recommended the appropriate daily levels of fats and salt necessary to maintain health and prevent disease. Other aspects of the board's work concerned the international dimensions of nutrition, such as how to correct the deficiency of vitamin A in the diets of Third World children that led to blindness. Still other parts of the board's mission involved the maintenance of proper nutrition during pregnancy and lactation. In 1988, the board's disparate activities cost about $1.5 million to run and required the services of some 14 professional staff members.23

Not only did the IOM acquire new agencies as part of its newfound prosperity, it also revived components that had been moribund and invented new entities. The Board on International Health served as a good case in point. An important priority of David Hamburg's, international health had languished as an IOM activity during the 1980s, becoming the IOM division that encountered the most difficulty in attracting outside funds. To the proprietors of an increasingly troubled American health care system, international problems appeared remote, and the Reagan administration was reluctant to spend money on controversial forms of foreign aid such as advice on population control. As a result of these forces, the Board on International Health, which had struggled to come into existence in the first place, was effectively dissolved by the end of 1987. Thier and his staff set out to raise funds for a revived board and succeeded in gaining money from the Rockefeller Foundation, the Public Health Service, and the Agency for International Development. The IOM also contributed some of its newly gained endowment money. As a result, the new Board on International Health met for the first time in January 1989.24

In reconstituting the board, Thier vowed to avoid the mistakes of the past. The new board, unlike the old one, would have a firm funding base and be less susceptible to changing political fashions in which health shifted as a priority in economic development and foreign aid portfolios. It would be smaller and better focused than the previous board, and it would include foreign experts on health care policy. With this new outlook, Thier hoped that the new board would shape "a clear image of a distinctive role for itself' and convey this to the international health community.25 By 1990, the IOM's program in international health included a wide array of projects, such as a study of malaria prevention and control and another of female morbidity and mortality in Africa.26

This latter project ultimately resulted in the publication of a 1996 volume that showed how the IOM had changed over the years. Like other complicated projects, this one took a long time to complete. It



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement