Doull, Kramer, 1948 - Doull1948

Association of Schools of Public Health
The First World Health Assembly

Author(s): James A. Doull and Morton Kramer
Source: Public Health Reports (1896-1970), Vol. 63, No. 43 (Oct. 22, 1948), pp. 1379-1403
Published by: Association of Schools of Public Health
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Public Health Reports
Vol. 63 * OCTOBER 22, 1948 * No. 43
The First World Health Assembly
By JAMES A. DOULL, Medical Director, and Morton KRAMER, Scientist (R),

Office of International Relations, Public Health Service
The Members of the United Nations have pledged joint and separate
action to promote higher standards of living, full employment, con-
ditions of economic and social progress and development, and the
solution of economic, social, health, and related problems. As a step
toward the solution of such problems, the Economic and Social
Council called an International Health Conference in New York in
1946 to consider establishing a single international health organization
as a specialized agency of the United Nations, integrating all existing
international and regional intergovernmental health organizations.
Since universal membership in the organization was envisaged, the
It is particularly appropriate that the Public Health Reports for

United Nations Week should devote space to the accomplishments of
the first meeting of the Assembly of the World Health Organization.
The basic authority for establishment of a specialized agency for
health is found in the Charter of the United Nations; the first con-
ference to be called by the United Nations, in the summer of 1946,
was the International Health Conference, and the Interim Commis-
sion of the World Health Organization operated for two years on
funds advanced by the United Nations. :Full credit, therefore, must
be given to the parent organization for making possible, for the first
time in history, the establishment of a single health organization,
broad in the scope of its activities and world-wide in representation.
Let us count the accomplishments of this First Health Assembly as
a significant step towards achievement of the objectives of the United
Nations.
LEONARD A. SCHEELE,
Surgeon G-eneral, Public Health Service.
(1379)
October 22, 1948 1380
Council invited representatives from 51 States, Members of the

United Nations, 16 nonmember States, and the Allied Control Au-
thorities for Germany, Japan, and Korea.
On July 22, 1946, representatives of 61 States signed the Constitu-
tion of the World Health Organization, designed to be the directing
and coordinating authority on international health work. It was
agreed that the Organization would come into being when 26 Members
of the United Nations formally accepted the Constitution. An
Interim Commission of 18 States was established to carry on essential
international health functions while the requisite number of ratifica-
tions was obtained. This commission was further instructed to make
preparations for the First World Health Assembly which was to be
convoked within 6 months after the date on which the Constitution
came into force. The World Health Organization came into existence
on April 7, 1948, with the acceptance of the Constitution by the
twenty-sixth and twenty-seventh Members of the United Nations-
Byelorussia and Mexico.
The First World Health Assembly convened in Geneva, Switzer-
land, on June 24, 1948, with delegates present from 52 of the 54 States
then members of the Organization. In addition, observers were
present from 11 nonmember States, from the Allied Control Authori-
ties for Germany, Japan, and Korea and from 10 other international
governmental organizations (appendix 1).
The United States was represented by Dr. Thomas Parran, former
Surgeon General of the Public Health Service, chief delegate, and Dr.
Martha Eliot, Associate Chief of the Children's Bureau and Dr.
James Ragland Miller, Trustee of the American Medical Association,
delegates. The Honorable Ivor D. Fenton, Representative from
Pennsylvania, was the congressional adviser. There were also 5
alternate delegates and 13 advisers (appendix 2).
The accomplishments of this Assembly demonstrate that health
workers of the world can cooperate effectively in planning a program
to promote " the attainment by all peoples of the highest possible level
of health." Despite the varying political backgrounds of the dele-
gates, the Assembly was marked by a spirit of cooperation and "give
and take." Within a period of 30 days-June 24 to July 24-the
Assembly adopted a practical program, a budget, and scale of contri-
butions to launch the Organization on its first year of operation;
elected its executive board and director-general, selected its site of
headquarters, delineated regional areas in which it is desirable to
establish regional organizations, and reached agreement on other
matters essential to the efficient operation of the Organization.
This report reviews the achievements of the Assembly. A
detailed report will be issued later by the Department of State.
1381 October 22, 1948
Organization of the Assembly
Pending the election of the president of the Assembly, Dr. Andrija

Stampar (Yugoslavia), chairman of the Interim Commission, was des-
ignated as temporary president. The Assembly adopted provisional
rules of procedure and established a Committee on Credentials and a
Committee on Nominations, each consisting of representatives of 12
States.
The Assembly approved unanimously the reports of the Committee
on Nominations, designating the president and the 3 vice presidents
of the Assembly; the chairmen and vice chairmen of the 5 main com-
mittees and the delegates of 6 States to complete the 15-member
General Committee as follows:
President: Dr. Andrija Stamipar (Yugoslavia).

Vice Presidents of the Assembly: The chief delegates of Brazil, Egypt, India.
Committee on Program:
Chairman: Dr. Karl Evang (Norway).
Vice Chairman: Dr. F. Castillo Rey (Venezuela).
Committee on Administration and Finance:
Chairman: Dr. M. Kacprzak (Poland).
Vice Chairman: Dr. A. J. van der Spuy (Union of South Africa).
Committee on Relations:
Chairman: Dr. Melville Mackenzie (United Kingdom).
Vice Chairman: Lt. Col. M. Jafar (Pakistan).
Committee on Headquarters and Regional Organization:
Chairman: Dr. J. Zozaya (Mexico).
Vice Chairman: Dr. E. Ungar (Czechoslovakia).
Legal Committee:
Chairman: Dr. C. van deni Berg (Netherlands).
Vice Chairman: Dr. F. S. Maclean (New Zealand).
I)elegates of Six States to Complete the General Committee:
Belgium, China, France, New Zealand, United States of America, Union
of Soviet Socialist Republics.
The General Committee, consisting of the presideint, three vice

presidents, the chairmen of the five main committees and the six
delegates elected by the Assembly, served as the steering body of
the Assembly under the chairmanship of the president. The main
committees, which were committees of the whole, debated the various
agenda items assigned to them, set up working parties to consider the
more technical items and to suggest solutions to the more controver-
sial, and submitted their reports to the full Assembly for final approval.
Seating of the United States
The joint resolution of Congress (P. L. 643), providing for mem-

bership and participation by the United States in the World Ilealth
October 22, 1948 1382
Organization, specifies (section 4) that in the absence of any provision

in the World Health Organization Constitution for withdrawal from
the Organization, the United States reserves its right to withdraw on a
1-year notice, provided, however, that the financial obligations of the
United States shall be met in full for the Organization's current fiscal
year.
The Secretary-General of the United Nations in transmitting the
instrument of acceptance of the United States to the World Health
Organization stated that in view of this provision he was in no posi-
tion to determine whether the United States had become a party to
the Constitution. However, he would be guided by the action of the
Health Assembly in regard to this matter.
Pending its decision on the validity of the ratification of the Con-
stitution by the United States, the Assembly, at its second plenary
meeting on June 24, decided to seat the United States provisionally
with full rights as a Member.
At the tenth plenary meeting on July 2, the Assembly took up the
validitv of the United States ratification. Sir Wilson Jameson, chief
delegate of the United Kingdom, asked that a realistic and not a
legalistic viewpoint be taken. He stressed the important contribu-
tions that the United States has made to the advancement of public
health and that it would be unthinkable that a World Health Organi-
zation be established without the fullest possible participation by
the United States. He urged that full membership be granted to
the United States without further delay. Sir Dhiren Mitra (India)
supported this point of view, adding that the United States should not
be placed in a more favored position than other Members and pro-
posed that the Constitution be amended to permit any Member to
terminate its membership on a 1-year notice.
Dr. Thomas Parran assured the Assembly that the United States
stands fully behind the Organization. He added that the reaction
of the Assembly to the United States instrument of acceptance would
be brought to the attention of the President and the Secretary of
State.
Dr. Nicolas Vinogradov, chief delegate of the U. S. S. R., stressed
that the United States was the only Member to make any reservations
in its acceptance of the Constitution. Nevertheless, in view of the
assurances given in the statement of the delegate of the United States,
the U. S. S. R. supported membership of the United States.
The president then asked that the Assembly show a unanimous
spirit of friendly collaboration and world-wide interest by admitting
the United States as a full Member. There were no objections and
the United States acceptance of the Constitution was approved
unanimously.
1383 October 22, 1948
Election of the Executive Board
Article 24 of the Constitution specifies that the Health Assembly,

taking into account an equitable geographical distribution, shall elect
18 Members, each to designate a person to serve on the Executive
Board. These Members are elected for 3 years and may be reelected.
Of the Members elected at the First Health Assembly, one-third are
to serve a term of 1 year, one-third for 2 years, and one-third for 3
years, as determined by lot.
Neither the Constitution nor the rules of procedure of the Assembly
provide for the nomination and election of members of the Executive
Board. The president proposed to the General Committee that in
order to facilitate the work of the Assembly it submit a slate of 18
names to the Assembly for approval. A free election was not con-
sidered practical on the grounds that an equitable geographical dis-
tribution could not be assured. Maintaining that this was an un-
democratic procedure, the representative of the United States ob-
jected strongly to the submission of a single slate of 18 States on which
the Assembly would have the opportunity of voting only "yes" or
"no.'' No agreement could be reached on any alternative procedure
and the committee adopted the president's proposal with the United
States' member dissenting.
When the president submitted the slate to the Assembly, the dele-
gate of Switzerland objected and asked for postponement so that
countries not yet represented on the General Committee might have
an opportunity to study the slate more carefully. This proposal was
strongly supported by the delegates of the Philippines, Venezuela,
Pakistan, Belgium, Turkey, Liberia, Italy, the United States and
Greece, and opposed with equal vigor by the delegates of Sweden,
New Zealand, Burma, Norway, India, Hungary, Poland, Czechoslo-
vakia, Ukraine and U. S. S. R. In view of the discussions that took
place, the president announced that the vote on the slate would be
postponed.
Because of the reaction to the proposal the chief delegate of the
United States presented a resolution at the next plenary session on
behalf of the delegates of Brazil, China, Egypt, France, Switzerland,
the United Kingdom and the United States, concerning the future
procedure for nomination and election of members of the Executive
Board; proposing that the Executive Board study the procedure
followed in the United Nations and its specialized agencies for selec-
tion of members of comparable organs and make recommendations to
the Second World Health Assembly concerning rules of procedure
for annugl nomination and election of six members of the Board.
Upon the suggestion of the president, the Assembly adopted the
resolution unanimously.
October 22, 1948 1384
Following speeches by the delegates of Italy and El Salvador, the

president called for a secret ballot on the proposed slate. Thirty-nine
votes were recorded for the slate and 10 against. The president
drew lots to determine the length of service, with the following results:
One year-Auistralia, Ceylon, Iran, Norway, United Kingdom, United
States Of America.
Two years-Brazil, China, Egypt, France, Mexico, Union of Soviet Socialist
Republics.
Three years-Byelorussia, India, Netherlands, Poland, Union of South
Africa, Yugoslavia.
Election of the Director-General
By a vote of 46 to 2 the Health Assembly elected Dr. Brock Chisholm,

executive secretary of the Interim Commission, as the Director-
General of the Organization. The Director-General will serve for
5 years with an annual salary of $18,000 and an annual representation
allowance of $6,500. Subject to the authority of the Executive
Board, he exercises the functions of the chief technical and adminis-
trative officer and performs such duties as may be specified in the
Constitution and in the rules of the Organization, and/or as may be
assigned by the Health Assembly or the Board.
Program
The functions of the Organization as outlined in the Constitution

are broad and diverse. Manifestly it will be impossible for the
Organization to carry out a comprehensive public-health program in
its initial year and perhaps not for many years. A selection was
necessary and the Assembly approached the matter in a practical
manner. There are statutory duties such as administration and
revision of the sanitary conventions, and making of recommendations
for international control of habit-forming drugs, for revision of the
international lists of causes of death, and for unification of pharma-
copoeia. Certain other technical activities inherited from the League
of Nations have proven to be of great usefulness, notably the establish-
ment of international standards for prophylactic and therapeutic
agents which can be determined only by biological methods. These
items, involving establishment of expert committees, employment of
the necessary secretariat, and issuance of numerous publications,
provide a basic core of responsibilities and duties and immobilize a
considerable proportion of the budget. The recommendations of the
Interim Commission were adopted in substance. The final actions
are reviewed.
1385 October 22, 1948
Statutory and Inherited Functions
International Epidemiology.-The Executive Board was instrlceted to

establish the Expert Committee on International Epidemiology and
Quarantine of the World Health Organization, and in addition an
Expert Committee on Plague. It was also decided:
That the Expert Committee on International Epidemiology and Quarantine
should include a subsection on quarantine and have available the services of a
legal subcommittee, a panel of experts on yellow fever, and joint study groups
on cholera, smallpox, vaccination, and other epidemiological problems.
That there should be set up within the Secretariat a division for the admin-
istration and revision of international sanitary legislation and for epidemio-
logical studies, publications of epidemiological reports, and codes and quaran-
tine directories.
That the Executive Board be instructed to establish a small committee of
three experts with broad knowledge of insecticides and their uses, preferably
representatives of the more important existing national insecticides commit-
tees, and to set up a panel of experts possessing specialized knowledge of
various subjects such as the chemistry of insecticides, disinsectization of air-
craft, mechanical devices for such disinsectization, airplane dusting and
insecticide application in houses.
Health Statistics.-The Executive Board was instructed to establish

an Expert Committee on Health Statistics, including necessary sub-
committees, and a section within the Secretariat on health statistics.
Additional resolutions adopted were as follows:
That the World Health Assembly adopt the draft World Health Organiza-
tion regulations regarding nomenclature with respect to diseases and causes
of death. (Certain modifications regarding the legal aspects of these regula-
tions were referred to the Legal Committee.)
That, as an interim measure, members include for statistical purposes
among live-born infants all infants who after complete separation from the
mother showed any sign of life.
That in publishing statistics, it should be indicated whether the tabulated
vital data refer to the place of occurrence or to the place of residence, whatever
the definition of "residence" may be.
That the principle contained in the recommendation and resolution of the
Paris Revision Conference regarding the establishment of inational committees
oIn vital and health statistics be endorsed, and that the Executive Board be
instructed to take steps necessary to coordinate the work of such committees
with that of the World Health Organization.
Biological Standardization.-The Board was instructed to establish

an Expert Committee on Biological Standardization with necessary
subcommittees on antibiotics, antigens, bloodgroups, vitamins and
hormones, and a section on biological standardization in the Secretar-
iat. It was also agreed to continue grants to the State Serum Insti-
tute, Copenhagen, and the National Institute for Medical Research
at Hampstead, England, and to take over the International Salmonella
Centre at Copenhagen.
806365-48 2
October 22, 1948 1386
Unification of Pharnacopoeias.-The Board was instructed to estab-

lish an expert committee and a section in the Secretariat.
Habit-Forming Drugs.-The Board was instructed to establish an Ex-
pert Committee of not more than 10 members (pharmacologists) to
act in an advisory capacitv to the World Health Organization and
the United Nations.
General Program
First Priority Activities.-Many suggestions were received by the
Interim Commission as to the most profitable fields of assistance to
governments into which the Organization might enter in 1949.
In determining the priority the prime considerations of the Com-
mission and the Assembly were the magnitude and seriousness of the
problem and the probable effectiveness of the available armamen-
tarium with which to attack it.
The Commission unanimously recommended first priority to malaria,
tubercuilosis, venereal diseases, and maternal and child health. The
Assembly concurred but added nutrition and environmental sanita-
tion. For each of these fields the Board was instructed to set up an
expert committee, and a section in the secretariat. For tuberculosis
a special expert panel on BCG was established. The question of
establishing panels of corresponding experts in each subject was re-
ferred to the Board for further study.
For nutrition and environmental sanitation only general program
policies were established and the details were left to the Secretariat.
The Executive Board was instructed to establish with FAO a joint
advisory committee on nutrition consisting of not more than 10 mem-
bers. The subjects of endemic goitre and pellagra were referred to
the committee when formed. As regards environmental sanitation,
it was agreed that the staff shall include at least one qualified sanitary
engineer with field experience and that the subjects to be dealt with
shall include urban and rural sanitation and bygiene, housing, town
and countrv planning, and natural resources.
Programs in some detail were adopted for malaria, tuberculosis,
venereal diseases, and maternal and child health, providing for scien-
tific investigations, assistance to governments in the form of expert
advice, fellowships, visiting experts, and field teams to demonstrate
practical programs.
In addition, the Assembly recommended that governments take-
subject to conditions in their respective countries-preventive, cura-
tive, legislative, social and other methods necessary for control of ma-
laria, tuberculosis, and venereal disease, for protection of the health
of mothers before, during, and after confinement, and for welfare and
upbringing of children. Special attentioD was directed to the fol-
lowing:
1387 October 22, 1948
MALARIA
Systematic registration where practicable of malaria cases.

An appropriate organization for detecting new cases.
Adequate treatment.
Measures, so far as practicable, for tracing movements of carriers to prevent
spreading of the disease.
Extensive use of insecticides.
Availability of therapeutic and prophylactic treatment to all who require it
regardless of ability to pay.
Improvement of methods of irrigation, cultivation, and animal husbandry (zoo-
prophylaxis wherever advantageous) so that they will reduce rather than inten-
sify malaria prevalence.
Careful planning of housing programs, taking into consideration the relevant
phases of malaria surveys.
Active support of scientific research directed toward improving therapy and
malaria prophylaxis.
TUBERCULOSIS
Registration of every case of confirmed and suspected tuberculosis and of death

from tuberculosis.
Making available institutional treatment to all who require it, regardless of
ability to pay. If such treatment is not possible, treatment at home with ade-
quate isolation.
Contact tracing or control.
Establishment of clinics for diagnostic examination and follow-up, with such
service available free of charge.
Establishment of procedures to ensure examination of all tuberculous suspects.
Provision of a sufficient number of beds in tuberculosis hospitals.
Routine tuberculin-testing free of charge when necessary.
BCG vaccination free of charge when necessary.
Compensation for lowered earning ability of afflicted persons.
Rehabilitation of patients.
Extermination of tuberculous cattle.
VENEREAL DISEASES
Notification of primary and secondary syphilis; declaration of sources of inlfec-

tious contacts, and national and international contact tracing.
Systematic premarital and prenatal examinations, including serological tests
for syphilis.
Comparative study of antigens and serodiagnostic methods in syphilis on the
national and international plane.
Establishment of optimum standards of treatment and making such treatment
available to all, emphasizing the importance of preventive treatment of syphilis
in pregnancy.
Comparative treatment of persons suffering from communicable venereal
diseases and compulsory hospitalization of those refusing treatment.
MATERNAL AND CHILD HEALTH
Protection of the health of adolescents-particularly girls-and expectant and

nursing mothers employed in gainful occupations and prohibition of the gainful
employment of children.
Introduction of leave of absence for expectant mothers and leave after the
October 22, 1948 1388
birth of the child, with continuation of adequate wages for the duration of leave.
Access to adequate attendance for mothers during the birth of the child both
at home and in hospital, especially for artificially aided births.
Organization of nongovernmental and governmental institutions where ade-
quate medical consultation on the hygiene of pregnancy and on feeding, care, and
upbringing of children can be made accessible to families.
Other Activities.-Faced with budgetary and personnel limitations

the other activities which were proposed and considered desirable
were grouped and given priority ranking for the guidance of the
Executive Board as follows:
PUBLIC HEALTH ADMINISTRATION
Second priority was given to public health administration, which includes

hospitals and clinics, medical care, rehabilitation and medical social work, nursing,
health education, industrial hygiene, and hygiene of seafarers. The minimal staff
will include one public health administrator and one nurse.
PARASITIC DISEASES
Third priority was given to parasitic diseases, which will include activities
relating to ancylostomiasis, filariasis, leishmaniasis, schistosomiasis, and trypan-
osomiasis. The minimal staff will include one parasitologist. The Board is au-
thorized to establish a nuclear committee of experts and also panels of experts
possessing specialized knowledge of these diseases.
VIRUS DISEASES
Fourth priority was given to a group of virus diseases, including poliomyelitis,

influenza, rabies, and trachoma. The minimal staff will include at least one
expert on virus diseases, and a nuclear committee and panels of experts were
authorized. It was also agreed to continue the grant to the World Influenza
Centre established at the National Institute for Medical Research in London.
MENTAL HEALTH
Fifth priority was given to mental health including alcoholism and drug addic-
tion. The staff will include at least one expert. A nuclear committee of experts
was authorized. The Board was further directed to take such interim action as
may be necessary and practicable on any recommendations for the Organization
which may be made by the International Congress on Mental Health.
MISCELLANEOUS
The study of statistics of cancer and rheumatoid diseases was entrusted to the
Section on Health Statistics; of statistics of leprosy to the Epidemiological Sec-
tion; and the subject of technical education was referred to the Section on Fellow-
ships.
A proposal by the delegation of Czechoslovakia to establish a bureau to give
advice on procurement of medical supplies and equipment was referred to the
Board.
Fellowships
The Assembly established an active fellowship program to assist in

implementing the proposed major activities of the Organization, to
1389 October 22, 1948
assist governments in strengthening their health services, and to meet

the probable increased demands from countries for which no pro-
vision was made in the UNRRA program or by the Commission in the
continuation of the UNRRA program.
In the granting of fellowships the Assembly accepted the following
guiding principles: (a) the possibility of granting fellowships of short
duration to candidates in key positions; (b) the desirability of con-
tributions being made by countries in a position to do so toward the
cost of the fellowships granted to their candidates; (c) the possibility
of additional fellowships being available for candidates fully paid for
by their governments; (d) the extension of the fellowship programs to
undergraduates and foreign graduates employed by the governments
of countries not possessing their own graduate health personnel
suitable for fellowships, provided that these fellows agree to return at
the termination of the period of study to the country granting the
fellowship.
Publications
The Assembly approved a program of publications to be handled

by a central editorial service as part of the Secretariat. This includes:
Bulletin of the World Health Organization.-For material relevant to the work

of expert advisory committees, and hence the main scientific organ of WHO.
Technical Supplements to the Bulletin and Monographs.-For the publication of
works of too specialized or detailed a character for the Bulletin, including special-
subject bibliographies, international pharmacopoeia, International Lists of Dis-
eases and Causes of Death, monograph on cancer-treatment statistics, interna-
tional list of treatment centers for venereal diseases (under the Brussels Agree-
ment), monograph of modern methods of treatment of venereal diseases.
Chronicle of the World Health Organization.-A monthly report of activities (in-
cluding technical publications) of WHO for the general information of the medical
and allied professions.
International Digest of Health Legislation.-Reproductions and translations
of, or extracts from, laws and regulations of significance in public-health adminis-
tration (published in fulfillment of statutory obligations inherited from the Office
International d'Hygiene Publique).
Additional publications are: Weekly Epidemiological Record; Epidemiological
and Vital Statistics Report; International Health Yearbook; International Maritime
and Aerial Ouarantine Handbook(s); Epidemiological Telegraphic Code (Codepid);
Epidemiological and Vital Statistics Annual; Weekly Fasciculus, Singapore Epidem-
iological Intelligence Station; Annual Report, Singapore Epidemiological Intelli-
gence Station.
World Health Day
Upon a request from the representative of Iran, the Assembly

authorized the Executive Board to sponsor a World Health Day and
suggested that July 22 be chosen in commemoration of the date of
signing of the Constitution of the World Health Organization.
October 22, 1948 1390
Administration and Finance
Scale of Contributions
Article 56 of the Constitution specifies that the expenses of the

World Health Organization are to be apportioned among the Members
in accordance with a scale fixed by the Health Assemblv
The Health Assembly, with the United States dissenting, adopted
a unit scale of contributions for the years 1948 to 1949 based on cri-
teria used by the United Nations in assessing its memibers for 1948
(table 1).
Table 1. Scale of contributions to the WHO for the financial years 1948 and 1949
(Sept. 1, 1948-Dec. 31, 1949)1
Country Units Percent Country Units Percent
United States of America - 4,787 37.96 Byelorussia - -26 .21

United Kingdom -1 378 10.93 Hungary 3 _-_-_._._._. 24 .19
Union of Soviet Socialist Repub- Peru 2 ___. _____.__.__._._. 24 .19
lics - 761 6.03 Austria 3 _._._._._._._._._ ._. 22 .17
China -720 5.71 Uruguay 2 -- ____.___._.__. 22 .17
France ----------- 720 5.71 Greece - - -- 20 .16
India-Pakistan -474 3.76 Iraq - - 20 .16
Canada -384 3.04 Bulgaria 3 __-___- - 17 .13
Italy 3_----- - __--_------------- 252 2.00 Finland 3 __.__.__._. _._. 17 .13
Sweden -245 1.94 Syria - -14 .11
Australia -236 1.87 Bolivia 2 _____._.____._. 10 .08
Argentina 2_______________________.222 1. 76 Ethiopia - -10 .08
Brazil -222 1. 76 Saudi Arabia - -10 .08
Netherlands - -- ------- 168 1.33 Lebanon 2 -____-_ _ _____ _ 7 .06
Belgium -162 1.28 Afghanistan - -6 .05
Union of South Africa -- - 134 1.06 Burma - -6 .05
Switzerland 3 -120 .96 Dominican Republic- 6 .05
Poland -114 .90 Ecuador2 -6 .05
Turkey -109 .86 El Salvador - -6 .05
Czechoslovakia -108 .86 Guatemala 2 - -6 .05
Ukraine -101 .80 Luxemburg 2 __-__-__--________ 6 .05
Denmark -95 .75 Panama 2 _-______--__ 6 .05
Egypt -95 .75 Albania 3 - -5 .04
Mexico
--- ------------- 76 .60 Ceylon 3 - -5 .04
New Zealand -60 .48 Costa Rica 2 5 .04
Norway -60 .48 Haiti ------------------- 5 .04
Chile 2 -.. -----------------. 54 .43 Honduras 2 5 .04
Iran -54 .43 Iceland - -5 .04
Portugal 3 ----------------------- 47 .37 Liberia - -5 .04
Colombia 2 44 .35 Monaco 32--------------------- - 5 .04
Ireland 32- __________..________-_-. 43 .34 Nicaragua 2 - -5 .04
Roumania 3 42 .33 Paraguay 2 - -5 .04
Yugoslavia -40 .32 Transjordan 3 5 .04
Cuba2 -35 . 28 Yemen2 - -5 .04
Philippines - ------ 35 .28
Siam -32 .25 Total - -12,612 100.00
Venezuela -32 .25
1 The states included in this table are Members of WHO and the United Nations except those indicated
by the following superscripts:
2 Non-Members of WHO, but Members of the United Nations.
a Members of WHO, but Non-Members of the United Nations.
UJnder the scale the United States' contribution is 4,787 units out
of a total of 12,612, or approximately 38 percent. In voting against
the scale, the representative of the United States held that it was an
unsound policy for an organization to rely too heavily on the financial
support of a single Member and that no Member should contribute
more than 25 percent of the budget. He maintained further that the
United Nations scale of contributions was not applicable to an organ-
ization with a relatively small budget such as the World Health
1391 October 22, 1948
Organization. As a result, it was agreed that the scale of contribu-

tions for the financing of 1950 operations would be reconsidered by the
second World Health Assembly.
Budget for 1948
The Health Assembly adopted a budget of $4,800,000 for the

period from September 1 (when the Interim Commission ceased to
exist) to December 31, 1948. Specific provision is made for continua-
tion of all activities carried on by the Interim Commission, repayment
to the United Nations of the full amount of the loans made to finance
the activities of the Interim Conmmission (totaling $2,150,000) and
the establishment of a working capital fund of $1,650,000. An addi-
tional $35,000 was allotted for organizational meetings and $965,000
for the Secretariat, teclmical services and technical meetings.
Budget for 1949
Upon a proposal of the South African delegation, a ceiling of

$5,000,000 was placed on the budget for the first full financial year,
January 1-December 31, 1949. This is 21 percent less than the
amount of $6,324,000 recommended by the Interim Commission for
the program it had proposed. The summary of the budget is as
follows:
tiopria- Purpose oe
tion section of a
appropriation
rprainU. S. Amount in
dollars
PART I
1 Organizational meetings -$264, 000
PART II
2 Secretariat - - 2, 411, 105
3 Regional Offices -300, 000
4 Epidemiological Intelligence Station, Singapore-- - 591 365
5 Advisory and demonstration services to governments 903, 350
6 Technical services--- 862, 500
7 Technical meetings-- 199, 680
Total, Part II-- 4, 736, 000
PART III
8 Working capital fund I
Total, all parts -5, 000, 000
I Established in 1948 Budget.
The Assembly took no direct action on the recommendations of the

Administration and Finance Committee regarding allocation of funds
to specific program items. The Director-General and the Executive
Board presumably will be guided by the specific allocations approved
by the Committee on Administration and Finance as follows:
October 22, 1948 1392
Recommendations of Committee on Administration and Finance Regarding Allocation of

Funds to Specific Items for the Calendar Year Starting Jan. 1, 1949
Organizational meetings -- $264, 000

Malaria--- 235, 320
Tuberculosis--- 270 520
Maternal and child health--- 167, 250
Venereal diseases--- 129 320
Nutrition-- 51, 800
Environmental sanitation--- 114, 240
Public health administration -. 120, 450
Parasitic diseases-- 30, 750
Virus diseases-- 13, 310
Mental health-- 13, 900
Medical supply advisory services - -19, 500
Pilot project in Haiti
Coordination of medical abstracting services-- 6, 000
Coordination of International Congresses of Medical Sciences - - 15, 000
Fellowship, med. lit., and teaching equipment - -705, 390
International standards --75, 750
International pharmacopoeia - -34, 380
International epidemiology-- 137 240
Health statistics-- 97 920
Epidemiological Intelligence Station, Singapore-- 56, 865
Publications ---_------------------- 108, 000
Editorial services-- 161, 640
Public information-- 77 850
Library and reference services - -103, 120
Office of Director-General-- 235, 000
Regional offices-- 300, 000
Technical liaison unit --52, 840
Legal services --23, 820
Budget and management - -34, 290
Personnel --45, 000
Conferences and general services - -263, 882
Finance and accounting --95, 430
Audit -------------------------------------------- 24, 700
Common services-- 600, 000
Expert Committee on Habit-forming Drugs - - 9 000
Initial recruitment costs -150, 455
Subtotal-- 4 843, 932

Distribution of remaining $156,068.
1. Publications and editorial services -50, 000
2. Program: for allocation by the Executive Board to increase allow-
ances for malaria, tuberculosis, venereal diseases, maternal and
child care, public health administration and coordination of
Congresses of Medical Science- 70, 000
3. Office of Director-General-- 36 068
Working capital fund 1
Grand total-- 5 000 000

I Established in budget for 1948.
Permanent Headquarters
Without dissent, Geneva was selected as the permanent head-

quarters.
The United States delegation had expressed the view that considera-
tion should be given to some city more prominently identified with
medical research and teaching. Not supported, this view was not
1393 October 22, 1948
pressed. In his speech of welcome to the Assembly, the head of the

Department of the Interior of the Swiss Government stated that
Geneva authorities recently submitted a plan to establish there an
Institute for Hygiene and Public Health, which would be national
and international in scope.
Regional Arrangements
The Assembly considered three formal proposals regarding the

delineation of geographical areas. The first, by the Egyptian delega-
tion, proposed integration of the Regional Bureau at Alexandria with
the World Health Organization. The Egyptian Government also
offered a large and suitable building at Alexandria. The proposal was
supported by a report from the chairman of the Interinm Commission
after a personal inspection. The second came from the Secretary of
Health of the Philippines who proposed a regional center at Manila
and offered to provide facilities. The Indian delegation sought to
establish headquarters of a regional organization for the Southwest
Pacific at Mysore and also offered a suitable building.
Additional proposals were made. The urgent health needs of
Africa were stressed especially by the representative of Liberia who
advocated an organization centered at Monrovia. The prevailing
opinion, however, was that if such a region should be established the
most ad vanitageous headquarters site would probably be at Leopold-
ville. The delegation of the U.S.S.R. pressed for a temporary regional
organization for Europe to serve countries devastated by the war.
Later this delegation dropped the ide i of a regional organization but
urged strongly the need for a European office specifically for this
puirpose.
In each area proposed, it became clear that further consultation
with governments and further study of problems such as mettFods of
supplemental financing and rights of Associate Members were neces-
sary. Nevertheless, opinion was unanimous that the principal work
of the Organization must be conducted on a regional basis.
As a first step, the Assembly, noting a reservation made by the
chief delegate of Greece, approved six geographic areas where it might
be desirable to establish regional organizations:
Eastern Mlediterranean Area: Egypt, Saudi Arabia, Iraq, Syria, Lebanon, Trans-
jordan, Yemen, Turkey, Pakistan, Greece, Ethiopia, Eritrea, Tripolitania, Do-
decanese Islands, British Somaliland, French Somaliland, Aden, Cyprus, Palestine.
Western Pacific Area: Australia, China, Indochina, Indonesia, Japan, Korea,
the Philippines, New Zealand, and provisionally the Malay Peninsula.
Southeast Asia Area: Burma, Siam, Ceylon, Afghanistan, India. (Inclusion of
the Malay Peninsula to await decision as to which regional organization this
country desires to join.)
European Area: Comprising the whcle of Europe.
806365-48-3
October 22, 1948 1394
African Area: "A primary region is suggested for all Africa south of the 20
degree N. parallel of latitude to the western border of the Anglo-Egyptian Sudan,
to its junction with the northern border of the Belgian Congo, thence eastwards
along northern borders of Uganda and Kenya; and thence southwards along the
eastern borders of Kenya and the Indian Ocean."
American Area: The Americas.
Secondly, the Assembly instructed the Executive Board to establish

regional organizations as soon as the consent of the majority of
Members in each indicated area was obtained. The Board was in-
structed to integrate the Alexandria Regional Bureau with the World
Health Organization as soon as possible, through common action, in
accordance with Article 54 of the WHO Constitution; and to establish
a temporary special administrative office for Europe as soon as
possible for the primary purpose of dealing with the health rehabilita-
tion of war devastated countries.
Relations
As one of the specialized agencies referred to in Article 57 of the

Charter of the United Nations, the World Health Organization must
be brought into relationship with the United Nations. Furthermore,
to fulfill its functions as a single directing and coordinating authority
in international health work, it is necessary for the WHO:
To establish and maintain effective relation.ships with various international

bodies that deal with problems of concern to the WHO (the Economic and Social
Council and its comimissions, the specialized agencies, the United Nations Inter-
national Children's Emergency Fund).
To assume the duties and functions of the preexisting interniationial organiza-

tions in the field of health (the Office International d'Hygiene Publique, United
Nations Relief and Rehabilitation Administration, the Health Organization of
the League of Nations).
To effect, in due course, integration with the Organization of the preexisting

health organiizations (Pan American Sanitary Organization and Pani Arab Re-
gionial Health Bureau).
To make arrangem-ents for effective relationships wvith nongovernmental pro-

fessional and scientific groups which contribute to the advancement of health.
To accomplish these ends, the Arrangement of July 22, 1946, in-

structed the Interim Commission to enter into negotiations to pre-
pare necessary agreements and to develop appropriate methods of
liaison. The Assembly took the following actions on the recom-
mendations of the Interim Commission:
The United Nations Economic and Social Council, and Trustee-

ship Council
The Health Assembly approved the draft agreement with the

United Nations, previously approved by the General Assembly on
1395 October 22, 1948
November 15, 1947. The agreement, which is now in force since an

identical text has been approved by both the General Assembly and
the Health Assembly, recognizes the WHO as the specialized agency
responsible for taking such action as may be appropriate under its
Constitution for the accomplishment of its priescribed objectives and
sets the pattern of cooperation between the World Health-Organization
and the United Nations.
The Assembly agreed to continue and extend the liaison and
cooperation initiated by the Interim Commission with the Economic
and Social Council and its commissions, in particular the Social,
Population, Statistical, Narcotic Drugs and Economic and Employ-
ment Commissions, and to advise and to assist on health matters
both the Trusteeship Council and the Special Committee of the
General Assembly on the Transmission of Information under Article
73 (e) of the Charter. Collaboration was provided with the United
Nations in its study of the prevention of crime and treatment of
offenders, in housing and town and country planning, in preparation
of the Declaration of the Rights of the Child, and in conservation and
utilization of resources. In addition, the Director-General was
instructed to cooperate fully with the Coordinating Committee of the
United Nations, composed of the Secretary-General and the heads
of all the specialized agencies, which was established to consider
administrative and all problems concerned with the implementation
of relationship agreements.
United Nations International Children's Emergency Fund
By unanimous decision the General Assembly created on December

11, 1946, the International Children's Emergency Fund, stipulating
that "the Fund shall be authorized and administered for the benefit
of children and adolescents of countries which wvere victims of aggres-
sion as well as those at present receiving UNRRA assistance, and for
child health purposes generally." The fund consists of assets made
available bv UNRRA or anv voluntary contributions made available
by governments, private organizations or individuals and is adminis-
tered by an executive director under policies established by an execu-
tive board composed of representatives of 26 governments in accord-
ance with policy set by the Economic and Social Council and its
Social Commission.
The Interim Commission cooperated actively with UNICEF by
assigning personnel to it, by making available the advice of expert
committees, and by joining with FAO to form a committee on child
nutrition to advise UNICEF in its child-feeding program. The
UNICEF has undertaken projects on BCG immunization, fellowships
and venereal disease control. The most extensive of these is the BCG
October 22, 1948 1396
immunization project which calls for the tuberculin testing of 50

million children in Europe alone and the vaccination of the estimated
15 million negative reactors. The Executive Board of the UNICEF
has allocated $4 million for the undertaking, of which $2 million is for
Europe and $2 million for countries outside Europe. Implementation
of the program is entrusted to the Danish Red Cross, under the direc-
tion of Dr. Johannes Holm, who also served as chairman of the Expert
Committee on Tuberculosis of the Interim Commission. The Interim
Commission agreed to furnish advice on the medical aspects of the
campaign. Responsibility for the field work, however, remained
with UNICEF and the participating governments.
Complying with a request made in April by the Social Commission,
the Health Assembly considered the Fund's program of BCG vaccina-
tion, fellowships and control of syphilis to determine the ability of
the WHO to administer programs in these fields.
There was general agreement among the Assembly delegates that
the health projects undertaken by UNICEF were clearly in the field
of competence of the WHO. There was disagreement, however, as
to how and when the Organization should assume full responsibility
for these programs and as to whether the UNICEF could legally
transfer to the WHO funds for their implementation. The situation
was further complicated by the fact that UNICEF had already
entered into contracts with four countries for carrying out BCG im-
munization programs. A working party of the Committee on
Relations, produced an acceptable resolution.
This resolution recommended formation of a temporary committee
on health policy, composed of representatives of the two organiza-
tions, acting on advice of the expert committees of the World Health
Organization. This committee will regulate all health programs and
projects of UNICEF already initiated or to be initiated in the future
but will provide this supervision only until these activities are taken
over by WHO. In cases of emergency the committee can delegate
its functions to the Directors-General of the two organizations.
The Specialized Agencies
Several specialized agencies have interests in the field of health:
The Food and Agriculture Organization (FAO): Concerned with nutrition,

rural hygiene, and improvement of the general well-being of rural populations
with particular reference to the control of malaria, bilharzia, and other diseases
which retard agricultural development and seriously affect world food production.
The United ATations Educational, Scientific and Cultural Organization
(UNESCO): Engaged in activities in education and the sciences, such as assist-
ance to scientific institutions, coordination of fellowships, grants-in-aid, health
education in fundamental education, the basic sciences in medical education and
research, nutritional science proposals, medical abstracting, the coordination of
the congresses of medical sciences and the Hylean Amazon Project.
1397 October 22, 1948
The International Labor Organization (1LO): Concerned with the prevention of

accidental injuries, housing, improvement of nutrition, sanitation, recreation,
industrial hygiene, hygiene of seafarers, medical care, examination of immi-
grants, and promotion of maternal and child health.
The International Civil Aviation Organization (ICAO): Concerned with the
revision of the international sanitary conventions for air navigation and with
problems of aviation medicine.
The International Refugee Organization (IRO): Concerned with problems
related to the medical care of displaced persons, sanitation within their camps,
and the resettlement of refugee doctors, dentists, nurses, and other specialized
personnel in the medical sciences.
The Assembly accepted draft agreements with FAO, ILO, and

UNESCO which will come into force when the texts approved by the
Health Assembly are agreed to by the Conference of FAO, the Govern-
ing Body of the ILO and the Executive Board of UNESCO,respectively.
Since the relationships of the Interim Commission and ICAO were
characterized by a close and productive collaboration, the Assembly
decided that no formal agreement was necessary and that the informal
arrangements at the Secretariat level would continue to form the
basis of future collaboration between the two organizations. The
Assembly also agreed that relationships with IRO be conducted at
the Secretariat level without formal agreement.
Certain cooperative projects with FAO and UNESCO were also
approved:
FAO: To establish a joint standing committee on policy and a joint advisory

committee on nutrition. To cooperate with FAO and ILO in problems of rural
welfare in which all three organizations have an interest; with FAO and UNESCO
in programs in nutritional sciences and food technology; and to invite repre-
sentatives of FAO to attend meetings of the Expert Committee on Biological
Standardization, particularly in connection with vitamins.
UNESCO: To continue the collaboration established by the Interim Com-
mission on the Hylean Amazon project, pilot project in fundamental education
in Haiti, and in medical abstracting. The Director-General was instructed to
open negotiations with UNESCO for the transfer to WHO of the coordination
of international congresses of medical sciences.
Pre-existing International Health Organizations
United Nations Relief and Rehabilitation Administration (UNRRA).-

The functions of UNRRA under the International Sanitary Conven-
tion of 1944 were taken over by the Interim Commission on December
1, 1946. An agreement was signed on December 9, 1946, providing
that the Commission would take over UNRRA's health activities
from January 1, 1947, for Europe, and from April 1, 1947, for the
Far East, with the exception of the medical care of displaced persons.
For this purpose UNRRA transferred $1,500,000 for 1947 and the
same amount for 1948. The funds were used to provide 14 UNRRA-
October 22, 1948 1398
receiving countries with one or more of the following types of aid:

missions, fellowships, visiting lecturers, medical literature and teach-
ing materials. On assuming the obligations of the Commission on
September 1, 1948, the Organization took over the responsibility
for the performance and completion of activities financed by unex-
pended UNRRA funds.
Office International d'HygienePublique.-The Interim Commission took
over on January 1, 1947, the epidemiological notification services of
the Office. The provisions of the Protocol authorizing the WHO to
perform the remaining duties and functions of the Office became
effective on October 20, 1947. Transfer of these functions was carried
out under the terms of an agreement signed on January 27, 1948.
The Office made available t-wo sums of 800,000 French francs each
for the years 1947 and 1948, towards defraying the expenses incurred
through the taking over of these duties and functions.
The Health Assembly instructed the Director-General to continue
such arrangements with the Office as may be necessary to insure coop-
eration in matters of common interest pending the termination of the
Rome Agreement of 1907 and the dissolution of the Office as provided
for in the Protocol of July 22, 1946.
League of Nations Health Organization.-The functions and activities
of the Health Organization of the League of Nations assigned to the
United Nations, including standardization of biologicals, unification
of pharmacopoeias and epidemiological intelligence, were transferred
to the Interim Commission on October 16, 1946. The Commission
arranged with the United Nations for the transfer to the WHO of the
archives, correspondence files and stock of publications of the League
health section, the archives and property of the League's Eastern
Bureau of Epidemiological Intelligence at Singapore, and other assets
of the Darling Foundation 1 and Fonds Leon Bernard.2
In response to a request from the Commission for the transfer to
WHO of the medical and health material of the League of Nations'
library, the General Assembly instructed the Secretary-General to
1 The Darling Foundation was established in 1926 in memory of Dr. S. T. Darling, a member of the Malaria
Commission of the League of Nations, for the purpose of granting periodically "the Darling Foundation
Prize," consisting of a bronze medal and a sum of 1,000 Swiss francs to the author of an original work on
malaria. The Health Assembly decided that the Expert Committee on Malaria of the World Health
Organization should redraft the statutes of the Foundation and that these statutes should delegate to the
Expert Committee on Malaria the responsibility for recommending the name of the candidate to whom
the WHO shall award the medal and the prize. The Director-General is to be the administrator of the fund
of the Darling Foundation.
2 The Fonds Leon Bernard, to perpetuate the memory of Professor Leon Bernard, a member of the Health
Committee of the League of Nations, was established by international suibscription in 1934, to award an
international prize for practical achievement in the field of social medicine. The Health Assembly in-
structed the Director-General to amend the statutes of the Foundation and decided that, at appropriate
times, it would appoint a committee of experts in social medicine to nominate the person to whom the medal
and prize should be awarded by the Health Assembly. The Director-General of the World Health Organi-
zation is to be the administrator of the Fund and of the Leon Bernard Foundation.
1399 October 22, 1948
submit to the Economic and Social Council a draft plan within the
framework of a general policy relating to the use of the central library
by the United Nations and specialized agencies. The Health As-
sembly, considering the Library of the League Health Organization
an essential part of the equipment of WHO, requested the ECOSOC
to arrange without delay for the transfer to WHO of the title to the
appropriate materials.
Pre-existing Regional Health Organizations
Pan American Sanitary Organization (PASO).-The Health Assem-

bly directed the Executive Board to continue negotiations with the
PASO with a view to integration as soon as possible and to conclude
an agreement in accordance with Article 54 of the Constitution. The
draft agreement approved by the Directing Council of the PASO is
to be used as a basis for these negotiations, subject to appropriate
modification of Article 9, which states: "This Agreement may be
revised or annulled by either of the parties, with a year's notice (after
legal consultation)."
Pending integration, the Executive Board was instructed to con-
clude a working agreement.
Pan Arab Sanitary Bureau.-The Egyptian delegation requested the
Health Assembly to integrate the Regional Bureau of Alexandria with
the WHO as a regional organization. This was supported by a
favorable report made by the chairman of the Interim Commission
after a personal inspection of the bureau. The Health Assembly
approved the request, instructing the Executive Board to integrate
the Regional Bureau of Alexandria with the WHO, through common
action, in accordance with Article 54 of the Constitution.
Nongovernmental Organizations
For the World Health Organization to achieve its objective it is

necessary for it to establish and maintain effective collaboration not
only with governments and governmental organizations, but also with
nongovernmental and other professional groups which contribute to
the advancement of health, such as the World Medical Association,
the World Federation for Mental Health, the International Unions
Against Tuberculosis, Venereal Diseases and Cancer, and the Inter-
national Council of Nurses. The Health Assembly established criteria
to be used in selecting the organizations to be brought into relation-
ship with it, the procedure to be followed to apply for such relation-
ship, and the privileges to be conferred.
The organization seeking relationship with the WHO must be
concerned with matters in the competence of the Organization and
must have aims and purposes in conformity with its Constitution.
October 22, 1948 1400
It must represent a substantial proportion of persons participating in

its field of operation and have authority to speak for its members.
Although the organization normally must be international in structure
with members who exercise voting rights on its policies and actions, a
national organization may be brought into relationship with the
consent of the Member concerned if the activities of the organization
are not covered by any international organization or if it offers
experience upon whicb the WHO wishes to draw. Applications for
relationship, which may be submitted either voluntarily or upon
invitation of the WNHO, will be considered by a 5-member standing
committee of the Executive Board which will recommend those
organizations to be admitted into relationship. Organizations
brought into relationship are conferred the privileges of representation
in the meetings of the WHO and its committees without the right to
vote; access to nonconfidential documentation of the WHO; and the
right to submit memoranda to the Director-General on pertinent
subjects.
Legal
Health Regulations
Under Article 21 (b) of the Constitution, the Health Assembly

adopted WHO Regulations No. 1, The Nomenclature Regutlations, 1948.
These come into force on January 1, 1950, for Members, except those
as may under Article 22 notify the Director-General by July 24, 1949,
of rejection or reservation. These regulations make it mandatory for
Members to code mortality statistics in accordance with the Inter-
national Statistical Classification of Diseases, Injuries, and Causes of
Death, and specify the minimum tabulations to be made by cause of
death, race, sex, and age for the territory of the Memnber as a whole and
its principal subdivisions, the form of medical certificate to be used,
and the rules for selecting the underlying cause of de ith. Similar
standards are prescribed for Members preparing statistics of morbidity.
Rights and Obligations of Associate Members
To enable the responsible governments to determine whether to

propose certain territories for associate membership at the next session
of the Health Assembly, action was taken to define the status of
Associate Members both in the central and regional organizations.
The Assembly approved a resolution submitted by the United
States representative which defines the rights and obligations of
Associate Members in the central organization, but refers to the
Executive Board for study and report the question of the rights and
obligations in regional organizations of Associate Members and of
1401 October 22, 1948
representatives of territories or groups of territories which are not

responsible for the conduct of international relations and which are
not Associate Members.
The rights accorded Associate Members in the central organization
are as follows: (a) to participate without vote in the deliberations of
the Health Assembly and its main committees; (b) to participate with
vote and to hold office in other committees of the Assembly except the
General Committee, the Credentials Committee, and the Nomina-
tions Committee; (c) to propose items for inclusion in the provisional
agenda of the Assembly; (d) to receive equally with Members all
notices, documents, and records; and (e) to participate equally with
Members in convening special sessions.
Associate Members are not eligible for membership on the Executive
Board but they have the right to submit proposals to the Executive
Board and to participate in committees established by it. Finally,
the difference in their status will be considered in determining their
contribution to the budget of the Organization.
Rules of Procedure
The Assembly adopted rules of procedure for the World Health

Assembly as recommended by the Interim CoTnmission and modified
by the Legal Committee.
There were also adopted regulations and rules of procedure for
expert committees. The principal items of contention in the discus-
sions of these rules concerned the method of appointment of such
committees. As finally adopted, experts are to be appointed by the
Director-General in accordance with regulations established by the
Executive Board.
Official Seal of the WHO
The Assembly adopted as its emblem the symbol of the United

Nations, surmounted by an Aesculapian staff and serpent in gold.
The Director-General was instructed to obtain the consent of the
United Nations for proposed use of its seal.
Site of the Second World Health Assembly
Finally the Assembly resolved the second World Health Assembly

shall meet in Europe and instructed the Executive Board to select a
suitable place. Invitations have been submitted by the governments
of Italy, Monaco, and the United Kingdom.
October 22, 1948 1402
APPENDIX 1
Members of the World Health Organization and Observers Present

at the First World Health Assembly
Geneva, Switzerland, June 24-July 24, 1948
Members Represented by Delegates: 52 1
*Albania France Poland

Australia Greece *Portugal
*Austria Haiti *Rumania
Belgium *Hungary Saudi Arabia
Brazil Iceland Siam
*Bulgaria India Sweden
Burma Iran *Switzerland
Byelorussia Iraq Syria
Canada *Ireland Turkey
*Ceylon *Italy Ukraine
China Liberia Union of South Africa
Czechoslovakia Mexico Union of Soviet Socialist
Denmark *Monaco Republics
Dominican Republic Netherlands United Kingdom
Egypt New Zealand United States of America
El Salvador Norway Venezuela
Ethiopia Pakistan Yugoslavia
*Finland Philippines
Members Absent: 2
Afghanistan
*Transjordan
Countries Represented by Observers: 14
Argentiia 2 Panama Korea:

Bolivia Paraguay United States Zonie
Chile San Mariiio Japan:
Ecuador Uruguay Representative of the
Guatemala Germany: Suprerme Coim-
Luxemburg United States Zone mander for the Al-
Nicaragua British Zone lied Powers
French Zone
International Covernmental Organizations Represented by Observers: 10
Food and Agriculture Organization Provisional Committee of the Interna-

International Civil Aviation Organiza- tional Refugee Organization (PCIRO)
tion United Nations
International Labor Organization United Nations Educational, Scientific,
Office International d'Hygiene Publique and Cultural Organization
Pan American Sanitary Organization United Nations International Children's
Permanent Central Opium Board and Emergency Fund
Drug Supervisory Board
*Non-United Nations Member.

1 The Constitution provides that each state Member of the WHO is entitled to be represented by not
more than 3 delegates.
2 Argentina completed its ratification of the Constitution during the Assembly. The Health Assembly,
when informed of the action, decided on July 17 to seat the delegation with full rights as a Member pending
the deposit of its instrument of acceptance with the Secretary-General of the United Nations. However,
at the close of the Assembly the deposit of the Argentine instrument of acceptance had not been received.
1403 October 22, 1948
APPENDIX 2
United States Delegation to First World Health Assembly
Geneva, Switzerland, June 24-July 24, 1948
CHAIRMAN James E. Perkins, M. D.,

Thomas Parran, M. D., Managing Director, National Tuberculosis Asso-
Medical Director, ciation,
U. S. Public Health Service, 1790 Broadway,
Federal Security Agency. New York, N. Y.
DELE GATES Miss Lucile Petry,

Director, Division of Nursing,
Martha M. Eliot, M. D., U. S. Public Health Service,
Associate Chief, Children's Bureau, Federal Security Agency.
Federal Security Agency.
Alvin Roseman,
James R. Miller, M. D., Deputy Director, International Activities Branch,
Trustee, American Medical Association, Bureau of the Budget.
179 Allyn Street,
Hartford 3, Conn. Paul F. Russell, M. D.,
Malariologist, Rockefeller Foundation,
CONGRESSIONAL ADVISER The Rockefeller Institute,
Ivor D. Fenton, York Avenue and 66th Street,
House of Representatives. New York 21, N. Y.
ALTERNATES James S. Simmons, Brig. Gen., U. S. Army, (Ret.)

Frank P. Corrigan, M. D., Dean, School of Public Health, Harvard Uni-
Political Adviser on Latin America, versity,
U. S. Mission to the United Nations, Cambridge, Mass.
No. 2 Park Avenue, New York, N. Y. John Tomlinson,
James A. Doull, M. D., Assistant Chief, Division of United Nations
Economic and Social Affairs,
Medical Director,
Department of State.
Chief, Office of International Health Relations,
U. S. Public Health Service,
Tom Whayne, Colonel, M. C., U. S. Army,
Federal Security Agency.
Chief, Preventive Medicine Division,
Wilton Halverson, M. D., Office of the Surgeon General,
Director, Public Health, Department of the Army.
State of California,
668 Phelan Building, Abel Wolman,
San Francisco, Calif. Professor, Sanitary Engineering,
Johns Hopkins School of
H. van Zile Hyde, M. D., Hygiene, and Public Health.
Alternate, U. S. Representative, Johns Hopkins University,
Interim Commission, World Health Organization; Baltimore 18, Md.
Division of International Labor, Social and Health
Affairs,
EXECUTIVE SECRETARY
William H. Dodderidge,
Durward V. Sandifer, Division of International Conferences,
Deputy Director, Office of United Nations Affairs, Department of State.
ADVISERS TECHNICAL SECRETARY
Howard B. Calderwood, Howard B. Calderwood,

Division of United Nations Economic and Social Division of United Nations Economic and Social
Affairs, Affairs,
Department of State. Department of State.
Nelson H. Cruikshank, ADMINISTRATIVE OFFICER

Director, Social Insurance Activities,
Lyle L. Schmitter,
American Federation of Labor, Division of International Conferences,
Washington, D. C. Department of State.
Albert W. Dent,
President, Dillard University, PRESS OFFICER
New Orleans, La. Mrs. Mildred Allport,
American Legation,
Morton Kramer, Bern, Switzerland.
Chief, Research and Information,
Office of International Health Relationq.
SPECIAL ASSISTANT TO CHAIRMAN
U. S. Public Health Service,
Federal Security Agency. Mrs. Florence Thomason,
Administrative Assistant, Office of United States,
Mrs. Adele R. Levy, Representative on Interim Commission, World
President, Citizens' Committee on Children of Health Organization,
New York City, Division of International Labor, Social and Health
300 Park Avenue, Affairs,
New York, N. Y. Department of State.

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Doull, Kramer, 1948 - Doull1948

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Association of Schools of Public Health

The First World Health Assembly

The First World Health Assembly

By JAMES A. DOULL, Medical Director, and Morton KRAMER, Scientist (R),

It is particularly appropriate that the Public Health Reports for

Council invited representatives from 51 States, Members of the

Organization of the Assembly

Pending the election of the president of the Assembly, Dr. Andrija

President: Dr. Andrija Stamipar (Yugoslavia).

The General Committee, consisting of the presideint, three vice

Seating of the United States

The joint resolution of Congress (P. L. 643), providing for mem-

Organization, specifies (section 4) that in the absence of any provision

Election of the Executive Board

Article 24 of the Constitution specifies that the Health Assembly,

Following speeches by the delegates of Italy and El Salvador, the

Election of the Director-General

By a vote of 46 to 2 the Health Assembly elected Dr. Brock Chisholm,

The functions of the Organization as outlined in the Constitution

Statutory and Inherited Functions

International Epidemiology.-The Executive Board was instrlceted to

Health Statistics.-The Executive Board was instructed to establish

Biological Standardization.-The Board was instructed to establish

Unification of Pharnacopoeias.-The Board was instructed to estab-

Systematic registration where practicable of malaria cases.

Registration of every case of confirmed and suspected tuberculosis and of death

Notification of primary and secondary syphilis; declaration of sources of inlfec-

MATERNAL AND CHILD HEALTH

Protection of the health of adolescents-particularly girls-and expectant and

Other Activities.-Faced with budgetary and personnel limitations

PUBLIC HEALTH ADMINISTRATION

Second priority was given to public health administration, which includes

Fourth priority was given to a group of virus diseases, including poliomyelitis,

The Assembly established an active fellowship program to assist in

assist governments in strengthening their health services, and to meet

The Assembly approved a program of publications to be handled

Bulletin of the World Health Organization.-For material relevant to the work

World Health Day

Upon a request from the representative of Iran, the Assembly

Administration and Finance

Article 56 of the Constitution specifies that the expenses of the

Country Units Percent Country Units Percent

United States of America - 4,787 37.96 Byelorussia - -26 .21

Organization. As a result, it was agreed that the scale of contribu-

Budget for 1948

The Health Assembly adopted a budget of $4,800,000 for the

Budget for 1949

Upon a proposal of the South African delegation, a ceiling of

Total, Part II-- 4, 736, 000

Total, all parts -5, 000, 000

I Established in 1948 Budget.

The Assembly took no direct action on the recommendations of the

Recommendations of Committee on Administration and Finance Regarding Allocation of

Organizational meetings -- $264, 000

Subtotal-- 4 843, 932

Grand total-- 5 000 000

Without dissent, Geneva was selected as the permanent head-

pressed. In his speech of welcome to the Assembly, the head of the

The Assembly considered three formal proposals regarding the