Delegation by the Surgeon General of the Army and by the Institute of Inter-American Affairs. Delegates and advisers were assigned to participate in and report on the work of each of the Working Committees of the Conference. They were also assigned, on the basis of special interests and associations, to maintain friendly relations with other delegations. Because of the size and technical competence of the Delegation, it was possible for the United States to play a vital role in all aspects of the Conference. 724741-47-2 II. Constitution of the World Health Organization The Constitution of the World Health Organization1 signed in New York on July 22, 1946 consists of a Preamble and 19 chapters. It enumerates the functions of the Organization and defines its structure. NAME The name, "World Health Organization", which was proposed by the Technical Preparatory Committee, was preferred by the Conference to "United Nations Health Organization", proposed by the United Kingdom, or its variant, "Health Organization of the United Nations", proposed by Australia. The Chinese Delegate made a strong and effective plea that the name "World Health Organization" be accepted as best signifying the universal character of the Organization and the growing spirit of internationalism evident since the San Francisco Conference. The Netherlands proposed the name, “United Nations World Health Organization". Seventeen votes were cast in favor of the Netherlands proposal and thirty against it. On the basis of this vote, the name "World Health Organization" was accepted by the Conference. The United States Delegation had supported the name accepted in the belief that it most truly expresses the breadth contemplated for the Organization, most clearly reflects the fact that disease recognizes no national boundaries, and carries the positive implication that health is the rightful heritage of all men. PREAMBLE The Preamble consists of statements of nine principles related to health, which are considered to be basic to the happiness, harmonious relations, and security of all peoples. Of fundamental importance is the definition of health, which is stated to be "a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity". This posi 1 For text of Constitution, see Annex 2, p. 43. tive definition extends the basis of international collaboration in health well beyond previous more limited concepts. The basic principles enumerated in the Preamble emphasize the importance of health in the social development of the world and the interdependence of states in the development of higher levels of national health. The responsibility of governments for the health of their peoples, the importance of an informed public opinion in matters of health, and the need for the extension to all peoples of the benefits of medical, psychological, and related knowledge are fully recognized. Particular emphasis is placed on the importance of the healthy development of the child. OBJECTIVE (Chapter I) In the report of the Technical Preparatory Committee, seven objectives of the Organization were listed. On the initiative of Canada, the chapter was amended to consist of a single sentence stating that "the objective of the World Health Organization . . . shall be the attainment by all peoples of the highest possible level of health”. The specific objectives listed by the Technical Preparatory Committee were, where appropriate, recast and placed in Chapter II as functions of the Organization. FUNCTIONS (Chapter II) By the terms of this chapter, the Organization is established as the directing and coordinating authority in international health work. It is to establish and maintain effective collaboration with the United Nations, specialized agencies, governmental health administrations, professional groups, and other appropriate organizations. One of its chief functions is to assist governments, upon request, in strengthening their health services. The United States Delegation believed this to be the method whereby the World Health Organization could contribute most effectively to the general improvement of health and to the control and eventual eradication of disease at its source in all parts of the world. In discussions on this point, cognizance was taken of the accomplishments of the Health Organization of the League of Nations and of the Pan American Sanitary Bureau in assisting in the development of national health services. The functions of the Organization include the promotion, in cooperation with other specialized agencies, of measures to improve nutrition, housing, sanitation, recreation, economic and working conditions, and other aspects of environmental hygiene, including the prevention of accidents. It was the view of the Conference and the understand ing of the United States Delegation that activities in these fields would be closely coordinated with related activities of other specialized agencies, such as the Food and Agriculture Organization and the International Labor Organization. Further functions of the Organization are the promotion and conduct of research, the improvement of standards of teaching and training, and the provision of information and counsel in the field of health. In these activities, it was understood that the Organization would work closely with the United Nations Educational, Scientific and Cultural Organization and other appropriate agencies. The Organization is authorized to undertake certain direct operations. These are limited to furnishing technical assistance, and, in emergencies, necessary aid upon the request or acceptance of governments, and to the provision, on the request of the United Nations, of health services and facilities to special groups such as the peoples of trust territories. Certain of the European states seriously affected by the war were anxious that the Organization be given authority to render direct assistance when necessary. It was the understanding that such assistance would normally be given only upon request of a government, but it was recognized that, on occasions, an emergency might be so great as to make it necessary for the Organization to give assistance, acceptable to a government, without awaiting formal request. It was understood that the Organization would not work in any country without the approval of the government of that country. The paragraph authorizing the Organization to provide services and facilities to special groups met opposition from the Ukrainian Delegation. As originally proposed by the Technical Preparatory Committee, this paragraph included reference to displaced persons as well as to the peoples of trust territories. In committee, the Ukrainian Delegate requested that the entire paragraph be deleted. He particularly opposed the reference to displaced persons, and a compromise was reached by the omission of that category. Although the Organization is not specifically authorized to render aid to displaced persons, the Constitution does not prevent its doing so if requested by the United Nations. Recognition is given in this chapter to the importance of medical care in the improvement of the health of nations and peoples. The Organization is authorized to study and report on the administrative and social techniques affecting public health and medical care from the preventive and curative points of view, including hospital services and social security. In these fields the Organization is to work in cooperation with other specialized agencies, in particular the International Labor Organization. Members of the Economic and Social Council had expressed conflicting views on this subject, some maintaining that the study and promotion of health insurance should be specifically mentioned as a function of the Organization, and others, that questions of health insurance should solely concern the International Labor Organization. Certain of the European states, including Belgium, the Netherlands, and Sweden, felt that social security measures beyond mere health insurance were basic to health. The United States Delegation agreed to the inclusion of the broader term, social security, in view of the fact that the authority of the Organization in these matters is limited to study and report, and the Organization is directed to cooperate with other specialized agencies interested in social security matters. The Organization is authorized to perform statistical work, to conduct the international exchange of epidemiological information, and to develop international standards in matters related to health. It is given general authority to propose international conventions, to adopt regulations, and to make recommendations to members. This authority is further developed in Chapter V under the functions of the World Health Assembly and is discussed in detail in the section of this report dealing with that chapter. The final subparagraph of Chapter II gives the Organization authority "generally to take all necessary action to attain the objective of the Organization.' MEMBERSHIP (Chapter III) The Technical Preparatory Committee expressed its conviction that membership in the Organization should be open to all states. It proposed that members of the United Nations should become members of the Organization by the act of accepting its Constitution and recommended that the Conference determine the procedure for admission of other states. This was one of the most fundamental questions with which the Conference dealt. It gave rise to active discussion and proved to be a difficult and delicate problem. The United States Delegation strongly supported the recommendation that membership in the Organization should be open to all states. In the Legal Committee the United States Delegate made a full statement of the United States position in the matter, which was subsequently circulated in written form. He expressed the view that it was essential to extend to all persons, as soon as possible, the benefits of international action designed to improve health, that the control of international spread of disease requires action on a uniform basis |