313. Editorial Note
On May 2, 1978, the White House issued a Presidential statement on international health. In January, the President’s Special Assistant for International Health Affairs Peter Bourne had recommended that President Jimmy Carter use either a message to Congress or a speech to explicate the administration’s international health strategy (see Document 306). In addition to the Presidential statement, Secretary of Health, Education and Welfare Joseph Califano, head of the U. S. delegation to the 31st annual World Health Assembly in Geneva, Switzerland, would formally reiterate the administration’s commitment to an increased role in international health activities. According to an April 26 memorandum from Bourne to Carter, it was necessary for the White House to release the statement on international health prior to Califano’s scheduled May 9 speech, “both to reaffirm this as your initiative, demonstrating your leadership in this vital area of human needs and also to lend weight to the message Joe will deliver. I believe both parts, your statement, and Joe’s speech are extremely timely and important to counter the criticism that we have been too long on rhetoric with regards to basic human needs, and short on specifics. It is particularly useful to do this following shortly after your trip to Africa.” (Carter Library, Staff Office Files, Special Assistant for Health Issues—Peter Bourne Files, White House Office File on International Health, Box 53, Principles Statement, 4–5/78)
The President used the statement to provide a brief overview of the world’s health problems and stress cooperation in an increasingly interdependent climate before outlining the administration’s proposed initiatives:
[Page 1055]“Consistent with the announced expansion of foreign aid, and our effort to focus that aid on the poorest of the world’s people, my administration has undertaken a review of international health needs. Our aim was to determine the most effective ways in which the U.S. Government and private organizations could help reduce the personal and economic impact of widespread malnutrition, infectious diseases, and other health hazards including those associated with frequent childbirth.
“As a result of that study, I am announcing today my intention to launch a program to strengthen the participation of the United States in worldwide efforts to overcome disease and ill health.
“Our efforts will be based on the following principles:
“—A basic minimum level of health, nutrition, and family planning services should be available to the world’s poor, whether they live in rural areas or urban slums.
“—Developing nations can eventually meet their own health needs if we assist them in strengthening their institutions and building their own health systems.
“—Community-based primary health care, including the use of community resources and the training of appropriate health personnel as near as possible to where they will deliver services, is the most effective means of achieving the standard of health we desire for all people.
“Our objective is to concentrate on the prevention of disease and ill health. We will put special emphasis on providing clean drinking water, basic sanitation, basic immunizations, and efforts to prevent and treat blindness. This emphasis will be reflected in our own programs and in our support of priorities established by various international organizations.
“We will work toward the lasting control or eradication of the major infectious diseases, particularly ‘tropical’ diseases that continue to be the leading causes of death and disability.
“We will give special attention to the major causes of death in children—diarrhea and respiratory disease, particularly when aggravated by malnutrition.
“Private industry provides most of the goods and services needed to sustain the world’s health. It can play an important role by exercising initiative and careful judgment in developing needed products and in helping to make sure they are used wisely to improve health in the developing world.
“We recognize the invaluable contribution voluntary organizations have made in improving the health of people throughout the world and their special services in developing nations. We will strive to aid them in their efforts and to coordinate our activities.
[Page 1056]“We plan to:
“—Strengthen institutions in our Government which are dealing with international health problems, reemphasizing our commitment to help meet the health needs of other nations, and improve the use of existing resources through better coordination.
“—Build greater awareness among the American people of the legitimacy and the importance for our foreign policy goals of improving other people’s capacity to meet their basic human needs.
“—Work closely with nations around the world, individually and through organizations such as WHO, UNICEF, the World Bank, and the regional development banks, to improve the health of people everywhere.
“—More fully involve American universities, technological foundations, and other private organizations in making U.S. scientific and professional resources more accessible to the developing world.”
The full text of the statement is printed in Public Papers: Carter, 1978, Book I, pages 816–817. In telegram 115550 to all diplomatic and consular posts, May 5, the Department repeated the text of the President’s statement with a request to “bring this statement to the attention of the Minister of Health and other appropriate officials.” (National Archives, RG 59, Central Foreign Policy File, D780193–0915)
Califano, in his May 9 address to the World Health Assembly, reemphasized many of the objectives outlined in the Presidential statement. The Secretary pledged additional resources for the combating of major infectious diseases, especially in the area of child immunization. Providing clean drinking water also existed as a high priority; to this end, Califano highlighted U.S. support for the United Nations Decade for Drinking Water and Sanitation (1980–1990). Califano also described American collaboration with the World Health Organization (WHO) and the UN Food and Agriculture Organization (FAO) in formulation of international nutrition programs. He indicated U.S. support for WHO programs dedicated to the prevention and treatment of blindness and extension of primary health care programs, including maternal and child health services, nutrition, and family planning. In his concluding remarks, Califano asserted, “We are, as you know, a nation seeking to reassert our commitment to human rights—at home and in the world. Our participation in this organization gives us an opportunity to express that commitment not simply in words but in deeds. Together with you, we stand ready to seize that opportunity. We can, and we must, build a healthier world for all our children.”
The full text of Califano’s remarks is printed in Department of State Bulletin, September 1978, pages 35–38. The other members of the U.S. delegation included Assistant Secretary of Health, Education and Welfare Julius Richmond; John Bryant (Director-designate, Office of In[Page 1057]ternational Health, Department of Health, Education and Welfare); Robert Andrew (Director, Agency Directorate for Health and Drug Control, Bureau of International Organization Affairs, Department of State); Lee Howard (Director of Health Services, AID), and U.S. Representative to the U.S. Mission in Geneva William vanden Heuvel. (Public Papers: Carter, 1978, Book I, page 885)