Having examined the Annual Report of the Director of the Pan American Sanitary Bureau, Regional Office of the World Health Organization for the Americas, for 1960 (Official Document Nº 38),

To take note of the Annual Report of the Director for 1960 (Official Document Nº 38), to congratulate him on the excellent work accomplished during the year and the manner in which the Report was presented, and to extend congratulations to the staff of the Bureau.

Oct. 1961 OD 41, 16

CD13.R2    The Directing Council,

1.      To appropriate for the financial year 1962 an amount of $5,240,000, as follows:

2.      [To approve that] amounts not exceeding the appropriations noted under paragraph 1 be [made] available for the payment of obligations, in accordance with the Financial Regulations of the Organization, incurred during the period 1 January to 31 December 1962, inclusive.

3.      [To approve that] the appropriations as noted above be financed by contributions from the Member Governments according to Article 60 of the Pan American Sanitary Code; contributions on behalf of France, the Kingdom of the Netherlands, and the United Kingdom according to Resolutions XV and XL of the V Meeting of the Directing Council; and miscellaneous income accruing to the Pan American Health Organization.

4.     [To authorize] the Director to transfer credits between parts of the budget, provided that such transfers of credits between parts do not exceed 10 per cent of the part from which the credit is transferred. Transfers of credits between parts of the budget in excess of 10 per cent may be made with the concurrence of the Executive Committee. All transfers of budget credits shall be reported to the Directing Council.

Oct. 1961 OD 41, 16

CD13.R3    The Directing Council,

Bearing in mind the continental scope of the program of the Pan American Health Organization; and

Considering that it is incumbent on the Governments to take suitable steps to safeguard the health of their peoples,

That the Pan American Sanitary Bureau should increase its work of international coordination, and

that, in keeping with the priorities established by its Governing Bodies, the Bureau should continue to make technical advisory services available to the Member Governments, especially for the formulation of national health plans.

Oct. 1961 OD 41, 17

CD13.R4    The Directing Council,

Bearing in mind the official request of the Representative of Peru 1 that the Pan American Health Organization cooperate with the Government of that country in the solution of technical problems at present faced by the School of Medicine of the University of San Marcos;

Bearing in mind that the Directing Council, in Resolution II, has approved the program and budget of the Pan American Health Organization for 1962, and

Bearing in mind that the improvement of medical education and training is one of the objectives of the Organization,

1.      To invite the Member Governments to study the possibility of lending all possible moral and material support to the School of Medicine of the University of San Marcos in Lima.

2.      To recommend to the Director of the Pan American Sanitary Bureau that, without detriment to the projects approved for 1962, he utilize funds that may be available from the regular budget, as well as any other extrabudgetary resources he may be able to obtain, in order to give the fullest cooperation in the solution of the School's technical problems, and that if necessary he include a specific project for this school in the general program of the Organization for 1963.

3.To recommend to the Director that similar assistance to the other schools of medicine in Peru be given upon request by the Government and within the limits of the resources of the Organization.

Oct. 1961 OD 41, 17

CD13.R5    The Directing Council,

Having examined Official Document Nº 35, submitted by the Director of the Pan American Sanitary Bureau and containing the Proposed Program and Budget of the World Health Organization for the Region of the Americas for 1963; and

Bearing in mind that the aforesaid Proposed Program and Budget of the World Health Organization for the Region, for review and transmittal to the Director-General of that Organization so that he may take it into consideration in the preparation of the proposed budget of the WHO for 1963,

To approve the transmittal of the Proposed Program and Budget of the World Health Organization for the Region of the Americas for 1963, contained in Official Document Nº 35, and to request the Regional Director to transmit it to the Director-General of that Organization so that he may take it into consideration when preparing the WHO budget for 1963.

Oct. 1961 OD 41, 18

CD13.R6    The Directing Council,

Having examined Official Document Nº 35, submitted by the Director of the Pan American Sanitary Bureau and containing a provisional draft to be considered as the preliminary basis for the 1963 Proposed Program and Budget of the Pan American Health Organization that will be submitted to the 46th Meeting of the Executive Committee and to the XVI Pan American Sanitary Conference;

Recognizing that the provisional draft of the Proposed Program and Budget comprises well-conceived and much-needed health projects; and

Taking into account the recommendations and comments made by various delegations during the discussion of the provisional draft,

1.     To take note of the provisional draft of the Proposed Program and Budget of the Pan American Health Organization for 1963, contained in Official Document Nº 35.

2.      To instruct the Director, in preparing his Proposed Program and Budget for 1963, and in his consultations with the Governments on this matter, to give due consideration to the recommendations and comments made by several delegations.

Oct. 1961 OD 41, 18-19

CD13.R7    The Directing Council,

Considering that the Pan American Health Organization has received a grant from the United States Public Health Service for the regional development of epidemiological studies in which an inter-American survey of the causes of death will be carried out in collaboration with participants in ten cities of the Americas, who will make a thorough study of a representative sample of cases to obtain information on the diseases that were the causes of death;

Considering that the results of this study of 40,000 deaths (the causes of which will be uniformly assigned by medical specialists who will review the clinical, laboratory, and pathological records) will provide essential comparable data that will serve as a basis for epidemiological studies and for programs of research on population groups in the Region of the Americas with widely differing medical and social backgrounds; and

Considering that this research program will also influence the development of standards for the diagnosis of diseases and of terminology in English, French, Portuguese, and Spanish, and that it will stimulate the teaching of diagnosis and medical certification in medical schools and thus directly and indirectly improve the accuracy of medical statistics in the Americas,

1.      To recommend that the Member Governments give full support to the development of the research program on mortality statistics so that the benefits of this first intensive regional investigation of mortality may be fully utilized not only to provide clues for epidemiological studies but also to improve the quality of mortality statistics, which are indispensable for health planning.

2.      To recommend to the Director of the Pan American Sanitary Bureau that the Organization assist the investigators in the cities selected so as to ensure that these coordinated investigations provide comparable basic data and that the results of this research program are fully utilized in health services, in epidemiological studies, and in teaching in medical schools.

Oct. 1961 OD 41, 19

CD13.R8    The Directing Council,

Bearing in mind that procedures for the certification of the cause of death vary widely in the Americas, where in some countries all, or nearly all, death certificates are issued by physicians, while in others less than half the deaths are medically certified; and

Considering that accurate data on the causes of death are essential for health planning and for measuring the progress made in programs such as malaria and smallpox eradication,

1.      To recommend that the Member Governments adopt a standard form of death certificate, in accordance with the International Form of Medical Certificate of Cause of Death contained in WHO Regulations No. 1 (1948), Nomenclature Regulations, so that comparable mortality statistics for the entire Region may be available.

2.      To recommend that the Member Governments promote as an important activity and responsibility of the health services the wider use of medical certificates of the cause of death and the improvement of the quality of such certificates in the Americas as soon as possible, so that data may be available for the planning and evaluation of health programs.

3.      To recommend that the Member Governments encourage the tabulation of mortality statistics that distinguish and present separately the causes of death that have not been medically certified.

4.      To recommend to the Director of the Pan American Sanitary Bureau that the Organization assist the countries in this field and encourage the national committees on vital and health statistics to take the necessary steps to coordinate the activities of the ministries that are entrusted with the registration, compilation, and analysis of vital statistics.

Oct. 1961 OD 41, 19

CD13.R9    The Directing Council,

Having examined the Financial Report of the Director and the Report of the External Auditor for 1960 (Official Document Nº 37); and

Bearing in mind the decision taken by the Executive Committee at its 43rd Meeting with respect to the aforesaid reports (Resolution IV),

To approve the Financial Report of the Director and the Report of the External Auditor for the fiscal year 1960, contained in Official Document Nº 37.

Oct. 1961 OD 41, 20

CD13.R10    The Directing Council,

Having examined the Report of the Director on the collection of quota contributions, presented in Document CD13/8 and Addendum I; and

Considering that the Pan American Health Organization continues to be faced with financial problems owing to the large amount of the quotas in arrears,

1.      To take note of the report of the Director on the status of the collection of quota contributions (Document 13/8 and Addendum I).

2.      To urge Member Governments whose quota contributions are in arrears to pay them at the earliest possible date, in order to ensure the normal development of the activities of the Organization.

Oct. 1961 OD 41, 20-21

CD13.R11    The Directing Council,

Having examined the nutrition program in the Americas presented by the Director of the Pan American Sanitary Bureau in Document CD13/14, 1 and having heard the opinions and suggestions of the representatives of all the countries;

Bearing in mind the seriousness of the nutrition problem, as evidenced, among other conditions, by the fact that the per capita production of food in Latin America in 1959-1960 was lower than that recorded prior to World War II;

Bearing in mind that among the factors aggravating this situation is the inadequate utilization of available foodstuffs, owing to cultural circumstances that could be overcome through effective educational measures;

Considering that the problem of nutrition in the Americas severely affects the state of health of the population, resulting in high mortality and morbidity, especially among children, as well as in inadequate physical development and output of work, all of which have deep repercussions on the social and economic development of the countries;

Considering that the shortage of properly trained personnel specialized in nutrition is one of the limitations faced by most of the countries today, and that a program for the improvement of nutrition can be planned only on a long-term basis and with sufficient resources available for its progressive development; and

Considering the good results obtained with the high-protein, low-cost product developed by INCAP in Central America, as well as the trials conducted in other countries with different high-protein mixtures,

1.      To express its conviction that the production and supply of basic foods sufficient in quantity and quality to meet the needs of the population is a factor fundamental to health and essential to social and economic development.

2.      To approve the nutrition program in the Americas, as set forth by the Director of the Pan American Sanitary Bureau in Document CD13/14, and to commend the Director for his cooperation with other international agencies, especially FAO and UNICEF, in nutrition activities.

3.       To give its full support to the recently initiated intensification of activities in this field, and to recommend that, in view of the severity of the problem, the Director include in future proposed budgets the necessary allocations to ensure the progressive development of these activities.

4.      To request the Director to give special attention to the training of the necessary personnel so that the different countries may be in a position to properly carry out their nutrition programs.

5.To recommend that the Member Governments:

a) Within their national health plans, and with due attention to the importance of this problem, include the programs related to nutrition among the activities accorded highest priority, encompassing both specific measures for the prevention of deficiency diseases and other measures to promote general improvement in the state of nutrition of the population;

b) Organize, or expand, the nutrition programs in the national health services;

c) Establish the means for achieving the proper planning of an agricultural policy that will take into account the basic nutritional needs of the population, and for attaining the proper coordination of efforts among the different official agencies, as part of the plan for social and economic development;

d) Promote the best utilization of high-protein, low-cost mixtures from products and by-products that are not at present used for the human diet;

e) Renew their efforts to achieve the effective application of a salt iodization program, as a preventive measure against endemic goiter; and

f) Take into account, as a complement to any program for improving nutrition in the population, the importance of raising, in all aspects, the level of education.

6.To request the Director to present annually to the meetings of the Council a report on the nutrition activities carried out in accordance with this program and on the progress made in overcoming the problems in this field.

Oct. 1961 OD 41, 21-22

CD13.R12    The Directing Council,

Bearing in mind that in the discussions held and in the resolutions adopted in recent years for the purpose of promoting the economic and social development of Latin America, which found expression in the decisions taken at Bogotá and Punta del Este, health has been acknowledged as a basic component of social and economic development;

Bearing in mind that, as a consequence of these decisions, funds have been allocated for the activities to be developed, and the areas in which major emphasis will be given to such activities have been defined;

Considering that these activities include housing, which is one of the essential factors for satisfying the basic needs of human life;

Considering that varied and complex factors of an economic, social, financial, and technical nature enter into the solution of the housing problem, and that in the formulation of a plan of operations and of practical recommendations consideration should be given primarily to general health aspects of housing as a social and economic problem; and

Considering both the foregoing statements and the resolutions already approved by the World Health Assembly,

To request the Director to make the necessary provision within the program and budget of the Pan American Health Organization to enable the Organization to begin to collaborate actively in the formulation and development of housing programs in the Continent, in cooperation with the agencies of the United Nations and of the Inter-American System that are responsible for the technical and financial aspects of the housing problem.

Oct. 1961 OD 41, 22

CD13.R13    The Directing Council,

Elected Nicaragua, Peru, and Uruguay to the Executive Committee upon termination of the periods of office of Brazil, Honduras, and the United States of America, and thanked the Governments of these countries for the valuable services rendered to the Organization by their representatives on the Committee.

Oct. 1961 OD 41, 23

CD13.R14    The Directing Council,

Having examined the annual report of the Executive Committee (Document CD13/44), presented by its Chairman, Dr. James Watt, Representative of the United States of America; and

Considering the terms of Article 8-C of the Constitution of the Pan American Health Organization,

To approve the annual report of the Executive Committee (Document CD13/44), and to congratulate the Chairmen, Dr. Elliott Ross Jenney And Dr. James Watt, Representatives of the United States of America, and all the members of the Committee on the work accomplished.

Oct. 1961 OD 41, 23

CD13.R15    The Directing Council,

Having examined the reports of the Permanent Subcommittee on Buildings and Installations, of the Executive Committee, and of the Director on the progress of the arrangements for the new Headquarters building;

Having heard a detailed report (Document CD13/9, Addendum II)2 on the decision of the Jury on the architectural design of the proposed Headquarters building and the bases for this decision; and

Noting the advisability of expansion of the proposed building to accommodate a greater growth of the Pan American Sanitary Bureau than that originally planned,

1.     To express its satisfaction with the results of the architectural competition and the decision of the Jury; to thank the members of the Jury-Messrs. Héctor Mardones-Restat, Samuel Inman Cooper, Luis González Aparicio, Augusto Guzmán Robles, and Dr. Abraham Horwitz-as well as the Professional Adviser, Mr. Leon Chatelain, Jr., for the valuable services they rendered; and to authorize the payment of the winning awards of $10,000 to Mr. Román Fresnedo Siri, $2,500 to Mr. José Luis Benlliure, and $1,000 to Mr. Adolfo F. Pozzi Guelfi.

2.     To express its thanks and congratulations to the Permanent Subcommittee on Buildings and Installations for the efficient work performed.

3.     To request the Permanent Subcommittee on Buildings and Installations to continue to act on behalf of the Pan American Health Organization regarding the construction of the Headquarters building, as provided in Resolution II of the 42nd Meeting of the Executive Committee.

4.     To authorize the Director of the Pan American Sanitary Bureau to go forward with the planning, financing, and construction of the building, taking into account the advisability of including planned expansion for a greater growth than that originally included in the estimates, and to report to future meetings of the Permanent Subcommittee on Buildings and Installations, the Executive Committee, and the Directing Council on the progress of this activity.

5.     To thank the Director and the staff of the Pan American Sanitary Bureau for the arrangements made for the construction of the new building.

Oct. 1961 OD 41, 23

CD13.R16    The Directing Council,

Having examined the Director's report (Document CD13/25) 1 and Resolution II of the 43rd Meeting of the Executive Committee on the establishment of a Special Fund for Health Promotion; and

Taking into account the generous offer of grant by the W. K. Kellogg Foundation,

1.      To express its deep appreciation to the W. K. Kellogg Foundation for the very generous grant of $3,750,000 for expanded program activities of the Pan American Health Organization, which will enable the Organization to proceed with the construction of a new Headquarters building.

2.      To authorize the Director to establish a Special Fund for Health Promotion, to which at least $187,500 per year shall be appropriated from the regular budget of the Pan American Health Organization until an amount of $3,750,000 has been committed for expanded program activities.

Oct. 1961 OD 41, 24

CD13.R17    The Directing Council,

Having examined the report presented by the Director of the Pan American Sanitary Bureau on the use of Emergency Revolving Fund (Document CD13/12); and

Considering that, if the Fund is to serve its important purpose of collaboration with the Governments, it is essential that it be maintained at the established level,

1.      To take note of the report on the use of the Emergency Revolving Fund (Document CD13/12) presented by the Director of the Pan American Sanitary Bureau.

2.      To invite Governments that request assistance from the Fund to reimburse the amounts advanced as soon as possible

Oct. 1961 OD 41, 24-25

CD13.R18    The Directing Council,

[Bearing in mind the decision] of the Executive Committee at its 43rd Meeting, and acting pursuant to Regulation 16.1 of the Financial Regulations of the Pan American Health Organization,

To take note of the Financial Rules of the Pan American Health Organization, issued by the Director and confirmed by the Executive Committee at its 43rd Meeting, which appear in Document CE43/3, Annex I.

Oct. 1961 OD 41, 25

CD13.R19    The Directing Council,

[Considering that this is the] first meeting since the death of Mr. Guillermo A. Suro, who for many years, as Chief of the Conference and Publications Branch of the Pan American Sanitary Bureau, rendered valuable service to the Governing Bodies of the Organization,

To express its deep sorrow at the death of Mr. Guillermo A. Suro, who, in addition to his abilities as an international civil servant, possessed a sense of humanity and of fraternity, the qualities of a gentleman, and a noble spirit, and to convey its condolences to his widow, Mrs. Piedad de Suro, and to his children.

Oct. 1961 OD 41, 25

CD13.R20    The Directing Council,

Noting with great satisfaction the work of the Pan American Sanitary Bureau during the past year in the stimulation and development of the community water program throughout the Americas and the assistance being rendered to the Member Governments;

Noting the contributions to the Special Community Water Supply Fund made by the Governments of the United States of America, Uruguay, and Venezuela;

Considering the contents of the Charter of Punta del Este, which establishes that at least 70 per cent of urban and 50 per cent of rural populations should be served by water supply and sewage disposal systems in the next ten years;

Believing that, whenever water supplies are planned, sewage disposal must also be considered;

Recognizing that the success of urban water supply and sewage disposal programs rests in large measure on the development of projects that reflect sound organization, administration, financial planning, and execution;

Acknowledging that the ministries of health have a major role to play in national water supply and sewage disposal programs, not only in the public health supervision of all such systems but also in the initiation and coordination of efforts to solve the national health problem, both urban and rural; and

Believing that the ministries of health, national water agencies, municipalities, and other government agencies dealing with water supply and sewage disposal systems are faced with an acute shortage of trained sanitary engineers, related professional groups, and auxiliaries,

1.      To request the Director to continue to give major emphasis to the community water supply program and to continue his efforts in the stimulation of investment in sound water projects from all possible sources of funds.

2. To express its appreciation to the Governments of the United States of America, Uruguay, and Venezuela for their contributions to the Special Community Water Supply Fund, and to request the Director to again invite the Member Governments to contribute to the Fund.

3. To call to the attention of the Member Governments the urgent need to include within national long-range plans estimates of the number of sanitary engineers and other auxiliary personnel required to carry out such plans, and to encourage them to make provision for the recruitment and training of such personnel.

4. To encourage the Governments, when planning for water supplies, to simultaneously develop master plans for sewage disposal that can be implemented in part or in total as financing becomes available and/or specific problems develop.

5. To request the Director to continue to lend all possible assistance to the Member Governments in the planning, development, financing, and operation of water supply and sewage disposal systems, including the training of personnel for such programs.

6. To stress to the Governments the need for placing high priority on water supply and sewage disposal programs and the necessity for making suitable provision for the financing of such programs through the mobilization of all possible resources, both national and local.

7. To reaffirm the basic responsibility of the ministries of health for the public health supervision of water supply and sewage disposal systems, extending from planning and design to the operation of such systems, and to express the conviction that the health ministries must be represented on the governing boards of national water agencies.

8. To emphasize to the Governments the great importance of good organization and administration to the success of water supply and sewage disposal systems, the need for close supervision in the continuing operation of such systems, and the important role that the ministries of health must play in such supervision.

Oct. 1961 OD 41, 25

CD13.R21    The Directing Council,

Having considered the report in Document CD13/21 on the new programming procedures of the Expanded Program of Technical Assistance;

Noting that the Technical Assistance Committee has decided that long-term projects should be prepared and submitted for their entire duration, and that such projects may be approved by the Committee for periods of not more than four years at a time; and

Noting further that the Technical Assistance Committee has extended the present system for a two-year program cycle on an experimental basis for the years 1963-1964, so that the next requests from the Governments for Technical Assistance will be made for that biennium,

1.     To confirm its support of the principle that health projects should be planned for the full duration of the assistance expected of the Organization.

2.     To recommend that the Member Governments, in presenting requests for Technical Assistance for the biennium 1963-1964, give full consideration to the importance of health projects as an essential element in social and economic development.

Oct. 1961 OD 41, 26

CD13.R22    The Directing Council,

Acting pursuant to Article 12.2 of the Staff Regulations of the Pan American Sanitary Bureau,

To take note of the amendments to the Staff Rules of Pan American Sanitary Bureau, presented by the Director in Document CE34/4, Annex I, and confirmed by the Executive Committee at its 43rd and 44th Meetings.

Oct. 1961 OD 41, 27

CD13.R23    The Directing Council,

Bearing in mind Resolution X adopted by the Executive Committee at its 43rd Meeting;

Considering that the Organization fully recognizes the importance of more firmly linking public health to the balanced economic and social development of nations and, in this connection, has taken an active role in the deliberations of the Organization of American States and its Committees;

Bearing in mind that in the "Declaration to the Peoples of America," 1 formulated at the Special Meeting of the Inter-American Economic and Social Council held in Punta del Este, Uruguay, in August 1961, the need was proclaimed "to press forward with programs of health and sanitation in order to prevent sickness, combat contagious disease, and strengthen our human potential";

Having been informed of the steps that are being taken by the Pan American Sanitary Bureau, in close cooperation with the Organization of American States and with the Inter-American Development Bank, to carry into practice the aims set forth in this Declaration; and

Taking into account the ideas and principles expressed by the observers from the Inter-American Development Bank and the Organization of American States,

1.     To declare that the Organization should orient its activities in the future toward the attainment of the following objectives:

a)   To fulfill the role of PAHO in the implementation of the Act of Bogotá and the Charter of Punta del Este, particularly with reference to the strengthening of national health services and to the provision of potable water;

b)   To contribute even more effectively, through health activities, to the balanced social and economic development of the countries of the Americas;

c)   To emphasize the importance of health programs in the preparation of plans for socioeconomic development, and to emphasize to the Member Countries the need for the participation of health authorities in the preparation of these plans;

d)   To give increasing emphasis to the improvement of the administration of health programs, through the strengthening of statistical services, improvement in administrative practices, personnel management and training, and other means for achieving the same end; and

e)   To assist in the establishment of more effective criteria for the assessment of the economic value of health programs.

2.     To recommend that the Pan American Sanitary Bureau render assistance, on request from the national health authorities, in planning in the field of health in such a way as to ensure the greatest contribution of health to the social and economic development of the countries.

Oct. 1961 OD 41, 27

CD13.R24    The Directing Council,

Having examined the report presented by the Rapporteurs of the Technical Discussions on "Methods of Evaluating the Contribution of Health Programs to Economic Development" held at the present meeting;

Considering the importance for the health of the Americas of achieving close integration of health planning with general planning for social and economic development; and

Recalling the emphasis accorded to health in the framework of social and economic planning in the Charter of Punta del Este,

1.     To take note of the report of the Technical Discussions (Document CE13/DT/6), expressing its satisfaction with the activities of the Pan American Sanitary Bureau in stimulating studies on the contribution of health programs to economic development.

2.     To recommend that the Director of the Pan American Sanitary Bureau give the report the widest possible distribution.

3.     To recommend to the Director of the Bureau that continuing attention be given to the integration of health with general development planning, including the stimulation of research and the provision of advice to the Governments when requested.

4.     To recommend to the Member Governments:

a)   That planning and evaluation units be created in the ministries of health;

b)   That provision be made for the representation of health services in national planning organizations; and

c)   That constant liaison and exchange of views and information be provided between health services and the planning organizations and other government agencies concerned with social and economic development.

Oct. 1961 OD 41, 28

CD13.R25    The Directing Council,

Having examined the IX Report on the status of malaria eradication in the Americas (Document CD13/3);

Bearing in mind the previous resolutions of the Governing Bodies, in particular Resolution XLII of the XIV Pan American Sanitary Conference and Resolution WHA8.30 of the Eighth World Health Assembly;

Bearing in mind the success attained by certain countries in their eradication campaigns in extensive fertile areas, which are already being made productive and are contributing to social and economic development; and

Considering, however, that malaria continues to be a serious obstacle to progress in other regions of the Americas,

1.      To take note of the IX Report on the status of malaria eradication in the Americas (Document CD13/3).

2.      To express its satisfaction with the success already achieved in some of the eradication programs.

3.      To express its satisfaction also with the continuing interest shown by the Governments and by the Pan American Sanitary Bureau in solving the technical and administrative problems encountered in eradication work, and the hope that their efforts to overcome these problems will be intensified.

4.      To convey once again its appreciation to the Governments that have generously contributed to the PAHO Special Malaria Fund, expressing the hope that they will continue their contributions and that other Governments will endeavor to contribute to the Fund.

5.      To again convey its appreciation to the United Nations Children's Fund and to the International Cooperation Administration of the United States of America for the collaboration they are rendering to the countries, and to reiterate the hope that this collaboration will continue.

Oct. 1961 OD 41, 29

CD13.R26    The Directing Council,

Having examined Document CD13/20, on the estimated requirements for the PAHO Special Malaria Fund; and

Having reviewed the requirements for individual program activities being developed or planned by the Pan American Health Organization,

1.     To take note of the estimates for future requirements for the PAHO Special Malaria Fund (Document CD13/20).

2.     To request the Director to prepare annual revisions of these estimates for study by the Directing Council.

3.     To urge the Member Governments to support the PAHO Special Malaria Fund so that eradication activities may proceed as rapidly as possible.

Oct. 1961 OD 41, 29

CD13.R27    The Directing Council,

Having examined in detail Document CD13/6 and its annexes,1 including the special report on Venezuela,

1.      To take note of the entry in the Register of Areas Where Malaria Has Been Eradicated of approximately 157,500 square miles of the territory of Venezuela, in accordance with the report prepared on this subject by the Pan American Health Organization.

2.     To recommend to Member Governments and to the national malaria eradication services the intensification of surveillance activies during the consolidation phase of their programs, and the organization of their epidemiological data in such a way as to facilitate the future registration of areas in the Register.

3.      To recommend to Member Governments that adequate rural health services be developed as one of the necessary elements in the maintenance phase of eradication, once eradication has been achieved.

Oct. 1961 OD 41, 30

CD13.R28    The Directing Council,

Considering that the Fourteenth World Health Assembly, in Resolution WHA14.39, requested "the Director-General, in consultation with the Executive Board and the Regional Committees, to reconsider the question of priorities in program, and to report thereon to the Fifteenth World Health Assembly";

Having considered the General Program of Work of PAHO/WHO covering the period 1962-1965 (Document CD13/27)1 and Priorities in Health Programs (Document CD13/48);

Having taken into account the recommendations of the Act of Bogotá and the Charter of Punta del Este, which placed emphasis on the health component of social and economic development and on the required planning for such development in the next decade; and

Being convinced that improvements in health must continue to lead the way toward economic and social development,

To reaffirm the priorities for health programs outlined in the General Program of Work of PAHO/WHO covering the period 1962-1965, recognizing that the priorities will be adapted as necessary to the needs established by national health plans and the requests of Member Governments.

Oct. 1961 OD 41, 30

CD13.R29    The Directing Council,

Having examined the report of the Director on the arrangements for the XVI Pan American Sanitary Conference (Document CD13/4),

1.     To take note of the present state of arrangements for the XVI Pan American Sanitary Conference (Document CD13/4).

2.     To authorize the Director of the Bureau to adopt such measures as may be necessary to organize the secretariat services for the XVI Pan American Sanitary Conference so that the business of the Conference may be dealt with in plenary sessions and in sessions of two main committees and of working parties.

3.     To request the Director to report to the first meeting of the Executive Committee in 1962 on such agreements as he may have entered into with the Government of Argentina in connection with the organization of the XVI Pan American Sanitary Conference.

Oct. 1961 OD 41, 31

CD13.R30    The Directing Council,

Having examined the report of the problems arising from the advertising of medicinal products (Document CD13/24), 1 presented by the Director of the Pan American Sanitary Bureau pursuant to Resolution XXX of the XI Meeting of the Directing Council, which had included this topic on its agenda in conformity with Resolution XXII of the XV Pan American Sanitary Conference;

Bearing in mind that all countries in the Americas recognize the danger to the health of their populations inherent in advertising of medicinal products that is exaggerated and without scientific basis;

Taking into account the difficulties that in some cases are encountered, for various reasons, in the application of existing regulations, as well as the lack, in other cases, of suitable legislation in this field;

Considering, on the other hand, that one of the most effective means of counteracting abuses in the advertising of medicinal products is to develop through better health education a public that recognizes the dangers of self-medication; and

Considering that pertinent self-regulatory measures that the pharmaceutical profession may establish and that the industry itself may adopt in each country are one of the effective means of solving the problem of advertising of medicinal products that is exaggerated and without scientific basis,

1.      To take note of the report (Document CD13/24) submitted to the Council by the Director of the Pan American Sanitary Bureau.

2.      To recommend that the Member Governments of the Organization:

a)    Keep under review the legislative measures governing the advertising of medicinal products so that deficiencies may be overcome and any new circumstances that arise may be dealt with; and

b)    Give special attention, as part of their health education activities, to emphasizing the dangers of self-medication.

3.      To recommend that the Member Governments enlist the cooperation of the pharmaceutical profession and industry in establishing and applying, respectively, effective self-regulatory measures.

4.      To instruct the Director to keep under review the problems related to the advertising of medicinal products and to transmit to the national public health services any information that he may consider of interest in this regard.

Oct. 1961 OD 41, 31-32

CD13.R31    The Directing Council,

Bearing in mind the provisions of Articles 1, 2, and 7 of the Rules for Technical Discussions,

To select the topic "Present Status of Medical Care in the Americas in Relation to its Incorporation as a Basic Service in Integrated Health Programs" for the Technical Discussions that will take place during the XVI Pan American Sanitary Conference, XIV Meeting of the Regional Committee of the World Health Organization for the Americas.

Oct. 1961 OD 41, 32

CD13.R32    The Directing Council,

Having examined the report on the status of smallpox eradication in the Americas (Document CD13/18) presented by the Director of the Pan American Sanitary Bureau; and

Considering that, although smallpox has already disappeared in several countries of the Hemisphere, its persistence in others poses a serious threat to the countries in which it has been eliminated, and that it also represents an economic burden, in many cases necessitating the execution of new mass vaccination programs,

1.      To take note of the report on the status of the smallpox eradication program in the Americas (Document CD13/18) presented by the Director of the Pan American Sanitary Bureau.

2.      To approve the criteria for smallpox eradication proposed by the Pan American Sanitary Bureau, Regional Office of the World Health Organization, in the aforementioned document.

3.      To express its satisfaction with the success achieved by various Member Governments in eradicating smallpox from their territories, and with the development of nation-wide vaccination campaigns in other countries, which makes it possible to foresee the disappearance of the disease in the near future.

4.      To urge that the Governments of countries that have not as yet eliminated smallpox accelerate, or initiate, programs of eradication.

5.      To recommend that the Governments endeavor to produce smallpox vaccine in amounts sufficient not only to meet the needs in their own countries but also to maintain a reserve for meeting emergency situations or for rendering assistance to other countries that may require the vaccine.

6.      To recommend that, so long as smallpox continues to constitute an international problem, the countries endeavor to maintain adequate levels of immunity in the population, and that they ensure strict application of the provisions of the International Sanitary Regulations, especially Article 3 on the notification of cases.

Oct. 1961 OD 41, 32-33

CD13.R33    The Directing Council,

Having examined Document CD13/29 and Addendum I, in which the Director brought to its attention a number of resolutions of the Fourteenth World Health Assembly and the Twenty-Sixth, Twenty-Seventh, and Twenty-Eighth Sessions of the WHO Executive Board,

1.     To take note of the following resolutions contained in Document CD13/29: WHA14.2 (Development of the Malaria Eradication Program), WHA14.38 (Malaria Eradication Program), WHA14.27 (Malaria Eradication Special Account), EB26.R32 (Financing of the Malaria Eradication Program), EB28.R27 (Malaria Eradication Postage Stamps), WHA14.39 (Priorities in Program), WHA14.56 (Radiation Health, Including Protection of Mankind from Ionizing Radiation Hazards, Whatever their Source), WHA14.40 (Smallpox Eradication Program), WHA14.37 (Continued Assistance to Newly Independent States-paragraph 2-1), EB27.R21 (Administrative and Technical Training: Resolution 797 [XXX] of the Economic and Social Council-paragraph 4-a), WHA14.42 (Activities Jointly Assisted by UNICEF and WHO), WHA14.58 (Declaration Concerning the Granting of Independence to Colonial Countries and Peoples and the Tasks of the World Health Organization-paragraph 1); WHA14.24 (Adoption of a WHO Flag).

2.     To urge the Member Governments to make voluntary contributions to the WHO Malaria Eradication Special Account.

3.     To take note also of the agreement concluded between WHO and the Inter-Governmental Philatelic Corporation concerning the arrangements for the sale of stamps and other related philatelic material, contained in Document CD13/29, Addendum I.

4.     To invite all the Member Governments that have not yet decided to issue a special postage stamp commemorating the world-wide malaria eradication program to do so, so as to contribute to the efforts in disseminating information on, and stimulating interest in, that program.

Oct. 1961 OD 41, 33

CD13.R34    The Directing Council,

Taking into account the final reports on Aedes aegypti eradication presented by Chile and Costa Rica, which declare those countries to be free of the vector, in strict compliance with the standards and the criteria for eradication established by the Pan American Sanitary Bureau,

1.      To accept the reports presented by Chile and Costa Rica, to congratulate those countries on the work accomplished, and to declare their territories free of Aedes aegypti.

2.      To recommend that countries and territories that are still infested and have not yet initiated an eradication campaign do so at the earliest possible date, and that those whose campaigns are progressing satisfactorily or are in the final stage accelerate their activities so that they may all complete the campaign within a five-year period and be able to report the eradication of Aedes aegypti to the XVII Pan American Sanitary Conference in 1966.

3.      To request that the Director, for the purposes of the recommendation above, obtain the necessary information in the countries on the possibility of attaining the stated goal and report on the progress made to the XVI Pan American Sanitary Conference in 1962.

4.      To stress to those countries that have already completed the eradication of Aedes aegypti the need for maintaining strict surveillance in international ports and airports and border areas in order to prevent reinfestation of their territories.

Oct. 1961 OD 41, 34

CD13.R35    The Directing Council,

Having examined the report of the Director on the collaboration of PASB in the administrative practices of national health services (Document CD13/13);

Bearing in mind the importance of good administration in the best possible utilization of the still insufficient resources available for public health programs, and the weakness of administrative services in the majority of the countries of the Americas; and

Considering the requests and needs of the Member Governments for assistance in the form of fellowships and advisory services,

1.     To take note of the report on the collaboration of PASB in the administrative practices of national health services (Document CD13/13), presented by the Director.

2.     To increase as much as possible the efforts of the Organization in collaborating with the Member Governments for the purpose of improving administrative practices by:

a)   Providing advisory services on a continuing basis;

b)   Awarding fellowships to worthy administrative personnel;

c)   Sponsoring additional meetings, especially national and international seminars;

d)   Conducting programs of in-service training on a continuing basis for the administrative personnel of national health services; and

e)   Preparing and distributing printed material on the techniques, procedures, and standards that may be utilized in training programs for administrative personnel.

Oct. 1961 OD 41, 34-35

CD13.R36    The Directing Council,

Considering that tuberculosis, which is a serious economic and social problem, continues to be one of the main causes of morbidity and mortality in the Americas;

Bearing in mind that, from the public health viewpoint, the approach to the problem of tuberculosis has changed fundamentally with the advent of new therapeutic products;

Bearing in mind that the cost of the prevention and control of this disease will be far less than the heavy burden of hospitalization, workmen's compensation, and loss of productivity in industry and agriculture; and

Bearing in mind that Document CD13/17, Rev. 1, 1 indicates the need for obtaining additional information on the nature and scope of the problem in each country in order to carry out a detailed study of the tuberculosis problem that will serve as a basis for formulating programs to combat the disease,

1.      To recommend that the Member Governments carry out tuberculosis surveys in their respective territories in order to gain a better knowledge of the incidence and prevalence of the infection and the disease, for which purpose it is essential to properly organize a more intensive search for cases still undetected and to ensure the timely reporting of all cases.

2.      To recommend that the Member Governments endeavor to determine the cost of specific tuberculosis control measures, their efficacy, and the country's financial possibilities of undertaking them, so as to be in a position to prepare, as soon as possible, national plans to combat the disease, supported by a progressive effort to provide for their adequate financing.

3.      To recommend the establishment of goals that should be attained as far as possible in the next ten years in order to make it possible to eliminate tuberculosis as a public health problem in the Americas in the not-too-distant future. In the preparation of plans to combat the disease, the countries could take into account the following goals:

a)    To reduce by at least one half the present mortality in each country within the next ten years;

b)    To reduce morbidity, when an adequate approximation of its rate is known, by 33 per cent within the next ten years; and

c)    To reduce tuberculosis primoinfection, when an adequate approximation of its rate is known, to levels below 2 per cent in children under five years of age, 10 per cent in children under ten, and 20 per cent in those under fifteen, within the next ten years.

4.      To recommend to the Member Governments that have not yet done so to review policy with respect to tuberculosis control programs in order to attain the best possible results with the human and material resources available, and to further recommend that the tuberculosis control programs be made a part of the regular activities of the local public health services.

5.     To recommend that there be encouraged in each country the active and well-organized participation of private initiative, so that it may join in the efforts, which should include the adoption of positive measures to bring about the improvement of all the factors that make up the physical, biological, and social environment of individuals and collectivities.

6.     To encourage the countries to obtain additional funds in accordance with the possibilities established in the Charter of Punta del Este, taking into account the important role of tuberculosis control in the development and progress of the Americas.

7.     To authorize the Director of the Pan American Sanitary Bureau to attempt to obtain additional financial resources that will make it possible to carry out a continental plan to combat tuberculosis, including the investigation of all problems that bear a relation to the disease, in order to help reach the most rapid solution possible.

Oct. 1961 OD 41, 35-36

CD13.R37    The Directing Council,

Having examined the revisions in the texts of the Basic Documents as proposed by the Subcommittee on Basic Documents (Document CD13/16);

Having studied the comments made by the Member Governments, and the further modifications proposed by the Subcommittee and by a working party of this Council in the light of the comments of the Governments;

Considering the terms of Resolutions XXX and XXXIV of the XV Pan American Sanitary Conference; and

Noting the recommendation of the 44th Meeting of the Executive Committee in Resolution II that the revisions in the Basic Documents proposed by the Subcommittee, as further modified by the Subcommittee in the light of the comments of the Governments, be adopted,

1.     To express its thanks to the Executive Committee and to the Subcommittee on Basic Documents for the important work accomplished.

2.     To thank the Governments that have submitted comments and suggestions.

3.     To express the conclusion that the proposed revisions in the Basic Documents, as further modified by the Subcommittee and by a working party of this Council (Documents CD13/16; CD13/16, Addendum II; and CD13/16, Addendum IV, Part I), will satisfactorily serve the purposes embodied in Resolutions XXX and XXXIV of the XV Pan American Sanitary Conference.

4.     To adopt the revisions in the Constitution proposed by the Subcommittee, as further modified by the Subcommittee and by the working party of this Council.

5.     To adopt the revisions in the Rules of Procedure of the Directing Council, as similarly further modified.

6.     To recommend to the XVI Pan American Sanitary Conference that it adopt the revisions in the Rules of Procedure of the Sanitary Conference proposed by the Subcommittee, as further modified by the Subcommittee and by the working party of this Council.

7.     To recommend to the 45th Meeting of the Executive Committee that it adopt the revisions in the Rules of Procedure of the Executive Committee proposed by the Subcommittee on Basic Documents.

8.     To request the Director to transmit the proposals submitted by certain Governments during the XIII Meeting of the Directing Council (Document CD13/16, Addendum IV, Parts II and III) to all the Member Governments for their consideration, with a view to possible action by a future meeting of the Directing Council or the Conference.

Oct. 1961 OD 41, 36-37

CD13.R38    The Directing Council,

Having examined the report of the Director on planning for the research program of the Pan American Health Organization (Documents CD13/15 and CE43/16), 1 and the steps already being taken for the expansion of research in the Region; and

Considering that such expansion of research will be of benefit to the health and medical programs throughout the Americas,

1.     To approve the plan and policies proposed by the Director of the Bureau in Document CE43/16 in connection with the research program of the Pan American Health Organization.

2.     To request the Director to take the necessary action to further intensify the research activities of PAHO for the benefit of the countries of the Region.

Oct. 1961 OD 41, 37

CD13.R39    The Directing Council,

Considering the existing needs of the Americas for adequately paid and professionally trained health workers;

Considering the information furnished by the Director of the Pan American Sanitary Bureau in the documents on this subject;

Considering the necessity for expanding the programs of collaboration with centers providing training in the health sciences;

Considering the constant increase in the requirements of the ministries of health for properly trained personnel; and

Considering that the funds at present available to the Organization are not sufficient to provide adequate assistance to the Governments for this activity,

1.     To recommend that the Member Governments increase their efforts to have the ministries of health and of education initiate, or accelerate, arrangements for strengthening their programs of mutual collaboration and establish close relationships with the pertinent university authorities in order to increase and improve the training of personnel for the health services of the Member Governments.

2.     To recommend that the Member Governments give priority to adequate salary scales for specialized health workers as just recognition of the high purpose of their functions.

3.     To instruct the Director to expand, within the limits of the budget, the activities of the Organization for the education and training of health personnel at all levels.

4.     To request the Director to further intensify his efforts to obtain extrabudgetary funds for the purpose of expanding the programs in this field.

Oct. 1961 OD 41, 37-38