4. UNESCO (United Nations Educational, Scientific and Cultural Organization)

The relationships of WHO with UNESCO are varied, and arise from the interrelated nature of many programs of both agencies.

As a delegate to the UNESCO Conference in Paris, in October 1958, I was able to note these relationships at first hand.

UNESCO and WHO have jointly sponsored the Committee for International Organizations of the Medical Sciences (CIOMS), a group devoted to the improvement of international communication in the medical sciences. While in Paris, I conferred, among others with Dr. J. F. Delafrasnaye, executive secretary of CIOMS.

WHO cooperated with UNESCO in the Joint Expert Committee on the Physically Handicapped Child, 1951, and in the study group on the child with impaired hearing, 1955.

WHO was represented at the second and third sessions of the International Advisory Committee on the School Curriculum. Interest in the work of this committee is a result of the joint activites of the health education and MCH sections on health education in schools. A study guide on teacher preparation for health education was prepared jointly by WHO and UNESCO.

The Organization, because of its interest in school health, was also represented at the 21st International Conference on Public Education, organized by UNESCO and the International Bureau of Education in Geneva in 1958.

5. ILO (International Labor Organization)

The responsibilities and interests of WHO and ILO meet at many points. ILO is interested in the total welfare of laboring people (including their health), while WHO is interested in the health of people (including special conditions affecting workers on the job). These common interests give rise to numerous cooperative efforts:

The social and occupational health activities of WHO are related closely with ILO in many fields, namely, occupational health, social security, and financial aspects of medical care, hygiene of seafarers, rehabilitation, and migration. In these fields many joint expert committee and ad hoc technical working group meetings have taken place between ILO and WHO since the beginning of the Organization. Technical conferences, seminars, symposia, etc., have been held in the field with both organizations participating.

Similarly, nurses from WHO have worked closely with the nursing consultant of ILO in the preparation of a report on employment conditions of nurses. This report has now been considered by an ad hoc committee. Helpful recommendations are expected to be presented to the ILO governing body.

Other U.N. agencies are as follows:

6. United Nations Relief and Works Agency (Arab refugees) (UNRWA) WHO provides the chief medical officer and technical advice to UNRWA. An important task undertaken by the Nutrition Section of WHO is to assist UNRWA in carrying out continual assessments of the nutritional status of the Palestine refugees. Limited rations are supplied but a high proportion of these large populations have some facilities for supplementing them. These facilities, however, differ considerably in different areas and at different times. There is, therefore, a need for careful periodic check on the health of these

people. A number of visits have been paid by staff of the WHO Nutrition Section to UNRWA and extensive clinical examinations have been made.

7. U.N. Department of Economic and Social Affairs

WHO has a working relationship with the Bureau of Social Affairs of the United Nations Department of Economic and Social Affairs in the Fields of medical rehabilitation, medicosocial work and the costs and finance of medical care. There are routine as well as special consultations on professional and administrative aspects of joint field projects, for example in rehabilitation. In addition, interagency technical working groups may from time to time be convened to discuss problems of mutual interest.

8. U.N. narcotics control

A number of international conventions on the control of narcotic drugs provide for the Director-General's taking decisions, on the basis of appropriate expert advice, with regard to the status of drugs under the international control provisions. Apart from that, WHO acts as adviser on the medical aspects of drug addiction and addictionproducing drugs to the United Nations' organs concerned, i.e., the Economic and Social Council, its Commission on Narcotic Drugs with the Division of Narcotic Drugs as Secretariat, the Permanent Central Opium Board, and the Drug Supervisory Body. The value of the existing close collaboration of WHO with the aforementioned bodies may be seen from the 1958 motion of the Commission on Narcotic Drugs:

To pay high tribute to the important contribution which WHO, and particularly its Committee on Addiction-Producing Drugs, continues to make to the international control of narcotic drugs.

The work leading to this section was outlined in part IV above, dealing with the development of WHO's research program. 9. The need for constant review of jurisdictional lines

It is clear from the preceding illustrations that the intergovernmental organizations-notably UNICEF, FAO, ILO, and UNESCO--share many interests in common with WHO. Under the circumstances, there must be constant reevaluation of what is the proper role that each organization should play, in relation to one another.

This is especially true because the responsibility of each organization changes with changing times and needs.

Jurisdictional lines between the organizations which might not have been wholly exact, even when originally laid out, have often tended to become blurred even further over a period of years.

It is a fact familiar to students of public administration that it is a tendency of organizations to maintain themselves in some activities long after circumstances require adaptation along new lines. Fortunately, the World Health Organization has, by and large, sensed the need for new patterns of activity. It is less clear that some of the other international organizations have always actually worked out with WHO new relationships to define necessary changes in jurisdiction. A constant effort must therefore, be made by the policymaking bodies of the intergovernmental organizations, and by their secretariats, to reappraise objectively what the optimum jurisdictions and interrelationships should be.

10. Cooperation on radiation problems

The newer the field and the greater the challenge, the more essential it is that there be a maximum of efficiency in the work of the specialized agencies and in their liaison with one another. The point is made throughout this report that there are few, if any, fields in which such efficiency and liaison are more necessary than in the appraisal of the effects of ionizing radiation. The world cannot be satisfied with the sum total of knowledge thus far available through all the many agencies concerned with this question. More fruitful work by each of these agencies, individually and in collaboration, is essential. WHO has a particular responsibility, as has the United Nations Committee on Effects of Radiation and the International Atomic Energy Agency, to name but three of the most concerned groups.

WHO has begun to meet this challenge. In 1955, an expert was appointed to the staff of WHO to advise the Director General on atomic energy in relation to health. Later that year, WHO in collaboration with the Government of Sweden and the Atomic Energy Commission of the United States of America, sponsored the first international course for health physicists ever to be held. This was followed by another course in Belgium in 1957, and in the United Kingdom and France in 1958. The Ninth World Health Assembly (1956) had already asked the Director General to warn all member states that the planning and execution of any project for the peaceful use of atomic energy should be done in close contact with public health authorities. The present program of WHO in this field is as follows:

1. Training for three distinct categories of workers: specialists for protective work in atomic energy laboratories or plants (normally either physicians or "health physicists"); public-health administrators, who would be particularly interested in such questions as the disposal of radioactive waste and the siting of reactors; and medical uses of radioisotopes.

2. Collection and distribution of information on the medical problems of atomic energy and on the medical uses of radioisotopes. 3. Study of the health problems involved in the location of reactors and in the disposal of radioactive waste from factories, laboratories, and hospitals.

4. Cooperation with the competent technical bodies on the standardization of radiation units, on codes of practice such as the recommendations of the International Commission on Radiological Protection; and on the pharmaceutical specifications of methods of preparing radiosotopes for medical use.

5. Coordination of research on the health aspects of radiation. This report cannot attempt to analyze the many implications of the radiation problem. Suffice it to say that I know of no scientist who is not convinced that the world is at present tragically deficient in some of the most elementary information bearing upon the effects of radiation. WHO is ideally suited among other purposes to spearhead the further collection of epidemiological information.

One of the best illustrations is in connection with WHO's interest in those unique geographic areas where substantial populations have long since been exposed to continuous doses of relatively high radiation from natural sources for long periods of time. Such a situation exists in the southernmost regions of the west coast of India, in parts of

Kerala and Madras states. Here, it is presumed, can and will be obtained indispensible information of the following types:

1. Essential demographic statistics, such as calculated birth rate, life expectancy, ratio between sexes.

2. Data on human growth and development.

3. Patterns of congential defects.

4. Patterns of morbidity and mortality.

5. Laboratory studies on blood groups, hemoglobin, and other genetic markers.

6. Post mortem studies.

7. Correlative studies on plant and animal material.

The availability of such knowledge can, and no doubt will, have immense significance to world science as well as to political decisions in the future.

D. COOPERATION WITH INTERNATIONAL PROFESSIONAL ORGANIZATIONS

Over the years, groups and individuals in various countries who are linked by common interests have banded together in unofficial but influential international organizations. Many of these are related to health-such as those having to do with medical practice, medical care, hospital administration, nursing, various areas of medical research, and various scientific disciplines.

These organizations and WHO supplement each other. The professional organizations are an indispensable means of international communication. The WHO has official relationships with governments, and often more extensive resources than the private organizations. Extensive cooperative relationships have evolved so that each may share the strengths of the other.

A few examples of cooperative relationships will be presented. A complete list of the nongovernmental organizations in official relationship with WHO will follow shortly (table 5-C).

Future reports by this subcommittee will include more detailed references to the very constructive work of organizations, which are not cited, for purposes of brevity, in the illustrations which follow. The forthcoming publications will refer, for example, to International Red Cross work, to the activities of the World Veterans' Federation, of the Inter-American Association of Sanitary Engineering, the International Conference of Social Work, the International Society for the Welfare of Cripples, and the World Federation of United Nations Associations. All of these groups have favored the subcommittee with helpful reports.

TABLE 5-C.-Nongovernmental organizations in official relationship with the World Health Organization

Biometric Society, Rathamsted Experiment Station, Harpenden, Herts, England; secretary, J. J. R. Healy.

Central Council for Health Education, 92, Rue Saint-Denis, Paris Ier, France; secretary general, Dr. Lucien Viborel.

Council for International Organizations of Medical Sciences, 19, Avenue Kléber, Paris 16e, France; secretary, J. F. Delafresnaye.

Federation Dentaire Internationale, 35, Devonshire Place, London, W. 1; secretary general, G. H. Leatherman.

Inter-American Association of Sanitary Engineering, Alfonso Herrera 11-103, Mexico 4, D.F.; secretary general, Francis W. Montonari, Ohio River Valley Water Sanitation Commission, 414 Walnut St., Cincinnati 2, Ohio.

International Academy of Legal Medicine and of Social Medicine, Via De Toni, 12, Genes, Italy; secretary general, Prof. G. Canepa.

International Association of Microbiological Societies; secretary general, Prof. G. Penso, Casella Postale 7078, Rome.

International Association for the Prevention of Blindness, 47, Rue de Bellechasse, Paris 7e; secretary general, J. P. Bailliart.

International Commission on Radiological Protection, Radiological Protection Service, Downs Nursery Hospital, Cotswold Road, Sutton, Surrey, England; secretary general, W. Binks.

International Commission on Radiological Units and Measurements, Radiological Protection Service, Docons Hospital, Cotswold Road, Sutton, Surrey, Great Britain, secretary; Mr. Walter Binks.

International Committee of Catholic Nurses, 16, Rue Tiphaine, Paris 15e; secretary general, Mademoiselle Callou.

International Committee of the Red Cross, 7, Avenue de la Paix, Geneva; president, Léopold Boissier.

International Confederation of Midwives, care of the Royal College of Midwives, 57, Lower Belgrave Street, London, SW. 1; executive secretary, Miss Marjorie Bayes.

International Conference of Social Work, 345 East 46th St., New York 17, N.Y.; secretary general, Joe R. Hoffer.

International Council of Nurses, 1, Dean French Street, Westminster, London, S.W. 1; executive secretary, Mlle D. C. Bridges.

International Diebetes Federation, 33 Prinsegracht, The Hague, Netherlands; executive secretary, P. Duys.

International Federation of Gynecology and Obstetrics, Maternité, Rue Alcide Jentzer, Geneva; secretary, Ř. Keller.

International Federation for Housing and Town Planning, 123, Loan Copes van Cattenburch, The Hague; secretary general, H. Van der Weijde.

International Hospital Federation, 10, Old Jewry, London, E.C. 2; secretary general, J. E. Stone.

International Hydatidological Association, (International Society of Hydatidosis), Canelones 1280, Montevideo; secretary, Alfredo Ferro.

International League Against Rheumatism, care of Dr. R. T. Smith, secretary treasurer, Dr. R. T. Smith, West Point, Pa.

International Leprosy Association; Secretary treasurer, Dr. E. Muir, 8 Portman St., London, W. 1.

International Organization Against Trachoma, 94, Rue Sylvabelle, Marseille, France; Secretary General, Jean Sédan.

International Paediatric Association; Secretary General, Prof. G. Franconi, Kinderspital, Steinwiesstr. 75, Zurich 32, Switzerland.

International Pharmaceutical Federation; secretary general, Dr. J. W. Birza, 196, Bilderdijkstraat, Amsterdam.

International Society for Blood Transfusion, 57, Boulevard d'Antenil, Boulognesur-Seine, France.

International Society for Criminology; secretary general, Jean Pinatel, 28, Avenue de Friedland, Paris, 8e, France.

International Society for the Welfare of Cripples, 701 First Avenue, New York 17, N. Y.; secretary general, Donald V. Wilson.

International Union Against Cancer, 25, Rue d'Ulm, Paris, 5e, France; secretary general, Dr. Harold F. Dorn.

International Union for Child Welfare, 1, Rue de Varembé, Geneva; secretary general, D. Q. R. Mulock Houwer.

International Union for Health Education of the Public, 92 Rue Saint-Denis, Paris ler; secretary general, Dr. Lucian Viborel.

International Union Against Tuberculosis, 15 Rue Pomareu, Paris 16e; secretary general, Etienne Bernard.

International Union Against Venereal Diseases and the Treponematoses, Institut Alfred Fournier, 25 Boulevard Saint-Jacques, Paris 14e, France; secretary general, A. Cavaillon.

League of Red Cross Societies, 40 Rue du 31 Décembre, Geneva; secretary general, B. de Rougé.

Medical Women's International Association, in care of Dr. Janet K. Aitken, honorary secretary, 30a Acacia Road, London, N.W. 8, England.

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