CD33.R1 The Directing Council,
Having examined the Financial Report of the Director and the Report of the External Auditor for 1986–1987 (Official Document 220) on the accounts of the Organization;
Noting the comments and concerns expressed by the External Auditor on the bank and imprest accounts, the new Headquarters office building, monitoring and evaluation, and control of manpower; and
Expressing satisfaction that the Organization has continued to maintain a balanced financial condition,
1. To take note of the Financial Report of the Director for 1986–1987.
2. To thank the External Auditor for presenting a clear and comprehensive report for the biennium 1986–1987 and to request the Director to encourage careful attention to the matters of concern expressed by the External Auditor.
3. To express concern over the low rate of quota payments to the Caribbean Food and Nutrition Institute (CFNI) and to the Institute of Nutrition of Central America and Panama (INCAP), and to urge the governments that are members of CFNI and INCAP to make every effort to pay their outstanding quota contributions as early as possible, so that the work of these Centers can continue and the financial burden of their programs be shared fairly among all participants in the Centers.
4. To request the Director to monitor carefully the financial situation of CFNI and INCAP, and to devise alternative policies should the quota situation fail to improve over the current 1988–1989 biennium.
5. To request the Director to review and evaluate thoroughly the relationship between the Organization and the Pan American Health and Education Foundation (PAHEF) and to report his findings through the Subcommittee on Planning and Programming for consideration by the Executive Committee in June 1989.
6. To endorse the Director's proposal to credit the surplus of US$859,500 from operations in 1986–1987 to the Miscellaneous Income Account to help assure adequate funding of the 1988–1989 Regular Budget.
7. To congratulate the Director on his efforts to maintain a balanced financial condition for the Organization.
September 1988 OD 225, 188
CD33.R2 The Directing Council,
Having considered Document CD33/3 and the tentative request for US$65,027,000 from the World Health Organization for the Region of the Americas for the biennium 1990–1991, which includes cost increases of $4,866,000, or 8.1%, over the revised 1988–1989 allocation; and
Noting the recommendation of the 101st Meeting of the Executive Committee,
To request the Director to transmit to the Director-General of WHO the request for $65,027,000 for the Region of the Americas for the biennium 1990–1991, for consideration by the WHO Executive Board and the World Health Assembly in 1989.
September 1988 OD 225, 119
CD33.R3 The Directing Council,
Having seen the Annual Report of the Chairman of the Executive Committee (Document CD33/8) on the work of the Committee from September 1987 to date, the period during which the 100th and 101st Meetings were held; 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 Chairman of the Executive Committee (Document CD33/8).
2. To congratulate the Chairman and the other members of the Committee on their excellent work.
September 1988 OD 225, 120
CD33.R4 The Directing Council,
Noting with regret the damage caused by Hurricane Gilbert to Jamaica, Haiti, the Cayman Islands, Dominican Republic, Cuba, Mexico, and the United States of America;
Noting, further, the damage suffered by the health sector of Jamaica and the assistance rendered by PAHO to that country;
Recalling that one of PAHO's objectives is to cooperate with Member Countries to combat disease and foster the physical and mental health of the peoples of the Hemisphere;
Bearing in mind that among PAHO's activities is the provision of emergency aid and assistance to Member Countries in times of natural disasters; and
Considering that the United Nations General Assembly has adopted the reduction of disasters as the topic for the forthcoming decade,
1. To request the Director to convey the sympathy of the Member Countries of PAHO to the Government and people of Jamaica and of the other affected countries.
2. To commend the Director for making available assistance from the Organization.
3. To urge Member Countries to:
a) Render assistance to those countries affected by Hurricane Gilbert;
b) Consider emergency preparedness of the health sector as a development priority for the allocation of national and international resources in the context of the forthcoming Decade on Disaster Reduction.
4. To request the Director to continue to assist Jamaica in assessing the damage to the health sector and in developing and supporting plans for the rehabilitation and reconstruction of the health system.
September 1988 OD 225, 120
CD33.R5 The Directing Council,
Having seen the Annual Report of the Director of the Pan American Sanitary Bureau for 1987 (Official Document 221); 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 1987.
2. To commend the Director for his continued efforts to transform his Report into a dynamic working tool, to provide a better understanding of the work accomplished by PAHO during the period covered, and to assist in the evaluation of the programming of PAHO's activities.
3. To thank the Director for his leadership and for his support to the Member Governments in the technical cooperation activities conducted by PAHO during 1987.
September 1988 OD 225, 121
CD33.R6 The Directing Council,
Having seen the report of the Special Subcommittee on Women, Health, and Development (Document CD33/28);
Bearing in mind previous resolutions adopted by the PAHO Governing Bodies on women, health, and development, in particular Resolution XII of the XXII Pan American Sanitary Conference; and
Taking into account Resolution WHA 40.91 adopted by the Fortieth World Health Assembly,
1. To urge the Member Countries:
a) To fulfill the provisions of paragraph 2(b) of Resolution XII of the XXII Pan American Sanitary Conference, regarding strengthening the national focal points on women, health, and development;
b) To develop training programs for all health personnel at different levels on the Women, Health, and Development Program, its objectives, content, and strategies, so that they will be able to attend to the comprehensive health needs of women;
c) To significantly increase women's participation at the directing and decision-making levels within the health sector institutions;
d) To continue to conduct the research necessary to design policies and implement programs that will substantially improve the current living conditions and health of women, giving priority to the subject areas recommended in the report of the Subcommittee.
2. To request the Director:
a) To intensify efforts so that all the Organization's technical programs will develop activities aimed at fulfilling the eight strategies on women, health, and development approved by the XXII Pan American Sanitary Conference;
b) To continue promoting collaboration with other international agencies, formalizing it through agreements and accords aimed at coordinating activities and mobilizing resources for the Women, Health, and Development Program;
c) To incorporate the priority subject areas recommended by the Subcommittee into the research grant program of the Organization;
d) To continue efforts to increase the participation of women in PAHO with a view to attaining the goal of 30% in professional and higher-level positions, as approved by Resolution XII of the XXII Pan American Sanitary Conference, and, at the same time, to increase the participation of women as temporary and short-term consultants, working with the national focal points on the identification of candidates;
e) To increase mobilization of the resources required for implementing the approved regional strategies and for the promotion, execution, and dissemination of specific activities under the Women, Health, and Development Program at the country and regional levels;
f) To report every two years to the Directing Council on the progress achieved in the eight strategies of the Women, Health, and Development Program.
September 1988 OD 225, 122
CD33.R7 The Directing Council,
Having considered the report of the Director on the collection of quota contributions (Document CD33/15 and Add. I) and the concerns expressed by the 101st Meeting of the Executive Committee1 with respect to the status of the collection of quota contributions;
Noting the report of the Working Party on the application of Article 6.B of the PAHO Constitution, regarding the suspension of voting privileges of Member Governments that fail to meet their financial obligations to the Organization (Document CD33/15, Add. II); and
Recognizing that, in the case of the three Member Governments subject to Article 6.B, the Governments of Bolivia, the Dominican Republic, and Suriname either had made payments towards their outstanding quota commitments or had formally indicated their intent to make such payments during the remainder of 1988,
1. To take note of the report of the Director on the collection of quota contributions (Document CD33/15 and Add. I).
2. To express appreciation to Member Governments that have already made payments in 1988, and to urge all Member Governments in arrears to promptly meet their financial obligations to the Organization.
3. To congratulate the Government of Haiti and, in particular, the Government of Paraguay, for continuing to successfully reduce the amounts of their outstanding quota assessments.
4. To permit the Governments of Bolivia and Suriname to vote at this meeting in view of their initial payment efforts and commitment to make additional payments.
5. To permit the Government of the Dominican Republic to vote at this meeting and to encourage it to make every possible efforts to meet its full payment commitment for 1988.
6. To request the Director to:
a) Continue to monitor the implementation of special payment agreements made by Member Countries in arrears for the payment of prior years' quota assessments;
b) Advise the Executive Committee of Member Countries' compliance with their quota payment commitments;
c) Report to the XXXIV Meeting of the Directing Council on the status of the collection of quota contributions for 1989 and prior years.
September 1988 OD 225, 123
CD33.R8 The Directing Council
Elected Canada, Trinidad and Tobago, and Venezuela to the Executive Committee upon termination of the periods of office of Argentina, the Bahamas, and Mexico, and thanked the Governments of these countries for the services rendered to the Organization by their representatives on the Committee.
September 1988 OD 225, 125
CD33.R9 The Directing Council
Having reviewed the report on acquired immunodeficiency syndrome (AIDS) in the Americas (Document CD33/21);
Recalling Resolution XII, adopted by the XXXII Meeting of the Directing Council (1987), dealing with AIDS in the Americas, and Resolutions WHA40.261 adopted by the Fortieth World Health Assembly and WHA41.242 adopted by the Forty-first World Health Assembly, dealing, respectively, with the global strategy for the prevention and control of AIDS and the avoidance of discrimination in relation to people infected with the human immunodeficiency virus (HIV) and those with AIDS;
Considering that the AIDS pandemic continues to grow throughout the Region of the Americas, requiring a sustained commitment by every country to control the spread of HIV and to mitigate the magnitude of the future impact of this disease on health services and national economies;
Recognizing the continued need for joint, coordinated international efforts to prevent and control this disease;
Cognizant of the need for WHO's global coordination and promotion through the Global Program on AIDS and the joint work carried out in the Region of the Americas by the Pan American Health Organization; and
Considering the profound impact that the care of AIDS patients has on the already overtaxed national health services and health resources and the need for national AIDS programs and activities articulated within national plans for strengthening health systems and services.
1. To endorse the objectives, strategies, and goals for the Global Program on AIDS in the Americas, as presented in Document CD33/21.
2. To urge Member Countries:
a) To make special voluntary contributions for the conduct of catalytic research and cooperative activities regarding AIDS in this Hemisphere;
b) To make available to PAHO human and institutional resources to enable the Organization to better fulfill its mandates in this regard.
3. To request the Director
a) To continue to search for funds, in addition to those already approved in the PAHO/WHO regular program budget for the biennium 1988–1989, to support the efforts of the Member Countries to carry out their short- and medium-term programs for AIDS prevention and control;
b) To study the feasibility of establishing a revolving fund for the procurement of reagents, equipment, and other critical materials in support of the Member Countries for the implementation of their plans of action against AIDS.
September 1988 OD 225, 125
CD33.R10 The Directing Council
Having seen the report on Andean cooperation in health (Document CD33/17), which summarizes the guidelines and strategies in the priority areas for joint action by the countries of the Andean Subregion;
Taking note of Resolution XXII of the XXII Pan American Sanitary Conference, which supports the formulation of a joint plan of action for the Andean area; and
Recognizing the efforts made by the countries of the Subregion, the Secretariat of the Hipólito Unanue Agreement, and PAHO to jointly frame and implement health measures,
1. To congratulate the Governments of the Andean countries on the preparation of the Joint Plan of Action and the commitment that this represents, especially in terms of the effort that the Andean countries will have to make to mobilize local resources and obtain support from external sources.
2. To forward this Plan to WHO and to the Andean Parliament in order to promote active consideration and support for it.
3. To request the Director:
a) To orient PASB technical cooperation to the Andean area according to the objectives and strategies of the Plan of Action;
b) To seek, jointly with the Governments of the Andean countries, the support of other agencies and governments in and outside the Region for the execution of this Plan;
c) To endeavor, jointly with the Governments of the Andean countries, to accelerate implementation of the Plan of Action.
September 1988 OD 225, 127
CD33.R11 The Directing Council,
Having examined Document CD33/26 on the 1988–1989 program budget situation;
Recognizing that Resolution VI of the XXXII Meeting of the Directing Council (1987) requested the Director to report to the Directing Council on the status of the collection of quota contributions for 1988 and prior years;
Noting Resolution II adopted at the XXXII Meeting of the Directing Council, in which the Member Countries approved the appropriations for the Pan American Health Organization for 1988–1989; and
Considering Resolution III of the same meeting, in which the Member Countries approved assessments for the 1988–1989 biennial budget,
1. To urge all Member Countries to pay their full quota assessment to avoid a worsening of the budget situation and the consequent damage to the Organization's ability to fulfill its technical cooperation responsibilities.
2. To request the Director to take a flexible approach in effecting cuts in the program budget for 1988–1989 in the event that the payments of Member Countries fail to provide adequate resources to execute it fully, drawing upon the priorities established by PAHO Governing Bodies and the views of Member Countries in relation to evolving health problems and needs.
3. To request that the Director continue to consult with the Subcommittee on Planning and Programming of the Executive Committee in order to assess the impact on the Organization's programs of any budgetary shortfalls that may occur throughout the current biennium.
September 1988 OD 225, 127
CD33.R12 The Directing Council,
Having taken note of Document CD33/29 on the World Conference on Medical Education and its "Declaration of Edinburgh" on the reform of medical education; and
Bearing in mind the proposed plan of action for implementing the respective recommendations at the institutional and national levels,
1. To thank the Pan American Federation of Associations of Medical Schools and, through it, the World Federation of Medical Education, for the report submitted, underscoring the reorientation of medical education towards the goal of health for all by the year 2000.
2. To urge Member Countries to give special consideration and support to the recommendations and concepts embodied in the "Declaration of Edinburgh."
September 1988 OD 225, 129
CD33.R13 The Directing Council,
Reaffirming and reiterating the concepts and mandates contained in Resolution VIII of the XXX Meeting of the Directing Council (1984) and Resolution XVIII of the XXXI Meeting of the Directing Council (1985);
Recognizing the advances achieved by the joint work of the Organization, the Member Countries, and the United Nations Fund for Population Activities in executing the mandates contained in the aforementioned resolutions;
Taking note of the constraints that prevent a faster pace of execution; and
Reaffirming the statements contained in Document CD33/13, "Maternal and Child Health and Family Planning Programs," which the Director has presented as a second progress report on the status of execution of the Organization's policy for action in population matters,
1. To urge Member Governments:
a) To continue efforts to implement the mandates contained and unanimously adopted in Resolutions VIII and XVIII, so that faster progress can be made in the strengthening of maternal and child health and family planning programs, stressing activities among groups at greatest risk, particularly adolescents, to reduce differences between and within the countries;
b) To make a special effort to study information on population, health, and existing services so as to update and maintain the situational diagnosis needed to program the measures to be taken in the last decade of the century;
c) To design specific proposals for the participation of other development sectors in coordinated actions to benefit the health of mothers, children, and the population at large;
d) To take the necessary action to coordinate technical and financial cooperation in the area of population, health, and development, and especially in maternal and child health and family planning programs;
e) To emphasize not only the extension of coverage but also the quality of maternal and child health, family planning services, and the prevention, detection and treatment of cervical cancer as part of the strategy for the development and strengthening of local health systems;
f) To set, before the end of 1990, national goals for the reduction of maternal mortality by the year 2000, and to design plans of action to this end so that maternal mortality may be reduced significantly-by at least 50% in countries whose index for this mortality is higher than 5 per 10,000 recorded live births;
g) To initiate intersectoral and sectoral actions directed toward the community, teachers, and parents, with a view to helping adolescents develop healthy lifestyles and avoid risk-associated behaviors that lead to drug addiction, accidents, sexually transmitted diseases, and unwanted pregnancies.
2. To request the Director:
a) To continue the support of activities required for implementation of the collective mandates in this field, especially the mobilization of national and international technical and financial resources for a more appropriate response to existing needs;
b) To propose to the Governing Bodies in 1990 a regional plan of action for the reduction of maternal mortality in the Americas;
c) To report on the progress made in this area to the Directing Council at its meeting in 1991.
September 1988 OD 225, 129
CD33.R14 The Directing Council
Having examined and reviewed the progress report presented by the Director on the implementation of the Plan of Action for the Eradication of the Indigenous Transmission of Wild Poliovirus from the Americas by 1990;
Noting with satisfaction that most countries have prepared five-year plans outlining the activities to be carried out and the costing of the program, with identification of the national and international funding sources;
Concerned that many countries have not made enough progress toward implementation of the strategies outlined in the Plan of Action and others have not maintained the strategies over time, and that immunization coverage remains critically low in several of them;
Cognizant that less than three years are left before the target date for eradication of wild poliovirus transmission from the Americas and that much remains to be done; and
Considering Resolution WHA41.281 (Global Eradication of Poliomyelitis by the Year 2000) of the Forty-first World Health Assembly,
1. To thank the United States Agency for International Development, the Inter-American Development Bank, UNICEF, Rotary International, and the Canadian International Development Agency/Canadian Public Health Association for the level of cooperation and coordination achieved among themselves and with the PAHO Member Countries in carrying out the campaign to eradicate poliomyelitis from the Americas by 1990.
2. To urge all Member Countries to make every effort to carry out their adopted national plans of action in accordance with the general guidelines of the Regional Plan of Action and the recommendations of the Technical Advisory Group (TAG).
3. To urge the acceleration and reinforcement of the work of the network of laboratories capable of performing virological tests, in support of diagnostic, surveillance, and control activities in programs of the Member Countries.
4. To place emphasis on the following critical actions requiring the immediate and continuing attention of the Member Countries for attainment of the goal of polio eradication:
4.1 Countries still endemic for polio should:
a) Hold at least two regular national mass vaccination days per year as part of their national vaccination programs;
b) Utilize these national vaccination days to deliver TOPV as well as other EPI antigens, so that the overall EPI coverage will be increased;
c) Continue these measures until eradication of the indigenous transmission of wild poliovirus is achieved and certified.
4.2 Countries not endemic for polio should ensure that high levels of immunization are maintained throughout the country and offer their technical knowledge, resources, and support to countries that may require them.
4.3 All Member Countries should:
a) Monitor immunization coverage at the level of the smallest political administrative units;
b) Take special measures to improve immunization rates in children under one year of age in areas where TOPV coverage is below 90% in that age group, and use this indicator as a measure of the functioning of the health infrastructure and as a basis for the reallocation of resources.
4.4 Surveillance systems should be strengthened to detect all cases of acute flaccid paralysis:
a) All cases of acute flaccid paralysis occurring in persons less than 15 years old should be considered a national emergency and investigated immediately to determine if they represent poliomyelitis;
b) Special control measures should be instituted immediately for all cases classified as probable polio cases;
c) All cases classified as probable polio cases should be reported as soon as possible to the international level, and specimens immediately sent to designated reference laboratories for prompt and accurate testing.
5. To request that the Director present a progress report to the XXXIV Meeting of the Directing Council in 1989, just one year before the target date for achievement of the goal of polio eradication.
September 1988 OD 225, 131
CD33.R15 The Directing Council,
Having seen Document CD33/14, "Development and Strengthening of Local Health Systems in the Transformation of National Health Systems," Resolution WHA41.341 of the Forty-first World Health Assembly, and the observations of the 101st Meeting of the Executive Committee;
Taking into account Resolution XXI of the XXII Pan American Sanitary Conference, which established the orientation and program priorities of PAHO for the quadrennium 1987–1990;
Recognizing the urgent need to accelerate the transformation of the national health systems in order to promote application of the primary health care strategy and to attain the goal of health for all by the year 2000;
Concerned about the constraints on the proper development of health care imposed by the present economic crisis and by limitations within the health sector itself:
Convinced that the challenge of improving the health of the neediest populations should be met, despite the crisis, with innovative measures for the structuring and administration of available resources;
Cognizant of the exercises already under way in most of the countries for the transformation of the national health systems based on the development of local health systems as part of national decentralization and deconcentration processes; and
Agreeing that it is at the local level that policies and strategies for social development and health care can be implemented on the basis of social participation, intersectoral action, coordination of financial sources, and integration of programs,
1. To thank the Director for Document CD33/14, "Development and Strengthening of Local Health Systems in the Transformation of National Health Systems."
2. To urge Member Governments:
a) To continued and to strengthen their work of defining policies, strategies, programs, and activities for the transformation of national health systems through the development of local health systems;
b) To ensure coordinated participation in the strengthening of local health systems by all government institutions responsible for the delivery of services, especially the social security administrations, and the international cooperation agencies;
c) To promote, in accordance with their institutional realities, the notion of a program-level partnership among the public sector, nongovernmental organizations, and the private sector;
d) To place special emphasis on the provision of resources and decentralization to strengthen the operating capacity of local health systems, and on specific programs for dealing with priority health problems;
e) To give special attention to the aspects cited in Section IV of Document CD33/14 as a response by the sector for the attainment of greater equity, efficiency, effectiveness, and participation;
f) To define and apply suitable indicators and processes for evaluating the development of local health systems and the progress made;
g) To promote research on health system services at the local level.
3. To request the Director:
a) To strengthen technical cooperation to the Member Countries so that resources will be mobilized for activities to transform national health systems and to support priority programs through the development of local health systems and, particularly, to develop the planning process and information systems, administration, community participation, the leadership of the sector, and personnel training;
b) To encourage exchanges of experiences between countries and groups of countries as a form of technical cooperation among countries, and to disseminate among governments and local organizations the available information on advances in the development of local health systems and the transformation of national health systems;
c) To promote the coordinated participation of all health-related agencies, including those providing services, those training human resources and pursuing research, and those for international cooperation;
d) To disseminate to the governments and their ministries and agencies the information available on methodological aspects and advances in the development of local health systems and the transformation of national health systems;
e) To support the monitoring of the evaluation of progress in the countries, and to include this topic in his annual reports during the present quadrennium (1987–1990).
September 1988 OD 225, 133
CD33.R16 The Directing Council,
Having seen Document CD33/23 on the Organization's food and nutrition policy;
Considering the persistence of serious food and nutrition problems in the Region, largely due to the marginal social and economic conditions of important population groups and to the severe economic situation in the countries;
Aware that the nature of the problem will require coordinated multisectoral action, in which the ministries of health carry out specific measures in the national health systems and provide leadership in the technical aspects of their interaction with the other sectors involved;
Concerned that the stabilization and structural adjustment measures being adopted by the countries may aggravate existing deficits in the availability and consumption of food in low-income groups and increase the prevalence of undernutrition;
Recognizing that, in addition to protein-energy malnutrition, there are specific iodine, iron, and vitamin A deficiencies, as well as malnutrition from nutrient excesses and imbalances in the diets of many population groups; and
Taking into account the important role that the Organization plays in the food and nutrition area, both directly and in coordination with other technical cooperation agencies,
1. To urge the Member Governments:
a) To strengthen their multisectoral policies and strategies for increasing purchasing power and improving the availability and consumption of food, particularly in low-income populations and groups at high biological risk, in order to improve their nutritional status;
b) To carry out measures for improving the food habits of the population that will result in a nutritionally balanced diet;
c) To step up food and nutrition activities in national health systems and under the primary health care strategy, with broad social participation, through the effective mobilization of local and external resources, and taking account of the important part played by women in this work.
2. To request the Director, in working with Member Countries, to emphasize technical cooperation in the following aspects:
a) The planning, execution, and evaluation of food and nutrition strategies directed at low-income populations and priority groups;
b) Food and nutrition surveillance;
c) Distribution of food to priority groups, especially mothers and children and other groups at the poverty level;
d) Education and social communication in food and nutrition, including warning against the effects of malnutrition caused by insufficiencies and excesses;
e) Control of specific nutrition deficiencies: iodine, iron, and vitamin A;
f) Preventive nutrition in the management of chronic diseases associated with food and nutrition;
g) Research into balanced diets using basic foods which, to the extent possible, are locally produced.
September 1988 OD 225, 135
CD33.R17 The Directing Council
Having seen Document CD33/22, which constitutes the chapter for the Region of the Americas in the document titled "Monitoring of the Strategies of Health for All by the Year 2000";
Recognizing that the presentation corresponding to the Region of the Americas has been prepared in compliance with the provisions contained in Resolution WHA39.71 of the Thirty-ninth World Health Assembly;
Aware of the difficulties faced by the countries in the implementation and utilization of this instrument-guideline; and
Bearing in mind that the report for this Region will be presented to the WHO Executive Board for consideration by the World Health Assembly along with the reports from the other WHO Regions,
1 To thank the Director for the report which has been prepared and presented by the Secretariat in cooperation with the countries of the Region of the Americas
2 To recommend to the Member Governments that they:
a) Adopt appropriate measures to strengthen both the process of health for all and implementation of the primary health care strategy;
b) Strengthen their health sector information, analysis, and evaluation systems in order to improve program planning and program execution.
3 To request that the Director:
a) Forward the report to WHO Headquarters, together with the comments of the Regional Committee for the Americas;
b) Request WHO to prepare guidelines that are more specific and operational than those used in the past, which have posed serious difficulties in their utilization;
c) Inform the members of the WHO Executive Board designated by Member Countries in the Region of the Americas about the report, the comments of the Regional Committee, and the need to improve the guidelines to be used in the future for monitoring of the health for all strategies;
d) Continue cooperating with the Member Governments to assist them as necessary in preparing any reports and evaluations that may be needed in the future.
September 1988 OD 225, 136
CD33.R18 The Directing Council,
Having seen the report "Drug Abuse Prevention" (Document CD33/19);
Considering Resolutions XLI of the XXVII Meeting of the Directing Council, XXV of the XXI Pan American Sanitary Conference, and XVII of the XXIX Meeting of the Directing Council, in which the Member Governments and the Bureau are requested to collaborate in the strengthening of national and regional activities for the control of drug abuse, in the development of systems to provide information on the size and nature of the problem, and in the study of the causal factors and the impact of drugs on the health of the population in the Region:
Recognizing the importance of the work done by PAHO/WHO in promoting prevention activities and research on drug abuse: and
Considering that the high levels of the traffic in and the production and consumption of illegal drugs are affecting primarily and increasingly the Region's young population, to the detriment of their health and well-being,
1. To support coordination between PAHO/WHO and the Inter-American Drug Abuse Control Commission (CICAD) of the Organization of American States (OAS), the United Nations Fund for Drug Abuse Control (UNFDAC), and other international agencies and bodies doing similar work in the Region.
2. To request the Member Governments to support PAHO/WHO activities in this area by making technical and institutional resources available to the Organization and providing voluntary contributions to the PAHO budget for such purposes.
3. To support, and to encourage cooperation among. Member Governments in their strong enforcement measures against drug traffickers.
4. To request health authorities of the Member Governments to intensify their participation and to provide leadership for groups and commissions that formulate intersectoral policies and programs for drug abuse control in the countries.
5. To promote the participation of the health sector in coordination with other sectors to promote and encourage primary prevention programs for the general population, with emphasis on groups at risk and on adolescents.
6. To request the Director, as available resources permit, including those of the Regional Director's Development Program and from extrabudgetary sources, to increase the attention and resources devoted by the Organization to this problem, and to make every possible effort to undertake the activities recommended in the report and additional ones as they are developed.
September 1988 OD 225, 138
CD33.R19 The Directing Council
Having seen the report on Aedes albopictus (Document CD33/6), which proposes a role for action by PAHO in this matter;
Taking note of Resolution XXVI of the XXXI Meeting of the Directing Council (1985) that urges the Governments of the countries to take appropriate actions to overcome barriers that may be hindering progress in their programs to control or eradicate Aedes aegypti, giving the necessary attention to the allocation of funds, personnel, and materials for these programs, and to implement measures to prevent exportation of the vector to other countries; and
Reaffirming Resolution XXV of the XXII Pan American Sanitary Conference (1986) which, inter alia, recommended to the Member Countries that they initiate or continue the necessary actions for effective surveillance of Aedes albopictus and measures to prevent its further dissemination or to eradicate it, if possible,
1. To urge the Governments of countries and territories infested with Aedes aegypti and Aedes albopictus to implement the resolutions mentioned above.
2. To reaffirm statements contained in the approved Plan of Action for Aedes albopictus control (Document CE99/15).
3. To urge all Member Countries:
a) To take note of the need for adequate legislation and to take the necessary steps to implement regulations regarding importation and exportation of used tire casings;
b) To prepare and implement national plans of action for the control of Aedes albopictus with strategies and activities similar to those existing in Aedes aegypti control programs.
4. To request Member Countries to report immediately to the Director on any infestations of Aedes albopictus.
5. To request the Director to continue to support Member Countries in their surveillance and control activities, with particular reference to dissemination of scientific and technical information which they may use in establishing the necessary legislative and operational steps to prevent the spread of Aedes albopictus.
September 1988 OD 225, 139
CD33.R20 The Directing Council,
Considering the revision made to the schedule of salaries of the professional and higher categories of staff in graded posts, effective 1 April 1988;
Taking into account the decision by the Executive Committee at its 101st Meeting to adjust the salaries of the Deputy Director and the Assistant Director (Resolution XII); and
Having noted the recommendation of the Executive Committee concerning the salary of the Director of the Pan American Sanitary Bureau (Resolution XII); and
Bearing in mind the provisions of Staff Rule 330.3,
To establish the net salary of the Director of the Pan American Sanitary Bureau at US$58,892 (single rate) per annum, effective 1 April 1988.
September 1988 OD 225, 140
CD33.R21 The Directing Council,
Having considered Document CD33/4 and Resolution XIII of the 101st Meeting of the Executive Committee; and
Believing it desirable to adopt an official flag for the Pan American Health Organization, to be flown on the premises of the Organization and to be displayed elsewhere on ceremonial and other appropriate occasions,
1. To adopt and approve as the official flag of the Pan American Health Organization the design described in Document CD33/4.
2. To request the Director to adopt a flag code and to draw up regulations concerning the use of the flag and the protection of its dignity, and taking into account the relationship between the Pan American Health Organization and the World Health Organization.
September 1988 OD 225, 141
CD33.R22 The Directing Council
Having seen Document CD33/24, entitled "Fight Against the Use of Tobacco";
Deeply concerned by the avoidable disease, disability, diminished quality of life, suffering, and premature deaths that occur each year in the Region as the unquestionable consequence of the use of tobacco;
Recognizing that passive smoking may endanger the health and lives of nonsmokers; and
Bearing in mind that there is sufficient evidence to indicate the addictive nature of the use of tobacco,
1. To promote the adoption of public health measures at the regional and national levels to prevent and control the use of tobacco as well as to protect the health of nonsmokers.
2. To urge Member Governments to:
a) Adopt legal measures aimed at protecting the health of nonsmokers;
b) Adopt measures to control the direct or indirect advertising of all types of tobacco;
c) Restrict the consumption of tobacco in any form whatsoever in public places;
d) Establish education programs on the dangers of smoking for students in all schools and at all educational levels;
e) Make systematic and effective efforts to inform the public through all means, including the mass media, as to the dangers of smoking.
3. To request that the Director:
a) Present to the XXXIV Meeting of the Directing Council a regional plan of action for prevention and control of the use of tobacco;
b) Explore the possibility of obtaining extrabudgetary funds from nongovernmental, bilateral, and multilateral organizations, from foundations and professional associations, and from all those sources which may be able to facilitate necessary assistance for the execution of a regional plan of action for the prevention and control of the use of tobacco.
September 1988 OD 225, 141