regional committee
PAN AMERICAN
HEALTH
ORGANIZATION
WORLD
HEALTH
ORGANIZATION
XXVIII Meeting
Washington, D.C. September-October 1981
XXXIII Meeting
INDEXED
CD28/SR/1
21 September 1981
ORIGINAL: ENGLISH-SPANISH
Monday, 21 September 1981, at 9:00 a.m. Lunes, 21 de septiembre de 1981, a las 9:00 a.m.
PROVISIONAL SUMMARY RECORD OF THE FIRST PLENARY SESSION ACTA RESUMIDA PROVISIONAL DE LA PRIMERA SESION PLENARIA
Provisional President; Presidente Provisional:
Dr. Jorge Michelsen Rueda
Dr. Miguel Coello FernAndez President;
Presidente:
Opening of the Meeting Inauguraci6n de la Reuni6n
Message from Dr. H. Mahler, Director-General of the World Health Organization Mensaje del Dr. H. Mahler, Director General de la Organizaci6n Mundial de la Salud
(continued overleaf) (continua al dorso)
Note: These summary records are provisional. Representatives are requested to notify Document Services (Room 207) of any changes they wish to have made in the text. The edited records will be published in the
Proceedings of the Meeting.
Notas: Esta acta resumida es provisional. Se ruega a los seftores Represen-tantes tengan a bien comunicar al Servicio de Documentos (Oficina 207) las modificaciones que deseen ver introducidas en el texto. Los tex-tos definitivos se publicarin en las Actas de Ia Reuni6n.
Colombia
Item 1; Tema 1:
Ecuador
Contents Indice
I
CD28/SR/1
Page 2Contents (cont.) Indice (cont.)
Address by Dr. HRctor R. Acufla, Director of the Pan American Sanitary Bureau
Discurso del Dr. Hector R. Acufla, Director de la Oficina Sanitaria Panamericana
Item 2: Appointment of the Committee on Credentials Tema 2: Nombramiento de la Comisi6n de Credenciales
First Report of the Committee on Credentials Primer Informe de la Comisi6n de Credenciales
Item 3: Election of the President, two Vice Presidents, and the Rapporteur
Tema 3: Elecci6n del Presidente, de dos Vicepresidentes y del Relator
Item 4: Establishment of a Working Party to Study the Application of Article 6.B of the PAHO Constitution
Tema 4: Establecimiento de un grupo de trabajo encargado de estudiar la
aplicaci6n del Articulo 6.B de la Constituci6n de la OPS Item 5: Establishment of the General Committee
Tema 5: Establecimiento de la Comisi6n General
Item 5: Adoption of the Agenda
CD28/SR/1 Page 3
The session was called to order at 9:25 a.m. Se abre la sesi6n a las 9:25 a.m.
ITEM 1: OPENING OF THE MEETING TEMA 1: INAUGURACION DE LA REUNION
El PRESIDENTE PROVISIONAL anuncia que, por estar ausente el
Dr. Roquelino Recinos Mdndez, Ministro de Salud de Guatemala, le han
correspondido el honor de presidir la sesi6n inaugural de la XXVIII Reuni6n' del Consejo Directivo de la Organizaci6n Panamericana de la Salud, reuni6n de gran trascendencia no solo por el ingreso de dos nuevos
paises en la Organizaci6n sino tambien por los asuntos que en ella se habrAn de tratar. El Comite Ejecutivo ha sefialado los aspectos de salud
de las Am4ricas que se consideraran durante la misma.
Despues de agradecer a los paIses representados· en la OPS la
gentileza de haberlo nombrado primer Vicepresidente en 1980, el orador declara inaugurada la XXVIII Reuni6n.
MESSAGE FROM DR. H. MAHLER, DIRECTOR-GENERAL OF THE WORLD HEALTH ORGANIZATION
MENSAJE DEL DR. H. MAHLER, DIRECTOR GENERAL DE LA ORGANIZACION MUNDIAL DE LA SALUD
The SECRETARY read out the following message from Dr. Mahler, Director-General of the World Health Organization:
I am sorry that previous commitments made it impossible for me to be with you to discuss the best ways of implementing our strategies for health for all. I am therefore taking the next best step of sending you
CD28/SR/l Page 4
Recently, I had the privilege of visiting a number of Member Countries in your Region and of seeing at close quarters how much effort is being made, and yet how much more remains to be done, to move forward in line with the policies and principles you have adopted collectively for attaining health for all. And I should add that these policies and principles are valid in all types of society. What is more, they have been arrived at through an unusual degree of cooperation between countries with widely varying political, social and economic backgrounds and just as varied health situations.
Indeed, the unanimous adoption by the recent World Health Assembly of a Global Strategy for Health for All by the Year 2000 is a major triumph for international cooperation in health. It crystallized the efforts set in motion by the Declaration of Alma-Ata and the call of previous Health Assemblies. In response to these, a large number of countries in all regions have formulated national strategies and all regions have formulated regional strategies. The Global Strategy reflects these and gives them a new strength, born of international coherence.
But we must not become euphoric nor lulled into a sense of com-placency just because we have an agreed Strategy. The Strategy will only be useful to the extent that it is used. We have spent enough time on conceiving it. We must now devote all our energies to delivering it.
It was in this spirit that the Health Assembly asked the Executive Board to prepare a plan of action for the immediate implementation of the Strategy. You have a draft of that plan of action before you. As you can see, it is only a skeleton. You have taken a further step forward by preparing a more detailed regional plan of action. but that too is still a lifeless document. It is for you and your people to bring those plans of action to life and give them flesh and blood, and it is WHO's duty to help you do so. For, when the Health Assembly adopted the Global Strategy, it called it a solemn agreement for health between three partners--governments, people and WHO.
How can we best carry out the terms of this agreement? I shall start with you as representatives of your governments, realizing full well that answers do not depend on you alone. What are you ready to do?
CD28/SR/1 Page 5
- Are you ready to continue the review of your health systems, and to strengthen your health infrastructures with primary health care as its central function and main focus whatever the obstacles you will have to
face?
- Are you ready to reconsider the health technology you are using so that it becomes really appropriate in your health and socioeconomic circumstances?
- Are you ready to mobilize all possible human, financial and material resources to ensure the implementation of your national strategy? - Are you ready to reinforce your managerial capacity to give effect to your strategy and plan of action, to monitor progress and to report on it openly and unashamedly to your colleagues in the regional committee so that all can learn from your experience?
- Are you ready to cooperate with one another in other ways to ensure the success of the Strategy?
As for your people, are you ready to give them the right to assume growing responsibility for their own health and to help them do so?
- Are you ready to help them understand what your national health strategy is all about, so that individuals, families, communities, as-sociations and non-governmental organizations can increasingly take an active part in developing your health system, in carrying out part of its functions, and in assuming social control over it and the technology used in it, and so that they can know where to seek appropriate help when they feel they need it?
And now for WHO's duties as one of the partners. I can assure you that your Organization is more than ready to support you in deciding how to convert your plans into realities, to cooperate with you in doing so, and to help mobilize the resources you require.
Let me deal first with the use of WHO's own resources in your countries. You have at your disposal an unusually flexible and pragmatic mechanism for programme budgeting WHO's resources in your countries. I beg of you, at least use these resources to ensure the progressive im-provement of primary health care where it is most needed and' for the
specific purposes that are most needed.
CD28/SR/l Page 6
vociferous champion of this contention. So I would also beg of all of you concerned to use WHO to identify those parts of your primary health care strategy that could benefit from more massive external support and to secure the commitment of the appropriate authorities to ask for such support. You will have to be absolutely ruthless in ensuring that ex-ternal support is channelled into your urgent primary health care needs. That is one sure way of redressing imbalances in the distribution of your health budget, and it will lead sooner or later to increased national investments in these same areas.
WHO has set up on a trial basis a Global Health Resources Group for primary health care whose aim is to match needs with resources to the extent that these can become available. Your Regional Committee can be of great value in identifying needs, but you must realize that there will be tremendous competition for funds, so you will have the difficult and delicate task of screening and guaranteeing the authenticity. of re-quests. These requests, and the ways they are dealt with by the Global Health Resources Group or any other mechanism, will be reviewed by the Executive Board and Health Assembly, illustrating how WHO's coordinating role is being used to help you in a way that goes far beyond the possi-bilities of its own limited funds. But here I have to ask you another question:
- Are you ready to use your regional committee as a peer group for reviewing objectively your needs for external resources in support of your strategies, so that the regional committees, the Executive Board and the Health Assembly can correlate their work in such a way as to ensure that all available resources are effectively and efficiently used in sup-port of well-defined strategies for health for all?
I wish you a most successful session of your regional committee, in the course of which I hope you will be ready to reply in the affirm-ative to all the questions I have asked you. If you do, I am confident that you will reach the goals you have set yourselves. Once more I pledge WHO's full support to you in your endeavours.
ADDRESS BY DR. HECTOR R. ACURA, DIRECTOR OF THE PAN AMERICAN SANITARY BUREAU
DISCURSO DEL DR. HECTOR R. ACURA, DIRECTOR DE LA OFICINA SANITARIA PANAMERTCANA
E1 Dr. AC1u]A (Director) da la mAs cordial bienvenida a los parti-cipantes en la XXVIII Reuni6n del Consejo Directivo de la Organizaci6n
CD28/SR/1 Page 7
Panamericana de la Salud, correspondiente a la XXXIII Reuni6n del Comite
Regional de la Organizaci6n Mundial de la Salud, y declara que,
indepen-dientemente del estudio que el Consejo hara de los temas presentados para su consideracion, entre los que sobresalen el Proyecto de Programa y
Presupuesto para el pr6ximo bienio, que se inicia el 1 de enero de 1982, y el Plan de Acci6n para poner en ejecuci6n las estrategias regionales
aprobadas durante la XXVII Reuni6n celebrada en 1980, aprovecha esta
oportunidad para hacer algunos comentarios sobre el futuro de la Organi-zaci6n y el de los organismos responsables de la salud dentro de sus Gobiernos Miembros.
En primer lugar, se refiere al compromiso universal contraido por todos los Estados Miembros de la OPS y de la OMS de propocionar "salud para todos en el aflo 2000". La Organizaci6n confirm6 esa decisi6n
polf-tica en 1980, al adoptar las estrategias regionales que implican compro-misos para los Gobiernos y para la OPS, especialmente para el Director y
la Secretarfa. En el curso de sus deliberaciones, el Consejo tendra
oportunidad de confirmar esa importante decisi6n y de adoptar un Plan de Acci6n que permita poner en ejecuci6n las estrategias.
Al conside,-ar y adoptar el Plan de Acci6n, -el Consejo Directivo
debera tener presente que se dara un paso trascendental al convertir las intenciones en acciones. EL Plan representa un compromiso ineludible de los lfderes de los Gobiernos de las Americas de forjar nuevas esperanzas
CD28/SR/1 Page 8
6nicamente una serie de objetivos secundarios bien definidos, sino tam-bien la determinaci6n inquebrantable de los parses de la Regi6n de las Americas para llevar los beneficios del desarrollo econ6mico y social a
la poblaci6n postergada, en las barriadas y en el campo.
Como muy sabiamente lo dijera el Presidente Rold6s del Ecuador, en su bienvenida a los Ministros de Salud del Area Andina en 1980: "Queremos
ver que las intenciones y los documentos se conviertan en actividades
permanentes, porque es injusto que los ninos sigan muriendo, sigan siendo afectados por gastroenteritis endemicas o sufriendo de enfermedades que puedan ser prevenidas".
A medida que se definen mejor los problemas de salud y se visua-licen medidas para solucionarlos, se hace mis evidente la necesidad de encontrar un financiamiento adecuado para esas actividades.
La preocupacidn de la Secretarfa se diversifica ante las severas limitaciones financieras que ha de afrontar la Organizaci6n y el papel que ha de desempefiar como agencia de cooperaci6n tecnica con los Gobier-nos, en sus esfuerzos para proporcionar "salud para todos en el aflo
2000", ya que es evidente la existencia de tendencias negativas en el nivel de los recursos reales que son asignados al sector salud por varios
Gohiernos y agencias internacionales. En el Documento Oficial 173 sobre las estraLegias regionales que el Consejo Directivo adopt6 en 1980
aparecen varios pafses que durante el decenio de los afos setenta disminuyeron los gastos per capita asignados a los servicios de salud.
:CD28/SR/1 Page 9
Una tendencia similar se manifiesta en las asignaciones de la OPS; por ejemplo en 1976 el presupuesto regular de la OPS incluy6 gastos equi-valentes a 8 centavos de d6lar por persona en los paises en vias de desa-rrollo de la Regi6n. Para 1980 esta cantidad se habia reducido, en
terminos reales, al equivalente de 6.5 centavos de d6lar por persona. Si esta reducci6n continua, la OPS podria encontrarse fuera del escenario
antes de que el objetivo de "salud para todos" sea alcanzado.
La cooperaci6n financiera internacional para salud, agua potable y
saneamiento basico, alcanz6 $500 millones en 1976. Para 1980 esta cifra ha Ilegado a $800 millones, pero en terminos de poder adquisitivo
constante, ha bajado de EUA$1.57 per capita en 1976 a EUA$1.49 en 1980. AdemAs, cerca de dos terceras partes de esta Oltima cantidad fueron
asignadas a programas de agua y saneamiento, bajando la cifra asignada a otros programas de salud, nutrici6n y planificaci6n familiar, a menos de 50 centavos per capita. Esta disminuci6n de los recursos internacionales
para el sector salud parece ser un tanto parad6jica, puesto que con frecuencia los que reciben mayores beneficios son los propios parses industrializados.
E1 caso de la viruela es tipico. Segdn las estimaciones de la Organizaci6n, uinicamente en el aflo 1981 los Estados Unidos de America ahorrarAn $500 millones en gastos de vacunaci6n y cerca de una cantidad semejinte en hospitalizaci6n, gastos de viaje, tiempo perdido, inspeccio-nes sanitarins en puertos y aeropuertos y otros gastos asociados. No se ha calculado a6n lo que otros parses industrializados ahorraran, pero se puede prever una suma considerable.
CD28/SR/I Page 10
Tambi4n se traducen en ahorros cuantiosos para los parses
indus-trializados el control de otras enfermedades en el hombre y en los
ani-males. Estudios efectuados por el Departamento de Agricultura de los Estados Unidos de America indican que "si la fiebre aftosa invadiera a
los Estados Unidos, esto se transformarfa en una disminuci6n de la
producci6n ganadera; en mAs de mil millones de d6lares en perdidas y
costos de erradicaci6n, y en la reducci6n o perdida de mercados extranjeros para los productos ganaderos de los Estados Unidos".
Podrian darse otros muchos ejemplos de c6mo tanto el bienestar de los paIses desarrollados como el de los paises en vfas de desarrollo se
encuentran estrechamente unidos a traves del mejoramiento de la salud y de la disminuci6n de las desigualdades sociales. Indudablemente, muchos
de los participantes en la reuni6n podrfan proporcionar aun mejores ejem-plos. De momento basta decir que si algunos de los representantes de los
parses industrializados o de mayor desarrollo piensan que se esta tra-tando de hurgar en sus bolsillos, mAs vale que no cambien de pensamiento.
Es evidente que desde muchos puntos de vista, varios paises en vfas de desarrollo de las Americas conffan menos en la cooperaci6n finan-ciera externa que los pafses en vfas de desarrollo de otras regiones. En las Amdricas, por ejemplo, la cooperaci6n externa proporcion6 unicamente
el 2% de los recursos financieros dedicados a salud en el afo 1979. El relativo bajo nivel de la cooperaci6n financiera externa oficial recibida
CD28/SR/L Page 11
solo reciben poca cooperaci6n, sino que esta cooperaci6n se proporciona por lo regular en terminos duros y no en prestamos blandos que benefician a muchos otros paises en vias de desarrollo.
Ademas, debe de tomarse en consideraci6n el hecho de que en las Americas la distribuci6n del ingreso tiene caracteristicas de desigualdad extrema. Segdn las estimaciones de la OPS, existen un poco mAs de 100
millones de personas que viven bajo condiciones de absoluta pobreza. Los informes del. Banco Mundial sobre distribuci6n del ingreso, muestran que
en dos paises de la Regi6n, el 40% de la poblaci6n recibe el 7% del in-greso nacional. El orador recuerda que en la 61ltima reuni6n del Comite
Ejecutivo de la OPS, celebrada en junio pasado, habia mencionado algunas de sus preocupaciones sobre las tendencias existentes en los recursos destinados a salud, en terminos reales, sugiriendo que se estableciese un Grupo Especial que iniciara una revisi6n total de las tendencias
finan-cieras que afectan tanto a la Organizaci6n como a la movilizaci6n de recursos, a nivel nacional e internacional, para la consecuci6n del
objetivo de "salud para todos en el afio 2000".
CD28/SR/1 Page 12
Independientemente de estas consideraciones, la Organizaci6n esta tratando de establecer una Oficina de Movilizaci6n de Recursos que
res-ponda directamente ante el Director y que tendrA la funci6n de cooperar con los Pafses Miembros en desarrollar y utilizar efectivamente
informa-ci6n sobre los costos y fuentes de financiamiento de los servicios nacio-nales de salud, ayudando igualmente en la definici6n de estrategias
apropiadas para generar nuevas fuentes domesticas de financiamiento. PodrA colaborar, por supuesto, con los Gobiernos Miembros en la obtenci6n
de cooperaci6n financiera apropiada en el ambito internacional, especial-mente bajo terminos favorables. Al conocer mejor la utilizaci6n de los
recursos nacionales puiblicos y privados dedicados a la consecuci6n de "salud para todos",' tanto la OPS como sus Parses Miembros estaran 'en una mejor posici6n de tomar 'decisiones mas racionales sobre el uso de la cooperaci6n financiera internacional y sobre los gastos recurrentes que
estas inversiones implican. A este respecto, quizas no este' de mas men-cionar que cuando un pafs sabe como se utilizan sus propios recursos
internos, los recursos 'externos podrtn ser utilizados mas sensatamente y con maxima efectividad.
Aunque 6xisten grandes diferencias en las Americas en los gastos
por persona par:I el mantenimiento y la recuperaci6n de la salud, gastos
que ia ha varia(lo dtli-rate este aflo entre $1,230 y $5 por persona, soil los
CD28/SR/1 Page 13
las provenientes del exterior. Sin embargo, es preciso recordar que los costos relativos de los servicios de salud varian de pafs a pals y adn entre diferentes regiones del mismo pais. Aquellos que gastan mas en
salud, no necesariamente reciben servicios de salud mas apropiados, mAs diversos o mejores.
En conclusi6n, el Director dice que durante los 6ltimos aftos se le viene preguntando con frecuencia si realmente cree que sera alcanzado el
objetivo de "salud para todos en el afio 2000". Invariablemente ha con-testado que dado el progreso pasado de esta Regi6n, el potencial socio-econ6mico de la misma y el ingenio de sus habitantes y de sus lideres
para encontrar formas efectivas de cooperaci6n entre los parses ricos y los pobres, el objetivo es alcanzable. El unico motivo de preocupaci6n es que, como en el caso de la erradicaci6n de la malaria y otras diversas enfermedades y problemas de salud, algunos parses hagan progresos consi-derables para alcanzar el objetivo y despues carezcan de la decisi6n polftica y la motivaci6n necesaria para ver que la batalla contra la
enfermedad, la insalubridad y la desigualdad. social, llegue a un final satisfactorio. Que no haya malos entendidos: la guerra no puede ser ganada a un precio razonable si no se esta preparado para hacer los sacrificios necesarios.
El ultimo decenio ha enseftado a la Organizaci6n que el poner en ejecuci6n el Plan de Acci6n de las estrategias regionales debe ser
CD28/SR/1 Page 14
y :hacer un esfuerzo sistematico para supervisar y evaluar su ejecuci6n. Esto debe incluir la compilaci6n rutinaria, evitando la irregular y
es-poradica, asf como el anAlisis de los datos sobre el flujo de recursos financieros al sector salud. El Director apela encarecidamente a los miembros del Consejo Directivo para que consulten con sus autoridades nacionales responsables del presupuesto y la contabilidad, acerca de la
recolecci6n rutinaria de esta informaci6n.
Esta informaci6n, como ya se ha dicho, ayudard a establecer las bases para transformar los conceptos de "salud para todos en el afio 2000"
en acciones.
Como ha sido tradicional, esta Regidn se encuentra un paso por delante del resto del mundo, que analizarA y aprobara su propio Plan de Acci6n Mundial en 1982. A pesar del entusiasmo y del anhelo de que goce. de los beneficios del desarrollo y de la salud, nadie ignora que existen obstaculos para alcanzar los objetivos, entre los cuales el proceso
inflacionario ha sido y continua siendo una fuerza que limita las posibi-lidades de la Organizaci6n y de la mayorfa de sus Pafses Miembros para responder de una manera 6ptima a tan trascendental cruzada.
El Director esta convencido de que el Consejo, con su usual sabi-durf:a, entusiasmo y dedicaci6n, encontrara la manera de que el objetivo "salud para todos en 'el afo 2000" sea una realidad para todos los
CD28/SR/1 Page 15
ITEM 2: APPOINTMENT OF THE COMMITTEE ON CREDENTIALS TEMA 2: NOMBRAMIENTO DE LA COMISION DE CREDENCIALES
El PRESIDENTE PROVISIONAL propone a Bolivia, Cuba y Trinidad y
Tabago para constituir la Comisi6n de Credenciales.
Decision: The Representatives of Bolivia, Cuba and Trinidad and Tobago were designated to form the Committee on Credentials.
Decisi6n: Los Representantes de Bolivia, Cuba y Trinidad y Tabago quedan designados para constituir la Comisi6n de Credenciales.
The session was suspended at 10:05 a.m. and resumed at 10:50 a.m Se suspende la sesi6n a las 10:05 a.m. y se reanuda a las 10:50 a.m.
FIRST REPORT OF THE COMMITTEE ON CREDENTIALS PRIMER INFORME DE LA COMISION DE CREDENCIALES
El Dr. SORUCO (Bolivia), Relator de la Comisi6n de Credenciales, manifiesta que esta Comisi6n de Crendenciales, constituida en la primera
sesi6n plenaria e integrada por el Sr. E. Small (Trinidad y Tabago), el
Dr. J. Aldereguia (Cuba) y el Dr. J. Soruco (Bolivia), celebr6 su primera sesi6n el dfa 21 de septiembre a las 10:15 a.m.
La Comisi6n eligi6 Presidente al Dr. Small, de Trinidad y Tabago, Relator al Dr. Soruco, de Bolivia, y Vocal al Dr. Alderegufa, de Cuba.
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Guatemala, Haiti, Jamaica, M4xico, Nicaragua, Panama, Paraguay, Perd, Reino Unido, Reptblica Dominicana, Suriname, Trinidad y Tabago, Uruguay y Venezuela. Se acept6 asimismo la credencial de Espafa como miembro
observador.
Decision: The first report of the Committee on Credentials was adopted.
Decisi6n: Se aprueba el primer informe de la Comisi6n de Credenciales.
ITEM 3: ELECTION OF THE PRESIDENT, TWO VICE PRESIDENTS, AND THE RAPPORTEUR
TEMA 3: ELECCION DEL PRESIDENTE, DE DOS VICEPRESIDENTES Y DEL RELATOR
El Dr. RODRIGUEZ (Venezuela) propone al Dr. Miguel Coello Fernandez
del Ecuador para el cargo de Presidente.
El Dr. ANDONIE FERNANDEZ (Honduras), el Dr. BLACK (CanadA) y el Dr. ALDEREGUIA (Cuba) apoyan la propuesta del Representante de Venezuela.
Decision: Dr. Miguel Coello FernAndez (Ecuador) was elected President by acclamation.
Decisi6n: Por aclamaci6n, el Dr. Miguel Coello FernAndez (Ecuador) es elegido Presidente.
El PRESTDRNTE agradece el honor que se le ha conferido con el
nombramienrto v lo ncepta como un homenaje a suti pals. Al mismo tiempo, ruega a todos los presenltes guarden un minuto de silencio en tributo a la memoria del Fallecido Presidente Jaime Rold6s Aguilera, gran dem6crata y
CD28/SR/1 Page 17
All present stood for a minute of silence as a tribute to the memory of Dr. Jaime Rold6s Aguilera.
Todos los presentes, puestos de pie, guardan un minuto de silencio en homenaje a la memoria del Dr. Jaime Rold6s Aguilera.
A continuaci6n, el Presidente hace una 11amada a todos los respon-sables de la salud en todos los parses para que intervengan activamente
cerca de sus respectivos Gobiernos con objeto de que puedan alcanzarse todos los objetivos propugnados por la OPS y la OMS.
Prosiguiendo la marcha de los trabajos pide que se propongan candidaturas para el cargo de Primer Vicepresidente.
Dr. KEY (United Kingdom) proposed Dr. Lyall M. Black of Canada as First Vice President.
Los Representantes de COLOMBIA, BAHAMAS, URUGUAY, PANAMA, JAMAICA,
ECUADOR, CHILE y TRINIDAD Y TABAGO apoyan la propuesta de la Representante del Reino Unido.
Decision: Dr. Lyall M. Black (Canada) was elected First Vice President by acclamation.
Decisi6n: Por aclamaci6n, el Dr. Lyall M. Black (Canada) es elegido Primer Vicepresidente.
Seguidamente, el Dr. RODRIGUEZ (Repdblica Dominicana) propone para Segundo Vicepresidente al Dr. Carmelo Calvosa Chac6n, de Costa Rica.
I.os Representantes de EL SALVADOR, PANAMA, VENEZUELA, URUClGAY,
CD28/SR/1 Page 18
Decision: Dr. Carmelo Calvosa Chac6n (Costa Rica) was elected Second Vice President by acclamation.
Decisi6n: Por aclamaci6n, el Dr. Carmelo Calvosa Chac6n (Costa Rica) es elegido Segundo Vicepresidente.
El Dr. ALVAREZ GUTIERREZ (Mexico) propone la candidatura del Dr. Jose Arturo Coto, de El Salvador, para el cargo de Relator.
Los Representantes de HONDURAS y COSTA RICA apoyan la candidatura.
Decision: Dr. Jos4 Arturo Coto (El Salvador) was elected Rap-porteur by acclamation.
Decisi6n: Por aclamaci6n, el Dr. Jose Arturo Coto (El Salvador) es elegido Relator.
El PRESIDENTE informa a los asistentes de que la Dra. Mdropi
Violaki-Paraskeva, Presidente de la 34a Asamblea Mundial de la Salud, se encuentra en la sala. La Dra. Violaki-Paraskeva es Directora General Honoraria 'de Salud en el Ministerio de Servicios Sociales de Grecia. Despuds de darle la bienvenida, el orador le concede la palabra.
Dr. VIOLAKI-PARASKEVA (President, Thirty-fourth World Health
Assembly), having expressed her appreciation for the warm reception and her wishes for the success of the meeting, said that she would deliver a
CD28/SR/l Page 19
ITEM 4: ESTABLISHMENT OF A WORKING PARTY TO STUDY THE APPLICATION OF ARTICLE 6.B OF THE PAHO CONSTITUTION
TEMA 4: ESTABLECIMIENTO DE UN GRUPO DE TRABAJO ENCARGADO DE ESTUDIAR LA APLICACION DEL ARTICULO 6.B DE LA CONSTITUCION DE LA OPS
El PRESIDENTE propone que el grupo de trabajo est6 integrado por los Representantes de la Argentina, Barbados y Panama.
Decision: The Representatives of Argentina, Barbados and Panama were appointed members of the working party.
Decisi6n: Los Representantes de la Argentina, Barbados y Panama son nombrados miembros del grupo de trabajo.
ITEM 5: ESTABLISHMENT OF THE GENERAL COMMITTEE TEMA 5: ESTABLECIMIENTO DE LA COMISION GENERAL
El Dr. ALVAREZ GUTIERREZ (Mexico) propone que los Estados Unidos de America formen parte de la Comisi6n General.
Los Representantes de JAMAICA, VENEZUELA, REPUBLICA DOMINICANA, PERU, ECUADOR, PANAMA y URUGUAY apoyan la candidatura.
Dr. KEY (United Kingdom) proposed the Representative of the Bahamas
as member of the General Committee.
Los Representantes de GRENADA, TRINIDAD y TABAGO, PANAMA, JAMAICA, URUGUAY y los ESTADOS UNIDOS DE AMERICA apoyan la candidatura de Bahamas.
E1 Clmte. RIVERA (Chile) propone la candidatura del. Peri como tercer miembro de la Comisi6n General.
CD28/SR/1l Page 20
Decision:
Decisi6n:
The Representatives of Bahamas, Peru and the United States of America were elected members of the General Committee.
Los Representantes de Bahamas, Per6 y los Estados Unidos de America son elegidos miembros de la Comisi6n General.
ITEM 6: ADOPTION OF THE AGENDA
TEMA 6: ADOPCION DEL PROGRAMA DE TEMAS
The SECRETARY drew attention to the proposed deletion of item 11(c): Provisional Draft of the Program Budget of the World Health
Organization for the Region of the Americas for the Biennium 1984-1985.
El PRESIDENTE somete a la consideracion del Consejo el proyecto de
programa de temas con la enmienda propuesta.
Decision: The agenda was adopted with the amendment proposed. Decisi6n: Se aprueba el programa de temas con la enmienda
propuesta.
regional committee
PAN AMERICAN
HEALTH
ORGANIZATION
XXVIII Meeting
WORLD
HEALTH
ORGANIZATION
XXXIII Meeting Washington, D.C.
September-October 1981
INDE
D
~~~,_-, ~
~
~
_.CD28/SR/2
21 September 1981
ORIGINAL: ENGLISH-SPANISH FRENCH-PORTUGUESE
Monday, 21 September 1981, at 2:30 p.m. Lunes, 21 de septiembre de 1981, a las 2:30 p.m.
PROVISIONAL SUMMARY RECORD OF THE SECOND PLENARY SESSION ACTA RESUMIDA PROVISIONAL DE LA SEGUNDA SESION PLENARIA
Dr. Miguel Coello Fernandez President:
Presidente:
Ecuador
Contents Indice
First Report of the General Committee Primer Informe de la Comisi6n General
Report of the Working Party to Study the Appplication of Article 6.B of the PAHO Constitution
Informe del Grupo de Trabajo encargado de estudiar la aplicaci6n del Articulo 6.B de la Constituci6n de la OPS
(continued overleaf) (continua al dorso)
Note: These summary records are provisional. Representatives are requested to notify Document Services (Room 207) of any changes they wish to have made in the text. The edited records will be published in the Proceedings of the Meeting.
Nota: Esta acta resumida es provisional. Se ruega a los selores Represen-tantes tengan a bien comunicar al Servicio de Documentos (Oficina 207) las modificaciones que deseen ver introducidas en el texto. Los tex-tos definitivos se publicaran en las Actas de la Reuni6n.
CD28/SR/2 Page 2
Contents (cont.) Indice (cont.)
Item 7: Request of the Government of St. Vincent and the Grenadines for Membership in the Pan American Health Organization
Tema 7: Solicitud de ingreso del Gobierno de San Vicente y Granadinas en la Organizaci6n Panamericana de la Salud
Item 8: Request of the Government of Dominica for Membership in the Pan American Health Organization
Tema 8: Solicitud de ingreso del Gobierno de Dominica en la Organizaci6n Panamericana de la Salud.
Item 9: Annual Report of the Chairman of the Executive Committee Tema 9: Informe Anual del Presidente del Comite Ejecutivo
Item 10: Annual Report of the Director of the Pan American Sanitary Bureau
CD28/SR/2 Page 3
The session was called to order at 2:40 p.m. Se abre la sesi6n a las 2:40 p.m.
FIRST REPORT OF THE GENERAL COMMITTEE PRIMER INFORME DE LA COMISION GENERAL
The SECRETARY read out the first report of the General Committee, as follows:
The General Committee held its first session on Monday, 21 September 1981, at 12 noon.
Present were: The President, the two Vicepresidents, the Rapporteur, the Representatives of the Bahamas, Peru and the United States of America, and the Director of the Pan American Sanitary Bureau.
In the course of its deliberations, the General Committee adopted the following decisions:
A. That the hours of work of the Directing Council be:
- for the morning session, from 9:00 a.m. to 12:30 p.m., with a 15-minute Coffee Break at 10:30 a.m.;
- for the afternoon session, it established the hours of 2:30 p.m. to 5:30 p.m., also with a Coffee Break of 15 minutes at 4:00 p.m. B. It established the following order of discussion of Agenda items
for this afternoon:
1. The Report of the General Committee, which I am now reading. 2. Item 7, Request of the Government of St. Vincent and the
Grenadines for Membership in the Pan American Health Organization.
3. Item 8, Request of the Government of Dominica for Membership in the Pan American Health Organization.
4. Item 9, Annual Report of the Chairman of the Executive Committee.
CD28/SR/2 Page 4
6. Item 11, Proposed Program and Budget of the Pan American Health Organization for the Biennium 1982-1983.
C. The General Committee established specific dates for discussion of the following items:
1. Item 20, Interim Financial Report of the Director for the Year 1980 and Report of the External Auditor, will be discussed on Tuesday, 29 September.
2. Item 22, Amendments to the Rules of Procedure of the Governing Bodies of the Pan American Health Organization and to the Rules for Technical Discussions at Meetings of the Pan American Sanitary Conference and of the Directing Council, will be considered in the afternoon of Tuesday, 22 September.
3. Item 24, Technical Discussions: "Sanitary Control of Food," will be held all day Friday, 25 September, and the morning of Saturday, 26 September.
4. Also with regard to Item 24, the Council is required to appoint a Moderator and a Rapporteur for the Technical Discussions. This will take place on the morning of Tuesday, 22 September. 5. With regard to Item 25, Selection of the Topic for the
Technical Discussions to be held in 1983 during the XXIX Meeting of the Directing Council of PAHO, XXXV Meeting of the Regional Committee of WHO for the Americas, the Council is to appoint a Working Group composed of three members to receive suggestions of possible items for the Technical Discussions to be held in 1983. The appointment of the Working Group will take place also on the morning of Tuesday, 22 September.
6. Item 29, Report of the PAHO Advisory Committee on Medical Research, will be considered on the afternoon of Monday, 28 September.
7. Item 30, Election of Three Member Governments to the Executive Committee on the Termination of the Periods of Office of Guatemala, Peru, and the United States of America, will be considered after the morning Coffee Break of Thursday, 24
CD28/SR/2 Page 5
8. Item 31, Report on the PAHO Award for Administration, 1981, will be considered after the afternoon Coffee Break on Wednesday, 23 September.
D. The General Committee also established the following order of discussion of Agenda items:
1. Item 12, Plan of Action for the Implementation of Regional Strategies of Health for All by the Year 2000.
2. Item 18, Status of the Implementation of the Directing Council's Recommendations on WHO's Structures in Light of its Functions.
3. Item 13, Seventh General Program of Work of the World Health Organization.
4. Item 39, Women in Health and Development: Proposed Five-Year Regional Plan of Action.
5. Item 15, Status of the Evaluation of the Pan American Centers: a) Caribbean Epidemiology Center; b) Latin American Center for Perinatology and Human Development; c) Caribbean Food and Nutrition Institute; d) Institute of Nutrition of Central America and Panama.
6. Item 14, Capitalization of the Revolving Fund of the Expanded Program on Immunization.
E. The General Committee also decided that at the conclusion of the discussion of Items 7 and 8, the Observer of CARICOM will be granted the floor in order that he may make some comments. In this connection, the General Committee concluded that this intervention, as well as any others that the General Committee may receive, should not extend more than five minutes, if possible, and should relate to specific Agenda items. The President of the Council will entertain any requests made in this regard.
F. The General Committee wishes to inform that at 1:30 p.m., on Thursday and also at 1:30 p.m. on Friday, 24 and 25 September, respectively, a film will be shown in Room B on the subject of "Journey for Survival." The Spanish version will be shown on Thursday and the English one on Friday.
CD28/SR/2 Page 6
H. The General Committee also took note that on Wednesday, 23 September, there will be a private session of Heads of Delegations to consider matters of interest regarding the 35th World Health Assembly.
I. The General Committee decided to meet again on Wednesday, 23 September at 12:30 p.m.
El PRESIDENTE, en vista de que no se formula ninguna observaci6n sobre el plan de trabajo y el primer informe de la Comisi6n General considera que quedan aprobados.
REPORT OF THE WORKING PARTY TO STUDY THE APPLICATION OF ARTICLE 6.B OF THE PAHO CONSTITUTION
INFORME DEL GRUPO DE TRABAJO ENCARGADO DE ESTUDIAR LA APLICACION DEL ARTICULO 6.B DE LA CONSTITUCION DE LA OPS
La Dra. BETHANCOURT (PanamA) da lectura al siguiente informe:
El grupo de trabajo designado para estudiar la aplicaci6n del Articulo 6.B de la Constituci6n de la OPS, integrado por los representan-tes de la Argentina, Barbados y PanamA, ha examinado la situaci6n de la recaudaci6n de las cuotas desde el punto de vista de las disposiciones del Articulo 6.B relativas a la suspensi6n de los privilegios de voto de los Gobiernos con atrasos que exceden del importe de las cuotas corres-pondientes a dos aflos.
E1 grupo de trabajo ha tomado nota de la satisfactoria situaci6n general en la recaudaci6n de las cuotas de todos los Gobiernos Miembros de la Organizaci6n. Se observ6 que tres Gobiernos tenian atrasos de mAs de dos aflos. Esos tres Gobiernos han adoptado planes de pago diferido. Dos de estos Gobiernos han efectuado pagos durante 1981 de acuerdo con sus planes respectivos. El tercer Gobierno tiene en proceso el pago de su plan para 1981. El grupo de trabajo recomienda, por tanto, que se permita votar en la XXVIII Reuni6n del Consejo Directivo a los Gobiernos de Haitf, Paraguay y la Republica Dominicana.
CD28/SR/2 Page 7
ITEM 7: REQUEST OF THE GOVERNMENT OF ST. VINCENT AND THE GRENADINES FOR MEMBERSHIP IN THE PAN AMERICAN HEALTH ORGANIZATION
TEMA 7: SOLICITUD DE INGRESO DEL GOBIERNO DE SAN VICENTE Y GRANADINAS EN LA ORGANIZACION PANAMERICANA DE LA SALUD
El Dr. ACURA (Director) indica que los documentos que se refieren a la solicitud de ingreso de San Vicente y Granadinas en la OPS son
cor-tos y precisos, por lo que no necesitan explicaci6n. Le complaceria que fuera admitido un nuevo miembro en la Organizaci6n.
El PRESIDENTE solicita a la Representante del Comite Ejecutivo que informe al respecto.
Dr. MOODY (Executive Committee) said that at its 86th Meeting in
June 1981 the Executive Committee had approved a resolution warmly recommending that the Directing Council should admit St. Vincent and the Grenadines to membership in the Pan American Health Organization.
Mr. McINTYRE (Trinidad and Tobago) wholeheartedly endorsed the recommendation of the Executive Committee. St. Vincent was a fellow mem-ber both of CARICOM and of the British Commonwealth, and possessed excel-lent credentials for admission to the Organization. There was close co-operation between St. Vincent and his own country and he was sure that, as a Member, it would contribute greatly to the work of the Organization.
CD28/SR/2 Page 8
assure the Government of St. Vincent and the Grenadines of its continued support and cooperation in all its endeavors in the health field. The Government of St. Vincent had already shown much initiative in the development of primary health care services, particularly the training of health care personnel at all levels, and she was sure it would continue
to go forward with great success.
Dr. BRATHWAITE (Barbados) joined the previous two speakers in sup-porting the recommendation. Barbados was, physically, St. Vincent's closest neighbor and enjoyed a very good relationship with it. The country was moving forward rapidly in terms of health institutions and should be welcomed unanimously into the Organization.
El Dr. ROSALES (Venezuela) tambien apoya la solicitud de ingreso de San Vicente y Granadinas en la OPS.
Dr. BLACK (Canada) said that Canada was particularly pleased to join the previous speakers in supporting the admission of a fellow member of the Commonwealth to membership in the Organization.
El Dr. ALDEREGUIA (Cuba) expresa la satisfacci6n de su Delegaci6n por el ingreso de un nuevo miembro de la Comunidad del Caribe en la
CD28/SR/2 Page 9
Mr. MILLER (Jamaica) joined in the warm welcome extended to St. Vincent by the previous speakers. As a Member, St. Vincent would be able
to contribute the special perspective of a small State to the Organiza-tion's deliberations.
Mr. LOUISY (Saint Lucia), in anticipation of the Council's
deci-sion, welcomed the Government of St. Vincent and the Grenadines into mem-bership in the Organization. Its participation would enrich the Council's deliberations and would help the Organization to take decisions in the overall interest of the health of all the peoples of the Hemis-phere. It would also help to enhance the preliminary approaches taking place among the small countries of the Caribbean in respect of technical
cooperation among developing countries.
La Dra. BETHANCOURT (Panama) apoya plenamente el ingreso de San Vicente y Granadinas en la OPS.
El Dr. MICHELSEN (Colombia) considera que se debe dar una calurosa
bienvenida a San Vicente y Granadinas.
Le Dr. BROYELLE (France) se joint aux del4gations qui ont appuy4
la candidature de St. Vincent-et-Grenadines et saisit l'occasion pour souhaiter a ce pays la bienvenue au sein de cette assemblee.
CD28/SR/2 Page 10
the Council and in other forums of PAHO where the Governments of the Americas shared the problems and opportunities of dealing with the health of all their peoples.
O Dr. GERHARDT (Brasil) manifesta a satisfagao de seu Governo em receber e apoiar a recomendacago no sentido de admitir Sgo Vicente e Granadinas como Membro da OPAS.
Dr. GITTENS (Grenada) said his country had pleasure in welcoming St. Vincent, as a neighbor, a fellow member of CARICOM, and one of the group of least developed among the developing countries, to membership in PAHO.
Ms. BROWN (Bahamas) supported the Executive Committee's
recom-mendation and looked forward to working with St. Vincent as a Member.
El Dr. CABRERA (Mexico) expresa su completo apoyo a la admisi6n de San Vicente y Granadinas en la Organizaci6n.
El Dr. RODRIGUEZ (Repdblica Dominicana) comparte la satisfacci6n
de los demAs representantes por el ingreso de San Vicente y Granadinas en la OPS.
El Dr. HENRIQUEZ (Ecuador) recomienda que se apruebe la solicitud de ingreso presentada.
CD28/SR/2 Page 11
El Dr. BACIGALUPI (Uruguay) ve con beneplacito el ingreso de San Vicente y Granadinas.
Le Dr. DESIR (Haiti) exprime la joie de la Dle4gation haitienne de
voir que l'admission de St. Vincent-et-Grenadines a 4te approuvee par
tous et il souhaite personnellement la bievenue a cette Delegation.
E1 PRESIDENTE pide al Relator que de lectura al proyecto de reso-luci6n sobre el tema.
El RELATOR da lectura al proyecto de resoluci6n siguiente:
THE DIRECTING COUNCIL,
Having examined the formal request for membership in the Pan American Health Organization made on behalf of St. Vincent and the Grenadines by its Minister of Foreign Affairs in a communication dated 12 May 1981; and
Considering that the Government of St. Vincent and the Grenadines has declared its readiness to accept all the obligations of the Constitu-tion of the Pan American Health OrganizaConstitu-tion, to comply with the provi-sions 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 St. Vincent and the Grenadines for membership in the Pan American Health Organization.
2. To instruct the Director to transmit this decision to the Member Governments of the Organization.
EL CONSEJO DIRECTIVO,
CD28/SR/2
Page 12
y Granadinas por su Ministro de Asuntos Exteriores en una comunicaci6n de fecha 12 de mayo de 1981, y
Considerando que el Gobierno de San Vicente y Granadinas se ha declarado dispuesto a asumir todas las obligaciones previstas en la Constituci6n de la Organizaci6n Panamericana de la Salud, a cumplir las disposiciones del C6digo Sanitario Panamericano enmendadas por el Protocolo Adicional del 24 de septiembre de 1952 y a contribuir con la cuota que se le fije como apoyo financiero a la Organizaci6n,
RESUELVE:
1. Aprobar con satisfacci6n la solicitud de ingreso en la Organizaci6n Panamericana de la Salud presentada por el Gobierno de San Vicente y Granadinas.
2. Pedir al Director que transmita la presente decisi6n a los Gobiernos Miembros de la Organizaci6n.
Decision: The proposed resolution was adopted by acclamation. Decisi6n: Se aprueba por aclamaci6n el proyecto de resoluci6n.
Mr. BALLANTYNE (St. Vincent and the Grenadines) said that his Government was grateful to the Member Governments of the Pan American
Health Organization for their support of its application, and looked
forward to joining them in pursuit of the goal of health for all by the year 2000, through the primary health care approach.
St. Vincent and the Grenadines was a small island State, only 150
square miles in area and with a population of 110,000. The dependency
rate was high, 55 per cent of the population being under 18 years and some 35,000 between the ages of one and twelve years. In 1979, the birth
rate had been 28.4 per 1,000, the death rate 5.7, and the infant
CD28/SR/2 Page 13
developing countries, some of the people had no access to safe drinking
water or basic sanitation. The mainstay of the economy was agriculture
and would be so for many years to come, despite the Government's efforts to promote industrial development and tourism. Both financial resources
and technical manpower were limited. The Government had accordingly taken steps to implement a primary health care program, in the conviction that the most rational approach to developing a healthy nation would be
to provide the basic amenities and to emphasize preventive care.
The country had suffered greatly from natural disasters. In 1979
it had been shaken by eruptions of the La Soufriare volcano, which had
disrupted agriculture and forced the evacuation of some 20,000 people from their homes. In 1980, agriculture had again been damaged, by Hurricane Allen. In 1981, heavy rains and floods had disrupted water
supplies and caused great financial loss. Despite those setbacks, the Government was continuing its efforts to overcome the country's problems.
It had received help and support from a number of Members of PAHO, in
addition to the prompt and effective contribution of the Office of the
n(r ilbhne I'rogram Coordinator, the Caribbean Food and Nutrition
Institute, and the Caribbean Epidemiology Center.
St. Vincent had benefited directly and indirectly from association
with PAHO for many years, and particularly since the establishment of the Caribbean Coordinator's Office. With the attainment of independence, the
CD28/SR/2
Page 14
country had raised from its meagre resources enough to pay its quota assessment and thus contribute to the Organization's deliberations and
the health of the Hemisphere. It expected to see some definite return on that investment in terms of improved health at home and throughout the Americas.
He expressed concern about the high administrative cost of aid
programs, most of which were of no immediate or direct benefit. Special
attention should be paid to reducing overhead costs. The time had come
for positive and concerted action to improve health conditions that could be seen and felt by the nations. Active and sustained community
partici-pation in a properly established and efficiently organized health system was an essential ingredient in the advancement of health. When it was
available, national and international efforts would be productive in the
attainment of the final goal. He firmly believed that the admission of St. Vincent and the Grenadines to the Organization as an independent
State would help it to achieve its goal of improving the health of the
people.
In conclusion, he reaffirmed that his Government would fulfill the
financial obligations imposed on Member Countries by the Constitution,
comply with the provisions of the Pan American Sanitary Code as amended by the Additional Protocol of 1952, and cooperate fully with the other
CD28/SR/2 Page 15
The Representative of St. Vincent and the Grenadines, Mr. Peter Ballantyne, then proceeded to place the flag of his country on the podium among those of the other Member Governments.
El Representante de San Vicente y Granadinas,
Sr. Peter Ballantyne, procede seguidamente a instalar en el
estrado la bandera de su pats entre las de los demos Gobiernos Miembros.
ITEM 8: REQUEST OF THE GOVERNMENT OF DOMINICA FOR MEMBERSHIP IN THE PAN AMERICAN HEALTH ORGANIZATION
TEMA 8: SOLICITUD DE INGRESO DEL GOBIERNO DE DOMINICA EN LA ORGANIZACION PANAMERICANA DE LA SALUD
El Dr. ACURA (Director) dice que, al igual que en el caso del tema
anterior, los documentos pertinentes a la solicitud de ingreso de la Mancomunidad de Dominica en la OPS se explican por sf solos. Se siente
complacido al presentar dicha solicitud a la consideraci6n del Consejo
Directivo.
Dr. MOODY (Executive Committee) said that the Committee was happy
to recommend to the Directing Council that it admit the Commonwealth of
Dominica to membership in the Organization.
Mr. McINTYRE (Trinidad and Tobago) said that all that had been
said about St. Vincent and the Grenadines applied equally to Dominica.
It too enjoyed impressive leadership, and he had no doubt that the course being charted by its Prime Minister would lead the country to better
times. In addition to the natural disasters to which they were subject,
CD28/SR/2
Page 16
principles of democracy with which, under British tutelage, they had been imbued. When those little countries were struggling to keep the light of
democracy alive, it was the duty of all great countries to come to their
assistance. He had been heartened by the support given to St. Vincent by the great countries in the Caribbean area, and was sure that Dominica would be similarly welcomed.
Dr. BRATHWAITE (Barbados) endorsed the views expressed by the Representative of Trinidad and Tobago. Dominica had a proud history,
despite its misfortunes in recent times. He urged the Council to give
its application unanimous support, and to adopt the Executive Committee's recommendation by acclamation.
Dr. KEY (United Kingdom) also supported the Executive Committee's recommendation. In spite of the almost insuperable difficulties caused by the two recent hurricanes, the Minister of Health of the Commonwealth
of Dominica and his staff were pressing forward with great dedication to redevelop the infrastructure of the health service, which had been almost totally destroyed, with the emphasis on basic services for all the
people. The Delegation and Government of the United Kingdom were proud
to have been associated with Dominica over the past years, and looked
forward to continued close cooperation.
M. CAREAU (Canada) se joint aux orateurs precedents pour appuyer
CD28/SR/2 Page 17
sant4. Le Canada qui a deja d'excellentes relations avec la Dominique sur le plan bilateral, les poursuivra maintenant sur le plan multilateral.
El Dr. RODRIGUEZ (Rep6blica Dominicana) dice que se sentiria muy
satisfecho de que Dominica fuera admitida en la Organizaci6n.
Mr. MILLER (Jamaica) welcomed Dominica into the family of the Pan
American Health Organization. PAHO had much to gain from admitting a
country whose people had shown such strength of character in triumphing over so many natural disasters. With its admission, the disaster
prepar-edness activities of the Organization would undoubtedly be brought into sharper focus. The small States of the Caribbean could make a valuable
contribution to PAHO's work, and Jamaica would therefore support the recommendation and vote in favor of the resolution.
Le Dr. BROYELLE (France) joint la voix de sa delagation a celles
qui se sont deja exprim4es en faveur de l'admission au sein de
l'Organisation de la Dominique, pays avec lequel, son gouvernement
entretient des relations de bon voisinage qui ne pourront que s'amplifier
au sein de l'Organisation.
E1 Dr. ALDEREGUIA (Cuba) expresa el apoyo total de su Delegaci6n a
la propuesta del Comite Ejecutivo de que se acepte el ingreso de Dominica
en la OPS. Esto no s6lo harA crecer a la Organizaci6n sino que
CD28/SR/2 Page 18
O Dr. GERHARDT (Brasil) ap6ia com satisfagao, em nome do Governo de seu pais, a recomendagco no sentido de admitir a Dominica como Membro
da OPAS.
La Dra. BETHANCOURT (Panama) se siente complacida con el ingreso
de Dominica en la OPS y asegura al Gobierno de ese pais que contarA con
el respaldo de Panama y de todos los demAs paises en la lucha contra las enfermedades en el mantenimiento de la salud de nuestras poblaciones.
El Dr. MICHELSEN (Colombia) tambien se adhiere a la propuesta del
Comite Ejecutivo de que se admita a Dominica como Miembro de, la
Organi zaci6n.
Mr. GITTENS (Grenada) joined the previous speakers in welaoming
Dominica to the Organization.
Le Dr. DESIR (Haiti) joint la voix de la Delegation haitienne a celles des orateurs des autres pays pour soutenir la recommandation du Comite executif favorisant l'admission de la Dominique au sein de
l'Organisation panamericaine de la sante.
El Dr. CABRERA (Mexico) expresa el apoyo de su Delegaci6n a la
admisi6n de Dominica.
La Dra. BEDOYA (Bolivia) se une a las expresiones de apoyo en
CD28/SR/2
Page 19
Mr. LOUISY (Saint Lucia), noting that his country had special
historical, economic, social and cultural bonds with the Commonwealth of Dominica, warmly welcomed that country to membership in PAHO. Technical
cooperation between the two countries in the health field was growing;
for example, Dominica had recently responded with alacrity to an urgent
appeal from Saint Lucia for the services of a pathologist.
Dr. BRYANT (United States of America) also extended a friendly
welcome to Dominica as a new Member of the Organization. It would have
the opportunity to join with all the Member Countries in the constructive
activities of PAHO.
El Dr. BACIGALIJPI (Uruguay) tambien apoya el ingreso de Dominica
en la OPS.
Ms. BROWN (Bahamas) warmly supported the admission of Dominica and
extended her country's best wishes for future working relations with the new Member Country.
El Dr. ROSALES (Venezuela) expresa su apoyo a la admisi6n de
Dominica.
El Dr. TRABANINO (El Salvador) ve con beneplAcito el ingreso de
Dominica.
El Dr. ENRIQUEZ (Ecuador) tambien se siente complacido con la
CD28/SR/2
Page 20
El PRESIDENTE pide al Relator que lea el proyecto de resoluci6n
sobre el tema.
El RELATOR da lectura al siguiente proyecto de resoluci6n;
THE DIRECTING COUNCIL,
Having examined the formal request for membership in the Pan American Health Organization made on behalf of the Government of the Commonwealth of Dominica by its Prime Minister and Minister of External Affairs, in a communication dated 14 May 1981; and
Considering that the Government of the Commonwealth of Dominica has declared its readiness to accept all the obligations of the Constitu-tion of the Pan American Health OrganizaConstitu-tion, to comply with the provi-sions 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 the Commonwealth of Dominica for membership in the Pan American Health Organization.
2. To instruct the Director to transmit this decision to the Member Governments of the Organization.
EL CONSEJO DIRECTIVO,
Habiendo examinado la solicitud oficial de ingreso en la Organizaci6n Panamericana de la Salud, formulada en nombre del Gobierno de la Mancomunidad de Dominica por su Primer Ministro (Ministro de Asuntos Exteriores) en una comunicaci6n de fecha 14 de mayo de 1981, y
CD28/SR/2 Page 21
RESUELVE:
1. Aprobar con satisfacci6n la solicitud de ingreso en la Organizaci6n Panamericana de la Salud, presentada por el Gobierno de la Mancomunidad de Dominica.
2. Pedir al Director que transmita la presente decisi6n a los Gobiernos Miembros de la Organizaci6n.
Decision: The proposed resolution was adopted by acclamation. Decisi6n: Se aprueba por aclamaci6n el proyecto de resoluci6n.
Dr. MAYNARD (Dominica) said that he felt reasured by the sentiments
expressed toward his country and was pleased to acccept the warm welcome extended to Dominica as a new Member of PAHO.
While he recognized that PAHO had the potential to provide
tremen-dous resources and support for small States like his own, he was concerned
about Dominica's future relationship with the Organization because he had found that many international organizations that were intended to serve
less fortunate countries were sometimes so structured that they became unresponsive to the critical needs of those countries. While Dominica appreciated the support it had already received from the Organization in
the form of training and fellowships, and the role PAHO had played as
executing agency on behalf of UNFPA in providing assistance, he had
certain misgivings regarding its ability to cope effectively with the
special problems of the mini-States.
Dominica required massive assistance in the form of supplies and
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polyclinics, but for jobs, and it needed to redirect local resources allocated for health services to enhance their cost-effectiveness.
Finally, as part of its health care, Dominica needed an extensive vector
control program and, although it had the personnel required to carry it
out, it would welcome technical advisory services from PAHO.
Unfortu-nately, with its very small tax base and limited revenue-producing
capability, it could not meet its urgent equipment and supply needs from its national budget. Moreover, it was still suffering the effects of two
natural disasters that had completely destroyed its economic, educational
and health infrastructures. In the circumstances, it was compelled to
seek aid on an ongoing basis from international agencies. If PAHO was not equipped to assist his country with supplies and equipment to mount a
satisfactory health program, there was a major deficiency in its ability
to respond to the urgent needs of the countries it was intended to serve. Particularly when a new group of Member Countries with special problems
joined the Organization, it should place an item on its agenda under which
it would evaluate the effectiveness of its programs for such countries and perhaps develop new thinking and a new approach to their health
service difficulties. PAHO should have sufficient resources at its
disposal to enable it to provide capital funds to Members expeditiously. While it was essential to maintain the necessary level of staff to deliver services, it was the delivery of those services that should be
given priority. A significant part of available funds should be allocated
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that a sufficient supply of vaccines, insecticides, vehicles, and even the minimal drugs required for primary health care was available. It was
no use providing assistance for health planning when the planned system
could not be implemented. The financing of the plan should have equal
priority with its implementation. He was encouraged that PAHO had helped
some countries to secure loans for development projects and had managed
to obtain funds for health projects from non-traditional sources by
cooperating with certain financial agencies operating in the health field. Assistance could likewise be obtained for non-traditional purposes, that is, purposes defined as priority concerns by the countries themselves at
a given time. As the President of the Caribbean Development Bank had
said, the mini-States of the Region suffered from three major drawbacks:
inadequate levels and narrow range of trained human resources; extreme external economic and financial dependence, sometimes including the need
for grants-in-aid to balance their budgets; and susceptibility to natural disasters.
He congratulated the Director on his annual report, in particular
its references to financial asistance required to overcome financial
constraints arising from inadequate local revenue-generation. In that
regard, Dominica had submitted its proposals to the Organization and was prepared to discuss the details with a view to obtaining support services that would enable it to implement them. He was convinced that PAHO could
develop the will to respond to the special concerns of its Members and
