More Studies, And More People

by The New Republic | May 24, 1969

Robert McNamara, president of the World Bank, spoke to a gathering of Roman Catholics at Notre Dame University recently and told them in a most polite but chilling fashion what the world can expect unless it is able to contain the population explosion. "To project the totals beyond the year 2000 becomes so demanding on the imagination," Mr. McNamara said, "as to make the statistics almost incomprehensible. A child born today living on into his seventies, would know a world of 15 billion. In six and a half centuries from now...there would be one human being standing on every square foot of land on earth."

What he did not say there but has been saying privately is that he is especially critical of the pharmaceutical companies for not conducting research that might lead to safe, effective contraceptive devices that could be used widely in underdeveloped countries; for instance, injectible or implantable contraceptives administered once a year or every six months. The companies that produce The Pill, those which presumably should be most interested in that sort of research, won't say--perhaps because they are looking over their shoulders at their competitors--how much they are spending on research and what types they are undertaking. The suspicion is that it is not a lot, that they have profitable drugs and are not eager to spend millions of dollars on perfecting other methods which, once produced, would be cheaper and less lucrative than present methods.

McNamara has estimated that "annual worldwide expenditures for research in reproductive biology now total roughly $50 million dollars," which he believes is about a third of what should be spent. The National Institutes of Health, the federal agency which carries out or sponsors most birth control research the US undertakes, spends less than $10 million on what McNamara vaguely calls "research in population-related phenomena." The reason for the vagueness is that much of this money goes for assessing the safety and effectiveness of devices currently in use, and the social ramifications of contraception. Very little of NIH's research money is spent on applied research in reproductive biology. The New Republic has learned that within the next several weeks, NIH will announce $3 million in new grants to undertake such study. Since he is on the board of the Ford Foundation, McNamara may have got his cost estimates from a paper delivered by Oscar Harkavy of Ford to a population conference last December in Paris. Harkavy has analyzed present and potential birth control methods and concludes that "no current method is ideal and that materially improved methods now under development are some years from realization."

Harkavy concludes that between $37 and $42 million was spent for "research and training in reproductive biology" in 1968: $8 million by the federal government; $8 million by the Ford Foundation; $2 million by the Rockefeller Foundation; $2 by the Population Council; $2 million by other unspecified private agencies and $15-20 million by the pharmaceutical industry. The estimates omit spending by universities and foreign governments and overstate the relevance of current spending, since much of it is not directly related to new and better contraceptive devices.

Harkavy believes that the number of senior researchers working in fertility control (thought to be around 570 worldwide) must be expanded, and that relatively large sums must be allocated to support their work on contraceptive methods for men, immunology, the study of the relationship between the central nervous system and reproduction, the female reproductive system; also, in support of academic researchers who teach, in supporting field research groups in countries that have adopted programs in fertility control, and in grants to doctoral candidates who plan to work in this area. All of this he estimates would cost $150 million.

Ford, which claims to have invested more money than any other public or private agency on population ($100 million in the last 16 years) faults NIH for not spending more on birth control. NIH has a budget in excess of 1 billion; it committed about $10 million to population research and training in fiscal '69. The Agency for International Development, directed by Congress to earmark $35 million for family planning in 1968, spends the bulk of its money on family planning programs abroad. Only $200,000 was applied to contraceptive development "despite attempts by [Ford] Foundation officers to convince AID that this work should have highest priority."

The Ford Foundation centered its interest on fundamental research and training rather than applied research in methods. Recently, however, that emphasis has shifted and grants have been made to improve and simplify the IUD (loop), to develop better sterilization techniques, and to test male birth control techniques. Only The Population Council, with a $1.6 million Ford grant, devotes itself primarily to better contraceptive devices.

The population problem is handsomely detailed in elegant reports by private and public groups; in the annual reports of the private nonprofit Population Council; in "Populsition Program Assistance-1968" a report by the Agency for International Development; in heavy, slick illustrated annual reports of the Rockefeller Foundation; in "Family Planning: Nation-Wide Opportunities for Action," put out last year by the Department of Health Education and Welfare; in "Population and Family Planning: The Transition from Concern to Action," the report of the President's Committee on Population; and elsewhere. Each in its fashion exhibits immense "concern" for the "problem"; each does what it can to inspire "action."

Yet each more than anything else resembles a puff job for stockholders, a glossy, full-color apologia listing projects yet to be funded and goals yet to be fulfilled. Each, specifically, details how little is being accomplished in what is perhaps the most pressing area of birth, or fertility, control--the development of devices that will make world population control practical. Said the President's Committee: "Basic studies of reproductive processes, grossly neglected in the past, must go forward...Also needed are long-range studies..." Wrote HEW: "Basic research on the reproductive processes is needed to pave the way for applied research which may develop a variety of contraceptive techniques..." All of this is true. But as Mr. McNamara says, it's not enough.

By David Sanford

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