borders, and that legislation which would constitute a constant reminder of this fact would be in the interest of effective medical research and thus in the interest of the American people.

The circumstance that such broadened research effort might also have some good side effects in terms of improved international relations of the United States and improved health conditions in some foreign countries should be welcome but overemphasis of these side effects, in my opinion, misses the principal purpose of this legislation-namely, strengthening U.S. medical research efforts.

The proposition that effective medical research cannot stop at our borders is not novel by any means as far as this committee is concerned. In 1956 the Subcommittee on Health and Science, under the chairmanship of the late great Chairman J. Percy Priest, of Tennessee, held several days of hearings on the subject of international health programs and the role which the U.S. Public Health Service plays in these programs. As a result of these hearings, the Committee on Interstate and Foreign Commerce, on May 23, 1957, filed a report on the organization and financing of, and the participation of the United States in, international health programs-House Report No. 474, 85th Congress, 1st session, Union Calendar No. 157.

The report attempted to present a complete résumé of what the United States is doing in the field of international health as a whole. The report stressed the importance of new insights which can frequently be obtained by studying the cause of particular diseases in different settings. Therefore, the report concluded, it is important that in addition to research carried on by American scientists at home, such research also be conducted abroad. The then Surgeon General, Dr. Leonard A. Scheele, testified that, for example, in the field of cancer there are substantial differences in the incidence of certain forms of cancer in different countries, and that by persuading researchers in these other countries to take on their country's side of the project "we might have some windows of knowledge opened because of these differences."

Similar studies conducted abroad, Dr. Scheele testified, in the case of certain heart diseases might suggest the circumstances responsible for the fact that some populations do not seem to have coronary heart disease and do not seem to have as much hypertension as we have.

Use of foreign opportunities for research investigations not only helps us to find answers to unsolved disease problems but enables us to check the continuing validity of solutions of old problems. For example, cases of typhoid are so rare in this country that it was difficult to test the continued effectiveness of typhoid fever vaccine used for many years in this country. Through the cooperation of another country where typhoid is prevalent, more is now known about the efficacy of various typhoid vaccines.

Similar results were reached through tests abroad of an antirabies serum. It would have been impossible to conduct satisfactory tests in this country because cases of human rabies are too rare to make possible valid tests.

I wanted to make this brief statement at the outset of these hearings because I wanted to call to the attention of the expert witnesses who have indicated to the subcommittee their interest in this legislation that theirs is the burden of proving to the satisfaction of the members

of the subcommittee and thereby to the members of the full committee and the Members of the House of Representatives, that this legislation is more than a good-will gesture and that it will materially aid in strengthening medical research efforts in the United States and thus will materially benefit the American people. As I said, I believe that the legislation will accomplish these objectives but the record before this subcommittee must adduce positive proof if this resolution is to become law.

Our first witness this morning is the Honorable John E. Fogarty, who has, as all of us know, done a magnificent job in the field of medical research, who has been generally successful on the floor of the House with his appropriation bills in the field of health, and he is chairman, of course, of that subcommittee of the Appropriations Committee. We would be glad to have the gentleman from Rhode Island come forward.

Mr. HARRIS. Mr. Chairman, before Mr. Fogarty presents his testimony, I would like to recognize and note for the record the presence of the chairman of the Appropriations Committee, the Honorable Clarence Cannon, who occupies the same position in that great committee as I do in this committee, and under whose full committee chairmanship Mr. Fogarty functions as chairman of the Subcommittee on Health, Education, and Welfare.

Mr. ROBERTS. I would like to say this: I know that the chairman, Mr. Cannon, is a busy man, and I know, too, that he would like to introduce the very eminent physician from his hometown.

The Chair would be glad if you would present your witness now, if you have to leave. Or, if you would like to stay with us, we would be certainly honored if you would stay.

STATEMENT OF HON. CLARENCE CANNON, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MISSOURI

Mr. CANNON. Mr. Chairman, it is my misfortune not to be acquainted with the problems which this committee is taking up this morning. But I came down because I learned that you would have this morning a very distinguished witness, a man who in my opinion has cured more hopeless maladies and who has mended more broken lives than any physician since the Master walked beside the Sea of GalileeDr. Rusk, with whom you are all familiar. So I am always interested in anything which Dr. Rusk advocates. And I took advantage of your kind hospitality this morning to be here with Dr. Rusk.

Mr. ROBERTS. Delighted to have you, Mr. Cannon.

Mr. Fogarty?

STATEMENT OF HON. JOHN E. FOGARTY, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF RHODE ISLAND

Mr. FOGARTY. Mr. Chairman and members of the committee, my name is John E. Fogarty. I represent the Second Congressional District of the State of Rhode Island and at the present time I am chairman of the subcommittee that handles the appropriations for the Department of Health, Education, and Welfare, the Labor Department, and related agencies.

Mr. HARRIS. I might add, Mr. Chairman, that he has occupied this distinguished position for the last several Congresses, except for one intervening Congress, when he and I and others were relegated to the minority for a very brief spell.

Mr. FOGARTY. I appreciate the opportunity that you have afforded me to appear before you this morning on what I think is one of the most important pieces of legislation we will consider at this session of the Congress.

First, let me say that the work that I have been privileged to do in the field of health, in terms of the Appropriations Committee, was made possible only by the legislation that has been acted upon by your committee, as the legislative committe that gives us on the Appropriations Committee the authorization to appropriate funds for programs in the health and related fields.

I have been in Congress a few years now-19 to be specific-and I have seen many chairmen of this committee. I remember Mr. Crosser, and then I remember our old friend Percy Priest from Tennessee, who was such a fine chairman of this committee and made such a wonderful name for himself in the field of health legislation for his sponsorship of institutes similar to the one that is being considered here this morning. Following Mr. Priest, in those intervening 2 years, there was Mr. Wolverton on the Republican side, who, I think, was one of the great leaders in the Congress in advocating health measures that we have the authority to appropriate funds for now. And then, of course, Mr. Harris, who succeeded Mr. Wolverton as chairman of this great committee, has been in the forefront of the health legislation field for many, many years. And I remember the old HillBurton days, when that legislation was put into effect by this committee, and I think of the good that such legislation has done for the small communities of our country and for the people in our country.

And then there is the chairman of the Health and Safety Subcommittee, Mr. Roberts. Without any hesitation, I can call attention for the record to the work that he is doing, patricularly in the field of health and accident prevention. I think Mr. Roberts you will be remembered for a long, long time for the leadership that you are providing in these fields as chairman of this most important committee. Without action by you members, as the legislative committee, we are unable to do anything, as you know, through the rules of the House, as far as appropriations are concerned.

I am here in support of these various bills that will set up an International Health Research Institute to declare war on disease not only in this country but all over the world.

A years ago last January, after listening to the President's state of the Union message, in which he stated that progress could be made in the fight against such diseases as cancer and heart and mental illness all over the world, and remembering the reply from the leader of Russia that perhaps in those areas they could reach some agreement and some advances could be made, Senator Hill and I were attending a meeting nearby with some leading medical men, and this subject came up. It was at that time, a year ago last January, that we started talking about this type of program to provide leadership that will in time get the answers to some of these problems that are killing human beings at this time.

And as a result of these many discussions, Senator Hill introduced a bill and I did last year. Then this year again Senator Hill introduced a bill, as did the chairman of the committee and others in the House. And as you have so well stated, Mr. Roberts, it has passed the Senate by unanimous vote, and now we have it before the House this

year.

I, too, would like to note the appearance of the chairman of our Appropriations Committee, Mr. Cannon, at this hearing. Although I cannot speak for him, I think that his presence here speaks well for the idea that if you give us the authority and make it possible this year for us to appropriate funds to get started in this field and set up this new International Health Research Institute, the very presence of our distinguished chairman of the full Committee on Appropriations is a good sign that funds will be forthcoming. If you will give us the legislative authority to appropriate those funds we will first listen to Mr. Cannon, because-and I have said this before many, many timesI do not believe there are two men in the Congress on this side of the Capitol or the other side who deserve more credit for an attempt to balance the budget than Mr. Cannon, the chairman of our Appropriations Committee, and Mr. Taber, the ranking minority member of that committee. I think they have done more in that field over the years and have worked harder and have received less credit than any other Members of Congress, regardless of whether they come from the House or from the Senate. And Mr. Cannon's very presense here this morning, in view of his record, I think is a good sign that the money will be forthcoming.

I cannot undertsand why there is some opposition to the bill. When hearings were held in the Senate, even though there were several days of hearings, no person requested to be heard in opposition to this particular bill. The administration did find some fault with two or three provisions, as mentioned by the chairman in his opening statement, and I want to say that I do not agree with the criticisms by the administration. I agree wholeheartedly with the bill as it passed the Senate. I think it is a workable bill, and I think it is a bill that will be kept nonpolitical, as all medical scientists want it to be.

It will be a medical scientists' bill, a scientist-to-scientist bill, to the advantage of all the peoples all over the world, and we will keep it out of politics that way.

We have international organizations of all kinds. We have the International Society of Cardiology and many other international societies of medicine and science. We have the World Health Organization and others. They all play their own part. The have their part in this particular field. But if we were given the chance to provide leadership by establishing this institute and sharing some of the scientific know-how that we have today with other peoples all over the earth, I am sure, in my humble judgment, that would be one of the best ways to create better medical research, better fellowship, and a better feeling among nations of the world.

It was my privilege to attend the World Health Assembly meeting in Geneva this past spring. I was also there 2 years ago. And I do not know of anything better that we can do than to continue our cooperation in that program. The chairman of our delegation this year, Dr. Burney, who is our present Surgeon General, held luncheons every

day and we were asked to sit beside some of the foreign delegates who were representing their countries. Some 90 nations attended this meeting. And I think that we produced a great deal of good will between nations on the basis of this friendly exchange alone.

But in talking with some of these foreign representatives, I felt that if we could set up an Institute such as we are talking about, we could stimulate other countries to follow our lead in what we have been doing, as an example, at the National Institutes of Health in Bethesda, Md. I know, Mr. Chairman, that you are familiar with those Institutes. You know how they have worked. And they were set up by your committee the Heart Institute, the Mental Health Institute, the Cancer Institute, and so on. They are established by law in much the same way that we are asking you to set up this new Institute.

A National Advisory Council of experts in the field of medical research would be set up, a group of advisers that would be nonpolitical. They would be appointed by the Surgeon General or by the President on the advice of the Surgeon General, and they would make recommendations on the applications for grants that are received from all over the world.

And may I say at this juncture that this is not all "give." We will be providing leadership and a means for stimulating other countries to do more in their own areas than they are doing now. But at the same time, we will be getting back, I think, many, many times more than the United States is going to put into it.

The bill, as you know, calls for an authorization of $50 million. I do not believe that the Institute would need the full $50 million for operation next year. I think it would get along with less, but I think it should have the authorization of $50 million to meet the needs in subsequent years. I would, if we had the legislative authority, ask my committee or any other committee to appropriate only enough funds to get this Institute into operation for the remainder of this fiscal year and then go on from there, as we have in all other pieces of legislation.

You know that under the hospital construction law, we have never appropriated the full authorization, and the same is true for many other legislative acts that have passed Congress; even though the authorizations may be for $100 million, or $200 million, that is not a mandatory demand on the Appropriations Committee to appropriate that amount of money. We appropriate only what we think can be used in a justifiable way and be expended in the coming fiscal

year.

The administration has suggested that the dollar amount might be high. Well, as I say, the full $50 million will not be needed for the first fiscal year. And I understand the administration would like to have the power vested in the President. I think that it should be kept free of international politics and politics of all kinds; that it ought to be on a scientist-to-scientist basis, the same as the National Institutes of Health are run.

The Cancer Institute has been established for 20 years; and the Heart Institute and the Mental Health Institute for 10 years. We have not had any real criticism of their operations to date. And as long as we have guidelines like that in setting up this International Health Research Institute, I think we are on sound grounds. We