1621 



AID had a budget of about $90 million for international health, of 

 which nearly a third consisted of funds for capital investments in 

 sanitary sewerage and water supply. Earlier hmitations of AID as 

 an organization serving U.S. interests in international health were lack 

 of staff in the medical field and its practice of concentrating assistance 

 in relatively few countries. In the fiscal year 1969, 87 percent of AID's 

 assistance to individual countries went to only 15 nations. Today, 

 however, AID provides health assistance to about 40 nations and co- 

 operates actively with WHO — not only with its Geneva headquarters 

 but with its various regional offices. Indeed, along with the growing 

 bilateral programs of HEW, the multilateral programs of WHO and 

 the bilateral programs of AID are the mainstay of global health ac- 

 tivities involving the United States. Both programs are increasing in 

 total funds and in scope. Furthermore, coordination between WHO and 

 AID is today much greater than in the past. Each knows what the 

 other is doing, and programs are coordinated. 



THE ROLE OF DHEW 



The Public Health Service (PHS) in the Department of Health; 

 Education, and Welfare is the primary U.S. Government resource 

 in both national and international health. It is the official technical 

 liaison with WHO and PAHO. Its chief medical officer played a major 

 role in the drafting of the WHO's constitution and has usually served 

 as head of the U.S. delegation to the World Health Assembly. PHS 

 prepares the U.S. technical position papers for the assembly and pro- 

 vides or assists in providing experts for the WHO advisory committees. 



Many of HEW's laboratories and institutes serve as WHO reference 

 centers or collaborating research institutes. There are many such cen- 

 ters and institutes in the United States; several of them are located 

 in the PHS National Center for Disease Control in Atlanta, Ga., 

 which is part of WHO's worldwide epidemiological intelligence net- 

 work. Besides playing a prominent role in international health or- 

 ganizations, HEW participates actively in U.S. bilateral health and 

 sanitation programs. 



The National Institutes of Health of the Public Health Service 

 (NIH) no longer maintains overseas offices in U.S. Embassies in 

 Paris, Rio de Janeiro, Tokyo, or New Delhi. It continues, however, 

 to support research laboratories in the Panama Canal Zone (the 

 Middle America Research Unit and the Gorgas Memorial Laboratory) 

 and Guam (Epidemiology and Genetics Centers). NIH also adminis- 

 ters the Pakistan Cholera Research Laboratory for SEATO, funded 

 under a bilateral agreement between AID and the Government of 

 Bangladesh. 



Funds obligated for HEW's international health activities, on a 

 relatively low plateau in recent years ($38.5 million in fiscal year 1973, 

 $39.0 million in 1974, $36.5 million in 1975), have risen sharply in fiscal 

 years 1976 and 1977 ($57.9 million and an estimated $72.2 million), re- 

 spectively. According to the HEW spokesman who furnished these 

 figures in July 1977, the increases have been mainly for research. 



THE DOD ROLE IN INTERNATIONAL HEALTH 



The Department of Defense (DOD) plays a special part in the inter- 

 national health field. Military medicine has long been the backbone 



