They do not believe what outsiders say, do not believe what they hear on the radio, but they do believe what people whom they respect come here and see and take back. And especially the people with respect in the community.

That is one facet of the situation. The second is the pooling of our ideas on research. Some spot checks in Europe this summer among the leading cancer institutes, one in Belgium, the other in Great Britain, show tremendous unmet needs in this field, programs that are ready to go now, if we could give them support, which they apparently are not able to give, because of either of two things-one, because they do not have the money, or, second, they do not have the desire to give the money for this, especially as individuals. We in the United States have a phenomenon that does not exist anywhere in the world; and that is that the people, not only Government, are interested in other people. And I think it is one of the most fundamental philosophies that we in a democracy have to sell.

Maybe I have oversimplified what this bill does, but to me it is relatively simple. We have these various magnificent institutes in the Institutes of Health. They by law can give certain of their moneys. to international research. Last year it was less than a half of 1 percent. And why? Very obviously-and I sat on the Council of the Arthritis and Rheumatism Foundation-when we had 200 approved requests in a given year that we could not meet, because of lack of funds, of course we gave high priority, first priority, to the programs in our own country. And that will always be so, and to me properly so.

As I visualize what this bill would do, it is this: The International Institute would be established. The present institutes all have their so-called study sections. If a project came in on cancer from a group in the Soviet Union who wanted to bring a team to work at the Rockefeller Institute and ask for certain moneys to do it under this mechanism, that project would go to the Cancer Institute. Is this good? Is this valuable research? They could report back to the Council for final action.

If it were a problem on rehabilitation, it would go to the Office of Vocational Rehabilitation.

One little aside on that. That is my interest, the problems of disabled people. You and the Congress by your appropriations of a million dollars a year since 1945-I was talking to General Bradley this morning. I was in on the first incident that set up this fund to develop our artificial arms and legs when four Air Force amputees walked into my office with papier mache legs falling apart. And it was Gen. H. H. Arnold who made the first plea to you, and you have made available these moneys through the years, and now we have the finest prosthetic devices in the world. But the two greatest developments that have come out came from Germany-one, the suction socket, and the other, the artificial arm that works by a carbon dioxide mechanism that can be put on a man with no stump at all and operate. I was in Hong Kong in December, and there I saw some of the most ingenious bamboo splints that could be used for crippled children in an economy where steel was not available, or where you might want lighter splints temporarily, that I have ever seen. I have never been any place in the world on these missions that I have not learned something.

The Children's Bureau would be a study section. If there is a problem in infant mortality, or if there is a problem in maternal and child welfare, and a project came in to this new International Institute, they would be the study section to make recommendations on whether or not it was good or whether or not it was mediocre, or whether it was not worthwhile looking at.

As to the amount of money: Frankly, I do not know whether it is possible to spend $50 million the first year. But I do know this, at least I believe this; with the kind of mechanism that has protected the taxpayers' money through the years of the development and operation of all of our Institutes of Health-and when they have not been able to spend it, it has come back-I think that the taxpayer will be completely protected, on the basis of supporting only the good and the valuable.

I am speaking here as a private citizen today. I am executive vice chairman, however, of the Committee on Health for Peace, that General Bradley and Dr. Bronk cochair, one on the lay side and one on the scientific side. I drew up the letter that invited the members of this committee to serve, and I worked on a number of similar programs and voluntary agencies during my career in medicine. And I have never seen any response like it in my life. Of 200 letters, there were 195 spontaneous responses to serve on this committee-physicians, citizen leaders, scientists. And of the five that did not serve, three said it would be so much trouble to go through the mechanism of their own organizations, which had a rule that you cannot go on another committee without board approval, that that is the reason they did not do it. I have never talked with anybody about this bill, about what we are trying to do in this bill, that did not say that this made

sense.

A word about what this might do in population control. The question was asked. I was in Burma in December. It was a proud day for me, because when U Nu was here, he asked for one thing. (They do not take ICA money there.) He asked for a team of five to come over and train to go back and set up the first rehabitation center in that part of the world. And we trained the team. And they had only been back a month when I visited there.

Of course, if it is not the first, it is the second unhealthiest country in the world. Compared to our 71-year expectancy, the average life expectancy is 29.3 years.

The infant mortality is 300 children. Three hundred babies per thousand per year die.

And yet I saw some of the finest cancer research going on there in the University of Rangoon I have seen any place. And I saw another thing that is tangential to what we are trying to do in this

We had $21 million in Burma in counterpart currency in payment for our agricultural surplus when they had the famine. I am as sure as I am sitting in this chair that if that money were invested in Burma, money that we could never take out or spend, in a health education and sanitation program, you would add 20 years to the expectancy in 5.

And I say that for this reason: that we did exactly that thing for Korea, when we made that investment in 1953, not of counterpart funds but of training money.

Here is a country-as one distinguished Burmese said to me"In Burma we have everything. We have rain and sun and minerals and precious jewels and oil and teak and ivory. We have everything but health and leadership." And they are struggling to find both. Well, I feel this very deeply, and what it could do. I am not legalistic enough to know what the mechanisms are. I know that you on this committee are. But I know in principle that we are dealing with a fundamental. The millions of cancer sufferers today, when the cancer is generalized, are fighting for one thing, for time. The answer may come tomorrow or next week, or not in our lifetime. And nobody knows. But we do know this, that the more people that are at work on cancer throughout the world, the better are the odds. And that is their hope. And I know, too, that there are no better ambassadors for the United States and our way of life than our research people and our young doctors.

We have trained more than 300 in rehabilitation in our own institute. And I have 70 in training today from other countries, of which 80 percent of the money came from voluntary contributions. And I know when they go back to set up rehabilitation institutions for the crippled in their countries, it comes from the United States.

So I feel that we have great opportunity, both in principal and dividends, and that is why I feel about this bill so very deeply.

The CHAIRMAN. Doctor, may I say that, as you so well know, we consulted many people, thinking from their work that their knowledge and experience would be helpful in drafting this legislation. We sought to get the best help we could. And no one gave us more help or more inspiration or made more fine contributions to the drafting of this legislation than you did. You have been a mighty good arm in trying to work out this legislation. And your statement here this morning is certainly most convincing. We are deeply grateful to you.

Any questions?

Senator JAVITS. I would like to ask Dr. Rusk to spread on the record his justification for a separate institution for this purpose. In other words, I think we will be asked, "Why can't the Surgeon General carry this on, as he carries on relations with the World Health Organization? Why do we need a separate Institute? And why do we need to have a fund out of which we can make contributions to international research in dollars, when we have all kinds of funds around?"

I think there are some millions of dollars in counterpart funds. If you would be kind enough just to give us your professional view on those two subjects, I think it would help us.

Dr. RUSK. I think as the program develops, counterpart funds can be used more and more. But they cannot be used for an exchange of scientists, except our scientists can use it for living expenses there. It cannot be used for some of the equipment that is not available, electronic equipment, and that sort of thing, in the countries.

Third, I think if it is scattered through all of the Institutes here, it will be diluted out and lost, for the reason I gave, that priority for those should first go to U.S. institutions.

Next, it will not include the Office of Vocational Rehabilitation and the Children's Bureau, which I think are vital members of this total team.

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As to the World Health Organization, we give 31 percent to support that, and I am one of their advisers. I think they have done magnificent work, but it is not primarily in basic research. This provides that if the World Health Organization came to the Institute with a specific research project that they wanted to do, that could be considered with any other.

And last but not least, in my own opinion, I would like to see this be a U.S. program, to help any country, to help any organization. But this is our program, and we do it because we believe in it, and because we want to, and not because we have to.

Senator JAVITS. Would you say, then, Dr. Rusk, that this is foreign aid in medical research in its finest sense?

Dr. RUSK. I feel it is; yes, sir.

Senator JAVITS. Thank you very much.

The CHAIRMAN. Any questions, Senator Williams?
Senator WILLIAMS. I just wanted to make a comment.

I was not here last year, when this resolution was first introduced. And my attention was directed to the measure then by the powerful editorial support the New York Times gave the measures, I believe early last August. I hope other papers copy or follow.

Dr. RUSK. I might comment on that and say that it has been amazing the supporting mail that we have had on the support that the Times has given this program. It has been very gratifying to us.

The CHAIRMAN. Doctor, again I want to thank you, not only for your exceptionally fine presentation here this morning, but for all that you have done in behalf of this legislation and all that you are doing. We are most grateful to you. Thank you, sir. (The prepared statement of Dr.

Howard A. Rusk follows:)

TESTIMONY BEFORE THE SENATE COMMITTEE ON LABOR AND PUBLIC WELFARE OF HOWARD A. RUSK, M.D., ON THE INTERNATIONAL HEALTH AND MEDICAL RESEARCH ACT OF 1959

My name is Howard A. Rusk. I am a physician specializing in rehabilitation services for the physically handicapped. I am professor and chairman, Department of Physical Medicine and Rehabilitation, New York University, Bellevue Medical Center, and an associate editor, the New York Times.

I have served or currently serve as a consultant in rehabilitation to the New York City Department of Hospitals; the Office of Vocational Rehabilitation, Department of Health, Education and Welfare; the United Nations and the International Labour Organization. I am a member of the Expert Committee on Rehabilitation of the World Health Organization and a member of the Board of Rehabilitation Consultance of the World Veterans Federation. I have been a member of the Armed Forces Medical Advisory Committee; the Council of the National Institute on Arthritis and Metabolic Diseases; was chairman of the Health Resources Advisory Committee, Office of Defense Mobilization, and chairman, National Advisory Committee to the Selective Service System from 1950 to 1957; and am currently a member of the Public Health Council of the State of New York.

Among my voluntary interests and activities: I am president, World Rehabilitation Fund; chairman, American-Korean Foundation; past-president, International Society for the Welfare of Cripples; and am a member of the Board of Directors, International Rescue Committee, the Board of Trustees of the Institute of International Education; the Public Policy Committee of the Advertising Council; Board of Directors, American Bureau for Medical Aid to China; Medical Advisory Committee, MEDICO; and the Committee for the Handicapped, People-to-People.

I am also or have been at some time a member of advisory groups associated 7th the National Foundation, the National Society for Crippled Children Adults, and the Arthritis and Rheumatism Foundation.

I have listed the above affiliations for the purpose of showing my deep professional and voluntary interest in the International Health and Medical Research Act of 1959.

I am also executive vice chairman, Committee on Health for Peace. This is a newly formed ad hoc group consisting of many of our Nation's leading scientists, clinicians, businessmen and civil leaders organized to increase public understanding of the principles underlying increased U.S. support of international health work. The Committee on Health for Peace believes in the principles of the International Health and Medical Research Act of 1959.

In both my prepared and extemporaneous testimony here today I do not testify as a representative of the Committee on Health for Peace or any of the organizations listed above. I testify as an individual citizen and physician who believes most sincerely in the values which would accrue to the United States and to the world if the International Health and Medical Research Act of 1959 were enacted.

In May 1956 I had the privilege of testifying before the Senate Foreign Relations Committee on the importance of increased support by our Government of international health work. At that time I said: "It is my belief that rehabilitation of disabled children and adults is one of the sharpest tools and most effective instruments which we in the United States have for making friends-a tool which can penetrate any Iron or Bamboo Curtain to reach the minds and the hearts of men. It is natural for all of us to take improved agriculture, industry, and utilities for granted, but men often regard these developments as somewhat remote from their immediate problems. Rehabilitation, however, makes a personal and significant impact, not only upon the disabled person himself and his family, but on those with whom he comes in contact."

It is, indeed, gratifying to me that we have progressed to the stage now, 3 years later, when the International Health and Medical Research Act of 1959 has actually been introduced, and today you on this committee are holding the first of a number of public hearings. I am also extremely gratified at the tremendous public interest and support for this legislation. Many of our Nation's leading newspapers have already given strong editorial support to the International Health and Medical Research Act of 1959. The newspaper with which I am associated, the New York Times, has had many, many letters commending it upon its strong editorial stand in favor of this legislation.

When Gen. Omar N. Bradley sent out his letters of invitation to a cross section of leading scientists, clinicians, businessmen, and civic leaders to join the Committee on Health for Peace, there were but five persons who declined his invitation to membership, and in four of these the writers stated their strong belief in this proposed legislation.

Since the Committee on Health for Peace was announced only 10 days ago, we have received scores of letters from American leaders in all walks of life asking if they might become members of the committee and scores more of other individuals who wrote us of their deep interest and belief in the significance of the legislation asking how they might help.

This morning one of our most distinguished Americans, Gen. Omar N. Bradley, has spoken to you of some of the reasons why enactment of the International Health and Medical Research Act of 1959 is so greatly within the national interest and the interest of the world. Already this morning you have also heard from two of America's and the world's most eminent scientists, Dr. Paul Dudley White and Dr. Detlev Bronk, who gave the strongest possible endorsement of this legislation. During the remainder of the hearings, you are to hear the testimony of other distinguished scientists. I should like, therefore, to confine my statement this morning to (1) outlining for you briefly the developmental steps leading to the introduction by Senator Lister Hill and 59 cosponsors of the International Health and Medical Research Act; and, then, (2) speaking briefly of the significance which I attach to inclusion of the resources and programs of the Office of Vocational Rehabilitation and the Children's Bureau in this legislation.

BACKGROUND AND DEVELOPMENT

Writing in the New York Times Sunday magazine 7 years ago, Arnold Toynbee said, "the 20th century will be chiefly remembered * ** as an age in which human society dared to think of the welfare of the whole human race as a practicable objective."

One and perhaps the most significant feature of social development which gives hope of Mr. Toynbee's objective becoming reality is the increasing recog