prevent many deaths, to improve health and nutrition, 

 and to facilitate family planning. Thus the potential 

 for effective action is very great. 



To stimulate interest and action in addressing such 

 problems, politicians, planners, and decision makers 

 need to be shown that basic health services can be 

 provided and that desirable results can be produced. 

 Furthermore, a carefully planned package, based to the 

 largest extent possible on local or community resources 

 (including community health workers) need not be 

 extravagantly expensive. It has been pointed out that 

 the current health care/nutrition package in Sri Lanka 

 has produced a life expectancy at birth greater than 

 that in Washington, D.C., at a cost of less than $15 

 per person per year. 



However well or poorly the United states is 

 providing domestic health care and "containing" health 

 care costs, there is no doubt that it can help 

 developing countries that want to improve their health 

 care systems. The United States has the technology, 

 much of the medical equipment, the organizational and 

 management skills, and useful experience working in 

 developing countries. 



Ongoing Work 



Many governmental and nongovernmental mechanisms 

 exist for the direct in-country transfer of technology. 

 The former include bilateral (AID, the Swedish and 

 Canadian international development agencies, etc.) and 

 multilateral agencies (WHO, the World Bank, UNFPA, 

 UNICEF, etc.). The latter include foundations (Ford, 

 Rockefeller, Volkswagen, etc.), educational 

 institutions, voluntary agencies (CARE, International 

 Planned Parenthood Federation, the Oxford Committee for 

 Famine Relief of England) , religious institutions, 

 nonprofit agencies (Battelle Memorial Institute, 

 Management Services for Health, Research Triangle 

 Institute, Population Council, etc.), and corporations 

 (Westinghouse, Whittaker) . Professional associations 

 such as the American Public Health Association and the 

 societies for medical anthropology and medical 

 sociology are also active in this field. The 

 effectiveness of these mechanisms varies, but 

 generally, the record is probably better when the 

 transfer concerns "hard science" or technology than 

 when it involves institution-building. 



Another important transfer mechanism is the 

 education of physicians, nutritionists, and family 

 planning specialists from developing countries in the 

 United States or other affluent countries. This 

 mechanism has been criticized on the grounds that many 



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