no doubt

tha t they were i n the process of driving Arab people from t h e i r lands i n order

t o replace them with I s r a e l i s .

3r NARIIST (.Tordnn) associated himself with the representative of the

United Arab Republic i n cong-atulating the Ch?.irmm and Vice-Chairmen on

t h e i r election and i n thanking the Cypr~zs Government f o r its hospi tal i ty .

The annual report so ably introduced bjr the Regional Director comprehensively

covered WHO activities in the Region. A s the Regional Director had stressed,

economic and soc ia l development was fundamental t o the improvement of the

heal th of countries. I n his cuuntry the economic, social , , ~ d health

s i tua t ion had been improving u n t i l the recent Middle East c r i s i s , which had

great ly af fected the hea l th programme. The s i t u a t i o n was de te r io ra t ing ,

not only i n relat . i ,3n t.o heal t .h , but a l s o i n r ~ l a t . i ~ n t.0 t.he p o l i t i c a l s i t u -

at ion, which might well cause another war. H i s country was now f u l l of

hundreds of thousands "f refugees whose conciition had been made worse

because the w inky of 1967-68 had been an exceptionally cold one; the r e s u l t

w a s the recrudescence ~f msny diseases, especia l ly tuberculos is . Much help,

f o r which h i s Government was very g ra te fu l , had been given by t he Regional

Orrice as well as by UNICEF and other agencies and A r a b and other fr iei idly

countries. The Government uf I raa had offered a hosp i ta l and sen t medical

teams, and the Government of I r a n had b u i l t a camp f o r 3000 refugees and was

supplying it with food and medicine.

He would have l i ked the Sub-Committee t o meet a t Jerusalem, but Jerusalem

was now i n occupied ter r i t0r .y and it would :lot be possible f o r h i s Government

t o i n v i t e the Sub-committee u n t i l it had been f reed.

D r MARDAN A L I (1raq) congratulated the Chairaman and other o f f i c e r s on

t h e i r e lec t io i i and wished the Sub-committee every success i n i ts del ibera t ions .

He expressed the I r a q i Government's appreciat ion t o the Government of Cyprus

f o r i ts generous hosp i t a l i t y .

The f a c t t h a t the hea l th projects i n 1rp.q were progressing s a t i s f a c t o r i l y

was clue i n large measure t o t he e f f o r t s made by the Regional Director and t o

the col laborat ion of the Regional Office with the Government of I raq .

Although the re had been some d i f f i c u l t i e s with the malaria eradicat ion

programme, the Ministry of Health had recent ly increased i ts a l loca t ion f o r

t h i s purpose and it had been decided t o apply the insec t i c ide OPE-33 i n

southern I r aq where sdme 10 000 persons were now protected 2gainst malaria.

No case of insec t i c ide poisoning had been detected.

The advisory se rv ices i n epidemiology had recent ly been extended by WHO

and the Ministry of Health intended t o bui ld l abora to r ies t o co-ordinate the

work t h a t was being developed i n t h i s f i e l d .

The provision of a WHO consultant t o a s s i s t the Government i n the design

of community water supplies was much appreciated as was the Organization's

assistance i n a l l aspects of medical and auxiliary education.

The importance tha t h is Gdvernment at lnuhed t o the rural health advisory

services was indicated by the f a c t tha t it had recently allocated the sum of

s i x million dinars for. ru ra l health centres.

H i s Government erideavo~ed t o c"1laborate with WHO i n every w a y and was

pleased tha t 2 WHO Representative was assigned t o Baghdad and hoped tha t the

new training centre there might be designated a Regional Centre.

He was much distressed a t the persecution of h i s Palestinian colleagues

by Is rae l , which was committing atrocities. It was up t u the members o f the

Eastern Mediterranean Region t o put an end t o such practices. I n matters of

health, Iraq wns assis t ing Jordan by the establishment of a hospital and by

the regular provision of medical supplies.

I n conclusion, he thanked the Regional Director and a l l h i s s t a f f for a l l

they had done fo r h i s country and fo r others i n the Region.

Dr RAIBAT (Syrian Arnb Republic) thanked the Cyprus Government for i ts

hospi tal i ty and expressed h i s appreciation t o the Regional Director fo r his

grent ass is tance over the past year. The o t h e r Member States i n the Region

were also t o be thanked fo r t h e i r collaboration one with another and for the

vas L amount bf inf orination tha t they had made available for the g r e a t e r benefit

of the Region as a whole.

One of the factors most seriously affecting health i n the Region was the

exploitation of man by man and the occupation of one country's land by another,

I n tha t connection, the Syrian Arab Republic wished t o associate i t s e l f with

the statements of previous speakers t o the e f fec t t ha t they must refuse t o be

seated a t the same Regional meeting as my representative of I s rae l . That

country was promoting epidemics by its bellicose a c t i v i t i e s and by exporting

human populations. Not only must mater ia l and medical a ss i s t ance be given

t o those suf fe r ing from aggression, but t h e i r d ign i ty and t h e i r land must be

restored t o t he Pales t ine refugees and t h e i r aggressors must be forced t o

cease t h e i r barbarian act ions .

D r C. K. HASAN ( ~ a k i s t a n ) congratul~tec! ?;he Chairman and other o f f i c e r s

on the i r e l e c t i on and expressed h i s g ra t i tude t o the Government of Cyprus f o r

i ts hosp i ta l i ty . He congratulated the Regional Director on h i s annual repor t

wl i i ch was a masterpiece o f l u c i d i t y and had h i s wholehearted support. It

l a i d the r i g h t s t r e s s on the important problems of malaria and smallpox eradi-

cation. It was thanks t o the help of WHO t h a t Pakistan hac! been ab le Lo

tackle these problems, although the work on smallpox eradicat ion w a s only

s ta r t ing . The great a ss l s t ance t h a t Who was providing towards the t r a i n ing

of medical and p a r a ~ a d i c a l personnel was g rea t ly appreciated a s it was indis-

pensable t o the successful prosecution of both immediate and long-term pro-

grammes, The d i v e r s i t y of such programmes i n which WHO was col laborat ing

was c l ea r from the headings i n the project l i s t f o r Pakistan contained i n the

annual report .

He requested the Regional Director , WHO, t o make it possible t o organize

R seminar i n year 1970 on Tropi c ~ l Di wasp i n & m a , where Government o f

Pakistan has es tabl ished recent ly a School of Tropical Medicine and Hygiene.

D r TEKLE (Ethiopia) , a f t e r congratulat ing t he Chairman and other o f f i c e r s

on t h e i r e l e c t i on , expressed the Ethiopian Government's thanks t o H i s Beatitude

the President of Cyprus f o r h i s generous i nv i t a t i on and hosp i ta l i ty .

He had k e n much impressed by the c l a r i t y , brevi ty and coherence of the

Regional D i r ec to r ' s annual repor t . The d ive r s i t y of a c t i v i t i e s shown there

reflec.t.ed t.he Regional M r ~ r t . o r ' s unswerving support. f o r heal t.h a c t i vi t i es i n

a l l countries of t he Region,

D r MALASPINA (France) associated himself with the thanks and congratula-

t ions of previous speakers, and wished pa r t i cu l a r l y t o express h i s apprecia-

t i o n of the help i n tuberculos is control t h a t WHO was providing i n the French

Ter r i to ry of t he Afars and the Issas .

E M / R C ~ ~ A / M ~ ~ . 1 page 26

D r HACHICHA ( ~ u i s i a ) congratulated the Chairman and Vice-Chairmen on '

t h e i r e l e c t i o n md thmked the Regional Director for the comprehensiveness

and meticulous analysis of h i s araual report . He also thanked the Cyprus

Covernmnt f o r t h e i r ~racious recei?t,i on and kind hdspitalit:? . He expressed h i s Government's solidaritjr with other Arab Sta tes regarding

I s r ae l , and emphasized tha t the Government of Tunisia would refuse t o sit a t

a Regional confereilce a t which tha t country was represented. He thanked

the Deputy Director-General fo r h i s presence, which he took t o be a reflection

of WHO'S concern a t the s i tuat ion.

M r HIJJT ( ~ u w a i t ) , a f t e r congratulating the various of f icers on t h e i r

c l e c t i on and thanking the Cyprus Government f o r i ts kind invitation, said

tha t h i s Government would also f ind it impossible t o attend a Regional meeting

at which Iarael was rcprcsented.

The Regional Director was t o be congratulated upon his annual report.

One of the most important problems i n which, so f a r as Kuwait was concerned,

was tuberculosis. Every e f f o r t was being made t o eradicate t h a t disease in

Kuwait, ?ad fo r tha t purpose the collaboration of WHO and of neighbowing

countries was essent ial . Smallpox eradication was another matter of great

concern t o h i s country which was doing a l l it could t o achieve the aims s e t

out f o r the Region. Great s t r ides had also been made i n improving school

heal th aid in the t raining of medical personnel.

He expressed his Goverrment's cundolences t o the Government of the United

Arab Republic on the recent death af the UAR Minister of Health.

Finally, he welcomed the Representative of the new Associate Member,

Bahrain.

D r JAL;LOUL (~ebanon) associated. himself with other speakers i n thanks

t o the Quvernment of Cyprus f o r t h e i r hosp i t a l i t y and i n congratulation t o

the various off icers on t h e i r e lect ion as well as i n appreciation of the

Hegional Director ' s report.

He a l so expressed h i s support af previous speakers regarding the a t roc i -

t i e s perpetrat'pd by Israel and expressed the hope that WHO would do a l l i n i t s

power t o a l l e v i a t e the s13fer ings of pedple made homeless and exposed t o

disease. The health problcms raiscd by the c r i s i s i n the Middle East would

be magnified if the c r i s i s continued. He was, however, g r a t e fu l f o r the

e f for t s made Poie t , i? : -~ei~~f ::, r e f ~ ~ e z ~ by ti:; Ii~~;,li):lzl Gffice i13~'I he greatly

appreciated the Regional U i r ec to r ' s cwnual repor t which s e t out the problems

r e a l i s t i c a l l y .

Reference was made i n t h a t r epor t t a the In te rna t iona l S t a t i s t i c a l

Centre i n Beirut ard he s a id t h a t the Lebanese Government would be most wi l l ing

t o col laborate with WHO i n developing a centre f o r biomedical s t a t i s t i c s the re

which could be used f u r t r a i n ing medical personnel from throughout the Region.

IIe associated himself with the previous speaker i n expressing condolences

on the death of the UAR Minister of Health.

D r YACOUB a ah rain) thanked the Cyprus Government f o r i ts hosp i t a l i t y

and congratulated the various o f f i ce r s on t h e i r e l e c t i on and the Regional

Director and his s t a f f on t h e i r magnificent record. It was a g rea t honour

f o r his country t o be represented as an Associate Member f o r the f i r s t t i m e .

He asked whether it would be possible f o r WHO t o conduct a survey of the

hea l th services i i l Bahrain and t o draw up a plan f o r t h e i r improvement. H i s

country was a l s a des i raus of appointing i ts own na t iona l s t o the hea l th se r -

vice and would g rea t ly appreciate appropriate ass is tance i n t r a i n ing school-

leavers f o r such posi t ions .

D r FARID ALI ( ~ a t a r ) associated. himself with the expressions of gra t i tude,

congratulat ion and condolence voiced by previous speakers eind s a id t h a t Qa ta r

a l so would f i n d it impossible t o s i t a t a Sub-committee meeting a t which I s r a e l

was represented.

D r MORSHED (1ran) a l so thanked t.he Government of Cyprus f o r i ts hosp i t a l i t y

and the members of the Sub-committee f o r e l e c t i ng him Vice-Chairman; he

congratulated h i s fel low of f ice r s on t h e i r e l e c t i on and the Regional Director

E M / R c ~ ~ P . / M ~ ~ . 1 page 28

f o r h i s report . Some weeks previously there had been i n Iran an "educational

revolution", within the frap.lework df the Revolution of the King and the People,

designed t o a l t e r the educationsll framework of the country i n such a way as

t ru ly t o prepare the youth t o trike Its courlLry's destiny i n hand. Among the

educational chan,ves tha-t wmld be made were changes i n university administra-

t ion, with emphasis on building up a body of full-time teaching s t a f f and on

research. He looked forward with hope t o the f r u i t s of these changes i n the

medical f ie ld , as well as i n others. Health i n Iran would also benefit by a

recent law under which younti; women might be called up f o r two years of service

i n the Health Corps and similar corps.

Tn the five-year development programme which was s t a r t ing i n 1968, special

a t tent ion was being paid t o medicine and public health. Within tha t pro-

gramme were a pro ject for t ra jn i .ng of pmsicians and auxi l iar ies , a pro ject

for increased research, provision f o r the improvement of the health insurance

system under whioh medical care would be elltrusted to l o c a l authorities, pro-

vision f u r the improvement of industr ia l health i n view of the rapid industrial-

izat iun uf the cuuntry, and provision for low-interest loans to p@sicians in

order t o enable them t o s e t up private hospitals whase service would be paid

f o r by the Government i n cases where a patient was unable t u afford them hiin-

s e l f . It was estimated tha t t h i s l a t t e r measure would add some 4000 hospital

beds t o the country's t o t a l .

Regarding the development of insecticide resistance by the malaria vector,

An.stephensi, i n suuthern Irm, it was hoped tha t successful malaria control

would be achieved by a combination of spraying with two annual cycles of DIYI!

and one of malathion, larviciding, and the introductivn of Gambusia f i s h i n

places where oily larvicides could not be applied.

Some 255 000 simultaneous BCG and smallpox vaccinations had been performed

i n Baluchistan i n 1968 with no serious reactions; t h i s provided fur ther evi-

dence of the usefulness of simultaneous vaccination t o which the Regional

Director had referred e a r l i e r i n the meeting.

Regarding t he c r i t i c a l heaith s i t u a t i o n i n some par ts of t h e FIegj-on,

which e r r l i e r speakers had mentioned, he thanked t he representa t ive of Jordan

f o r h i s appreciat ive words regarding I r an ' s nodest ass is tance t o t he people

of Jordan and assilred the Moslem countries of Iran1 s sympathy and support of

the resolut ions of t he United Rat ions concerning the evacuation of occupied

lands. A s h i s countryrs delegation had had t he occasion t o ind ica te i n t he

Credentials Committee and during the previous sess ion of the World Health

Assembly, only e n t i t i e s who were l ega l l y e n t i t l e d t o be iiembers of W O should

be ab le t o pa r t i c ipa t e i n i t s deliberations and, furthermore, delegations

par t i c ipa t ing i n i ts gatherings should be appointed lega l ly according: t o t h e i r

Consti tut ionn The Gwernment of Iran1 s objections on these cases remain t he . ,. . .. ..

same.

D r OSl4AN (Sudan) associated himself with the expessions of congratulation

and gra t i tude voiced e a r l i e r i n t h e meeting and sa id t h a t t h e Regional

Director 's annual repor t was an admirable r e f l ec t i on of t h e highly commend-

a b l 6 work EeZp car r ied out by t h e Regional Qff ice. The projects i n t h e

Sudan were a l l progressing s a t i s f a c t o r i l y , owing in la rge measure t o the

valuable ass is tance of InMO.

H e thsnked both I a O and rJiTRWA for the ass i s tance rendered t o the refugees

in the recent Middle Eastern c r i s i s . He hoped t h a t the r e f u s a l of I s r a e l

t o a t tend mcetings of Sub-Committee B would i n no wa.. weaken t h e repor t t h a t

w o a d be submitted by Sub-Committee A .

Plr ZWRI (Yemen) s a i d t h a t , despite t h e unsat is factory standard of heal th

i n Yemen, t h e e f f o r t s nade i n consequence of t h e 1962 revolution there had

led t o very considerable accomplishments, pa r t i cu l a r l y in t he decentral ization

of hea l th services , i n the establishment of new medical centres and i n s e t t i ng

up a new hosp i ta l a t Samta and a new resp i ra to ry d i seases sanatorium. It

was hoped t h a t by 1970 quarantine centres and school heal th services would be

established. I I

He expressed h i s appreciat ion f o r t h e ass i s tance received f r m IdHO, parti-

cu l a r l y i n tuberculosis con t ro l and malaria eradication, and h i s g ra t i tude t o

the Government of Cyprus Tor i ts hospi ta l i ty . H e associated himself w i t h t h e

statements made regarding I s r a e l by t h e representatives from other Arab States.

Dr EL KADI (United Arstb Republic) thanked previous speakers f o r t h e i r

expressions of condolence on the death of Dr E l Mohandes, l a t e l y Minister of

Health of t he United Arab Republic.

The CHAIRMAN ca l led f o r a minute's s i l ence in memory of t he l a t e

Dr E l Mohancles. He ;~mounced t h a t a telegram would be sen t t o his family and

h i s Health Ministry colleagues on behalf of the Sub-committee.

The REGIONAL DTBCTOR thanked t he previous spcakers f o r t h e i r expPesslons

of appreciation f o r the work done by WHO. He looked forward t o continued

c lose collaboration with the Member S t a t e s i n t he Region.

The CHAIRMAN then proposed the adoption of the following dr& Po~ol~ticJL:

The Sub-Committee,

Having reviewed the Annual Report of t he Regional Director f o r the period 1 July 1967 t o 30 June 1968;

Recognizing t h a t t he ult imate aim of sonfo-economic devolopment i n countries of the Region is the s a t i s f ac t i on of the needs of the population, t v which end the Govcrnmcnts m e harnessing tha nations' resources and energies by formulating na t iona l plans and po l ic ies i n keeping with the needs and aspira t ions of the people;

Real iz l rg -Lllr,; 2ur the attainment of higher l eve l s of health, well-being and soc i a l secur i ty , the maximum re tu rn from the invest- ment i n hea l th and soc i a l services of scarce human and mater ia l resources, should be ensured, t o which end the optimum combination of services and s k i l l s should be sought i n an i n t e r - s ec to r i a l and inter-disc ipl inary approa.ch t d the planning and execution of the countr ies ' major hea l th and soc i a l policy, the main consideration being t h a t t he hea l th sector, as any other sec tor of na t iona l pro- gramme, should be given the means and opportunit ies t o grow i n pro- port ion t o i t s demonstrative contribution t o t he achievement of n a t r i o n ~ l goals f o r which the avai lable resclurces could be mobilized with a view t o making t he services as widely and equally accessible a s possible t o those i n need;

Appreciating t h a t t h ~ public hea l th administrat ions should en- sure steady progress i n t h a t d i rect ion, maintain programme f l e x i b i l i t y and respul~s iveness to changing circumstances and needs, and engage i n a continuing t a sk of evaluztion of objectives and endeavours so a3 - , ?

st imulate t he act ive Tnterest of t he c i t i z ens i n the implementation of the programmes;

E M / R c ~ ~ A / M ~ ~ . 1

page 31

1. Ei\SDORSES the high pr ior i ty given t c j the t ra ining of national health manpower, Dhe emphasis on control and eradication of com- municable diseases, improvement ot' environmental health, community water supplies, development of laboratory services, nu t r i t ion and radiation protection;

2. RE0,UE:STS the Regional Director ts cmtinue t o a s s i s t i n the co-ordination and evaluation of health programmes i n the region and, t o the extent possible, with the neighbowing countries of the Region; and

3. COMMEND3 the Regional Director fo r h i s substant ial report which r e f l ec t s the e f fo r t s made by the W~rld Health Organization i n its assistance towards the promotion of health i n the Region.

Decision: the resolution was adopted.

The meeting rose a t 1.35 p.m.