295. Memorandum From the President’s Special Assistant for Health Issues (Bourne) to His Assistant (Fill)1


  • Themes for World Health

In my previous overview memo2 I failed to adequately stress the use of health as a way, not merely to help us restore diplomatic relations with nations we do not currently have relations with but to bring us closer together with countries such as Burma and Somalia with whom we have formal relations, but are not close. Many of those countries are ignored or given a low priority because they are militarily or strategically unimportant. Traditional use of foreign aid for this purpose has not been as useful as had been hoped because of the lack of flexibility and the severe constraints under which it operates.

As a strategic element in our overall foreign policy, health has been extraordinarily underutilized. We have seen what Cuba has done in [Page 977] this regard, and our initiative with the Soviet Union could be a beginning example of how health could be used more aggressively.3 We should look at a potential for health to be used as an effective tool to swing countries towards us in a way that we only do now with armaments.

The argument will be made to us that most leaders, particularly in Africa, do not really care about health. We need to refute this strongly because whereas it may have been true in the past, and many people in the foreign policy establishment still believe it, times have changed and health now has far higher priority than at any time previously. Emphasizing the clear links between economic development, political stability and health is important.

  1. Source: Carter Library, Staff Office Files, Special Assistant for Health Issues—Peter Bourne Files, Subject Files, Box 34, International Health, 8/1/77–8/31/77. No classification marking.
  2. See Document 294.
  3. See Document 286.