799 



evident internal instability that arises from urban migration, un- or 

 underemployment, lack of adequate food and sanitation, and serious health 

 problems. 



Science and technology cannot solve the population problem, but can make 

 important contributions, and can provide the necessary tools for public 

 policy. In particular, more R&D is needed to help provide an array of 

 available low-cost contraceptive technologies (especially including male 

 contraceptives), and on the social determinants of effective family planning 

 policy. Fertility decline is so closely related to other aspects of 

 development, in particular health, food, sanitation, transportation and 

 communications, that in a sense all development-related R&D can contribute 

 indirectly, sometimes directly to the population problem. 



Once again, the institutional constraints in the U.S. make it difficult to 

 engage U.S. science and technology resources adequately. U.S. departments and 

 agencies are not able to devote substantial resources on problems not defined 

 as domestic, which effectively precludes realizing the scale of contributions 

 U.S. scientists and engineers could make to these issues. 



In population -related (and health-related) subjects, a special variant of 

 this institutional problem exists. It is the health and safety regulation of 

 drugs in the U.S. based on risk/benefit criteria applicable only to the U.S. 

 Thus, proposed contraceptive drugs are evaluated for safety based on the risks 

 of health side effects in the U.S. environment, when the risks and benefits 

 are likely to be quite different in another country. In some cases, American 

 pharmaceutical companies are deterred from developing a drug at all, since the 

 benefits of protecting against some diseases (schistosomiasis, for example) 



