1. INFORMATION MEETING FOR PERMANENTAMBASSADORS TO THE ORGANIZATION OFAMERICAN STATES AND OTHER AMBASSADORS OFPAHO/WHO MEMBER STATES51st Directing Council of PAHO63rd Session of the WHO Regional Committee for the AmericasWashington, D.C.26-30 September 2011Mirta Roses PeriagoDirector

2. PROGRAM51st Directing Council of PAHOWashington, D.C., 26-30 September 2011 Matters related to:RegulationsConstitutionProgram PolicyAdministration and FinanceAwardsGeneral Information 3. REGULATIONS AND COMPOSITION Executive Committee of PAHO2008-2011:ArgentinaGuatemalaHaiti2009-2012:ColombiaSaint Vincent and the GrenadinesBolivarian Republic of Venezuela2010-2013:GrenadaPeruUnited States of America2011-2014 Candidates: Brazil, Chile, El Salvador 4. WHO Executive Board2009-2012: Canada (PBAC) Chile2010-2013: Barbados Ecuador United States of America2011-2014: Mexico2012-2015 Candidates: Cuba, Panama 5. OFFICERS51st Directing Council Proposed officers:General Committee President:Panama Vice-president: Bahamas Vice-president: Uruguay Rapporteur: Bolivia Other members:Cuba Guatemala United States of America Committee on Credentials Antigua and Barbuda Honduras Canada 6. ELECTIONS51.Directing CouncilExecutive Committee Term ending Candidates Argentina Brazil Guatemala Chile Haiti El SalvadorBIREME Advisory Committee Term endingCandidates JamaicaBolivia Mexico Suriname 7. ELECTIONS 51st Directing CouncilAppointment of the External Auditor of PAHO for the bienniums 2012-2013 and 2014-2015Proposed AuditMember State thatentityproposed itCourt of Audit of Spain PanamaSupreme AuditPeruInstitution of Germany(Bundesrechnungshof) 8. OPENING SESSIONWashington, D.C., PAHO, 26 September 2011, 9:00 AM Table of Honor Head of Delegation, MexicoOutgoing President of the Directing Council Dr. Mirta Roses, Director of PAHO Mr. Jos Miguel Insulza, Secretary General of the OAS Mrs. Kei Kawabata, Social Sector Manager, Inter-AmericanDevelopment Bank Dr. Margaret Chan, Director of WHO Dr. Kathleen Sebelius, Secretary of Health, Department ofHealth and Human Services, United States of America 9. HIGHLIGHTED EVENTSSaturday, 24 and Sunday, 25 September Time and place- Room B. Special Program Caribbean CaucusMonday, 26 SeptemberTime and place-Meeting of Heads of Delegation 8:30 AM Room B-Opening ceremony 9:00 AM Room B-Launch of exhibits:10:00 AM PAHO lobby -Photographic exhibit: Safe Motherhood in Latin America and the Caribbean -ECLAC/PAHO Regional Atlas of Subnational Vulnerability and Faces, Voices,and Places exhibit -25th Anniversary of the PAHO Program in International Health-Commemorative photo with Directing Council Heads of Delegation 12:30 PM Lobby, 1st floor-Awards dinner honoring excellence in Inter-American Public Health 2011 7:00 PM Lobby of the Americas, main building of the OASTuesday, 27 September Time and place-Regional Consultation on WHO Reform (Plenary and Roundtables)8:30 AM Room A-Luncheon of the World Council of Women Leaders (Event by invitation to Women Ronald Reagan Building Ministers of Health)-Presentation of the Commission on Information and Accountability for Womens 2:30 PM Room A and Childrens Health-PANEL: SAFE MOTHERHOOD AND UNIVERSAL ACCESS TO SEXUAL AND REPRODUCTIVE HEALTH-Signing of PAHO/WHO-ACTO Agreement 6:00 PM Room 1017-Meeting of the ORAS-CONHU countries6:30 PM Room 1017-Meeting of the Central American and Mesoamerican countries 6:30 PM Room B 10. HIGHLIGHTED EVENTSWednesday, 28 September Time and place-Technical coordination meeting between PAHO, representatives of12:30 PM State Plaza Hotel the GAVI Alliance, and Ministers of the countries of the Region that receive support GAVI-Celebration of 25th Anniversary of the PAHO Program in 3:30 PM Room A International HealthThursday, 29 SeptemberTime and place-Private meeting with heads of delegation 8:30 AM Room B-Launch of the ECLAC/PAHO Regional Atlas of Subnational Vulnerability10:30 AM Room A-Launch of the Supplement on Elimination of Rubella and12:00 PM Room A Congenital Rubella Syndrome in the Americas (Journal of Infectious Diseases)-Technical meeting between PAHO, the secretariat of the Global Fund and Ministers of Health 12:30 PM Room BFriday, 1 October Time and place-149th Session of the Executive Committee of PAHO At the end of the Directing Council, Room B (Saint Vincent and the Grenadines - Outgoing President - Colombia, the United States, Grenada, Peru, Venezuela, and the members to be elected during the Directing Council: Brazil, Chile and El Salvador) 11. Awards for Excellence in Inter-American Public Health 2011 Monday, 26 September 2011. 3:30 p.m. PAHO Award for Administration Dr. John Edward Greene, Guyana Abraham Horwitz Award (leadership in public health) Dr. Peter J. Hotez, United States Clarence Moore Award (voluntary service) Womens International Network for Guatemalan Solutions(WINGS), Guatemala Pedro Acha Award (veterinary health thesis) Dr. Francisca Andrea Samsing Pedrals, Chile Manuel Velasco Surez Award (Bioethics) Dr. Laura Adriana Albarellos, Mexico Sergio Arouca Award (universal access to health) Integrated Management of Adolescent and Adult Illness Program (IMAI), Ministry of Health, Guyana 12. RESOLUTIONS17 Resolutions adopted by the Executive Committee Collection of quota contributions Plan of action on psychoactive substance use and public healthStrategy and plan of action onclimate change Strategy and plan of action onurban health Strategy and plan of action on Plan of action on road safetyepilepsy Amendments to PASB staff rules Strategy and plan of action onand regulationseHealth PAHO Award for Administration Strategy and plan of action on2011malaria Plan of Action to accelerate the NGOs in official relations with reduction in maternal mortality andPAHOsevere maternal morbidity Amendment of the principles Provisional agenda of 51st Directinggoverning relationships between CouncilPAHO and NGOs Proposed PAHO Program and Plan of Action to reduce theBudget 2012-2013harmful use of alcohol Assessments of Member States 13. Proposed PAHO Program and Budget2012-2013[ RESOLUTION CE148.R16]The Executive Committee agreed to: Approve the program of work for the Bureau as outlinedin the PAHO Proposed Program and Budget 2012-2013(Official Document 338). that requires an increase of 4.3% to the assessmentsof PAHO Member States and further request the Director to present a newscenario with an increase of 2.15% to the assessedcontributions of Member States 14. Financing of the Program and Budget2012-2013 by Funding Source Assessed Contributions fromMember States31%Other Sources(PAHO/AMRO)54% MiscellaneousRatio of 46/54 RB/OSIncome2% AMRO Share (regularbudget) 13% 15. Scenario D: Zero Nominal Growth9% of Strategic Plan targets will not be met by 2013 2010-2011 Change 2012-2013PercentageAssessed Contributions186.400 8.000194.400 4,3%Miscellaneous Income 20.000(8.000)12.000 -40,0%WHO/AMRO (Approved byWHA) 80.700 - 80.700 0,0%Total Regular Budget287.100 -287.1000,0%Total Other Sources355.851(16.226) 339.625 -4.5%Total Budget 642.951(16.226) 626.725 -2.5% 16. Comparison ofScenarios D, E, and C Scenario DScenario EScenario CAssessed Contributions 194.4004,3% 190.400 2.15% 186.400 0.0%Miscellaneous Income12.000-40,0% 12.000 -40.0% 12.000 -40.0%WHO/AMRO (Approved by WHA)80.7000,0% 80.7000.0%80.7000.0%Total Regular Budget 287.100 0,0%283.100 -1.4% 279.100 -2.8%Total Other Sources 339.625 -4.5%332.300 -6.6% 329.685 -7.4%Total Budget626.725 -2.5%615.400 -4.3% 608.785 -5.3%Negative Impact on Program (%of targets that will not beachieved)9%14% 19%Proposed resolution for the Directing Council: Scenario D (4.3% increase in Assessed Contributions) 17. PAHO/WHO WORKFORCE EFFICIENCY RATE 1992-93 / 2008-09 100%90%80%70%In Percentage (%)60%50%38%40%28.2%27.9%30% 25.8%20%10% 0%35791 3579-9-9-9-9-0 -0-0-0-09600929498 0204060819191920202019 2020Total Workforce CostTotal Expenditure 18. Productivity: PAHO/WHO total expenditure in constantdollars per full time equivalent *1990-91 / 2008-098000007000006000005000004000003000002000001000000 3 5791 15793-9-9 -9 -9 -0-9 -0 -0 -0 -0 9092 94 96980002040608* Value added per FTE in dollars at constant 2000 prices. 19. Budgetary Implementation by OrganizationalLevels and Source of Funds, End-of-Biennium, 2008-2009Funds available for the biennium ExpenditureImplementation rate(US$ thousand)(US$ thousand) (%)OrganizationallevelRBOS TotalRBOS TotalRB OS TotalCountry 103,965 119,968 223,933 103,241 103,935207,176 998793Subregional15,276 14,576 29,85215,11613,42828,544999296Regional158,823 146,132 304,955 157,672 131,606289,278 999095Total 278,064 280,676 558,740 276,029 248,969524,998 998994 Note: The figures do not include funds from government-financed internal projects, the Revolving Fund, the Strategic Fund 20. Strategy and Plan of Action on Climate Change [RESOLUTION CE148.R2]To the Member States:To the Director: measure the impacts of climate establish networks that facilitate thechange on health and address its gathering and dissemination ofeffectsinformation strengthen the capacity of health promote campaigns for raisingsystems for monitoring and analyzing awareness about climate changeclimate and health information work with countries to mobilize empower and strengthen national andlocal health systems to effectivelyresourcesprotect human health from risks create partnerships that promoterelated to climate changesustainable actions develop adaptation options based on assessments assist the Member States in implementing the Action Plan, inPlan developing national plans tailored to local needs 21. Strategy and Plan of Action on Epilepsy[RESOLUTION CE148.R3]To the Member States: To the Director: make epilepsy a priority assist the Member States in the strengthen the legal frameworks inpreparation and execution of nationalorder to protect human rights programs universal equitable access to medical give priority to vulnerable groupscare and essential drugs collaborate in the evaluation and strengthen human resourcesrestructuring of the countries close the information gap neurology and mental health services facilitate the dissemination ofstrengthen partnerships between theinformation and the sharing ofhealth sector and other sectorsexperiences promote partnerships and a broad andmultisectoral response 22. Strategy and Plan of Action on eHealth[ RESOLUTION CE148.R4]To the Member States: To the Director: facilitate the dissemination of studies, studiesgive priority to the use of innovative reports and solutions to serve astools and methodologiesmodel for eHealth interministerial policies, plans, promote the formation of national,programs, and interventionsmunicipal, and local partnerships to promote greater competencies facilitate the sharing of capacitiesamong human resources promote coordination between the encourage partnerships and the Strategy and Plan of Action andsharing of experience, respecting thesimilar initiativesprinciples of informationconfidentiality, equity, and equalityconfidentiality support the capacity to generateinformation and research 23. Strategy and Plan of Action on Malaria [RESOLUTION CE148.R5]To the Member States:To the Director: review national plans or establish new continue advocating for theones for the prevention, control, andmobilization of resourcesthe potential elimination of malaria promote and strengthen technical coordinate with other countries andcooperation among the countries andinitiatives in:form strategic partnerships-epidemiological surveillance of ensure that malaria drugs meetmalariainternationally recognized quality -surveillance of resistance toassurance standards and are antimalarial medicinesconsistent with PAHO/WHO -and insecticides recommendations sustain or increase resources establish integrated strategies forvector control with broad communityparticipation 24. Plan of Action to Reduce the HarmfulUse of Alcohol[RESOLUTION CE148.R8]To the Director:To the Member States: collaborate in the assessment of Identify harmful alcohol consumptionalcohol and services in the countriesas a public health priority facilitate the dissemination of reduce alcohol-related problems withinformation and the sharing ofpopulation-wide policiesexperiences promote programs that educate promote partnershipschildren, young people, and those establish a dialogue with the privatewho choose not to drink alcohol about sector on how to reduce alcohol-how to resist peer pressure related harm ensure effective prevention, treatment,and care services allocate financial, technical, andhuman resources 25. Plan of Action on Psychoactive Substance Use and Public Health[ RESOLUTION CE148.R9]To the Member States:To the Director: Identify psychoactive substance use support the Member States in theas a public health prioritypreparation and implementation of national implement national and subnational and subnational plans on psychoactiveplans to tackle psychoactive substance usesubstance use problems promote partnerships support the multisectoral response required to implement Plan of Action 26. Strategy and Plan of Action on Urban Health[ RESOLUTION CE148.R10]To the Member States:To the Director: produce and disseminate criteria, support national health promotion guidelines, model policies, and legal policies and programsInclude determinants and indicators frameworks for urban health planning related to urban health in surveillance rel collect and disseminate new information systems about (the issue)further the commitment to healthy urban further develop health promotion and planning and development health determinants approachesdevelop transport systems that prioritize safe walking, cycling, and public support ministry of health engagement transport with city and metropolitan authorities andand other relevant sectors 27. Plan of Action on Road Safety[ RESOLUTION CE148.R11]To the Member States:To the Director: prioritize road safety through the support the Member States in theirdevelopment of national, subnational efforts to improve road safetyand local plans for the Decade of facilitate the identification andAction for Road Safety sharing of good practices improve the urban road and highway provide cooperation for the creationinfrastructure of capacity reduce the incidence of risk factors provide technical assistance to enforce the laws (on road safety)improve prehospital treatment and strengthen the technical and care for victimsinstitutional capacity for providing promote associations andcare to victimscollaboration improve data on traffic accidents 28. Plan of Action to Accelerate theReduction of Maternal Mortality andSevere Maternal Morbidity[ RESOLUTION CE148.R14]To the Member States:To the Director: adopt national policies, strategies, promote the implementation andplans, and programs that increasecoordination of this Plan of Action,womens access to quality health ensuring its horizontal natureservices promote and strengthen information prioritize womens lives as a humansystems and maternal healthrights and development issue surveillance promote the empowerment of women support the Member States inand the participation and co-developing human resourcesresponsibility of men in sexual and consolidate and strengthen technicalreproductive healthcooperation with other bodies advocate for dedicated and strategicpublic budgets 29. Contributions received as of 13 September 2011 corresponding to the years 2000 to 201178.1 94.0 79.0 81.0 84.0 77.180 74.069.0 65.3 63.763.670US$ millions/millones60 53.05040302010 0202020202020202020202020000102030405060708091011 Years/Aos 30. Outstanding contributions as of 13 September 20115550US$ millions/millones45 3534402835 273025 18 19 162013 13156 6102 5 0 20 20 20 20 20 20 20 20 20 20 20 20 00 01 02 03 04 05 06 07 08 09 10 11Years/Aos 31. Panel Discussion on Safe Motherhood and Universal Access to Sexual and Reproductive Health27 September 2011, 2:30 PM PANELISTS Dr. Mirta Roses, Director of PAHOIntroduction to the topic Dr. Michelle Bachelet, UN WomenAchievement of MDG 5: Universal access to sexual and reproductive health Mrs. Marcela Suazo, UNFPAUniversal access to family planning: Challenges of the decade Dr. Anbal Fandez, Coordinator of FLASOGPrevention of unsafe abortion and its consequences H.R.H. Infanta CristinaPresentation on Motherhood and Safe Birth: A commitment for all Dr. Margaret Chan, Director-General of WHOClosing remarks 32. Roundtable on antimicrobial resistanceStructure of the Roundtable CONTAINING ANTIMICROBIAL RESISTANCEOpening remarks: Dr. Patrick Kelley, Institute of MedicineAntimicrobial resistance: Global Health ImpactDiscussion panel 1 Discussion panel 2 Discussion panel 3Susan Foster, Alliance for Mario Raviglione, WHOJos G. Orozco, ReActthe Prudent Use ofLatin AmericaAntibioticsThe health, social, andThe extent ofTowards aeconomic impact of antimicrobialmultifaceted approachantimicrobialresistance in theto containresistance Region and its trends. antimicrobial Data for actionresistanceModerator: Moderator: ViceModerator: VicePresident of the President of the President of theDirecting CouncilDirecting CouncilDirecting Council 33. Regional Consultation on WHO Reform Milestones in WHO Reform 2010-2012 Discussion on WHO Reform began with a consultation on the Future of Financing for WHO that wasJan 2010 discussed in 128th EBFeb-Sea 2011 WHO working groups prepare initial proposalsSea 2011 Discussions in Global Policy Group (GPG)Apr 2011 Consultation with Member States & Staff20 May 20116th WHA adopts resolution WHA64.2 on WHO reform25 May 2011129th EB adopts decision EB129(8) on WHO reform1 July 2011Mission briefing on "three concept papers"Jul-Oct 2011 Member States web-based consultations on three concept papersAug-Oct 2011 Strategic discussions in Regional Committees on WHOS reform15 Sep 2011Geneva mission briefing on managerial reform papers18 Sep 2011Review of Drafts of elements of a Comprehensive Document on WHO Reform in GPG Special Session of EB on WHO reform to discuss outcomes of consultative process on the threeNov 2011 papers, strategy and priority setting for the five core business areas approved by the 64th WHA and draft proposals on managerial reform prepared by the SecretariatJan 2012 Presentation of draft package of reforms and detailed implementation plan to 130th EB Presentation of package of reforms, implementation plan, and first report of independent evaluationMay 2012 65th WHA 34. Expected Outcomes of the Reform Transforming governance to strengthen public health Reforming the financing and management of WHO Refocusing WHO core business to address the 21stcentury health challenges 35. What are we expecting from the51st PAHO/AMRO Directing Council? Member States views on the agenda and process ofWHO reform Guidance on key issues raised in the 3 conceptpapers on governance; independent evaluation andWorld Health Forum; and on the working document:WHO Managerial Reforms Contributions to inform the Special Session of theEB on 1-3 November 2011 36. Discussion in the 51st DirectingCouncil Morning of Tuesday, 27 September Introduction by the AMRO/PAHO Director, Dr. Mirta Roses Comments by WHO Director-General, Dr. Margaret Chan Three roundtables, arranged by subregion, chaired by the President and two VicePresidents of the Directing CouncilDiscussion guidelines for the three concept papers and managerialreform paper Rapporteurs for each roundtable to capture discussion Summary Report of roundtable discussions presented morning ofWednesday, 28 September Report sent to Geneva as input for the Special Session of the EB inNovember 2011 37. Progress Reports on Technical MattersA. Immunization: challenges and outlookB. Implementation of the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual PropertyC. Advances in the Implementation of the WHO Framework Convention on Tobacco ControlD. Implementation of the International Health Regulations (2005)E. Progress toward Achievement of the Health-related Millennium Development Goals in the Region of the AmericasF. Review of the Pan American centersG. Regional Initiative and Plan of Action for Transfusion Safety 2006-2010: Final evaluation 38. Resolutions and Other Actions ofIntergovernmental Organizations of Interest to PAHO: 64th World Health Assembly Forty-first Regular Session of the GeneralAssembly of the Organization of AmericanStates Subregional Organizations 39. Thank you verymuch!