national nursing organizations, very gratifying progress along these lines has been made in the last few years.

Chairman HILL. We will come back promptly at 1:45 o'clock. Before you leave, I want to ask you about another matter, Mrs. Hobby. I know that we were all thrilled-in fact, I am sure the whole Nation was thrilled-on yesterday by the announcement of Dr. Salk's great discovery. And yet, those of us who saw the Edward Murrow TV program last night, I am sure, were somewhat disquieted. Dr. Salk, Dr. Francis, and Dr. Gregg appeared on that program. I do not know whether the Secretary had the opportunity to see it or not, but they spoke of a possible black market in the vaccine. They talked of the possibility that some selfish individuals might pay any price for vaccine, which they might not need, because of the general immunity for adults, but that by buying up this vaccine they might leave a child crippled for life.

I am sure that you and I, all of us, would agree that it would be tragic, indeed, if some 8-year-old child, we will say, was allowed to die, to go through life unnecessarily crippled because some adult had some selfish purpose and decided to build a black market. Such a black market, I believe, occurred in penicillin, in Europe, after World War II.

I have faith to believe, and I believe you share this faith, that such can be prevented, and prevented by voluntary action, but that the action must be planned and organized.

I wanted to ask you, Mrs. Hobby, as Secretary of the Department of Health, Education, and Welfare, if you would not urge the President to call a national conference of those concerned immediately, professionally, or by virtue of their special knowledge to work out a plan which will result in assurances to the parents of the children of America that so long as the supplies of the Salk vaccine are insufficient to meet the demand, that the supplies will be used fairly and justly, where they will do the most good, to take care of the largest number of children.

I believe that the American people are entitled to this assurance. I am sure that Dr. Salk would certainly be tremendously interested in such procedure.

We must not let anything happen now that would in any way besmirch or undermine the benefits of this great discovery.

Senator BENDER. I would like to commend you, Mr. Chairman, for asking that question of the Secretary. I think it is highly essential, since this commodity was developed through private efforts, that there should be some Federal regulatory matter, that we should make it as nonpolitical as possible. And certainly, the Department, I hope, will answer the Senator's question.

Chairman HILL. Let me say one further thing to my good friend from Ohio. I am delighted that he has expressed himself as he has, in speaking of a regulatory approach. I do not think that it will be a question of a regulation. I think it is a question of doing this job by voluntary action. But I do think, to get the results by voluntary action, that we must have some action, that the action must be planned and organized.

I believe that the President, at the request of the Secretary, could call a conference that would bring about such voluntary action and a

plan that would get this vaccine to the greatest number and for the greatest good.

Secretary HOBBY. I think that you have really spoken words that are in the hearts of every citizen today.

As to how the Department might work with it, let me say, as you may well know, it has had this on its conscience and will live with it. Not only the Public Health Service but every part of the Department, and every part of the Government, will work to assure that every young child gets this protection first. We are not closing the door to any problem, because we are aware of what may happen.

any

I would like to ask Dr. Scheele to comment to you, though you may have gotten it on the Edward Murrow program, which I am sorry to say I missed last night. The problem of supply enters into some of the problems that you have mentioned.

Dr. SCHEELE. Mr. Chairman and members of the committee, our information on supply stems primarily from some of the comments that were made in Ann Arbor by people who know about the supply. Apparently in the early days, the supply will be somewhat limited. A national conference would not increase that supply. Industry will move ahead to increase the supply, now that the green light has been given by the successful study and by the licensing by Mr. Hobby. They will begin stepping up production, and by the time we approach the peak polio season, I hope there will be enough for everyone who wants it.

On the other hand, in this matter of allocation, I do not think we are going to have any great problems, because the medical profession itself, the practicing profession, is keenly aware of this problem. Yesterday in Ann Arbor, Dr. Dwight Murray, chairman of the board of trustees of the American Medical Association, urged all physicians to recognize the short supply and the necessity, therefore, for using the material on those age groups who are most susceptible to polio, the younger age groups primarily, and pregnant women, of course, too.

And also, I understand that the producers have announced that they are distributing their supplies throughout the entire country and that they will keep it in the normal trade channels and give the appropriate quantities to all areas of the country.

I do not think that a Federal allocation program here would improve the situation. In fact, it might create more confusion than help. At this moment our inclination is that it is not necessary.

This situation may change as we talk to more people. We may change our minds along the way, but I think that, if everyone will recognize that he must wait in some instances, that vaccine will be available later, that one does not actually need it right away in some cases, then I think that we will come out all right in this program by the time we hit summer, which becomes the critical time in polio. Chairman HILL. Did you hear the program last night?

Dr. SCHEELE. No, sir, I did not, but I heard a full report on it. Chairman HILL. It was a most interesting and challenging program. As I say, Dr. Salk, Dr. Francis, and Dr. Gregg, were on that program. I do not think anyone could have heard that program with these experts, these men who have given us this vaccine, without a feeling of disquietude over the thought expressed that the supply is now not sufficient.

I am sure you are right that our pharmaceutical houses will proceed to produce and step up the supply, but we do not have a sufficient supply now. And this is the middle of April. We are rapidly approaching that season of the year when the polio epidemics are so bad.

I was not thinking, as I said and I emphasized, in the sense of regulation or allocation by the Federal Government. I am a great believer that you can get voluntary action, particularly in a matter of this kind. I think that by a plan of voluntary action the country would be inspired and confidence would be fortified in the belief that the supply that we do now have at hand would be used to take care of children first, those who need it first, and who should have it first.

I am looking to voluntary action, not any allocation by Government or regulation or anything of that kind, but bringing together the representatives of the American Medical Association, representatives of the doctors, representatives of the pharmaceutical houses, and others, like Dr. Salk and Dr. Francis, and all of these others, who are concerned immediately and directly and professionally with this matter. I think that if they sat down in a room together for a few hours they might come up with a plan, and an organization that might prevent events from transpiring and actions from happening that we would sorely regret.

Secretary HOBBY. I am so glad that you say on a voluntary basis. If we were to try to put this on a regulatory basis, because of the length of time that it would take to achieve the regulatory basis it is entirely possible that many children would thereby have been denied the shots.

Mr. Chairman, I think that it might be of interest to you, if Dr. Keefer would speak to us. He handled the allocation of penicillin for this country when it was a scarce item. I think it would help if he was to comment on how he did handle it.

Dr. KEEFER. Senator Hill, the point that you have raised with respect to the possibility of the black market arising in poliomyelitis vaccine is a very good one. However, I believe that the pharmaceutical industry that is responsible for the manufacture of vaccine at the present time is doing everything possible to prevent any such problem from arising. They, of course, are expert in the problems of distribution of products. That is their business.

And with the experience that I had with the distribution of penicillin to civilians during the wartime, when it was a scarce item, and later with the distribution of streptomycin to civilians when it was a scarce item, and still later when cortisone was still a scarce item, I am convinced that the best way to handle this is to inform the public and the medical profession constantly with respect to the supply and demand and the areas in which the vaccine will be of greatest possible benefit.

The pharmaceutical industry today, and the medical societies, the American Academy of Pediatrics, and the State health departments, have already circularized the physicians throughout the country explaining the supply situation, how it will be distributed. And they are in a voluntary way doing everything possible to prevent such a contingency as you mentioned from arising.

And constant flow of information to the public from industry and from the organized efforts of the medical profession, I think will be successful in avoiding these contingencies.

Chairman HILL. I am glad you said what you did about informing the public and the medical profession. That was one of the primary thoughts in my mind in suggesting this conference. I think a conference here, called by the President of the United States, would do more to serve this cause of informing the public and the medical profession than any other step you could take. It would dramatize it. You would get attention, as Madam Secretary so well knows, having been a great publisher herself. It would attract the attention of radio and television and the public generally. It would dramatize this thing. It would bring it home. It would challenge the American people and all who have a responsibility in this matter to play their full part. It would be a magnificant thing, it seems

to me.

The more I think about it, the more it challenges me-the more it appeals to me. It would be a wonderful thing.

Here is something that must be done by voluntary action. Have this conference, give this information, challenge the American people, and all those who have a direct responsibility in it, and you will get the response.

Senator BENDER. Do you not believe that because of private enterprise and private medicine, this discovery is attributed to them? What I had intended to say, in augmenting what you said, was that we do have the Pure Food and Drug Act that applies in these instances. I think whatever is necessary to do in order to protect the public, I am sure might be done through some simple statement or regulation, or something that would help in this situation.

If what you say is correct about the danger of commercializing this or making it not available to the people as is indicated by your television program

Chairman HILL. I will say to my friend that I am a strong supporter of the Pure Food and Drug Act, but I do not think that act would in any way apply to or reach the thing that we are now considering. That goes to an entirely different thing from this matter of informing the people, and then, as a result of this information, getting that wholehearted cooperation and response which we need and which I think we must have, if we are going to insure that the vaccine supply we now have on hand will do the greatest good for the greatest number. I do not think that act would help us in this

case.

Secretary HOBBY. May I say, Mr. Chairman, that it is very good to have your thought and suggestion in this cause., because I agree with you that it would dramatize it. The White House is very much aware of this problem and how best it can be publicized almost in the words you have used-not only here in the United States, but in the world.

I think it might be useful if Dr. Scheele would speak on this. He is trying to get together a group of the State and Territorial health officers. He can tell you of his concern there. Perhaps we could work in some of this other thing with the State and Territorial health officers.

Chairman HILL. May I ask this. Do you have any plan now to combat what might be a black market operation in this vaccine?

Secretary HOBBY. No, sir; we have no plan that would go into effect overnight. I have such confidence in the medical profession

that I cannot believe that in this instance a black market would develop. Maybe I am too trusting.

Chairman HILL. May I say that I share your confidence in the medical profession. I will not take time to enumerate, starting with my father, the members of my family who are in the medical profession. I have great confidence in them. But I do know this about it: if there is any one thing I have learned in my long years in public office, it is that the kind of individual reactions you get depends so much upon the system that you have. If you have the right plan, the right system, and then inspire and challenge people to follow the plan or the system, they will come forward with the best there is in them. Secretary HOBBY. I think that is true.

Chairman HILL. If you have a system that is not properly worked out and does not appeal to the best, you do not get the best results. Secretary HOBBY. I could not agree more with the chairman.

Dr. SCHEELE. My remarks earlier were directed at the concept of some sort of legal regulatory control which I think you, Mr. Chairman, have suggested is not necessary.

Chairman HILL. I was not thinking in terms of the Federal Government stepping in with a lot of regulations.

Dr. SCHEELE. I think you have also suggested the best technique that could possibly be followed at this stage, to get everybody on the team doing this thing in the right way. That is an educational program. And everyone representing major organizations getting back down to his group, the doctors, the pharmacists, and all, to see things in true light, and then to act accordingly. A conference of the type you suggest certainly could have great value.

Mrs. Hobby has asked me to mention to you a conference that is actually being discussed at this very moment. Well, during the time we have been here with you this morning, I asked Dr. Otis Anderson, Chief of our Bureau of State Services, to get in touch with Dr. Roy Norton, president of the Association of State and Territorial Health Officers, to discuss with him the possibilities of having a conference at a very early date, possibly as early as this week or next to which would be invited members of the medical profession, the American Medical Association, and various other groups, probably Dr. Salk, to discuss a number of technical questions which have now arisen in connection with the best plan for the utilization of the vaccine supply available. That conference could well cover this, and arrive at some concensus on the kind of statement that should go out to the American public, telling them what the situation is and how they should respond in helping to make the supply of vaccine stretch as best we can for he time being; also to alleviate any panic-I do not like to use that word--that might occur because people want to have someone immunized immediately. We could probabily explain to them that we ultimately want as many people to be immunized as possible, and that it is not absolutely necessary today or tomorrow. There is time to do this job.

Such a conference could produce that sort of preventive effect that you were describing and could help prevent problems in this field. Chairman HILL. Do you think that the conference might well promise much?

Dr. SCHEELE. Yes, indeed, I do.