1774 



The study then raises the question as to whether technology, 

 recognized as a potent factor of change and national power, 



... is to operate in a random way, or whether it is possible, and desirable, 

 to devise a national strategy to guide and direct it, to stimulate innovation in some 

 directions, and possible to slow and inhibit innovation in others.^^s 



The study next takes up the question of whether the United States 

 should opt for a strategy of high or low technology: "It has supported 

 the laser but not the science of processing garbage." Asserted U.S. 

 lags in the technology of the commonplace could "impair the credi- 

 bility of the U.S. posture of world technological leadership": 



... On this point, one issue of U.S. technological strategy would seem to be 

 a conscious set of decisions as to the domestic technological gaps to be closed or 

 ignored. What older technologies might be revitalized by an infusion of fresh 

 technological eflFort, such as the railroads, glass and ceramics, coal, lumber, and 

 textiles? What would be the diplomatic consequences of a vigorous technological 

 effort in one, several, or all of these fields? *^* 



Even in a country as rich in technological resources as the United 

 States still continues to be, there are evident limits. How best can these 

 resources be employed, not only for domestic economic health but 

 also for worldwide economic stability and growth? What are the policy 

 resources the United States can bring to bear on these issues of national 

 strategy in materials? Said the study: "U.S. efforts have been con- 

 centrated in fields of high technology in a reaction against external 

 threats; the result has been to assemble large organizations in the 

 fields of military, space, and atomic technologies. That these fields 

 continue to be important is not questioned. But in the design of a 

 total national strategy of technology, the effect of their being already 

 on the scene in great numbers is to provide pressures for the United 

 States to keep on doing what it has been doing. Where can objective 

 analysis and innovative policy be found that can examine alternatives 

 or additions to the national program?" *^^ 



ISSUE two: the politics of global health 



It is hard to apply the high-low technology dichotomy to the field 

 of global health. One area of high technology in medicine is the use 

 of the computer for rapid diagnosis and the handling of massive 

 quantities of pathology laboratory data. Another is the development 

 of "bio-matenals." 



However, another kind of analog might be drawn between the 

 philosophy of curative medicine in the United States and the em- 

 phasis of the World Health Organization on preventive medicine 

 (and public health in particular). While both concepts are science- 

 based, the expensive equipment, treatment, and operating procedures 

 of curative medicine preclude its general availability. Medical care 

 in the United States is expensive and growing more so with each 

 further innovation of high technology in curative medical practice. 

 It is inconceivable that this philosophy of medical care could be made 

 available worldwide; even in the United States itself, the trend ^and 

 its impUcations raise many questions. On the other hand, the sys- 

 tematic application of the science, skills, and practical knowledge 

 of pubhc health yields massive reductions in the incidence of diseases 



«3 Ibid., p. 675. 

 «< Ibid., p. 677. 

 «5 Ibid., p. 678. 



