283. Memorandum From the Secretary of the Cabinet (Watson) to President Carter1


  • Formation of a Cabinet Level Task Force on International Health

I have been working with Peter Bourne regarding formation of a Cabinet level task force on international health.2 As in so many areas of interagency concern, the principal problem is the lack of coordination and focus among multiple departments and agencies (in this case, at least 16), with a consequent failure to maximize the beneficial effects of the dollars we have to spend.

As outlined in the attached memorandum, we propose formation of an executive overview committee consisting of State, acting as Chairman, Defense, Commerce, Treasury, HEW and AID. I will coordinate the activities of that group. Peter will chair a coordinating committee of all the affected agencies and will divide them into working groups to address the administrative and legislative policy options outlined on page 2 of the proposed memorandum.3 In doing the work, we [Page 940] will involve many private sector groups, including business, labor, foundations, universities and church groups.

In reviewing the situation, we believe that an outline of initiatives can be presented to you on or before August 15th.


Draft Memorandum From President Carter to the Cabinet and Other Affected Agencies4


  • U.S. International Health Policy

Approximately two billion human beings in Third World nations face premature death due to preventable parasitic and infectious diseases, malnutrition and lack of sanitary water supply. Similarly, in the industrialized nations of the world, many crippling and debilitating diseases continue to cut short productive and happy lives. This state of affairs has continued in the face of unprecedented advances in medical science and technology.

A preliminary assessment conducted at my request by Peter G. Bourne, M.D., found that the United States government is not building adequately on the mutual self interest of all nations to use readily available medical scientific knowledge to improve the health and well being of people everywhere. I believe that the United States government needs to take steps to improve its capacity to fight disease in partnership with other nations.

I have asked Jack Watson to organize a Cabinet-level Task Force on International Health. The work of the Task Force will be overseen by an Executive Committee consisting of the following agencies: State (Chmn.), Defense, Commerce, Treasury, HEW, AID. The White House Office of the Special Assistant for Health Issues will also be a member. Jack will serve as Executive Secretary of the Executive Committee and Peter Bourne will chair a coordinating committee which will be supported by working groups. The charge of the Task Force will be to prepare a report for me recommending government action to strengthen the U.S. government’s capacity to cooperate in health with the developing and developed nations of the world.

[Page 941]

Specifically, the Task Force shall recommend administrative and/or legislative policy options on the following by August 15:

—More effective ways in which to facilitate greater private sector involvement in international health, including international voluntary agencies, industry, labor, foundations and universities.

—More effective measures to improve the quality and ensure an appropriate supply of health manpower in developing countries.

—Measures to improve the effectiveness of international health research in the United States, and to improve cooperation with other nations and international organizations.

—Measures to improve the organization and management of international health programs.

—A long-range strategy for United States international health policy.

I ask all affected Department and Agency heads to assist in completing this assessment.5

  1. Source: Carter Library, Staff Office Files, Special Assistant for Health Issues—Peter Bourne Files, Subject Files, Box 34, International Health, 6/1/77–6/15/77. No classification marking. There is no indication that Carter saw the memorandum.
  2. See Document 281.
  3. As chairman of the coordinating committee, Bourne subsequently established four working groups: Strategy Development; Research, Development, Demonstration, and Application; Health Manpower; and Private Sector Involvement. The Strategy Development working group was further subdivided into four functional working groups: Development and Supporting Assistance; Health of U.S. Citizens and Scientific and Professional Cooperation; Commerce and Finance; and Foreign Policy and Medical Diplomacy. (New Directions in International Health Cooperation: A Report to the President, pp. XXVII–XXVIII)
  4. No classification marking. No drafting information appears on the memorandum.
  5. Fill, in a June 11 memorandum to Watson, noted that Hutcheson did not think the draft should go to Carter at that time; see Document 285. According to a June 24 memorandum from Watson to Califano, Christopher, Gilligan, Brzezinski, Cutter, and Bourne, Watson had not yet forwarded the memorandum to the President by that date. (Carter Library, Staff Office Files, Special Assistant for Health Issues—Peter Bourne Files, Subject Files, Box 34, International Health, 6/16/77–6/30/77)