tion can accomplish this result. In most cases, it will only be necessary to modify existing domestic regulations, within the scope of the executive branch of the Government, to meet the requirements of international health regulations. When more is required the Government can reserve its position pending necessary reference to Congress.

Recommendations (Article 23)

Belgium proposed a procedure for the adoption of recommendations based on that of the International Labor Organization. Incorporation of this proposal in the Constitution would have constituted an undertaking by states to take action, within a period of 18 months, in regard to the acceptance of any recommendation made by the Organization. The United States Delegation approved the proposal, but, in view of the authority that had been given to the Organization in regard to conventions and regulations, did not give active support to it. The Conference adopted a modified form of the Belgian proposal which gives the Organization authority to make recommendations to members and which constitutes an undertaking by members only to make annual reports concerning action taken in regard to them.

THE EXECUTIVE BOARD (Chapter VI)

It was agreed that the Executive Board should consist of 18 persons technically qualified in the field of health, who should be designated by 18 members elected by the Health Assembly. On the proposal of Australia, it was decided that the Health Assembly should take equitable geographic distribution into account in electing these states. A Ukrainian proposal that China, France, the Union of Soviet Socialist Republics, the United Kingdom, and the United States be made permanent members of the Executive Board was defeated with only two supporting votes.

The United States Delegation submitted a series of amendments to the Technical Preparatory Committee proposals which were designed to define clearly the position of the Board as that of a policy body and that of the Director-General as the chief executive of the Organization. In Committee these amendments received support only from China. It was the consensus of the Conference that the DirectorGeneral should be responsible to the Health Assembly through the Executive Board, and not directly. In order to fix this relationship the Constitution includes a provision (Article 28b) that the Board shall "act as the executive organ of the Health Assembly", and a pro

vision (Article 31) that "the Director-General, subject to the authority of the Board, shall be the chief technical and administrative officer of the Organization".

THE SECRETARIAT (Chapter VII)

The Director-General, who is appointed by the Health Assembly upon nomination of the Executive Board, is described as the chief technical and administrative officer of the Organization and is given responsibility for developing, on an international basis, such staff as the Organization may require. He is given the right to establish, by agreement with members, direct access to government departments, especially to the national health administrations. The United States Delegation supported the principle of direct access, in recognition of the technical nature of the work of the Organization. A move on the part of Syria to require that the Director-General have access to national health services only through the Executive Board was defeated on the basis of the administrative complexities involved.

The Constitution provides that the conditions of service of the staff shall conform as far as possible to those of other United Nations organizations.

COMMITTEES AND CONFERENCES (Chapters VIII and IX)

The Health Assembly and Executive Board are empowered to establish any committees considered desirable and may provide for the creation of, or the participation of the Organization in, joint or mixed committees with other organizations.

The Health Assembly and Executive Board are each given authority to convene local, general, technical, or other special conferences to consider any matter within the competence of the Organization. They may provide for the representation at such conferences of other international organizations and, with the consent of the government concerned, of national organizations, governmental or non-governmetal.

HEADQUARTERS (Chapter X)

The Conference considered the question as to whether it should take a decision as to the site of the headquarters of the Organization or should authorize the Health Assembly to determine the site. Canada, the United Kingdom, and the United States had submitted proposals which would make this determination a function of the Health As

sembly, whereas Australia had submitted a proposal which would fix the headquarters at the site of the United Nations, and the Soviet Republics, one which would fix it at Paris.

After exhaustive discussion of these proposals the Health Assembly was authorized to determine the site, after consultation with the United Nations. In the Arrangement establishing the Interim Commission, the Commission was instructed to prepare studies regarding the site, giving due consideration to the proceedings of the Conference, and to submit its studies to the signatory states at least six weeks prior to the first session of the Health Assembly.

REGIONAL ARRANGEMENTS (Chapter XI)

Two major problems confronted the Conference with respect to regional arrangements: (1) the establishment, functions, and organization of new regional branches or offices of the Organization; and (2) the relationship of existing regional health agencies to the Organization.

The Technical Preparatory Committee report contained alternative proposals with respect to these matters. Both alternatives provided for the establishment by the Health Assembly of (1) "Regional Committees," as regional policy bodies, with functions delegated by the Health Assembly, and (2) "Regional Offices," as administrative branches of the Organization. The first alternative proposed that, where a regional health agency was already in existence, it should be transformed into a Regional Office of the Organization through agreements and that transitional arrangements should be made with such agencies in order fully to utilize their services "with a view to developing them as quickly as practicable into regional offices". The other alternative provided only that "special arrangements" be made with such existing agencies "with a view to their facilities and services being utilized to the fullest possible extent as Regional Offices of the Organization."

The specific issues which arose at the Conference are discussed below under the headings:

1. The Relationship of the Pan American Sanitary Bureau to the World Health Organization;

2. The Participation in Regional Organizations of Non-SelfGoverning Territories;

3. The Establishment and Organization of New Regional Committees and Offices;

4. The Appointment of Regional Directors and the Selection of the Staff of Regional Offices.

1. The Relationship of the Pan American Sanitary Bureau to the World Health Organization

Since the principal existing regional health organization is the Pan American Sanitary Bureau, originally established in 1902 by the First Pan American Sanitary Conference, primary attention was given to working out its relationship with the World Health Organization. Specific amendments were presented by the delegations of Brazil, Canada, France, Norway, the United Kingdom, the United States, the Soviet Republics, jointly, and Venezuela. The United States proposal, offered as a basis for discussion, consisted primarily of a constitutional provision to the effect that regional agencies should be integrated or brought into relationship with the Organization through special agreements providing either that the agency be transformed into a Regional Committee or Office, or that its facilities and services be utilized with a view to its progressive absorption through subsequent agreement, as circumstances might permit. The proposal also included a draft resolution which set forth the possible content of an initial agreement between the Pan American Sanitary Bureau and the Organization.

In the initial Committee discussions, the United States suggestions received warm support from most of the other American republics. At the same time, however, these governments expressed the view that the Pan American Sanitary Bureau should continue its separate existence. Amendments and suggestions submitted by Canada, China, Norway, and the United Kingdom laid greater emphasis than had the United States initial proposal on the necessity of ultimate integration of the Bureau with the Organization. The delegations of India, Liberia, Poland, the Soviet Republics, South Africa, and Yugoslavia, particularly, strongly supported the language of the first alternative of the Technical Preparatory Committee proposal, which was interpreted to require complete early transformation of the Bureau into a Regional Office of the Organization. ·

Egypt called attention to the existence of the Pan Arab Health Bureau of the League of Arab States and requested that it be given equal consideration with the Pan American Sanitary Bureau as an existing regional health agency.

Following Committee discussion, a "Harmonizing Subcommittee" of 16 members was appointed to prepare an acceptable text. The subcommittee was composed of delegates from Brazil, China, the Dominican Republic, El Salvador, France, India, Lebanon, Mexico, the Netherlands, Norway, Peru, the Union of Soviet Socialist Republics, the United Kingdom, the United States, Venezuela, and Yugoslavia.

The text worked out by the subcommittee provided that:

"The Pan American Sanitary Organization represented by the Pan American Sanitary Bureau and the Pan American Sanitary Conferences and all other intergovernmental regional health organizations in existence prior to the date of signature of this constitution should in due course be integrated with the (World Health) Organization. The integration should be effected as soon as practicable through common action based on mutual consent of the competent authorities expressed through the organizations concerned."

This text was unanimously approved by the Committee on Regional Arrangements and later by the Conference in plenary session. 2. The Participation in Regional Organizations of NonSelf-Governing Territories

A second major problem concerned the participation of non-selfgoverning territories in the Organization at both the regional and central levels. Several delegations, including those of the United Kingdom and France, expressed the view that while the participation of such territories in the central Organization should be limited they should be admitted to full membership in Regional Committees and Offices, with voting rights equal to those of members. The French Delegation suggested that the state responsible for such territories should determine the representation and participation.

The United States Delegation favored participation by these territories in regional organizations but took the position that they should not be given a status equal to that of members and that the Constitution should not seek to determine the details of participation.

Joint consideration of the problem by subcommittees of Committee III (Legal) and Committee V (Regional Arrangements) resulted in agreement on the following formula which was incorporated in the Constitution (Article 47):

"Territories or groups of territories within the region, which are not responsible for the conduct of their international relations and which are not Associate Members, shall have the right to be represented and to participate in Regional Committees. The nature and extent of the rights and obligations of these territories or groups of territories in Regional Committees shall be determined by the Health Assembly in consultation with the Member or other authority having responsibility for the international relations of these territories and with the Member States in the region”.