In the poverty pockets of the world, millions of children die every year of preventable "killer" diseases for lack of immunization and medical care. The paper-shuffling of U.S. agencies.
The depressing story is told in a 500 page report, which President Carter solicited from aide Peter Bourne. Bourne has laid it on the line, assailing a dozen agencies for neglecting world health. They are more engrossed in their petty rivalries and bureaucratic empire building, he complains, than in saving children from disease.
"While both you and Secretary of State [Cyrus] Vance have made repeated strong statements about the importance you attach to meeting basic human needs." Bourne wrote to Carter, "there is little or no intergration of international health into the formulation and execution of U.S. foreign policy."
Too much emphasis has been placed in the past on training physicians and building hospitals with U.S. money, Bourne contends, rather than grass-roots program "to reach poor and rural people." Furthermore, he says, our world health effort has "over whelmingly emphasized problems of developed industrial nations such as cancer heart disease."
Bourne advocates, therefore, that Carter should focus on such problems as the need for clean water and such debilitating health handicaps as blindness.
"It is estimated that by making clean drinking water readily available to all people in the world, 50 million lives a year would be saved," the memo says. "While less dramatic than some other initiatives, strong clear support by you of the goal of clean drinking water for people everywhere would, in the long run, have the most significant lasting impact on world health of anything you could do."
On the prevalence of blindness, the president was told: "More than 30 blind - most of them from preventable causes. A major administration effort to reduce blindness worldwide would have dramatic appeal, could be uniquely and distinctively identified with you from other present international health emphasis, would be geared to the poorest people in the world as well as being relevent to the industrialized nations including the United States, and would not be vulnerable to the criticism that we were saving lives that would only amount to more mouths to feed."
Bourne suggests the proposed campaign should be built around a heavy publicity opetation. "We will seek to involve public figures, including those from the entertainment industry, in building public support for this initiative," he writes. "We would do this as part of the overall strategy now being developed with the [National Security Council] to build public support for foreign aid in general."
Bourne's memo, which was a summary of the report and intended for the president's private reading, doesn't spare the encrusted government agencies. Here are some examples from the memo:
"The State Department has the formal policymaking authority in this area but currently lacks the organizational structure or technical competence at a high level to carry out this responsibility or to take the lead which theoretically it should."
"Treasury regularly makes major decisions . . . that have extraordinary impact on world health, often without any awareness of that impact."
"Peace Corps, NASA, DOD [Department of Defense], the Commerce Department, CIA, the Veterans Administration, EPA and others all have specific specialized areas of interest, but make decisions in their own interests in isolation, unrelated to any overall coordination or policy."
The report urges that a concentrated attack on world health should be linked with a coordinated war on hunger, all as part of Carter's human-rights stance. It would provide a political boon as well, the memo suggests.
"Focusing public attention on an issue such as health, I believe, humanizes our foreign policy and makes it personally understandable in a way that amorphous impersonal issues like SALT and the Panama Canal do not," Bourne argues. He adds that there would be "a spill-over benefit" from the humanitarian campaign to help win congressional acceptance of the controversial canal and disarmament pacts.