Report to the Secretary-General dated 15 July 1991 on humanitarian needs in Iraq prepared by a mission led by the Executive Delegate of the Secretary- General for humanitarian assistance in Iraq

S/22799, 17 July 1991

I have the honour to transmit herewith for the attention of the members of the Council the report of the interagency mission headed by my Executive Delegate for the United Nations Inter-Agency Humanitarian Programme for Iraq, Kuwait and the Iraq/Turkey and Iraq/Iran border areas, Sadruddin Aga Khan.

The task entrusted to the mission, which visited Iraq from 29 June to 13 July 1991, was to assess current needs for humanitarian assistance and recommend measures for meeting those needs.

(Signed) Javier PÉREZ DE CUÉLLAR

Annex
Report to the Secretary-General dated 15 July 1991 on humanitarian needs in Iraq prepared by a mission led by Sadruddin Aga Khan, Executive Delegate of the Secretary-General

The aftermath of the Persian Gulf war of January and February 1991 presented a compelling spectacle of suffering and devastation to the international community. The tragic consequences of conflict, the untold loss of life and destruction were compounded by massive displacements of ill-prepared populations, by ecological disasters of unprecedented magnitude, by the collapse of the structures that sustain life in today's human societies. The region continues to face an enormous challenge in its attempt to recover from the ravages of war. In Iraq itself, the upheaval's insidious effects are leading to the gradual but inexorable collapse of essential services, leading to the risk of a humanitarian crisis whose eventual dimensions would dwarf today's difficulties.

When we decided, last month in Geneva, to try to confront these urgent issues, we knew that speed was vital. We were also aware that our findings had to be factual, precise and credible. The expert team from the United Nations programmes and agencies concerned - the United Nations Children's Fund (UNICEF), the World Health Organizadon (WHO), the Food and Agriculture Organization of the United Nations (FAO), the World Food Programme (WFP), the Office of the United Nations High Commissioner for Refugees (UNHCR) and the United Nations Development Programme (UNDP) - carried out a most professional and effective assessment, well supported by their colleagues already in Iraq. The mission fanned out throughout the country, revealing both pockets of destitution and the full scale of the problems in all regions. This was a field-based mission; the observations and conclusions were drawn from on-the-spot country-wide evaluation, not imposed from the vantage point of predetermined opinion.

As well as our United Nations partners and their colleagues based in Iraq, we benefited from a third tier of expertise: a very distinguished group of non-United Nations specialists and personalities participated in the mission and its activities. I am deeply grateful to Donato Chiarini, Thomas Hammarberg, Arve Johnsen, Jean-Daniel Levi, Sir John Moberly, Edwin Moore, Elliot Richardson and Nico Schrijver for having accepted my invitation to join us. They made a contribution of outstanding intellectual, moral and technical value, which undoubtedly enhances the report's scope and credibility. Needless to say, it represents a consensus view to which all of us subscribe, while not committing every member to every single phrase and sentence written.

Our aim has been to be sober, measured and accurate. We are neither crying wolf nor playing politics. But it is evident that for large numbers of the people of Iraq, every passing month brings them closer to the brink of calamity. As usual, it is the poor, the children, the widowed and the elderly, the most vulnerable amongst the population, who are the first to suffer. This cannot leave us unconcerned, whatever the solution proposed. In the pages of this report we have tried, in accordance with the purely humanitarian remit that was ours, to diagnose the problem and suggest remedies. It will be for the international community to decide how to respond further.

(Signed) Sadruddin Aga KHAN

1. The decision to undertake the present mission was made by the Secretary-General, his Executive Delegate Sadruddin Aga Khan, and the executive heads of United Nations specialized agencies and programmes responsible for the humanitarian programmes in Iraq, Kuwait and the Iraq/Turkey and Iraq/Islamic Republic of Iran borders at a meeting held at Geneva on 13 June 1991. Extensive first-hand reports had been received in previous weeks indicating that the conditions of the civilian population in many parts of Iraq were steadily deteriorating. The onset of summer was likely to exacerbate the situation further, while the return of large numbers of those displaced was also having a considerable impact on severely strained food, medical, water and infrastructural resources.

2. Given the indications of the worsening plight of the majority of Iraq's population, the meeting decided that a high- level mission should proceed to Iraq to assess the current humanitarian needs and recommend measures to address them. The mission was to be action- and field-oriented, should he carried out rapidly and should focus in particular on the emergency needs of vulnerable groups. Within its overall framework, the mission would concentrate on four main sectors: food supply; water and sanitation; health; and energy (with special reference to power generation).

3. The mission was led by the Secretary-General's Executive Delegate, Sadruddin Aga Khan, and was composed of experts from the relevant United Nations programmes and agencies, namely, UNICEF, WHO, FAO, WFP, UNHCR and UNDP, as well as consultants, specialists and eminent personalities from outside the United Nations system. The latter comprised participants from Canada, France, the Netherlands, Norway, Sweden, the United Kingdom of Great Britain and Northern Ireland, the United States of America and the Commission of the European Communities. While not part of this mission, a separate team from the International Telecommunication Union (ITU) was in Iraq at the same time. Several of their findings are noted in the present report and a summary of their own mission report is included as appendix X.

4. Mission members received briefings at Geneva from the Executive Delegate before flying to Baghdad on 29 June to join with staff from United Nations agencies already in the country. The first part of the mission was devoted to information collection and analysis in Iraq. At Baghdad mission members were briefed by United Nations staff, non-governmental organizations (NGOs), and the International Committee of the Red Cross (ICRC) and were welcomed by the Minister of State for Foreign Affairs and members of the National Committee for the Coordination of Relief and Assistance. After meetings and discussions with staff of the relevant technical ministries on 1 July, mission members visited various sites, mainly outside Baghdad, from 2 to 7 July. The mission divided into four teams, which visited sites in 16 of the 18 governorates (including Baghdad).

5. The Executive Delegate and additional mission members arrived in Baghdad on 8 July. Together with certain members of his team, he met with various government officials, including the Deputy Prime Minister, the Foreign Minister, ministers of relevant technical Ministries and other senior officials. The Executive Delegate also visited the southern region in order to further the provision of relief assistance to vulnerable groups and displaced persons in the area of the marshes. The mission team departed for Geneva on 13 July.

6. The Executive Delegate and members of the mission greatly appreciated the support and cooperation extended to them by the Iraqi authorities throughout the course of their stay in the country.

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13. The mission members concluded that the scale of damage and decline in Iraq in the past year had indeed been dramatic. Eight years of war with the Islamic Republic of Iran had taken their toll even before the destruction of the Persian Gulf war. In significant parts of the country, the destruction caused by the internal civil conflicts that followed the war was comparable or even greater. A final factor had been the consequence of economic and financial sanctions imposed on Iraq, including the freezing of its foreign assets and a ban on the international sale of its oil. It was clear to the mission that the impact of the sanctions had been, and remains, very substantial on the economy and living conditions of its civilian population. The mission was informed that the last reserves of food commodities that are included in the ration basket are in the process of being exhausted.

14. During the past several months major efforts have been made by the Government of Iraq to restore the country to some semblance of its pre-war situation. These efforts have been only partially successful. For example, a number of bridges have been repaired, and with the limited pumping of oil for local consumption, internal transport capabilities have in large part been restored.

15. However, the mission found that in the sectors of concern to it, the process of restoration had in many crucial respects reached its limit. Indeed, there are a number of problem areas that are likely to worsen in the foreseeable future. A review of several of the main findings within each of the sectors, which are discussed in more detail in the later sections of this report, gives reason for alarm.

16. As far as water is concerned, damage to water treatment plants and the inability to obtain needed spare parts have cut off an estimated 2.5 million Iraqis from the government system they relied upon before the war. The perhaps 14.5 million Iraqis who continue to receive their water through this system are now provided on average with one quarter the pre-war amount per day. Much of this water is of doubtful quality, owing to such problems as defective treatment and lack of sufficient hours of electric power. Major damage was also suffered by the national sewerage system owing to the loss of electric power during the war. Most of this damage has not been repaired, with raw sewage now flowing in some city streets and into the rivers. Diarrhoeal diseases, thought to be mainly caused by water and sewage problems, are now at four times the level of a year ago. The country is already experiencing outbreaks of typhoid and cholera.

17. The health of the population in Iraq is now challenged by growing environmental hazards, insufficient access to quality medical care and inadequate nutrition. Public health programmes have reduced their activities for lack of supplies. Hospitals and public health centres are severely affected by lack of electricity, water and medicines. Medical, surgical, dental and laboratory equipment suffer from the lack of spare parts, reagents and maintenance. The fleet of vehicles that once assured the effectiveness of the health services has been reduced to a few units. Iraq used to import annually approximately US$360 million worth of drugs and medical appliances alone. It is highly improbable that international humanitarian aid will be able to meet this demand. Mechanisms need to he established urgently for the country to procure its own medical supplies and to maintain its equipment in operation. Failing this, the health situation will further worsen. Vulnerable groups, each day more numerous, will be the first victims.

18. As for the food supply, the position is deteriorating rapidly in virtually all parts of the country. Preliminary forecasts for the current main harvest indicate that this year's aggregate cereal production will be around one third of last year's. This will further increase the country's dependence on imports, which even in good years has meant that approximately 70 per cent of its food needs must be imported. Data collected on prices throughout the country show tremendous levels of inflation. For example, current retail prices for wheat and rice - the two normal staple food items - remain 45 and 22 times their corresponding price levels of last year, while average incomes have shown only moderate gains. The government rationing system, even if basically equitable in its distribution, can provide only about one third of the typical family's food needs, resulting in a strikingly low level of dietary intake. The situation is particularly alarming with respect to the nutritional status of children, pregnant and lactating mothers as well as households headed by widows. Several independent studies and direct observation by the mission confirmed the high prevalence of malnutrition among children. There are numerous, reliable reports of families resorting to sales of personal and household items to meet their immediate needs. Taken collectively, this information clearly demonstrates a widespread and acute food supply crisis which, if not averted through timely intervention, will gradually but inexorably cause massive starvation throughout the country.

19. The current emergency feeding programmes, such as those being implemented by WFP for vulnerable groups, refugees, returnees and internally displaced persons, accordingly acquire special significance and need to be maintained for at least the next few months. The process of repatriation must be encouraged by the continued provision of timely and adequate amounts of relief aid, not least to ensure that the situation in the areas to which the refugees are returning reverts to normal as quickly as possible. It should be noted that the economic sanctions also lessen the ability of the returning refugees to resume their ordinary lives and traditional economic activities. Indeed, the mission was informed by the Kurdish leadership that the sanctions were taking an unfortunately harmful toll upon the living conditions of the Kurdish population.

20. In terms of power generation, Iraq's capacity had been reduced to a negligible level by the end of February 1991. At present, the power generating capacity has been restored to 25 per cent of the pre-war level. As it is operating continuously, electricity production is about 40 per cent of the 1990 level. However, this restoration process has been accomplished through such methods as cannibalizing parts from damaged units, making risky makeshift repairs and operating the remaining plants without the normal breaks for maintenance and repairs. At this point, little more can be done to increase power generation further unless major imports of new parts are allowed. Barring this, power output can be expected to decline from now on. The mission has also assessed the situation of the oil sector. The requirements of the internal market can essentially be met with the current production and refining capacity, although with repairs needed soon for some refineries that are in precarious condition. The main concern is the oil export capacity, which is now only one third of the pre-war level.

21. As for telecommunications, the ITU team noted that at least 400,000 of the original 900,000 telephone lines were damaged beyond repair, while additional ones were partly damaged. The main microwave links connecting most of the cities were also damaged. This has had an obvious negative impact on the operation of health and social services as well as on humanitarian assistance programmes. All international telecommunications were put out of service. Even after restoration work, the system can still handle only 30 per cent of its pre-war internal service, while international telecommunications remain out of service.

22. Clearly, the situation described above is one that deserves urgent attention and immediate response. In considering what actions to recommend, the mission came to a series of additional conclusions.

23. As spelled out in the specific sector reports, the primary action that is needed to address these needs is the import of material goods. This includes such items as drugs, vaccines, medical equipment, ambulances, spare parts and replacements for water and sewerage equipment, food and agricultural inputs and equipment and parts for power generation plants and the oil sector, as well as for the telecommunications network.

24. A review of the relevant Security Council resolutions and decisions by the Security Council Committee established by resolution 661 (1990) concerning the situation between Iraq and Kuwait indicates that the sale or supply to Iraq of most of these items is not restricted, although for most items notification to or prior approval by the Sanctions Committee would be required. Many fall under the clauses exempting "medicine and health supplies" and "foodstuffs" from the sanctions (see resolutions 661 (1990), 666 (1990) and 687 (1991)). Others fall under the category of materials and supplies for "essential civilian needs" as exempted in resolution 687 (1991), as well as the clause contained in the 20 March 1991 Sanctions Committee decision. The latter provides that civilian and humanitarian imports to Iraq, as identified in the report of that date to the Secretary-General, are integrally related to the supply of foodstuffs and supplies intended strictly for medical purposes ... and that such imports should also be allowed ..., subject to approval by the Sanctions Committee under its no-objection procedure. So far, the relevance to the humanitarian programme of the import of spare parts and equipment for the restoration of electric power plants and for the telecommunications network has not been recognized.

25. In this context, the mission observed that, in most of the cases that came to its attention, problems to date with importing the above items had more to do with the financing of such imports than actual prohibitions. The question of financing becomes even more crucial in relation to future importations that need to be made.

26. The mission members utilized the best information available to them to estimate the costs of returning the systems in each of the four sector areas to their pre-war condition. This proved possible for most sectors, with the estimates being US$12 billion for the power-generating capacity, US$6 billion for the oil sector, US$450 million for the water and sanitation systems, US$2.64 billion for food imports and US$500 million for agricultural imports. While these calculations were not possible for health, an indicative figure would be the typical level of international imports for the health sector for one year, which has been approximately US$500 million.

27. The principal criterion adopted by the mission in evaluating these needs has been that it is concerned not only with addressing immediate requirements of humanitarian scope and nature, but also with averting a crisis in the next 6 to 12 months. To illustrate this point, urgent measures must be taken now to ensure that the next agricultural planting season can be completed under reasonably normal conditions.

28. Consequently, the mission attempted to determine the costs for some lower level of actions, over a one-year time-frame. Figures were calculated for providing approximately two fifths of the pre-war per capita levels of clean drinking water and putting a corresponding proportion of the damaged sewage-treatment capacity back in operation. Expenditures for imports for health services were calculated at the pre-war level. Food import calculations were based on the ration level that WFP provides to sustain disaster-stricken populations. Special supplemental feeding programmes to support the nutritional needs of malnourished children and pregnant and lactating mothers for one year were calculated. Power generation estimates were based on restoring approximately one half of the pre-war capacity of the country. For the oil sector, the mission worked out a cost based on the consolidation of existing refineries, the restoration of lubrication units, the repair of the Iraq-Turkey pipelines, and of the oil facilities in the Kirkuk areas. This would not include repair of the southern oil fields.

29. The total estimated costs for this greatly reduced level of services came to approximately US$6.8 billion over a one-year period. This includes US$180 million for water and sanitation, US$500 million for health services, US$53 million for supplemental feeding, US$1.62 billion for general food imports, US$300 million for essential agricultural needs, US$2 billion for the oil sector and US$2.2 billion for power generation. If this analysis is applied to a four-month time-frame, the requirements would come to US$60 million for water and sanitation, US$167 million for health services, US$18 million for supplemental feeding, US$540 million for food imports, US$100 million for essential agricultural imports, US$667 million for the oil sector, and US$1.1 billion for power generation. The power and oil sectors include allowances for the front-end costs occurring in these sectors. Thus, the total for an initial four month period would be US$2.63 billion.

30. The massive financial requirements to establish even this reduced level of service are of a scale far beyond what is, or is likely to be, available under any United Nations-sponsored programme. The current United Nations appeal for humanitarian assistance for Iraq, Kuwait and the border areas with the Islamic Republic of Iran and Turkey has received only some US$210 million to date. Most of these funds are pledged for the needs of refugees and returnees. Further, any additional requests for aid to Iraq must compete with a continually lengthening list of other emergency situations around the world with very compelling needs.

31. It is evident that the Iraqi Government itself will have to revise its priorities and mobilize all internal resources. It will also have to finance the import of the type of materials under discussion, for which it has already requested approval from the Security Council Committee established by resolution 661 (1990). It certainly appeared that the Iraqi Government has the potential itself to generate the funds required to cover the needs identified by the team. This could be done either by the unfreezing of substantial amounts of Iraqi assets now held abroad or through the pumping and subsequent international sale of oil. The mission was informed that foreign exchange reserves of only US$14.75 million were on hand in the central bank and that the Government's holding of gold bullion in support of the national currency had remained constant for the last 20 years.

32. With respect to the possible sale of oil by the Iraqi Government to finance such imports, paragraph 23 of Security Council resolution 687 (1991) empowers the Security Council Committee established by resolution 661 (1990) to approve exceptions to the prohibition against the import of commodities and products originating in Iraq, with the explicit purpose of assuring "adequate financial resources" on the part of the Iraqi Government to procure medicine and health supplies, foodstuffs and materials and supplies for "essential civilian needs".

33. According to the Government, the current oil production capacity of the country is 1,455 million barrels per day. Taking into account internal consumption requirements, the production available for export could be about 1 million barrels per day. This would mean a potential net revenue of US$5.5 billion over one year. Furthermore, in order to increase the production to the pre-war level, extensive repairs and rebuilding would have to take place, particularly in the Basra area. The mission therefore recommends that Iraq be allowed to import over a four-month period US$1 billion worth of equipment, spare parts and consumable materials to start restoration of the oil sector.

34. If the Security Council Committee were to decide that Iraq should he allowed to use funds from oil sales or facilitate the use of blocked accounts in order to meet urgent humanitarian needs, the Government indicated that it would cooperate in making available documentation relating to sales of crude oil as well as purchases of the authorized imports. It noted that all revenues accruing from oil sales were normally held in United States banks and that a suitable device for monitoring such credit balances could he established. This procedure could include information on the use of unfrozen accounts. In addition, the staff of the United Nations and other humanitarian agencies present in Iraq, as well as special missions designated by the Secretary-General as required, might for instance submit periodic assessments and in particular report on the changes in the composition of the rations of foodstuffs and the provision of health and social services brought about by increased imports. The staff concerned would also obtain up-to-date information on the repair and improvement of power-generating capacity, the operation of water and sewerage plants and the like. The envisaged procedure would thus help to ensure the actual receipt of the civilian and humanitarian goods in Iraq and their utilization by the intended beneficiaries.

35. In summary, the mission recommends that:

1. Immediate steps be taken to alleviate the priority needs identified by the mission in the areas of food supply, health services, water and sanitation, power generation, the oil sector and telecommunications;
2. To meet these needs, essential goods and materials should be imported, including:
1. Food to meet the minimum consumption requirements, in part to reduce and shorten the emergency relief operation now in operation at donors' expense;
2. Agricultural inputs, including fertilizers, pesticides, animal feed and drugs, machinery and spare parts needed to repair the damaged irrigation and drainage system;
3. Drugs, including raw materials needed for local pharmaceutical production, vaccines, medical supplies and medical, surgical, dental and diagnostic equipment for the health system;
4. Vehicles (and spare parts for them) needed by the health system, including ambulances;
5. Spare parts, supplies and equipment and replacement pumps and other heavy equipment needed by water-treatment and pumping facilities and by the sewage treatment system;
6. Equipment, materials and spare parts for the electric power system, the oil sector and for the telecommunication sector;
3. A monitoring system should be instituted for this purpose. The relevant commercial transactions relating to the export of oil and the import of the above-mentioned goods and services could he made sufficiently transparent at the international level to allow adequate controls with respect to their shipment and entry into Iraq. The monitoring arrangements in the context of the United Nations humanitarian presence in Iraq, as outlined in paragraph 13 of the Memorandum of Understanding of 18 April 1991, could be further developed and strengthened so as to provide adequate information on the destination and use of the goods in question.

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130. None of us on the mission team could overlook a glaring paradox: at a time when the international community is beset with disasters of daunting dimensions around the globe, we continue to appeal to the same donors to fund emergency programmes in Iraq that the country could pay for itself. With considerable oil reserves in the ground, Iraq should not have to compete for scarce aid funds with a famine-ravaged Horn of Africa, with a cyclone-hit Bangladesh.

131. We saw with our own eyes the scenes already reported at length: the raw sewage pouring into the Tigris and the Euphrates, the children afflicted by malnutrition. Our report is inevitably but a photograph in time, fast obsolete, yet the urgency of relief from suffering remains. Further, the hard statistics speak for themselves. Conditions are already grave in all of the essential sectors assessed and can only worsen in the weeks ahead. We must achieve a breakthrough to avert the looming crisis.

132. We have not set our sights on the optimum but no doubt unrealistic goal of full restoration of services to pre-war levels. We have not even aimed at funding for a full year. Instead, more modest objectives for the key sectors, for a limited initial four-month period (September to December 1991), have been quantified. Essential civilian needs must be assured for this immediate future.

133. To fund even this partial endeavour is far beyond the capacity of the United Nations system. Nor should the resources emanate exclusively from international programmes, given the dictates of common sense and of solidarity with those needs elsewhere I referred to above. Iraq's own national resources, whether material or human, must obviously be put to good use.

134. The mandate assigned to me as the Secretary-General's Executive Delegate is of a humanitarian nature: political determinations are not in my purview. Indeed, we have consistently focused upon the needs of the most vulnerable groups, wherever they may be identified and located throughout the country. The United Nations presence in Iraq, which for the purposes of our operation has been managed through United Nations humanitarian centres with their accompanying complement of United Nations guards, has monitored and reported on the provision of humanitarian assistance and advised the authorities in this respect. This will continue to constitute a major priority. The right to food, water, shelter and adequate health care are amongst the most fundamental of all human rights and must he assured to all people in all areas. As with all the key rights and freedoms set out in the Universal Declaration of Human Rights and the International Covenants, there can be no discrimination whatsoever in their enjoyment. Due note was taken, during our stay in Iraq, of the authorities' declared objective of fostering the democratic process, with its intrinsic attributes of political pluralism and freedom of the press. The present negotiations with the Kurdish leadership were cited as an example of this trend.

135. Events of earlier years and, more recently, the civil strife that followed the Persian Gulf war, brought harmful consequences for vulnerable groups, for displaced populations, which must continue to be redressed. Those affected must be reassured and encouraged to return to their homes. The amenities so commendably accorded to those involved in the civil unrest must be extended. Where mines have been sown as indiscriminate seeds of death around refugees' home regions, they must be detected and removed. Where original habitats have been destroyed, they must be rebuilt: this is particularly true of the Kurdish villages and towns that had been razed in previous years. It takes on an added urgency with the approach of winter. Indeed, massive transformations inflicted upon the human and natural environment in any region are unacceptable and can only be injurious to all concerned in the long term.

136. The creation of confidence, which is sadly lacking in some parts of the country, is crucial. It is in the interest of Iraq, of the displaced populations and of the international community. The United Nations presence in the country has welcomed the cooperation it has received from the authorities in pursuing this shared interest. In the coming weeks, as the need to maintain confidence in the equitable distribution of goods and services throughout all segments of the population takes on critical importance, such transparency and cooperation will be essential. We will have to be assured, in particular, of the maximum distribution to the civilian population, whose proportion can indeed only grow as the time of conflict and the militarization of society recedes.

137. This mission has addressed the current humanitarian needs in Iraq and has concluded that their magnitude requires funding that exceeds international aid and short-term palliatives and can be met only from the country's own resources. How this finding is to be reconciled with, the Security Council's imposition of sanctions is a determination that is not ours to make. On the basis, however, of our deliberations and meetings with the authorities in Iraq, it would appear feasible to institute arrangements whereby Iraq's requests for imports to meet the needs outlined in this report would be submitted to the United Nations and subjected to appropriate monitoring. The precise mechanism need not be specified here. The formula agreed upon would provide for clear records of all transactions to be furnished to the Organization. Constant accountability would be assured, as would the humanitarian purposes of imports financed by oil sales. As for the question of equitable distribution, a functioning food rationing system is already in place. Other aspects have been mentioned in preceding paragraphs and concern the United Nations presence in the country.

138. It remains a cardinal humanitarian principle that innocent civilian-and above all the most vulnerable-should not be held hostage to events beyond their control. Those already afflicted by war's devastation cannot continue to pay the price of a bitter peace. It is a peace that will also prove to be tenuous if unmet needs breed growing desperation. If new displacements of Iraq's population result from hunger and disease, if relief is again sought across national frontiers, the region's stability will once more be set at risk with unforeseeable consequences. Humanitarian and political interests converge in the aversion of catastrophe. It is clearly imperative that Iraq's "essential civilian needs" be met urgently and that rapid agreement be secured on the mechanism whereby Iraq's own resources be used to fund them to the satisfaction of the international community.