Too Few and Too Little: Barricades to the Pursuit of Health

Academic responsibilities in the field of international health are considered. Too often the instructional process neglects essential aspects of the natural history and the control of infectious diseases. Few scientists are able to teach from a background of practical experience in the field. Little emphasis is placed on the continuum of problems deriving from an ever-changing human ecology. The program of "Health for All" of the World Health Organization and the recognition by the World Bank of health as an integral component of the developmental process are salutary events. Yet, progress depends on dedicated, informed leadership. Past examples can be found in the global contributions of the International Health Division of The Rockefeller Foundation, at the national level in Costa Rica where disease preventable by immunization has disappeared, and at the community level in the successes of Drs. Warren and Gretchen Berggren in Haiti. While new "magic bullets" are to be anticipated, the resurgency of yaws, in spite of penicillin, emphasizes the need for leadership in achieving a sustained, societal effort based on sound ecologic considerations.