Bearing in mind the official request for admission to membership in the Pan American Health Organization submitted on behalf of the Government of Guyana by the Acting Prime Minister of Foreign Affairs of that country on 20 September 1966;

Considering that the Director of the Pan American Sanitary Bureau has communicated the aforementioned request to the Governments of the Pan American Health Organization; and

Considering that the Government of Guyana has declared its willingness to assume all the obligations set forth in the Constitution of the Pan American Health Organization, to comply with the provisions of the Pan American Sanitary Code as modified by the Additional Protocol of 24 September 1952, and to contribute a quota to the finances of the Organization,

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

Oct. 1967 OD 82, 56

Bearing in mind the official request for admission to membership in the Pan American Health Organization submitted on behalf of the Government of Barbados by the Permanent Secretary of the Ministry of External Affairs of that country on 5 April 1967;

Considering that the Director of the Pan American Sanitary Bureau has communicated the aforementioned request to the Governments of the Pan American Health Organization; and

Considering that the Government of Barbados has declared its willingness to assume all the obligations set forth in the Constitution of the Pan American Health Organization, to comply with the provisions of the Pan American Sanitary Code as modified by the Additional Protocol of 24 September 1952, and to contribute a quota to the finances of the Organization,

1. To approve the request submitted by Barbados for admission to membership in the Pan American Health Organization.

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

Oct. 1967 OD 82, 57

Having reviewed the Annual Report of the Chairman of the Executive Committee, Dr. Alberto E. Calvo, Representative of Panama (Document CD17/9, Rev. 1); and

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

To approve the Annual Report of the Chairman of the Executive Committee, Dr. Alberto E. Calvo, Representative of Panama (Document CD17/9, Rev. 1), and to commend him and the other members of the Committee for the work accomplished.

Oct. 1967 OD 82, 58

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 1966 (Official Document 78),

To take note of the Annual Report of the Director for 1966 (Official Document 78), 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. 1967 OD 82, 58

Having examined the Financial Report of the Director and the Report of the External Auditor for the fiscal year 1966 (Official Document 75); and

Considering that there has been an improvement in the financial situation of the Organization with regard to collection of quotas, increase in the level of the Working Capital Fund, and reserve for termination costs,

1. To approve the Financial Report of the Director and the Report of the External Auditor for 1966 (Official Document 75).

2. To again draw the attention of the Governments to the need for quotas to be paid as early as possible within the course of each financial year, and especially to the need for plans for the payment of arrears within stipulated periods to be strictly adhered to.

3. To commend the Director of the Bureau for having achieved a sound financial situation through the consistent application over the years of policies for maintaining budgetary expenditures within income, building up the Working Capital Fund, And establishing reserves for termination costs.

Oct. 1967 OD 82, 59

1. To appropriate for the financial year 1968 an amount of $10,190,000, as follows:

3. That, in accordance with the Financial Regulations of the Organization, amounts not exceeding the appropriations noted under paragraph 1 shall be available for the payment of obligations incurred during the period 1 January to 31 December 1968, inclusive.

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

Oct. 1967 OD 82, 59

Having examined Official Document 76 submitted by the Director of the Pan American Sanitary Bureau, which contains the Proposed Program and Budget of the World Health Organization for the Region of the Americas for 1969; and

Bearing in mind that the aforesaid Proposed Program and Budget is submitted to the Directing Council, as Regional Committee of the World Health Organization, for review and transmittal to the Director-General of the Organization so that he may take it into consideration in the preparation of the proposed budget of WHO for 1969,

To approve the Proposed Program and Budget of the World Health Organization for the Region of the Americas for 1969 contained in Official Document 76, and to request the Regional Director to transmit it to the Director-General of the Organization so that he may take it into consideration when preparing the WHO budget for 1969.

Oct. 1967 OD 82, 61

Having examined Official Document 76 submitted by the Director of the Pan American Sanitary Bureau, which contains the provisional draft that is to constitute the basis for the preparation of the Proposed Program and Budget of the Pan American Health Organization for 1969 to be considered by the 59th Meeting of the Executive Committee and by the XVIII Meeting of the Directing Council;

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

Taking into account the recommendations and comments made by the representatives during the discussions 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 1969 contained in Official Document 76.

2. To instruct the Director, in preparing the Proposed Program and Budget for 1969 and in his consultations with the Governments on this matter, [to] give due consideration to the recommendations and comments made by the representatives.

3. To refer the provisional draft of the Proposed Program and Budget of the Pan American Health Organization for 1969 to the 59th Meeting of the Executive Committee for detailed examination, and to instruct the Committee to submit its recommendations thereon to the XVIII Meeting of the Directing Council.

Oct. 1967 OD 82, 61

Having examined the XV Report of the Director of the Bureau on the status of malaria eradication in the Americas (Document CD17/12);1

Mindful of the progress achieved in 1966 in shifting further areas into the maintenance and consolidation phases;

Recognizing that in other countries the program has made no headway and that areas in the consolidation phase have to be put back into the attack phase;

Bearing in mind that the extent and nature of the so-called "problem areas" are known and that technical difficulties have hampered the progress of the eradication programs;

Recognizing that some of the technical problems besetting those areas have been solved through research;

Considering that malaria eradication programs are still plagued by serious administrative and financing difficulties, but that some countries have solved their financing problem by means of external loans;

Bearing in mind that some progress has been made in coordinating the malaria eradication program and the general health services; and

Considering that the Twentieth World Health Assembly decided by Resolution WHA20.14 to carry out a re-examination of the global strategy of malaria eradication,

1. To take note of the XV Report on the status of malaria eradication in the Americas (Document CD17/12).

2. To re-emphasize the need to redouble efforts to eradicate malaria in the Americas by giving particular attention to adequate and timely financing, efficient program administration, and improved coordination of the malaria eradication and the general health services.

3. To request the Director to intensify his collaboration with the Director-General of the World Health Organization in carrying out the re-examination of the global strategy for malaria eradication.

4. To express its satisfaction to the Governments that further areas have been shifted into the maintenance and consolidation phases.

5. To recommend to the Governments that they pay special attention to the eradication of malaria in "problem areas," in collaboration with the Pan American Sanitary Bureau.

6. To again draw to the attention of the Governments the need to strengthen the training of health personnel so as to facilitate coordination with malaria eradication activities, particularly in the consolidation and maintenance phases.

7. To reiterate the importance of speeding up the coordination of the general health services with the malaria eradication programs by strengthening the network of basic health services in rural areas and by giving priority to the extension of these rural services to the originally malarious areas, and to request the participation of the United Nations Children's Fund (UNICEF) and PASB.

8. To recommend to PASB that it continue to collaborate in operational and other research aimed at finding solutions to the various problems involved in malaria transmission, bearing in mind the importance of coordinating intra- and interzone activities.

9. To recommend to the Governments that they coordinate their malaria eradication activities, especially in border areas where the epidemiological situations exercise considerable reciprocal influences on one another.

10. To request that international lending agencies, [in] making loans designed to speed up eradication programs, avoid requirements that might weaken the prime purpose of such programs.

Oct. 1967 OD 82, 62

Having considered the document presented by the Government of Cuba on the attendance by the Governments of the Organization at technical meetings organized by it (Document CD17/24);

Bearing in mind that regional technical meetings are to the common benefit of the participants in that they promote an exchange of ideas and experiences and encourage cooperation in the health field for the good of the peoples of the Americas; and

Considering that the Pan American Sanitary Bureau has always made special efforts to secure the active participation of technical personnel from all the countries of the Hemisphere in meetings organized or sponsored by it,

1. To reaffirm the policy of PAHO/WHO with respect to the importance of regional meetings of technical personnel designed to promote an exchange of ideas about and of experience with the prevalent health problems in the Americas and measures for solving them.

2. To recommend to the Governments that they take the necessary steps to facilitate the attendance of persons invited by the Pan American Sanitary Bureau or designated by the Governments themselves at meetings of this nature that are held in their territories.

3. To recommended to the Director of the Pan American Sanitary Bureau that, when making arrangements for regional meetings of technical personnel, he encourage the attendance of professional workers from all PAHO/WHO countries.

Oct. 1967 OD 82, 64

Elected Nicaragua, Trinidad and Tobago, and Uruguay to the Executive Committee upon termination of the periods of office of Jamaica, Panama, and Venezuela, and thanked the Governments of these countries for the valuable services rendered to the Organization by their representatives on the Committee.

Oct. 1967 OD 82, 65

Noting the kind invitation extended by the Representative of Argentina to hold the XVIII Meeting of the Directing Council, XX Meeting of the Regional Committee of the World Health Organization for the Americas, in Buenos Aires, the capital of Argentina; and

Considering that, in accordance with Rule 1 of the Rules of Procedure of the Directing Council, the place of the meeting shall be chosen by the Council,

1. To offer its sincere thanks to the Government of Argentina, and to accept with satisfaction its invitation to hold the XVIII Meeting of the Directing Council, XX Meeting of the Regional Committee of the World Health Organization for the Americas, in the city of Buenos Aires.

2. To instruct the Director to take, in consultation with the host Government, the necessary steps to organize the meeting and to fix the date thereof.

Oct. 1967 OD 82, 65

Having considered the report on the estimated requirements for the eradication of malaria in the Americas (Document CD17/13);1

Bearing in mind the great interest of the Governments in obtaining suitable financing for their malaria eradication campaigns;

Bearing in mind that the delay in obtaining funds for some campaigns is increasing both their duration and cost;

Considering the importance of the assistance rendered by the Special Malaria Fund and the contributions of PAHO and WHO that have enabled the Pan American Health Organization to provide the Governments with specialized assistance and supplies; and

Considering that PAHO, in conformity with the approved plan, continues to take into its regular budget costs [that are] presently associated with special funds,

1. To take note of the estimated requirements for the eradication of malaria in the Americas (Document CD17/13).

2. To commend the Governments for the efforts they are making to solve the problem of financing malaria eradication campaigns until eradication is achieved.

3. To express its thanks to the Government of the United States of America for its assistance and its keen interest in the eradication of malaria in the Americas.

4. To note that PAHO continues to take into its regular budget costs [that are] presently associated with special funds, but to insist on the need to maintain the Special Malaria Fund by means of voluntary contributions and WHO funds.

5. To instruct the Director of the Bureau to continue to review the estimated costs of the eradication program and report to the Directing Council in due course.

Oct. 1967 OD 82, 66

Considering that in spite of immunization programs poliomyelitis continues to be a serious health problem because of insufficient coverage of the exposed population;

Bearing in mind that improvements in environmental sanitation and rising standards of living have reduced opportunities for contact with the virus in the first years of life, and that coonsequently older segments of the population continue to be susceptible to the disease;

Recognizing that extensive epidemics of the disease have recently occurred in some countries and that the inicidence of the disease may go on increasing in the immediate future and even more severe outbreaks may occur; and

Taking into account that the appropriate use of vaccine has made it possible to reduce the incidence of the disease in countries in which the effective immunity level has been attained,

1. To recommend to the Governments that in order to protect all the susceptible population against poliomyelitis they conduct systematic general immunization programs in which priority attention is given to the most vulnerable age groups.

2 To recommend to the Governments that, without prejudice to their continuing their regular immunization programs, effort be made to achieve the highest immunity level as quickly as possible by conducting mass oral vaccination campaigns of the shortest possible duration and covering the highest possible percentage of the susceptible population, so as to break the chain of transmission.

3. To recommend that, in order to achieve appropriate coverage, mass immunization campaigns be based on the voting districts in countries where this or a similar system exists,

4. To urge Governments to improve their epidemiological and statistical services so as to obtain prompt notification of cases, thereby enabling the trend of the disease to be ascertained and the causative virus to be typed at an early stage.

5, To request the Pan American Sanitary Bureau to continue to provide the countries with such assistance as they request in bringing epidemic outbreaks under control and in facilitating the purchase of vaccines, and to give them such technical advisory services as are considered necessary.

6. To congratulate the Government of Nicaragua on the excellent campaign it waged against the poliomyelitis epidemic in the child population of that country.

Oct. 1967 OD 82, 67

Having examined the report of the Director on the progress made in the continental program of water supply and sewage disposal services during the first half of the Alliance for Progress decade, with projections of needs and proposed actions for the second half (Document CD17/16);1

Bearing in mind the urgency and the significance of community water supply and sewage disposal services to the health and social and economic well-being of the peoples, and the recognition of these relationships by the Governments of the Organization;

Noting with satisfaction the unprecedented accomplishments of the continental water supply program, especially in urban areas, where eight countries already exceed the Charter of Punta del Este goal of providing water services for at least 70 per cent of the urban population and most of the other countries are on schedule of attaining this goal;

Considering the urgency to strengthen and expand national programs to accelerate the rates of progress in providing water supply services for rural communities;

Acknowledging, with appreciation, the excellent support and assistance of international financing agencies, especially the Inter-American Development Bank; and

Taking into account that the Declaration of the Presidents of America, [signed] at Punta del Este in April 1967, reaffirms the importance of providing community water supply and sewerage services and endorses the objectives of the Pan American Health Organization, including the establishment of national revolving fund mechanisms to ensure program continuity,

1. To urge the Director of the Bureau to continue giving priority attention to the continent-wide programs of urban and rural water supply, sewerage, and water pollution control, taking all appropriate steps to assist the Governments of the Organization in accelerating action in these matters.

2. To instruct the Director to give special attention to water and sewerage programs for rural communities, including broader assistance in community organization, the development of self-help concepts and systems, and the establishment of national revolving funds.

3. To ask the Director to continue his close collaboration with the national and international organizations that are the sources for grants and/or credits, so that external financial support for national water and sewage proposals [may] be given priority consideration and granted the most favorable terms accorded programs for social progress, keeping in mind the framework of the instructions given by the PAHO Directing Council, the recommendations of the Inter-American Economic and Social Council, and the Declaration of the Presidents of America at Punta del Este in April 1967.

4. To recommend to the Governments of the Organization that they re-evaluate their plans for urban and rural water supply and sewerage services and analyze the status and trends of water pollution, with a view to strengthening national structures and accelerating program actions, in order to achieve the goals established in the Charter of Punta del Este.

5. To instruct the Director to draw up and submit to the XVIII Meeting of the Directing Council a special report of projected community water supply and sewerage needs for the period 1968-1971, including a schedule of work with realistic objectives, together with his recommendations for broadening the Organization's assistance and suggestions for financing.2

6. To urge the Director to expand the Organization's program of cooperation in applied research on engineering education and training, giving appropriate attention to expanding industrialization and urbanization and the changing character of environmental health problems and needs.

Oct. 1967 OD 82, 68

Having considered the report of the Director on the nutrition program in the Americas and the proposals for expanding the existing program (Document CD17/23);1

Bearing in mind the Declaration of the Presidents of America (Chapter V, Section C., paragraph c)2 and the Charter of Punta del Este;

Considering that as long as current trends in food supply and population persist malnutrition is likely to continue to be a major public health problem in the Hemisphere;

Recognizing that radical steps will be required to bring about gradual improvements in the production of protective and energizing foodstuffs to meet the needs of the countries of the Americas; and

Accepting that past activities in nutrition form a sound basis for the expansion of the current program,

1. To express its satisfaction with the results of the nutrition program during the past decade, in particular in professional training and basic epidemiological research.

2. To instruct the Director of the Bureau to continue to develop all aspects of the nutrition program in progressive steps consonant with the development of the over-all program of PASB and in accord with items in the program and budget that have received specific prior approval of the Executive Committee and the Directing Council, special emphasis being given to: (a) assistance to Governments in drawing up national nutrition policies; (b) the establishment of a data collection and analysis system for nutrition in the Americas; and (c) an increase in epidemiological and operational research, in order to produce a significant reduction in the prevalence of malnutrition in the Hemisphere within the next ten years.

3. To recommend that this expanded program be developed in close collaboration with other international and bilateral agencies, and [that], in this context, collaboration [be intensified] with the Food and Agriculture Organization of the United Nations (FAO) in the study of possibilities for, and stimulation of, increased food production in the countries in a manner both desirable from the nutrition point of view and economically feasible.

4. To emphasize the importance, for nutrition program planning, of the close collaboration of all national institutions in the agriculture, industry, education, and health fields.

5. To request the Director to seek grants from the Governments and from private sources to supplement the regular PAHO/WHO budget in order to implement the proposed expansion of the nutrition program.

6. To recommend to the Director that he organize an intensified program of research covering all the contributing factors that relate to the problem of preschool mortality.

Oct. 1967 OD 82, 70

Having seen Document CD17/10, in which the Director of the Bureau submits to the attention of the Regional Committee for the Americas several resolutions adopted by the Twentieth World Health Assembly; and

Bearing in mind that the Pan American Sanitary Bureau already has under consideration the subjects to which the World Health Assembly resolutions refer,

1. To take note of the following resolutions contained in Document CD17/10: WHA20.13 (Assessment of New Members: 1966 and 1967), WHA20.14 (Malaria Eradication Program), WHA20.15 (Smallpox Eradication Program), WHA20.17 (Effective Working Budget and Budget Level for 1968), WHA20.18 (WHO Nomenclature Regulations, 1967), WHA20.19 (Compendium of Recommendations, Definitions, and Standards Relating to Health Statistics), WHA20.20 (Scale of Assessment for 1968), WHA20.21 (Extension of the Use of the Russian and Spanish Languages), WHA20.22 (Decisions of the United Nations, the Specialized Agencies, and the IAEA affecting WHO's Activities: Administrative budgetary, and financial matters), WHA20.27 (Joint FAO/WHO Food Standards Program: Amendments to the Statutes of the Codex Alimentarius Commission), WHA20.32 (Program and Budget Estimates for 1968: Voluntary Fund for Health Promotion), WHA20.34 (Quality Control of Pharmaceutical Preparations), WHA20.37 (Voluntary Fund for Health Promotion: Progress report on world health foundations), WHA20.39 (Selection of the Country in which the Twenty-First World Health Assembly will be Held), WHA20.40 (Twentieth Anniversary of the World Health Organization), WHA20.41 (Health Aspects of Population Dynamics), WHA20.42 (Control Measures for LSD and Related Substances), WHA20.43 (Control Measures for Certain Dependence-Producing Drugs), WHA20.48 (Organizational Study on Coordination at the National Level in Relation to the Technical Cooperation Field Program of the Organization), WHA20.52 (Decisions of the United Nations, the Specialized Agencies, and the IAEA Affecting WHO's Activities: Program matters), WHA20.53 (Health and Economic Development).

2. To elect Chile and Jamaica to designate a representative to speak at the Twentieth Anniversary Commemorative Session at the Twenty-First World Health Assembly.

Oct. 1967 OD 82, 71

Having considered the report of the Director on the status of Aedes aegypti eradication in the Americas (Document CD17/15 and Addenda);1

Having also considered the reports of the Conference on Aedes aegypti Eradication in the Americas (3-5 April 1967), of the Study Group on the Eradication of Aedes aegypti in the Americas (6-12 April 1967), and of the Working Group on Laboratory Colonies of Aedes aegypti (17-19 July 1967), all of which [met] in Washington, D.C., under the auspices of the Pan American Sanitary Bureau;

Considering that delay in achieving eradication of A. aegypti in extensive areas of the Hemisphere not only gives rise to a risk of urban yellow fever and other diseases transmitted by that vector, but also continues to be the cause of the reintroduction of the mosquito into areas that have achieved eradication;

Recognizing that reinfestations require substantial unanticipated expenditures by Governments that have already spent considerable sums on the eradication of A. aegypti and delay even further the completion of the continental program;

Considering that in the last five years the eradication campaign has made progress only in rather limited areas and that in several countries and territories the situation during that period has in fact deteriorated;

Bearing in mind that the Governing Bodies of the Organization have urged the countries and territories still infested to complete their A. aegypti eradication programs as soon as possible, since the success of the continental program can only be ensured if all sources of reinfestation are promptly eliminated; and

Considering that insecticides that can be successfully used against the mosquito are now available and that administrative and financial difficulties are at present the sole obstacles impeding the satisfactory conduct of the campaign,

1. To take note of the report of the Director on the status of Aedes aegypti eradication and of the reports of the aforementioned meetings (Document CD17/15 and Addenda).

2. To urge the Governments of the countries and territories still infested to fulfill their commitments and eradicate A. aegypti.

3. To recommend to the Governments of the Organization that they provide one another with reciprocal assistance, through the Pan American Sanitary Bureau, in the form of loans and grants or supplies and equipment.

4. To recommend to the international lending agencies that they make funds available to the Governments for the eradication of A. aegypti, and to request the Director to advise the Governments on ways of making these international funds available to supplement national funds.

5. To authorize the Director to seek additional funds for strengthening the assistance that PASB has been giving to the Governments for the eradication of A. aegypti.

6. To determine that, in special cases and at the specific request of each Government, the Pan American Sanitary Bureau may participate directly in the A. aegypti eradication programs.

7. To urge the Governments of the countries and territories already free of the mosquito to maintain strict epidemiological surveillance against reinfestation.

8. To request PASB to provide assistance to establish and maintain these services and to make periodic evaluations of them so that deficiencies may be corrected.

9. To authorize the Director to limit certification of A. aegypti eradication to a period of three years and to request recertification thereafter.

Oct. 1967 OD 82, 72

Recognizing the significance of foot-and-mouth disease for health and economic development, and the key role of the Pan American Foot-and-Mouth Disease Center with respect to this problem;

Noting the action of the Executive Committee at its 56th and 57th Meetings (Resolution XVIII, 56th Meeting; Resolution II, 57th Meeting) in supporting the program and financing arrangements for the Pan American Foot-and-Mouth Disease Center contained in the report of the mission of His Excellency the Vice President of Peru and the Director of the Pan American Foot-and-Mouth Disease Center;

Noting that at its Fifth Annual Meetings at the Expert and the Ministerial Levels (Viņa del Mar, Chile, 15-24 June 1967) the Inter-American Economic and Social Council decided,1 inter alia, "to request the Pan American Health Organization to continue to take technical and administrative responsibility for the Pan American Foot-and-Mouth Disease Center in accordance with the standards issued by the Inter-American Economic and Social Council," and authorized the Inter-American Committee on the Alliance for Progress (CIAP) to determine at its next meeting, jointly with the Pan American Health Organization and the Secretariat of the Organization of American States (OAS), arrangements for the financing of the Pan American Foot-and-Mouth Disease Center;

Noting further that CIAP, at its thirteenth meeting (Rio de Janeiro, Brazil, 29 September-2 October 1967), approved Resolution CIAP-3/67,2 which included, inter alia, the following key provisions:

2. To recommend financing the Pan American Foot-and-Mouth Disease Center, so as to ensure its financial and operational stability, by means of a system of contributions from the governments of the member states of the OAS on the basis of a scale of quotas established by the Pan American Union.

3. That, pursuant to the resolution of the Inter-American Economic and Social Council, the Pan American Health Organization shall continue to bear the technical and administrative responsibility for the Pan American Foot-and-Mouth Disease Center, in accordance with the policy determined by the Inter-American Economic and Social Council. The Directing Council of that Organization shall determine the amount of the contributions and the way in which they are to be made.

5. To recommend that government contributions start as of 1 January 1968, so as to be able progressively to absorb the financing of the Center's activities.

6. To authorize the Special Development Assistance Fund (SDAF), should sufficient amounts not be available in time to pursue the activities of the Center, to advance funds, which may also be taken from its working reserve, up to an amount not exceeding 50 per cent of the appropriation corresponding to the 1967-1968 budget. PAHO will reimburse the sums received from the SDAF as advance payments.

7. PAHO will submit an annual report to CIAP on the activities of the Center, and also on its program and budget, for consideration and reference to the Inter-American Economic and Social Council.

8. To recommend that PAHO negotiate financial contributions from other countries outside the system.

1. To express its appreciation to the Organization of American States, the Inter-American Committee on the Alliance for Progress, and the Inter-American Economic and Social Council for the assistance they have rendered to the Center.

2. [To recommend] that PAHO, as requested by the Inter-American Economic and Social Council, continue to assume technical and administrative responsibility for the Pan American Foot-and-Mouth Disease Center.

3. To instruct the Director of the Pan American Sanitary Bureau to present an annual report to CIAP on the work of the Center and on program and budget estimates.

4. To authorize the Director to convene annually, beginning in 1968, a meeting of representatives of ministries of agriculture to review the program of the Center and to consider matters of mutual interest.

5. [To agree] that the Directing Council, as proposed by CIAP, determine the amount of and the manner in which the contributions are to be paid.

6. [To recommend] that the system of contributions by the Member Governments of the OAS be based on the scale of assessments established by the Council of the OAS and that other Member Governments and Participating Governments of PAHO shall contribute in accordance with the method approved by the Directing Council for the Pan American Health Organization.

7. To authorize the Director to establish a Working Capital Fund for the Center, subject to the provisions of the Financial Regulations of PAHO.

8. To appropriate for the financial year 1968 an amount of $1,202,836 for the operation of the Center.

9. [To recommend] that the appropriation be financed from contributions in respect to:

10. [To recommend] that, in accordance with the Financial Regulations of the Organization, amounts not exceeding the appropriation noted under paragraph 8 be available for the payment of obligations incurred during the period 1 January to 31 December 1968, inclusive. Any remaining balance shall be transferred to the Working Capital Fund for the Center.

Oct. 1967 OD 82, 74

Having considered the report of the Director on the progress achieved in the coordination between the services and programs of the ministries of health, social security institutes, and other institutions that conduct activities related to health (Document CD17/18 and Addenda I and II);1

Noting that a number of countries in the Americas are taking steps to coordinate medical services with a view to improving their performance and extending their coverage; and

Considering that the measures recommended in the Final Report2 of the Technical Discussions held at the XVII Pan American Sanitary Conference constitute a simple method for reaching this goal in progressive stages,

1. To thank the Director for preparing the report (Document CD17/18 and Addenda I and II).

2. To urge the countries that have already initiated coordination to continue their efforts until it is achieved, and to recommend coordination [to] other countries that have not yet taken steps in that direction.

3. To recommend to the countries that they undertake, as part of economic and social development, broad and coordinated planning of the health sector in which all the agencies concerned participate, especially social security institutes that provide health services, with a view to (a) providing, with the participation of the community, as extensive coverage as possible, in keeping with the main health problems and the capacity of the resources to satisfy the demand for services; (b) drawing up local integrated health programs covering both the preventive and the curative aspects of medicine; (c) organizing the local health service infrastructure on the basis of the decentralization of administration through a regional and coordinated system of hospitals and other health services; and (d) having universities, and especially medical and paramedical schools, participate in order to ensure the joint education and training of the personnel necessary for reaching national health goals.

4. To recommend to the Director that the Bureau continue to provide countries that request them with consultative and advisory services in this field, and that it strengthen assistance to the Governments that require it for training national personnel for this purpose.

5. To recommend to the Director that, in consultation with the Organization of American States, he explore ways of organizing a study group composed of recognized authorities on the administration of the health services of ministries of health, social security institutes, and other institutions conducting activities related to health, whose purpose it will be to advise the Organization, find ways and means of coordinating all available resources, and periodically prepare technical reports for submission to meetings of the Governing Bodies.

Oct. 1967 OD 82, 76

Having considered the report on the program for the supply of textbooks for medical students (Document CD17/20);1

Bearing in mind the value, importance, and pressing necessity of this program for raising the level of medical education;

Considering that the XII Meeting of the Directing Council, XII Meeting of the Regional Committee of WHO for the Americas, urged the Director, in Resolution XXIV, to intensify his efforts to obtain extrabudgetary funds with which to expand the PAHO educational program; and

Bearing in mind that the Executive Committee, at its 56th Meeting, recommended to the Director that he continue pertinent negotiations for implementing the program and use existing funds for that purpose,

1. To note with satisfaction the report on the program for the supply of textbooks for medical students (Document CD17/20).

2. To reaffirm the importance, interest, and urgency of the program, and to approve the steps taken so far.

3. To endorse Resolution XIX of the 56th Meeting of the Executive Committee.

4. To commend the Director for the progress made in implementing the program.

5. To request the Director to continue his negotiations with the Inter-American Development Bank and with other potential sources of funds for financing this program.

6. To reaffirm Resolution XXIV of the XII Meeting of the Directing Council and to urge the Director to seek extrabudgetary funds with which to strengthen and expand the PAHO program for the education and training of health personnel.

7. To request the Director to submit for review to the XVIII Meeting of the Directing Council a report on the progress achieved in the first phase of the currently planned program covering the first five subjects selected, as set forth in Document CD17/20.2

Oct. 1967 OD 82, 78

Having considered the report of the Director on the status of smallpox eradication in the Americas (Document CD17/11);1

Bearing in mind the previous resolutions of the Governing Bodies of the Pan American Health Organization and of the World Health Organization on this subject; and

Noting that, although progress has been made in some countries in which eradication has been achieved after intensive vaccination campaigns, the disease still represents an important problem in certain areas, and that there exist in the Americas endemic foci that constitute a paramount threat to the life and health of their populations,

1. To take note of the report on the status of the smallpox eradication in the Americas (Document CD17/11).

2. To reaffirm that smallpox eradication in the Americas is one of the major objectives of PAHO, as part of the worldwide program for the purpose.

3. To recommend to the ministries of health of those countries in which the disease is still present and which have not yet launched eradication campaigns that they make every necessary effort to surmount any administrative and financial difficulties that may exist and that they give the smallpox eradication program the high priority it deserves.

4. To recommend that neighboring, and particularly contiguous, countries coordinate their smallpox activities and/or eradication campaigns in order to reduce the risk of the spread of the disease between their respective territories during the course of such activities.

5. To recommend to all the Governments that they maintain a high level of immunization and a constant vigilance against the introduction or reintroduction of the disease.

6. To express its thanks to the countries of the Hemisphere that have so generously donated smallpox vaccine to countries that need it.

7. To recommend to the Governments that special attention be paid to the preparation of smallpox vaccines that meet the international standards established by the World Health Organization, and to urge them to make appropriate use of the services of the reference laboratories of the Pan American Sanitary Bureau.

8. To emphasize the need for PASB to continue to coordinate the continental smallpox eradication program; to provide the Governments that request them with technical advisory services in planning, operations, research, and personnel training; and to furnish them with vaccine, supplies, and equipment, subject to the availability of budgetary funds.

Oct. 1967 OD 82, 79

Having considered the document submitted by the Government of Peru on health law as an independent branch of law in general (Document CD17/27);

Bearing in mind that this matter calls for a preliminary investigation of its technical and practical aspects and its financial implications, since it is a new field of activity for the Organization; and

Bearing in mind the opinions expressed by the representatives in the course of the discussion,

1. To instruct the Director of the Bureau to submit to the 59th Meeting of the Executive Committee a preliminary report on the [relations between health and] law, outlining a plan for collaboration in this matter with the Governments that request it.

2. To urge the Executive Committee to make, in the light of the preliminary report submitted by the Director, such recommendations as it deems pertinent on the matter to the XVIII Meeting of the Directing Council.1

Oct. 1967 OD 82, 80

Having noted the report on the research policy and program of the Pan American Health Organization (Document CD17/17);1

Having reviewed the Organization's proposal for cooperative programs to strengthen multinational activities for advanced training and research in the health sciences in Latin America, requested in Resolution XVI of the XVII Pan American Sanitary Conference;

Having taken cognizance that this proposal coincides in principle and methodology with the Regional Scientific and Technological Development Program called for in the Declaration2 of the Presidents of America at their meeting in Punta del Este in April 1967;

Having noted that the Director has requested the Organization of American States to assign to the Pan American Health Organization the responsibility for developing the biology, health, and medicine components of the Regional Scientific and Technological Development Program; and

Realizing that the implementation of well-conceived and adequately financed multinational science programs in Latin America would (a) contribute to the more effective development and use of scientific capability and increase the number of investigators and academicians; (b) facilitate the pursuit in Latin America of advanced training and research, thus reducing the incentives to migrate; and (c) contribute to the mobilization of scientific resources for the solution of health problems and for the greater socioeconomic development of the Americas,

1. To congratulate the Director of the Bureau on the progress of the PAHO research program and on the timeliness of its studies and the promptness with which they have been published.

2. To express its satisfaction with the approach and practicability of the proposal developed for cooperative programs to stimulate multinational activities for advanced training and research in the health sciences in Latin America, and with the emphasis placed on strengthening existing institutions.

3. To emphasize the success achieved in initiating the PAHO Regional Library of Medicine, discussed as a proposal by the XVI Meeting of the Directing Council,3 [which is] the first multinational center to be implemented under this program.

4. To instruct the Director to continue to stimulate cooperative multinational programs for advanced training and research in the health sciences in additional areas that promise significant and rapid advances in levels of health.

5. To confirm that, with reference to the Regional Scientific Technological Development Program of the OAS, PAHO is the logical international organization in the Western Hemisphere to sponsor and coordinate cooperative multinational programs for research and graduate education in the health sciences, and to request the Director to continue to take this position.

6. To authorize the Director to continue to utilize the resources of PAHO, within the terms of its approved program and budget, to augment and complement the multinational research and research training programs that it administers at the request of other organizations.

7. To instruct the Director to pursue all possible avenues of support at international, national, and private levels in order to stimulate the development of multinational programs in the biomedical sciences that are of interest to the PAHO.

8. To request the Governments to contribute to the Special Fund for Research established by the XVII Pan American Sanitary Conference.

Oct. 1967 OD 82, 81

Having considered the report of the Director of the Bureau on the fellowship program (Document CD17/14),1 submitted pursuant to Resolution XV of the 56th Meeting of the Executive Committee;

Bearing in mind the importance of the fellowship program for the education and training of the professional and auxiliary personnel of the national health services, as well as the faculty of medical and related schools, in order to achieve the short-term and long-term objectives of health and medical education programs;

Considering that the fullest cooperation of the Governments at all stages of the fellowship program is essential to its success;

Believing that it is highly advisable to maintain the existing coordination [between] the fellowship program of the Pan American Health Organization and those of the World Health Organization and other specialized agencies of the United Nations and to follow uniform procedures, since a substantial number of the fellowships are financed with funds from WHO and the United Nations Development Program; and

Bearing in mind that, as a result of the scope acquired by the fellowship program in recent years; it is essential to intensify efforts to evaluate the results obtained,

1. To commend the Director for the report on the fellowship program (Document CD17/14), and to approve the report.

2. To recommend to the Governments that they continue to use such procedures as they deem most appropriate to ensure that the best fellowship applicants are selected, including, inter alia, the establishment of special selection committees.

3. To point out to the Governments, where appropriate, that it is necessary to select fellowship applicants in the light of the manpower needed for carrying out national short-term and long-term health and medical education plans.

4. To again emphasize to the Governments the importance of making full use of the services of the fellows of the Organization, when they complete their studies, in their specialized field and in close relationship to national health plans.

5. To reaffirm Resolution XIX of the IX Meeting of the Directing Council, which recommended to the Governments that they continue to pay the salary and safeguard the seniority and other rights of officials pursuing studies abroad in order to facilitate the selection of the best qualified candidates and contribute to the efficient conduct of the fellowship program.

6. To recommend to the Director that, in view of the satisfactory results obtained so far, he maintain the existing coordination of the fellowship program of the Organization and those of the specialized agencies of the United Nations, of the Inter-American System, and other agencies.

7. To recommend to the Director that he continue his efforts, in the way he deems most effective and in cooperation with the Executive Committee and the Governments, to carry out in the next two years an evaluation of the fellowship program, and that he submit a preliminary report on his findings to the XVIII Meeting of the Directing Council.

Oct. 1967 OD 82, 83

Having considered the report on the collection of quota contributions (Document CD17/22), as well as the information and comments on quotas contained in the Financial Report of the Director and the Report of the External Auditor for 1966 (Official Document 75);

Noting that the rate of payment of quota arrears is lower that in the previous year;

Recognizing that the rate of collection of current quotas has improved but is still too low;

Considering the importance of the prompt and full payment of quota contributions to assure financial support of the entire approved program,

1. To take note of the report on the collection of quota contributions (Document CD17/22) and the information and comments on quotas contained in the Financial Report of the Director and the Report of the External Auditor for 1966 (Official Document 75).

2. To commend Governments for the progress made in paying current quotas and urge them to renew their efforts in this respect.

3. To urge Governments which have quotas in arrears to pay them at an early date.

4. To commend the Dire for his efforts to improve the level of quota payments and recommend that he continue to keep Governments informed of the status of quota payments.

Oct. 1967 OD 82, 84-85

Having approved the report of the working party on quota assessments, which included the recommendation "to establish the quotas for Barbados and Guyana at the equivalent of the minimum percentage shown on the OAS scale of quota assessments"; and

Noting the entrance of Barbados into the OAS since the date of the report of the working party on quota assessments,

1. To establish the quota for Barbados at the percentage shown in the OAS scale of quota assessments.

2. To establish the quota for Guyana at the equivalent of the minimum percentage shown in the OAS scale of quota assessments.

Oct. 1967 OD 82, 85

Recognizing the implications for other countries of the establishment of quotas for Barbados and Guyana, since the remaining populations in the Americas represented by France, the Kingdom of the Netherlands, and the United Kingdom are comparable to that of Guyana and greater than that of Barbados, and their per capita income is also approximately equivalent;

Bearing in mind that the Directing Council at its V Meeting adopted Resolution XL, which established the principle that the contributions of France, the Kingdom of the Netherlands, and the United Kingdom would be based on the per capita assessment of tHe comparable country, and that in the past this principle resulted in quota assessments below the minimum of the OAS scale for France and the Kingdom of the Netherlands because the populations represented by them were smaller than that of the smallest Member State assessed at the minimum on the OAS scale;

Believing that if the two new Member Governments having comparable or smaller populations and comparable per capita income are now assessed the minimum quota as recommended, it follows logically that the minimum quota should also be applied to France, the Kingdom of the Netherlands, and the United Kingdom; and

Taking into account the fact that budgetary plans for 1968 are already well advanced; that the countries whose tentative assessments are affected-namely France, the Kingdom of the Netherlands, and the United Kingdom-will need a reasonable period in which to make budgetary adjustment; and, further, that the remaining territories represented by the United Kingdom, whose contributions represented roughly one half of the quota when the quota was shared by Barbados and Guyana, will also need a period in which to adjust to the new budgetary requirements,

1. That no Member or Participating Government shall be assessed less than the minimum quota appearing on the OAS scale.

2. That the application of the minimum quota assessment to France, the Kingdom of the Netherlands, and the United Kingdom shall commence with the budget for 1969.

Oct. 1967 OD 82, 85

Noting that the working party on the application of Article 6, paragraph B, of the PAHO Constitution examined individually the circumstances of each of the four countries whose quotas are more than two years in arrears; and

Having approved the report of the working party, which recommended that Bolivia, Haiti, Paraguay, and Uruguay be accorded the right to vote in the XVII Meeting of the Directing Council,

That Bolivia, Haiti, Paraguay, and Uruguay shall have the right to vote in this XVII Meeting of the Directing Council.

Oct. 1967 OD 82, 86

Having considered the report of the Director on buildings and installations (Document CD17/28);1

Taking note of Resolution XIII approved by the 56th Meeting of the Executive Committee; and

Appreciating the need for prudent advance planning of the physical facilities of the Organization,

1. To take note of the report of the Director on buildings and installations (Document CD17/28);

2. To commend the action taken by the Director in his efforts to obtain accommodations for the Zone Offices on favorable terms.

3. To commend the long-range plans of the Director in regard to Headquarters [accommodations] for the period after 1976.

4. To urge him to continue the study of possible solutions to the long-range needs at Headquarters, including further conversations with the Government of the United States of America, and to report to the 59th Meeting of the Executive Committee on this matter.

5. To express its appreciation to the members of the Permanent Subcommittee on Buildings and Installations for their continued counsel in the management of these facilities.

6. To thank the Government of Jamaica for the works of art it has donated to the Headquarters building.

7. To request the Governments to continue to contribute works of art to the Headquarters building.

Oct. 1967 OD 82, 87

Bearing in mind the importance of Chagas' disease as a health problem in the Hemisphere and the extent of the area affected;

Considering its prevalence and its impact on health and economic and social conditions, as well as its scope; and

Mindful that knowledge of epidemiological characteristics, preventive measures, disease mechanisms, and therapeutic possibilities is incomplete, which consequently hampers control activities,

1. To instruct the Director of the Pan American Sanitary Bureau to submit to the XVIII Meeting of the Directing Council of PAHO a report1 on the present status of the problem of Chagas' disease in the Americas, based on available information and such other information as may be obtained from particular studies that are undertaken subject to the availability of budgetary funds.

2. To recommend to the Director that current research on the biology and control of the vector, as well as on laboratory diagnostic methods and therapeutic products, be continued and strengthened.

Oct. 1967 OD 82, 88

Having considered the Final Report of the Technical Discussions on "Methods for Increasing Health Service Coverage in Rural Areas"1 held during this meeting; and

Considering the magnitude and importance of the health problems of rural communities, and bearing in mind in particular the shortage of personnel and physical facilities for serving these communities,

1. To take note of the Final Report of the Technical Discussions, and to express its satisfaction with the [deliberations].

2. To express its thanks to the officials of the other international agencies, social security institutions, and nongovernmental organizations who participated.

3. To recommend to the Director of the Pan American Sanitary Bureau that he give this report the widest possible distribution.

4. To recommend to the Director of the Bureau that, subject to the availability of budgetary funds, he study the possibility of increasing advisory services designed to promote a further development of health services in rural areas.

5. To recommend to the Governments that they expand the training at the local level of the personnel the services need.

Oct. 1967 OD 82, 88

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

1. To select the topic "Participation of the Health Sector in Population Policy" for the Technical Discussions to be held during the XVIII Meeting of the Directing Council, XX Meeting of the Regional Committee of the World Health Organization for the Americas.

2. To invite the Executive Committee to review the "Rules for Technical Discussions at Meetings of the Pan American Sanitary Conference and of the Directing Council" and to submit its suggestions to the XVIII Meeting of the Directing Council.

Oct. 1967 OD 82, 89

Bearing in mind the provisions of Staff Regulations 12.2,

1. To take note of the amendments to the Staff Rules of the Pan American Sanitary Bureau presented by the Director in the annex to Document CE56/6 and confirmed by the Executive Committee at its 56th Meeting.

2. To instruct the Director to explore any remaining differences between the Staff Rules of the Pan American Sanitary Bureau and the World Health Organization and to report the results of this study and the progress made in reconciling them to the 59th Meeting of the Executive Committee.

Oct. 1967 OD 82, 90

Recognizing the importance of assuring that short-term consultant services planned as a part of the program of the Organization should be provided in full, even when the period of assignment has not been completed by the end of the financial year; and

Desiring to follow the practice of the World Health Organization with respect to obligations covering short-term consultants,

To confirm the amendment to the Financial Rules1 of the Pan American Health Organization that adds the following subparagraph to Article III, paragraph 103.2:

(c) The entire costs relating to short-term consultants whose period of assignment may not have been completed by the end of the financial year.

Oct. 1967 OD 82, 90

Noting the report on the resignation of the External Auditor presented in Document CD17/7, to which was attached Document CE56/16 of the 56th Meeting of the Executive Committee;

Bearing in mind that it has been the practice of the Pan American Health Organization and the World Health Organization to have the same External Auditor; and

Noting further that the Executive Committee at its 56th Meeting approved Resolution VI, which recommended the appointment of Mr. Lars Breie, the External Auditor of WHO, as the External Auditor of PAHO,

1. To note with regret the resignation of Mr. Uno Brunskog as External Auditor of PAHO, for reasons of age, and to express its appreciation for his conscientious services and his many valuable recommendations on the Organization's financial policy.

2. To appoint Mr. Lars Breie the External Auditor of the Pan American Health Organization.

Oct. 1967 OD 82, 91

Having considered the report of the Director... (Document CD17/26), which contains a summary of his statement to the Fifth Annual Meetings of the Inter-American Economic and 1 Social Council on the health aspects of the Declaration of the Presidents of America;2

Bearing in mind the background information contained in the annexes to Document CE56/19;

Mindful that the Declaration of the Presidents of America reaffirmed the policy followed by the Organizations in the last ten years, which is based on the principle that health activities are a social service and a component of development;

Considering that in the Action Program approved at Punta del Este the Pan American Health Organization was called upon to cooperate with the Governments in the preparation of specific programs aimed at reaching the objective set forth in the Declaration, namely to improve health conditions in Latin America; and

Bearing in mind Resolution XX of the 56th Meeting of the Executive Committee,

1. To commend the Ministers of Health and the Director for the steps taken to comply with the instructions given them by the XVII Pan American Sanitary Conference (Resolution XXX).

2. To express its satisfaction with the full recognition given to the health sector in the Declaration of the Presidents of America and in the Action Program approved by them at Punta del Este on 14 April 1967, and to incorporate into the policy of the Organization the proposals in that document that are directly or indirectly related to health.

3. To accept with deep gratitude the task entrusted to the Pan American Health Organization of collaborating with the Governments in preparing specific programs relating to the health objectives set forth in point C of the Action Program approved by the American Chiefs of State.

4. To express its thanks to the Government of Argentina for its offer to be host to a special meeting of Ministers of Health of the Hemisphere to be convened immediately prior to the XVIII Meeting of the Directing Council for the purpose of discussing and drawing up a plan of operations for implementing the decisions adopted by the American Chiefs of State.

5. To recommend to the Ministers of Health that they invite representatives of other health institutions in their countries to attend the aforementioned meeting.

6. To authorize the Director to take the pertinent steps to convene and organize the aforementioned special meeting of Ministers of Health and to keep the Minister of Public Health of Argentina duly informed.

Oct. 1967 OD 82, 92

Considering that the Governments of Brazil and Nicaragua have submitted a proposed amendment to Article 15, paragraph A, of the Constitution of the Pan American Health Organization that would increase to nine the number of Member Governments forming the Executive Committee, and that they have also submitted a transitional provision which would facilitate the entry into force of the proposed Article 15, paragraph A;

Considering that the proposal is to be considered communicated to the Member Governments for the purposes of Article 28 of the Constitution; and

Bearing in mind the provisions of Article 14, paragraph D of the Constitution,

1. To instruct the Director of the Pan American Sanitary Bureau to transmit to the Member Governments of the Organization the proposed amendment to Article 15, paragraph A, and the transitional provision submitted by the Governments of Brazil and Nicaragua, which read as follows:

Article 15. Composition

A. The Executive Committee shall be composed of nine Member Governments of the Organization elected by the Conference or the Council for overlapping periods of three years. Each of the elected Member Governments shall be entitled to designate one representative to the Executive Committee. Each representative may be accompanied by one or more alternates and advisers. A Member Government shall not be eligible for reelection to the Executive Committee until one year has elapsed since the expiration of its term of office.

Transitional article. On the entry into force of the amendment to Article 15-A, the vacancies on the Executive Committee shall be filled and two additional members shall be elected to bring the membership to nine. At subsequent elections a sufficient number of vacancies shall be filled to keep the membership of the Executive Committee at nine Member Governments of the Organization and, if necessary, the terms of office of the Governments elected shall be adjusted, provided that in no instance shall a Government be entitled to be a member of the Executive Committee for more than three successive years.

2. To recommend to the 59th Meeting of the Executive Committee that it consider the proposed amendment to the Constitution submitted by the Governments of Brazil and Nicaragua, paying special attention to the adaptation to the new composition of the Executive Committee.

3. To instruct the Director to include the following item in the draft agenda of the XVIII Meeting of the Directing Council: Amendment to Article 15, paragraph A, of the Constitution (Proposed by the Governments of Brazil and Nicaragua).

Oct. 1967 OD 82, 93