286. Memorandum From the President’s Special Assistant for Health Issues (Bourne) to the President’s Assistant for National Security Affairs (Brzezinski)1


  • Proposed Joint U.S.–U.S.S.R. Health Cooperation in Selected Third World Countries


As you know I have been consulting with a number of agencies regarding the subject proposal to obtain their views prior to submitting a recommendation to you. State, AID, HEW, and the Science Advisor were requested to comment on the concept paper2 and offer their views. NASA and Transportation (FAA) were also sent copies for their information in view of their involvement with the Soviet Union in the medical scientific area.

They have all commented, and what follows is a summary of their views and my overall analysis. A copy of each agency’s comments is at [Page 947] tached at Tab A;3 the recommended transmittal letter to the Soviet Union is attached at Tab B for your review and approval.4

Summary of Department and Agency Views

1. State supports the proposal. They suggest that “the initial approach to the Soviets should be low key and of sufficient detail to make our intentions clear.” Further they recommend that “first contact be made through our embassy in Moscow at a high level and privately conveying a supporting statement of White House interest.” State also recommended that before a presentation is made to the Soviets that specific project outlines be developed and carefully analyzed from the following perspectives:

—“U.S. political interest in the country or area concerned

—“Interests of U.S. allies and other powers which are pertinent; and

—“Implications of proposed activities for our involvement in WHO or other multilateral organizations.”

They also recommend that an ad hoc interagency group be formed to develop a range of projects in adequate detail to assure technical and political feasibility. They further recommend that the overall effort be chaired by State, with my office and the National Security Council represented in all phases, and a technical sub-group co-chaired by HEW and AID to outline projects, specify candidate countries, and develop them for a steering group review.

2. AID supports the proposal. However, they express concern with respect to the commingling of U.S. AID funds with those of communist nations; inevitable congressional criticism of joint activities which AID is involved in that would potentially damage the bilateral assistance program in general; and also express concern about the emphasis on joint programs in the field rather than additional cooperative efforts in the research area. They also point out (as other agencies have) that it is important that there be technically sound projects that are offered so that we can assure that the program is successful.

3. DOD supports the proposal. They comment that the proposal may have the effect of “reducing competition in Third World countries” and [Page 948] “can have long term humanitarian and national security benefits to the United States”. They also recommend that a strategic working group be formed with representatives from DOD, State, AID, HEW and CIA to undertake the planning for this joint project.

4. HEW supports the proposal. They suggest that a joint working group be charged with identifying the best means for conducting specific cooperative projects. They also pointed out that a new intergovernmental agreement with a new permanent technical working group may be necessary for some kinds of specific projects. For other projects amendments to existing bilateral cooperative agreements such as the current agreement on medical science and public health will provide a more advantageous mechanism.5 And finally, they suggest that some joint or trilateral projects might be best accomplished through specific agreements with multilateral organizations such as the World Health Organization.

5. The Science Advisor’s Office fully supports the proposal. They suggest that perhaps the forthcoming meeting of the U.S.–U.S.S.R. Commission on Scientific and Technical Cooperation scheduled for July 6–8 might be used as an opportunity to discuss the health cooperation agreement concept with Soviet representatives.6 The leader of the Soviet delegation will be academician Kirillin, a deputy premier and Chairman of the State Committee for Science and Technology. It is expected that Dr. Kirillin will meet with the President and it was suggested that this may be an avenue to present the proposal.

Analysis and Conclusions

The concerns of the State Department with respect to the specificity of the proposal are valid but only in the context of implementation and preplanning with respect to a joint working group. Specificity can be worked out once the proposal is found acceptable.

Two different approaches have been suggested by State and OSTP in conveying the idea of medical cooperative relationships in the Third World. State suggests that the traditional diplomatic route be followed [Page 949] and that the concept be conveyed through the U.S. Ambassador in Moscow. The Office of the Science Advisor suggests that Dr. Kirillin be approached in July during the forthcoming meeting of the U.S.–U.S.S.R. Commission on Scientific and Technical Cooperation. Either approach seems appropriate. My own judgment is that routine diplomatic channels seems to have the benefit of not suggesting anything extraordinary on this new initiative and would not unduly sensitize them to this proposal.

Attached at Tab B is a recommended letter from the Secretary of State to Foreign Minister Gromyko and the accompanying proposal for your review and consideration.

All of the agencies who have a background in this area have had an opportunity to review and comment on the proposal both informally through a working group and formally. If you have any further questions, please give me a call.

  1. Source: National Archives, RG 59, Policy and Planning Staff—Office of the Director, Records of Anthony Lake, 1977–1981, Lot 82D298, Box 2, TL 6/16–30/77. No classification marking.
  2. Not found and not further identified.
  3. Attached but not printed are agency comments on the proposal.
  4. Attached but not printed is a proposed letter of transmittal to Gromyko, dated June 17, and the joint health proposal. There is no indication that the letter was sent to Gromyko. In remarks made at the annual meeting of the Southern Legislative Conference in Charleston, South Carolina, on July 21, Carter announced that the United States and Soviet Union were “seeking ways to cooperate in improving world health and in relieving world hunger.” (Weekly Compilation of Presidential Documents, August 1, 1977, p. 1066). In a September 27 memorandum to Christopher (see Document 298), Lake noted that the White House had approved the joint health initiative.
  5. American and Soviet officials concluded an agreement on health cooperation on May 23, 1972, during the Moscow Summit meetings. The agreement committed the United States and the Soviet Union to sharing scientific knowledge regarding the eradication of cancer and heart disease and collaborating with international organizations in the health field. The text of the Joint Communiqué, of which the agreement is part, is printed in Department of State Bulletin, June 26, 1972, pp. 899–902.
  6. The Moscow Summit also yielded an agreement on cooperation in the fields of science and technology, which authorized the creation of a U.S.–Soviet Joint Commission on Scientific and Technical Cooperation. (United Nations Treaty Series, vol. 852, p. 141) At the July 1977 meeting of the Joint Commission, U.S. and Soviet officials opted to renew the agreement for an additional 5 years. (United Nations Treaty Series, vol. 1087, pp. 102–103)