Having examined the Annual Report of the Chairman of the Executive Committee (Document CD22/5)1 on the work of the Committee from October 1972 to the present, during which period its 69th and 70th Meetings were held; and

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

Resolves:

 To take note of the Annual Report of the Chairman of the Executive Committee (Document CD22/5) and to commend him and the other Members of the Committee on the excellent work done.

 Having examined the Financial Report of the Director and the Report of the External Auditor for fiscal year 1972 (Official Document 120);

 Noting the modifications in expenditures from amounts originally budgeted for some activities and projects; and

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

1. To take note of the Financial Report of the Director and the Report of the External Auditor for fiscal year 1972 (Official Document 120).

2. To request the Director to provide the Directing Council with a detailed list of activities budgeted but not implemented and also one of the projects implemented but not previously budgeted.

3. To again commend the Director for having enabled the Organization to achieve and maintain a sound financial position.

 Having been informed of the resignation of Mr. Lars Breie, External Auditor of the Pan American Health Organization, to be effective upon completion of the audit for financial year 1973; and

 Bearing in mind that it has been the practice of the World Health Organization and the Pan American Health Organization to have the same External Auditor, and that Mr. Lars Lindmark, who has been appointed External Auditor of WHO effective beginning with financial year 1974, has expressed his willingness to serve as the External Auditor of PAHO,

1. To note with regret the resignation of Mr. Lars Breie as External Auditor of the Pan American Health Organization effective upon completion of the audit for financial year 1973.

2. To express its thanks to Mr. Breie for his conscientious service and his many valuable recommendations on the Organization's financial policy.

3. To appoint Mr. Lars Lindmark as the External Auditor of the Pan American Health Organization to be effective beginning with the financial year 1974.

 Having examined the Annual Report of the Director of the Pan American Sanitary Bureau for 1972 (Official Document 124); and

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

1. To take note of the Annual Report of the Director of the Pan American Sanitary Bureau for 1972 (Official Document 124).

2. To commend the Director and the staff of the Bureau on the work accomplished during the period covered by the Report.

 Considering the extended debates during the 68th Meeting of the Executive Committee, the III Special Meeting of Ministers of Health of the Americas, and the 70th Meeting of the Executive Committee1 on the subject "Pan American Health University;" and

 Recognizing the worthy objectives of the proposed "Pan American Health University", as expressed by the III Special Meeting of Ministers of Health,

1. To commend the Director, his staff, and consultants on their efforts in furthering health manpower development in the Americas.

2. To reiterate acceptance of such objectives as set forth at the III Special Meeting of Ministers of Health.

3. To restate the intent of the Member Governments that such objectives, as well as the development of health manpower, be assisted and accelerated through the strengthening and perfecting of the Department of Human Resources Development of the Pan American Sanitary Bureau.

4. To request the Director to take the necessary steps so that the activities set forth not be identified as "Pan American Health University."

5. To request the Director that, in view of operative paragraphs 3 and 4 above, the funds proposed in Official Document 121 for project AMRO-6234 be assigned to the attainment of the approved objectives, deleting all references to "Pan American Health University" from the program and budget estimates.

 Having heard the report of the Director on the steps being taken by the countries and the Organization in fulfillment of the provisions of Resolution XIII of the XXI Meeting of the Directing Council of PAHO (Document CD22/17);

 Bearing in mind that the Ministers of Health have specified that in order to meet the goals of the Ten-Year Health Plan1 it is necessary for each country to define a policy consistent with its economic and social development, clearly setting forth the objectives, strategies, and programs for attaining them; and

 Considering that, pursuant to Resolution XIII, the Director convened a Working Group on Evaluation of the Ten-Year Health Plan, whose report stated that the process of evaluating the Plan will depend on the way in which the national health policies are defined and that it should reflect the efforts made by the countries and the progress achieved in solving their priority health problems,

1. To urge the Governments to continue and if possible intensity the review and formulation of their health policies during the current year, and to draw up and develop their priority programs.

2. To recommend to the Director that he continue to render PAHO collaboration to the countries in these activities.

3. To request the Director to put into effect the recommendations concerning studies of costs and financing of the health sector contained in Resolution XIII mentioned above and to keep the Governments informed on the results of the programmed activities and of the experiences of the countries.

4. To request the Director to take the necessary steps so that the documents relating to evaluation, including those resulting from the experience of the countries up until 1 May 1974, be the subject of special consideration during the 72nd Meeting of the Executive Committee, and that those countries desiring to do so participate in the discussion by sending observers.

 Having examined the XXI Report of the Director of the Bureau on the status of malaria eradication in the Americas (Document CD22/4);

 Noting that most of the countries of the Americas have complied with Resolution WHA22.39 of the Twenty-second World Health Assembly1 on reexamination of the global strategy of malaria eradication;

 Considering that the objective of the malaria eradication program in the Americas has been reaffirmed in the Ten-Year Health Plan;

 Taking into account that malaria transmission usually has local epidemiological characteristics which often create technical problems that hinder its interruption;

 Recognizing that research on new methods of combating malaria offers encouraging perspectives for accelerated progress toward eradication;

 Bearing in mind the need to incorporate the malaria eradication program within the health sector portion of the respective national economic development plans; and

 Recognizing that some of the Governments need to obtain funds from international lending sources in order to ensure adequate financing for their programs,

1. To take note of the XXI Report of the Director on the status of malaria eradication in the Americas (Document CD22/4).

2. To express its satisfaction that most of the countries have complied with Resolution WHA22.39, and to request the Director to continue to cooperate with the Governments in their program review and evaluation activities.

3. To insist on the need for the Governments to make available to their respective malaria eradication programs the administrative, technical, and human resources they will require in order to implement the strategy and meet the goals that have been set forth in the Ten-Year Health Plan.

4. To recommend that research be intensified in the areas where transmission persists in order to determine its causes and permit application of the most effective measures available, in accordance with the epidemiological characteristics of each area.

5. To emphasize the need to expand the training of future malariologists, providing them with a broad background in the epidemiology and ecology of malaria eradication and in the control of other parasitic and vector-borne diseases.

6. To take note of the studies being made by PAHO, directly or with the support of other institutions, to discover new attack measures, and to request the Director to continue and intensify these efforts.

7. To reaffirm the need for increased coordination of the malaria eradication services: with general health services, in order to effect epidemiological surveillance; with urban and rural development agencies, so as to prevent or reduce vector infestation; and with the agricultural and livestock sectors, with a view to regulating the use of pesticides.

8. To insist on the need for those countries that produce DDT to continue to manufacture it for use in health programs, particularly in malaria campaigns.

9. To request the international lending agencies to facilitate the granting of loans under terms that will help to achieve eradication of the disease in the areas that are still affected.

Resolves:

In establishing the contributions of Member Governments and Participating Governments, their assessments shall be reduced further by the amount standing to their credit in the Tax Equalization Fund, except that credits of those Governments who levy taxes on the emoluments received from the Pan American Health Organization by their nationals and residents shall be reduced by the amounts of such tax reimbursements by the Organization.

3. That, in accordance with the Financial Regulations of the Organization, amounts not exceeding the appropriations noted under Paragraph I shall be available for the payment of obligations incurred during the period 1 January to 31 December 1974, inclusive. Notwithstanding the provision of this paragraph, obligations during the financial year 1974 shall be limited to the effective working budget, i.e., Part I–VI.

4. That the Director shall be authorized to transfer credits between parts of the effective working 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 and/or the Conference.

 Taking into account that the Member Governments appearing in the scale adopted by the Council of the Organization of American States are assessed according to the percentages shown in that scale, in compliance with Article 60 of the Pan American Sanitary Code; and

 Considering that other Member Governments and Participating Governments are assessed on the basis of percentages which would be assigned to such countries if they were subject to the OAS scale,

 To establish the assessments of the Member Governments and Participating Governments of the Pan American Health Organization for 1974 in accordance with the scale of quotas shown below, and in the corresponding amounts.

 Having considered Official Document 121 submitted by the Director of the Pan American Sanitary Bureau, which contains the proposed program and budget estimates of the World Health Organization for the Region of the Americas for 1975;

 Bearing in mind that the proposed program and budget estimates are submitted to the Directing Council as Regional Committee of the World Health Organization for the Americas, for review and transmittal to the Director-General of that Organization so that he may take them into account in preparing the proposed budget estimates of WHO for 1975; and

 Noting the recommendations made by the 70th Meeting of the Executive Committee,

 To approve the proposed program and budget estimates of the World Health Organization for the Region of the Americas for 1975 appearing in Official Document 121, and to request the Regional Director to transmit them to the Director-General of that Organization so that he may take them into account in preparing the WHO budget estimates for 1975.

 Having considered the proposed program and budget estimates of the World Health Organization for the Region of the Americas for 1974 and 1975 contained in Official Document 121; and

 Recognizing the advisability of projecting probable program needs for future years,

 To recommend to the Director-General that he include in the program and budget estimates of the World Health Organization for 1976 the propose program for the Region of the Americas as detailed in Document CD22/25.

 Having examined Official Document 121 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 estimates of the Pan American Health Organization for 1975, to be considered by the 72nd Meeting of the Executive Committee and by the XIX Pan American Sanitary Conference;

 Recognizing that the provisional draft of the proposed program and budget estimates contains much-needed projects, prepared in cooperation with the national authorities; and

 Recognizing also the increasing demands being placed on the resources of Member Governments and the need for a period of consolidation,

1. To take note of the provisional draft of the proposed program and budget estimates of the Pan American Health Organization for 1975 appearing in Official Document 121.

2. To request the Director to use the provisional draft as a basis for the preparation of the proposed program and budget estimates for 1975, after further consultation with the Governments to determine their latest desires and requirements in relation to the health priorities of the countries.

3. To request, further, that the Director reexamine the proposed estimates for 1975 with a view to identifying additional areas where economies can be made so as to reduce the percentage increase requested for 1975.

4. To request the Executive Committee to make a detailed examination of the revised program and budget estimates for 1975 to be presented by the Director after further consultation with the Governments, and to submit its recommendations thereon to the XIX Pan American Sanitary Conference.

 Bearing in mind the provisions of Staff Regulation 12.2; and

 Having considered Resolution XXIII approved by the 70th Meeting of the Executive Committee,

1. To take note of the amendments to Staff Rules 255.1 and 255.2 of the Pan American Sanitary Bureau, under the heading "Education Grant," presented by the Director in the Annex to Document CE70/13 and approved by the Executive Committee at its 70th Meeting, to be effective as of 1 January 1973.

2. To endorse the Director's plan to continue a restudy of Staff Rule changes regarding the Zone Boards of Inquiry and Appeal and to report thereon to the XIX Pan American Sanitary Conference

 Having considered the recommendation of the Executive Committee and the changes in the Financial Regulations proposed in Document CE70/9;

 Taking into consideration that similar changes in the Financial Regulations of the World Health Organization have been approved by the Twenty-sixth World Health Assembly;1 and

 Bearing in mind the provisions of Financial Regulations 15.1,

 To approve the changes in the Financial Regulations of the Pan American Health Organization as they appear in the Annex to Document CE70/9.

 Having considered the report of the PAHO Award for Administration Committee (Document CE70/12, Add. I); and

 Bearing in mind the criteria for the PAHO Award for Administration,

 To declare Mr. Guillermo Istúriz of Venezuela the winner of the 1973 PAHO Award for Administration.

Elected Argentina, Cuba, and Nicaragua 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 services rendered to the Organization by their representatives on the Committee.

 Considering that the interruption of smallpox transmission in the Americas since 19 April 1971 has been confirmed on the basis of documents presented to and conclusions reached by the Special Commission for the Assessment of the Smallpox Eradication Program in South America, which met in Brazil in August 1973;

 Bearing in mind that, despite the importance accorded to epidemiological surveillance by the countries of the Region among the activities of their health services, this activity needs to be further intensified in certain areas of some of the countries.

 Being aware that, in general, the level of protection of children under five years of age and of other high-risk groups is not adequate; and

 Considering that, in view of the rapidity of the means of transportation presently in use, the risk of importation of variola major into this Region still remains.

1. To note that, in terms of the criteria set by the World Health Organization Expert Committee on Smallpox, the disease has been eradicated in the Region of the Americas.

2. To congratulate all the countries of the Hemisphere, especially Brazil, for their vigorous and decisive efforts to eradicate smallpox.

3. To request the health authorities to give special attention to programs for maintenance and epidemiological surveillance, being sure not to prematurely interrupt application of the measures recommended under the International Health Regulations.

 Having examined Document CD22/3, containing resolutions approved by the Twenty-sixth World Health Assembly1 which the Director of the Bureau has brought to the attention of the Council as Regional Committee of the World Health Organization for the Americas,

 To take note of the following resolutions of interest to the Regional Committee:

 WHA26.35: Organizational Study on Methods of Promoting the Development of Basic Health Services.

 WHA26.49: Coordination within the United Nations System: General Matters.

 WHA26.58: WHO's Human Health and Environment Program.

 WHA26.59: Development of Environmental Manpower.

 WHA26.61: Long-Term Planning of International Cooperation in Cancer Research.

 Having examined the report of the Group of Experts for the Study of Supplemental Financing to the Quota Contributions of the Member Governments, annexed to Document CD22/12;

 Recognizing the need to supplement the financing of the budgets of the Organization without involving any additional commitment on the part of the countries; and

 Considering that the efforts that have been made by the Organization to obtain extrabudgetary funds have been very successful, since such funds represent approximately 30 per cent of the total resources of PAHO,

1. To express its appreciation to the members of the Group of Experts for the report it has presented and to the Director of the Bureau for his unremitting efforts to obtain extrabudgetary funds.

2. To request the Director to appoint a select group of consultants to advise him on ways and means of getting industrial, university, nongovernmental, and intergovernmental institutions to collaborate in PAHO-assisted programs, this group to study, inter alta, the possibility of establishing a health fund based on loans or subsidies which would supplement, but not compete with, existing loan institutions.

 Having considered the Final Report of the VI Inter-American Meeting, at the Ministerial Level, on Foot-and-Mouth Disease and Zoonoses Control (Document CE70/10);

 Bearing in mind the need to improve the quantity and quality of animal vaccines, particularly for rabies; and

 Considering the urgent need to expand activities for the training of animal health assistants in order to achieve the goals of animal health programs,

1. To take note of the Final Report of the VI Inter-American Meeting, at the Ministerial Level, on Foot-and-Mouth Disease and Zoonoses Control (Document CE70/10) submitted by the Director of the Bureau.

2. To commend the Ministries of Agriculture for the efforts they have made toward controlling these diseases which are of importance to human and animal health and which at the same time are retarding the countries' socioeconomic development.

3. To recommend to the Member Governments that they reinforce their surveillance and improve diagnostic capability with a view to detecting and controlling vesicular diseases, rabies, equine encephalitis, and diseases exotic to the Americas, which could cause very serious damage to the livestock industry.

4. To reaffirm its support of the Pan American Foot-and-Mouth Disease Center and the Pan American Zoonoses Center and the programs they are conducting.

5. To commend the Ministries of Health and the Ministries of Agriculture for their cooperative efforts to improve the nutritional status of the people of their countries, in particular by preventing losses of food of animal origin.

 Having considered the report of the Director on the collection of quota contributions (Document CD22/8 and Add.);

 Having noted that in the first six months of 1973 the amount of quotas received was less than the amount received during this period the year before;

 Noting that not all of the five countries with approved payment plans for liquidating their arrears had made payments by the time of the Directing Council Meeting; and

 Bearing in mind the importance of prompt and full payment of quota contributions to assure financing of the authorized program and budget and to maintain the Organization's sound financial position,

1. To take note of the report of the Director on the collection of quota contributions (Document CD22/8 and Add).

2. To permit, after noting the report of the working party on the application of Article 6.B of the Constitution, the Representatives of Chile, Haiti, Paraguay, and Uruguay to vote in the XXII Meeting of the Directing Council.

3. To thank the Governments that have already made payments in 1973, and to urge the other Governments to pay their outstanding balances of arrears and current year quotas as soon as possible so that the work of the Organization can continue and the financial burden of its programs may be fairly spread among all the Members.

4. To again direct the attention of the Governments to the provisions of paragraph 5.4 of Article V of the Financial Regulations of PAHO which reads in part as follows "Contributions shall be considered as due and payable in full...as of the first day of the financial year to which they relate...As of 1 January of the following financial year, the unpaid balance of such unpaid contributions shall be considered to be one year in arrears."

5. To request the Director to continue to inform the Governments of any balances due.

 Having studied the Final Report1 of the Technical Discussions on "Community Health Services and Community Involvement" held during the present meeting;

 Recognizing the increasing demand of the communities for active participation in matters concerning their well-being;

 Being aware of the pressing need for support and participation of the community in the planning and implementation of health programs for improvement of the delivery of health care;

 Recognizing the goals set in the Ten-Year Health Plan for the Americas; and

 Considering the need for active community participation in order to utilize fully available resources,

1. To recommend that the Member Governments assign a high priority to the formulation and implementation of programs designed to develop in individuals a sense of responsibility for their own health and that of the community and also the ability to participate responsibly and constructively in programs aimed at the well-being of the population.

2. To request that the countries that have already formulated plans for stimulating and encouraging community participation in the delivery of health services receive all possible support in the execution of their programs.

3. To urge other countries to formulate plans and take the necessary action for their execution with a view toward achieving the greatest possible community involvement.

4. To request the Director of the Bureau to give high priority to the training of health and related personnel in health education and provide as soon as possible the necessary facilities for the implementation of training programs to meet the needs of the community.

5. To recommend to the Director that urgent and substantial support be given to the countries in order to achieve the foregoing objectives.

 Having examined Document CD22/21 reporting on the action of the 70th Meeting of the Executive Committee regarding the proposal of the Director of the Bureau to study the feasibility of revising the form of presentation of the program and budget of the Pan American Health Organization,

1. To endorse the action taken by the Executive Committee at its 70th Meeting authorizing the Director to proceed with the study on the basis of the classification established under the Ten-Year Health Plan for the Americas.

2. To request the Director to make the results of the study available to the 72nd Meeting of the Executive Committee and to the XIX Pan American Sanitary Conference as appropriate.

 Having heard with great interest the report presented by the Delegation of Mexico on the I National Health Convention of Mexico, held in that country in July 1973; and

 Considering that the report contains important indications relative to a new methodology for health planning,

1. To note the report of the I National Health Convention of Mexico.

2. To congratulate the Government of that country on having taken the initiative to hold this important meeting, whose valuable contributions will be of great usefulness to all the countries.

3. To request the Government of Mexico to keep the Governing Bodies of the Organization informed of progress in its health planning.

 Having noted the report of the Director on regional assistance for rehabilitation of the public health system of Nicaragua (Document CD22/20); and

 Having heard the statements by the Minister of Health of this country on the subject,

1. To express its solidarity with the Government of Nicaragua in its efforts to solve the problems created by the earthquake of December 1972.

2. To urge the Governments to take the necessary measures to fulfill Resolution EB51.R43 adopted by the Executive Board of the World Health Organization.

3. To request the Director to continue the assistance that is being extended to the Government of Nicaragua so that the reconstruction of its health establishments may be completed at the earliest possible date and promote cooperation in a spirit of solidarity for the achievement of these aims.

 Having examined the report of the Director on the status of Aedes aegypti eradication in the Americas (Document CD22/6);

 Bearing in mind that at its 70th Meeting the Executive Committee called attention to the importance of preventing diseases transmitted by Aedes aegypti and to the problem presented by reinfestation of countries free of the vector from areas of the Hemisphere that are still infested;

 Recognizing that eradication of the mosquito was recommended by the III Special Meeting of Ministers of Health of the Americas and calls for a coordinated Hemisphere-wide effort;

 Considering that the progress achieved to date in several of the countries justifies the exertion of still greater effort to meet the ultimate objectives; and

 Noting with appreciation that the United States of America has initiated a program of research into the development of an effective vaccine against dengue,

1. To endorse the recommendations contained in Resolution XVII of the 70th Meeting of the Executive Committee.

2. To urge the countries and territories of the Hemisphere to make every effort to comply with those recommendations.

3. To urge the Governments to organize, or intensify, activities for the epidemiological surveillance of diseases transmitted by Aedes aegypti, without prejudice to the continuation of action for the eradication of the vector.

4. To encourage the Governments to continue research on other mechanisms for the control of diseases transmitted by Aedes aegypti, including the development and testing of an effective vaccine against dengue, with due regard for methods currently being used against the vector.

 Bearing in mind the provisions of Rule 9 of the Rules for Technical Discussions.

 To select the topic "Studies and Strategies to Reduce Morbidity and Mortality from Enteric Infections" for the Technical Discussions at the XIX Pan American Sanitary Conference. XXVI Meeting of the Regional Committee of WHO for the Americas.

 Taking into account the frequency and regularity with which disasters due to seismic disturbances occur in certain countries of the Region;

 Mindful of the fact that the grave loss of life and material damage caused by such calamities can be largely prevented by the establishment and application of construction standards designed to ensure that buildings are earthquake-proof; and

 Considering the implications that the prevention of such damage has for health, and the responsibility which therefore rests with the Pan American Health Organization in this matter,

1. To recommend to the Director that, in consultation with appropriate agencies of the United Nations and of the inter-American system, steps be taken to convene a group of experts to study the criteria-standards, and methods of building inspection currently prevailing in the Member Countries, especially those most subject to disasters due to seismic disturbances, and that the necessary technical manuals be prepared to guide the Member Governments in the review and updating of their relevant legal instruments and assure the use of suitable indicators for guaranteeing the safety of buildings to the greatest possible extent.

2. To urge the Director, in the light of the recommendations of the group of experts referred to in the preceding paragraph, to take measures to encourage a review of university curricula related to building techniques with a view to inclusion of the necessary course material to create the awareness and the technical competence in future professionals that in the course of their work they will take into account, and comply with appropriate requirements for preventing damage to buildings by seismic disturbances.

 Having studied the report of the Director on buildings and installations with respect to Brazil (Document CD22/22);

 Considering the progress made in arrangements for the construction of the Zone V Office in Brasília, thanks to the generous assistance of the Government of Brazil; and

 Bearing in mind the provisions of Resolution XX adopted at the 70th Meeting of the Executive Committee,

1. To note the report presented by the Director on buildings and installations with respect to Brazil (Document CD22/22).

2. To note the recommendations contained in Resolution XX of the 70th Meeting of the Executive Committee.

3. To request the Director to continue with the steps he is taking toward the construction of the Zone V Office building in Brasília.

 Having studied the report of the Director on buildings and installations with respect to Haiti (Document CD22/22);

 Having noted the offer of a construction site by the Government of Haiti for a PAHO/WHO office building in that country;

 Recalling that it is the responsibility of the Governments to provide office space for the PAHO/WHO staff in the country; and

 Concerned with the precedent that may be established by the proposed construction project,

1. To note the report of the Director on buildings and installations with respect to Haiti (Document CD22/22), and to thank the Government of Haiti for the gesture it has made toward solving the problem.

2. To request the Director to make a detailed study of the matter and report thereon to the 72nd Meeting of the Executive Committee and the XIX Pan American Sanitary Conference.