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INTRODUCTION TO THE CONFERENCE ON "PHARMACEUTICALS FOR DEVELOPING COUNTRIES" David A. Hamburg DR. HAMBURG welcomed the audience and speakers to the National Academy of Sciences and the Institute of Medicine. He noted that the Conference constituted a landmark both for the Institute of Medicine and for pharmaceutical development. Briefly outlining the history of the Institute, created in 1970 with the broad charge to study issues pertaining to the health of the public, he explained that the relatively new International Health Divi- sion focuses primarily on the health problems of developing countries, enlisting leading members of the American academic community and their overseas colleagues to work with government and the private sector to address those problems. The Institute's perspective has been that, with the enormous scientific capability of the United States and of other technologically advanced countries, even a modest increase of interest and concern from the scientific community could yield highly significant benefits for the developing world. Such efforts will prove beneficial for all nations in an increasingly interdependent world. Several years ago, attempts to increase the interest of the Administration and Congress toward the health problems of developing countries were not very successful. Beginning in 1976, however, and under the leadership of the Executive Office of the President of the United States, several governmental agencies undertook cooperative efforts to organize and increase assistance toward improving health in developing countries. Concomitantly, and stimulated by renewed inter- est in the legislative branch, the Institute of Medicine undertook to identify opportunities for research and health care innovations that might receive further encouragement and support from government, indus- try, and the academic community. The widely dispersed potential of diverse governmental and non- governmental organizations must now be mobilized to increase the effi- cacy of work directed towards improving health in developing countries. The first major study on these issues was conducted by the Institute of
of Medicine in 1977,* and defined current opportunities to broaden program activities in international health. DR. HAMBURG expressed his belief that the principles and issues illuminated in that report have provided a useful framework for analysis, and that the Congress will act upon the recommendations contained therein. DR. HAMBURG then cited the annual meeting of the Institute of Medicine held in October 1978, at which an entire afternoon was devoted to international health issues. Drs. Halfdan Mahler, Adetokunbo Lucas, and Sune Bergstrom contributed major addresses to the program, present- ing principal aspects of World Health Organization activities. The mem- bership reacted enthusiastically to the Institute's new international initiative, promising future interest and support. As a sequel to this Conference, which has been sponsored by the Department of Health, Education, and Welfare, the Institute will con- duct a study on "Clinical Investigation in Developing Countries." That study will be chaired by Dr. Robert Petersdorf, and is sponsored by the Office of Science and Technology Policy in the Executive Office of the President. The Steering Committee will define and analyze the principal problems and issues attendant upon the conduct of cooperative clinical investigations in developing countries, and will then develop pertinent recommendations for governments, donor agencies, academic institutions, and investigators from developed and developing countries. Continuing these activities, a study on health services research in developing countries is anticipated, which should complement the Institute's efforts in connection with this Conference, and in the study on "Clini- cal Investigation in Developing Countries." DR. HAMBURG concluded by noting the long-standing commitment and contributions by Senators Kennedy, Javits, and Schweiker to solving the health problems of developing countries. He acknowledged Senator Kennedy's leadership in the Senate in providing strong encouragement to the Institute, to the academic community, and to the government toward substantively addressing the issues of increasing access to improved health care by people in developing countries. He then introduced Senator Kennedy as the keynote speaker of this Conference. * Strengthening U.S. Programs to Improve Health in Developing Countries. Report of a Study by the Institute of Medicine/National Academy of Sciences, Washington, D.C., April 1978.
