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 PAHO 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 1 shall be available for the payment of obligations incurred during the period 1 January to 31 December 1976, inclusive. Notwithstanding the provision of this paragraph, obligations during the financial year 1976 shall be limited to the effective working budget, i.e., Parts 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 Member Governments appearing in the scale adopted by the General Assembly 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 1976 in accordance with the scale of quotas shown below and in the corresponding amounts.

 Having reviewed the changes in the budget estimates of the World Health Organization for the Region of the Americas for 1977, as reflected in PAHO Official Document 134 and summarized in Document CD23/7,

 To note the changes in the budget estimates of the World Health Organization for the Region of the Americas for 1977 which have occurred since the preparation of WHO Official Record No. 220.

 Having examined the Annual Report of the Chairman of the Executive Committee, Dr. Roberto Pereda Chávez, Representative of Cuba (Document CD23/6), on the work of the Committee from October 1974 to the present, during which period the 73rd and 74th Meetings were held; and

 Considering the provisions of Article 9, paragraph C, of the Constitution of the Pan American Health Organization,

 To take note of the Annual Report of the Chairman of the Executive Committee, Dr. Roberto Pereda Chávez. Representative of Cuba (Document CD23/6), and to commend him, together with the other Members of the Committee, for the excellent work accomplished.

 Having considered the report of the Director on the collection on quota contributions (Document CD23/3 and Add.);

 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 in a sound financial condition;

 Taking into account Resolution IV adopted by the Executive Committee at its 74th Meeting; and

 Having considered the report of the working party appointed to study the application of Article 6, paragraph B, of the Constitution, which states that countries with approved plans for deferred payments are meeting their commitments satisfactorily,

1. To take note of the report of the Director on the collection of quota contributions (Document CD23/3 and Add.).

2. To thank the Governments that have already made payments in 1975 and to urge the other Governments to pay their outstanding arrears and current year quotas as soon as possible so that the work of the Organization can continue and the financial burden of its program be fairly spread among all the Members.

3. To again direct the attention of 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."

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

5. To permit the countries having approved plans for deferred payments to vote at the XXIII Meeting of the Directing Council.

 Having examined the Financial Report of the Director and the Report of the External Auditor for fiscal year 1974 (PAHO Official Document 135);

 Noting the percentage of expenditures in relation to amounts originally budgeted; and

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

1. To take note of the Financial Report of the Director and the Report of the External Auditor for fiscal year 1974 (PAHO Official Document 135).

2. To again commend the Director for having achieved and maintained a sound financial condition.

 Having examined the Annual Report of the Director of the Pan American Sanitary Bureau for 1974 (Official Document PAHO 136); and

 Bearing in mind the provisions of Article 9, paragraph 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 1974 (Official Document PAHO 136).

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

 Having examined the report of the Director on the preparations for the First Intersectoral Meeting on the Health of Man in the Americas (Document CD23/24), pursuant to instructions of the XIX Pan American Sanitary Conference (Resolution XLII);

 Considering that the report brings out the economic impact which the holding of such an event would have on PAHO;

 Bearing in mind that the advantages of intersectoral coordination are already being studied by other United Nations agencies (UNICEF, Quito, August 1975), and that specific recommendations have been made on this topic;

 Taking into account that, as a result of the discussions at the Quito meeting, UNICEF is preparing a document which will serve as a basis for establishing norms and methodologies applicable to multisectoral coordination; and

 Considering that the resolutions adopted in Quito emphasized the need for establishing coordination among the international organizations in order to avoid duplication of efforts and expenditures and to achieve greater efficiency in bringing technical assistance to the countries,

1. To postpone the holding of the First Intersectoral Meeting on the Health of Man in the Americas.

2. To request UNICEF to make available the document resulting from the meeting in Quito in August 1975, so that the PAHO Executive Committee can study it at its 76th Meeting and submit a report on its findings to the XXIV Meeting of the Directing Council.

3. To ratify operative paragraphs 1 and 2 of Resolution XLII of the XIX Pan American Sanitary Conference.

 Having considered the report of the Award Committee of the PAHO Award for Administration (Document CD23/23 and Annex); and

 Bearing in mind the criteria established for granting the Award,

 To declare Mr. Dennis Sánchez Acuña of Costa Rica the winner of the 1975 PAHO Award for Administration.

 Bearing in mind Resolution XXXVII of the XIX Pan American Sanitary Conference which, in connection with the International Women's Year, urged the Governments to promote greater participation by women in the formulation of health policies and the administration of health programs, and considering Resolution XXXII adopted by the Executive Committee at its 74th Meeting;

 Having examined the report of the Director (Document CD23/17, Rev. 1) which gives an account of the activities carried out by PASB during the International Women's Year, including its participation in the Conference at Mexico City and in similar meetings organized in various countries in the Region;

 Recognizing the special efforts which have been made at the different levels of PASB to analyze the role and status of women as staff members, without discrimination of any kind;

 Recognizing that the objective of the International Women's Year is to promote equality as well as to change traditional attitudes and to integrate women into the developmental process, especially through greater participation in planning, decision-making, and implementation of policies adopted; and

 Noting the dearth of women in decision-making positions in the health sector and the need to obtain more accurate data regarding opportunities for women in that sector, and particularly in PAHO,

1. To thank the Director of the Bureau for the report presented (Document CD23/17, Rev.

2. To urge the Governments to assign high priority to the promotion and protection of women's health, together with employment and educational opportunities, and particularly to meeting their needs in the rural areas, in order to ensure their own welfare and that of their families.

3. To urge the Governments to give high priority to the inclusion of women in the planning, decision-making, execution, and evaluation phases of health programs at all levels, and to promote increased participation by women in the meetings of the Governing Bodies of the Organization.

4. To urge Governments to improve the information available on participation by and opportunities for women in the health sector, to make every effort to review the matter of utilization of women in the sector, to design and institute career paths and training patterns, and to set up the necessary administrative machinery to achieve the desired integration.

5. To recommend to the Governments that they develop the necessary machinery for ensuring the creation or improvement of public or private institutions to take responsibility for the care of children of working mothers during working hours and endeavor to improve the health, educational, and nutritional conditions of the children in their care, special emphasis being placed on the desirability of locating such institutions as close as possible to places to work (factories, industrial plants, etc.).

6. To recommend to the Director that the Organization:

a) Provide the necessary assistance to the countries in obtaining data concerning the participation of women in health occupations throughout the Region;

b) Encourage greater participation by women in the health sector;

c) Take positive action to establish an active policy of recruitment, promotion, and training of women for professional and other posts, including participation in the planning, decision-making, execution, and evaluation phases of health programs at all levels, and increased representation of women at the decision-making levels in the Pan American Sanitary Bureau; and

d) Present a report on the measures taken and the progress achieved in these areas to the 76th Meeting of the Executive Committee and to the XXIV Meeting of the Directing Council.

 Having examined Document CD23/11, containing resolutions of the Twenty-eighth World Health Assembly presented by the Director of the Bureau to the Council as Regional Committee of the World Health Organization for the Americas; and

 Having taken note of the information provided by the Director on the activities being carried out by the Bureau in the various fields,

 To take note of the resolutions of the World Health Assembly contained in Document CD23/11.

 Having considered the report of the Director on buildings and installations (Document CD23/28),

1. To take note of the report of the Director on buildings and installations (Document CD23/28).

2. To express satisfaction with the progress made in the construction of the Zone V Office in Brasília, Brazil, which is expected to be occupied during the current year.

3. To express appreciation to the Government of Peru for its important contributions to the construction of the main building and annexes of the Pan American Center for Sanitary Engineering and Environmental Sciences.

 Having reviewed the progress made in connection with the programs for medical and nursing textbooks and for basic diagnostic instruments for medical students, and the efforts made to obtain additional funds (Document CD23/22); and

 Bearing in mind the value and importance of these programs for the training of health professionals in the Americas,

1. To express its satisfaction at the progress made to date and emphasize the need for expanding the programs in order to serve the greatest possible number of students.

2. To request the Director to continue negotiations with the Inter-American Development Bank and explore other potential sources of financing.

3. To urge the Member Governments to lend their cooperation and assistance not only in operating the programs through the schools and universities but also in seeking the capital needed for their expansion.

 Bearing in mind Resolution VIII approved at the 74th Meeting of the Executive Committee, concerning the priority which the Governments should assign to the health care of youth;

 Recognizing that the health of the young people of the Region merits special attention because of their increasing numbers, the characteristics acquired by the pathology of youth during the development process, and the capacity of young people to promote health and social welfare activities for their own benefit and that of the family and the community; and

 Having examined the report submitted by the Director on the present health status of youth in Latin America and the Caribbean countries and the role which the Organization can play in this field (Document CD23/18),

1. To endorse Resolution VIII on health and youth approved at the 74th Meeting of the Executive Committee.

2. To recommend to the Governments that they establish a diagnosis of the health conditions of the youth in their countries, with a view to initiating appropriate programs for the promotion of the health of young people, due regard being paid to the desirability of youth participation in the execution of such activities.

3. To thank the Director for the information supplied and to request that he provide assistance in the form of technical advisory services, biomedical and social research, and the training of the personnel needed for such programs.

4. To instruct the Director to prepare an intersectoral action plan for the purpose of promoting the technical and financial assistance of international agencies-governmental and nongovernmental-and of national institutions-public and private-wishing to participate in the important task of improving the health conditions of young people, enabling them at the same time to play an effective part in the development plans of their countries.

5. To recommend to the Director that he provide up-to-date information on the progress of activities related to the Executive Committee's resolution on health and youth.

Elected Bahamas, Colombia, and Costa Rica to the Executive Committee upon termination of the periods of office of Haiti, Mexico, and Panama, and thanked the Governments of these countries for the services rendered to the Organization by their representatives on the Committee.

 Having considered the report of the working party set up to study the possibility of reducing the length of meetings of the Directing Council; and

 Bearing in mind the possible implications-constitutional, statutory, and financial-of the measures considered by the working party,

1. To request the Director to prepare a study of the constitutional, statutory, and financial implications of each of the measures suggested by the working party and any others that are deemed appropriate for shortening the number of days of Directing Council sessions, and to include the item on the agenda of the 76th Meeting of the Executive Committee.

2. To instruct the Executive Committee to study this matter and submit its final recommendations to the XXIV Meeting of the Directing Council.

 Having considered the Final Report of the VIII Inter-American Meeting, at the Ministerial Level, on Foot-and-Mouth Disease and Zoonoses Control (Document CD23/9);

 Bearing in mind the valuable technical assistance the Organization has been providing Governments through the Pan American Foot-and-Mouth Disease and Zoonoses Centers in the design, preparation, formulation, conduct, and evaluation of programs for the control of those diseases of human and animal health significance; and

 Mindful that the development and implementation of many new programs by the countries are resulting in an expansion of the activities of these Centers,

1. To take note of the Final Report of the VIII Inter-American Meeting, at the Ministerial Level, on Foot-and-Mouth Disease and Zoonoses Control (Document CD23/9).

2. To thank the Ministers of Agriculture for their continuing and expanded efforts to improve the health of the peoples of the Americas through the control and prevention of those diseases.

3. To express appreciation to the Ministers of Agriculture for their willingness to provide voluntary assistance as a partial solution to the financial problems being experienced by the Centers, as expressed in Resolutions III and V contained in Document CD23/9.

4. To recognize and support the requests made by Governments to the Inter-American Development Bank for financial assistance to the Centers, so as to enable them to continue or expand the technical assistance considered essential for the control of diseases of human and animal health importance.

5. To commend the Ministers of Agriculture for their efforts in the control of animal diseases affecting the health and economy of the countries of the Hemisphere.

 Having examined the report of the Director on the contribution of the Region of the Americas to the Sixth General Program of Work of WHO for the period 1978–1983 (Document CD23/14);

 Bearing in mind that the recommendations contained in Resolution EB55.R251 of the WHO Executive Board and the guidelines established by the working party appointed by the WHO Executive Board for that purpose were followed in preparing the document;

 Considering that, although the continental health policy embodied in the Ten-Year Health Plan for the Americas2 only relates to the period 1971–1980, it is believed, in view of the characteristics and seriousness of the existing problems that the essential elements of that policy will continue to be valid in the early years of the following decade;

 Bearing in mind that the contribution of the Americas to the Sixth General Program of Work is based on the content and priorities of the Ten-Year Health Plan for the Americas and that the indicators are identical with those being used by the countries for evaluating that plan;

 Considering that the "Principal and Detailed Objectives" identified by the working party of the WHO Secretariat are identical with the program areas of the Ten-Year Health Plan for the Americas;

 Considering that, at their III Special Meeting, the Ministers of Health of the Americas recognized that 40 per cent of the population lack health services and decided to establish as a fundamental objective the extension of the coverage of those services, giving priority to the control of communicable diseases, maternal and child health, nutrition, and environmental improvement, and emphasizing that for that purpose it was necessary to plan and strengthen the health systems and to develop the necessary human, physical, and financial resources; and

 Bearing in mind that in analyzing their health policies in the light of the Ten-Year Plan, most of the Latin American countries have confirmed those priorities.

1. To approve Document CD23/14 (Contribution of the Americas to the Sixth General Program of Work of WHO), and to request the Director to transmit it to the Director-General of WHO so that he may take it into account when preparing the above-mentioned Sixth General Program of Work.

2. To confirm that the priority objectives proposed by the Region of the Americas for the Sixth General Program of Work of WHO are identical with the priority areas of the Ten-Year Health Plan.

3. To recommend to the Member Governments that, in accordance with the conditions in each country, they increase their efforts and make use of the most efficient means of programming and developing service coverage, giving priority to the areas agreed upon in the Ten-Year Health Plan for the Americas.

4. To urge the Member Governments to ensure that, in this endeavor, maximum use is made of the available and potential resources through programming, evaluation and information, internal coordination of the components of the health sector, the use of multisectoral approaches, linkage of the health sector to economic and social development, and analysis of internal or external financing based on national priorities.

5. To request the Director to continue to provide such assistance as the countries require in achieving the priority objectives embodied in the Ten-Year Health Plan.

 Bearing in mind the provisions of Staff Regulation 12.2.

1. To take note of the amendments to the Staff Rules of the Pan American Sanitary Bureau presented by the Director in Annexes I and II of Document CE74/20 and confirmed by the Executive Committee at its 74th Meeting, with the effective date of 1 January 1975.

2. To take note of Document CE74/18 and the action1 taken by the Executive Committee at its 74th Meeting regarding employment conditions of non-local staff in the general service category of the Pan American Sanitary Bureau.

 Considering the revision made to the schedule of salaries of the professional and higher categories of staff in graded posts, effective as of 1 January 1975;

 Taking into account the decision taken by the Executive Committee at its 74th Meeting to adjust the salaries of the Deputy Director and the Assistant Director (Resolution XXXV);

 Having noted the recommendation of the Executive Committee concerning the salary of the Director of the Pan American Sanitary Bureau (Resolution XXXIV); and

 Bearing in mind the provisions of Staff Rule 230.3,

1. To establish the salary of the Director of the Pan American Sanitary Bureau at $36,625 per annum, effective 1 January 1975.

2. To note that consequent upon the salary adjustment for the Director, appropriate revision will be made of the post adjustment rate.

 Considering that previous resolutions of the World Health Assembly (in particular Resolutions WHA20.53, WHA23.61, WHA25.17, WHA26.35, WHA26.43, and WHA27.44)1 stress the need to encourage the provision and expansion of integrated health services to meet the needs of all the peoples and give recognition to their fundamental rights;

 Having noted the renewed emphasis and the priority given by the Twenty-eighth World Health Assembly to the promotion of primary health care (Resolution WHA28.88);2 and

 Being mindful of the need to attain the goals of the Ten-Year Health Plan for the Americas,

1. To request the Pan American Sanitary Bureau to give the highest priority to the expansion of health services designed to provide total coverage, in keeping with the life patterns and needs of the communities served, and at the same time promoting direct community involvement in local health activities.

2. To urge the Governments to make explicit in their health programs the decision to expand and improve rural health services and use all the possible manpower resources of the community served through continuous efforts to train professional, technical, and auxiliary personnel in accordance with local needs.

3. To encourage the Governments which have already initiated programs to share with other countries information and experience on the progress made or alternative procedures used, in collaboration with the Pan American Sanitary Bureau, with a view to proposing general standards for planning.

4. To request the Governments to promote effective coordination with those other components of socioeconomic development that are intimately related with the well-being of the rural population.

 Having examined the XXIII Report of the Director of the Pan American Sanitary Bureau on the status of malaria eradication in the Americas (Document CD23/21);

 Bearing in mind the resolutions of the PAHO and WHO Governing Bodies, in particular Resolution VI of the 74th Meeting of the PAHO Executive Committee and Resolution WHA28.871 of the Twenty-eighth World Health Assembly;

 Recognizing the importance of the recommendations approved by the Directors of the National Malaria Eradication Services of the Americas in Quito, Ecuador, in April 1975;

 Mindful of the financial difficulties that confront some countries in developing their programs; and

 Alarmed by the serious deterioration in the epidemiological situation of malaria in some countries,

1. To recommend to the Governments and to the Director of the Pan American Sanitary Bureau that they promote the development of malaria control methodologies better adapted to the epidemiological and economic conditions in each country.

2. To request the Director to increase the cooperation of the staff of the Bureau with those Governments which so request, in the planning, execution, and evaluation of malaria programs, and also in the investigation of problems and the training of personnel.

3. To reaffirm the need for the Governments to take steps to facilitate the procurement and ensure the timely supply of antimalaria drugs, insecticides, equipment, and other materials necessary for the efficient conduct of the program.

4. To authorize the Director to convene a coordination meeting with international and bilateral loan and technical assistance agencies in order to study the possibilities for financing malaria programs.

5. To recognize the support the Director has provided in research in new fields of malaria control and in the reorientation of malariologists, pursuant to the resolution of the 74th Meeting of the Executive Committee, and to request the Governments and the Director to intensify such activities.

 Having considered the Director's report on the Aedes aegypti situation in the Americas (Document CD23/19);

 Noting that the Director has expanded the Scientific Advisory Committee on Dengue to include experts on yellow fever and A. aegypti; and

 Bearing in mind that the new Scientific Advisory Committee on Dengue, Yellow Fever, and Aedes aegypti is expected to meet early in 1976,

1. To request the Director to entrust the Scientific Advisory Committee with a study of the present A. aegypti situation in the Americas and with a review of the present PAHO policy in the light of recent scientific advances in the control of yellow fever and dengue and the reinfestation with Aedes reported by several countries which had previously achieved eradication.

2. To recommend to the Director that he circulate the report and recommendations of the Scientific Advisory Committee to Member Governments for their comments in advance of the XXIV Meeting of the Directing Council in 1976.

3. To ask the Director to prepare for the consideration of the XXV Meeting of the Directing Council an updated policy statement on A. aegypti, dengue, and yellow fever, incorporating the comments of the Member Governments and the recommendations of the Scientific Advisory Committee.

 Bearing in mind that, as a result of the control of communicable diseases, the increases recorded in life expectancy at birth, and the environmental changes taking place in some countries of the Region, cardiovascular diseases, diabetes mellitus and cancer are among the principal causes of death;

 Considering that many countries have not yet formulated definite policies in regard to programs for the control of these diseases; and

 Bearing in mind the relevant goals contained in the Ten-Year Health Plan for the Americas,

1. To request the Director of PASB to collaborate with the countries in epidemiological studies that will enable them to define the extent of the problem of chronic diseases and to identify the risk factors involved in their pathogenesis, in order to provide guidance for control programs.

2. To recommend to the countries that they establish technical units for noncommunicable diseases at the central level of health administrations with a view to programming and coordinating control activities on a national scale, as part of regionalized national health care systems.

3. To request the Bureau to promote and coordinate intercountry programs in specific communities and on a restricted scale, with a view to demonstrating the feasibility and effectiveness of epidemiological studies and preventive and therapeutic measures, thus facilitating the organization of permanent control programs of broader coverage.

4. To request the Director to consider the establishment of an information system designed to monitor the situation at the regional level and to identify collaboration aspects of epidemiological, basic, and clinical research.

 Having taken note of the kind invitation of the Government of Mexico to hold the XXIV Meeting of the Directing Council, XXVIII Meeting of the Regional Committee of WHO for the Americas, in Mexico; and

 Bearing in mind the provisions of Article 7, paragraph B, of the PAHO Constitution and Rule 1 of the Rules of Procedure of the Directing Council,

 To thank the Government of Mexico for its kind invitation, and to accept the invitation with pleasure.

 Bearing in mind the provisions of Rules 7, 8, and 9 of the Rules for Technical Discussions,

 To select the topic "Development of the Health Service Infrastructure with Due Regard to the Need for Extension of Coverage" for the Technical Discussions to be held during the XXIV Meeting of the Directing Council of PAHO, XXVIII Meeting of the Regional Committee of WHO for the Americas.

 Having studied Document CD23/16 and its Annex I on the study of the Technical Discussions carried out by the Executive Committee; and

 Agreeing with the Executive Committee1 that the Technical Discussions have an intrinsic and significant value in the development of the programs of the Organization,

1. To continue to hold the Technical Discussions at each meeting of the Conference or the Council, as has been the practice up to the present.

2. To note with satisfaction the study and the documents of the Executive Committee and the recommendations contained therein.

3. To instruct the Executive Committee to continue to study the matter thoroughly, with due regard to the observations made at the present meeting.

 Having examined Document CD23/15 and its annexes, concerning the functions of the Executive Committee;

 Having noted that the discussions on this subject at the 72nd and 74th Meetings of the Executive Committee indicated a willingness and desire on the part of the Director and the Committee that the latter should play a more active role in determining the policies and programs of the Organization; and

 Having taken note of the amendments to the Rules of Procedure of the Executive Committee (Resolution XL), which imply greater participation by the Committee within the powers assigned to it under the Constitution,

1. To take note of Document CD23/15 and its annexes.

2. To welcome the two additional members designated by the Executive Committee to attend the meetings of the Directing Council, with a view to participating actively in them and providing any orientation which may be necessary.

3. To urge the Executive Committee, as part of its constitutional functions, to seek concrete ways of participating more fully with the Director and his staff in analyzing the main sectors of policy, programs, and aspects of special importance such as those relating to health services coverage, malaria eradication, nutrition, and environmental health, including possible new approaches.

4. To urge the Executive Committee, pursuant to Article 14, paragraph D of the PAHO Constitution, to undertake on its own initiative and with the cooperation of the Director and his staff, such studies and evaluations as it deems necessary to improve the work of the Organization.

5. To encourage the Director to take advantage of the expertise and experience available in the Executive Committee, not only during the regular meetings, but throughout the year, as is done by the Director-General and the Executive Board of WHO.

6. To report on the above activities to the Directing Council as appropriate

 Taking into account the report submitted by the Director (Document CD23/27) on the situation in 17 countries in regard to nursing personnel resources, estimates of future needs, their training and absorption into the health services, and the inadequacy of the present situation in most countries;

 Bearing in mind that, in order to make available in the health services the type and quantity of nursing personnel resources needed to achieve health program goals, it is necessary to have effective coordination between the health, education, and economic sectors as well as between institutions within the health sector itself; and

 Recognizing that, in order to plan effectively for the provision of the required nursing personnel resources, it is essential to have information on the major aspects that influence the situation,

1. To recommend to the Governments that they take direct action to ensure that more adequate estimates are made of the nursing personnel resources required, and that more effective planning for the provision of these resources and their absorption into the services is carried out through:

a) the establishment of mechanisms that will result in effective coordination of the aforementioned activities between the health, education, and economic sectors as well as between the major institutions within the health sector;

b) the creation of an appropriate information system which will provide data on the main factors affecting the availability in the health services of the type and quantity of nursing personnel resources needed to achieve health program goals, and will facilitate continual monitoring and adjustment of the situation;

c) the modification and strengthening of the nursing education system in order to prepare personnel who will, in turn, train the type and quantity of nursing manpower that is required; and

d) the adoption of measures to create the positions needed in order to utilize the graduates of all programs.

2. To request the Director to provide the assistance needed by countries to achieve the foregoing objectives.

3. To request the Governments to provide the Director in 1977 with information on the measures they have taken and progress made so that he may submit a consolidated report to the XXV Meeting of the Directing Council.

 Having examined the Director's report (Document CD23/20) on the progress made by the countries and the assistance given them by PAHO in compliance with Resolution XV of the XIX Pan American Sanitary Conference;

 Bearing in mind Resolution XIV adopted by the Executive Committee at its 74 Meeting;

 Recognizing that the participation of all the countries is essential if the evaluation of the Ten-Year Health Plan for the Americas is to have real meaning;

 Recognizing further that there is an urgent need to carry out this evaluation systematically; and

 Considering that it is necessary for the countries to improve their programming, execution, and evaluation processes in order to carry out their health policies and strategies successfully,

1. To request the countries that have not been able to establish the initial frame of reference to forward the necessary information to PAHO as soon as possible on the forms designed for this purpose by the Organization.

2. To request the Director to assist the countries, at their request, in producing and organizing the information in question, and to take steps to enable the Organization to systematize and analyze the data and distribute the results of these operations in the first quarter of 1976.

3. To urge the Director to continue to assist the countries in developing their procedures for programming, implementing, and evaluating their health policies and strategies.

 Having examined the Final Report of the Technical Discussions on "Methodologies for the Formulation of National Food and Nutrition Policies and their Intersectoral Implementation" held during the current meeting (Document CD23/DT/3);

 Recognizing that there has been no substantial improvement in regard to the problems of food and nutrition in the Region despite the efforts of the Governments, and that they may even grow worse as a result of the instability of world economy, which affects the prices of inputs essential to the production of basic foodstuffs;

 Reaffirming that the Ten-Year Health Plan for the Americas recognizes as a priority area for action by the Governments the reduction of nutritional diseases and the achievement of an optimum nutritional status for the entire population;

 Realizing that the problem is bound up with many causal factors directly related to the production, consumption, and biologic use of foods; and

 Acknowledging that, in this context, ministries of health bear a heavy responsibility as catalysts and guides to assist the other development sectors in achieving appropriate levels of health and nutrition for the entire population.

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

2. To recommend to the Member Governments that they intensify their efforts for the formulation and implementation of national food and nutrition policies and plans through multidisciplinary and intersectoral action as an integral part of each country's development plans.

3. To recommend to the ministries of health that they strengthen technical nutrition services at the central level and increase nutrition services at the intermediate and local level, as an integral part of general health activities.

4. To request the Director to continue the technical assistance to the countries for:

a) The strengthening of the nutrition infrastructure in the primary health services as a part of the extension of that coverage.

b) The establishment of nutritional surveillance systems, and the encouragement of evaluation of nutrition programs at all levels.

c) The education and training of personnel in nutrition.

5. To thank the consultants and the Secretariat for their valuable contribution in the preparation and development of the Discussions.

 Considering that a large sector of the population has difficulty in procuring drugs because the production and marketing system utilized results in high costs which make them inaccessible to the majority;

 Taking into account the experience of the Government of Peru over the past four years in the implementation of the Basic Drugs Program, which has aroused the evident interest of several countries;

 Recognizing the urgent need to bring about a reduction in the price of high-quality drugs, in order to put them within the reach of the socially and economically less privileged population; and

 Considering the existence of local factors that must be taken into account with a view to reducing the cost of drugs,

1. To take note of the statement made by the Representative of Peru.

2. To draw the attention of Member Governments to the desirability of carrying out an analysis of local factors that might contribute to reducing the cost of drugs without sacrificing quality.

3. To request the Director to afford the necessary cooperation in conducting the relevant studies.