(1) At the first part of the 22nd session (January and March 1961: CO-ORDINATION/R.351, para.bn27) CCAQ agreed that in emergency circumstances at any duty station where medical treatment could not be obtained locally organizations might pay travel costs of staff to the nearest point where adequate treatment could be obtained. Normally, however, this would be confined to:
isolated areas where there were no medical facilities whatever, and
cases where the medical officer of the organization agreed that adequate facilities were not available. If there was no time to seek the opinion of the medical officer, the chief of mission could act on the basis of the best available local medical opinion.
(2) At the second part of the 22nd session (July 1961: CO-ORDINATION/R.373, paras. 20-21) the Committee confirmed the agreement in paragraph (1) above, and also agreed, with reference to conditions in West Africa, that consideration should be given to the question of organizing adequate medical facilities in areas where they did not then exist. WHO would follow up the matter.
(3) At the 23rd session (March 1962: CO-ORDINATION/R.391) CCAQ considered the liability of organizations to pay travel costs for dependants who were obliged to leave the area to obtain adequate medical care. WHO paid for such travel in emergency circumstances, and the Committee agreed that other organizations might do likewise; home leave entitlement could be used in appropriate cases.
(4) At its 25th session (April 1964: CO-ORDINATION/R.451, para. 110) CCAQ stressed the need for organizations to give to all staff going on mission to tropical areas medical advice on the kind of health problems which might be encountered, and on methods of dealing with them.
(5) At its 59th session (July 1983: ACC/1983/18, para. 90) in the context of the establishment of a work programme in the area of conditions of service in the field, CCAQ agreed that UNDP, in consultation with WHO and the medical directors of the organizations, should review the question of medical facilities in the field.
(6) At its 18th session (July 1983), ICSC requested the organizations to report to its 19th session (March 1984) on arrangements made to ensure efficient financing of dispensaries where needed and on appropriate inter-agency co-operation to assist staff evacuated on medical grounds and requiring urgent hospitalization or treatment involving salary advances or guarantees to hospitals or doctors.
(7) At its 59th session on financial and budgetary questions (September 1983) CCAQ(FB) agreed to a UNDP proposal, based on a recommendation by the Medical Directors, that in cases where the latter determined that the establishment of a field dispensary was warranted, UNDP would request concurrence within 30 days from the organizations' administrative services, silence on their part being deemed to signify consent. Pending the establishment of cost-sharing arrangements, the expenses involved, which were expected to be modest, would be absorbed (ACC/1983/21, para. 63).
(8) At its 60th and 61st sessions (March and June-July 1984: ACC/1984/9, paras. 81-83 and ACC/1984/16, paras. 102-106) CCAQ(PER) took a number of decisions relating to medical facilities inthe field. The Commission was informed of these decisions in document ICSC/19/CRP.10.
(9) At its 62nd session (March 1985: ACC/1985/6, paras. 126-127), CCAQ agreed on a framework of measures regarding the payment of daily subsistence allowance in cases of medical evacuation, the detailed application of which should be left to each organization (see also section 4.3, para. (29)).
(10) At its 64th session (March 1986: ACC/1986/3, para. 108), CCAQ took note of the arrangements made by UNDP for air ambulance medical evacuation services. It also took note of the agreement by UNDP and WHO to follow up on the proposal for a Regional Medical Officer stationed in Abidjan, in consultation with the CCAQ secretariat.
(11) Following the introduction of a new mobility and hardship package for staff in the Professional and higher categories (General Assembly resolution 44/198), CCAQ at its 72nd session (February-March 1990:ACC/1990/4, paras. 56-58) referred to the Medical Directors three proposals to facilitate proper medical attention at duty stations where staff would no longer qualify for time-off for medical check-ups (see also section 3.4).
(12) At its 74th session (March 1991: ACC/1991/5, paras. 107-114) CCAQ recommended to organizations a number of administrative actions to reduce the possible health impact on staff of continuous, severe air pollution at certain duty stations. The specific duty stations involved would be determined later when more information was available. The Committee asked the Medical Directors to take up this issue at their next meeting.
(13) At its 76th session (March 1992: ACC/1992/6, paras. 126-128) CCAQ received information suggesting that action should be taken to palliate the effects of air pollution in Mexico City and Ankara and agreed that organizations which felt a genuine need could implement those administrative actions that seemed necessary at those duty stations. At the same time CCAQ requested its secretariat to collect more information on other duty stations that might be affected.
(14) At its 78th session (March 1993: ACC/1993/6, para. 151) CCAQ asked that UN, UNDP and WHO work together to make proposals on how best to apply the latest WHO guidelines on air quality measurements in assessing the need for the application of CCAQ's administrative actions. The Committee also agreed to forward to the Medical Directors a proposal for additional lung-function tests for staff assigned to locations where air pollution was at a high level.
(15) At its 90th session (April 1999: ACC/1999/5, para. 34) CCAQ was informed of the intention of the UN Medical Directors to undertake a comprehensive review of 43 UN sponsored dispensaries to determine in which dispensaries the services should be: (a) upgraded, (b) maintained or (c) phased out, in the light of the availability of satisfactory local health facilities. The Committee noted that this evaluation would take into account: (i) the current services being provided vis-a-vis local medical facilities; (ii) the quality of the current services; (iii) the level of satisfaction of users; and (iv) the training/support required by UN dispensary physicians. Ten locations had been identified by the Medical Directors for assessment in 1999 on a priority basis: Afghanistan, Bangladesh, Guyana, Liberia, Mozambique, Rwanda, Sao Tome and Principe, Cape Verde, Madagascar and the Comoros. The Committee also requested the Medical Directors to evaluate the need to establish new dispensaries in locations, normally outside capital cities, with minimal health facilities or where health facilities were lacking altogether. It requested the UN Medical Service to provide contributing/participating organizations with the terms of reference of the review, the criteria for selecting the first ten locations to be reviewed and cost estimates of the proposed comprehensive review in order to make a commitment to finance it and to include all contributing or participating organizations in the quarterly meetings by taking advantage of video-conference facilities.
(16) At its July 2003 meeting (CEB/2003/HLCM/20, paras. 19-20) the HR Network reviewed a note prepared by WHO and containing proposals developed in collaboration with UNDP, UNICEF, WFP and the UN and WHO Medical Services in a bid to put in place comprehensive measures for coordinating, planning and implementing inter-agency health-related emergency and safety measures. The Network thanked WHO for its leadership and support to organizations during the recent SARS crisis and noted that WHO had the capacity to serve as the repository for information for the common system on health-related emergency and safety measures. It expressed appreciation to WHO for developing proposals that addressed the need to improve inter-agency coordination in risk situations and agreed that in order for the proposals to be dealt with speedily, organizations should forward their comments to WHO with the view to finalizing the proposals for submission to the next session of HLCM. The Network requested the CEB secretariat to undertake consultations on how better to address inter-agency coordination on other health-related issues, including consideration by the Network and HLCM of reports from the meetings of the Medical Directors.
(17) During its eighteenth session (CEB/2009/6, paras.72-76), HLCM took note of the presentation from the Medical Directors, and requested the Medical Directors Working Group to continue their work in benchmarking and identifying risks, and to develop and prioritize specific proposals that would update and enhance the provision of healthcare in the UN system. It also requested the Medical Directors Working Group to develop its proposals in close collaboration with the HR Network and the Inter-Agency Security Management Network (IASMN).