XXXV Directing Council of the Pan American Health Organization
CD35.R1 The Directing Council,
In establishing the contributions of Member and Participating Governments, their assessments shall be reduced further by the amount standing to their credit in the Tax Equalization Fund, except that credits of those countries which levy taxes on the emoluments received from the Pan American Sanitary Bureau (PASB) by their nationals and residents shall be reduced by the amounts of such tax reimbursements by PASB.
3. That, in accordance with the Financial Regulations of PAHO, amounts not exceeding the appropriations noted under paragraph 1 shall be available for the payment of obligations incurred during the period 1 January 1992 to 31 December 1993, inclusive. Notwithstanding the provision of this paragraph, obligations during the financial period 19921993 shall be limited to the total program budget, i.e., Parts IIV and Part V. Provision for Cost of Exchange/Inflation Rate Differential. Any balance in Part V will be available to be used for this purpose in subsequent financial periods.
4. That the Director shall be authorized to transfer credits between parts of the effective working budget, provided that such transfer of credits between parts as are made do not exceed 10% of the part from which the credit is transferred. Transfers of credits between parts of the budget in excess of 10% of the part from which the credit is transferred may be made with the concurrence of the Executive Committee. Part V may be transferred entirely into Parts IIV, if necessary. All transfers of budget credits shall be reported to the Directing Council or the Conference.
September 1991 OD 247, 112
CD35.R2 The Directing Council,
To establish the assessments of the Member and Participating Governments of the Pan American Health Organization for the financial period 19921993 in accordance with the scale of quotas shown below and in the corresponding amounts:
24 September 1991 OD 247, 113
CD35.R3 The Directing Council,
Having considered and approved the proposed program budget of the Pan American Health Organization for the biennium 19921993 and the report of the Director on the adverse effects of inflationary changes on it;
Aware of the impact on the Organization's regular program budget of movements of the rates of exchange between the US dollar and other regional currencies, many of which have already occurred in 19901991 and have adversely affected program implementation;
Conscious of the need to ensure that resources are available to the Organization to finance at least part of the additional costs that come from the exchange/inflation rate differentials; and
Believing that quota collections and revenues for the 19901991 biennium can be expected to exceed the Organization's approved effective working budget of US$130,023,000 and that surplus funds should be placed in a special fund to cover costs arising from exchange and inflation rate differential fluctuations.
1. To authorize the Director to establish a special account to meet the cost of exchange/inflation rate differentials and to transfer to this account funds not to exceed US$5,973,000, subject to availabilities from collections and revenues in excess of the 19901991 effective working budget of US$130,023,000, in order to meet part of the estimated increase in cost for 19921993 due to these differentials arising in the 19901991 biennium.
2. To authorize the Director in the future to credit or debit gains and losses from exchange inflation rate differentials to this special account.
3. To approve the availability of funds in this special account for subsequent financial periods.
September 1991 OD 247, 116
CD35.R4 The Directing Council,
Bearing in mind that it has been the practice of the Pan American Health Organization and the World Health Organization to have the same External Auditor, and that the holder of the Office of the Comptroller and Auditor General of the United Kingdom of Great Britain and Northern Ireland, who has been appointed External Auditor of the World Health Organization for the financial periods 19921993 and 19941995, has expressed a willingness to continue to serve as External Auditor of the Pan American Health Organization,
1. To appoint the holder of the Office of the Comptroller and Auditor General of the United Kingdom of Great Britain and Northern Ireland as External Auditor of the accounts of the Pan American Health Organization for the financial periods 19921993 and 19941995, and to request that he conduct his audits in accordance with the principles set forth in Article XII of the PAHO Financial Regulations, with the provision that, should the need arise, he may designate a representative to act in his absence.
2. To express its thanks to Sir John Bourn for the work he has performed for the Organization in his audit of the accounts for the financial periods 19861987 and 19881989.
September 1991 OD 247, 116
CD35.R5 The Directing Council,
Considering the revision made to the schedule of salaries for the professional and higher categories of staff in graded posts, effective 1 March 1991;
Taking into account the decision by the Executive Committee at its 107th Meeting to adjust the salaries of the Deputy Director and the Assistant Director (Resolution CE107.R13);
Having noted the recommendation of the Executive Committee concerning the salary of the Director of the Pan American Sanitary Bureau (Resolution CE107.R13); and
Bearing in mind the provisions of Staff Rule 330.3.
To establish the annual net salary of the Director of the Pan American Sanitary Bureau at US$77,639 (dependency rate) or US$69,628 (single rate), effective 1 March 1991.
September 1991 OD 247, 117
CD35.R6 The Directing Council,
Having considered the Final Report of the Special Subcommittee on Women, Health, and Development (Document CD35/12);
Aware of the importance of fully involving professional women in the Secretariat in attaining the goals of the Organization and in decision-making within the Organization, and in view of the inadequate progress made in these areas, as indicated in part in the Report on the Situation of Women in the Secretariat (Document SMSD11/9); and
Taking into account the resolutions adopted previously by the Governing Bodies of PAHO on Women, Health, and Development, and particularly Resolutions CSP22.R12 of the XXII Pan American Sanitary Conference and CD32.R9, CD33.R6, and CD34.R5 of the XXXII, XXXIII, and XXXIV Meetings of the Directing Council, respectively,
1. To request the Member Governments to:
a) Strengthen their strategies and plans of action for improving the quality of education: the sociocultural, economic, and legal situation; and the living and health conditions of women by taking a comprehensive, decentralized approach which addresses the health and social needs of all women:
b) Foster the promotion and recruitment of women to the managerial levels of the health sector:
c) Devise and adopt monitoring and evaluation methods that will document the progress made in implementation of the strategies and plans of action referred to in the foregoing paragraph;
d) Designate Focal Points on Women, Health, and Development if they have not yet done so, with access to the highest decision-making levels, and ensure that the Focal Points in all the countries of the Region have the opportunities for training, the information, and the resources needed for the performance of their functions;
e) Establish and tighten bonds of collaboration between the agencies responsible for health and those responsible for women's affairs, so that their programs will use resources efficiently and avoid duplication of efforts:
f) Establish and tighten bonds of collaboration between the agencies responsible for health and women and nongovernmental organizations, universities, and research centers working for the benefit and health of women, in the formulation and implementation of joint projects;
g) Facilitate the admission of the spouses of international civil servants to their labor markets;
h) Participate actively in the Technical Discussions on Women, Health, and Development to be conducted at the next World Health Assembly in May 1992;
i) Strengthen the arrangements for social participation by women in promoting the health of communities, enterprises, and education centers.
2. To congratulate the Director for the accomplishments, to date, of the Program on Women, Health, and Development, and particularly for its technical cooperation with the countries in the Region, and for his support of the development of that program as an integral activity of the Organization.
3. To recommend to the Director that he continue to strengthen the Organization's Program on Women, Health, and Development, and in particular that he:
a) Promote the establishment of mechanisms for coordination and collaboration between the Program on Women, Health, and Development and the Organization's other programs so that program activities address, as a priority, the needs and concerns of women in the Region;
b) Intensify the actions of the Program on Women, Health, and Development, and the identification and development of projects for technical cooperation at the national level and among countries (TCAC);
c) Pursue vigorously increased recruitment, hiring, and promotion of women into positions of authority in the Organization and in the health and social agencies within the Member States, and that he review the Organization's recruitment and hiring criteria, rules, and guidelines to assure that there are no discriminatory practices; and
d) Take a leadership role, in consultation with other international agencies and organizations and with Member States, to find solutions to the employment problems of the spouses of international civil servants.
25 September 1991 OD 247, 118
CD35.R7 The Directing Council
Elected Honduras, Peru, and Saint Vincent and the Grenadines to the Executive Committee upon termination of the periods of office of Canada, Trinidad and Tobago, and Venezuela, and thanked the Governments of these countries for the services rendered to the Organization by their representatives on the Committee.
September 1991 OD 247, 119
CD35.R8 The Directing Council
Having examined the report on acquired immunodeficiency syndrome (AIDS) in the Americas (Document CD35/14);
Recalling and reaffirming Resolution XIX of the XXIII Pan American Sanitary Conference;
Taking into account the difficulties of undertaking national, regional, and global efforts to prevent AIDS and human immunodeficiency virus (HIV) infection as identified therein; and
Considering the need for a concerted, continuous effort to reduce the social and economic consequences of the AIDS epidemic and of increasing HIV infection rates in the Americas,
1. To support the lines of action and biennial goals of the AIDS Program in the Americas as presented in Document CD35/14.
2. To recommend to the Member Governments that they place special emphasis on evaluating the effectiveness and efficiency of activities carried out under their national HIV and AIDS prevention and control programs, especially in the areas of infection prevention and health education.
3. To urge the Member Governments to promote the development of activities in the areas of research, technology transfer, and the dissemination of technical and scientific information.
4. To recommend to the Member Governments that they intensify activities designed to influence health behavior and prevent HIV infection through an approach based on intersectoral integration and decentralization to the state, provincial, and community levels.
5. To request the Director of the Pan American Sanitary Bureau to continue the Organization's support to national AIDS and HIV prevention and control programs through interprogram efforts coordinated both at Headquarters and in the Country Offices.
September 1991 OD 247, 120
CD35.R9 The Directing Council
Having considered and examined the progress report presented by the Director (Document CD35/15 and Add. I and II) on the implementation of the Expanded Program on Immunization and the Plan of Action for the Eradication of Indigenous Transmission of Wild Poliovirus from the Americas;
Noting with satisfaction that: a) immunization coverage levels for children under one year of age have achieved at least 75% for each of the vaccines included in the program (DPT, polio, measles, and BCG), the highest level ever achieved in the Americas; b) transmission of wild poliovirus has been virtually interrupted in the Hemisphere, with only 17 cases reported in 1990 and only two during the first six months of 1991; and c) considerable progress has been made in regard to strategies to control or eliminate neonatal tetanus and measles;
Recognizing that considerable efforts will be needed to: a) achieve final eradication of indigenous transmission of wild poliovirus in the few remaining foci; b) maintain and increase the overall immunization coverage levels; c) control or eliminate neonatal tetanus and measles; and d) include new vaccines in the national immunization programs; and
Concerned that the global shortage of EPI vaccines, particularly measles and polio, could jeopardize the efforts of countries in maintaining the immunization coverage already achieved and the control of the EPI diseases.
1. To congratulate all Member Governments and their health workers on the progress achieved so far, which demonstrates their high level of commitment to the health of the children of this Hemisphere.
2. To express appreciation and request continued support from the various agencies (United States Agency for International Development, UNICEF, Inter-American Development Bank. Rotary International, and the Canadian Public Health Association) which, together with PAHO, have given strong support to the national immunization programs and efforts to eradicate poliomyelitis.
3. To commend the Organization for its enthusiastic, outstanding support of the Member Governments' efforts to implement their national immunization programs and to eradicate poliomyelitis.
4. To urge Member Governments to adopt the "Priorities for Action" described in Chapter II of the progress report (Document CD35/15), to ensure that:
a) Immunization coverage is monitored by districts and that missed opportunities for vaccination are eliminated;
b) All vaccines used in the program conform to the minimum requirements of PAHO/WHO;
c) Weekly negative reports are transmitted in a timely manner from all health facilities included in the surveillance system, and that the PAHO reward of US$100.00 for any person reporting the first confirmed polio case of an outbreak is widely publicized by all countries;
d) "Mop-up" operations are properly implemented, with two cycles of house-to-house vaccination, one month apart, in which all children under five years of age living in an extensive area, usually encompassing several districts, receive one OPV dose in each cycle, regardless of their previous vaccination status;
e) The surveillance system records separately neonatal and post-neonatal tetanus cases, and that vaccination programs are implemented in those districts already identified as at risk;
f) Human and financial resources are assigned to the program in the national health budgets and in the 19911996 national EPI Work Plans.
5. To request the Director to:
a) Apply all the needed measures to ensure the final interruption of transmission of wild poliovirus in the Western Hemisphere;
b) Evaluate the strategies for measles control/elimination being used in Cuba and the English-speaking Caribbean and the feasibility of their implementation in the rest of the Western Hemisphere;
c) Monitor the activities for neonatal tetanus control in those areas identified as at risk and support the expansion of surveillance to verify the degree of impact;
d) Continue aggressive efforts to mobilize the needed additional resources to face the challenges described in the progress report;
e) Take the necessary actions to address the issue of vaccine shortage, with the aim of achieving regional self-sufficiency in all matters of vaccine production and quality control;
f) Report on the progress of the program to the XXXVI Meeting of the Directing Council in 1992.
September 1991 OD 247,121
CD35.R10 The Directing Council,
Having considered the Annual Report of the Chairman of the Executive Committee (Document CD35/8) on the work of the Committee from September 1990 to date, the period during which the 106th and 107th Meetings were held; and
Bearing in mind the provisions of Article 9.C of the Constitution of the Pan American Health Organization,
1. To take note of the Annual Report of the Chairman of the Executive Committee (Document CD35/8).
2. To congratulate the Chairman and the other members of the Executive Committee on their excellent work.
September 1991 OD 247, 123
CD35.R11 The Directing Council,
Having examined the Annual Report of the Director of the Pan American Sanitary Bureau on the activities of PAHO during 1990 (Official Document 243); and
Bearing in mind the provisions of Article 9.C of the Constitution of the Pan American Health Organization,
1. To take note of the Annual Report of the Director of the Pan American Sanitary Bureau for 1990.
2. To congratulate the Director for his continued efforts to make the Report a dynamic working tool that accurately reflects the work done by PAHO and assists in evaluating the execution of the cooperation activities carried out during the period covered.
3. To thank the Director for his leadership and support to the Member Governments in the technical cooperation activities carried out by PAHO during 1990.
September 1991 OD 247, 123
CD35.R12 The Directing Council,
Having considered the report of the Director on the Collection of Quota Contributions (Document CD35/21 and Add. I) and the concerns expressed by the 107th Meeting of the Executive Committee with respect to the status of the collection of quota contributions;
Noting the report of the Working Party on the application of Article 6.B of the PAHO Constitution relating to the suspension of voting privileges of Member Governments that fail to meet their financial obligations to the Organization (Document CD35/21, Add. II);
Recognizing that, in the case of the seven Member Governments subject to Article 6.B, Guyana and Bolivia, through recent payment action, are no longer subject to Article 6.B; and
Further noting that Antigua and Barbuda, the Dominican Republic, Guatemala, Haiti, and Suriname are not present at this Meeting of the Directing Council.
1. To take note of the report of the Director on the Collection of Quota Contributions (Document CD35/21 and Add. I).
2. To express appreciation to those Member Governments that have already made payments in 1991, and to urge all Member Governments in arrears to meet their financial obligations to the Organization in an expeditious manner.
3. To congratulate Guyana and Bolivia for their payment efforts to reduce quota arrears for prior years.
4. To recognize the concern expressed at the meeting of the Working Party with respect to the future voting privileges of Antigua and Barbuda and to request the Director to advise the Government of the views of the Council.
5. To request the Director to notify Antigua and Barbuda, the Dominican Republic, Guatemala, Haiti, and Suriname that their voting privileges will be suspended effective with the commencement of the XXXVI Meeting of the Directing Council unless specific and acceptable plans of payment are received by the Secretariat, and that the voting privileges will be automatically restored by this action.
6. To endorse the Working Party's recommendation that all deferred payment plans be considered firm commitments by the countries concerned and not be modified in the future.
7. To request that the Director:
a) Continue to monitor the implementation of special payment agreements made by Member Governments in arrears for the payment of prior years' quota assessments;
b) Advise the Executive Committee of Member Governments' compliance with their quota payments' commitments;
c) Report to the XXXVI Meeting of the Directing Council on the status of the collection of quota contributions for 1992 and prior years.
September 1991 OD 247, 124
CD35.R13 The Directing Council,
Having examined the Interim Financial Report of the Director for the Year 1990 (Official Document 242); and
Noting the report of the 107th Meeting of the Executive Committee on its review of the financial statements and schedules of the Organization as contained in Official Document 242,
1. To take note of the Interim Financial Report of the Director for the Year 1990.
2. To endorse the comments and concerns expressed by the 107th Meeting of the Executive Committee in its report on the financial condition of the Organization as of 31 December 1990, and in particular the concern expressed with respect to the impact that the delayed payment of quota assessments may have on the financial status of the Organization's Centers in Jamaica and Guatemala.
3. To commend the Director for having maintained the Organization in a satisfactory financial condition.
September 1991 OD 247, 125
CD35.R14 The Directing Council
Having seen Document CD35/16 on the status of the eradication/elimination of certain diseases from the Region;
Taking into account Resolution XVI of the XXIII Pan American Sanitary Conference; and
Recognizing that some countries have eradicated or eliminated poliomyelitis, neonatal tetanus, urban rabies, and foot-and-mouth disease; that the decision has been made to eliminate measles (in the Caribbean); and that it is feasible to seek to eradicate or eliminate from the Region of the Americas other communicable diseases such as American trypanosomiasis transmitted through blood transfusion, leprosy, the nonvenereal treponematoses, onchocerciasis, and micronutrient deficiencies,
1. To adopt the recommendations contained in Document CD35/16 for the elimination, eradication, or control of certain diseases.
2. To urge the Member Governments:
a) To continue giving priority to the effective prevention, control, and surveillance of diseases preventable by immunization until they are eliminated:
b) To foster the necessary collaboration and coordination between the different levels of the public sector, and between it and the private sector, for the completion and execution of updated plans of action to prevent, control, and maintain surveillance of:
i) the following infectious diseases: American trypanosomiasis transmitted by blood transfusion, leprosy, the nonvenereal treponematoses (yaws and pinta), and onchocerciasis; and
ii) deficiencies of the following micronutrients; iodine and vitamin A;
c) To incorporate activities for the prevention and control of these diseases into local health systems and to encourage community participation and local programming so that the measures taken will be comprehensive and make use of all available resources.
3. To request the Director:
a) To promote the mobilization of institutional, human, and financial resources in the countries, the Region, and the rest of the world for the development and use of the health system infrastructure, especially the local health systems, in effective and consistent control programs;
b) To foster the establishment, strengthening, and proper functioning of epidemiological services that can analyze health situations, risk factors, and the characteristics of ecosystems, and evaluate social and health services;
c) To promote technical cooperation for the development of epidemiological programs and surveillance in joint efforts for the preservation of transmission-free areas;
d) To support the development of managerial and administrative capabilities at the lowest decision-making levels in order to promote local programming and the evaluation of prevention, control, and surveillance methods in local situations.
September 1991 OD 247, 126
CD35.R15 The Directing Council,
Having seen the document presented by the Director on the evaluation of the International Drinking Water Supply and Sanitation Decade (IDWSSD) (19811990);
Recalling Resolution XXII of the XXVI Meeting of the Directing Council of PAHO (1979), and Resolutions WHA36.131 (1983) and WHA39.202 (1986) of the World Health Assembly on the Decade, which recognized water supplies and sanitation as essential elements for the achievement of Health for All by the Year 2000;
Noting the efforts made by the Governments, the contribution of the external support agencies (ESA), and the achievements of the IDWSSD program;
Aware of the efforts made by the Governments and the Director in the national and regional evaluation of the IDWSSD;
Considering that several countries of the Region were unable to attain their national goals due to the unfavorable socioeconomic conditions in the Region and to other factors;
Recognizing that the IDWSSD program has created considerable awareness of the need for water supplies and sanitation as essential elements for primary health care;
Noting further that the continued expansion of poor urban marginal areas where water and sanitation services are deficient constitutes high risks for transmission of diseases, particularly typhoid and cholera; and
Taking into account the recommendations of the Declaration of New Delhi, the Declaration of Puerto Rico, and the recommendations of the Director concerning a plan of action for IDWSSD,
1. To urge Member Governments to:
a) Renew their political commitment to the improvement of water supplies and sanitation services, and to reiterate the importance of the relationship of health to access to adequate water supplies and sanitation services;
b) Intensify, with urgency, the action needed for the formulation and implementation of programs and projects to increase further the coverage of water supplies and of sewerage and excreta disposal services, particularly in poor marginal urban and rural areas, and to promote the rehabilitation of existing services where such services have shown signs of deterioration;
c) Improve water quality through the protection of water sources, including the treatment of waste that may affect them, and the improved management of water treatment and distribution systems,
d) Define policies and promote practices for water conservation, including the control of water losses, and to optimize the use of existing systems through better operation and maintenance and more efficient use of the facilities, and through the education of consumers about the conservation and use of water;
e) Define effective policies and promote practices for financial and engineering management of the systems that will provide more sustainable services, including appropriate recovery of costs with due regard for social equity and the adoption of appropriate technology;
f) Promote social mobilization in the water and sanitation sector, involving communities in planning, financing, and managing water and sanitation services;
g) Develop national monitoring and management information systems to improve knowledge of conditions in the sector and provide the basis for decision-making.
2. To urge bilateral, multilateral, and nongovernmental cooperation agencies to:
a) Recognize the importance of water and sanitation for socioeconomic development and to promote research in this area;
b) Increase their financial contribution to the water and sanitation sector in order to help the countries meet their respective objectives;
c) Develop effective mechanisms for coordination of sector activities within the external support community;
d) Support sector development and monitoring.
3. To request the Director to:
a) Continue to give high priority to the promotion of the development and efficient management of basic water supplies and sanitation services in the countries, with emphasis on the urban and rural poor and high-risk groups;
b) Develop, as soon as possible, a plan of action to guide and support the countries in their efforts to implement the recommendations of the Declarations of New Delhi and Puerto Rico toward the achievement of water and sanitation goals, within the strategy of Health for All by the Year 2000;
c) Assist the countries in developing and maintaining a national information system to monitor and evaluate program progress as well as sector and regional progress;
d) Support actively actions which are complementary to water and sanitation programs, and to increase their sanitary and health impact; these actions should include education and training programs, research, technology development, information exchange, and community participation;
e) Continue to work closely with bilateral and multilateral cooperation agencies in order to optimize resource mobilization and to promote intersectoral collaboration among national sector agencies;
f) Support technical cooperation efforts among the countries by strengthening subregional and regional professional organizations;
g) Encourage translation of the results of the current country evaluations of programs and projects carried out during the Water Decade into effective action plans for programs during the decade of the nineties.
September 1991 OD 247, 127
CD35.R16 The Directing Council,
Having considered Document CD35/17 on maternal and child health and family planning programs, which contains the third progress report presented by the Director on execution of the Organization's action policy on population matters;
Recognizing the progress made in execution of the strategies recommended by the XXIII Pan American Sanitary Conference in 19901 and by the Directing Council of PAHO in its meetings of 1984,2 1985,3 and 1988,4 Considering the present state of development of the national programs in the field of maternal and child health and family planning, and of the areas that require strengthening;
Cognizant of the improvement in the indicators of maternal and child health and family planning in the population of Latin America and the Caribbean at the close of the 1980s and of the expected trends in the 1990s; and
Mindful of the commitments undertaken by the Presidents or Heads of State of the Americas in the Declaration of the World Summit for Children,
1. To urge the Governments:
a) To review and update their national maternal and child health and family planning programs before December 1991 so that they will reflect the spirit, strategies, and goals recommended in their respective plans of action;
b) To promote at the central, regional, and local levels in their countries the decisions and commitments of the Summit, and to call upon the public and private sectors to join in attaining the national goals on behalf of women and children;
c) To help devise a methodology for better estimating the costs of the maternal and child health and family planning programs in the 1990s, which will facilitate the design of financial strategies and the mobilization of resources;
d) To facilitate obtaining better working conditions for mothers, and reducing the unemployment of parents of children under one year of age;
e) To give priority in their actions to i) coverage of as yet neglected geographic areas, ii) marginal urban and rural population groups, and iii) comprehensive care of women, children, and adolescents, with strengthened sex and health education, and to make efforts to improve the quality of care in order to close existing gaps;
f) To strengthen the establishment and consolidation of interagency coordination mechanisms for maternal and child health, through a committee to be headed by a Government employee with decision-making authority;
g) To continue developing their epidemiological surveillance systems and data bases for improved monitoring and evaluation of programs;
h) To ensure that in their countries the aspects of population, development, health, and reproductive health are covered in their reports and proposals at the International Conference on Population in 1994;
i) To continue implementing the recommendations and resolutions issued by the Governing Bodies of PAHO in the area of maternal and child health and population;
j) To give special attention to comprehensive care for preschool children through strategies for the stimulation of their optimal growth and development.
2. To request the Director:
a) To continue his guidance of technical cooperation in the field of maternal and child health toward execution of the mandates of the Governing Bodies in support of implementation of the Plan of Action of the World Summit for Children, in keeping with the strategic priorities of the quadrennium, especially by participating actively with the countries in each phase of development and in the implementation of national maternal and child health plans;
b) To continue his efforts to find and to support strategies for financing and mobilization of national and international resources;
c) To give priority to development of the data bases needed for the monitoring and evaluation of conditions of maternal and child health and reproductive health;
d) To promote, in conjunction with the Governments, the formation and development of interagency committees as an arrangement for making better use of existing resources;
e) To include the topic "Comprehensive Health of Adolescents" on the agenda of the next meeting of the Directing Council.
3. To take note of the "Memorandum of Interagency Collaboration to Support Implementation of the Agreements of the World Summit for Children in the Region of the Americas," and to commend and express its satisfaction to the Heads of the signatory agencies for the actions taken in developing an interagency work plan for 19911992 which will contribute to achieving the common goal of promoting the health of children, adolescents, and women in the Region.
September 1991 OD 247, 129
CD35.R17 The Directing Council
Considering the spread of the cholera epidemic in several countries of the Region;
Recognizing that, in the face of the threat of introduction of the disease to other countries of the Region, concrete measures must be adopted to limit its spread and to prevent mortality and reduce morbidity from the disease;
Cognizant that the parenteral vaccines presently available are not recommended for the prevention or control of cholera;
Aware of the link between the occurrence of cholera and the socioeconomic and sanitary situations in affected areas;
Noting the Director's initiative to coordinate the Organization's response to this emergency;
Mindful of the subregional action of the Andean and Central American countries to prepare coordinated plans for dealing with the emergency and to reinforce preparations against the threat; and
Informed of the general strategy proposed by the Organization to address the problem, and of Resolution WHA44.6,1
1. To call upon the international community to intensify its cooperation with the countries affected or threatened by cholera.
2. To urge the international and regional agencies concerned to give more priority to granting to these countries the technical and financial cooperation they may request for their struggle against cholera.
3. To express appreciation for the Organization's response, to date, in support of Member Governments' efforts to contain the cholera epidemic in the Region.
4. To urge the Member Governments:
a) To report any case of cholera immediately, in compliance with the International Sanitary Regulations;
b) Not to apply to countries affected by the epidemic restrictions on passenger transit and imports of products which are not justified from the standpoint of public health;
c) To establish and execute national plans for the prevention and control of cholera that identify the most vulnerable areas and population groups, allocate the resources required to launch those plans, assure use of an intersectoral approach, address the need for effective social communications, and indicate the need for international technical and financial cooperation in the context of the Organization's general strategy;
d) In the countries as yet untouched by the epidemic, to strengthen capabilities for epidemiological surveillance, control of the quality of drinking water, basic sanitation and food protection and control, social communication, and to strengthen diarrhea control programs with emphasis on proper case management, public information, and health personnel training.
5. To request the Director:
a) To strengthen measures that will ensure a prompt and effective response by the Organization to the needs of countries affected or threatened by cholera;
b) To assure that the Organization plays an active, creative role in mobilizing resources from all sources to provide the countries in the Region with the financial support required for their cholera prevention and control plans;
c) To coordinate regional measures against cholera so that technical and financial resources will be put to the most efficient possible use;
d) To continue activities for the development and evaluation of effective new vaccines against cholera;
e) To continue his efforts, in collaboration with the Member Governments and interested agencies and organizations, to implement the proposed general strategy by drawing up plans, programs, and projects for its implementation and full execution;
f) To prepare, in close collaboration with the Member Countries and other cooperation agencies, a long-term plan of investment in health and the environment for meeting the infrastructural requirements in those areas.
September 1991 OD 247, 131
CD35.R18 The Directing Council,
The economic crisis in the countries of the Region and their policies for adjusting to it have reduced the resources available to the health sector;
Several initiatives have been undertaken to convert the external debt of countries in the Region into local currency and to obtain additional resources for the financing of socioeconomic development projects, the initiatives having been conducted both in negotiations by the debtor countries with private banks and in the area of bilateral relations, as in the case of President Bush's Enterprise for the Americas initiative;
Consideration is being given to the possibility of converting the indebtedness to the public sectors of the Club of Paris countries for application to social projects in the debtor countries;
Other United Nations agencies are experimenting with debt conversions to finance social projects; and
The health sector has hitherto benefited very little from these initiatives,
1. To recommend to the economic and health authorities in the PAHO/WHO Member Countries that they explore the possibilities of converting part of their respective debts into local currency for the financing of health projects and, if they consider this course feasible, that they establish the mechanisms needed to implement such operations.
2. To urge the creditor countries, the international financing agencies, and the private banks to extend to the developing countries in the Region debt conversion facilities for the financing of projects in the health sector as is done in other sectors.
3. To call upon the nongovernmental organizations operating at the country and regional levels to support the countries of the Region in their efforts to introduce cost-effective health services and to search for new resources to finance health projects through external debt conversion operations.
4. To request the Director of PASB to support the Member Countries in their efforts to attract resources for the financing of health projects through external debt conversion, in the promotion of this mechanism at the international level, and in the formulation, execution, and evaluation of the resulting projects, and to report to the XXXVI Meeting of the Directing Council on the progress of his efforts in this direction.
September 1991 OD 247, 133
CD35.R19 The Directing Council
Having examined the document presented by the Director to the XXXV Meeting of the Directing Council on the Second Evaluation of the Strategies for Health for All by the Year 2000 and primary health care (Document CD35/19); and
Mindful of the commitments undertaken by the Member States of WHO in the Thirty-ninth World Health Assembly (Resolution WHA39.7, 1986)1 on the presentation of monitoring reports on these matters.
Resolves:To approve the document presented by the Director and to request that he send it to WHO as the regional report, with the changes suggested by the Members of the Regional Committee. To request that an in-depth review be carried out of the instruments used for monitoring and evaluation, which are regarded as in need of adjustment for a proper response on the part of the countries. To call for a renewal of the commitment of the Member Countries of the Region to the Strategies for Health for All by the Year 2000 and to primary health care, which provide the indispensable conceptual framework for addressing the epidmeiological, socioeconomic, and financial situation of the sector in the last decade of the 20th century.
September 1991 OD 247, 134
CD35.R20 The Directing Council,
Having considered the recommendation of the Executive Committee and the changes in the Financial Regulations proposed in Document CD35/25; and
Taking into consideration that the changes in the Rules and Regulations will provide conformity between the Financial Rules and Regulations of WHO and PAHO with respect to the availability of appropriations,
To approve the changes in the Financial Rules and Regulations of the Pan American Health Organization as they appear in Document CD35/25.
September 1991 OD 247, 135
CD35.R21 The Directing Council,
Taking note of the negotiations during the period JuneSeptember 1991 between the Government of Argentina and the Director of the Pan American Sanitary Bureau for the establishment of a Pan American Institute for Food Protection and Zoonoses;
Considering the importance for all Member Countries of having an international institute for providing technical cooperation with regard to reference, research, and information in matters of food protection, the strengthening of official public health laboratories, and zoonoses; and
Acknowledging the interest and generous commitment of the Government of Argentina to host the Institute in its territory,
1. To congratulate the Government of Argentina and the Director of the Pan American Sanitary Bureau for the negotiations toward the establishment of a Pan American Institute for Food Protection and Zoonoses (INPPAZ) and to approve the establishment of this Institute as a Pan American Center in accordance with Resolution CSP20.R31 of the XX Pan American Sanitary Conference (4 October 1978).
2. To authorize the Director of the Bureau to sign an agreement with the Government of Argentina along the lines of the draft agreement included in Annex I (Part B) of Document CD35/27, and to make the necessary legal and administrative arrangements to formalize the agreement and implement it.
3. To express profound appreciation to the Government of Argentina for its interest and commitment to host the Institute.
4. To request the Director to report next year to the Governing Bodies of PAHO on the establishment and initial development of INPPAZ.
September 1991 OD 247, 135