Harry S. Truman Presidential Library & Museum


Oral History Interview with
Henry Van Zile Hyde

During the Truman Administration, was Chief, Health Division, UNR'RA, 1945; Chief, Division of International Health, USPHS, 1948-49; Assistant Chief, Health Services Branch, Division of International Labor, Social and Health Affairs, 1950-52; Director, Division of Health and Sani-tation, Institute of Inter-American Affairs, 1950-52; U.S. representative on the executive board, World Health Organization, 1948-52; and Director, Health and Sanitation Staff, Technical Cooperation Administration, 1952-53.

Bethesda, Maryland
July 16, 1975
by Richard D. McKinzie

[Notices and Restrictions | Interview Transcript | Additional Hyde Oral History Transcripts]


NOTICE
This is a transcript of a tape-recorded interview conducted for the Harry S. Truman Library. A draft of this transcript was edited by the interviewee but only minor emendations were made; therefore, the reader should remember that this is essentially a transcript of the spoken, rather than the written word.

Numbers appearing in square brackets (ex. [45]) within the transcript indicate the pagination in the original, hardcopy version of the oral history interview.

RESTRICTIONS
This oral history transcript may be read, quoted from, cited, and reproduced for purposes of research. It may not be published in full except by permission of the Harry S. Truman Library.

Opened September, 1981
Harry S. Truman Library
Independence, Missouri

[Top of the Page | Notices and Restrictions | Interview Transcript | Additional Hyde Oral History Transcripts]



Oral History Interview with
Henry Van Zile Hyde

Bethesda, Maryland
July 16, 1975
by Richard D. McKinzie

[1]

MCKINZIE: Dr. Hyde, perhaps a good place to start would be to ask you to talk about why you got interested in organized medicine, as opposed to the practice of internal medicine in which you were trained.

HYDE: Well, I would say Hitler drove me out of the practice of medicine, into public health. That's a complex story, but I was in practice of internal medicine in Syracuse, New York, and went into the State Health Department in Albany as the director of the Bureau of Pneumonia Control in April, 1941. I had been doing pneumonia research in the state program. With World War II pressing on us, I was

[2]

commissioned in the Public Health Service after only four months in Albany and was assigned to the Office of Civilian Defense (OCD), in charge of the health aspects of civilian defense in New York, New Jersey, and Delaware.

I was transferred to Washington by OCD as Chief of the Division of Emergency Medical Services. When it became clear that the U.S. was not going to be bombed, that is in early 1944, I was transferred to the Foreign Economic Administration on the request of James M. Landes, who had been Director of OCD on leave as Dean of the Harvard Law School, and was now assigned to Cairo by the Foreign Economic Administration.

I went to Cairo as head of the Medical Division of the Middle East Supply Center, an Anglo-American Agency that had complete control of the flow of civilian supplies into the Middle East. The Medical Division was concerned with medical and health supplies required by the twenty countries in that region.

[3]

MCKINZIE: I'm sure there were shortages, but were there any tense, war-generated problems?

HYDE: Yes. The ports in the Middle East had become blocked during the North African war, with non-essential goods impeding the landing of war material and equipment. Shipping was scarce and was being used for unnecessary civilian supplies.

A joint Anglo-American agency was set up to control the use of ports and shipping, the Middle East Supply Center (MESC). It determined the civilian requirements for every country in the region and licensed their import. Each country programmed its needs and these were screened by the MESC and approved as the basis for licenses. The supplies ordered under the approved programs came from either the United States or England, the two "loading zones." In this way it was possible to maintain an orderly flow of essential supplies into the Middle East.

The Director of the MESC was a very remarkable 35-year old Australian, then a commander in the

[4]

British Navy; now, Sir Robert G. A. Jackson. He is now in the office of the Secretary General of the United Nations. He went in 1945 from the Middle East to the UNRRA as Deputy Director General serving in that capacity under both Herbert L.ehman and Fiorello La Guardia. He was the number two man assigned to UNRRA by the British treasury. He was able to keep on top of every detail of that vast operation, while at the same time concerning himself with its impact upon the postwar economy in Europe, America and the rest of the world. After UNRRA he served in the United Nations, as the Assistant Secretary General in the Office of the Secretary General, under Trygvie Lie. But he just moved too fast for Trygvie Lie and there was some hoopla over that. He stepped out for awhile and now is back.

Well, I had the opportunity of working under him; he was then in his early thirties when he was running that operation. I remember one time being in his office in Cairo during the MESC period and hearing one end of a telephone conversation; it

[5]

was just after Greece had been liberated and [Sir Winston] Churchill and Eden had gone down to Greece. Jackson went up there to make some supply arrangements and I was in his office after that when he received a phone call from Sir Bernard Padget, commanding general of the Middle East forces. I heard his end of it, and he said, "Well, why do you ask this, General? I don't need anything now. There isn't any help I need from you now, so why do you ask?"

The General replied, "Well, I just received a cable from London saying, 'Do anything Jackson asks. Signed, Churchill."'

Jackson was the one who arranged sessions for LaGuardia with the Pope, and with Stalin. But anyway, I had the opportunity of working under a man I consider a great man.

Jackson took over as Senior Deputy Director General of UNRRA. He and a group came out to the Middle East and reorganized the Balkan Mission and appointed me as the Director of the Middle East

[6]

office, which had charge of the refugees in the camps there. We had something like 80,000 refugees in the Gaza Strip, the Sinai, and North Africa.

MCKINZIE: At that early time did you anticipate that there was going to be an even greater problem in the future with refugees?

HYDE: No, we thought we had a big problem then. No, I'll say not.

These refugees had been moved out of the Adriatic coast of Yugoslavia and then out of the islands -- the Greek islands -- in the Aegean, under the Churchill concept of coming up through there. It was either a decoy to make people think that was where they were coming in, or it was a serious move. But these people were moved out and placed in camps in the deserts of Sinai and Palestine. The Greeks didn't adjust to it well. Many of the Greeks went down into Kenya, down further south, but the recalcitrant ones, the difficult ones, said they wouldn't go there. They stayed near their home and were very

[7]

difficult to deal with, really, because they weren't the best. The Yugoslavs were highly organized. You could see then the difference between a democracy and a dictatorship, because when those people were giving any minor trouble, all you'd have to do was speak to a Colonel Jaksie, Tito's representative there, and he'd say, "Give me 24 hours." In 24 hours they had a committee structure right down the line. The word went down and, bing; like that, everything was in order. For the Greeks, it was entirely different. There was no order, no organization.

I remember I had a session once with the committee at the Moses Wells camp in the Sinai, and I met with the committee representing the refugees, and of course their great drive was to get home. And during the meeting, which went on into the evening, we were getting nowhere, and we were threatened with the burning down of this frame building we were in. The committee didn't want to leave us and go out and talk to the people, because they were afraid of the women. They were afraid of

[8]

what would be done to them by their own people if they didn't get transportation immediately home. We found out the next day that they had kindling and gasoline there, and they were going to burn the thing down.

Fortunately, they hadn't bothered cutting the phone lines . We were able to call the British military, and they sent in some fire engines containing their own water and sent in some troops, and that ended the fracas.

MCKINZIE: In those camps, were there any Jews who had come from Germany?

HYDE: These were Greeks, Dodecanese islanders, and Yugoslavs. There were some sephardic Jews, who had come around years ago from Spain, across North Africa. I think they were still Spanish citizens legally, although they hadn't been there for a few centuries. However, they were a separate community in the Gaza Strip.

Well, this is some background. When the war

[9]

was over and I came home, the question was whether I was going to go back into the practice of internal medicine in Syracuse or stay as an officer in the U.S. Public Health Service . I felt if I could stay in international activities it would have some appeal. When I first came back, I was told there wasn't any chance there, but they were going to assign me to, oh, Surplus Property or something exciting like that. And my wife and I decided, "Well, if we're going back into practice, we don't have to do it right now; let's give it three months and see what develops."

When I came back to Washington in September or August of '45, the Surgeon General wanted to see me and said that he was going to assign me to the State Department. Dr. Louis L. Williams, a great man that I was exposed to, had been assigned over there, but he'd had a coronary occlusion when he was in North Africa, and he was only working half-time, supposedly (his working half-time was a lot more than most people working full-time). But he wasn't

[10]

supposed to work full-time, so I was assigned to assist him.

The reason I was assigned to him was that before I left Cairo, an inspector of the Department of State, who was later the Ambassador to Indonesia and sorted things out there as a middle man between Indonesia and the Dutch, was in Cairo making a routine inspection of the U.S. ministry--- legation, as it was in those days. So, I wrote him a memorandum of what I thought the U.S. should do in health in the Middle East. And this floated around in State until it happened to hit Louis Williams' desk. It coincided with some ideas that he had been developing and had some other ideas that intrigued him. And so he asked the Surgeon General where I was and what they were doing with me.

It was agreed that on this basis that I'd be assigned to work with Dr. Williams in the State Department. That was in '45. Louis Williams, I think, was assigned in May of '45 to the State Department. And then Howard B. Calderwood, a State

[11]

Department official who had been a professor at Michigan with international organization affairs as a specialty, had been assigned to Dr. Williams to handle the organizational aspects of things. Williams was chiefly concerned with the technical aspects, but he himself was a great organizer. He was the one that conducted the "malaria control in war areas program" in the South of the United States and established the Office of Malaria Control in War Areas, which later, when the war was over, was converted into the Communicable Disease Center. It is a big and important operation in Atlanta, and you see it referred to frequently whenever there's any suggestion of an epidemic of any sort; it's become a great institution, and this was something Louis organized. And Louis was the first one to really talk of eradication of malaria in the United States and the concept of eradication, which has been accomplished. So, he was assigned to the State Department.

At that time there was Otis Mulliken, chief of

[12]

the Division of International Labor, Social, and Health Affairs (ILH), in State. His prime interest was in labor and labor relations. He worked with the Department of Labor which had labor attaches stationed around the world and was concerned with the U.S. participation in the International Labor Organization. He was very forward looking, and he saw that in the organizational activities of the State Department that were developing into what became the United Nations, no attention was being given to the health aspects. He recognized that in the League of Nations health activities were one of their stellar performances -- their only stellar performance. It had been a solid achievement. It was still continuing; it continued all through World War II to a lesser degree than before, but it continued its statistical work. And he saw that this whole area, which had been so important to the League of Nations, was being bypassed. So he discussed it with the Surgeon General, Dr. Thomas Parran, and they agreed that, certainly, something should be done about it.

[13]

So, to this Division, which had been primarily labor, health was added, and then the social people sort of got concerned and had the social affairs added to it. So it became the Division of International Labor, Social, and Health Affairs. And it was in -- strangely enough --the Office of International Trade Policy, under the economic arm of the State Department. By the time I got there in August, there had been a lot of thinking about what type of organization should be developed. At the time of the San Francisco Conference that set up the U.N., which had a large delegation that included no health personnel, an effort by the Public Health Service and by Dr. Parran to get somebody included in the delegation in the field of health didn't materialize. So Dr. Parran sent Dr. James Doull to San Francisco on Public Health Service business.

Dr. Doull was a distinguished Public Health man who was professor of preventive medicine and public health at Western Reserve University in Cleveland, and Dr. Parran had recruited him into

[14]

the Public Health Service and commissioned him in the Public Health Service to be head of a Division of International Health Relations in the Public Health Service. He became sort of a counterpart to Dr. Williams in the State Department.

So, he sent Dr. Doull to San Francisco, and Dr. Doull, being a good operator, pretty soon had organized the health people who were on delegations; several of the delegations had health personnel who were not there as health personnel but as general members of the delegation. But he had gotten together such people as Geraldo de Paula Sousa of Brazil, who graduated in the first class of the Johns Hopkins School of Hygiene and Public Health. He was on the Brazilian delegation to the United Nations. Dr. Szeming Sze was the member of the Chinese delegation. His father had been the Chinese Ambassador to England and the United States. And Szeming Sze was a very brilliant young Chinese.

Oh, the French had a Dr. LeClainch there, I think it was, and the Russians had a doctor in the

[15]

delegation. There were about six, I think, doctors. They got together and decided something should be included in the Charter on health. They introduced a resolution, but found that it was too late by the time they got around to introducing it, but that a "declaration" could be introduced.

But they did two things. One, they got health inserted in the Charter about three or four times as one of the areas in which there could be a specialized agency, which was a very important concept, because prior to then, in the League of Nations' day, health was a division in the political secretariat, and the director of the division was appointed by the political top, the Secretary General. But as a specialized agency, it meant that there would be an agency in which the Director General would be elected by the Assembly composed of the health leadership of the world and would not be an appointee subject to the will of the Secretary General of the United Nations.

So this concept was important. But as the

[16]

Charter was originally drafted, there was no reference to health as one of the key areas in which there might be such an agency. So they got that implanted.

Then this declaration that they came forward with and got jointly introduced by Brazil and China was a declaration that called for the convening of an international health conference to consider the organization of health within the U.N. framework. And this was adopted unanimously and became the base on which action took place. As a matter of fact, one of the first actions of the Economic and Social Council was to convene a preparatory committee for an international health organization.

Now, getting back to the State Department, I was assigned to the Division of International Labor, Social, and Health Affairs. So, there's Dr. Williams, Mr. Calderwood, and myself as that health unit, with relationships with the Public Health Service being with Dr. Doull and the Surgeon General. And I might say that the Surgeon General,

[17]

Dr. Thomas Parran, who again was a great man, made himself fully available. This, at that time, was a major interest of his as Surgeon General, and he was accessible at any time that we wanted to get his advice, help, and support, down to the smallest detail. He didn't interfere, but he was there.

So, by the time I got there, Dr. Williams and Mr. Calderwood, with the interest and support of the Surgeon General, had gotten out a draft of a constitution for a World Health Organization, a first draft. And this we continued to work on; there wasn't any final form even of the first draft, but we were working on it. But a meeting was convened in October of 1945 by the Surgeon General and the State Department to review this draft. I think it was about 33 of the leading health people, medical people, of the United States and a two-day meeting held in the Department of State. And it went over a draft which was then the current draft, in great detail, broke up into some working groups to work on certain aspects of it. And this, of course, generated interest

[18]

in the medical community and a sense of participation -- for instance, by the American Medical Association. Morris Fishbein, who was editor of the Journal of the American Medical Association at that time and was really "Mr. AMA," was deeply involved in the work of the subcommittees. And as one looks at the list of the people in that meeting, it represented the best in American medicine at that time. That review led to some further crystalization of the draft constitution, that we in the Department were working on. But then, as I say, the Economic and Social Council set up a preparatory committee to convene the International Health Conference.

And at that time the United Nations was in London and Dr. Doull was sent over there to talk with the U.N. and with the British. The British had been deeply involved in this. I might say, as a background of this, that here in Washington Dr. de Paul Souza and Dr. Sze were assigned here, and Dr. Leclainch came over for awhile. There was a brain

[19]

surgeon in the Russian Embassy who died during this process, but he was involved in some initial planning.

MCKINZIE: This planning you spoke of preceded the meeting of the doctors?

HYDE: This preceded the meeting of the Technical Preparatory Committee, which was convened in March '46 by the Economic Social Council. Prior to that, in this draft we were developing in the U.S. that we had this committee go over, the British (Sir Wilson Jameson, who was really the father of the British National Health Service) were involved, and so were Szeming Sze, da Paula Souza, Leclainch and others, giving it, even here in Washington, an international spread of interest and involvement. So when it came time to set up a Technical Preparatory Committee, the question was who should be invited, and this was a problem for the United Nations, and its Economic and Social Council. So Doull went over to London to participate in this --

[20]

sort of in the background -- and to talk with the British and others. Interestingly enough, the vice-chairman of the Economic and Social Council at that time was Andrija Stampar, who was one of the great men of Public Health. In Zagreb, Yugoslavia, the School of Public Health is the "Andrija Stampar School of Public Health." After World War I, when Yugoslavia was first established, Stampar set up a model health service all over the country that's been a model for the world since then. He was the Yugoslav delegate to the Economic and Social Council and was vice-chairman of it, and health was of particular interest to him. The chairman of the Economic and Social Council at that time was Sir Ramas Suanee Mudaliar, whose identical twin was the leading health man of India. At that time, he was rector, I believe, of the University of Madras; he'd retired 25 years before as a professor of obstetrics and gynecology at Madras, and they asked if he would take the rectorship on an acting basis, so he "acted" for 25 years in that role. He was one of the great men of

[21]

medicine in that era, so that the Economic and Social Council had two people interested in health at that moment.

There was discussion, and then Dr. Doull teletyped back a list of the people that were proposed and we had a lunch -- Dr. Parran, Dr. Williams, and I -- at the Cosmos Club to go over this list. And the thing that struck me, because I had recently returned from the Middle East, was that there was nobody from the Middle East on the list. So I pointed this out, and the three of us agreed that there had to be somebody from that area.

Well, it so happened that there was a first-class man there, Aly Tewfik Shousha, who, when I first went out there, was Aly Tewfik Shousha Bey. And now, instead of a Bey, the King had made him a Pasha, and it was Aly Tewfik Shousha Pasha. And then he got a CG or whatever it is from the British and became Sir Aly Twefik Shousha Pasha. And being a man with great foresight, in due course he became just ordinary Dr. A. T. Shousha, dropping all this title.

[22]

So, I said he was the man, and they took my word for it.

We signaled the British, or Doull, on that. We got the word back that the British didn't think it was necessary to have anybody from the Middle East, and Shousha was a medical politician. But we insisted that Shousha be included. Well, I might say that he went on to have a very distinguished international career. He was the first chairman of the Executive Board of the WHO and became Regional Director for the future Eastern Mediterranean Region of the WHO.

I might say that he is one of the few foreigners who've ever been given the Freedom Medal by the United States, and I'll never forget when the papers in Geneva said that President Eisenhower had gone to Walter Reed Hospital to honor John Foster Dulles, who was dying there, to give him as a last tribute, the Freedom Medal. Shousha came to me and said, "I'd never had any concept of what the significance of this was." He was given the Freedom Medal for

[23]

having handled the Egyptian side of setting up what is now well-known as NAMRU III, which is the U.S. naval medical research unit in Cairo which has continued, ever since then, to be probably the most important scientific medical and health activity in the Middle East. And even during the Suez crisis and everything else, it has continued to operate, because it's always been a combined U.S.-Egyptian activity with everybody on a par -- I mean, nationality making no difference.

Well, anyway, Shousha was added to the list and the Technical Preparatory Committee was convened in Paris, in April 1946, and lasted some six weeks, five weeks, or something of that sort. And there Dr. Rene Sand of Belgium was elected as chairman. He was a very gracious, lovely person. I'11 never forget his introduction of everybody; he went around the table and introduced them to one another. It was a very nice presentation, and made one feel that they were all wonderful fellows with whom to work.

[24]

He had one little trick that intrigued me greatly. If the discussion of an issue came to a complete impasse, where there were two sides that weren't getting together, he referred it to the drafting committee. And the drafting committee would come back with something that he would see was adopted. That was a very handy device.

Dr. Parran was there with Sir Wilson Jameson from England, Stampar from Yugoslavia, [Dr. Andre"'] Cavaillon from France, de Paula Sousa of Brazil, whom I mentioned before, Szeming Sze of China, and Shousha of Egypt -- a very distinguished group. After some discussion and introductory business, the draft that we took to the meeting, which became known as the Parran draft, became the basis of discussion for the whole matter. Certain issues emerged.

In the draft that we took over, there was no real preamble; it was an organizational thing without any preamble. Stampar introduced a draft preamble, and that preamble was worked over and the drafting committee put a lot of work on it. I consider

[25]

my contribution to it was taking the "whereas's" out of it. I served as secretary of the Drafting Committee appointed by Mr. Calderwood who was secretary of the Technical Preparatory Committee. That preamble has the now famous definition that you've probably heard, that is repeated over and over, about health being "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity." I must say we worked over that for some days and came up with it, and it's become sort of a clarion call. As Dr. Parran once said, that whole preamble became the Magna Carta of health, recognizing Government responsibility for the health of the people.

MCKINZIE: Dr. Hyde, did the political people in the State Department show sudden interest when you started talking about things like preambles?

HYDE: No. The interesting thing is that, in those days, health was a minor public concern. Before Parran went to the Public Health Service he had been

[26]

Commissioner of Health in New York State, and FDR brought him down here as Surgeon General. At that time, the Public Health Service was a unit in the Treasury Department concerned with quarantine, customs, and that sort of thing. And at one time the Secretary of Treasury was asked about it by somebody, and he didn't even know he had a Public Health Service under him.

Then, when the Federal Security Agency was set up, Parran and the Public Health Service were moved there and health became of increasing importance. And when they got the Social Security development and the social developments under FDR, health emerged. But health was always a minor consideration of Government until it became a multi-million or billion dollar enterprise, and now it's politically important. You'll see that now you have an Assistant Secretary of Health in HEW, a political position. Health used to be the concern of only the Surgeon General, who had to be appointed from the Commission Corps of the Public Health Service, and

[27]

therefore, had to be a technical man.

It so happens that the appointments of Assistant Secretary so far, despite all the political "umph" that health has now, have been good technical men. But at that time, 1945, there was very little interest in what was going on in health; it was a sideline. As a matter of fact, Calderwood and I, I think, were responsible for the development of the "position paper" approach to things. I remember once we sat down and drafted a letter of instruction to the chairman of the delegation, and that letter, signed by the Secretary of State, now is standard; all U.S. delegations get that letter telling them how to behave. But at that time, as a matter of fact, we had a little system there -- Williams and Calderwood and I -- where we'd write position papers and instructions and get them approved in order to commit the State Department, not to instruct the delegation, but to get commitments, because, as you know, we're a government that operates by crisis. If you don't have a crisis, you can't get any

[28]

attention to a problem. You can create a crisis; "a meeting's going to be held ." "We have to have your signature!" Well, they'd sign about anything, you see, to get us out of the room in those days. Now, of course, health is a different matter. But we considered that the relationships with other governments, in an area that was not controversial, was important.

I remember, I think it was after the first World Health Assembly in 1948, Dr. Parran called on President Truman to report to him on the meeting, and he described the atmosphere of the Health Assembly; it was all friendly and constructive. And so something came up about the Russians, and President Truman asked about that. And Parran described the relationship there, which was a very friendly, constructive one, with no problems in the relationships. The individuals were friendly, and everything worked very nicely.

President Truman's comment on that, according to Dr. Parran, was, "We should have sent you people

[29]

over to Moscow instead of sending Mr. [Dean] Acheson." I think it was Acheson that had been over there recently, and things didn't work out very well. But that good relationship has always existed in the health field.

Later, when Dr. Parran and I with some others visited Russia, we were received as personal friends. As a matter of fact, I've always been called by my first name in the Russian Ministry of Health, and I still am, as a matter of fact. So we could consider that important. But health was not big business; its claim to political significance was that it was apolitical, so that there wasn't much interest in the State Department on the whole thing. We could go ahead pretty much in our own way.

And there's an interesting relationship there that maybe comes up later. There's an interesting situation in that the constitution of the WHO elects certain governments to designate a person to serve on the Executive Board, a technically qualified person who serves in his personal capacity, although

[30]

he is named by the government. Whereas, the legislation that makes us members of the WHO provides that the representative on the Executive Board shall be appointed by the President with the advice and consent of the Senate. So you are in a situation where from the WHO standpoint, you don't represent the Government, but it's difficult to say you don't represent the Government when you are appointed by the President and confirmed by the Senate.

We worked out a system where, as the member of the Executive Board, I was given "guidance papers" -- instead of instructions. They were guidance papers, and I could follow them in the manner that I saw fit. I don't know what the situation is now; I think it may have tightened up some. But at that time, as I say, there was so little interest in health that you could get away with that.

MCKINZIE: But there surely must have been some sort of philosophical differences between the people who were on the drafting committee or who had input to that

[31]

committee about the extent to which Government should support such activities itself.

HYDE: No, I don't -- you mean in the State Department?

MCKINZIE: Well, among the people who turned up at Paris.

HYDE: Oh. Well, the people that were in Paris were all public health people; they were serving there in a personal capacity. Now, Russia wasn't on the Technical Preparatory Committee, and personal capacity to them was meaningless, of course. But the ones that were there were all there in a personal capacity, and the constitution was developed. There were issues that arose there, but not issues as to support. There were some issues as to whether this statement which was being made was too broad, but the governments didn't come into it. That draft of the preamble -- which is a very broad social document, giving the governments responsibility for the health of the people -- went through the International Health Conference later in July, with scarcely any discussion. It was unanimously accepted. That was one of the things

[32]

that was not debated. There was a committee on the preamble at the International Health Conference (that was the summer of '46), and that finished its business in no time at all, because there was no discussion. And I don't think there were any changes made in it; there may have been a few little drafting changes. But here this great social concept was accepted without any debate. Jim Doull was the member of the U.S. delegation who sat on that committee. He thought there was going to be a lot of contention over it, but there wasn't, there just wasn't.

MCKINZIE: Did Mrs. Roosevelt take any particular interest in it?

HYDE: No, she wasn't involved in that.

Now, let's see, we were back to the State Department, weren't we?

MCKINZIE: And the preparations for this Paris meeting.

HYDE: The Paris meeting had adopted a constitution, a draft constitution, with some commentary. They were

[33]

charged with preparing an annotated agenda for an international health conference. The annotated agenda was primarily the draft constitution, and the agenda of the conference, when it came up, was based on that. So the International Health Conference was convened in New York in the summer of 1946, about three months after the Technical Preparatory Committee, and all members of the United Nations were invited as participants. Other governments were invited as observers -- those who were not members of the U.N.; Ireland, for instance, and Trans-Jordan, it was in those days. There was a series that were not members. Switzerland was not a member of the U.N. but had observers and had the privilege of the floor. That was the composition of it and, of course, various agencies were there -- the representation of the old League of Nations.

They were there as observers, I guess, as was the Office International d'Hygiene Publique, which had been existing in Paris, and of which the U.S. was a member. The U.S. was never a member of the

[34]

League of Nations, so the International Office in Paris was kept active because the U.S. was a member, and its committee served as an advisory committee to the League of Nations, which meant our Surgeon General was involved in the League of Nations through that devious route. So the International Health Conference met, then, to adopt a constitution.

There were issues that occurred in Paris and New York both, but which were resolved one way or another. Oh, there were such things as trying to arrive at what the administrative authority was going to be. The constitution makes the Director General the chief professional and administrative officer. Well, there are differences in administrative concept between the U.S. concept with which we are so familiar and the European. In Europe, for instance, they set up a committee to do something, to make decisions, because then the finger of blame cannot be placed on anybody. The idea that there should be a Director General who could be criticized and who had responsibility for making decisions is

[35]

abhorrent to some of the Europeans, and this had to be debated. Well, finally, it was set up so the Director General was a man who makes decisions and runs the show. The assembly lays down policies within which he works, but he calls the shots. That was one type of issue.

Another, and the big issue which ran through the Technical Preparatory Committee and the assembly of the International Health Conference, was the question of regionalization. In this hemisphere since 1902, there had been a Pan-American Sanitary Bureau. And if you look at the international convention treaty that sets that up in 1924, it was signed by all the state in the Americas -- which was unique in being the first American treaty to be signed by all the American states. But that gives -- and this is unique -- the director of the Pan-American Sanitary Bureau the authority to go into any country and demand to see their health records. He has authority to do that but I don't think it's ever been exercised. It however, had the effect of getting from the governments an increased flow of information than had

[36]

existed.

The Pan-American Sanitary Bureau was pretty much a speechmaking organization, and there were men in the hemisphere who would leave for the meeting in Washington or Atlanta or wherever it was to be, and their local press would have a big play about this man going off to this important international meeting. He'd go there and make speeches about what they were doing or what they should be doing. And one of those men, who was known as "the orator of the Andes," once told me that for three weeks -- he was a professor of public health in a medical school -- he had been the Director General of Health for the country, but it only took him three weeks to find out that he couldn't direct it. He could talk about it, he could preach it, but he couldn't do it, and so he stepped aside. And he was one of the greatest health orators of all time. Although I didn't know Spanish, I could get every idea that he was putting over from his heavy gesticulation. So there was a lot of that speechmaking. And these

<

[37]

men didn't want to see the organization swallowed up that they attached great importance to.

So this became a very difficult issue, what was to be done with this thing. I might say that at that time it consisted of a staff of three men and a couple of girls located upstairs in the Pan-American Union Building, with the files out in the hall and a room with a library of reports. The Director at that time was Dr. Hugh Cumming, a retired Surgeon General, and his only pay was a car and chauffeur. One of the other of the three was an officer of the Public Health Service, Dr. Murdock, who was detailed there by the Public Health Service and paid by the Public Health Service. The other was Dr. Aristides Moll. The only other professional employee was Dr. Esmond Fory stationed in Peru. This was the organization, small but with great emotional appeal to the Latin Americans. The U.S. was footing the bill, by and large, so they wanted to maintain that.

There were no other regional structures, but

[38]

the whole question of regionalization arose. This was a hot issue in the International Health Conference. At first it was in the committee of the whole; they set up a working group, and then they set up a study group. Finally there was a "harmonizing committee," and there was great debate as to what integration meant. Then they got out the Spanish dictionaries and the American dictionaries as to the question of what it was to be "integrated" into the World Health Organization.

Finally, that issue was solved by some special language in the constitution that it's to be integrated "in due course" into the World Health Organization. This led to a lot of thinking about the question of regionalization.

Now, the result of all this is that the Structure of the World Health Organization is unique in the U.N., because in each of six Regions there is a Regional Committee made up of the governments of that Region and a Regional Office under a Regional Director. The six Regional Directors are appointed

[39]

by the Executive Board of the World Health Organization in consultation with the regional committee, which means that the Regional Directors are really elected at the regional level. They report to the Director General, but the Director General, instead of having full control and authority over the Regional Directors, has to be able to drive a very strong team of people who have their own support, their own political constituency.

Fortunately, the Directors General thus far have been strong men and men that are so highly regarded and respected by the Regional Directors that this has been possible. Here in this hemisphere the Americas, the Pan American Sanitary Bureau then became the Pan American Health Organization, because it had this Regional Committee and Regional Director, and a feature of that is that it gets contributions at the regional level in addition to funds from the WHO budget.

For instance, the U.S. paid, at that time, 39.89 percent of the budget of the WHO, and money

[40]

flowed from the WHO to the Pan American Health Organization in the same way it did to other Regions. But in addition to that, the Pan American Health Organization had its own budget and resources from the region. Of that the U.S. paid 66 percent, as against 39 percent (now 25 percent or 26 percent) of the World Health Organization budget. And that still is the situation.

I think that the regional structure has given great strength to the World Health Organization, because the Government deals with the Regional Office and the Regional Director who was their man in their office, and it gives them a greater sense of participation when they have their annual meetings of the Regional Committee. You have a World Health Assembly every year, and you have a Regional Committee meeting every year, which is considered by some as too demanding on national directors of health.

MCKINZIE: But in a way, that's a very political issue that you're talking about, the business of regional

[41]

organization. Even if they didn't care very much about health, they do care very much -- I'm talking about the State Department -- about how sub-organizations are structured. I'm really rather surprised that they didn't get hot in the middle of that.

HYDE: Well, I think they were certainly involved in this; we had discussions in the Department. I would have to look to see just how our position changed. But, really, the decisions were being made at the International Health Conference; there wasn't any strong feeling in the Department. Otis Mulliken and Calderwood were on the delegation of the International Health Conference. In fact, Calderwood was the secretary, appointed by the United Nations, for the Technical Preparatory Committee in Paris. But this theme ran through, and it was a matter of compromise.

MCKINZIE: What was your own feeling about that?

HYDE: Well, I was just looking the other day at a document I ran across over in Geneva that we had

[42]

prepared in our delegation in Paris. I remember sitting up in a room writing it. A certain portion of that described our state-Federal relationship and proposed that this be the pattern; and it really is. I mean, now there's a federation of regional organizations when you get right down to it, except that the money is flowing out from the center, which gives quite a bit of strength to the center. And this paper was describing how our state and Federal relationships were in health. But federation was strongly opposed by some of the people who were strong centralists. For instance, Stampar was (and so was Dr. Karl Evang of Norway) a very influential figure at both those meetings.

They wanted a strong central organization; they had no sympathy with the Pan American Sanitary Bureau and separate regionalization. They wanted strong centralization. Well, as I say, it was a compromise. I think we realized at the time that the regional directors should be appointed by the Executive Board. And we knew then that it was obvious

[43]

that the regional committees had the real strength. This whole health area got really no attention above the level of the Office of International Labor, Social, and Health sphere. What interest would the chief of the Office of International Trade Policy have in this sideshow on health? And the implications that it might have in an area like regionalization and the regional structure didn't bother them at that level.

MCKINZIE: Did you feel the responsibility to report to the Public Health Service about all this?

HYDE: Well, Dr. Parran was the Surgeon General, you see, and he was involved. And Jim Doull was in his staff of the Public Health Service. As a matter of fact, Jim Doull was chief of the Office of International Health Relations in the Public Health Service. This was all developed in one room in the State Department, where we had a pair of two desks facing each other. There was Williams and Hyde, and Doull and Calderwood, and over in the corner there was a man handling narcotics. We had

[44]

one secretary between the five of us, and that was where this was developed. And, over in the Public Health Service Doull had his responsibilities there. For instance, the Public Health Service had a mission in Liberia as a result of Mrs. Roosevelt's wanting one sent over there; somebody got to her. And so they were running that mission and running some other things; there was at that time some Smith-Mundt activities that had come along. So he had some administrative responsibility there. But we had these four desks and one secretary in the State Department, and this was just a sideshow to many. At that time, Louis Williams, Jim Doull and I were all still in uniform; the war was just finished. The Public Health Service was part of the Armed Forces during the war and is a uniformed service. So we were functioning in uniform, and when you went in to see somebody to get something signed, the factor of the uniform got you by the secretary, so you got in to see the boss. And when he found out you were a pill doctor

[45]

instead of a Ph.D., then he just figured you knew your medical business. But it was mainly because health was not a great, predominant government or social function in those days, and it didn't have hundreds of millions or billions of dollars in Federal funds; it wasn't so significant politically.

MCKINZIE: But when you get a draft charter, somebody has got to deal with that.

HYDE: I remember that there wasn't much interest about that provision; even the chief of our bureau didn't hear much about it. And it involved, of course, legislation.

MCKINZIE: It involved financing, too, which is another area I wanted to ask you about.

HYDE: Well, there was a division in State that had to do with the financing of international organizations, and in that division the one who was specifically concerned with the financial aspects of the WHO was

[46]

Carol [Caroline Clendening] Laise, who is now Assistant Secretary dealing with agencies outside the Government. I probably remember her largely because she was a lovely young lady. One big issue was whether the United States was going to join WHO after all this. And this, after the International Health Conference, was developed into a bill that would provide for our membership. It wasn't a treaty, but an executive agreement, but it would have to have legislation providing for membership and for financing. Well, now, that was quite a long battle. There was a committee in the House, and Walter Judd and Mrs. [Frances P.] Bolton were very active in supporting it, and finally the legislation got through. The problem was that the Rules Committee blocked the thing for a long time to the extent that there were Herb Block cartoons, and other cartoons, attacking the Rules Committee. This was one of the issues they were holding up, and finally it got through. And then, with a very strict limitation on our contribution it passed the Congress.

[47]

The International Health Conference set up an Interim Commission that carried on the business through the two years until 1948, when the WHO constitution received the necessary ratifications to bring it into being. The Interim Commission met every three months.

MCKINZIE: It had something to do with the U.S. commitment to this?

HYDE: Oh, yes. At one meeting of the Interim Commission, the U.N. had asked the WHO Interim Commission how much the WHO was going to cost the first year. I was on the commission then; I was the alternate, but Dr. Parran only went to the first two, and I was chairman of the delegation for the rest of them. And so I said we shouldn't give them any figure, but the Secretary General of the Interim Commission, Dr. Chisholm, said he was obliged to give them an estimate, with whatever caveats were necessary. I can remember making the statement that any figure we gave "would become sacrosanct and frozen into

[48]

law." But he insisted, and the Interim Commission decided it must give U.N. a figure. The Deputy Executive Secretary, Dr. Yves Biraud, previously a member of the League of Nations staff, had a stack of books in front of him, and he said he had carefully studied the entire Constitution and everything provided in it, and to carry out everything required by the Constitution would cost 4 million 800 thousand dollars.

Well, then I hit the roof again and got nowhere. That figure was given to the U.N., 4 million 800 thousand; 39.89 percent of 4 million 800 thousand is one million 920 thousand. And, by gosh, our law when finally enacted limited our annual contribution to one million 920 thousand dollars. That got through the Congress of the United States, and with a provision that if any action was taken to increase our commitment without our consent, we would no longer be members of WHO. That legislation was passed. Then the fight was, after that, to get rid of this ceiling. Now, of course, our contribution is up into about

[49]

35 million or something like that.

I remember I had the unusual privilege of being invited to sit in on the Senate-House Conference Committee that considered this. Very seldom does anybody from the executive branch get in on those, but Dr. Judd, Walter Judd, asked Senator Vandenberg if he had any objection to my attending, and he said, "No," so I attended and heard this discussion.

The thing that intrigued me was that as Judd was presenting the case in a very effective way; Senator Lodge, [Henry] Cabot Lodge, interrupted at one point and said, "Is that in there to make it different from UNESCO?"

And Walter Judd said, "Yes."

Lodge said, "Well, I'm for it then. Anything to make it different from UNESCO."

Well, anyway, it got through the committee, but it had this reservation in it, you see, and this caused difficulties later. And then another problem that we had is the question, at the first World

[50]

Health Assembly, of our membership, because we had this reservation of right to withdraw. The treaty encompassing the constitution of the World Health Organization was deposited with the U.N. At that time, the U.S. Government was anxious in getting the U.N. to be a repository of treaties. Our treaty people were teaching them the business and had people assigned there and so forth.

Well, the U.N. had to take the stand that this reservation would have to be accepted by all signatories of the constitution. After waiting two years to get the signatories to the level where the constitution came into being it was too much to expect to get any prompt action on this. Finally, the U.N. decided that if the First World Health Assembly accepted the U.S. as a member with this reservation, that would satisfy the U.N.

MCKINZIE: Who set the 39 percent figure?

HYDE: Well, there's a story behind that, too. It was the U.N. figure for its budget, and at the first

[51]

Health Assembly in 1948 there was a great debate as to whether the WHO should have its own scale of contributions or use the U.N. scale. After considerable debate, it was decided to use the U.N. scale, and then the question was, what about members who were not members of the U.N.? And what was the affect of the U.N. scale minimum and maximum? After this basic decision had been taken in the committee, the chairman of the Finance Committee of the Assembly said, "Now, after the next coffee break we'll decide on the ceiling, and the floor and what to do about members who aren't members of the U.N.; we'll come back to those."

So, I raised the point that there was no point in that, that we had decided to use the U.N. scale which already had a minimum and a maximum. It was 100 percent, and therefore the non-members of the U.N. couldn't be included, so that there was no point in having any further discussions. It was thus already decided that they wouldn't have to contribute. And, oh, boy, this really got things spinning.

[52]

So, the chairman, after talking with the representative of the Director General decided to postpone this until after the coffee break. In the resolution from, I think, New Zealand, it was decided to obliterate from the record everything that had transpired that morning and start fresh on this issue. So that doesn't now show in the record. The chairman was a Pole, Dr. [M.] Kacprzak, who was also a graduate of the first class of the Johns Hopkins School of Hygiene and Public Health; he and de Paula Souza were both in that class.

I gave him a lot of trouble in that committee, I'm afraid. I loved him; he was a dear man.

At one cocktail party a couple of years later, he asked Mrs. Hyde, "Can you handle him? How do you handle him? He was a wonderful person.

But the 39.89 percent was an adjustment of the U.N. scale. Now, of course, the U.N. scale was supposed to be based on ability to pay, but if you look at it, it had little relationship to that. It was politically determined. The WHO, in general,

[53]

followed that pattern.

MCKINZIE: After this period in 1946, after the initial drafting committee met, there was that Interim Committee that you mentioned which kept things together until such time that the charter was ratified.

HYDE: They had the first Assembly, yes.

MCKINZIE: And you served on this Interim group?

HYDE: Interim Commission, yes.

MCKINZIE: What kinds of business did you have to cope with there? Was the progress towards ratification a major issue?

HYDE: Well, that was only one thing. You see, the Interim Commission, by a protocol signed at the International Health Conference, absorbed the residual League of Nations health staff and activities that, during the war, had gone into UNRRA as a holding operation. It absorbed, also, the International

[54]

Office of Public Health in Paris, so that those two were brought together in Geneva. And then it began operations called for in the constitution of the WHO. So, as it began developing, it had a readymade staff by bringing certain of these League people and those of the Office in Paris together. They were concerned with the international quarantine operations and the spread of disease. So that was an operation that was taken on at that time.

Then there were the organizational aspects of the WHO, the development of an initial program and budget -- for instance, the question of priority; what is this organization going to do? Here it is, what are we going to do? Well, certain priorities were adopted, and they were based, at that moment in history, on the attack on certain things that had deteriorated -- the health situation that had deteriorated during the war -- and for which there were new weapons to be used that hadn't gotten widespread because of the war. One of these was malaria,

[55]

because DDT had come along and here was a chance for a fresh approach against the situation that had grown worse during the war. Another was venereal disease, because penicillin had come along, you see, during the war . Tuberculosis was another one, because the BCG vaccine was very popular in Europe, much more so than here; they had had much more faith in it. And then added to this was the question of sanitation and maternal and child health. And those became the priorities that were adopted at that time, because you couldn't do everything. And so, there was the matter of developing programs in those areas and getting staff to do the program planning and thinking, shaping up some of these other issues like the regionalization (which con-tinued under discussion). And it was left primarily to the first Assembly to organize the Regions. I mean, you're going to have a regional structure; then what are your Regions going to be? And there were no ready-made Regions at that time. Finally, the governments themselves could decide

[56]

which Region they wanted to belong to. America is well-defined geographically and historically, Europe pretty much the same, and the Middle East, in people's mind, pretty well. But then you got into the problem of Southeast Asia and the Western Pacific. Is Pakistan going to be in Southeast Asia with India, or is it going to go with the Middle East? It's up to them.

So, there were these problems. And, as I say, the commission had to put before the first World Health Assembly a budget for the first year's operation, and this is where the 4.8 million came in.

MCKINZIE: You mentioned establishing these priorities. Those priorities were almost inherent in some other things the Government was doing. That is, those problems were inherent in other things that the Government was trying to confront. I'm thinking of the beginning of the American foreign aid programs. At least talk of them preceded the Marshall plan talks, and then, of course, there was already

[57]

existing this coordinator of inter-American affairs that became the IIAA.

HYDE: Well, I think there was a basic difference here in the approach, and the WHO is now getting back to this broader approach . The IIAA was concerned with the establishment of health services and health centers -- sanitary services and that sort of thing -- on a very broad basis. They didn't make attacks on specific diseases. Well, the WHO, at the present time, is critical of what it did in its early days because of this, that enough attention wasn't paid to the development of the basic health structure of countries and the delivery of health and medical services. There was too much focus on specific disease control. So, there was a basic difference of approach there, and both of them paid off. Malaria eradication was one of the programs of the WHO. Well, it hasn't been eradicated, but when you think of the fact that, as one states, there are a hundred million cases of malaria in India a year and now there are just a

[58]

handful -- maybe a few thousand cases here and there -- that paid off.

Take syphillis. The whole picture's different due to penicillin, but penicillin had to get out and get into use; it was the same thing with DDT. Now, all the time, there was this underlying building of the health structure, which is a long term thing. One difference -- but a very fundamental difference -- between the IIAA and the World Health Organization is that the IIAA had money to do these things. They could build a health center; they built 14 hospitals in Ecuador alone. The WHO didn't have that; with billions of people, you couldn't do that.

MCKINZIE: You don't do much with that.

HYDE: No. So, what could you do with that small amount of money?

MCKINZIE: Well, I am still interested in this interim period. Were you devoting your full attention to that?

[59]

HYDE: Let's see, that was '46-'48. I was, at that time, pretty much full-time in that, I guess. There were meetings every three months in Geneva. It was a matter of dealing with these things, getting agreement in the State Department and the Public Health Service on some of the issues that were facing this amorphous thing that had to be shaped into something. And we had some distinguished people involved. I had the honor of having people like Martha Elliot, Abel Wolman, and Lowell Coggeshall go along as my assistants in this, in shaping the thing up. But you asked a difficult question, and you often look back on your career and wonder what the dickens you were doing that was so important at such a time, you know.

One of the big things then was this fight to get the U.S. to join. Now, that took a lot of time.

MCKINZIE: How were you going to do that? I mean, did you work through the State Department, and did you

[60]

get your friends in the Public Health Service to push from their side?

HYDE: Well, we were working with some of the Congressmen, particularly those I mentioned before, but we were getting some support from the American Public Health Association and the State Health officers. And we got some public interest in that. I mean, a fight always gets them. We got a lot of editorials and news stories partly attacking the Rules Committee, using this as a good example of their bad performance, if you will. So, we got quite a bit of support there.

MCKINZIE: Who went down to testify on the Hill?

HYDE: Dr. Parran. And, of course, he was considered far off to the left in those days, you know. I was his alternate on the Interim Commission. You will see that the bill that makes us members has another provision in it that the man who is appointed as the U.S. member of the executive board must have

[61]

had five years of practice. I think that was put in there by some of the conservatives to block Parran being the U.S. member of the executive board. He was too liberal for Congress at that time. Well, an interesting thing is that I was involved, as I say, in this promotion, fight, to get us in. And after it was all over, despite the fact that I was Parran's alternate in this business, the AMA sounded me out as to taking a job as their lobbyist in Washington. And I couldn't quite see my way to doing that.

MCKINZIE: You were talking about priorities and what this organization would do and what emphasis it would give those things. Did you have to make any commitment not to do certain things, or did anyone else?

HYDE: No, I don't think so. The birth control business bobbed up slightly once in awhile; at that time, if there had been any real active promotion of that, it would have ruined the organization. That was so until about

[62]

1954, when it was possible -- well, even then it was pretty hot. But, no, I don't remember anything of that sort.

MCKINZIE: Well, I had just wondered if there was a kind of quiet agreement that certain subjects or certain activities would not become a part of the program.

HYDE: Well, there was one basic administrative point -- a very fundamental point -- and that was whether it was to be a centralized organization with the program conceived centrally, carried out through the regions, or whether it was going to be a fund in which "X" amount would be set up for each country, and the country pretty well decided what it was going to do -- somewhat like UNICEF. The Russians were very anxious to have it as a fund, to get a lot of U.S. money set up for the satellites, you see -- that sort of thing. This was a real scrap, and in the First World Health Assembly I was the representative of our delegation on the Administration

[63]

and Budget Committee, and this issue came up there, really head-on with the Russians. And we fought strongly to make it an organization in which the organization carried out a program which wasn't just the earmarking of funds by countries. And we won that one, but it was quite a scrap. UNICEF followed the other pattern, and it has done a remarkable job. But they are two quite different types of organizations. Remember, in UNICEF at that time most of the money was going into Eastern Europe. And so that was an issue that had to be decided then and has shaped the whole future.

MCKINZIE: I'd like for you to talk about what happened in 1948. Were there special circumstances that were memorable?

HYDE: Well, one very dramatic thing happened in the first World Health Assembly. That was a long Assembly, because it had a lot of policy decisions to take, organizational decisions. I mean, the recommendations of the Interim Commission were just

[64]

recommendations, and they had to be put into action by the first assembly -- such things as the regional structure, the level of the budget, the priorities, and all of this sort of thing.

The one very dramatic thing that happened at the first World Health Assembly in 1948 was the question of U.S. membership. I pointed out we had a reservation. We wouldn't be members unless the Assembly voted us in unanimously; this was what the U.N. had decided. If the Assembly elected us unanimously, we were in.

Well, just before that, there was a closed meeting of the Interim Commission to decide certain things in the organization of the Assembly itself. And during that meeting it became apparent that the Executive Secretary of the Interim Commission had seated the U.S. back in the back, where the non-members were. Then we had to be elected in.

Well, I raised plenty of fuss over this. I felt that to have the World Health Assembly meet and have the U.S. in the cheap seats and not on the

[65]

floor would attract the attention of the press and cause a lot of furor. And I persuaded the Interim Commission to instruct the Executive Secretary, Dr. Chisholm, to place the U.S. in its proper alphabetical order on the floor.

Of course, he was perfectly right in what he did, but, politically, I thought it was worth the battle to see that we were properly seated. I thought this would have a psychological effect when it came to voting us in.

Dr. Stampar had been elected president of the first World Health Assembly. Dr. Parran, who had been the chairman of the International Health Conference, turned the chair over to Stampar. Stampar was then president, and he was sitting in the chair when this debate on U.S. membership occurred. A whole series of delegates talked about what fine people we were, how much the U.S. had done for public health, and so forth; all for us, no opposition. Then Dr. Vinogradov of the USSR went up to the podium, and he started blasting the U.S., giving us

[66]

hell. And you could see Stampar, who understood Russian; you could see his face falling and looking grimmer and grimmer. And we sat there not knowing Russian, but it was obvious that he was just giving us the works. Then he ended up by saying, "Despite this, we should accept them into membership." We saw the big grin on Stampar's face and knew we were in. But that was a very tense situation, because just the opposition of the USSR could have kept us out of the World Health Organization. Well, of course, with the financing of it and everything else, they would have been really politically stupid to have thrown us out of it; they had nothing to gain.

MCKINZIE: Well, that's interesting, because you're quite convinced that it wasn't automatic just because the United States was paying 38 percent of the bills?

HYDE: Well, now, there wouldn't have been much of a World Health Organization at that time without the U.S.; I guess they knew that, and they weren't about to take it up. Their contributions were very small

[67]

in all sorts of ways, financially, technically, and so forth. But that was a dramatic moment.

Well, as to the other matters, there's this one I mentioned before of whether it was to be just a funding operation or whether it was to be a technical organization.

An interesting bit of the history is its relationship to the League of Nations and UNICEF. Dr. Ludwik Rajchman was director of the Health Division of the League of Nations, a Pole, and a very brilliant and distinguished person. Rajchman put in a proposal to the Technical Preparatory Committee in which the WHO would have a hundred million dollars which would be used to support health activities. This somehow was buried and was never debated. I'm not sure I ever saw it, but it was extant. But it was buried and the Parran draft accepted, and the Reichman thing never considered.

Well, then, Rajchman became the father of UNICEF. And UNRRA had some residual funds of, oh, about a hundred and twenty-five million, something

[68]

like that, of which UNICEF got the bulk and the WHO got about a million 500 thousand. I remember at that time having represented the U.S. on the council of UNRRA for that particular meeting. But the WHO got a million and 500 thousand, and Rajchman got the rest of it and set up UNICEF. Well, then Rajchman headed UNICEF, and he was a very high-handed administrator in the League of Nations and in UNICEF. UNICEF has done a magnificent job, but the relationship with the WHO was always a problem, until it was finally decided and accepted that WHO should have the technical responsibility for the professional and technical aspects of the UNICEF program. And then there was an issue of who was going to pay for that -- whether the UNICEF was going to pay the WHO for this, or if it would come out of the WHO budget, which it finally did.

Well, then, a Joint Health Policy Committee was set up and decided on the policies of UNICEF -- what it was going to do in the health field and so forth. And to show his high-handedness, Rajchman

[69]

was a Pole who was a member of the Cosmos Club here. He lived in the U.S., but he would go to Poland, and, he was all-out Communist in Poland; over here he was quite the opposite, but he was playing it both ways at that time.

The way he'd run the Joint Health Policy Committee you'd get no advance documentation; you'd get to Paris from the meeting, there'd be a whole pile of documents, and you had to get them done that day. I mean, it was just high-handed as the devil. And this caused some difficulty. I was always for getting the WHO to have a bigger hand in the UNICEF health activities, and it worked out so that we did have this. But that was a very difficult issue for some time. Now they're getting along beautifully; of course, that Joint Health Policy Committee is very fundamental to both organizations. Recently, they've gotten down to our major emphasis on the delivery of health services, and it's all right. But Rajchman stormed out of one meeting once because he didn't like something I said.

[70]

MCKINZIE: Was it the old business of one person feeling someone else is building an empire, a bureaucratic empire? Did you feel that this was an erosion of the...

HYDE: Well, I think that he was not handled properly, as I see it, from the time of the Technical Preparatory Committee. I mean, he was a man of substance whose document should have been thrown on the table with the rest of them but wasn't somehow, and I think there was some personal resentment there. But he was a very high-handed person.

We had a meeting once of this Health Policy Committee in Geneva, and during the meeting Martha Eliot (then one of the Assistant Director Generals of the World Health Organization) was in charge of all maternal and child health matters. So she handled the relationships of the secretariat with the UNICEF. And on the other side, there was Rajchman.

At this meeting there was a document being

[71]

developed on the relationship, and we went through the thing step by step, as Rajchman brought points up. And we reached the conclusion on each and got through his points. This was a draft. Rajchman and I had been given the responsibility for approving the final document of the meeting, and scheduled a meeting for the next day where we would go over the reports done by the secretary. He had a series of points, and we reached a conclusion on that, and then I said, "Now, I have some points." And he got up to go. And I said, "Dr. Rajchman, I've got a few points here I want to make." He went ahead and walked down the hall.

Well, I took the document and threw it down on the table and I said, "Put at the end of this document that the World Health Organization in no way associates itself with any part of this document."

I got a phone call from Alfred Davidson, who was a good friend of mine and a lawyer with the UNICEF, and we set up an appointment for the next morning. And Rajchman came around to the Bean

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Rivage Hotel with Davidson to see me.

Meanwhile, I had collected from colleagues all sorts of points to raise, and so we sat there all morning. He had to go once to the phone -- apparently he called off some appointment -- and he sat there all morning while we went over point by point. We finally got it settled, but that's the kind of guy he was. He would just settle his point and off he would go.

And another time, as I say, he stomped out of a meeting with some final word about the whole fix of World Health Organization. And Stampar, who was known as the "Bear of the Balkans," was on the Joint Health Policy Committee. One time I was arguing with somebody on the other side (Debre of France, I think), and Rajchman moved in and gave support to the other position. Stampar, who was on my side, representing WHO, suddenly agreed with them and under-mined our position. And afterward he said to me, "I don't know why I did that, but when that man is around, I turn into a bowl of jelly." This guy

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Rajchman could do it to you. He was a brilliant s.o.b. He accomplished great things -- I mean, he was the father of UNICEF; there isn't any doubt about it.

MCKINZIE: Earlier you said something about there being some criticism about failure to develop health delivery systems, or to emphasize that in the early period. Was that discussed at all?

HYDE: Oh, yes, the building of administrative health and departments of health. But getting down to the business of health centers, UNICEF did more of this because they had money. I mean, they could supply the money to governments to set up local health services, and they actually provided a little black bag to the midwives and this sort of thing. The WHO didn't have that kind of money, and it still hasn't, but it's putting a great deal of emphasis on health planning at the national level, making it part of the total economic and social planning, and developing health centers. But a lot of this now comes up as

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something new.

Recently, I met with some people in leadership positions in international health who were talking about community medicine, community health. I read to them a document and asked them how they liked that; if that seemed to cover what they had in mind. They all agreed it did, and at least one of them thought this was something I'd just written and was testing on them. But what it was was a recommendation from the League of Nations Intergovernmental Conference on Rural Health in South Asia held in 1936. So, it's a matter of getting on with the job; the concepts aren't new. As you say, the IIAA did it -- health centers and all sorts of things in Latin America. I was director of Health and Sanitation in the IIAA late in the game, but at least I got a chance to see what they had done.

I think we should go from UNICEF and that relationship, which was quite thorny, to look at the relationships of certain other organizations, the U.N. itself. The Charter of the U.N. provides

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that specialized agencies will give an administrative report to the U.N. There's no budget control of specialized agencies from the U.N. and no policy control from the U.N., but they do give a report. What happens is that they provide to the U.N. all the official documents and the report of the Director General. But there was a real issue in the beginning as to whether the U.N. was going to have any health operation within it. They had an Assistant Secretary General then, a Frenchman, [Henri] Laugier, who was a distinguished scientist. He wanted to have some health activities within the framework of the U.N. So, when it came to negotiating the agreement with the U.N. which was called for, I guess, under the Charter (I'm not sure), an agreement was worked out with the U.N. One of the issues which was resolved was that the WHO is, as its constitution states in Article 2(a), "the directing and coordinating authority on international health work." The question was whether it was the or an, you see. And we sat down in New York with representatives of the

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U.N. and debated this issue and finally we got in the agreement that it was the coordinating and directing authority in International Health, whereas the U.N. had wanted it an instead of the.

That led at least one Regional Director to think that that meant he had authority over governments. What it meant was the directing and coordinating authority of the international activities, not of national, of course. That was out in Southeast Asia, and he thought he could tell the Indian ministry what they could do and whit they couldn't do, but he got disabused of that in due course; it all smoothed out. It meant that in the International U.N. orbit there was one organization, WHO, that was the coordinating organ and the responsible organization in health.

UNESCO was another matter. In UNESCO science was under James Needham, the great British scientist who is now preparing an encyclopedia on Chinese science, a fantastic person. He was setting up in UNESCO a health division or a section, and he had a

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White Russian woman there that was very aggressive. It came to a point where it was necessary to work out an agreement with UNESCO. And a committee of the Interim Commission went to Paris to meet with a committee of the Executive Board of UNESCO. There were four of us from the WHO, and I happened to be chairman of the group. Our main object was to keep UNESCO from developing, not in the basic sciences, but in public health; that was the main thing. They were having a meeting of their board which included members of the committee that we were to meet with. We were on hand there a day ahead, so they sent for us – I guess it was Needham – and said that since we were there and they had on the agenda of the Executive Board the item of relationship with the WHO, we were invited to sit in on that meeting, which was an open meeting, to hear their discussion.

So, we sat there in the specialized agency section. And so Dr. Martinez Baez of Mexico, who was on the Interim Commission, but also on the Executive Board of UNESCO, introduced each of us as

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individuals. And so Julian Huxley was the Director General then, and the chairman was a Canadian, Victor Dore, a descendant of Gustave Dore who illustrated Dante's Inferno (I grew up on that; was always shown that when I got out of line). Dore was the Canadian Ambassador to Belgium at that time. Huxley said, "Well, we might proceed to this item on the agenda that has to do with the World Health Organization, since we're honored to have the representatives here," and so forth. They had a document that had been passed around. The document was introduced by Martinez Baez, and it was very favorable to the WHO position. So, Needham interrupted him and said that he didn't think this should be discussed in the presence of the World Health Organization representatives who should be excused from the room while they discussed it.

So, I turned to the other members of our group and said, "Let's go." We marched out.

Then word got around to us that we were invited to lunch with the Board. Dore apologized to us with

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tears in his eyes, literally, Neither Huxley nor Needham ever made any apology for it, but we had a good lunch out of it.

And then the next day when negotiations started, here we were, four of us on one side of the table and four on the other; the secretariat at the head. We had somebody from our secretariat, and they had Needham. E. Ronald Walker of Australia was chairman of their group and served as chairman of the joint meeting the first morning. We had a considerable delay over various points. But Needham got more and more into it, and at noon Walker said to me, “I don’t know how to control Needham; he wants to run the whole thing.”

I said, “Well, put me in the chair; I’ll handle him.” And so that afternoon we met, and Needham indicated he wanted to speak and I didn’t pay any attention to it. Then, after ignoring him a couple of times, one of the UNESCO secretariat came around and whispered , “Dr. Needham wants to speak.”

I said, “Well, you just tell him this is a

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meeting between the Boards of the two organizations, and if he has anything to say, he can say it through representatives of the UNESCO Executive Board."

I got away with it, and we didn't let him have the floor. The UNESCO group did not want him to speak for them.

The next day Dr. Walker invited me to his apartment for lunch. We sat down and wrote the document that finally was approved. We agreed that the agreement should not be drafted by the secretariat of one of the agencies concerned, i.e. by UNESCO, and took it upon ourselves to draft it.

MCKINZIE: All of this still with comparatively little interest by the political officers in the Department?

HYDE: At that time Archibald McLeish was our representative in UNESCO; he didn't even know this argument was going on, as far as I know. There wasn't anybody paying any attention to it.

MCKINZIE: Well, after the World Health Organization

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existed, didn't that give people in the Department more interest?

HYDE: No, I don't think so. As I say, health was in ITP, International Trade Policy, so any State Department interest would go through that channel; but made a stop there.

MCKINZIE: Well, there was a group called U.N. Affairs too, though, wasn't there?

HYDE: Not then. This developed somewhat later with reorganization that I cannot give you in detail because I did not follow it closely. But they began pulling U.N. interests together, and Walter Kotschnig was the head of economic and social affairs. At some stage there was an office of U.S. Affairs with a Division of Economic and Social Affairs under Walter Kotschnig and in that was the health activity. Howard Calderwood was the permanent State Department official dealing with health under Kotschnig.

MCKINZIE: Being involved on the groundwork of all this,

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sort of setting everything up, how did you determine to have the annual meeting of the World Health Organization? Was there some idea of having that at Geneva every year because Geneva represented the...

HYDE: No, I'll tell you, the question of headquarters of WHO came up early, of course. Even in the Technical Preparatory Committee, we had discussion, and then we left it open. As a matter of fact, the Interim Commission headquarters, by a vote of the Interim Commission, was located in New York, but there was the League of Nations staff in Geneva and the Paris staff was moved to Geneva, so de facto headquarters became Geneva and de jure became New York. And most of the time Chisholm, who was the executive secretary, was in Geneva and moved his family there. As a matter of fact, he didn't want it in New York. So this was always a big factor, I think; he wanted it in Geneva.

The U.S. took the position that the WHO should be headquartered in a place where there was an active,

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live, medical community, where the experts could deal with their counterparts in their professional field. We thought of a place like London, less so, Paris. And it really came down to London, because politically we didn't want it in New York, and when you started pushing New York and Boston, it looked political. Some thought of San Francisco as a good place, but everybody else was in favor of Geneva for some reason or other. And I don't think we had a single vote with us against Geneva, so Geneva was it.

Now, the idea was the Assembly would move around to different places, and it did. The second Assembly was held in Rome. Then there was an Assembly in Minneapolis, there was an Assembly in Mexico, and there was an Assembly in Boston. But now, the estimate is that it would cost a million dollars to have it anyplace other than Geneva, just moving the secretariat, all the translating facilities, and all this. We obtained an appropriation of 400 thousand dollars to make it possible to have it in

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Boston. So to have it outside of the headquarters is now such an expensive thing as just to rule it out. It did have great advantages; I mean, when we had it in Minneapolis, it attracted some attention. We got more press in the United States; all the people in that area were excited about having this great international meeting there. It did a lot of good. And Boston was the same thing. In Mexico, at the time of the Assembly they had a cabinet meeting which decided they were going to eradicate malaria in Mexico, and this was announced to this Assembly. And they've done it.

So, it can have a great impact where it meets, but it's too expensive to move it about. It's money down the rathole if you pay an extra million dollars to have a meeting outside of headquarters. It isn't worth that; it's valuable, but it isn't worth that. So, now it's fixed in Geneva.

One of the mistakes that was made grew from regionalization. Nobody knew how that was going to develop. The way it was developed, the

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Assembly should meet on alternate years and the regional committees in the year between. Having both meetings each year makes too great a demand for the national leaders of health to be away from their desks. If they attend the Regional Committee meeting, the Assembly, and, if they happen to be on the Board or an Expert Committee, they spend a highly significant portion of their time out of their own country. I remember one friend of mine. Every time he left the country for an international meeting, the papers were full of criticism, that he wasn't paying attention to his job; that he was just "'skylarking" around at international meetings.

There has been a continuous move for years to try to bring such a change about, and now the budget of the WHO, for the first time, is on a biennial basis. At the Assembly this year, they adopted a biennial budget; this is a step in the direction of trying to spread the meetings out. One of the problems -- a very real problem, politically -- is that the WHO pays the travel of one representative. Now,

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to vote yourself out of an annual trip from, say, Chile to Geneva is asking quite a bit of a man. If governments made their decisions without human beings it would be easier.

It costs a lot for Australia, for instance, or New Zealand or Chile or Argentina to send somebody to Geneva every year, and it is only fair that the WHO should even out the costs by paying for a delegate. We tried some years ago to put through an amendment to the Constitution, with no success, and there is a continuing move in that direction. I think eventually they'll do it, or have some lesser Assembly authorized to take certain actions in the alternate years. But now the Executive Board's grown so big, it's almost an Assembly in itself. I think it's 36 countries now. They just added six this year, and it's interesting that four of the six are African, to give it geographic balance.

MCKINZIE: In these very first assemblies, was there any implication that the pre-existence of the American

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regional group loaded it some way? Was there the implication that there was going to be block voting according to region?

HYDE: I don't think there was, no. I think some resented the fact that the American organization wanted to keep some of its autonomy. Of late, block voting has developed into a science. Sometime after I got out of the thing, there was developed what is called the Committee of Twelve; these were the donor countries. If I had been there, I would have fought like hell against that; it was just asking for the trouble they're getting now. Now there's a Committee of Seventy-six or something like this, which is all the Third World. They had an announced meeting to discuss matters of common interest. It's just the kind of thing that you'd want to avoid and that the developed countries gave leadership to by their own action rather than preventing it.

This year it worked out pretty well, even though there was a real danger of a major breakdown on the basis of the Middle East. Last year they set up a

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committee to study how Israel was taking care of the peoples in the occupied area. And so the committee was to make a field inspection, but two of the governments included on the committee did not recognize Israel. Therefore, Israel wouldn't allow this committee in, because the two were representing governments that didn't recognize them.

It looked as though the Arabs were going to invoke Article VII of the constitution, which pro-vides that the vote can be withdrawn from any country who has not paid his contribution in two successive years or for other cause. Boy, I remember there was a debate over that little phrase "for other cause" but it was that phrase that they were depending on now.

Well, it looked as though this could have really rocked the ship badly, but the Committee of Seventy-six decided apparently that because there was a new Director General, they didn't want to cause him and the organization, with new leadership developing,

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major difficulties. They slapped Israel on the wrists lightly. I think that they set up a new committee. I don't know just how that developed. I saw the resolution, but I don't know who was put on that committee -- whether they put on countries that recognized Israel, or whether the whole thing is still going to explode.

MCKINZIE: After the organization was set up, and had its first meetings, had its first budget, and had its first priorities, did that take a lot of the excitement out of it for you?

HYDE: The second Assembly was very important, because there the whole regional thing came up, and also the question of size of the budget. As a matter of fact, it's rather interesting and what is now the U.N. Development Program in a way had its origins there. The WHO budget was limited so strictly by the U.S. financial limitation, which was raised to about three million after the first Assembly. But they had what became known as the "green sheets" -- I call

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them the "dream sheets." It consisted of green pages, at the end of the budget, of things they'd like to do but they couldn't do within the necessary funds.

And so they tried to obtain funds for a supplemental budget. That's been going on ever since, but at that time it was proposed as a technical assistance budget. And I think from this, in the U.N.E., the idea developed of "Well, let's have a technical assistance budget separate from the political and the central budget." And the appropriations are made for technical assistance in addition. That was a device for trying to get more money.

You asked if my interest continued. There were always issues of one sort or another. In '49, as I say, I went to the IIAA as the Director of Health and Sanitation. And then Point IV came on, and TCA, and I was Director of Health and Sanitation of that, and then went back to the Public Health Service as head of the Office of International Health Relations.

MCKINZIE: The reason I asked the question was that it's

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been something that you had worked for, really, since the war. Then when it came into being, did you really feel that the thing was going to float?

HYDE: Yes, that was the thing. You've got it going along, and the Executive Board had a lot of say about the direction in which it moved. And I had the privilege of serving as the U.S. member of the Board for a number of years.

MCKTNZIE: You referred to donor and receiver, or at least to donor countries. Did you get appeals from people who were not donors to undertake certain things? For example, did anyone come and suggest in very strong terms that there ought to be research programs on thus and so a subject?

HYDE: Oh, yes. This would come up in the program committees, yes. That will go on forever, and they'll eventually get around to doing many of the things that come up in the program committee over a period of years. I remember the second Assembly; I was chairman of the program and budget committee then.

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The question of research came up, and we set up a working group to work out a statement on the role of the WHO in research. We developed a policy statement to the effect that we should support research that was directed to the general program, priority things.

Then, when we had the Assembly in Minneapolis in 1958 (that was the 10th anniversary); we had a notable meeting. The first few days were a celebration of the ten years; then for the rest we got down to business. So, we had two delegations, really; we had a ceremonial delegation, if you will, and then we had the regular delegation. On the ceremonial delegation, Milton Eisenhower represented the President; the Secretary of HEW was on it; Jonas Salk was on it; and there were some people that had taken an active role during the years, as members of delegations, like Charles Mayo, for example.

So, we had that, but what we wanted to do was to have the U.S. make a gesture, and that took a bit of doing. Finally, we got out of NIH a miserable

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30 thousand dollars for making a study of what WHO should do in research. We only got that because we had to threaten NIH that the National Science Foundation had agreed to do it if they didn't do it. So, suddenly, they found they had the legal authority to do so. Pragmatically, they put up the money, after a phone call saying, "Well, all right, if you can't do it, then the National Science Foundation has agreed to do it."

They said, "Well, now, give us a little more time." So, they called back and did it.

This was the nub of a speech that Milton Eisenhower made at the ceremonial opening. And the Secretary of HEW was there, and he had to make a speech at the regular meeting. Milton Eisenhower made the announcement of this miserable 30 thousand dollars at a luncheon of delegates before the opening of the ceremonial session, and then the Secretary made a speech at the Assembly. It was the same 30 thousand they were talking about, and the Secretary thought it was his 30 thousand and not Milton's, and he

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always had some resentment about this. As for Milton Eisenhower's speech, we wrote the speech. John Haines was then Assistant Secretary for U.N. Affairs, and John and I went to Baltimore to meet with Milton Eisenhower on the draft we had written. We spent three hours there going over commas and phrases and words, without any discussion of principle or substance at all. And meanwhile, I'd invited the Russian delegation to lunch. They were coming from New York to Washington, enroute to Minneapolis, for this lunch that the Surgeon General had set up at the Cosmos Club. I knew they were going to be there, and we got tied up over the Eisenhower speech. Finally I excused myself and talked to the Surgeon General and told him what the situation was. He was coming to the luncheon, and I asked him to go to the Club and receive them; I wasn't going to be able to make it on time. So they arrived and were met. I got back about 12:30, just in time for the luncheon. We had a nice luncheon with them, and then we went off to Minneapolis together.

But we're talking about research. Now, out of

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this grew a research orientation that hadn't existed, and they now have a very high-powered research advisory committee with several Nobel Prize winners. There's one thing about the WHO I always thought was very gratifying, and that is that no matter how distinguished a man is in the medical field, science, and so forth, he's responsive to an invitation from the WHO, which is not true of scientists in UNESCO. As a matter of fact, there was real danger of the British pulling out of UNESCO once; there were scientists who didn't think much of it. That has not been true of WHO.

I always resisted all the public relations pressure to get more inches in the newspapers for WHO. I thought that the basic support they had from the professional and scientific community was the important thing, and you could prejudice this if you had a lot of hoopla and bleeding heart stuff in the press.

MCKINZIE: Since you were really in a position of determining what U.S. policy was, I wonder if you would talk a little about the issue of birth control. I understand

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it did come up once in awhile and certainly has come up in later years, not only in the case of the World Health Organization, but with all the international organizations that deal with the Third World.

HYDE: Well, it did come up, even in the International Health Conference. Something was said by the Trans-Jordan observer, but it didn't explode into anything. Then, in due course, Norway and Ceylon began introducing it. The Vatican had an observer, Father Reidmont, always hovering around the place and watching for it, to smack it down when it came up.

At one stage when Chisholm was Director General -- I think it was in 1952 -- he sent, at the request of India, Dr. Abraham Stone of New York and a couple of women experts out to India to advise them. This caused a great furor in the Assembly among the Catholic states. And about 1954 this thing came up in severe form; a resolution introduced by Norway and Ceylon was causing such a furor that finally it came to the point where Catholic countries threatened

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to bolt. Belgium was always one of the leaders in that.

MCKINZIE: But not Latin America?

HYDE: Well, Latin America never felt so strongly about it, but I think, if there had been a Catholic bolt, that some of the Latin Americans would feel that they had to follow it. It was mainly the Europeans, particularly Belgium -- Belgium and Ireland were the two main ones. And so this resolution was withdrawn. It was a very innocent one, that "technical assistance could be given when requested by the government."

Progressively, then, the U.N. began to take it over, take action in it. The WHO followed, rather than led, in the matter; I think that's the way to look at it. Then it began paying attention to the reproductive biology and research in this, rather than family planning programs. It has a very substantial operation in this field now, but the whole atmosphere has changed.

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MCKINZIE: The organization did exist in 1948, and in 1949 President Truman talked about technical assistance to countries overseas in his inaugural address. Was there any feeling or was there any exploration of the possibility that this technical assistance should be funneled in a major part through organizations such as the World Health Organization or UNICEF or UNESCO?

HYDE: I don't think that there was at that time. This was seen as a national program, giving American technology. And one reason the Point IV, I think, had such appeal was that it was appealing to our national ego: We know the answers! Another thing, it was on the cheap; you can get a lot for nothing in this. And we weren't about to turn these two things over to a multilateral organization. Of course, there were some of us who would have liked to have seen that. But I always thought that the two programs were equally valid. I felt that eventually they would all gravitate to the multilateral because of the political implications of the

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other, and that's happening, really. The U.S. is getting less welcome. I think the developing countries look to the international organizations as their organizations, and if it comes through them, it's welcome. If it comes through bilaterally, it has a lot of political implications they want to keep away from. But at the time of the Point IV, I mean, the world wasn't ready to operate that way -- I mean, the U.S. wasn't.

So, this bilateral and multilateral thing will continue to go on, I guess, but now it's more and more multilateral. The U.S. has made contributions. In malaria it has made very important supplementary contributions to WHO; that program was carried out largely by the WHO. What the U.S. did was to assure that there was very real coordination between the WHO, UNICEF, and the bilateral programs in the whole malaria eradication program. And there is a program now developing in Africa, where U.S. aid funds are being channeled through the WHO and an organization of West African states for the development of health

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services in West Africa.

So I think that the trend has been that the U.S. has operated increasingly through the WHO. I mean, in the matter of population, they've made substantial grants to the Pan American Health Organization, as the regional office of WHO, and to the WHO program; some of it was through the U.N. program. And so that aid money has been channeled out to the multilateral organizations.

MCKINZIE: I understand that at this very early period the feeling was that if the U.S. was going to pay for it, then it ought to be bilateral.

HYDE: Yes, I think that's true. You know, I think it's very interesting that the WHO, I'm glad to say, has been the best administered of any of the U.N. agencies. Now that, I think, is generally accepted in the State Department, and I happen to know the present Assistant Secretary of State for U.N. Affairs has recently said that to Milton Segal, who set up, really, the administrative side of the WHO. And it's

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the one agency that hasn't had to have an investigation and a study, bringing in auditors and overhauling the whole structure. It's been well administered.

But in the others, there has been this attitude I mentioned of Senator Lodge: "Make it different from UNESCO, I'm for it." Well, that was the attitude toward international organizations; you couldn't expect to turn funds over to them. But now that they have developed as responsible agencies, the WHO being less political; being competent technically; being accepted by the scientists and the professionals, and having a good record of administration, then you could turn funds over with a high degree of confidence, which you couldn't have done in the beginning.

We knew how to run things. Under Point IV, we'd send somebody out to advise on municipal organizations, and he was a good man because he had been the city manager of x, y, z. He had been fired from every darn one of them, so we send him out as an expert; he's had all this experience.

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On the other side, I remember in the Point IV program a man was to be sent to Iraq as an agricultural consultant or expert to carry out the TCA-Point IV commitment in agriculture in Iraq. At that time, personnel in State was controlling the personnel of the Point IV program, and they turned this fellow down as unqualified; he wasn't adequately qualified as an expert in agriculture to go out there. And while there was fuming in Point IV, the papers announced that he had just been appointed as the Secretary of Agriculture of the United States -- Ezra Benson.

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