1619 



country to use it, which should largely determine the size of WHO'a 

 budget. Dr. Quimby's study suggested that WHO's budgetary re- 

 straints necessitated the setting of a few high-priority programs, and 

 that there would still be numerous countries in desperate need of 

 advice and assistance because of degrading health conditions. 



A further perspective on WHO's failure to realize its fuU potential 

 may be found in the author's concluding comment: 



Public health on a worldwide scale has yet to command the attention of govern- 

 ments which a global perspective of health would appear to require. The nature 

 of the work is undramatic; the subject oflFers little in the way of political capital 

 as do so many other medical topics. Disciplinary development and professional 

 status for public health and preventive medicine are low compared with those of 

 modem diagnostic and curative medicine in the United States and other de- 

 veloped countries. The public and its elected representatives may not be aware of 

 the miracles which have been achieved in the field of preventive medicine; it was 

 these, rather than the glamorous surgical and pharmaceutical inventions of 

 recent vintage, which so dramatically changed the life expectancy of man. The 

 world was made a relatively safe place in which to live and travel many years ago 

 by the iippli cation of what now appear to be rather simple biological, medical, 

 and engineering facts. Indeed, the techniques of preventive medicine have been 

 80 successful in developed lands that neither crisis nor controversy worthy of 

 intensive political attention has emerged in recent years. 



In the less-developed lands, the power to improve human health at least cost 

 ■still lies in the application of proven technology in the public health and sanitation 

 field. Curative medicine in the poor countries has as much appeal as it does in 

 advanced countries with large populations of people with various forms of degen- 

 erative disease, but there are lacking the medicines, the doctors, and the places 

 in which to apply the cures. In many of these developing areas, the services of 

 sanitary engineer, hydrologist, or geologist are more essential to permanent 

 health gains than is the increased availability of doctors and clinics. Plant geneti- 

 cists and agrarian reform, together with culturally adapted population policies, 

 will contribute more at this time to a revolution in the health of some of the 

 economically depressed countries than will the importation of modem technology."^ 



U.S. Involvement 



The United States has played an active, if not necessarily a leading, 

 part in many of the international health initiatives of the 19th and 20tn 

 centuries. U.S. financial support of the World Health Organization 

 since its inception has been steady, and has far exceeded that of any 

 other country. (The U.S. assessment ranged from about $6 milHon 

 or 31.7 percent of the WHO assessed budget of about $20 million in 

 1961 to roughly $23.65 million or 30.87 percent of the WHO total 

 assessed budget of more than $73 million in 1971. In 1975 the U.S. 

 assessment for WHO was $30.15 milhon, or 25.64 percent of the WHO 

 total assessed budget of $115.4 million.) The United States has a re- 

 spectable record of faithful payment of its WHO assessments and good 

 performance in voluntary contributions to international health activi- 

 ties in general. On the other hand, U.S. support from the beginning has 

 been less than all-out ; the United States has rarely voted for approval 

 of the WHO budget, and in recent years has worked to reduce it. This 

 situation could change : as of July 1977, U.S. policies and actions in 

 support of international health activities were undergoing a White 

 House review. According to the office of Dr. Peter Bourne, Special 

 Assistant to the President for Health and International Human Needs, 

 an interagency task force headed by Dr. Bourne was to report to Presi- 

 dent Carter by early fall 1977 on problems, prospects, and policy op- 

 portunities in the associated areas of international health, nutrition, 

 and population. 



"' yuimby. The Politia of OMxU Health, vol. 11, p. 757. 



