US Medical Research Abroad: For the Power Not the People

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US Medical Research Abroad: For the Power Not the People

by Christine Rack

‘Science for the People’ Vol. 9, No. 1, January/Februrary 1977, p. 20–26

Throughout the spring of 1975, massive strikes by medical students, interns and residents directed against foreign funding of the health sciences threatened to engulf Colombia. Under this pressure the Universidad del Valle in Cali, Colombia, requested that the U.S.-funded International Center for Medical Research (ICMR) remove their offices from the campus before the end of the year. The U.S. State Department explained that relocation was due to “anti-Americanism”. A faculty member of Tulane University which had operated the ICMR for fifteen years was more blunt; the Colombians “thought it was the CIA”.1 The pivotal position of the Universidad del Valle in the anti-imperialist struggles of Colombia is due to the well-known fact that, since its founding in 1945, the university, and particularly its medical division, has been the target of massive North American funding and consequent infiltration. In spite of repressive policies in student and faculty selection, well-coordinated and meaningful political agitation and strike activities have marked the past decade with the profound support of other Colombian universities, high school students and peasant unions.*

There are three major characteristics of U.S.- funded medical research in Colombia. First, the research effort itself does not benefit the Colombian people and often works to their disadvantage. Second, under the auspices of “medical research”, massive amounts of data are collected, organized and stored that could be used for social control; several programs constitute a direct means of implementing that control. Finally, and essential for the first two, training scholarships to the States and U.S. research funding promote a Colombian medical elite strongly biased in favor of such programs. This powerful group helps to implement the U.S. objectives of cultural penetration and political control of the Colombian health system. 

Research: Against the People’s Interest

The Cali ICMR has supported directly three loosely defined areas of research: Nutrition and Metabolism, Infectious Disease, and Social and Behavioral Sciences. The first category includes all projects connected with the Metabolic Unit in the Hospital Universitario which provides an adult, child and infant population suffering from moderate to severe dietetic malnutrition for experimental purposes. 

Studies for various projects are done while the subject is maintained in the malnourished state and at various intervals during the “refeeding” process (anywhere from weeks to several months). The subjects are fed a scientifically prepared and complex diet, which teaches them nothing about nutrition. The “after” studies are done, and the subject is discharged as soon as his or her circulating protein level (plasma albumin) approaches normal. No attempt is made to build up amino acid storages necessary for the manufacture of proteins within the body. In the one case where the author was aware of any follow-up being done, plasma albumin had returned to starvation levels within one month of hospital discharge. 

Like many other departments of the U. del Valle, the scientific and human resources of the Metabolic Unit are utilized in pursuit of North American goals. The most severely malnourished subjects, brought from “socio-economically deprived areas” after other illness had been ruled out, are used to demonstrate the nutritional superiority of hybrid crop varieties developed by the U.S.-financed International Center for Tropical Agriculture (CIAT). (See box on page 23.) The Unit’s nutritionists collaborate with ClAT’s attempts to change food habits through marketing techniques and in the development of “high protein” food commodities for industrial production.2

The research subjects are starving because they are poor; they could never be the beneficiaries of research clearly targeted for consumers in developed capitalist countries. 

Using the rural area organized by the Rockefeller Foundation (RF) into the “Candelaria Health System”, researchers from the Metabolic Unit experiment with programs to minimize the problem of malnutrition without structural change. Over approximately ten years, supplementary feeding programs were administered to a target population of young children, from which they were gradually weaned. The programs, eventually limited to dried skim milk donated by CARE, resulted in the reduction of moderate malnutrition and the virtual elimination of starvation among the children, and promoted trust within the community for the project. Over the last five years of the project, health promotoras (Colombian outreach personnel) “assist the mothers in avoiding malnutrition in their children with only very selective occasional use of supplementary feeding.” This technique reduced moderate malnutrition and “maintained” starvation at lower levels in spite of a reduction in protein consumption per person. (Food prices had skyrocketed while median family income diminished.) 

The study group was doing better, but the families of the subjects were doing worse: “older children and adults fared slightly worse in intake relative to requirement,” and children who required the least amount of food to show improvement, fared slightly better. The government-contracted scientists who evaluated this project for the NIH concluded that “this is a dramatic confirmation of the value (of the promotora technique) for control of malnutrition in the preschool child at far Jess the cost than any kind of supplementary feeding program, and is a refutation of the thesis that nutritional problems can be met only by economic improvement.”3

What the study actually proved is the ability of the promotoras to deeply influence family behavior as reflected in the altered distribution of food. They also were able to collect detailed information, at little expense, on the socio-economic and cultural conditions of the rural masses without arousing hostility.

Data Collection for Social Control 

Another data collection apparatus has been developed by the ICMR under the auspices of epidemiological research. The epidemiology facilities, shared with the social sciences group, included a map library, cartographic equipment, a large, well-equipped darkroom and an ICMR-owned computer.4 In spite of these specialized facilities, very few epidemiological surveys have been reported that would require their use. 

However, numerous studies of human disease transmission by foreign organisms have been carried out, including the survey of various insects, reptiles, birds and mammals to learn if they are reservoirs of human parasites.5 The studies involve extensive travel throughout the country to collect the specimens and several laboratories for related research. The ICMR maintained a number of animal colonies to experimentally induce disease transmission, particularly with insect vectors, and collaborated with CIA Tin the use of larger animals.6

The interest of the U.S. in tropical disease transmission and control has been primarily military. It was pointed out in Cali and elsewhere that such research is applicable to the development of germ warfare techniques.7 The ICMR is within the Tulane School of Public Health and Tropical Medicine (SPHTM), which maintains close ties with the U.S. Armed Forces. The school has a cooperative degree program in public health with the U.S. Army Academy of Health Sciences in Texas, and approximately 10 percent of the SPHTM faculty are adjunct Army professors.8 The initial ICMR Director, from 1961-1966, was a Consultant Physician in tropical medicine to the Army Hospital at Fort Polk, Louisiana. Dr. Paul C. Beaver, ICMR Director since 1967, has been a member of the Armed Forces Epidemiological Board’s Commission on Parasitic Diseases since 1954 and its director from 1967-1973.9

The activities of the ICMR’s Social and Behavioral Sciences group also reflects the interests of the U.S. Defense Department. Though the overt attempts to organize social-science research in pursuit of the Army’s “limited war” objectives under Project CAMELOT (see Science for the People, March 1976) were rapidly abandoned, the goals of CAMELOT were not. In accordance with the 1959 Defense Department recommendations, the ICMR provides “relatively few capable scientists with supurb facilities, adequate interdisciplinary and technical help, and continuity of support”.10 Justified in 1961 as a means to “expedite the accumulation of reliable data from (the various) population groups”,participation of Tulane’s Department of Sociology and Anthropology in the ICMR would also “develop new information about the sociology and anthropology of the area” .11 Consistent with Defense Department emphasis on studies of persuasion and motivation,12 ICMR studies aim at elucidating factors of individual and group motivation. For example, between 1973-75, the decision-making process had been studied with regard to seeking health care, committing suicide, having an abortion, hospitalizing a family member in a mental institution, and committing homicide.13 Of primary interest to the U.S. military is “the discovery of symptoms indicating … that internal war (i.e., revolution) will occur in the society’s future”.14 One long-term ICMR study aimed at analysis of the expectations of recent high school graduates upon entering the labor force with follow-up interviews to determine their reaction to the inevitable disappointment. After six months of job seeking, 25 percent of the subjects could not be located and only one third had found employment. The component “adaption to work” had to be dropped for statistical reasons.15

In a 1962 symposium the Chief of Army Research and Development told the audience that he. was interested in “the sociophysiological factors (necessary for methods development)… for successful organization and control of guerillas and indigenous peoples by external friendly forces.”16 Between 1973-75, the traditional medical practices of four Indian tribes were under study by ICMR anthropologists; a fifth such project was abandoned because it was considered politically unsafe.17 The U.S. proposed, funded and controlled rural health delivery system (see USAID below) offers an opportunity to penetrate the guerrilla movements operating from such areas. 

IMCR Funding: Overt and Covert 

The ICMR has received approximately $500,000 a year in granting periods of five years from the National Institutes of Health since 1961. It enjoys a privileged status in Colombia which includes duty-free importation of equipment, supplies and personal effects of its members, and special visa arrangements. Though the ICMR in Cali consistently maintained that the NIH was its sole means of support, internal documents received under a Freedom of Information Act request to the NIH help to explain why the ICMR appeared to spend far more than its NIH grant could have supported. One of the functions of the ICMR, the documents state, is to serve “as a base, a center, a core around which additional funds, persons and research problems could accrete.18 The principal sources of such additions have been USAJD and the Rockefeller Foundation (RF). 

For example, the Candelaria project was begun by the RF and presented by the ICMR. It is currently funded by USAID.19 Both the RF and the Peace Corps have supported staff members of the ICMR.20 In this way, the ICMR offers a bureaucratic structure and scientific cover for projects funded by the RF and USAID. These types of arrangements are unmentioned in any public documents concerning the ICMR, and all requests for funding information addressed to Tulane have remained unanswered, presumably because funding by the RF or USAID to the Universidad del Valle would not be tolerated if it were known. 

USAID involvement in the Colombian health sector dates from 1950. Activity was “stepped up” in 1965 with $36 million in health sector loan funds disbursed from 1965-71. This rate of funding has doubled since 1973: $36.7 million was allotated to the health sector in the three-year period, 1974-77.21 The latest increase is the result of two factors. The Foreign Assistance Act of 1973 demands priority attention to Program areas affecting the poor majorities in Third World countries and health, population planning and nutrition are among those singled out.22 The second factor is the acceptance by the Colombian government of most of the recommendations for a regionalized, integrated health system made in a study prepared under the auspices of AID and issued in 1974.23 

The “model” for this health system is being researched and evaluated at the U. del Valle in a program known as “PRIMOPS”. Through a USAID contract for technical assistance in this endeavor, Tulane public health specialists from the SPHTM currently have offices on the medical school campus where they keep a low profile and regularly claim to be distinct from the ICMR. However, both the former and current directors of the Tulane program were past participants in the ICMR.24 PRIMOPS represents an attempt to export an “industry model” for health care delivery using techniques developed by the SPHTM for dissemination of birth control.25 One major feature of the approach is the use of promotoras, Colombian personnel hired at low cost, to educate and advise barrio households on “maternal and child health, family planning and nutrition.”26

U.S. CONTROL OF SUPPLY AND DEMAND 

Located several miles from CALI, CIAT is an agri-institute supported by the Rockefeller, Ford and Kellog Foundations, and, in addition, USAID. It is a primary force in US development schemes for Colombia. The hybrid crop varieties developed necessitate the purchase of large quantities of pesticides, herbicides and fertilizers making the large landowners the primary “beneficiaries”. The majority of Colombian farmers operate minifundistas (subsistence plots) and can neither afford the expensive industrial inputs nor the seeds. (75 percent of all Colombian farms are Jess than 7.5 acres, while 3.5 percent of all landowners hold 66 percent of all farm land. One million farm families are landless). 

Combined with US-encouraged reliance on cash crops such as coffee, sugar and cotton to earn the foreign exchange necessary for high-technology farming, the vast potential for growth of Colombian agriculture has been thwarted and development distorted in the pattern of economic dependency found throughout the Third World. The result is the need to import basic foods as well as the agricultural inputs from the US, further concentration of land into the hands of the landed oligarchy, malnutrition and political unrest. 

Having been increasingly involved in Colombia’s agricultural misdevelopment since 1942,* the Rockefeller Foundation (RF) quickly seized upon the “family planning” solution to the consequent hunger and rural rebellion. The RF and Ford Foundation heavily funded the mobilization of the Colombian medical establishment in support of population planning through the Colombian Association of Medical Schools (ASCOFAME) which, together with the U. del Valle, sponsored the first Panamerican Assembly on Population in Cali in 1965. In conjunction with Harvard professors with funding from the two foundations, the Valle of Educational Sciences developed “population awareness” programs for teachers of all educational levels and other settors of society. The RF, Ford Foundation and USAID are largely responsible for the fact that the Colombian government has accepted the limitation of population growth as a national objective: it remains the only Latin American nation to do so. 

* The Rockefeller Foundation progressed from supporting the agronomy faculty of the National University (1942-49) to directing national agri-research (1950-59). With the Ford and Kellog Foundations, and USAID loans, the RF created a “semi-autonomous agency” in 1963 controlling the entire effort of the Ministry of Agriculture in research education and extension. See the RF Special Report on Colombia, Agricultural Change: The Men and the Methods, written by Carroll P. Streeter (The Rockefeller Foundation. New York, 1972), p. 25-33. 

 

The promotoras also collect information to be fed into the computerized system developed by the SPHTM. This information forms the “input” on socioeconomic-population-health conditions used to determine the “output” (programs) necessary. PRIMOPS is intended to show the cost-effectiveness of the computerized technology which will then be integrated into the national health system.27 Tulane investigators program computers in Cali and Bogota for use in the health system while the “sociological data” on the receptivity of the test barrio population is analyzed at Tulane.28

PRIMPOS is often claimed to be a Colombian program due to the nearly $1 million in funding supplied the Colombian government over three years (in addition to the $1 million USAID-Tulane contract for the same period, 1974-77.29 In fact, these “Colombian” funds come from a special clause in the USAID “Health Sector Loan” which is distinctive in that this allocation requires no Colombian matching funds. Furthermore, through various loan “conditions”, USAID controls the program.30

The Role of the Rockefeller Foundation 

The Rockefeller Foundation (RF) chose the U. del Valle as one of the original five universities receiving funds under its “University Development Program” in 1963. This field staff-operated program to “strengthen selected universities” has cost the Rockefeller Foundation more than $75 million on a total of twelve universities in Latin America, Africa and Asia. Although Valle is a state university, in 1968 more than $1.3 million was received by the medical division alone in foreign grants, only slightly less than the $1.5 million contributed by the Colombian government.31 A substantial proportion of this came from the Rockefeller Foundation. 

Repeated attempts to prevent and expose the university’s collaboration with imperialist interests led to revolt in 1971.32 Students broke into the Rockefeller offices on the medical school campus where faculty and student sources maintain they found dossiers on dissident student leaders and sophisticated communications equipment. The strike called by Valle professors and students spread throughout the country. The government responded with violence; at least one student was killed by the troops sent onto the campus and martial law was declared nationwide.33 The RF was forced to vacate their offices at the Universidad del Valle Medical School. 

The Valle Dean of Health Sciences resigned to set up in 1972 the private agency used by the RF and USAID to fund projects and persons in the University on a more covert basis.** The Fundacion para Ia Educacion Superior (FES) has maintained close ties with the ICMR. After losing their facilities on the Valle campus in 1975, the Social and Behavioral Sciences Division of the ICMR permanently relocated to offices adjoining those of FES. Together, they are involved in the establishment of a central data bank for all information generated by the various research programs, including PRIMOPS. They have developed “a battery of standardized tests and measuring instruments that could be used by the various agencies … (to) improve inter-study linkage and comparability.”34

Are the socio-economic and physiological data generated by the programs described plugged into a computerized system for evaluating social and political stresses of interest to the U.S. Defense Department? Is the knowledge gained used for counter-operations using the same intermediaries and designed with the insights acquired through these types of social science research? Throughout the Valle medical community and the city of Cali were individuals with personal accounts of harrassment, bribery, surveillence and threats. Coupled with the security precautions, the half-truths and the outright lies of the ICMR, a coherent network of suggestive facts, undocumentable quotes and circumstantial evidence emerged to support allegations of corruption, of clandestine activities and of ICMR involvement in the exportation of priceless archeological items (illegal under Colombian law but clearly taking place on a large scale). The author’s attempts to have these allegations investigated by the “proper authorities” (HEW, State Department, Church Committee on Intelligence, a senator and a congressman) met with consistent resistance. 

Collaboration Is Purchased 

These allegations still remain unproven. Nevertheless, they were widely believed throughout the university and hospital. The apparent inability of the ICMR to deal directly with them provides insight into the tremendous gap that existed between the ICMR’s goal of “international understanding”35 and the means by which it attempted to achieve it. 

Through various programs over the years, the Tulane SPHTM has evolved a complicated network of relationships with the Colombian health establishment in general and with the Universidad del Valle in particular. The Tulane Dean of Tropical Medicine dates the university’s involvement with Colombia back to the Second World War. The earliest program that can be documented is a “Tulane-Colombia medical education program” carried out from 1955-62. Through this program, funded by USAID, “many of the U. del Valle senior faculty were given one to several years of training at Tulane” .36 The Tulane-Valle Center for Tropical Medicine Training was established in 1959 after a “suggestion” by the U.S. State Department that a relationship be established between Tulane and Colombia.37 It was expanded to include other academic departments as part of the NIH-ICMR program in 1961. In the early ’60’s, several more Valle faculty received ICMR-funded training at Tulane.38

The effects of such faculty exchanges on Colombian academics cannot be overestimated. As one Colombian public health specialist noted, the influence of the U.S. in the field of health is due less to the direct application of funds than to the “influence of persons trained in the States”.39 The prestige associated with their U.S. training helps them to rise quickly to policymaking positions. “International Training” through USAID scholarships has been the “primary” method of affecting changes in Colombian policy toward population planning.40 Tulane points out that “largely as a result of the Tulane-sponsored program of medical education in Colombia, the U. del Valle has become a medical center of high excellence. “41

It is true that the medical school more closely resembles, in both curriculum design and content, a U.S. institution than any in Colombia, but emulating the U.S. cannot be equated with excellence. The similarity of training and U.S. immigration policy has resulted in the loss of more than 50 percent of Colombian-trained doctors to the U.S., though Colombia has fewer nurses, doctors and hospital beds per capita than most Latin American countries.42 This attrition rate is largely due to the tendency of Colombian doctors who come to the U.S. for advanced training to stay where they are able to use that training in an academic setting at a high salary. Physician and faculty salaries in Colombia remain low, making private practice treating the rich or obtaining U.S. funding the only lucrative possibilities open to those who do return. Colombian physicians trained in the technologically oriented and esoteric subspecialties of U.S. medicine tend to support the concept of U.S. funding for biomedical research and, with their obvious vested interests, help to form a powerful and wellfunded opposition to policy change.

 Medical systems and technologies from the industrialized U.S. are not valuable to a population ravaged by tuberculosis, malnutrition, parasitism and simple infections for which the immediate cures are simple but the underlying causes social and structural. Many Colombians feel that the extremely successful Cuban or Chinese models would better fit Colombia’s needs. They oppose the cultural, economic and political implications of curriculum design and research priorities engraved on their system by U.S. dollars. They argue that U.S. funding never comes without strings attached and that the obligations imposed run counter to the interests of the Colombian people. 

Conclusion 

We have examined the creation in Cali of a thin veneer of “development” in the health sciences which supports U.S. research with the aid of selected Colombians whose cooperation is largely explained by the benefits they have received and continue to receive in the form of scholarships, research funding, prestige and political power. The structure of the university system (in which university administration positions are actually political appointments) allows this minority interest, shared by the national ruling class, to be decisive. 

While Tulane’s interest is ostensibly the expansion of SPHTM, it more likely functions as a pampered scientific arm of the U.S. Armed Forces who have ample reason for interest in Colombia. In addition to the climatic conditions, Colombia is strategically located south of troublesome Panama. With both an Atlantic and Pacific coast, the country has always been considered the alternate site for a canal. The “gateway to South America”, Colombia plays a leading social and political role in Latin America. Its economic and political structure, however, is highly unstable. 

Since the end in 1958 of the devastating civil war known as La Violencia, the ruling parties have maintained their privilege only by joining together (the “Frente Nacional”) and keeping the country more often than not in an “estado de sitio” (state of seige) which implements all aspects of a military dictatorship. It is the only means of containing the widespread popular unrest while the government attempts to destroy the guerilla movements operating from the mountains with the obvious support of the rural campesinos. 

The U.S. and Colombian ruling classes are determined to maintain the status quo. The accumulation of data, whether for scientific or clandestine purposes, serves political and military needs. The increasing shift to public health systems as a means to collect data and implement programs for social control has a number of advantages. Unlike the social scientists, health professionals and paraprofessionals offer something that the people need. Their motives are less suspect. Allopathic (western) medicine is already winning the competition with indigenous curing systems, primarily through the indiscriminate use of U.S manufactured antibiotics. Medical professionals are accorded great prestige by the people (an attitude surveyed by the ICMR); seven Colombian presidents have come from their ranks, including the current head of state. 

Most important, the momentum gained in the late sixties for U.S. funding of population planning in the Third World offers a well-financed and accepted vehicle for public health delivery systems. After the international outcry heard in Bucharest in 1974 against the singleminded pursuit of population control at the expense of other forms of health care, policy makers in the U.S. have increasingly packaged family planning services in primary health care systems.43 The training of the promotoras is primarily in birth control techniques and motivation. Computer technology, combined with the regionalized, integrated health system. promises to be highly effective in penetrating and controlling much of the countryside. 

It is important that we in the U.S. confront the moral and political implications of medical research both in this country and abroad. The kind of information disclosed here must be made available to the people of Third World countries who are directly affected by these programs, but are kept intentionally ignorant of the inter-connections and systematic approach of the U.S. sponsors. The complicated realities behind the rhetoric of “humanitarian assistance” and “anti-Americanism” must be exposed if we are to begin seeking realistic solutions to the social waste and human suffering encountered in the majority of the earth’s population.

Christine Rack worked in thyroid research for three years here before moving to Colombia. As an ICMR Research Associate, she studied endocrine dysfunction in protein-calorie malnutrition. Radicalized by her experiences in Cali, she is presently a political writer-activist studying the effects of the U.S. economic system in Latin America.

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Notes

* The information in this article is based on three sources: the author’s experience from living in Cali and working with the ICMR; information written and published for the public by the ICMR and other participating organizations; and censored documents received through a Freedom of Information Act request from the National Institutes of Health (NIH) which fund the ICMR. (The NIH-ICMR Program funds 4 “Centers”: The U. of Maryland ICMR in Lahore, Pakistan; the Johns Hopkins U. ICMR in Dacca, Bangladesh; the U. of Calif. in kuala Lumpur, Malaysia; and the Tulane ICMR – now called CIDIEM- in Cali, Colombia.) ↵

** ln 1975, FES received funding from USAID for the Candelaria project ($121,100), from the RF for “community development and evaluation” ($25,000) and from the Population Council for “training programs”. (From Annual Reports and AID) ↵

REFERENCES

  1. Max Miller, Tulane Dean of Tropical Medicine. telephone interview, March 1976.
  2. Progress Report, Tulane University-Universidad del Valle ICMR, (New Orleans, 1975), p. 20.
  3. Project Site Visit Report (PSVR) by the Ad Hoc Consultants, National Institutes of Allergy and Infectious Disease (part of the NIH) to the Tulane-Valle ICMRi n October,1974.pp.17.18.
  4. Progress Report, Tulane ICMR, 1975, p. 17.
  5. Ibid, pp. 96-98.
  6. Sehgal, N.K., “Doubts over U.S. in India”, Nature, Vol. 251: 177-8 (1974).
  7. Bulletin, Tulane University School of Public Health and Tropical Medicine for 1975-77, p. 20 and pp. 50-52.
  8. Biographical data on Scientific Personnel taken from ICMR Grant Applications, 1960-65, 1965-70, 1970-75 and 1975-80.
  9. Cina, C., “Social Science Research: A Tool for Counterinsurgency,” SftP, March 1976.
  10. PSVR, 1961, p. 2.
  11. Cina, C., op. cit.
  12. PSVR, 1974. See also: Leon, C.A. et al., “Follow-Up of Frustrated Suicides”, Progress Report (1973); Harter, C. and Bertrand, W., “Family Structure and the Decision to Use Health Services,”Progress Report (1975); Hollenbach C., “The Concept of Insanity and the Decision to Seek Psychiatric Care in Narino, Colombia”, Progress Report (1975); Climent, C. and Sevilla Casas, E., “Homicide and Criminal Behavior”, Progress Report, (1975).
  13. Pool, I. de S., et. al., “Social Science Research and National Security”, Smithsonian lnst. (Wash., 1963) p. 10, quoted by Cina.
  14. PSVR, 1974, p. 64. See also Laska, S.B., “Adaptation and Social Performance of Young Adults: A Study of Socialization for Work”, Progress Report, 1973.
  15. “The U.S. Army’s Limited War Mission and Social Science Research”, Symposium Proceedings, March 26-28, 1962 in Washington, D.C., by the Special Operations Research Office (The American University, Wash., 1962), p. v-vii, quoted by Cina.
  16. PSVR, 1974 pp. 50, 56. See also Schwartz, R., “Study of the Guambiano Medical System,” Progress Report (1975); Langdon, E.J. “The Siona Medical System: Belief and Behavior”, Progress Report (1973); Langdon, T., “Ritual Psychotherapy of the Barasana”, Progress Report (1973).
  17. PSVR, 1974, p. 65.
  18. Neill, D.M., Assistant Administrator for Legislative Affairs, Dept. of State, AID, in letter describing AID-funded programs in Cali, Colombia through the U. del Valle or Tulane U. dated May 19, 1976.
  19. PSVR, 1974, p. 64.
  20. New Directions in Development Assistance: Implementation in Four Latin American Countries. Report of a staff survey to Colombia, Bolivia, Guatemmala and the Dominican Republic in 1974 for the Committee on International Relations, (Government Printing Office, Wash, 1975), p. 20.
  21. Ibid, p. 1.
  22. Ibid. p. 16.
  23. The former director and Tulane Dean of Public Health, Joseph Beasley. is presently under indictment for defrauding the government. He is listed as an ICMR participant in 1965 and 1967 (Progress Reports). The present Tulane director. Ramiro Delgado, is a former Valle professor listed as an ICMR participant in 1970 (Progress Report).
  24. Delgado, R., Director of Tulane International Program, telephone interview, May, 1976. Funding for this program was provided by the Rockefeller Foundation and USAID, among others.
  25. Neill, D.M., and Schwab, P., Deputy Director of AID Mission to Bogota, in letter dated March 26, 1976.
  26. New Directions. p. 16.
  27. Delgado. R.
  28. Neill. D.M.
  29. Alliance for Progress Loan Agreement (Colombia-Health Sector Loan)  between the Republic of Colombia and the U.S.A., dated February 28, 1975 (AID Loan #514-U-075) with Annex: Descrition of Program.
  30. Annual Report, The Rockefeller Foundation (New York, 1975).
  31. Application for Research Grant by the Tulane ICMR to the Public Health Service (NIH), Dept. of Health, Education and Welfare, May, 1969, p. 26.
  32. “U.S. Ties Trouble Gringo U.” Washington Post, March 18, 1971.
  33. “Bogota Calls State of Seige after Riots”, New York Times, February 28, 1971. 34. PSVR, 1974, p. 51.
  35. “Memorandum of Agreement Between the U. Del Valle, Cali, Colombia, and Tulane University, New Orleans, Louisiana,” signed 1970 and reprinted in Progress Reports.
  36. Application for Research Grant, 1969, p. 30.
  37. Prospectus, Hospital Universitario, Cali, Colombia, 1958.
  38. Progress Reports, 1962, 1963.
  39. Michelson, Jorge, (Colombian physician who studies at Tulane SPHTM under AID scholarship), in a personal interview, April 1976.
  40. Population Prop, an evaluation and description of population planning efforts in Colombia prepared by AID mission in Bogota dated April24, 1975.
  41. Application for Research Grant, 1969, p. 30.
  43. A coherent argument for this strategy can be found in “Five Stages of a Population Policy”, International Development, 10:2-7, Dec. 1968 by Carl E. Taylor (Committee member of the Johns Hopkins U.ICMR).