Proposed Initiatives 



To provide a focus for government, industry, and 

 academic research on these problems, w e recommend that 

 the United states create a new, highly visible program 

 to improve understanding, prevention, and treatment of 

 the infectious diseases of the tropics. This could be 

 accomplished either by creating a National Institute 

 for Infectious Diseases of the Tropics, or by providing 

 an appropriate mandate and funding for an intensified 

 program at the National Institute of Allergy and 

 Infectious Diseases of NIH, which already has many of 

 the relevant research capabilities. Either institution 

 could help provide for an integrated problem- solving 

 effort with a specific orientation to the needs of 

 developing countries. 



The new program should have the capability to 

 handle all stages of technology development, 

 adaptation, and transfer into various cultural 

 settings. Assistance should also be provided in 

 manufacturing, assembling, packaging, distributing, and 

 marketing innovations. 



Specific research might be undertaken on: long 

 term prophylaxis against malaria and various parasitic 

 diseases; heat-stable vaccines for such diseases as 

 measles and malaria; simplification of the BCG 

 vaccination procedure; new products and packaging for 

 oral rehydration, particularly for children; and 

 delivery mechanisms in areas without electricity for 

 immunizations and medications that presently require 

 refrigeration. However, the investment of fiscal, 

 human, and organizational resources in the biomedical 

 research issues described should not detract from, or 

 overbalance, investment in the development of basic 

 health services and the organization of health, 

 nutrition, and family planning delivery systems. These 

 are of equal or higher priority. 



We recommend that the United States allocate 

 increased financial resources to support public and 

 private sector research and training. Research support 

 should be balanced between support of domestic 

 institutions, including the proposed new institutional 

 arrangement, and the development and strengthening of 

 institutions in developing countries. Support can be 

 provided through both bilateral and multilateral 

 agencies, especially through WHO for the special 

 programs mentioned above. An appropriate balance 

 should be struck between short-term and long-term goals 

 (immediate control programs versus biomedical research) 

 and between basic and applied research. Initially, 

 most of the necessary biomedical research will have to 

 be undertaken in developed countries, with gradually 



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