,758 



and of knowledge yet to be gained for preventing some forms of the 

 disease in the first place."'^ Other experts have made similar arguments 

 with respect to cardiovascular diseases. 



The magic of health as a rallying point for international unity 

 does exist to a degree but it is not as persuasive as some well-turned 

 phrases would imply. Transnational medical work, of course, is 

 performed with greater ease by private organizations (such as, for 

 example, the hookworm eradication program of the Rockefeller. 

 Foundation), but multilateral institutions are necessary and might 

 function almost as well if fewer reservations and restraints were 

 imposed upon them. Thus the hypothesis is advanced that it may be the 

 attitudes of member governments of international health institutions 

 which are in need of change, as well as the priorities and management 

 l^ractices of the institutions themselves. The nations have experimented 

 for 70 years with organized intergovernmental cooperation in the 

 control of disease and more recently in the direct promotion of health. 

 From agreement to agreement, it is generally held among health 

 authorities that the member states have been overcautious and have 

 either stmctured the organizations to protect their sovereign interests 

 or have avoided full coiiunitment to the regional or global health 

 objectives which were formalized in the charter of those organizations. 



When special circumstances kept member governments occupied with 

 other important matters, so that the health institutionc were left to 

 their own devices, a great deal somehow was accomplished, even with 

 very modest resources. The Health Organization of the League of Na- 

 tions is an example of this. However, when relative bigness and in- 

 creased autliority prevail, as in WHO and PAHO, there is some anxiety 

 about new international health regulations, concern over the high arid 

 growing costs of operations, and sus])icion and fear that global health 

 philosophies might challenge traditional health care systems of any 

 given country. The pharmaceutical industry may be especially wary 

 of resolutions and regulations affecting their products and their profits. 



The WHO/PAHO arrangement grew slowly at first, adapted to 

 many kinds of anticipated resistance and to some difficulties which 

 M-ere not anticipated — the cold war, the Korean conflict, the Vietnam 

 war, and even to the situation in WHO's Eastern Mediterranean 

 region. But the system of international health institutions flourished 

 anyway and it continues to grow in worldwide influence. There are 

 several reasons for this relative success : 



1. There was work to be done; it was needed, as statesmen and 

 doctors had agreed when they established prior conventions, offices, 

 and organizations over a period of many years. 



2. WHO has utilized di idiomatic assistance both during the structur- 

 ing of its constitution and hi subsequent problem 'olving, but WHO is 

 a professional, scientifically based, international complex. Wliile all 

 of its halls may not be decked with eminent scientists and physicians 

 it still has them at its disposal. It appears to have followed at least 

 two of the axioms of successful international technical enterprise : 



a. If se/enf/-'^.fs or enfjineerfi con render technical a^shtance to a 

 ilevelo'ping country it can succeed }) est with good science at the helm. 



»' .Toshua Lederberg. "Cancpr 'Cure' Has Limitations." The Washington Post (t'eb- 

 riiary 14. 1971), page C-2. It is well known among dermatologists, for example, that an 

 important reduction in the incidence of skin cancers of the most prevalent type could be 

 eflFected by the simple expedient of shielding the body from the sun more carefully, 

 especially in subtropical latitudes and in open-air occupations. 



