The Chief U.S. Delegate, Dr. Theodore Cooper, Assistant Secretary for Health, HEW, emphasized to the Assembly that the future could be viewed with optimism because of the new realism with which WHO was facing the problems of providing health care to the world's population. He said that emphasis on improved country health programming was a critically important element in a coherent strategy for the organization. The Director General of WHO, Dr. Halfdan Mahler (Denmark), reemphasized the need for WHO leadership in international health and for a logical system of health priorities in a multidisciplinary setting. He pledged to pursue these aims and promised even more cooperation between WHO and the other multinational and bilateral donor agencies.

General Activities

The year 1975 saw an intensification of country health programming exercises carried out jointly between WHO and the individual countries. This approach allows for a closer integration of the objectively determined priority needs of the country and WHO assistance and for a more rational allocation of WHO resources: In order to offer more health leadership and assistance to member countries, the organization has begun a program of decentralization, providing more decision-making authority at the regional and country levels. A major review of staffing patterns at the headquarters and at regional and country levels is underway.

During 1975 work began on the sixth Program of Work of WHO (1978-83) which will establish the framework for its activities during this period. The chairman of the working group was the U.S. Representative on the Executive Board, Dr. S. Paul Ehrlich, Jr. In collaboration with the secretariat staff, the working group developed a detailed draft program highlighting future priority areas and closer ties between objectives and programs.

In addition to administering its regular budget of approximately $120 million, WHO continued in 1975 to act as the executing agency for health and healthrelated projects valued at $110 million that were financed by the UNDP, UNICEF, IBRD, the UN Fund for Drug Abuse Control, the UN Fund for Population Activities, regional development banks, and other voluntary

contributors.

Adverse Reactions to Drugs

WHO has taken the lead in organizing an international early-warning system for suspected adverse reactions to drugs. Monitoring centers in 19 countries currently submit information on reported adverse reactions, which is made available to health officials throughout the world. This information is important to the U.S. Food and Drug Administration in determining drug safety and efficacy. The United States also supported the proposed Certification of Good Manufacturing Practices in the manufacture and quality control of drug products moving in international commerce, which was adopted by the 28th Health Assembly. For products imported under this procedure, the national health authorities would certify that the product was authorized for sale in the exporting country.

With respect to drug dependence, a resolution cosponsored by the United States was adopted calling for increased activities in this area and closer collaboration with the UN Fund for Drug Abuse Control. The United States attaches considerable importance. to the drug-related studies and research being conducted by the two bodies.

Smallpox

The smallpox eradication program has continued to make remarkable progress. The only remaining country in the world with endemic smallpox is Ethiopia. With the help of the United States and others, WHO is actively engaged in locating, isolating, and eliminating the last centers of infection. Health authorities have cautioned that close surveillance will be needed for at least 2 years after the last case is identified before total eradication can be finally certified.

Influenza

One of the most notable achievements of WHO has been its establishment of listening posts around the world for early detection and diagnosis of influenza and identification of new strains of the virus. Prompt action by WHO and collaborating reference centers permits the preparation of appropriate vaccines, often before foreign-originated strains reach U.S. shores. The number of days of illness and the number of lives lost due to influenza are therefore sharply curtailed, and the consequent humanitarian and economic benefits are considerable.

Schistosomiasis

WHO has had a program against schistosomiasis (snail fever) for a number of years. With the height

ened interest in the disease that resulted from a passage in Secretary Kissinger's address to the UN General Assembly in 1974, and in response to resolutions introduced by the United States and other WHO members at the Health Assembly in 1975, WHO began intensifying its efforts in this area. A U.S. spokesman at the Assembly welcomed the new emphasis, but warned that the problem of controlling the disease might be further complicated as a result of the 1974 World Food Conference recommendation that developing countries increase their land area under irrigation. An international conference on schistosomiasis was held in Cairo in October 1975, organized by Egyptian authorities in association with WHO, UNEP, and the United States.

Research in Cancer

WHO continued its role in international cooperation in cancer research during 1975. The program has been proceeding in close collaboration with the International Agency for Research on Cancer and the International Union Against Cancer. The U.S. delegation to the World Health Assembly expressed satisfaction with the progress made and the emphasis on environmental factors, but urged caution in initiating a wide range of new programs which might have the effect of diffusing limited resources or weakening WHO's special role in key activity areas. The Assembly decided that WHO should continue its efforts to develop an international program by fostering international collaboration, and by coordinating the efforts of national, international, intergovernmental, and nongovernmental organizations. The United States and other members agreed that WHO's unique services could best be applied to such areas as evaluation, standardization of terminology and research methodologies, and the development of a basic information system.

INTERNATIONAL CIVIL AVIATION ORGANIZATION

In 1975 the Bahamas, Lesotho, Nauru, and Papua New Guinea adhered to the 1944 Chicago Convention on International Civil Aviation, increasing ICAO's membership to 133. ICAO moved to a new headquarters building, International Aviation Square, a few blocks from its former location in Montreal. Walter Binaghi of Argentina, who had been President of the ICAO Council since 1957, decided to retire, and the Council elected the Secretary General, Assad Kotaite of Lebanon, to succeed him.

Council

The ICAO Council, the executive body of the organization, now consists of 30 ICAO member states, including the United States. The Council, its standing committees, and the Air Navigation Commission meet at ICAO headquarters during a major portion of the year. One of the most important functions of the Council is the adoption of International Standards and Recommended Practices concerned with the safety, regularity, and efficiency of air navigation, in accordance with the terms of the Chicago Convention. During 1975 the Council adopted important amendments to the Standards and Recommended Practices (contained in the ICAO Annexes) on rules of the air, operation of aircraft, facilitation, aeronautical telecommunications, air traffic services, search and rescue, and aeronautical information services. In addition, Annexes concerning meteorology, aircraft accident inquiry, and aerodromes were not only amended but completely revised.

The United States was instrumental in obtaining approval by the Council's Committee on Unlawful Interference of recommendations for upgrading and strengthening regulatory provisions in Annexes on security and protection against unlawful interference aimed at preventing hijacking and sabotage. The proposals will be considered by the Council for adoption as international standards and, if adopted, will be more clearly aligned to U.S. regulations than those currently in effect.

The Council has called a special air transport conference for April 1977. At this meeting tariff enforcement, policy concerning international nonscheduled air transport, regulation of capacity in international air transport services, and machinery for the establishment of international air transport fares and rates will be considered on a worldwide basis.

On the recommendation of its Committee on Joint Support of Air Navigation Services, and as the result of a U.S. initiative, the Council decided to establish a panel to review the air navigation facilities and services in the North Atlantic under the Danish and Icelandic Joint Financing Agreements. This panel will report back to the Committee and the Council in time. for them to make recommendations to the next conference of states parties to the Joint Financing Agreements, which includes the United States.

Air Navigation Activities

Much of the work of ICAO in the various technical ail navigation fields originates in panels of experts established and convened by the Air Navigation

Commission.

In 1975 the Commission, which consists of 15 air navigation specialists nominated by states (including the United States) established two new panels to prepare documentation for ICAO's Ninth Air Navigation Conference, scheduled for 1976. The Operational Flight Information Service Panel, which met in October, made recommendations for providing aircraft in flight with operationally integrated air traffic information as well as weather and other aeronautical information. Another recommendation was designed to insure coordination of air traffic and weather information. The Data Acquisition, Processing, and Transfer Panel, which met in November, prepared recommendations to simplify completing and submitting flight plans and facilitating the processing and transfer of air traffic services data.

Other technical groups that met in 1975 were the Automated Data Interchange Systems Panel and the Review of the General Concept of Separation Panel. The United States furnished experts to serve on all four of these panels.

The fourth meeting of the Committee on Aircraft Noise, which consists of experts nominated by selected ICAO members (including the United States) and international organizations, was held at ICAO headquarters, January 27-February 14, 1975. The Committee developed specifications for aircraft noise suppression at the source, which if adopted by the ICAO Council will be applicable toward the end of 1976. The proposed specifications, less stringent than those of the United States, include: (1) standards for noise certification of future subsonic jet airplanes, (2) guidelines for noise certification of future supersonic transport airplanes, (3) standards for noise certification of heavy propeller-driven airplanes, (4) standards for noise certification of light propeller-driven airplanes (to replace the current recommended practices in Annex 16 on aircraft noise), (5) guidelines for noise certification of propeller-driven short-takeoff-and-landing airplanes, and (6) guidelines for noise certification of installed auxiliary power units and associated aircraft systems during ground operations.

The Committee also proposed that appropriate modification be made, at the earliest practicable date, of all subsonic jet airplanes engaged in international air navigation which produce noise levels in excess of the relevant limits specified for certain new airplane types. The Committee recommended making those noisereduction modifications that were regarded by the state of manufacture to be technically feasible and by the state of registry to be economically reasonable. The ICAO Council subsequently approved this recommendation.

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