When the World Health Organization was established in the summer of 1948 as a permanent Specialized Agency an important step was completed in the concerted effort of the United Nations to create a firm foundation for carrying out its economic and social responsibilities under Article 55 of the Charter. The Organization was conceived as a worldwide cooperative effort to make knowledge and skills available to those countries needing them for the improvement of their health services. It was also intended to assist in mobilizing resources for the solution of those health problems which lend themselves to international action.
2. In the years since its inception WHO has been exposed to the problems, pressures, stresses and frustrations commonly associated with post-war efforts to develop cooperation through international institutions. It is, therefore, encouraging that the Director-General has been able to report "further advances toward the objective 'the attainment by all peoples of the highest possible level of health"'. In the foreword to his Annual Report the Director-General also states that "the Organization has now passed through its formative period. Its general policies and problems and relationships, both internal and external, have been established". On the basis of these successes Dr. Chisholm13 may not be over-optimistic in suggesting that "the Organization can look to the future with confidence".
3. At the same time the difficulties already surmounted have served to highlight the conditions necessary for future progress. Measured against the tremendous health needs of mankind the progress to date is a mere beginning. Despite the growing recognition of the important place to be allocated to a healthy community as a prerequisite for economic and social well-being, the resources, both of funds and personnel, that are likely to be available in the immediate future are not unlimited. Even though the Organization's regular budget has doubled since 1948 ($4.4 million to almost $9 million) and it has been the recipient of large appropriations under the Expanded Programme of Technical Assistance, available funds are still far below estimated requirements. Competition for trained specialists and skilled technicians is keen. There is a clear and over-riding need for the most resolute concentration of resources on projects and areas likely to produce the greatest and most immediate return for funds and efforts expended. Although the administration has made serious efforts to direct the main energies of the Organization toward under-developed countries, there is still considerable room for further concentration, consolidation and administrative improvement.
4. The Sixth Health Assembly is in a unique position to give clear direction to the new Director-General in planning a sound work programme for the Organization. In seven years, under Dr. Chisholm's leadership, the Organization has acquired much useful experience, as well as a competent and devoted Secretariat. As a result of past efforts, there is a growing recognition among member states of the assistance the Organization can offer toward improvement of the physical health of member nations of the international community and especially of the under-developed countries. In a very real sense the way has been paved for orderly and purposeful progress toward the Organization's main goals, but the favourable start may well be lost if the Assembly does not take steps to encourage and develop even sounder and more effective policies for the future. By establishing a sound basis for future activities, the Assembly can assure the continuing support of member states. With tangible and lasting results the Organization may, in due course, be able to enlist the increased financial support it considers necessary for the fulfilment of its responsibilities.
5. In considering its general approach to administrative and financial questions in WHO, the Delegation will wish to bear in mind that the total budgets of the United Nations and the Specialized Agencies have increased sharply in recent years and that this fact is causing many member governments to examine carefully the work all of the international agencies are doing, both to ensure that the money is being well spent and to make certain that the budgets do not increase at a rate that is out of proportion to the readiness of member countries to give financial support. It is of interest to note that from a total of $43.4 million in 1947, the combined administrative expenditures of the United Nations and the Specialized Agencies rose to $61 million in 1948; $75 million in 1949; $76.4 million in 1950; an estimated $84.1 million in 1951. In 1952 expenditures ran to an estimated $82.8 million -- the first decrease.
6. In addition to these administrative costs which were financed through the regular budgets of the organizations, member states were requested to make voluntary contributions to a number of special operational programmes established by the General Assembly (Korean Reconstruction, Technical Assistance, Palestine Refugees, International Children's Emergency Fund).
7. Many member states have expressed concern about these growing costs at a time when their resources are already heavily taxed to meet other commitments. Both in parliaments and among the general public there has been a growing recognition of the need for the most careful and judicious allocation of available national resources between the many competing demands. Some United Nations members have even gone so far as to state publicly that, if the costs of international activity continue to increase, they may be forced to withdraw from certain organizations.
8. Recognizing this situation, the United Nations Advisory Committee on Administrative and Budgetary Questions recommended in 1948 that "every endeavour should be made to stabilize expenditure at a level commensurate with the ability of members to pay and to participate at the proper levels in the decisions and the execution of the decisions of the international organizations". More recently the Sixth General Assembly of the United Nations recommended intensification of efforts to stabilize expenditures of the United Nations and all the Specialized Agencies.
9. These developments have been of special interest to the Canadian Government since it has from the beginning given strong support to efforts to develop sound, well conceived programmes in these international organizations and to encourage them to achieve efficient and economic methods of administration. The Canadian Government realizes that just as a fixed amount is not adopted as a continuing estimate for individual government departments year by year, so with international organizations it recognizes that the level of desirable future expenditure is dependent upon a number of unpredictable factors and cannot be determined precisely. What the Government does consider important is the development of a framework within which orderly progress towards the main objectives can be made by the organization concerned. In view of this the Government advocates a thorough and painstaking examination of the programme and budget of each international organization in the light of the main purposes for which the organization was created and taking into account the readiness of member countries to give it the necessary financial support. It is this last consideration -- the willingness of countries to contribute -- which has become a major determining factor in setting budget figures within the past two or three years. A number of financially responsible countries in addition to ourselves -- United States, United Kingdom, France, Australia and others -- have made it clear in meetings of international organizations that they are reluctant at the present time to agree that budgets of international organizations be increased much beyond their existing level. This has been true in WHO as much as in other organizations and the Delegation will undoubtedly find that this is the attitude prevailing amongst the main contributing countries represented at the Sixth World Health Assembly. The objective for 1954 should therefore be to maintain the level of expenditure at a figure as close to that of last year as possible without impairing the effectiveness of the organization.
10. While the particular methods adopted to achieve this objective have varied from agency to agency, they have usually included the following procedures which the Delegation will find of interest in its consideration of the WHO programme and budget:
(a) a searching examination of programmes to ensure that resources are concentrated on the most urgent and productive fields of endeavour, wherever possible, projects of doubtful urgency or secondary importance have been eliminated or reduced in scope;
(b) the elimination of waste and extravagance by a critical examination of budget estimates and by closer supervision over approved expenditures;
(c) organizational and administrative improvements designed to raise efficiency and reduce costs;
(d) better co-ordination of programmes in order to avoid costly overlaps or duplication of effort;
(e) achievement of other operating economies through improved personnel policies and the development of common services.
. . .
Item 6.3 -- Expanded Programme of Technical Assistance (Proposed Cooperation with Colombo Plan)
Under Executive Board Resolution EB 11. R 57.4 Rev. 1 of February 3, the suggestion was made that the Director-General should take all possible action to alleviate the financial deficiency of the WHO. The Board asked the Director-General to explore the possibility of some projects being taken over for financing by other organizations or by private foundations. In this connection Mr. H.C. Grant, an official of WHO who visited Ottawa recently, raised this question informally with Dr. O.J. Leroux14 and put forward unofficially a proposal for Canada to finance on a temporary basis from the Canadian share of Colombo Plan technical assistance funds, the cost of Canadian personnel engaged on WHO projects in the Colombo Plan area.
This proposal may not be brought up formally at the meeting of the Assembly, in which case the Delegation need not raise it. However, in case it is brought up, or in the event that it is the subject of informal discussions, the following comments may be useful for the guidance of the Delegation.
The proposal appears to offer an opportunity for Canada to give concrete expression to the offer which we have made frequently in general terms to cooperate with the United Nations and the Specialized Agencies wherever possible. Under present legislation and policies Canada could not, however, provide assistance out of Colombo Plan funds direct to the WHO. If the WHO would arrange with the countries concerned to ask Canada to provide them with the services of Canadians engaged on WHO projects in their respective countries, we should be prepared to consider each request on its merits. We should, of course, require full information regarding each project on which an expert is engaged, the precise pay and allowances paid in each case, both by WHO and by the recipient country. We should know whether we are expected to pay return transportation to Canada, and any other details which will be of assistance in considering the application here. If there are substantial differences between the terms of employment under WHO arrangements and those under the Colombo Plan, we would not be able to pay these people on higher scales than we customarily pay under the Colombo Plan. However, the information at our disposal suggests that there would not be much difficulty in making appropriate financial arrangements. We feel that both administrative and financial problems would be reduced if each case were treated separately.
While we should not like to see sound projects which have been carefully prepared by the WHO abandoned for any reason, we do not look upon the present proposal as a "bailing out" operation. From our point of view, it is only incidental that the WHO is asking for assistance because they are short of funds. If they have over-budgeted this year, and if they do so again, they should not feel that they can expect financial assistance from us. We are willing to consider the present proposal largely because it offers us an opportunity to consider implementing, under our own arrangements, projects which have had the benefit of prior consideration by a technically-competent body, and for which the benefiting governments may request assistance from Canada. We would regard this arrangement as an opportunity to provide aid to the countries concerned rather than as assistance given to WHO to relieve it of its financial problems.
Item 6.3 -- Expanded Programme of Technical Assistance (general)
In his report to the Executive Board (EB 11/65 Rev. 1 of 16 January, 1953) the Director-General draws attention to the "striking progress in the rate of growth of WHO's part in the Expanded Technical Assistance Programme". At the same time he refers to the difficulties faced by the Organization in its efforts to plan a long term programme and negotiate agreements with participating governments. He also comments on and, (inferentially), criticizes the procedures established by the Economic and Social Council (and the Technical Assistance Board) for overall coordination and integration of the Technical Assistance Programme.
While the Director-General's observations are developed in considerable detail and raise a number of technical and other problems peculiar to the World Health Organization, they are mainly concerned with the following broad policies affecting the review, supervision and financing of the Expanded Programme.
Review and Supervision
(a) indicates disagreement with the criteria applied by the Technical Assistance Board in establishing the priority classification of projects submitted for approval; and
(b) expresses reservations on the procedures developed by the Economic and Social Council for coordinating projects and for achieving integration and balance in the Expanded Programme. In particular he observes that "the reorganization tends to strengthen the centralization and operation of the programme and, to that extent, introduces complexities and, to some degree, limits the freedom of choice and action of the participating organizations". He also observes that "it would be quite impractical to interpose the resident Technical Assistance representatives in their contacts with the health ministries".
(c) indicates that available resources for 1953 will not be sufficient to allow WHO to complete its programme and fulfil its commitments to various governments; and
(d) registers objections to the "lump sum (Biddle) formula" for sharing local costs which has been approved by the Economic and Social Council.
After reviewing the experience of the World Health Organization under each of these headings the Director-General indicates the changes he would consider desirable to meet the World Health Organization's requirements.
Most of the recommendations of the Director-General were endorsed by the Executive Board at its Eleventh Session.
It seems clear that the observations and recommendations of the Director-General (as well as the Executive Board) may be attributed to a genuine desire to press forward vigorously and resolutely with the Organization's campaign against disease and its programme for the betterment of health. Viewed in this light, the efforts as well as the motives, of the Director-General and the Executive Board are to be commended. At the same time, as indicated above, the World Health Organization, like the other Specialized Agencies, is part of the United Nations system. Its interests cannot be separated from those of the other agencies. Rather it must assist in furthering the main aims of the Programme as a whole. To this end WHO should offer full cooperation in developing and improving the machinery and procedures for integration, coordination and the priority allocation of resources. It must also base its long-term plans on a realistic assessment of its probable financial resources. Any failure to take account of the considered decisions of the Economic and Social Council or to exert undue "pressure" on member governments to make expenditures beyond what they consider appropriate must in the long-run tend to undermine confidence, and could easily jeopardize future financial support.
The following paragraphs analyze each of the problems confronting the World Health Organization and suggest a suitable approach for the Canadian Delegation in the event that they are the subject of detailed discussion at the World Health Assembly:
Review and Supervision
(a) The decision of the Economic and Social Council to appoint a Permanent Chairman to the Technical Assistance Board and provide for resident technical assistance representatives in the main regions receiving aid reflected a general desire for "strong central leadership and more continuous central guidance". The Canadian Representative expressed the view that the new arrangements would help to improve the Programme's efficiency and suggested "that final judgment should be withheld until more experience had been gained".
The World Health Organization should be encouraged to report any difficulties it is experiencing in the conduct of its technical assistance activities, so as to enable the Technical Assistance Board and the Economic and Social Council to meet legitimate complaints and effect necessary improvements. The investigation and elimination of specific sources of friction or disagreement should contribute to the evolution of sound relationships and higher administrative and technical efficiency.
The ultimate goal should be the development of machinery, procedures and standards which will
(i) give recipient governments an opportunity to give a clear indication of their immediate requirements and long-term objectives;
(ii) take full advantage of the technical competence of the agencies in planning and evaluating projects in their specific fields, while
(iii) reposing sufficient authority in the Technical Assistance Board for equitable and orderly allocation of resources and effective coordination of the overall programme.
Financing the 1953 Programme
(b) As indicated above, it would be inappropriate to finance additional technical assistance activities through the regular budget of the World Health Organization, supplementary appropriations or the Working Capital Fund. However, there would be no objection to efforts to obtain the co-operation of other international or intergovernmental agencies provided that these arrangements are mutually agreed upon.
For instance, there would be no objection to governments in South East Asia seeking assistance through the Colombo Plan for completion of projects prepared with the cooperation of the World Health Organization. Indeed, from the point of view of Canada's Colombo Plan operations, the assistance of the World Health Organization in planning and determining the value of health projects would be welcome. If a benefiting government were to seek assistance in completing a project (or part of a project) which has been planned or is in the process of implementation by a specialized agency, Canada would be willing to give sympathetic consideration to the project. In cases of this kind the recommendations of the World Health Organization should be helpful in ensuring that the project is as sound (and perhaps better) than could have been planned out of Canadian experience or by the limited Canadian personnel in the area.
Projects of this kind should be considered as an integral part of the Colombo Plan operation, to be undertaken on the request of the recipient government. Participation by the World Health Organization would merely represent a convenient means for utilizing the technical competence of that agency, where its own resources are not adequate to finance the project.
It is, however, important to ensure that the WHO does not look upon these external sources of funds as a means for circumventing the controls and supervision which member governments hope to maintain on technical assistance projects in general. In particular, the Organization should not deliberately enter into excessive commitments in the hope that recipient governments will thereby be inclined to exert pressure on member governments for provision of funds to finance projects of doubtful priority.
Sharing of Local Costs
(c) The formula for sharing local costs is a compromise worked out after the most careful consideration in the Technical Assistance Committee, the Economic and Social Council and the Technical Assistance Board. Full account has been taken of the views of the main contributors, recipient governments and the specialized agencies.
While the new procedures may not be entirely satisfactory to the World Health Organization, the Organization should be willing to give them a fair trial for the next financial period. If the experience during this period is unsatisfactory, it would then be possible to call for a further review and seek appropriate adjustments in the procedures and formula for sharing costs.
. . .
Item 6.4 -- Review and Approval of the 1954 Programme and Budget
The programme submitted by the Director-General (and approved by the Executive Board) calls for an effective working budget of $8,547,202 to be financed as follows (1953 figures are shown for purposes of comparison):
|Less: Casual income
|Less: Assessments on inactive Members
|Assessments on active Members
|Add: Casual income
|Less: Special Fund for Extra Costs of Organizational Meetings
|Effective Working Budget
The Director-General has pointed out that the 1954 Budget is only "slightly higher than that of the preceding year" and has intimated that he would have pressed for higher appropriations if he had not expected "that increased resources will be available through the United Nations Technical Assistance Programme and UNICEF allocations for health programmes". He states that "should this assistance fail to materialize it will be necessary to ask the Health Assembly for a supplementary budget for 1954 to enable WHO to meet the urgent needs of governments".
While the Director-General is to be commended for his personal energy and the enthusiasm imparted to the Secretariat in seeking to advance the objectives of the Organization, it is necessary to caution against financial policies which do not carry the support of the main contributors.
The decision of the General Assembly to urge the specialized agencies to "stabilize" expenditures was not borne out of parsimony or quixotic adherence to an abstract "principle". On the contrary, it expressed the clear and genuine desire of the vast majority of member states for a halt in the upward trend in Agency expenditures during a period of general financial stringency and heavy competing demands. Similarly, the pledges to the Expanded Programme of Technical Assistance established a clear upper limit on the amounts member states are prepared to make available for (UN) technical assistance during the next financial period.
It is to be hoped that the future will bring sufficient improvement in the financial circumstances of most UN members to allow increased allocations to international activities in general and to the WHO in particular. However, in the interim, the World Health Organization (like all the other specialized agencies) must co-operate fully in giving effect to the clearly expressed wishes of most of its member states in current decisions of the General Assembly or other United Nations organs. It would be equally wrong for the WHO to ignore the General Assembly's exhortation for a "stabilized" budget or to seek to circumvent the decisions of the Technical Assistance Conference by requesting supplementary appropriations for technical assistance through the regular budget of the WHO.
In an effort to develop a common budgetary approach, pre-Assembly consultations have been held between the Governments of the United States, United Kingdom and Canada. In these discussions the United States indicated that it was anxious to limit gross assessments to $9 million in order to keep its contribution within the ceiling of $3 million fixed by Congress. (The United States contribution is set at one-third of gross assessments.) Originally the United Kingdom expressed a desire to reduce its overall financial commitment and suggested that the 1954 budget should be reduced to the 1952 level of expenditures. After doubts had been expressed on the desirability (and feasibility) of securing so large a reduction, it was agreed that efforts should be made to "stabilize" the 1954 appropriations at an "effective" level not higher than that provided for 1953, i.e. $8.49 million.
Even though "stabilization" at this level would require absorption of automatic salary increments, it has been agreed that this could be achieved without interfering with any essential activity already under way or contemplated. At the same time it is considered that the search for economies (to absorb the salary increments) will exert a useful compulsion to administrative reforms and programme improvement.
While there is general agreement on an "effective" budget of $8.49 million for 1954, some differences still persist on the exact figure for gross assessments to provide for this level of expenditures. As indicated above, the special circumstances of the United Kingdom may cause it to press for a somewhat lower ceiling than the United States. A further complication may also be introduced if the United States continues to press a proposal to allow China to resume participation in the WHO on the basis of a "token" contribution. (See article on Item 7.5.2).
However, despite this slight divergency in approach, it seems likely that the United Kingdom and United States will be able to reconcile their differences and join in supporting gross assessments not exceeding $9 million for 1954. The Canadian Delegation should co-operate fully in review of the programme and the estimates and support a gross budget for 1954 at or near this level.
. . .
Item 7.3.4 -- Rules and Criteria for Assignment of Countries to Regions
Under the WHO Constitution (Article 44) the Health Assembly was charged with the responsibility of defining the geographical areas in which it was desirable to establish regional organizations. The First Health Assembly established the present six regions: Africa, the Americas, Southeast Asia, Europe, East Mediterranean, Western Pacific. The method employed for defining each region was not uniform, e.g. region of the Americas was defined as including the continents concerned, while with the East Mediterranean region the method was to enumerate the states involved. In this latter process certain political considerations were taken into account, in addition to the realities of purely geographical frontiers. Thus, for example, Pakistan at its own request was assigned to the East Mediterranean region, while Afghanistan, which is closer to the East Mediterranean area than are some portions of Pakistan, was nevertheless assigned to Southeast Asia. During subsequent Health Assemblies assignment of states to regions and, in some cases, reassignment from one region to another took place.
The Fifth Assembly decided that it was necessary to determine basic rules and criteria for the assignment of member countries to regions. For this purpose a list of criteria was prepared and sent to all member countries for comment. In the light of the comments it had received and the study it gave to this question, the Executive Board at its Eleventh Session drew up two draft resolutions for the consideration of the Sixth Health Assembly. The first resolution stipulates that in assignment to regions the wishes of the appropriate sovereign authority of the state or territory shall be paramount. It then lists considerations which such an authority should take into account before stating its wishes. The second draft resolution would resolve that certain criteria be considered in the assignment of territories to regions and of these criteria the wish of the appropriate sovereign authority is placed first.
The views of the Canadian Government on the principle involved in this question were put on record in a letter of November 13, 1952, to the Director-General of WHO. The substantive paragraph of this letter was as follows:
"Although the Canadian authorities recognize the importance of the points included in the plan set out on page 3 of your circular letter, I have the honour to suggest that these matters are better judged by the government of the country concerned or, in the case of a territory not having responsibility for its international relations, by the government of the country responsible for those relations. It is the view of the Canadian authorities, therefore, that the preference of the government of a country, or the government responsible for the international relations of a territory, taken in the light of the criteria suggested in categories (a) to (g) in the closing portion of your letter, should be the determining factor when a country or territory is assigned to a region. It is understood, however, that any assignment to a region will be subject to the overriding consideration that such assignment is administratively practicable from the point of view of WHO."
In keeping with this position and with the attitude of the Canadian Delegation at previous Assemblies, the Delegation should support the first of the two resolutions proposed by the Executive Board.
Apart from the principle involved, there is certain to be discussion at the Sixth Health Assembly of assignment to geographical areas of Morocco and Tunisia and of the French departments of Algeria. Assuming that the protectorate of Spanish Morocco is admitted to associate membership, it is probable that there will also be discussion relating to the region to which it should be assigned. At the Fifth Health Assembly there was extended discussion of this question. The representatives of Tunisia and Morocco who attended the Assembly with the approval of the French authorities said that they were anxious to have the two territories assigned to the European region. The countries of the Eastern Mediterranean region were successful, however, in having action in this direction delayed and in calling for the procurement of opinions from member states. The Canadian Delegation did not support this resolution since it was of the opinion that the request of France and of the representatives of the two territories themselves that Tunisia and Morocco be assigned to the European region should be approved.
The Delegation should take the same position this year on this question but in so doing should emphasize two points. The first is that it places considerable emphasis on assignment of territories to regions in keeping with convenience and effectiveness of administrative operations. This point was mentioned in the letter to the Director-General of November 13, 1952, but might well be stressed again at the Assembly.
. . .
Item 15 -- Report on Organizational Study Relating to Regionalization
Under this item some question may arise about Canada's relationship to the Regional Committee for the Americas. Under an agreement approved by the Second Health Assembly, the Directing Council of the Pan-American Sanitary Organization, with headquarters in Washington, serves also as a regional committee for WHO. In view of the fact that Canada is not a member of PASO and has not associated itself with the work of PASO in its capacity as a regional office of WHO, the Delegation should not make any criticism of the administration or financial arrangements which prevail. In private discussions it would be in order for members of the Delegation to express their interest in seeing the operations of PASO become more fully integrated with WHO as was envisaged by Article 54 of the WHO Constitution.
On various occasions in the past several years, the Director of PASO, Dr. F.L. Soper, has suggested in conversations or informal exchanges of correspondence with Canadian Government officials that Canada should consider joining the Organization. His latest proposal is that Canada would participate in the activities of PASO, making a contribution to PASO's budget and would have full voting privileges on all matters except the Constitution of PASO and the relations of PASO with the Organization of American States and with the World Health Organization. It is on this basis that France, the Netherlands and the United Kingdom participate in PASO meetings on behalf of their dependent territories in this region.
There is some doubt on the part of government officials concerned about the advisability of recommending that Canada should participate in PASO on the basis proposed by the Director. Furthermore, we understand it is the opinion of the Secretariat that if Canada became a member of PASO on this basis it would strengthen the independence and separation of PASO from WHO. The Secretariat hopes that with the nomination of a Latin-American as Director-General of WHO, and with the expiry in two years of the contract of the Director of PASO, there may be a possibility of developing a closer integration between PASO and WHO. The Secretariat would not like to see Canada take any action which would decrease the pressure for further integration.
It is recognized that there would be some value in Canada participating in PASO discussions as a means of exercising some control on the expenditure of WHO funds in the Region of the Americas. In the past Canada has felt that PASO budget proposals for this Region were somewhat excessive but Canadian Delegations have not been in a strong position to quarrel with the amount or nature of the expenditure. In addition, there may be some moral obligation for Canada to help develop in this way a well organized and effective regional organization for the area to which it belongs. From the medical standpoint Canada does not stand to benefit to any extent from participation in PASO but there is no doubt that this would provide an added opportunity to help shape and to guide technical assistance programmes in the medical field which are carried out for the benefit of Latin-America.
An additional argument in the past against the suggestion that Canada join PASO has been the Canadian policy of avoiding closer associations with Pan-American organizations in general. This policy is now under extensive review and Canada's relationship with PASO is being considered in respect of its significance in the broad question of the Canadian attitude toward Pan-American affairs.
With these considerations in mind, the officials with whom Dr. Soper has spoken or corresponded in the past have informed him that they are giving careful attention to his proposals but that they are not in a position to give him any definite reply at this stage. The Delegation should avoid making any public statement on this question other than, if necessary, to express its interest in the work PASO does as a regional committee of WHO and to re-affirm Canada's desire to see closer integration between PASO and WHO.
Item 16 -- Appointment of Director-General and Approval of his Contract
At the 11th session of the Executive Board at a secret meeting and by secret ballot, the Board nominated Dr. M.G. Candau of Brazil to succeed Dr. Chisholm as Director-General in accordance with Article 31 of the Constitution.
Subsequently the Chairman of the Board, Dr. Jafar, who was himself a candidate up until the final ballot, questioned the procedure adopted by the Secretariat in issuing a resolution announcing the nomination of Dr. Candau. While no formal. resolution was in fact put to the Board at the meeting, a resolution was prepared by the Secretariat and presented to the rapporteurs of the Board to the Assembly for initialling at the final meeting of the session. This practice had been followed by the Board many times, but it was this procedure which Dr. Jafar questioned.
On learning of Dr. Jafar's protest, the Director-General immediately circulated members of the Board to find out if they approved of the procedure followed. To date 14 members have indicated their approval. However, the information given to the Canadian Permanent Delegation in Geneva in strictest confidence, is that Dr. Jafar is continuing to be difficult on this point and is proposing to raise the question at the Assembly. Since Dr. Jafar is not questioning the decision but rather the procedure by which the decision was recorded, his motives are not clear. However, a special meeting of the Executive Board immediately before or during the Assembly to formally approve Dr. Candau's nomination, is a possibility.
So far as can be learned Dr. Candau is eminently qualified and highly suited for the post of Director-General and was supported by the Canadian member of the Executive Board. The Delegation should support whatever action appears necessary to secure acceptance of the nomination by the Assembly.
. . .
Item 7.5.2 -- Assessment of China
At the Fifth World Health Assembly consideration was given to a request from the Republic of China that its assessment be reduced in proportion to its current ability to pay and that in this way it be allowed to continue its participation in WHO. The Fifth Assembly passed this question to the Executive Board. At its Eleventh Session the Executive Board expressed the view that a plan should be developed to enable China to resume active participation in the Organization. It recognized that an adjustment could be made either by altering the scale of assessment or by accepting a reduced payment for the amount China owed. It favoured the latter course and has submitted to the Sixth Assembly a proposed resolution whereby a token payment of $15,000 would be accepted in settlement of arrears for the year 1948 and the balance of arrears would be settled later.
2. Similar proposals for settling China's debts have been raised in UNESCO, ILO and the International Hydrographic Bureau. In UNESCO, the General Conference decided in 1951 to postpone decision on this question and meanwhile to permit the representatives of Nationalist China to continue to participate in the Organization. In ILO last year China requested permission to continue to vote despite its excessive arrears. The General Conference of ILO adopted a resolution in which it recognized that China's failure to pay was due to conditions beyond China's control and therefore granted permission to China to participate in ILO affairs. In the International Hydrographic Bureau a vote was taken on a proposal to permit China to continue to participate in the work of the Bureau despite its outstanding arrears. This proposal was carried. In all three of these bodies the United States was in favour, the United Kingdom was against and Canada abstained.
3. In the resolution passed by UNESCO the Organization decided to take into account the action taken by the United Nations. In actual practice, China has not allowed itself to get sufficiently in arrears in the United Nations that consideration of the problem has been necessary. The United Kingdom view on these occasions -- and the United Kingdom brief for the Sixth Health Assembly takes the same position -- was that token payments should be opposed both on principle and because they created a bad precedent in United Nations Agencies in general.
4. The Canadian Government is likewise reluctant to see the principle established whereby member countries will be permitted to clear off their debts by making a token payment. However genuine is China's financial distress, the precedent could lead very quickly to appeals from other countries for reduction of debts on a similar basis.
5. Since the United States is strongly in favour of an adjustment to permit China to continue its participation and the United Kingdom is opposed, the Delegation should content itself with abstaining on this question. Canadian representatives at other conferences have abstained, not only for the reasons given above but also because of our disinclination to take any stand which would appear to strengthen the claim of the Nationalist Government to be the legitimate representative of the Chinese people.
. . .
Brock Chisholm, directeur général de l'Organisation mondiale de la santé jusqu'en mai. Dr. Brock Chisholm, Director-General, World Health Organization until May.
Directeur adjoint, Service de la santé nationale, ministère de la Santé nationale et du Bien-être social; président du Comité des programmes et du budget, sixième Assemblée mondiale de la santé.Assistant Director, National Health Services, Department of National Health and Welfare; Chairman, Committee of Programme and Budget, 6th World Health Assembly.