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19th Directing Council of the Pan American Health Organization
CD19.R1 The XIX Directing Council,
Having considered the report of the Director (Document CD19/13) prepared in implementation of Resolution XV of the XVIII Meeting of the Directing Council;
Taking into consideration that similar changes have already been introduced in the Rules of Procedure of the Executive Committee;
Bearing in mind the recommendation adopted in Resolution I of the 61st Meeting of the Executive Committee; and
Bearing in mind the provisions of Rule 58 of the Rules of Procedure of the Directing Council and Rule 61 of the Rules of Procedure of the Conference,
1. To approve changes in the Rules of Procedure of the Directing Council as they appear in Document CE61/11 (Annex II), with Rule 23 as amended during the consideration of the document.
2. To transmit Document CE61/11 to the XVIII Pan American Sanitary Conference, and to recommend favorable consideration [by this body] of the proposed changes in the Rules of Procedure of the Conference (Annex III) [and of] Rules 1 and 37 as amended during the consideration of the document.
Sept.–Oct. 1969 OD 99, 53
CD19.R2 The XIX Directing Council,
Noting that four Governments have quotas more than two years in arrears and are thus subject to [the provisions of] Article 6, paragraph B, of the PAHO Constitution, and that three of these Governments have sent representatives to the XIX Meeting of the Directing Council; and
Having examined the efforts made by these Governments to meet their obligations,
To permit Bolivia, the Dominican Republic, and Haiti to vote in this XIX Meeting of the Directing Council.
Sept.–Oct. 1969 OD 99, 54
CD19.R3 The XIX Directing Council,
Noting that four Governments have quotas more than two years in arrears and are thus subject to [the provisions of] Article 6, paragraph B, of the PAHO Constitution, and that three of these Governments have sent representatives to the XIX Meeting of the Directing Council; and
Having examined the efforts made by these Governments to meet their obligations,
To permit Bolivia, the Dominican Republic, and Haiti to vote in this XIX Meeting of the Directing Council.
Sept.–Oct. 1969 OD 99, 54
CD19.R4 The XIX Directing Council,
Having considered the report on the collection of quota contributions (Document CD19/6 and Addenda I and II), as well as the information and commnents on quotas contained in the Financial Report of the Director and the Report of the External Auditor for 1968 (Official Document 91;
Noting with satisfaction that, as a percentage, the total amount in arrears more than one year is the lowest in the last ten years, but noting with concern that the number of countries in arrears more than two years has not diminished; and
Considering the importance of obtaining the full support of all Governments for the program of the Organization through prompt and full payment of quota contributions,
1. To take note of the report on the collection of quota contributions (Document CD19/6 and Addenda I and II), and of the information and comments on quotas containded in the Financial Report of the Director and the Report of the External Auditor for 1968 (Official Document 91)
2. To thank the Governments and the Director for the success achieved in reducing arrears to the lowest level in many years.
3. To express concern about the number of Governments in arrears more than two years and to recommend to those Governments that they fulfill their financial plans for the payment of arrears witing a definite period.
4. To request the Director to continue to inform the Governments of the status of quota collections and to bring to thir attention the importance of unanimous support of the program of the Organization through the full and prompt payment of quota contributions by each Member Government
Sept.–Oct. 1969 OD 99, 54-55
CD19.R5 The XIX Directing Council,
Having examined the Financial Report of the Director and the Report of the External Auditor for 1968 (Official Document 91);
Noting with satisfaction that the Organization continues to be in a sound financial condition, as shown by the fact that the total amount of quotas more than one year in arrears is the lowest in many years and that the level of the Working Capital Fund and the reserve for termination costs were both increased; and
Observing that the External Auditor, in accordance with the provisions of Article 12.6 of the PAHO Financial Regulations, has made positive comments with respect to the efficiency of the administrative, financial, and accounting procedures and controls,
1. To approve the Financial Report of the Director and the Report of the External Auditor for 1968 (Official Document 91).
2. To commend the Director on having placed and maintained the Organization's finances in sound condition through the consistent application of the policies for maintaining budgetary expenditures within income and building up the Working Capital Fund and the reserves for termination costs.
3. To thank the External Auditor for including in his Report the necessary and appropriate observations with respect to the efficiency of the administrative, financial, and accounting procedures and controls.
Sept.–Oct. 1969 OD 99, 55
CD19.R6 The XIX Directing Council,
Having considered the 1968 Annual Report of the Director of the Pan American Sanitary Bureau, Regional Office of the World Health Organization for the Americas (Official Document 95);
Bearing in mind the statements of the representatives emphasizing the valuable support given by the Pan Amerian Health Organization to the efforts of the countries to raise the level of health of the population;
Bearing in mind also the concern expressed by the representatives about the persistence of problems of sanitation, communicable diseases, and nutrition and the complexity of the situation in the Region, where the health services in the countries have achieved different levels of development; and
Taking into account the provisions of Article 4-F of the Constitution of the Pan American Health Organization,
1. To approve the Annual Report of the nnual Report of the Director of the Pan American Sanitary Bureau for 1968 (Official Document 95), and to commend him and his staff on the excellent work done during the year.
2. To recommend to the Member Governments that they make a careful review of the health situation in their countries so as to determine the priority areas in which the work of the Pan American Sanitary Bureau can be most effective.
3. To recommend to the Member Governments that they regard the Annual Reports of the Director of the Pan American Sanitary Bureau as working documents of regional importance, indicating where the interests and efforts of each country fit into the welfare of the countries of the Americas as a whole
Sept.–Oct. 1969 OD 99, 56-7
CD19.R7 The XIX Directing Council,
1.To appropriate for the financial year 1970 an amount of $15,475,578, as follows:
| Part I Part II Part III Part IV Part V Part VI Part VII |
Organizational meetings Headquarters Field and other programs Special Fund for Health Promotion Increase to assets Subtotal Parts I–V Pan American Foot-and-Mouth Disease Center Effective working budget (Parts I–VI) Staff assessment (transfer to Tax Equalization Fund) Total all parts |
$ 334,205 3,192,260 8,604,938 250,000 150,000 $12,531,403 1,320,716 $13,852,119 1,623,459 $15,475,578 |
|
a) Assessments in respect to: Member Governments and Participating Governments, assessed under the scale adopted by the Council of the Organization of American States, in accordance with Article 60 of the Pan American Sanitary Code, or in accordance with Directing Council resolutions b) Miscellaneous income Total |
$15,270,578 205,000 $15,475,578 |
In establishing the contributions of the individual Governments and Participating Governments, their assessments shall be reduced further by the amount standing to their credit in the Tax Equalization Fund, except that the credits of those Governments that levy taxes on the emoluments received from PAHO by their nationals and residents shall be reduced by the amounts of such tax reimbursements by the Organization.
3. That, in accordance with the Financial Regulations of the Organization, amounts not exceeding the appropriation noted under paragraph 1 shall be available for the payment of obligations incurred during the period 1 January to 31 December 1970, inclusive. Notwithstanding the provision of this paragraph, obligations during the financial year 1970 shall be limited to the effective working budget, i.e., Parts I–VI.
4. That the Director shall be authorized to transfer credits between parts of the effective working budget, provided that such transfers of credits between parts as are made do not exceed 10 per cent of the part from which the credit is transferred. Transfers of credits between parts of the budget in excess of 10 per cent of the part from which the credit is transferred may be made with the concurrence of the Executive Committee. All transfers of budget credits shall be reported to the Directing Council.
Sept.–Oct. 1969 OD 99, 57
CD19.R8 The XIX Directing Council,Recognizing that nutrition has a high priority in national health services in the Hemisphere;
Seeing that there is a gradual increase in the demand for improved health, in particular for specialized training and consultation services in nutrition, as well as for applied research in this field;
Considering that over the years the Institute of Nutrition of Central America and Panama (INCAP) has gained excellent experience in providing needed nutrition services both in Central America and in the rest of the Hemisphere;1 and
Acknowledging that the needs of INCAP must be considered within the over-all nutrition program of the Americas and the total resources available to support that program,
1. To recommend to the Director that he provide INCAP with assistance in reorienting its present programs in order to better meet the needs of the present members of the Institute and the remaining countries of the Hemisphere.
2. To recommend that the Director continue to seek funds for INCAP from its traditional sources, and increase, to the extent the budget of the Organization so permits, the annual grant that is made to the Institute to enable it to effectively carry out the proposed expansion of its services.
3. To recommend that the INCAP program and budget be adjusted to coincide with estimated resources.
Sept.–Oct. 1969 OD 99, 58
CD19.R9 The XIX Directing Council,
Considering that human malnutrition continues to be a major problem of health and welfare for many populations of this Hemisphere;1 and
Considering that present demographic and food production trends indicate that this problem [may] become more serious in the future,
1. To recommend to the Pan American Sanitary Bureau that it continue to give high priority to this program, and that it assign corresponding resources to provide the services required for effective action, especially in the formulation of national food and nutrition policies.
2. To recommend to the Member Governments that national food and nutrition policies be formulated according to suggested guidelines as soon as possible with the objective of controlling the problem of malnutrition, thus reducing the costs of health care and allowing reassignment and more efficient use of resources.
Sept.–Oct. 1969 OD 99, 59
CD19.R10 The XIX Directing Council,
Having considered the preliminary report of the Director on the use of resources of the World Food Program for health programs (Document CD19/19);1
Bearing in mind the level of the present contribution of the Program to the health sector and the possibility that this contribution may be substantially increased;
Considering that, if good results are to be obtained from this Program, the conditions for operating it in each country must be advantageous;
Taking into account the possible effects that the supply of food under the World Food Program may have on the development of national and regional agricultural and industrial programs; and
Bearing in mind the recommendation of the 61st Meeting of the Executive Committee,
1. To take note of the preliminary report of the Director on the use of the resources of the World Food Program for health programs, and to express its interest in the possibilities set forth in this document.
2. To recommend to the Director that he continue to encourage the use of the resources of the World Food Program, periodically informing the Governments and providing those Governments that request it with assistance in preparing applications for aid from the Program.
3. To recommend to the Governments that they study the availability of the transportation, food storage, and food distribution facilities necessary for operating the Program.
4. To recommend to the Goverments that, in studying the possible effects of the World Food Program on national plans for the production and marketing of foodstuffs, due priority be given to the food needs of the population.
Sept.–Oct. 1969 OD 99, 60
CD19.R11 The XIX Directing Council,
Having considered Document CD19/25 and Addendum on the Inter-American Emergency Aid Fund and the emergency situation in Honduras and El Salvador;
Bearing in mind the action taken by the Secretary General of the Organization of American States and by the Director of the Pan American Sanitary Bureau in this situation; and
Bearing in mind the statements made by the representatives at this meeting of the Council,
1. To take note of the establishment of the Inter-American Emergency Aid Fund and of its Statutes.
2. To thank the Secretary General of the Organization of American States for promptly making available the necessary funds for carrying out the purposes of the Inter-American Emergency Aid Fund.
3. To thank the Governments that have provided Honduras and El Salvador, either through PAHO or on their own account, with effective assistance in the form of manpower or material resources for improving health conditions in the areas affected by the emergency.
4. To express its satisfaction with the action taken by the Director of the Pan American Sanitary Bureau, and to authorize him, in accordance with Article 6.5 of the PAHO Financial Regulations, to make an advance of up to $100,000 from the Working Capital Fund for the purpose of providing Honduras and El Salvador with assistance if the urgency of the situation so requires.
Sept.–Oct. 1969 OD 99, 61
CD19.R12 The XIX Directing Council,
Bearing in mind that the XVII Pan American Sanitary Conference in Resolution XX established that in order for a country to be declared by the Governing Bodies of the Pan American Health Organization to be free of Aedes aegypti it must not permit the existence of any colony of the mosquito in its territory except in areas ecologically unfavorable to the vector and subject to conditions making it impossible for the country to be reinfested by A. aegypti from such colonies;
Considering that in the same resolution the Conference recommended to the Director of the Pan American Sanitary Bureau that he convene a group of experts to establish the conditions that colonies of the mosquito must satisfy if their presence in the ecologically unfavorable areas of a country is not to prevent that country from being considered free of A. aegypti;
Bearing in mind that pursuant to this recommendation the Bureau sponsored the meeting of a Working Group on Laboratory Colonies of Aedes aegypti at PAHO Headquarters in Washington, D C., from 17 to 19 July 1967;
Having examined the report2 prepared by the aforementioned Working Group, which contains detailed conditions governing the establishment and operation of colonies of A. aegypti and specifies the security and surveillance measures required to avoid reinfestation from those colonies; and
Considering that the conditions and measures in question are adequate for the purpose intended,
1. To reiterate that, in addition to the eradication requirements established by the Pan American Sanitary Bureau and included in the Guide for the Reports on the Aedes aegypti Eradication Campaign in the Americas, in order to be considered by the PAHO Governing Bodies to be free of the vector a country must satisfy the following conditions:
a) Eliminate all colonies of A. aegypti that exist in areas in their territory in which the ecological conditions are favorable to the development of the vector;
b) Not permit the existence of any colony of the mosquito except in recognized research centers situated in areas that are ecologically unfavorable to the vector; and
c) Ensure that colonies of the vector existing in these unfavorable areas are permanently maintained in such a way as not to allow the country to be reinfested by A. aegypti from such colonies.
2. To approve the conditions and security measures recommended by the Working Group on Laboratory Colonies of Aedes aegypti for the establishment, operation, and inspection of colonies of the mosquito.
3. To adopt those standards and security measures that colonies of A. aegypti must satisfy if their presence in ecologically unfavorable areas of a country is not to prevent that country from being declared free of the vector by the Governing Bodies of the Pan American Health Organization.
4. To recommend to interested Governments that they prepare and promulgate as rapidly as possible the regulations needed to ensure that such colonies of A. aegypti as Governments may decide to allow in their particular countries comply with the aforestated conditions and security measures.
Sept.–Oct. 1969 OD 99, 61
CD19.R13 The XIX Directing Council,
Having studied in detail Official Document 92 submitted by the Director of the Pan American Sanitary Bureau, which contains the provisional draft that is to constitute the basis for the preparation of the Proposed Program and Budget Estimates for the Pan American Health Organization for 1971 to be considered by the 64th Meeting of the Executive Committee and by the XVIII Pan American Sanitary Conference; and
Recognizing that the provisional draft of the Proposed Program and Budget Estimates contains soundly conceived and much-needed health projects,
1. To take note of the provisional draft of the Proposed Program and Budget Estimates of the Pan American Health Organization for 1971 appearing in Official Document 92.
2. To request the Director to use the provisional draft as a basis for the preparation of the Proposed Program and Budget Estimates for 1971, after further consultations with the Governments to determine their latest desires and requirements in relation to the priorities of the Organization.
3. To request the Executive Committee to make a detailed examination of the revised Proposed Program and Budget Estimates for 1971 to be presented by the Director, after further consultations with the Governments, and to submit its recommendations thereon to the XVIII Pan American Sanitary Conference.
Sept.–Oct. 1969 OD 99, 63
CD19.R14 The XIX Directing Council,
Having studied in detail Official Document 92 submitted by the Director of the Pan American Sanitary Bureau, which contains the Proposed Program and Budget Estimates of the World Health Organization for the Region of the Americas for 1971;
Bearing in mind that the aforesaid Proposed Program and Budget Estimates are submitted to the Directing Council, [as] Regional Committee of the World Health Organization, for review and transmittal to the Director-General of the Organization so that he may take them into account in preparing the budget estimates of WHO for 1971; and
Noting the recommendations made by the Executive Committee at its 62nd Meeting.
1. To approve the Proposed Program and Budget Estimates of the World Health Organization for the Region of the Americas for 1971 appearing in Official Document 92, and to request the Regional Director to transmit them to the Director-General of the Organization so that he may take them into account in preparing the WHO budget estimates for 1971.
2. To request the Regional Director to transmit to the Director-General a request that he maintain the level of the WHO budgetary appropriation for malaria eradication in the Americas by increasing the appropriate allotment in the WHO regular budget to the extent necessary to offset any reduction in the allotment from the WHO Malaria Eradication Special Account.
Sept.–Oct. 1969 OD 99, 64
CD19.R15 The XIX Directing Council,
Elected Guyana, Peru, and Venezuela to the Executive Committee upon termination of the periods of office of Brazil, Colombia, and the United States of America, and thanked the Governments of these countries for the valuable services rendered to the Organization by their representatives on the Committee.
Sept.–Oct. 1969 OD 99, 64
CD19.R16 The XIX Directing Council,
Taking into account that the Member Governments appearing in the scale adopted by the Council of the Organization of American States are assessed according to the percentages shown in that scale, in compliance with Article 60 of the Pan American Sanitary Code; and
Considering that other Member Governments and Participating Governments are assessed in accordance with Resolutions XXVII and XXVIII of the XVII Meeting of the Directing Council,
To establish the assessments of the Member Governments and Participating Governments of the Pan American Health Organization for 1970 in accordance with the scale of quotas shown below, and in the corresponding amounts.
Sept.–Oct. 1969 OD 99, 65
CD19.R17 The XIX Directing Council,
Having considered the XVII Report of the Director of the Bureau on the status of malaria eradication in the Americas (Document CD19/2);1
Bearing in mind Resolution WHA22.39 of the Twenty-second World Health Assembly on the revision of the strategy of malaria eradication;
Cognizant of the progress made in 1968 in shifting new areas into the consolidation and maintenance phases and in protecting all the malarious areas for the first time, even though administrative and financial difficulties persist;
Taking into account that there are areas with technical problems the extent and origin of which are in large measure known, and that investigations have shown that there are effective methods for solving some of these problems;
Aware of the importance of the work of the general health services, especially in areas in the maintenance and consolidation phases;
Considering that some countries have or are preparing overall economic development plans that provide for activities in malarious areas;
Bearing in mind that if malaria eradication programs are to be given appropriate priority in the assignment of funds their economic value must be demonstrated; and
Considering that the Governments have received valuable assistance from some international agencies,
1. To take note of the XVII Report on the status of malaria eradication in the Americas (Document CD19/2).
2. To request the Director to assist the Director-General of the World Health Organization in applying the new world-wide strategy for malaria eradication.
3. To express to the Governments its satisfaction with the progress made by the malaria eradication programs and to urge them to continue to take the necessary steps to ensure that these programs are properly financed and efficiently administered and that the most effective methods are promptly used.
4. To recommend to the Governments and to international agencies that they continue to undertake and encourage research designed to identify, study, and solve present and potential technical problems.
5. To request the Governments to strengthen the coordination of the malaria eradication services and general health services and to ensure that the transfer to the general health services of the responsibility for malaria surveillance activities is carefully planned so as to avoid unfavorable repercussions.
6. To remind the Governments of the importance of malaria eradication programs, as part of the health sector, in their over-all economic development plan[s] and to request them, as well as international agencies, to continue research on the economic and social effects of malaria and malaria eradication.
7. To thank PASB, WHO, UNICEF, and the United States Agency for International Development for their assistance to the Governments in their 1968 campaigns.
8. To express at the same time its concern over the tendency of voluntary cooperation, and of the cooperation of some international agencies in financing malaria eradication program activities, to decline, and to request the authorities concerned to reconsider their policy of regional and world collaboration for this program.
Sept.–Oct. 1969 OD 99, 67
CD19.R18 The XIX Directing Council,
Having examined the report of the Director of the Pan American Sanitary Bureau (Document CD19/19, Rev. 1)1 apprising the Directing Council of the Final Report of the Study Group on the Coordination of Medical Care Services of Ministries of Health, Social Security Institutes, and Universities, jointly convened by the Organization of American States and the Pan American Health Organization, which met at Washington, D.C., from 4 to 8 August 1969,
1. To thank the members of the Study Group for their work.
2. To thank the Organization of American States for its assistance in organizing the meeting.
3. To confirm the recommendations of the Study Group.
4. To recommend to the Director that he give the report the widest possible circulation so that the health authorities in the countries of the Americas may take it into account in organizing their national health services.
5. To recommend to the Director that he organize zone meetings of senior health, social security, and medical education officials for the purpose of discussing how and to what extent the recommendations of the Study Group can be applied in the countries concerned.
Sept.–Oct. 1969 OD 99, 68
CD19.R19 The XIX Directing Council,
Having considered the report on the status of the PAHO Regional Library of Medicine (Document CD19/8)1 and the report of the second meeting of its Scientific Advisory Committee (Document RD8/16);
Having noted the rapid progress made by the Regional Library in the first eight months of its regional services to Brazil;
Noting with concern that the demand for the Library's services is already such that it is becoming difficult to satisfy it efficiently; and
Considering that there are bibliographic centers and libraries in the Member Countries of the Organization that could be used for a program of this kind,
1. To congratulate the Director and his staff on the progress attained, which has enabled the Regional Library of Medicine to become an active center for biomedical communications.
2. To thank the Government of Brazil, the United States National Library of Medicine, the Commonwealth Fund, and the Pan American Federation of Associations of Medical Schools for the excellent cooperation they have extended to the Regional Library.
3. To instruct the Director to give the highest priority in the further development of the Regional Library to planning its activities, establishing a sound internal organization staffed by a sufficient number of well-trained personnel, and improving the basic collection, in accordance with recommendations of the Scientific Advisory Committee of the Library (Document RD8/16).
4. To instruct the Director to submit each year to the Executive Committee the program and budget of the Regional Library for the following year.
5. To instruct the Director to explore all possibilities of supplementing the financing of the Regional Library with international, national, and private funds, and to make a study of partial self-financing based on specific payment by the countries for the use of certain services offered by the Library.
6. To emphasize the need to begin the program for training the staff in modern procedures for the collection, classification, and use of bibliographic information in the biomedical sciences, for which provision is made in the plans of the Regional Library of Medicine.
7. To recommend to the Director that he study the possibility of increasing the resources of the Regional Library by incorporating into the program other bibliographic centers and libraries in other Member Countries of the Organization.
Sept.–Oct. 1969 OD 99, 69
CD19.R20 The XIX Directing Council,
Considering the presentation made by the Representative of Brazil on the Plan for the Coordination of Activities Relating to the Protection and Recovery of Health (Document CD19/ 26, Annex), which is being put into effect in that country;
Bearing in mind that, in its general lines, this plan follows the ideas embodied in Resolution XX of the XVII Meeting of the Directing Council of the Organization and the recommendations in Section VIII1 of the Final Report of the Special Meeting of Ministers of Health of the Americas, held in Buenos Aires, Argentina, in October 1968; and
Considering that the Plan provides administrative machinery [that constitutes] a new experiment for that country in the health field and is worthy of study,
To take note of the Brazilian Plan for the Coordination of Activities Relating to the Protection and Recovery of Health and of the steps taken to put it into practice, and to thank the Brazilian Government for the paper on the subject presented at this meeting of the Directing Council.
Sept.–Oct. 1969 OD 99, 70
CD19.R21 The XIX Directing Council,
Bearing in mind the provisions of Staff Regulation 12.2,
To take note of the amendments to the Staff Rules of the Pan American Sanitary Bureau presented by the Director in the Annex to Document CE61/8 and approved by the Executive Committee at its 61st Meeting with the effective date 1 January 1969.
Sept.–Oct. 1969 OD 99, 71
CD19.R22 The XIX Directing Council,
Considering the revisions that were made effective as of 1 January 1969 in the salary scales for internationally recruited staff in graded posts;
Having noted the action by the Executive Committee at its 61st Meeting to establish the annual salary of the Deputy Director and the Assistant Director; and
Bearing in mind the importance of the Pan American Health Organization as the specialized agency for health in the Organization of American States system, and the weight of the executive and technical responsibility involved in the direction of PAHO/WHO activities in the Americas,
To establish the net salary of the Director of the Pan American Sanitary Bureau at the level of $25,225 per annum, effective as of 1 January 1969.
Sept.–Oct. 1969 OD 99, 71
CD19.R23 The XIX Directing Council,
Recognizing that the prevention or control of urban yellow fever, dengue, and other diseases transmitted by Aedes aegypti1 is of serious concern to all the Member Countries of the Organization;
Noting the success [achieved] in some of the Member Countries in their programs to eradicate A. aegypti, but fully cognizant of the continuing problem of reinfestation in areas that [have] been cleared;
Considering that the hemispheric campaign to eradicate A. aegypti has in the last few years encountered serious obstacles; and
Recognizing that control of diseases transmitted by A. aegypti must be a hemisphere-wide coordinated program,
1. To request the Director to sponsor an in-depth study of the strategy and methods of preventing the diseases transmitted by A. aegypti, and to this end:
a) To name, as quickly as possible, while continuing assistance to ongoing programs, a multidisciplinary group to review the present strategy for the prevention and control of diseases transmitted by A. aegypti in the Americas and, as necessary, to define the objectives and guidelines of a study that would examine all possible alternative systems, including the public health and economic consequences of the different systems;
b) To engage an independent agency to carry out as necessary the study defined by the multidisciplinary group, and to provide that agency with all assistance needed to obtain the facts and professional technical advice required, presenting an assessment of the various alternatives, the relevancy of which should be based on a cost/benefit analysis; and
c) To present the results of these studies to the XVIII Pan American Sanitary Conference, with an interim progress report to the 64th Meeting of the Executive Committee.
2. To request the Director to seek through voluntary contributions the funds to cover the costs of this study.
3. To recommend to the Governments that, independently of the results of this study, they continue to give all possible support to programs of A. aegypti eradication and take appropriate measures to safeguard the gains already obtained.
Sept.–Oct. 1969 OD 99, 72
CD19.R24 The XIX Directing Council,
Having considered the report on the fluoridation of public water supplies (Document CD19/21),1 submitted by the Director in accordance with Resolution X of the 61st Meeting of the Executive Committee;
Considering that dental caries is an important health problem in all the Member Countries; and
Considering that the Twenty-Second World Health Assembly made a thorough analysis of this problem and recommended2 to the Member States that they examine the possibility of introducing the fluoridation of public water supplies where the fluoride intake from such sources is below optimum levels,
1. To take note of the report of the Director on the present status of fluoridation of public water supplies, including financing, in the various countries.
2. To take note of the recommendations of the Twenty-Second World Health Assembly on the fluoridation of public water supplies.
3. To urge the national water authorities to take the necessary measures to introduce fluoridation of public water supply systems where the fluoride intake from such sources is below optimum levels.
4. To recommend to the Director that he continue to promote the fluoridation program and, in particular, the training of personnel in this field.
Sept.–Oct. 1969 OD 99, 73
CD19.R25 The XIX Directing Council,
Having examined Resolution VIII adopted by the Executive Committee at its 61st Meeting;
Bearing in mind the report by the Director of the Bureau (Document CD19/21)1 on the study of the production of drugs and the manufacture and maintenance of equipment and instruments for health programs; and
Considering also Resolution XII of the XVI Meeting of the Directing Council, according to which Recommendations VII.C.1 and C.22 of the Task Force on Health at the Ministerial Level (Washington, D.C., April 1963) were made part of the policy of the Organization,
To recommend to the Director that he request the Governments to consider the possibility of having such studies carried out in their particular countries, with the technical assistance of the Organization, provided the costs involved are borne by the country concerned.
Sept.–Oct 1969 OD 99, 74
CD19.R26 The XIX Directing Council,
Having considered the report of the Director on the process of evaluation in the Organization (Document CD19/21);1
Recognizing the importance of evaluation of all the programs and projects operated by the Governments in collaboration with the Organization;
Recognizing that the active participation of the Member Governments is essential for the initiation and improvement of the evaluation process; and
Having studied Resolution XIII of the XV Meeting of the Directing Council, Resolution XIII of the 61st Meeting of the Executive Committee, and the views expressed during the discussions of the subject,
1. To take note of the report of the Director on the evaluation process (Document CD19/21) and place on record its satisfaction with the progress made.
2. To request the Director to continue his efforts to improve the evaluation procedure and ensure its application to all projects and programs, paying special attention to projects of long duration as well as to those that are about to terminate but whose extension is contemplated.
3. To call upon the Governments to participate to the utmost in strengthening the evaluation process introduced by the Organization.
Sept.–Oct. 1969 OD 99, 75
CD19.R27 The XIX Directing Council,
Having seen Resolution WHA22.53 of the Twenty-Second World Health Assembly on long-term health planning, biennial programming, and improvement and strengthening of the evaluation process;
Considering that the PAHO annual budget is the practical expression of its policy and programs within the Hemisphere, and that it is desirable to continually improve the procedure for preparing the budget with the participation of the Governments, the Secretariat, and the Governing Bodies of the Organization;
Having studied Document CD19/14 and CE61/141 on long-term planning and evaluation and the summary account of the proposed method in the document entitled "Plan for the Preparation of Four-Year Country Projections";
Having duly noted Resolution XIV of the 61st Meeting of the Executive Committee, which recommended to the Directing Council that it approve the report of the Director on this item and urge the countries to collaborate in applying the proposed procedure;
Bearing in mind that the assistance activities of the Organization must be planned within the same frame of reference as is used by the countries in formulating their health policies and in defining priority health problems;
Cognizant of Document CD19/212 on the strengthening of the evaluation process; and
Bearing in mind that the long-term activities of the Organization must be closely coordinated with those of other agencies involved in the social and economic development of the Region,
1. To approve the report of the Director on long-term planning and evaluation, as well as the proposed method for making four-year projections of the assistance activities of the Organization.
2. To urge the Member Countries to actively participate in the joint planning process based on the proposed methods.
3. To recommend to the Director that he prepare long-term plans and the corresponding budget estimates for PAHO/WHO assistance activities at both the country and the regional level, bearing in mind the guidelines and stages proposed by the Twenty-Second World Health Assembly in Resolution WHA22.53 and in conformity with national health plans, the needs of the countries, and the objectives of the Governments.
4. To bring to the attention of the Governments Resolution XXVI approved at the present meeting on the strengthening of program and project evaluation procedures in order to improve long-term planning.
5. To recommend to the Director that in the course of long-term planning he endeavor to strengthen liaison with agencies of the Inter-American System and other agencies involved in the social and economic development of the Region.
6. To request the Director to report to the 64th Meeting of the Executive Committee on progress in implementing the planning process, including the participation of Member Countries.
Sept.–Oct. 1969 OD 99, 76
CD19.R28 The XIX Directing Council,
Having examined Document CD19/21, containing the preliminary report submitted to the 61st Meeting of the Executive Committee (Document CD61/4), in which the Director gives an account of the steps taken in compliance with the recommendation by the Special Meeting of Ministers of Health of the Americas (Buenos Aires, Argentina, October 1968) that studies be made on the status of health legislation in the Americas; and
Taking note of Resolution XV of the 61st Meeting of the Executive Committee,
1. To ask the Director to continue the comparative study of health legislation in the Americas and to submit it to the Executive Committee at its 64th Meeting.
2. To urge the health authorities of the Member Countries to collaborate and assist in the study in question.
Sept.–Oct. 1969 OD 99, 77
CD19.R29 The XIX Directing Council,
Having considered the report of the Director on buildings and installations (Document CD19/5, Corr.);
Taking note of Resolution XXI approved at the 61st Meeting of the Executive Committee;
Observing with satisfaction that the Director has acquired property that guarantees the availability of land within the immediate vicinity of the present Headquarters building to meet long-range space requirements of the Organization, and that this has been done without involving budgetary expenditure; and
Bearing in mind that the requirement for any space outside the present Headquarters building, and the consequent use of office space in the newly acquired building, will be reflected in the annual budget for consideration by the Governing Bodies of the Organization,
1. To note the report of the Director on buildings and installations (Document CD19/5, Corr.).
2. To commend the Director on having provided a solution to the long-range land requirements of the Organization without need for budgetary expenditure.
3. To request the Director to keep the Governing Bodies informed with respect to future space requirements.
Sept.–Oct. 1969 OD 99, 78
CD19.R30 The XIX Directing Council,
Having considered Document CD19/18, in which the Director of the Pan American Sanitary Bureau submitted to the Regional Committee for the Americas three resolutions of the Twenty-Second World Health Assembly; and
Seeing that the Pan American Sanitary Bureau is already concerned with the subjects referred to in these resolutions,
To take note of the following resolutions of the Twenty-Second World Health Assembly contained in Document CD19/18: WHA22.34 (Smallpox Eradication Program), WHA22.39 (Re-examination of the Global Strategy of Malaria Eradication), WHA22.53 (Long-Term Planning in the Field of Health, Biennial Programming, and Improvement of the Evaluation Process).
Sept.–Oct. 1969 OD 99, 79
CD19.R31 The XIX Directing Council,
Having been informed of the status of the smallpox eradication campaign in the Americas (Document CD19/18, Addendum); and
Bearing in mind that as long as endemic foci persist in the Hemisphere smallpox will continue to be a serious problem,
1. To reaffirm that the eradication of smallpox is one of the highest priorities for the Continent and for the Pan American Health Organization.
2. To recommend to the countries in which smallpox is endemic that they strengthen their programs and give special emphasis to epidemiological surveillance, case investigation, measures for containing outbreaks, and evaluation activities.
3. To recommend to countries bordering on those in which smallpox is endemic that they continue their maintenance and epidemiological surveillance programs, especially in border areas.
4. To urge countries that produce smallpox vaccine to accelerate efforts to standardize a freeze-dried vaccine that meets the WHO requirements, and to thank them for gifts of vaccines made to the Fund of the Organization and express the wish that they continue to make such contributions.
5. To instruct the Director of the Pan American Sanitary Bureau:
a) To take the necessary measures for coordinating national programs and, with the funds allotted by PAHO/WHO, to continue to provide the programs with technical and material assistance; and
b) To report to the 64th Meeting of the Executive Committee and to the XVIII Pan American Sanitary Conference on the progress made in the smallpox eradication program.
Sept.–Oct. 1969 OD 99, 79
CD19.R32 The XIX Directing Council,
Bearing in mind the provisions of Rule 9 of the Rules for Technical Discussions,
To select the topic "Venereal Diseases as a National and International Health Problem" for the Technical Discussions at the XVIII Pan American Sanitary Conference, XXII Meeting of the Regional Committee of the World Health Organization for the Americas.
Sept.–Oct. 1969 OD 99, 80
CD19.R33 The XIX Directing Council,
Having studied the information presented by the Director in Documents CD19/3, Corr., and CE61/151 and Resolution XXIV approved by the Executive Committee at its 61st Meeting; and
Recognizing the desirability of augmenting the size and scope of the Special Fund for Health Promotion, with the objective of further strengthening the health programs of the Americas,
1. To take note of the information provided by the Director in Documents CD19/3, Corr., and CE61/15 and of Resolution XXIV approved by the Executive Committee at its 61st Meeting.
2. To approve the expansion of the program of the Special Fund for Health Promotion to cover any other authorized health activities of the Organization.
3. To approve augmentation of the resources of the Fund in the following ways:
a) To authorize the Director to increase the amount of regular budget contributions to the Special Fund for Health Promotion (Part IV) in years when the budgetary situation will permit, subject to the limitations concerning transfer of credits between parts of the budget contained in the appropriation resolution;
b) To consider proposals that the Director may make for approval by the Directing Council of the transfer to the Special Fund for Health Promotion of any surplus that may occur and that is not required to maintain the Working Capital Fund at an adequate level; and
c) To request the Director to seek extra budgetary sources of funds, including voluntary contributions from public and private agencies.
Sept.–Oct. 1969OD 99, 81
CD19.R34 The XIX Directing Council,
Recognizing, on the basis of the fact, now well established, that cigarette smoking is an important cause of, or a substantial factor contributing to, premature deaths from bronchopulmonary cancer, coronary disease, chronic bronchitis, and chronic respiratory insufficiency;
Considering that cigarette smoking should be presented as harmful to health, and that an organization devoted to promoting health should set an example in this respect; and
Believing that each individual can decide for himself whether or not to indulge in the habit, bearing in mind that his example may invite others to smoke,
1. To request the Director to report to the XVIII Pan American Sanitary Conference:
a) On measures that have been taken to control the advertising of cigarettes by restriction of promotional material or by the inclusion of appropriate warnings on the packaging;
b) On other possible methods of warning the public; and
c) On measures that might be taken to control smoking in places of work or in public gatherings.
2. To recommend to persons attending meetings of the Governing Bodies of the Pan American Health Organization that they refrain from smoking.
Sept.–Oct. 1969 OD 99, 82
CD19.R35 The XIX Directing Council,
Having examined the report of the Director on the medical education programs undertaken by the Pan American Sanitary Bureau in collaboration with the various countries (Document CD19/16);1
Bearing in mind the urgency and importance of giving an impetus in the countries of the Region to programs for the development of health manpower, in particular manpower connected with medical education;
Having noted with satisfaction the direction being given by the Department of Human Resources Development of the Pan American Sanitary Bureau to its programs for collaboration with the Governments in the field of medical education in the Hemisphere; and
Considering the interest expressed by various universities of the Region in the review of their medical education programs, on the basis of objective information, with a view to bringing the training of health personnel more into line with the needs of the individual countries,
1. To urge the countries to review their programs for health personnel training on the multidisciplinary or health team basis in order to cater for the needs of the various services and to introduce new types of program and teaching structures more in line with the new orientation.
2. To express satisfaction with the Director's approach to medical education programs and to recognize the value of research on the teaching of medicine carried out by the Organization, and to request him to continue to provide the countries with assistance in studies of this type.
3. To recommend to the Director that he continue to give priority attention to continental programs for the development of health manpower in general.
4. To instruct the Director to pay special attention to medical education programs and to the close relationship they need to have with educational and training programs for other types of health personnel, along the lines set forth in Document CD19/16.
5. To request the Director to continue the close cooperation of the Bureau with universities and institutions of higher education in general that have responsibility for medical education in the various countries.
6. To reiterate the need to establish interinstitutional relations for the development of plans and the execution of training programs for health personnel and, in particular, the desirability of closer relations between ministries of health, universities, social security institutes, and national professional institutions.
Sept.–Oct. 1969 OD 99, 82
CD19.R36 The XIX Directing Council,
Having studied the report and recommendations presented by the Director in Document CD19/16, Addendum;
Bearing in mind the urgent need for full implementation of the textbook program, the purpose of which is to improve the quality of medical education and provide students as well as medical libraries with modern textbooks on terms suited to their financial possibilities;
Considering the essential role that would be played by the Pan American Health and Education Foundation in the financing of the textbook program as well as in the support of health and education programs in the Americas; and
Recognizing the need for interim financing to continue gradual implementation of the program pending approval of loan funds,
1. To reaffirm the importance for medical education of the textbook program, and to approve the steps taken so far.
2. To instruct the Director to continue negotiations with the Inter-American Development Bank.
3. To support and approve the activation of the Pan American Health and Education Foundation.
4. To authorize the Director, until such time as the textbook program is functioning under the Pan American Health and Education Foundation, to make temporary advances from the Working Capital Fund for the purchase of books under the textbook program. Such advances will be subject to approval by the Executive Committee in specific instances and will be repaid with the earliest proceeds from the sale of books.
Sept.–Oct. 1969 OD 99, 84
CD19.R37 The XIX Directing Council,
Having considered Resolution XII approved by the Executive Committee at its 61st Meeting and the information provided by the Director on the present status of multinational centers (Document CD19/21, Addendum);
Bearing in mind the extent of health problems in the Americas as compared with the limited funds available to the Organization for dealing with them;
Bearing in mind the importance of the efforts of the countries as a basic contribution to the solution of their problems, through programs in which the fundamental purpose of the Organization's participation is to promote and coordinate these efforts; and
Bearing in mind also the possibilities that the countries have of assuming more responsibility in this regard,
1. To declare that multinational centers are needed and useful, provided their policy continues to be designed to benefit all the countries; to support the steps taken by the Organization to develop and improve existing centers, which constitute an effective means whereby PAHO exercises its functions of stimulating and coordinating multinational programs for the improvement of health; [and to recommend that], in the future, multinational centers be established in accordance with the pertinent guidelines to be approved by the XVIII Pan American Sanitary Conference pursuant to operative paragraph 2 of this resolution.
2. To request the Director to appoint a study group to draw up a set of general guidelines [laying] down the basic conditions for the establishment and operation of multinational centers in the light of the observations contained in Resolution XII adopted by the Executive Committee at its 61st Meeting and in this resolution.
3. To recommend to the Member Countries that are the seat of multinational centers receiving funds from the PAHO budget that they study the possibility of assuming a progressively larger share of the operating budget of these centers, while maintaining their multinational character, within the ambit of the set of guidelines [that ultimately] will be approved by the XVIII Pan American Sanitary Conference pursuant to operative paragraphs 1 and 2 of this resolution.
4. To recommend to the Member Governments that they consider the possibility of national centers of recognized standing extending their services to the countries of the Continent, in the first place to other countries in the Zone, without necessarily using the funds of the Pan American Health Organization.
5. To recommend to the Director that the funds made available as a result of the implementation of the recommendations set forth in operative paragraphs 3 and 4 of this resolution be primarily used for aiding those Member Countries that request more assistance, bearing in mind the funds available to them, the program for which assistance is requested, and the effort that has been or will be made by the requesting country.
Sept.–Oct. 1969 OD 99, 84
CD19.R38 The XIX Directing Council,
Having considered Document CD19/15 containing proposed criteria for the award of within-country fellowships;
Considering that this program must be carried out gradually and be sufficiently flexible to allow desirable changes to be introduced into it; and
Considering Resolution XXIII approved by the Executive Committee at its 61st Meeting.
1. To approve provisionally the proposed criteria for the award of within-country fellowships, taking into account the discussion at the XIX Meeting of the Directing Council.
2. To request the Director to submit a report to the Directing Council on the program after it has been in operation for one year in order to ascertain whether or not it is necessary to modify the criteria.
3. To request the Director to inform the Governments of the proposed criteria for the award of within-country fellowships.
Sept.–Oct. 1969 OD 99, 86
CD19.R39 The XIX Directing Council,
Having considered the Final Report1 of the Technical Discussions on the "Financing of the Health Sector" held during the present meeting,
1. To take note of the Final Report of the Technical Discussions and to express its satisfaction with the [deliberations].
2. To express its thanks to the officials of the other international agencies and nongovernmental organizations who participated.
3. To recommend to the Director of the Pan American Sanitary Bureau that he give this report the widest possible distribution.
4. To recommend to the Director that he study the possibility of the Bureau:
a) Promoting national studies on the financing and expenditure of the health sector and also on the use of sectoral resources in aspects such as structure and institutional coordination, technical and administrative efficiency, and productivity of services both in the sector and in institutions;
b) Organizing a regional study for the purpose of improving the machinery for the allotment of domestic funds to the health sector;
c) Encouraging and coordinating feasibility studies of national health insurance schemes and other similar services, and of the possibility of establishing a multinational fund for the financing of the health sector; and
d) Organizing a regional study for the purpose of improving the machinery, conditions, and terms for external funds for developing the health infrastructure in the broad sense given in the Technical Discussions.
5. To recommend to the Director that, subject to budgetary limitations, the Bureau provide the necessary technical assistance for the proposed national studies.
Sept.–Oct. 1969 OD 99, 87
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