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fro, the slow speed of such movement, and the general agrarian dis- 

 persal of the population. Today the world is small in these latter re- 

 spects, is rapidly becoming a unit, epidemiologically speaking, and 

 urban sprawl threatens to renew the dangers which were inherent in 

 the unsanitary conditions of the past. 



International health institutions, the public health profession, in- 

 dividual nations in bilateral agreements, and the private foundations 

 have attempted to keep pace with these explosive developments. The 

 nature of the problems was such that most of these efforts have focused 

 on large sections of a country, on large geographic regions, or on vir- 

 tually the entire globe. All of the efforts liave been temporarily in- 

 terrupted by the great wars; conditions against which such efforts 

 were aimed have been worsened by these wars. 



Public health on a worldwide scale has yet to command the atten- 

 tion of governments which a global perspective of health would appear 

 to require. The nature of the work is undramatic; the subject offers 

 little in the way of political capital as do so many other medical topics. 

 Disciplinary development and professional status for public health 

 and preventive medicine are low compared with those of modern 

 diagnostic and curative medicine in the United States and other de- 

 veloped countries. The public and its elected representatives may not 

 be aware of the miracles which have been achieved in the field of pre- 

 ventive medicine ; it was these, rather than the glamorous surgical and 

 pharmaceutical inventions of recent vintage, which so dramatically 

 changed the life expectancy of man. The world was made a relatively 

 safe place in which to live and travel many years ago by the application 

 of what now appear to be rather simple biological, medical, and engi- 

 neering facts. Indeed, the tecliniques of preventive medicine have been 

 so successful in developed lands that neither cris'is nor controversy 

 worthy of intensive political attention has emerged in i-ecent years. 



In the less developed lands, tlie power to improve human health at 

 least cost still lies in the application of proven teclinology in the pub- 

 lic health and sanitation field. Curative medicine in the poor countries 

 has as much appeal as it does in advanced countries with large popula- 

 tions of people with various forms of degenerative disease, but there 

 are lacking the medicines, the doctors, and the places in which to ap- 

 ply the cures. In many of these developing areas, the services of sani- 

 tary engineer, hydrologist, or geologist are more essential to permanent 

 health gains than is the increased availability of doctors and clinics. 

 Plant geneticists and agrarian reform, together with culturally 

 adapted population policies, will contribute more at this time to a 

 revolution in the health of some of the economically depressed coun- 

 tries than will the importation of modern medical technolog\'. 



The skills to prevent or control the spread of a new virulent "germ" 

 lie in the now vast and potent technologj'^ embracing physical and 

 chemical detection, microbiology, biochemistry, molecular biolog}', 

 water treatment and rapid A'accine development. These are perhaps 

 the more modern elements of preventive medicine. Some students be- 

 lieve that a resurgence of the preventive medicine and public health 

 point of view will also prove to be the most incisive channels of ex- 

 ploiting modern biological knowledge on behalf of the degenerative 

 diseases. Lederberg, for example, has noted the high cost of a cure 

 of cancer after the fact, versus the application of existing knowledge 



