Health Services and Mental Health Administration

The Special Foreign Currency Program of the Health Services and Mental Health Administration (HSMHA) shares the primary research goals of the domestic program: development of the most effective methods of preventing, diagnosing, and treating serious communicable disease, mental disease, heart disease, stroke, cancer, malnutrition and other important organic disease; testing the development of comprehensive medical care systems in the light of their provision of adequate care and effective utilization of health manpower; and development of workable emergency medical methods most adaptable to all types of medical emergencies. Available excess foreign currencies have allowed HSMHA to extend its program to meet these objectives in several important and unique ways. In the recognized priority area of population and family planning, the Agency is concerned with the collection of quantitative information on natality, fertility, family planning, and related demographic variables. The Scientific Activities Overseas appropriation contributes to the progress of this objective by offering unusual opportunities for the testing of data-collection techniques of competent foreign research personnel under a wide variety of conditions. Unusual disease and social conditions in the excess foreign currency countries provide a unique setting for the carrying on of significant clinical studies in such priority areas as malnutrition, cardiovascular disease, cancer, endocrine disorders, renal disease and radiation hazards.

Communicable diseases are responsible for most of the sickness and death throughout the world. To find better ways of eradicating, preventing, diagnosing, and treating these conditions, projects have been developed overseas in locations where the environment and patterns of the disease to be studied are most favorable for research.

Similarly, excess-currency countries provide excellent opportunities for the study of mental disorders. Since the determining factors in the etiology and outcome of mental illnesses may be biological, psychological or cultural, there is a real advantage in performing comparative and parallel studies on individuals from different ethnic groups, living in varying cultural environments. Excess foreign currency countries also provide an excellent spectrum of linguistic and pharmacologic resources for the International Reference Center for Information on Psychotropic Drugs administered by the National Institute of Mental Health.

Methods for the organization and delivery of health services and health manpower development represent other areas of high priority in domestic programs as well as in the international health field. Of particular importance are methods for improving health services to the disadvantaged and other special population groups. Similarly there is need for developing new categories of health manpower and new methods for health education in order to increase the effectiveness of available resources.

The allocation of excess currencies to HSMHA in FY 1970 is estimated at the equivalent of $1.5 million. Approximately 60% of this sum will be devoted to research in the health services field and the project of highest priority is in support of the newly established, "Institute for Population Studies in Social and Biological Sciences" in Belgrade. It is also planned to extend the Public Health Service International Fellowship Program to India and Pakistan by implementing a pilot training project in each country; to implement a combination nutrition and family planning project in Pakistan; and to undertake two research projects in disease control research, one in Yugoslavia and another in either India or Pakistan.

Consumer Protection and Environmental Health Service

The objective of the Consumer Protection and Environmental Health Service (CPEHS) is to assure that our growing knowledge of both ecology and technology is vigorously applied to man's environment and the products he consumes so that he will be afforded the greatest possible protection from hazards to his health and economic and social well-being. CPEHS supports studies in excess currency countries which will enhance our knowledge and capabilities in these areas and ultimately advance the health of all mankind.

One of the primary goals of the CPEHS is to promote the implementation of measures and standards which will insure a high level of protection for man against environmental insults. Accordingly, CPEHS has the responsibility for the investigation of causes of air pollution, the determination of its effect upon life and property, and the development of air-quality criteria and emission standards. Available excess currencies have allowed research to be conducted on improving established control techniques and processes for air pollutants. The CPEHS also has the responsibility for safeguarding consumers from products exposed to potentially hazardous radiation, upgrading the quality of drinking water supplies, and improving solid waste management.

To promote the development and improvement of techniques and procedures necessary to meet existing and emerging needs for consumer protection, CPEHS is carrying out an intensified drug inspection program, is determining the safety of drugs, and is investigating the therapeutic equivalency of drugs.. Comparable studies in excess foreign currency countries would increase, intensify, and solidify hypotheses developed and being tested domestically. For example, projects are being developed to assess the risk of thrombosis, carcinoma, abnormalities of carbohydrate metabolism, and congenital malformations resulting from oral contraceptives.

To increase social and technical knowledge about the broad influence of all factors upon positive consumer protection and environmental control, man's ecology is examined and evaluated. Extensive surveillance techniques and methods are developed to measure the impact of environment on man's health and welfare, and to ensure that measures are taken to minimize or avert current or potential hazards.

The tentative allocation to CPEHS of excess currencies equivalent to $310,000 will be used for the continued support of the existing program for translating air pollution research and technology literature during FY 1970.

Travel funds are requested by the Office of International Health to enable the PHS program coordinator and members of the professional staff to visit countries in which excess currencies are available. Travel will be performed for the purpose of developing policy and program objectives consistent with both United States and host country interests. Working relationships with the Ministries of Health will be developed and potential project areas explored. Looking toward U.S. interest in providing leadership in the search for solutions to important international health problems in fields such as nutrition, population, and environmental health, the staff will attempt to assure maximum utilization of P.L. 480 research toward progress in these areas.

OFFICE RESPONSIBILITIES

Senator BIBLE. We next go to the scientific activities overseas, the special foreign currency program. Dr. Leo Gehrig is the Director of the Office of International Health.

Dr. GEHRIG. I have on my left Dr. Frank Freeman, coordinator in the Office of International Health. I do have an opening statement I would like to read, if you concur.

Senator BIBLE. You may proceed.

Dr. GEHRIG. Mr. Chairman and members of the committee, I am Leo J. Gehrig, Director of the Office of International Health which is a staff office of the Assistant Secretary for Health and Scientific Affairs.

The Office of International Health is responsible for the development of public health service policies concerning international health activities; participation with the State Department in formulating U.S. technical positions relating to the World Health Organization and on other international health matters; guidance to the administrations of the public health service in their international health programs; and for administering and coordinating activities of the special foreign currency program. It is with this latter program that we are concerned today.

Funds were first appropriated in 1961 for the special foreign currency program under which local foreign currencies derived principally from the sale of U.S. agricultural commodities may be used to support scientific activities overseas in countries where these funds are declared to be in excess of operating needs of the United States. These scientific activities assist us in achieving goals within the mission of our domestic programs, and promote U.S. foreign policy through assistance in the health efforts of participating countries.

Since excess foreign currencies were first made available to the public health service for scientific activities overseas, this program has grown and matured. It is a significant resource for supplementing and extending the research and research related efforts of the administrations of the public health service. During fiscal year 1969, 83 new obligations for projects were made to a total in foreign currencies equivalent to approximately $16.8 million. There are currently 263 active projects chosen on a basis of scientific and program merit. Projects are developed and supervised by most operating programs of the three administrations of the public health service. Activities encompassed range from basic biomedical research, through applied research studies on communicable diseases, occupational and environmental health problems, to translations of foreign medical literature for the benefit of U.S. scientists and practitioners alike.

The program is based on collaboration and mutual benefit between the United States and participating countries. Of advantage to the U.S. health concern, is the potential to utilize foreign resources which are often unique. Uniqueness may derive from a variety of circumstances, such as the increased frequency or occurrence of a disease condition for study, the existence of unusual research talent, and interest or availability of language expertise.