1750 



eradication program." '*^ Dr. Quimby observed, however, that the- 

 Peterson Report's assertion that "a predominantly bilateral U.S, 

 program is no longer poUtical tenable in our relations with many 

 developing countries" ran counter to congressional preferences for 

 bilateral programs. 



The rationale for a shift from bilateral to multilateral programs in 

 the health field, according to Dr. Quimby, is as follows: 



The expansion of national public health interests to global dimensions calls 

 not only for diplomacy or statesmanship of the conventional type; it calls for 

 worldwide experience with science, medicine, and public health as political 

 systems themselves and for experts in the subject matter. The more reliance 

 there is on multilateral organizations for controlling disease and assisting all 

 the countries of the world in improving their state of health, the less need there 

 is for a national or bilateral point of view. The. more the health of the State 

 becomes dependent upon the health of the world, the more the interests and 

 technology of the State become blended into those of the world. If and when 

 it appears that the only feasible approach to the problems of human health is 

 indeed a worldwide approach, it will be necessary for knowledge to be shared 

 and exchanged by those who are in possession of it and who by tradition and 

 practice are used to sharing and exchanging it. The multilateral health organiza- 

 tions are simply institutional devices for encouraging this process in the inter- 

 national health profession.^'* 



The concept of multinational regionalism, developed in the Mekong 

 study,'^* offers signal opportunities in the field of health. Regions of 

 endemic disease and regions in which particular disease vectors are 

 common might warrant cooperative control measures by the nations 

 in the region, perhaps with the support of WHO. While some success- 

 ful programs of this sort have been recorded, as for example the work 

 of the Pan American Health Organization (PAHO), the principle 

 seems capable of more extensive exploitation as indeed Dr. Quimby 

 suggests. 



ISSUE three: beyond malthus 



The two subjects of this study — food and population — both require, 

 for cornpletely different reasons, a multilateral approach. The global 

 allocation of food to alleviate starvation and desperate shortage can 

 scarcely be managed on the basis of a network of bilateral agreements. 

 The unfortunate experience of the U.S.-U.S.S.R. grain transaction 

 (discussed in Case Six above) demonstrates this clearly. To be sure, 

 the equitable distribution of foods to all populations on the globe is 

 still a remote goal. But the present scheme of production and distri- 

 bution has already become too complex an international operation 

 to be resolved by an intricate series of bilateral arrangements. 



The matter of population involves a quite different set of considera- 

 tions. Long regarded as a personal or familial matter from which all 

 official intervention was excluded, the right to procreate is increasingly 

 recognized as posing a general political problem related to the future 

 well-being of nations and indeed the entire world's people. As this issue 

 becomes clarified and its policy requirements are defined, perhaps there 

 will be further adaptations in the approaches to its political and 



3»^ Ibid., p. 760. 



3»3 Quimby, The Politics of Global Health, vol. II, p. 761. 



'M U.S. Congrcs,s. House, Committee on Foreign Affairs, The Mekong Project: Opportunities and Problems 

 of Regionalism, a study in the series on Science, Technology, and American Diplomacy, prepared for the 

 Subcommittee on National Security Policy and Scientific Developments by Franklin P. Huddle, Science 

 Policy Research Division, Congressional Research Service, Library of Congress, Washington, U.S. Govt, 

 Print. Off., 1972. See vol. I, pp. 361-434. 



