DALHOUSIE UNIVERSITY, HUBERT H. HUMPHREY, Chairman, Subcommittee on Reorganization and International Organization, May I state that the assistance which the U.S. Government has provided through various agencies in furthering medical research is without question of tremendous value. In my own specialty of epidemiology there are certain problems which can only be studied on an international basis; for example, the factors which influence the distribution of disease in various parts of the world as related to climatic and other conditions. Dalhousie University has been pleased to cooperate with the National Institutes of Health on one such project recently. It is hoped that your subcommittee will find means to encourage and support further international cooperation in the fields of medical research. Yours very truly, C. B. STEWART, M.D., Dean. UNIVERSITY OF WASHINGTON, Hon. HUBERT H. HUMPHREY, Washington, D.C. DEAR SENATOR HUMPHREY: I have been greatly interested in your recent proposals for stimulation of worldwide interest in medical research, including the proposed International Medical Year. I believe that the United States is, of course, the logical country to take the lead in organizing such things as an International Medical Year, and I am particularly interested in the proposals for U.S. grants to foreign medical researchers. I believe, however, that consideration should be given to grants to the institutions accepting such foreign medical researchers as well, since it is impossible to establish a research or teaching program of this nature without adequate funds. It is apparent that such grants to foreign medical researchers, however, do serve a dual purpose in that they not only promote advancement in medical science throughout the world but also promote understanding of this country by some of the most influential citizens in other countries. Although I am completely in sympathy with the idea of establishing such things as an International Medical Year and grants for foreign medical researchers, I think it must be kept in mind that the situation in the field of medicine is somewhat different from that that pertains in such areas as physics, mathematics, and chemistry. In the field of medicine there is such a vast gap between the standards set primarily by such countries as the United States, Great Britain, the Scandinavian countries, and even some other European countries, that all too frequently the backgrounds of individuals who come to this country for research purposes are totally inadequate. It is, of course, to improve this situation that such programs as you have proposed would be of great value. Very sincerely yours, JOHN R. HOGNESS, M.D., Medical Director, University Hospital. BIOKEMIALLINEN TUTKIMUSLAITOS, BIOCHEMICAL INSTITUTE, Senator HUBERT H. HUMPHREY, DEAR SENATOR HUMPHREY: At first I wish to express my pleasure at having had the opportunity to meet you when you visited Helsinki, and at having had a longer discussion with you. I have a very pleasant memory of this occasion. According to your kind request I formed a committee to make proposals for the effective use of the means for the furthering and stimulation of medical sciences in Finland you informed me could perhaps be granted. Since the support of basic research in the field of medical sciences according to your mentioning came in the first place, which I was glad to note, I also invited a representative for biology in addition to the representatives of medical sciences. The composition of the committee was the following: Chairman: A. I. Virtanen, Ph. D., president of the State Academy of Finland for Science and Arts, head of the Biochemical Institute, Helsinki. Members: K. Hartiala, M.D., professor of physiology, University of Turku; S. Mustakallio, M.D., professor of radiology, University of Helsinki; N. Pesonen, M.D., head of the Central Medical Board, earlier professor of anatomy at the University of Helsinki; O. Renkonen, M.D., professor of bacteriology and serology, University of Helsinki; E. Suomalainen, Ph. D., professor of genetics, University of Helsinki. Secretary: L. Saxen, M.D., assistant professor of embryology, University of Helsinki. The proposal is made in haste. In my opinion it gives, however, a good picture of the problems the intensification of the research of which is hoped for with the means granted by the United States. There appear also the scientists which at the moment belong to the leading ones in these fields. *** In my opinion the ability and the activity of the scientists is the most important circumstance in the distribution of the means. Nice programs can be drawn up even by poorest scientists. * * * I can I hope that the enclosed preliminary proposal answers your purpose. assure you that the means planned to be granted by the United States for research work in the fields of medical sciences will influence the progress of research work decisively in this country, as well as in many other countries. The thought lying behind this action is noble and as such it is understood here at least. With kindest personal regards. Prof. A. I. VIRTANEN. TYÖTERVEYSLAITOS, Senator HUBERT H. HUMPHREY, INSTITUTE OF OCCUPATIONAL HEALTH, DEAR SENATOR HUMPHREY: I like to thank you on behalf of the entire staff of the Institute of Occupational Health for your visit. It was particularly encouraging for us who had the good fortune of meeting you personally, to experience the way in which you opened new avenues of thought in our minds. Your visit was certainly a stimulus. As you suggested, we have written down the outlines of the major projects now at the planning stage at our institute. These projects have been maturing in our minds gradually. Preparatory work for the realization of some has already been made, as you will see. I hope that the information given will be of value for you. I have also been in contact with the president of the Finnish Academy, Prof. A. I. Virtanen. I understand that a committee appointed by him will include our Research Project 8 in its list of recommendations for further action. You asked also for our opinions on some more general points. We use the opportunity for making two suggestions: (1) If U.S. money will be appropriated for medical research in Finland, the distribution of the grants should be held in the hands of experienced American authorities. In this way the advantage of an impartial expert assessment of the value of our work is insured, which in a small country often is at least as important as a grant. A local committee for advising the applicants will, of course be also needed. (2) When large scale plans are considered, we like to draw attention to an inter-Scandinavian scheme which now is taking shape: The Institute of Arctic Medicine. A special committee is making the plans. In the establishment of such an institute, U.S. expertise and material aid would certainly be of singular value, particularly since a great amount of experience has been collected in your country on this field. We all send our best wishes to Mrs. Humphrey and yourself, and we hope to see you some other time as a guest in our country. With the Minnesotans we feel very much like with close relatives. Sincerely yours, MARTTI J. KARVONEN, M.D., Ph. D., Director of the Physiological Department. ISTITUTO SUPERIORE DI SANITA, I send you the data concerning the Istituto Superiore di Sanita, which you have requested. The institute is the foremost Italian center for scientific re search in the field of health. The budget of the institute, consisting of $2 million a year, is supported by the government. The staff is formed of about 750 persons, 400 of them are graduated. The institute has its own premises and is unanimously considered to be perfectly equipped and in possession of scientific apparatus of a great value, so that it is one of the best institutes for scientific research in Europe. The institute gives hospitality to many graduates coming all over the world to specialize in some particular subjects and also receives foreign scientists wishing to work for some time in the institute. The institute gives postgraduated courses for international expertees in the various fields of public health. Unfortunately, the young members of the staff do not receive adequate salaries and this, in a way, is a great handicap as they cannot carry out their scientific work with the necessary peace of mind. A young doctor's salary is about $100 to $120 a month. In spite of this, an excellent work is performed in the institute in the fields of biology, biological chemistry, chemistry, microbiology, parasitology, pharmacotherapeutics, physics, and sanitary engineering. Last year one of our collaborators received the Nobel Prize for the work he performs in the institute, where another Nobel laureate has now been working for many years. Enrico Fermi worked in our physics laboratory before leaving Italy for the United States. Many American scientists, among them Dunn, Nachmanshon, and Rapport of the Columbia University, Kempe of the California University, Gertner of Jersey City Medical Center, Schueler of the College of Medicine of Jowa, have worked for long periods in the institute. A series of lectures on the last scientific discoveries is held every in the institute. Up to now 20 Nobel laureates have given lectures in the institute. * * The relationships between the institute and the U.S. agencies and other international organizations are excellent. It is continually in touch with the National Institutes of Health, with WHO, FAO, and UNESCO. Many members of our staff participate in the committees of experts of these organizations. In the institute are also located some international centers for the study of special prob lems concerning health. * Should the institute receive financial support, the young assistants' conditions would very much improve, enabling them to carry out their research work without troubles. I think I have answered all your questions and I am at your disposal for any further information you may require. Yours sincerely, DOMENICO MArotta. DIRECTOR OF THE INSTITUTE OF NATIONAL HEALTH, Paris, France. DEAR SENATOR HUMPHREY: Your idea of "a Marshall plan for medical research" is wonderful and another testimony of the enormous generosity of the Americans. I believe that it will lead to great results in that field, and that there is much that can be done with an assurance of efficiency producing effective results. In expressing to you my joy over our collaboration, please accept, dear Senator, the assurance of my feelings of friendship. Prof. L. BUGNARD. WESTERN RESERVE UNIVERSITY, CENTER FOR DOCUMENTATION AND COMMUNICATION RESEARCH, SCHOOL OF LIBRARY SCIENCE, Cleveland, Ohio, January 8, 1959. Mr. JULIUS N. CAHN, Committee on Government Operations, DEAR MR. CAHN: With his letter of December 30, 1958, Senator Humphrey asked for our comments with regard to the field of medical documentation which is being studied by the subcommittee on reorganization in connection with its program in the field of international medical research. The documentation problem in the field of medicine is a severe one. The various literature processing and dissemination services already available are making heroic efforts to cope with the problem, but are encountering difficulties similar to those in other scientific fields due particularly to the difficulties of coping with the large quantities of recorded information using traditional library tools. This problem is all the more severe because the dependence of medical research scientists on other bodies of literature, such as chemistry, biology, physics, etc., in addition to "pure" medical information. In working toward more effective exploitation of the scientific literature, we have prepared a report proposing the setting up of a model center for the mechanized exploitatation of the scientific and technical literaure, which has been sent to Senator Humphrey recently. A copy of this report is enclosed. Although we have not mentioned the field of medicine in our proposal, we are nevertheless actively interested in this field. As a matter of fact we are working toward a cooperative program with the Communicable Disease Center of the Public Health Service, and we have already contacted Dr. Willey of the National Institutes of Health with regard to support for this program. In addition, a local organization, the Allen Memorial Medical Library of Cleveland is considering support of our work in the field of medicine. We will keep in touch on this matter. Sincerely, JESSE H. SHERA, Executive Secretary, Council on Documentation Research. To: Mr. Julius N. Cahn, Director of Program, Study of International Health Program, Senate Office Building. From: Dr. James A. Doull, Medical Director, Leonard Wood Memorial (American Leprosy Foundation), Washington, D.C. Memorandum No. 4: Leprosy research needs. Financial aspects. Wanted: $2 million annually. The greatest immediate need in leprosy is money for research. Discoveries can never be promised but it is a safe prediction that adequate salaries and facilities for scientists will result in productive research and this in turn to the elimination of leprosy. This has been the experience in many other infectious diseases. Only leadership and financial assistance from the United States can provide these salaries and facilities at the present time. These premises lead to the conclusion that it is within the capacity of the United States to rid the world of leprosy. A time limit for this effort cannot be stipulated. The disease is of slow development and millions now infected will not show signs for some years. A shortterm program of research should not be embarked upon. Money is needed specifically for training of scientists in biochemistry, bacteriology, pathology, and epidemiology, and for support of such projects as cultivation of the leprosy bacillus, experiments in transmission of leprosy to animals, study of biochemical and pathological changes which follow infection, determination of value of sulfones and other drugs in preventing complications and sequelae, and exploration of the potentialities of reconstructive surgery in rehabilitating the patient after the disease has struck. Large sums are now being spent for care of leprosy patients and this is, of course, necessary. In the next decade, $30 million to $40 million will be spent on leprosy by the United States alone, and, unless a change takes place, only 3 or 4 percent of this expenditure will be available for research. In countries where leprosy is highly prevalent it is difficult to obtain enough money for drugs, food, and shelter, and most governments are spending nothing for research. Our Government and foreign governments must somehow be convinced that this is a shortsighted policy. Obviously, it is uneconomic-or worse to pay tribute indefinitely to any extortionist, whether a man or a microbe. It is proposed therefore that the United States take the leadership in promoting leprosy research in foreign countries, using much the same approach and mechanism as are used by the Public Health Service in its grants program. The CHAIRMAN. Well, gentlemen, we certainly want to thank you all. Mr. Secretary, is there anything you want to add? Secretary FLEMMING. Mr. Chairman, I do not think there is anything else I need to add, except I would like to underline another point, which Senator Humphrey made, namely, the desirability and necessity of getting better coordination of all of the activities that are being carried on in this area. He, very effectively pointed out the ICA operations, the contracts that in some instances have been worked out by the Defense Department, and I hope that I can work with you and other members of the committee with that particular objective in mind, also. The CHAIRMAN. Thank you, sir. We were very glad to have heard from you. Now, Dr. Burney, I wonder if you could supply for the record a statement showing approximately how much of the $100 million in expenditures the Secretary contemplates our spending on international health next year go for the kind of medical research contemplated under Senate Joint Resolution 41? Dr. BURNEY. I can supply that. The CHAIRMAN. And, Miss Switzer, could you supply that information as far as vocational rehabilitation is concerned. Miss SWITZER. Yes. (The information requested follows:) Hon. LISTER HILL, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, PUBLIC HEALTH SERVICE, Washington, D.C., March 19, 1959. Chairman, Committee on Labor and Public Welfare, DEAR MR. CHAIRMAN: At the conclusion of our recent testimony before your committee with respect to Senate Joint Resolution 41, you asked me to furnish for the record an estimate of projected expenditures during fiscal year 1960, within the President's budgetary proposals, for the kind of international health research and research training activities contemplated by Senate Joint Resolution 41. As Secretary Flemming indicated in his prepared statement, we estimate that approximately $100 million will be expended in fiscal year 1960 for international health purposes generally. This is, of course, only a general estimate, since many of the items do not represent earmarked funds but are projections based on previous experience. Within this total estimate he identified two specific items related to the purposes of Senate Joint Resolution 41: (1) Five million dollars (estimated) for NIH research, research training, and related activities. |