1623 



funds, coordination, review, and decision in technical assistance for 

 country-centered liealth programs, and — even though such an ap- 

 proach could not have been put into practice for several years — sug- 

 gested to U.N. member governments that they could stabilize the 

 WHO budget at the level already achieved. 



Three: The Peterson Report of March 4, 1970 (Report to the 

 President from the Task Force on International Development) , which 

 proposed to rely on multilateral organizations like WHO in place of 

 AID, but included no specific recommendation that AID funds for 

 health and sanitation be transferred to WHO. Indeed, it did not even 

 mention WHO directly, and rarely mentioned health. 



INADEQUATE BUDGET JUSTIFICATION FOR U.S. SHARE OF W.H.O. FUNDING 



SUPPORT "^ 



Nor does the method by which the executive branch presents its 

 budget justification for the U.S. share of funding support for WHO and 

 PAHO provide Congress with a clear and emphatic picture of the 

 needs of these organizations in relation to potential for accomplish- 

 ment. This justification is submitted to the House and Senate Appro- 

 priations Committees (the respective Subcommittees on State, Justice, 

 Commerce, and the Judiciary) as part of a total package that includes 

 the United Nations and its nine specialized agencies — of which WHO 

 is one; the package also includes PAHO and five other inter- American 

 organizations, NATO and 6 other regional organizations, and 15 

 miscellaneous bodies. Related hearings records typically do not deal 

 with the nature and merit of the substantive work of agencies like 

 WHO and PAHO; attention is largely focused on budgets and balance 

 of payments. The prevailing view seems to be that the United States 

 is overassessed and overcommitted to ever-increasing organizational 

 budgets; assessments for multilateral enterprises are seen as one more 

 form of foreign aid. Not only has international health not been spared 

 from rising congressional concern about costs, lack of control over 

 budgets, and the need to restrict the outflow of American dollars; 

 on the contrary, international health organizations — as modest as 

 their demands are in comparison with nuclear power and weapons 

 donations, and in relation to possible returns — have often been singled 

 out for budgetary discussion in both Senate and House appropriations 

 hearings. 



LACK OF UNDERSTANDING OF MULTILATERAL HEALTH PROGRAMS 



Congressional frugality with respect to multilateral health programs 

 would seem to reflect in large part a commimications gap — that is, a 

 lack of understanding of how much international health activities 

 have accomplished and also how much remains to be done that cannot 

 effectively be done through bilateral measures — and the absence of a 

 sense of Jurgency. Symptomatic of the latter was the failure of a bill 

 (H.R. 12453, the International Health Act of 1966) aimed at the 

 shortage of manpower trained for international health activities and 

 at raising the low level of U.S. participation in the WHO staff. The 

 bUl was supported by the HEW Secretary, tlie Surgeon General, the 

 American PubBc Health Association, the Association of American 



1*8 For a recent account of this problem as it relates to U.S. funding support of intemational organisations 

 generally, see: U.S. Congress. Senate, Committee on Coveniment Operations, L'.»S. Participation in lutir- 

 national Organizatiovs, Washington, D.C., U.S. Government Printing Oflice. February 1977, 140 p. (Senate 

 Document No. 95-50), pp. 48-50. 



