CSP21.R1  The XXI Pan American Sanitary Conference,

Having examined the formal request for membership in the Pan American Health Organization made on behalf of the Government of Antigua and Barbuda by the Deputy Prime Minister (Minister of Foreign Affairs) in a communication dated 27 February 1982; and

Considering that the Government of Antigua and Barbuda has declared its readiness to accept all the obligations of the Constitution of the Pan American Health Organization, to comply with the provisions of the Pan American Sanitary Code, as amended by the Additional Protocol of 24 September 1952, and to contribute by means of a quota assessment to the financial support of the Organization

Resolves:

1. To approve with satisfaction the request of the Government of Antigua and Barbuda for membership in the Pan American Health Organization.

2. To instruct the Director to transmit this decision to the Member Governments of the Organization.

Sept. 1982 OD 185, 52

CSP21.R2  The XXI Pan American Sanitary Conference,

Having examined the formal request for membership in the Pan American Health Organization made on behalf of the Government of Belize by the Prime Minister (Minister of Foreign Affairs) in a communication dated 17 March 1982; and

Considering that the Government of Belize has declared its readiness to accept all the obligations of the Constitution of the Pan American Health Organization, to comply with the provisions of the Pan American Sanitary Code, as amended by the Additional Protocol of 24 September 1952, and to contribute by means of a quota assessment to the financial support of the Organization,

Resolves:

1. To approve with satisfaction the request of the Government of Belize for membership in the Pan American Health Organization.

2. To instruct the Director to transmit this decision to the Member Governments of the Organization.

Sept. 1982 OD 185, 52

CSP21.R3  The XXI Pan American Sanitary Conference,

Having considered the report of the working party on the application of Article 6.B of the Constitution of the Pan American Health Organization relating to the suspension of voting privileges of Governments that fail to meet their financial obligations.

Resolves:

To permit the delegates of the countries mentioned in the report of the working party to vote at the XXI Pan American Sanitary Conference.

Sept. 1982 OD 185, 53

CSP21.R4  The XXI Pan American Sanitary Conference,

Having considered the amendments to the Rules of Procedure of the Pan American Sanitary Conference recommended by the 88th Meeting of the Executive Committee1 and contained in Document CSP21/8; and

Considering the desirability of facilitating the conduct of business at meetings of the Pan American Sanitary Conference,

Resolves:

To adopt the following wording for Rules of Procedure 45, 46, and 53:

Rule 45

For the purpose of these Rules, "Governments present and voting" means Governments casting a valid affirmative or negative vote; or in an election, a valid vote for a person or a Government eligible in accordance with the Constitution or these Rules of Procedure. For the purpose of these Rules, "majority" means any number of votes greater than half the votes cast by the Governments present and voting or, in the case of the election of the Director, any number of votes greater than half the number of the Governments of the Organization. Governments abstaining from voting or who cast blank ballots or invalid votes are considered as not voting In computing a majority, any fraction shall be counted as a whole number.

Rule 46

A motion shall be considered adopted when it has received the affirmative vote of the majority of the Governments present and voting, except when the Constitution or these Rules of Procedure otherwise provide. If the votes are equally divided on a matter other than an election the motion will be regarded as not adopted.

Rule 53

In an election each Government, unless it abstains, shall vote for that number of candidates equal to or less than the number of elective places to be filled. Any ballot paper on which there are more names than there are elective places to be filled, or on which the name of any candidate appears more than once, or which is illegible or signed or which reveals the identity of the voter, shall be considered null and void.

Sept. 1982 OD 185, 54

CSP21.R5  The XXI Pan American Sanitary Conference,

Having examined the Annual Report of the Chairman of the Executive Committee (Document CSP21/27) on the work of the Committee from October 1981 to date, the period during which the 87th and 88th Meetings were held; and

Bearing in mind the provisions of Article 9.C of the Constitution of the Pan American Health Organization,

Resolves:

1. To take note of the Annual Report of the Chairman of the Executive Committee (Document CSP21/27).

2. To congratulate the Chairman and the other members of the Committee on their excellent work.

Sept. 1982 OD 185, 55

CSP21.R6  The XXI Pan American Sanitary Conference,

Having examined the Quadrennial Report, 1978-1981, and Annual Report, 1981, of the Director of the Bureau on the activities of the Pan American Health Organization during the period between the XX and XXI Pan American Sanitary Conferences (Official Document 183); and

Bearing in mind the provisions of Article 4.F of the Constitution of the Pan American Health Organization,

Resolves:

To approve the Quadrennial and Annual Reports of the Director (Official Document 183) to the Governments of the Pan American Health Organization, and to congratulate the Director and the staff of the Bureau on the work accomplished in the past four years.

Sept. 1982 OD 185, 56

CSP21.R7  The XXI Pan American Sanitary Conference,

Having reviewed the report of the Director on the Expanded Program on Immunization (EPI) (Document CSP21/18 and Add. I), and taking note of the status of capitalization of the EPI Revolving Fund;

Recognizing that the limited capitalization of the Fund continues to hamper its smooth operations; and

Considering that the EPI Revolving Fund is of crucial importance for the implementation of this high priority program and noting that from time to time surplus funds are available within the Reserve Account for the EPI Revolving Fund that could be beneficially used as additional capital,

Resolves:

1. To express its thanks to the Governments of Bahamas, Barbados, Belize, Cayman Islands, Chile, Cuba, Dominica, Kingdom of the Netherlands, Mexico, and Panama for the donations to the Fund as well as to express appreciation to those persons and the group that made private donations to the Fund.

2. To urge other Member Countries to contribute to the Fund.

3. To commend the Director for the efforts being made to assure efficient operation of the Fund within the limited capitalization available, and to recommend that efforts to secure additional capitalization be continued.

4. To authorize the Director to transfer available funds over and above a minimum Reserve Account balance of US$100,000 to the EPI Revolving Fund as additional capital.

5. To further authorize the Director to transfer funds from the Revolving Fund to the Reserve Account in the event that the dollar balance in the latter account at any one time is insufficient to defray any single or series of unexpected losses that might occur within the EPI in amounts that do not exceed those which the Revolving Fund shall have previously received from the Reserve Account.

6. To request the Director to designate a Regional Advisory Committee to assist him, at his discretion, in technical and administrative aspects of the EPI as the Program develops, without exceeding the existing budgetary availability.

Sept. 1982 OD 185, 56

CSP21.R8 The XXI Pan American Sanitary Conference,

Bearing in mind Articles 4 E and 21.A of the Constitution of the Pan American Health Organization, which provide that the Pan American Sanitary Bureau shall have a Director elected at the Conference by the vote of a majority of the Governments of the Organization:

Bearing in mind Rule 45 of the Rules of Procedure of the Conference, which provides that the Director of the Bureau shall be elected by any number of votes greater than half the number of the Governments of the Organization;

Bearing in mind Article 4 of the Agreement between the World Health Organization and the Pan American Health Organization and Articles 49 and 52 of the Constitution of the World Health Organization, which establish the procedure for the appointment of Regional Directors of the World Health Organization; and

Satisfied that the election of the Director of the Bureau has been held in accordance with the aforestated procedure,

Resolves:

1. To declare Dr. Carlyle Guerra de Macedo elected Director of the Pan American Sanitary Bureau for a period of four years to begin 1 February 1983.

2. To submit to the Executive Board of the World Health Organization the name of Dr. Carlyle Guerra de Macedo for appointment as Regional Director for the Americas.

Sept. 1982 OD 185, 57

CSP21.R9  The XXI Pan American Sanitary Conference,

The XXI Pan American Sanitary Conference elected the Governments of Cuba, Ecuador, and the United States of America, to the Executive Committee upon the termination of the periods of office of Chile, Guyana, and Mexico, and thanked the Governments of these countries for the services rendered to the Organization by their representatives on the Committee.

Sept. 1982 OD 185, 58

CSP21.R10  The XXI Pan American Sanitary Conference,

Having considered Resolution XVII of the 88th Meeting of the Executive Committee and the tentative allocation of US$50,834,000 from the World Health Organization for the Region of the Americas for the biennium 1984-1985; and

Noting the recommendations made by the 88th Meeting of the Executive Committee,

Resolves:

To take note of the US$50,834,000 tentatively allocated to the Region of the Americas by the Director-General of WHO to contribute to the support of the PAHO/WHO regular provisional program, whose tentative distribution has been considered.

Sept. 1982 OD 185, 15

CSP21.R11  The XXI Pan American Sanitary Conference,

Convinced that the reports from the Governments of the Organization on health conditions and the progress achieved in the interval between one Conference and the next provide extremely useful data and records of experience; and

Considering that their presentation by the Governments constitutes a useful and important item on the agenda of the Conference,

Resolves:

To thank the Governments for the reports presented by their Delegates to the Conference, and to underscore their value for future programming of the activities of the health sector.

Sept 1982 OD 185, 60

CSP21.R12  The XXI Pan American Sanitary Conference,

Having examined the progress report on the Plan of Action (Document CSP21;26 and Add. I) prepared by the Director, as well as the report of the Executive Committee;1

Noting the steps that the Director has taken to strengthen the catalytic role of the Organization in the implementation of the Regional Plan of Action for health for all as well as the reports of Member Governments on their own activities to implement the process of health for all;

Taking note of the Global Strategy of Health for All by the Year 2000, approved by Resolution WHA34.562 of the World Health Assembly (1981) and Resolution XX of the XXVII Meeting of the PAHO Directing Council (1980);

Considering that Resolution XI of the XXVIII Meeting of the Directing Council (1981) recognizes the urgency of pursuing the required strategies of health for all; and

Recalling that Resolution XI urged the Governments to instruct their Ministers of Health to formally reaffirm at this XXI Pan American Sanitary Conference their commitment to the implementation of the Regional Plan of Action,

Resolves:

1. To reaffirm the commitment of all the Member Governments of the Pan American Health Organization to develop the necessary activities that will ensure the implementation of the Regional Plan of Action.

2. To urge the Governments to:

a) Support and promote the implementation of the Plan of Action by initiating further activities at the national level to promote a broader understanding of the process of health for all;

b) Take further steps to adjust national health plans in keeping with the Plan of Action and, in that process, to assure the most effective reprogramming of external cooperation;

c) Set in motion the process of improving national information systems so as to contribute to the effective incorporation of monitoring and evaluation systems in the managerial process for national health development;

d) Ensure, at the highest level, the effective communication and cooperation among the different political, social, and economic sectors in order to make health an integral part of socioeconomic development.

3. To express appreciation to the Director for the activities initiated by the Organization in support of the implementation of the Plan of Action, and particularly for the series of regional seminar/workshops on the Plan of Action.

4. To request the Director to:

a) Encourage and support additional activities at the national level to implement the Plan of Action;

b) Support and increase the measures adopted to strengthen the catalytic role of the Organization in the exchange of experiences and cooperation among Member Countries and the international community.

Sept. 1982 OD 185, 60

CSP21.R13  The XXI Pan American Sanitary Conference,

Having seen the report of the Director (Document CSP21/23) on the implementation of the Directing Council's recommendations on WHO's structures in light of its functions;

Bearing in mind Resolution WHA33.171 and the extensive efforts by the Subcommittee set up to study the subject at the 84th and 86th2 Meetings of the Executive Committee:

Considering the positive impetus for change generated by the XXVII Meeting of the Directing Council, particularly in Resolutions X and XX; and

Recognizing the integral and complementary aspects of Resolutions XI, XII, XIII, and XIV of the XXVIII Meeting of the Directing Council.

Resolves:

1. To take note of the innovative and positive efforts made by the XXVII and XXVIII Meetings of the Directing Council in generating the impetus for change integral to the strategies of health for all by the year 2000 and the Regional Plan of Action.

2. To congratulate the Member Governments on their commitment and their continued efforts to implement the recommendations of Resolution X of the XXVII Meeting of the Directing Council.

3. To thank the Director for his report.

4. To request the Director to continue to monitor the further progress of these initiatives and inform the Governing Bodies through the reporting process of the monitoring and evaluation of the Regional Plan of Action.

Sept. 1982 OD 185, 62

CSP21.R14  The XXI Pan American Sanitary Conference,

Having considered Document CSP21/24, which contains a PAHO Classified List of Programs based on the Program Classification System established by WHO under the Seventh General Program of Work (Annex C), and a tentative percentage distribution for 1984-1985 of PAHO/WHO Regular resources by the new program classification system and by location (Annex D);

Bearing in mind Resolution XVI of the XXVIII Meeting of the Directing Council which requests the Director to formulate the draft program and budget for 1984-1985 using certain guidelines provided; and

Noting the recommendations1 made by the 88th Meeting of the Executive Committee,

Resolves:

1. To accept the PAHO Classified List of Programs set forth in Annex C of Document CSP21/24, with the addition of Classification 2.6. Disaster Preparedness, and with modifications in some of the classification descriptions to take into account recommendations of the Subcommittee on Long-Term Planning and Programming, as the structure to be used in the 1984-1985 program and budget document, while requesting the Director to continue to work with WHO to develop appropriate adjustments in either the WHO or PAHO classification systems to ensure that they are as identical as possible, and present the results of these discussions to the Executive Committee for its approval.

2. To request the Director to:

a) Increase the proportion of funds allocated to country programs to at least 35 per cent of the PAHO/WHO Regular budget, taking into account the proposed programs and budgets to be submitted by the Member Countries, in formulating the draft program and budget for 1984-1985.

b) Make appropriate reductions in other budgetary locations, taking into account the regional baseline target areas established in Chapter 6 of Part II of Official Document 173 (Health for All by the Year 2000-Strategies), and the ongoing studies related to the PAHO Centers and the Area Offices;

c) Make a study of the matter with a view to establishing a more equitable form of distributing PAHO resources, endeavoring to pay due attention to the needs and characteristics of the countries, and to report thereon to the 90th Meeting of the Executive Committee in 1983.

Sept. 1982 OD 185, 63

CSP21.R15 The XXI Pan American Sanitary Conference,

Having reviewed the report of the Award Committee of the PAHO Award for Administration and Resolution XII of the 88th Meeting of the Executive Committee (Document CSP21/14 and Annexes); and

Bearing in mind the regulations set forth in the procedure and guidelines governing the PAHO Award for Administration,

Resolves:

To declare Dr. Julio César Mérida de León of Guatemala winner of the PAHO Award for Administration, 1982.

Sept. 1982 OD 185, 64

CSP21.R16 The XXI Pan American Sanitary Conference,

Having seen the progress report submitted by the Director concerning the study of the functions of the Area Offices of the Pan American Sanitary Bureau, and the comments made by the Executive Committee (Document CSP21/30),

Resolves:

1. To note with thanks the progress report submitted by the Director (Document CSP21/30).

2. To request the Director to:

a) Continue the evaluation study initiated by Resolution XII of the XXVIII Meeting of the Directing Council;

b) Ensure that the study includes, inter alia, attention to the functions of the Area Offices, to the appropriateness of the distribution of countries served by each Office, and to the issue of the need for the Area Offices in the effective operation of the Organization;

c) Report on the results of this study to the 90th Meeting of the Executive Committee and to the XXIX Meeting of the Directing Council in 1983.

3. To thank the Executive Committee for its comments.

Sept. 1982 OD 185, 65

CSP21.R17  The XXI Pan American Sanitary Conference,

Having reviewed the report of the Director on the collection of quota contributions (Document CSP21/19 and Adds. I and II); and

Considering the importance of prompt and full payment of quota contributions in ensuring the financing of the authorized program and budget and maintaining the Organization in a sound financial position,

Resolves:

1. To take note of the report of the Director on the collection of quota contributions (Document CSP21/19 and Adds. I and II).

2. To thank the Governments that have already made payments in 1982 and to urge the other Governments whose legal circumstances so permit to pay their current quotas as early as possible in the year in which they are due, so that the work of the Organization may continue and the financial burden of its programs be shared among all Members.

3. To request the Director to continue to inform the Governments of any balance due.

Sept. 1982 OD 185, 65

CSP21.R18  The XXI Pan American Sanitary Conference,

Having examined the Financial Report of the Director and Report of the External Auditor for the Biennium 1980-1981 (Official Document 182); and

Recognizing that the Organization continues to be in a sound financial situation,

Resolves:

1. To take note of the Financial Report of the Director and Report of the External Auditor for the Biennium 1980-1981 (Official Document 182).

2. To commend the Director for having maintained a sound financial situation and to thank the External Auditor for the report presented.

Sept. 1982 OD 185, 66

CSP21.R19  The XXI Pan American Sanitary Conference,

Having examined the tentative provisional agenda of the Seventy-first Session of the Executive Board of the World Health Organization (Document EB71/1, annexed to Document CSP21/9),

Resolves:

1. To take note of the tentative provisional agenda of the Seventy-first Session of the Executive Board of WHO (Document EB71/1, annexed to Document CSP21/9).

2. To urge the Member Governments to review carefully the issues to be considered by the WHO Executive Board, and to make their views known to the Director and to the members of the Executive Board from the Region of the Americas, in order to ensure that the Region's views are fully reflected at the Board's session.

3. To request the Director to call an orientation meeting of the Members of the Executive Board who are from the Region of the Americas, to be held at PAHO Headquarters in Washington, D.C., immediately prior to the meeting of the Executive Board of WHO.

Sept 1982 OD 185, 67

CSP21.R20  The XXI Pan American Sanitary Conference,

Having considered the document prepared for the Subcommittee on Long-Term Planning and Programming of the Executive Committee (Document CSP21/21), which describes the financial and budgetary implications of the Regional Strategies and Plan of Action;

Bearing in mind Resolution XI of the XXVIII Meeting of the Directing Council, which adopted the Regional Plan of Action for health for all by the year 2000, and Resolution WHA35.23,1 in which the World Health Assembly adopted the Global Plan of Action for implementing the global strategy for health for all by the year 2000;

Noting the revisions and recommendations made by the Subcommittee on Long-Term Planning and Programming and by the 88th Meeting of the Executive Committee;2 and

Considering that health is a basic human right that must be safeguarded by the State,

Resolves:

1. To express appreciation to the Director for the study on the financial and budgetary implications of the Regional Strategies and Plan of Action.

2. To request the Member Governments to make studies of the financial machinery in their countries and to adjust their national and international financial resources to their health needs, while implementing a policy of rationalization of current expenditures, austerity in personnel costs, and optimization of management functions in the health field.

3. To request the Director to:

a) Pay special attention to the allocation of resources and provision of technical assistance to those Member Countries that are in greatest need;

b) Continue to examine the international economic environment and national and international resource allocations to the health and related sectors and to inform the 92nd Meeting of the Executive Committee in 1984 of any significant changes affecting the attainment of health for all by the year 2000;

c) Advise those Member Governments which may request it on ways to implement the outcome of these studies.

Sept. 1982 OD 185, 67

CSP21.R21  The XXI Pan American Sanitary Conference,

Having reviewed the report on the evaluation of the Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS) (Document CSP21/11);

Considering the provisions of Resolutions XXXI of the XX Pan American Sanitary Conference and XXXI of the XXVI Meeting of the Directing Council; and

Mindful of the significant requirements of the International Drinking Water Supply and Sanitation Decade,

Resolves:

1. To take note of the report on the Pan American Center for Sanitary Engineering and Environmental Sciences, and to thank the Member Governments which have actively participated in the evaluation process.

2. To thank the Director for making available the evaluation report and the recommendations of the Evaluation Team of CEPIS

3. To request the Director to:

a) Support and implement, as appropriate and with due caution in regard to direct technical assistance to the countries and to research projects for which CEPIS is responsible, the findings and recommendations of the Evaluation Team;

b) Continue to seek extrabudgetary resources to further CEPIS' collaboration with Governments in implementing their programs.

4. To request the Governments to:

a) Contribute financial and other support for activities carried out by CEPIS in the countries, for training programs which require national support, for the reproduction of materials initially prepared by CEPIS, and for the general costs of those programs;

b) Identify and support national institutions that would join CEPIS as part of a network of collaborating centers to further training, information exchange, and applied research programs.

5. To thank the Government of Peru for its unflagging support to CEPIS and for generously supplying to the Center all resources needed for the performance of its functions.

Sept. 1982 OD 185, 69

CSP21.R22  The XXI Pan American Sanitary Conference,

Considering that the Inter-American Commission of Women is an inter-American specialized organization devoted to the development of civil and political rights of women in the Hemisphere;

Considering that the Inter-American Commission of Women, through its President, has requested the establishment of official relations with PAHO by according to it the status of Observer to meetings of the Pan American Sanitary Conference, PAHO Directing Council, and PAHO Executive Committee, with regard to the issue of women in health and development; and

Acting pursuant to Article 26 of the PAHO Constitution, and in accordance with Resolution XXVIII of the XIV Pan American Sanitary Conference and Resolution XXXVIII of the XXVII Meeting of the PAHO Directing Council,

Resolves:

1. To express its satisfaction that the Inter-American Commission of Women has indicated its desire to enter into official relations with PAHO.

2. To declare that cooperation with the Inter-American Commission of Women will serve the best interests of PAHO and of the women in the Western Hemisphere.

3. To welcome the Inter-American Commission of Women into official relations with PAHO and thereby to accord it the status of Observer to PAHO, without vote, but with rights of participation (with the permission of the Chairman), in discussions of the issue of women in health and development, in meetings of the Pan American Sanitary Conference, the PAHO Directing Council, and the PAHO Executive Committee.

Sept. 1982 OD 185, 70

CSP21.R23  The XXI Pan American Sanitary Conference,

Having examined the report of the PAHO Advisory Committee on Medical Research to the Director for 1982 (Document CSP21/17);

Having heard the presentation on the activities of the Advisory Committee as given by the Chairman, Dr. H. Groot;

Aware of the emphasis placed on research and the development of appropriate technology as integral parts of the Plan of Action for implementing the Regional Strategies for health for all by the year 2000; and

Taking note of the emphasis being placed on such priority areas as health services research, socioepidemiological research, and, particularly, acute respiratory infections in children,

Resolves:

1. To commend the PAHO Advisory Committee on Medical Research for its report to the Director (Document CSP21/17).

2. To recommend that within available resources, including new available extrabudgetary funds, the Director strengthen the capacity of the Organization to deliver technical cooperation in the countries in the area of health research and to give high priority to those research issues addressed by the Advisory Committee, particularly the area of acute respiratory infections in children.

3. To commend the Director for the initiative taken with respect to the recommendations made by the Advisory Committee on Medical Research.

4. To request the Director to arrange for the wide dissemination throughout the Region of the proceedings of the Pan American Conference on Health Research Policies (Caracas, April 1982) and the Declaration on Research Policies which emanated therefrom.

Sept. 1982 OD 185, 71

CSP21.R24  The XXI Pan American Sanitary Conference,

Considering that Resolution XXX of the XXVIII Meeting of the Directing Council of PAHO approved in principle the final transfer of INCAP to a new political and administrative status as an agency of Central America and Panama, and the participation of PAHO/WHO as a member of INCAP;

Considering that Resolution XXX also requested the Director to continue supporting the restructuring of INCAP until it is finally completed;

Having reviewed the new Basic Agreement on INCAP signed on 25 September 1981 by the six member countries of INCAP and by the Director of PASB (Annex to Document CSP21 25);

Having seen the resolutions approved by the XXXIII Meeting of the INCAP Directing Council on the further restructuring of the Institute, including new instruments (Rules of Procedure for the Directing Council and the Technical Advisory Committee, Financial Rules, and Staff Rules) and the Working Capital Fund, and

Bearing in mind that, in approving the new INCAP Staff Rules to become effective 1 January 1983, the XXXIII Meeting of the INCAP Directing Council in Resolution VI requested the Director of PASB to ensure that the arrangements for PAHO staff currently assigned to INCAP are in keeping with the practical economic realities of the Institute,

Resolves:

1. To ratify the new Basic Agreement on INCAP signed in Washington, D.C., on 25 September 1981 (Annex to Document CSP21/25).

2. To urge all the member countries of INCAP to ratify the new Basic Agreement as soon as possible.

3. To take note of the resolutions of the XXXIII Meeting of the INCAP Directing Council and to request the Director to continue supporting the restructuring of INCAP until it is finally completed, in consonance with the decisions of the INCAP Directing Council.

4. To request the Director to keep the PAHO Directing Council informed of the progress of these important measures.

Sept. 1982 OD 185, 72

CSP21.R25  The XXI Pan American Sanitary Conference,

Taking note of the Director's report on drug abuse (Document CSP21/13).

Considering Resolution XLI of the XXVII Meeting of the Directing Council, which called upon the Member Governments to establish mechanisms for monitoring drug abuse and to integrate drug abuse into their national health programs and plans;

Recognizing Resolution EB69.R91 of the WHO Executive Board concerning obligations under the international conventions and the need for WHO to intensify its efforts to strengthen national drug regulatory mechanisms;

Taking into account Resolution WHA33.272 concerning the need for greater attention to drug abuse in the WHO program;

Being aware of the growing social, economic, and public health problems related to the use and misuse of psychotropic and narcotic substances;

Realizing that an isolated medical approach to the prevention and treatment of drug abuse is more costly and provides less relative benefit than innovative multisectoral efforts, in which the health sector's role is defined more broadly;

Realizing the political, administrative, and technical deficiencies in the existing national drug regulatory systems and the potentially adverse consequences they may have for the general health and well-being of the public; and

Recognizing the important and valuable role which has been played by the United Nations Fund for Drug Abuse Control (UNFDAC) in financing country projects in the Region,

Resolves:

1. To urge the Member Governments to:

a) Consider concentrating the broad spectrum of health sector drug abuse activities in a single office within the Ministry of Health, with adequate resources to be used for existing health programs such as drug control, health education, epidemiology, and mental health, in accordance with clearly defined program priorities;

b) Recognize the need for multisectoral planning and programming as part of an overall national drug abuse plan in which health sector objectives, strategies, and responsibilities are clearly identified;

c) Adopt policies which will permit and facilitate the integration of drug abuse activities into the general health services system, and, in particular, to explore new prevention and treatment approaches geared to specific high-risk groups (such as adolescents) and covering a wide spectrum of health and social needs;

d) Collaborate with the private sector in exploring new prevention and treatment approaches utilizing existing community resources, and, in particular, community groups and voluntary organizations;

e) Strengthen their drug management and regulatory systems with a view to reducing costs and improving the delivery of essential drugs, while at the same time increasing the effectiveness of drug abuse prevention;

f) Accede to the international conventions and take steps toward implementing them.

2. To call upon the Director to:

a) Collaborate with the countries in designing and implementing simple, low-cost systems for monitoring usage patterns and social and public health problems associated with the use and misuse of psychotropic and narcotic substances;

b) Continue to work with the countries in strengthening their drug management and regulatory measures;

c) Facilitate the transfer of information and technology among the countries of the Region concerning epidemiological methods, innovative low-cost approaches to treatment, the impact of policy on the field of prevention, and training methods and materials which can be used for professional and paraprofessional personnel in the general health services system;

d) Assist the countries in seeking extrabudgetary financing for projects;

e) Report to the XXIX Meeting of the Directing Council in 1983 on drug abuse prevention efforts in the Region.

Sept. 1982 OD 185, 73

CSP21.R26  The XXI Pan American Sanitary Conference,

Having examined the document presented by the Director on this subject (Document CSP21/10);

Bearing in mind the provisions of Rule 7 of the Rules for Technical Discussions;

Aware that the 88th Meeting of the Executive Committee has recommended that the topic "Increasing the operational capacity of the health services for the attainment of the goal of health for all by the year 2000" be selected for the Technical Discussions to be held in 1984 during the XXX Meeting of the Directing Council of PAHO, XXXVI Meeting of the Regional Committee of WHO for the Americas; and

In view of the considerable expenditure for Technical Discussions by PAHO and the Member Governments, in terms of time and financial and human resources.

Resolves:

1. To select the topic "Increasing the operational capacity of the health services for the attainment of the goal of health for all by the year 2000" for the Technical Discussions to be held in 1984 during the XXX Meeting of the Directing Council of PAHO, XXXVI Meeting of the Regional Committee of WHO for the Americas.

2. To ask the Executive Committee to review carefully all aspects of the Technical Discussions and to submit a report to the XXIX Meeting of the Directing Council with recommendations aimed at maximizing the impact and significance of the Technical Discussions and minimizing the expenditure of time, human, and financial resources on the part of the Secretariat and Member Governments.

Sept. 1982 OD 185, 75

CSP21.R27  The XXI Pan American Sanitary Conference,

Recognizing the importance of integrating the Five-Year Regional Plan of Action on Women in Health and Development into the Regional Plan of Action to implement the strategies to achieve the goal of health for all by the year 2000;

Acknowledging the progress which has been made in some countries but that information on women in health and development is still scarce and that many activities are in the planning stages;

Mindful of the need for each country to establish a mechanism to coordinate the implementation of activities and collect information on women in health and development at the inter-sectoral level;

Bearing in mind the urgent need to improve the situation of women in health and development;

Recognizing the value of fellowships as a tool for professional development, and the underrepresentation of women as recipients of the same;

Noting that some progress has been made by the Secretariat in institutional strengthening, training, and recruitment of women to professional posts within the Organization; and

Renewing its commitment to the implementation of the Five-Year Regional Plan of Action on Women in Health and Development,

Resolves:

1. To thank the Special Subcommittee of the Executive Committee on Women in Health and Development for its work in monitoring and reporting on the progress made, and for the cooperation of the PASB (Document CSP21/15)

2. To recommend that Member Governments:

a) Establish, in each country, a focal point for women in health and development to coordinate related intersectoral activities;

b) Establish mechanisms for the regular collection of information required to monitor and evaluate the progress made and to submit this information to the Secretariat as requested;

c) Incorporate the special health needs and requirements of women into ongoing activities without creating new programs focused solely on women, and to incorporate activities of the Five-Year Regional Plan of Action into national health and development strategies and plans;

d) Develop and implement national policies to provide for the health and well-being of working women and their dependents, especially for those women employed in unregulated sectors of the economy;

e) Enhance professional training opportunities for women, especially in sectors in which they are underrepresented, with particular reference to the PAHO fellowship program;

f) Ensure equal opportunities for women in recruitment and selection to professional and senior management positions;

g) Encourage and promote the interchange among countries of results of activities carried out in connection with the Five-Year Regional Plan of Action.

3. To request that the Director:

a) Encourage and support activities at regional, Area, and national levels for the implementation of the Five-Year Regional Plan of Action;

b) Intensify efforts to obtain and channel funds in support of activities related to women in health and development;

c) Review the mechanisms and human resources needed for the effective coordination and implementation of activities related to the Five-Year Plan of Action and strengthen these where indicated to ensure successful achievement of the goals;

d) Develop a simplified, uniform methodology for compiling national and regional information on progress made toward reaching the goals of the Five-Year Plan;

e) Support the continued coordination of activities with other organizations in the Inter-American and United Nations Systems, and other women's organizations;

f) Strengthen efforts for the recruitment and selection of women for senior professional and managerial posts and further develop the leadership potential and technical skills of women within the Organization;

g) Promote the greater use of fellowships by Member Governments for the development and training of women.

4. To request the Executive Committee to convene its Special Subcommittee on Women in Health and Development at least twice a year in the remaining years of the Plan of Action to monitor the program and review achievements.

Sept 1982 OD 185, 76

 

CSP21.R28  The XXI Pan American Sanitary Conference,

Having studied the Final Report of the Meeting of the Technical Group on Aedes aegypti, Dengue, and Yellow Fever (Document CSP21/22);

Considering the Regional Plan of Action for the implementation of the Regional Strategies for health for all by the year 2000, with particular reference to those activities relating to the control of vector-borne diseases;

Considering the present status of the program for the eradication of Aedes aegypti in the Americas and the serious problems of reinfestation plaguing many of the countries;

Considering that the risk of urbanization of jungle yellow fever and the aggravation of the dengue situation in the Americas-given the increase in virus activity in many countries, the spread of the disease to new areas, the appearance of the hemorrhagic form with the occurrence of fatal cases-pose serious threats to the Hemisphere; and

Bearing in mind that the decision1 taken by the Directing Council at its I Meeting (1947) is still in effect,

Resolves:

1. To maintain the present policy for eradication of Aedes aegypti from the Hemisphere and to recommend to the Governments of the countries and territories still infested by the vector that they take appropriate measures to remove the financial and administrative difficulties that may be hindering the progress of their programs, and that they give such priority as is necessary to the allocation of funds, personnel, and materials for the completion of those programs.

2. To recommend to the countries and territories already free of Aedes aegypti that they step up their surveillance efforts with a view to the early detection of any reinfestation and to its elimination before it spreads.

3. To request the countries that had succeeded in eradicating Aedes aegypti and have later been reinfested to take every appropriate measure to eradicate the vector.

4. To recommend that countries still infested give the necessary priority to the implementation of measures which prevent exportation of the vector to other countries, at least increasing surveillance and control efforts based on epidemiological knowledge of local situations.

5. To recommend to each Government, considering that the general goal of eradication will not be reached by all the countries in the Region in the short run, and in view of the danger of fresh dengue epidemics and the threat of urbanization of yellow fever, that it draw up an emergency plan to inventory the resources available in neighboring countries and a plan of operations for implementation in the event of an epidemic.

6. To recommend that the countries assist each other either directly or through the Pan American Sanitary Bureau, by means of bilateral loans and grants and the provision of equipment and materials, and with technical advisory services to vector eradication programs.

7. To ask the Director to take all appropriate measures to promote and support national, subregional, and regional activities as specified in the areas of action for the eradication of the vector of urban yellow fever (item 1.1.4 B.3 of the Plan of Action).

8. To recommend that the Director take all the appropriate measures to intensify and accelerate the Hemisphere-wide campaign for the eradication of Aedes aegypti, including the search for extrabudgetary funds, so that the goal of elimination of the vector may be attained as quickly as possible.

9. To request that the Director take all the necessary steps to enable PAHO/WHO to coordinate, identify, and allocate resources in the event of an emergency caused by an epidemic of hemorrhagic dengue in any country of the Hemisphere.

10. To thank the scientists of the June 1982 meeting in Mérida, Yucatán, Mexico, for their study and evaluation of the present situation of Aedes aegypti, dengue, and yellow fever and to take note of their recommendations.

Sept. 1982 OD 185, 78

CSP21.R29  The XXI Pan American Sanitary Conference,

Bearing in mind Resolution WHA28.721 of the World Health Assembly (1975) and Resolution XVIII of the XXII International Conference of the Red Cross;

Conscious of the need for effective blood transfusion services for the achievement of the goal of health for all by the year 2000;

Expressing concern over the quality and availability of blood transfusion services in some developing countries of the Region and the lack of effective legislation governing the provision of such services.

Aware of the risk of transmitting disease through lack of effective controls and inadequate training of health personnel in the provision of blood transfusion services; and

Convinced that PAHO has the necessary technical and administrative capacity to coordinate cooperation among Member Countries for the development of safe and effective blood transfusion services,

Resolves:

1. To urge Member Countries to consider the control of blood transfusion services a priority in their national strategies for health for all by the year 2000.

2. To set the year 1990 as the goal for achieving effective blood transfusion services in all countries of the Region, taking into consideration each Member Country's needs and capacity to provide such services.

3.  To request the Director to:

a) Seek the technical cooperation of the League of Red Cross Societies, the International Society of Blood Transfusion, and other international bodies concerned with the use of blood products in the provision of health care;

b) Assist Member Countries in need to establish cooperative mechanisms for the provision of adequate and safe supplies of blood and other blood transfusion products.

c) Develop with the international and national organizations an appropriate methodology to evaluate Member Countries needs and the methods of assistance required for the processing and control of blood and blood products and for the provision of effective blood transfusion services;

d) Present proposals for the achievement of the goal of effective blood transfusion services by 1990 for the consideration of the 90th Meeting of the Executive Committee and the XXIX Meeting of the Directing Council in 1983.

Sept. 1982 OD 185, 80

CSP21.R30  The XXI Pan American Sanitary Conference,

Bearing in mind that animal health activities have implications for human health and socioeconomic development, and consequently for primary health care;

Realizing the particular importance of harmonizing animal health activities, which are part of the goal of health for all by the year 2000, with the strategy of primary care;

Recognizing that the technical cooperation activities of the Pan American Foot-and-Mouth Disease Center (PANAFTOSA) are an important part of the aims and strategies contained in the Plan of Action for implementation of the Regional Strategies;

Considering that the close interaction between the technical cooperation programs of PANAFTOSA and those of the other units of PAHO's Special Program for Animal Health has resulted in the formation of a valuable pool of international resources to serve the countries;

Taking into account Resolution XXVI of the XXVI Meeting of the Directing Council, and bearing in mind the desire expressed by the Ministers of Agriculture during the XII Inter-American Meeting, at the Ministerial Level, on Foot-and-Mouth Disease and Zoonoses Control1 that PANAFTOSA should remain part of PAHO;

Aware that the Food and Agriculture Organization of the United Nations (FAO), the Inter-American Institute for Cooperation on Agriculture (IICA), the International Office of Epizootics, and other international agencies conduct animal health and production programs;

Recognizing the value of international cooperation in matters of animal health; and

Mindful of the views expressed by the Member Governments in this Conference,

Resolves:

1. To request that the Director, in consultation with the appropriate international agencies (FAO, IICA, etc.) and in accordance with the program priorities and needs of the Member Governments, develop a policy aimed at maximizing the horizontal cooperation of agencies serving the countries in matters of animal health and veterinary public health, and in so doing, avoid duplication of effort.

2. To keep the Pan American Foot-and-Mouth Disease Center as a regular program of PAHO until such time as the study proposed to PAHO by IICA is carried out and the Governing Bodies can decide the matter.

3. To thank the countries and international organizations that are supporting the Center, particularly the Government of Brazil, for their valuable and continued contribution to the Center's operation.

Sept. 1982 OD 185, 81

CSP21.R31   The XXI Pan American Sanitary Conference,

Considering that El Salvador and Guatemala have been recently stricken by floods which have caused tragic loss of human life and enormous material damage;

Having seen Resolution X adopted by the Directing Council in its XXIV Meeting and establishing a Natural Disaster Relief Voluntary Fund; and

Aware that this Fund lacks the necessary resources, owing to a lack of contributions from the countries,

Resolves:

1. To request the countries to provide emergency aid for the health sector of El Salvador and Guatemala to cope with the damage recently inflicted there by floods.

2. To urge the Governments to make contributions to the Natural Disaster Relief Voluntary Fund administered by PAHO.

3. To request the Director to provide needed technical cooperation in evaluating the damage and coordinating aid to El Salvador and Guatemala.

Sept. 1982 OD 185, 82

CSP21.R32  The XXI Pan American Sanitary Conference,

Having considered the report of the Technical Discussions on the managerial analysis of health systems (Document CSP21/DT/4, Rev. 1);

Considering that the World Health Assembly in Resolution WHA32.301 endorsed the Declaration of Alma-Ata, which emphasized primary health care as the basic approach for attaining health for all by the year 2000, and the important implications of this goal for the development of the health management system;

Recognizing that the Regional Strategies of health for all by the year 2000, approved by the Directing Council at its XXVII Meeting2 (1980), and the Plan of Action for the implementation of these Regional Strategies, as approved by the Directing Council at its XXVIII Meeting3 (1981), both place great importance on strengthening the operating capacity of the health systems, including the planning and management systems;

Being aware of the increasing responsibilities that are being placed on Member Governments and the strong implications of these responsibilities for the improvement of the health management process; and

Viewing with concern the critical nature and scope of the problems as presented by Member Governments in their analysis of the health management systems and the need to strengthen the managerial process for achieving health for all by the year 2000,

Resolves:

1. To take note of the report of the Technical Discussions and to express its satisfaction with it.

2. To recommend that Member Governments:

a) Incorporate a policy formulation and implementation process within the health sector that leads to the development of strategies and managerial practices that favor both the more effective and efficient achievement of results and an increased commitment to social equity;

b) Utilize a creative and innovative approach in their management development process and emphasize extension of coverage, through the primary health care approach, with priority given to preventive and promotional activities and incorporating the concepts of intersectoral coordination, community participation, and appropriate technology;

c) Strengthen the strategic management process by developing long-, medium-, and short-term plans directed toward the attainment of the goal of health for all by the year 2000;

d) Undertake an intensive, objective, and multidisciplinary analysis of the institutional, financial, and administrative constraints on access, for different human groups, to health services, and develop alternative solutions;

e) Establish specific and clear goals through a participatory approach which heightens the commitment of the health teams and the community to the attainment of the goals, and improve management information systems with special emphasis on monitoring and evaluating results;

f) Give priority to the development of human resources as an essential element for attaining the goal of health for all, through academic and continuing education programs, strengthening health manpower planning, reorienting the curriculum of health science schools, and developing incentives for the retention of personnel;

g) Promote and develop operational research on salient aspects of health services management that identify the constraints which exist in the application of community participation, and develop appropriate approaches for involving the community and for supporting decisions which favor increased efficiency, effectiveness, and equity;

h) Refine the process of functional planning, programming, and implementation of physical infrastructure projects so as to ensure efficient investment in and maintenance of installed capacities,

3. To recommend that the Director:

a) Strengthen and support research aimed at producing knowledge on better managerial alternatives to meet the critical health issues and challenges mentioned in the PAHO documents;

b) Support the development and implementation of education and training programs that strengthen the strategic managerial capacity of the health sector;

c) Strengthen programs of technical cooperation in strategic management and planning aimed at transferring and demonstrating new ideas in this area;

d) Foster the establishment of a mechanism for disseminating among Member Governments information on national experiences and approaches in strategic management;

e) Distribute the working document and report of the Technical Discussions to Member Governments, national and international agencies, and other organizations.

Sept 1982 OD 185, 83

CSP21.R33 The XXI Pan American Sanitary Conference,

Mindful that for the last eight years Dr. Héctor R Acuña has devoted his best efforts to the post of Director of the PASB; and

Cognizant of the work done by Dr. Acuña on behalf of PAHO during his Directorship and considering that his term of office as Director of the PASB is about to expire,

Resolves:

To tender very special thanks to Dr. Héctor R. Acuña for his services to the Pan American Health Organization.

Sept. 1982 OD 185, 85