those that should have been heard today, Dr. Ernest L. Stebbins, dean of the School of Hygiene and Public Health, Johns Hopkins University; Dr. Thomas Hunter, chancellor for medical affairs, University of Virginia, and chairman of the Committee on International Medical Education Association; Warren Zeph Lane, M.D., the Norwalk Hospital, Norwalk, Conn.; and Mr. David Whatley, Washington, D.C.

If any of you gentlemen are present and wish to present your statement for the record, you might do that at the present time, but if you wish to come back tomorrow at 10 o'clock you will be heard first before the others will be heard.

The committee will adjourn until tomorrow at 10 o'clock.

(Whereupon, at 12:36 p.m. the committee adjourned until 10 a.m. Wednesday, February 16, 1966.)

59-494-66- 4

INTERNATIONAL HEALTH ACT OF 1966

WEDNESDAY, FEBRUARY 16, 1966

HOUSE OF REPRESENTATIVES,

COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D.C.

The committee met at 10 a.m., pursuant to recess, in room 2123, Rayburn House Office Building, Hon. Harley O. Staggers (chairman) presiding.

The CHAIRMAN. The committee will come to order.

Yesterday when the committee adjourned we had not heard all the witnesses scheduled on H.R. 12453, known as the International Health Act of 1966. When we adjourned the next witness to be heard was Dr. Ernest L. Stebbins, dean of the School of Hygiene and Public Health of Johns Hopkins University, Baltimore, Md.

However, we have with us at this time our colleague from Minnesota, the Honorable Donald Fraser, who wishes to make a short statement. You may proceed Mr. Fraser.

STATEMENT OF HON. DONALD M. FRASER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MINNESOTA

Mr. FRASER. Mr. Chairman, members of the committee, I am happy to give my enthusiastic support to H.R. 12453, the International Health Act of 1966.

I was very much impressed by the following language in President Johnson's message on international health.

Control or eradication of animal diseases could increase the meat supply by more than 25 percent in a number of developing nations. As many as threefourths of the rural population suffer from debilitating diseases that originate in animals.

Here certainly is a challenge to the United States where we have learned to control diseases in animals so that they will not spread to people who must handle animals nor to the consumer of milk. I would certainly hope that the International Health Act of 1966 will be broad enough to address itself squarely to this problem.

Certainly a greatly expanded dollar figure would be necessary if we really intend to have an impact in this type of health activity.

In addition, it is not enough for us to only train doctors and nurses to treat the people after they become ill. If we are wise, we will train the veterinarians who can go overseas and help establish proper disease control and proper steps for eradicating these debilitating diseases. In addition, our veterinarians can help train local people to become veterinarians.

Diseases transmitted directly from animals such as rabies-and those spread by consuming contaminated food--such as tuberculosis,

brucellosis, and tapeworms-need the expert skills and training of veterinarians to provide maximum health protection for the people. For these reasons, I was most impressed by the statement of the American Veterinary Medical Association in support of H.R. 12453. It says, in part:

The social and economic progress of a developing nation depends first of ali upon the health and vigor of its human population. Human health and welfar depend to a very great extent upon the adequacy of man's food supply and the effectiveness of measures to protect his health. Stable institutions cannot be expected to materialize among sick and hungry people.

That certainly is an excellent statement of the problems we face in trying to bring political stability and economic progress to the underdeveloped nations.

I am convinced that the International Health Act of 1966 can be an important means of advancing our foreign policy. I certainly feel that veterinarians should be among the health professions covered in this legislation.

The CHAIRMAN. Thank you for your views Mr. Fraser.

Mr. FRASER. Thank you for the opportunity, Mr. Chairman.

The CHAIRMAN. If there are no questions we will now hear from Dr. Stebbins. Doctor, would you take the stand please, sir, and you may proceed. You may insert your prepared statement in the record and give it extemporaneously, or do as you please.

STATEMENT OF ERNEST L. STEBBINS, M.D., DEAN, SCHOOL OF HYGIENE AND PUBLIC HEALTH, JOHNS HOPKINS UNIVERSITY

Dr. STEBBINS. Thank you, Mr. Chairman.

I want to first express my appreciation to the committee for this opportunity to testify concerning H.R. 12453. I am here not in my capacity as dean of the school of public health, but rather as a representative of the American Public Health Association of which I am president, and the Association of Schools of Public Health. I would like to submit the statement of the American Public Health Association along with my own prepared statement.

(The material referred to will be found at the end of Dr. Stebbins' testimony.)

Both of these organizations have taken the position of support for legislation for the development and improvement of the international health activities of the U.S. Government. Our activities have involved international relations in the health field for many years.

Since the beginning of the American Public Health Association over 90 years ago it has had an international flavor in that Canada and Mexico have been a part of the organization. For example, each year a vice president is named from our Canadian membership and from our Mexican membership. The two associations have also been closely related with the various activities of the U.S. Government in the international health field, at the present time working closely with AID as well as with the U.S. Public Health Service in its broad international interests.

I would like to comment on three points: First, the importance of health in international relationships; second, the importance of this legislation in furthering the development of our Government's activi

ties in international health growth; and, finally, the advantage to the United States that would result from the enactment of this legislation. In doing this, with your permission, I would like to draw somewhat from my own personal experience.

Over the last 35 years I have been involved in a number of international programs sponsored by the World Health Organization, Pan American Health Organization, and the various foundations, particularly the Rockefeller Foundation and the Ford Foundation.

In the various capacities in which I have served I have had an opportunity to observe the impact of our Federal Government health assistance to other nations, particularly the developing nations, and I have been impressed with the acceptance by the peoples of underdeveloped countries of these activities on the part of the Agency for International Development.

In many instances where there has been evidence of anti-American feeling, the health activities have been given high praise by the same. groups that have criticized other phases of our international policy. In other words, I believe that the corps of international health workers would in essence be ambassadors of good will for the United States. I have seen so many examples of this in various parts of the world.

Another important consideration I believe in the development of a career corps of international health workers, which would be provided by this legislation, is the advancement of other aspects of our aid program.

There are innumerable examples of where the health program of our Federal international agencies have been effective in improving the general condition of the population.

The control of such diseases as malaria, schistosomiasis, malnutrition, has materially contributed to the economic development in the countries where these activities have been carried out.

Just to cite two examples, one in the Amapa territory on the Amazon. It was impossible to develop a very rich source of manganese which was of vital importance to that country, Brazil, and to the United States.

It was not until a health program was developed by a graduate of one of the schools of public health in this country that it was possible to fully develop this very major economic resource for that country and to supply urgent needs to our country for that product.

For example, it was economically unacceptable to the people in Brazil who were to develop this resource because it required three times as many railroad workers to operate the railroad that carried the ore from the site to the ports from which it would be shipped. When malaria was eradicated from that particular section of the country, they were able to reduce the number of persons that had to be employed in order to have personnel healthy enough to operate the railroad at one-third the previous number.

This has been extended to broad health services for the workers in this industry and it is a thriving industry providing greatly increased resources for the country.

Another example is in the rubber industry. During World War II, as you all know, there was an urgent need for an increased supply of rubber to meet the war needs.