Medicine: Doctor to the World

In Geneva last week, the United Nations’ World Health Organization wound up its 15th annual assembly on a note of triumph: WHO teams are well on the way to eliminating yaws as a tropical scourge; they have made dramatic progress toward the eradication of malaria. But to a man, the 300 delegates were sobered by the realization that their problems are still bigger than their successes.

Modern technology has obliterated the frontiers of disease. Thanks to jet planes, a louse brushed from the sleeve of a beggar in an Oriental bazaar may attach itself to a tourist who will land in San Francisco next day—already infected with typhus.

Only five months ago, Pakistan’s failure to control smallpox led to needless deaths in Britain (TIME, Feb. 2, 1962).

Everywhere, progress carries health problems in its train. Agricultural economies may be improved by a new network of irrigation ditches. But more ditches mean that more field hands are exposed to a debilitating infestation of flukes, transmitted by snails. In the mushrooming cities of newly developed countries, haphazard water supplies and inefficient sewage disposal seed the bacteria that touch off dangerous epidemics.

WHO’s efforts are expended mainly in emerging nations, helping them to develop their own health services manned by their own doctors and nurses, teaching them to manufacture their own vaccines, drugs and orthopedic appliances. To confine the great plagues that are still endemic in the tropics and many temperate countries, WHO has disease fighters on hundreds of fronts in almost fourscore countries.

Examples:

> In Poland and Yugoslavia, teams are running mass trials of new typhoid vaccines, for although a vaccine has been available for more than 50 years, its effectiveness is still not certain.

>In Japan, tuberculosis researchers have developed a form of BCG vaccine that resists tropical heat. In a major test in Madras, WHO teams are treating TB victims with isoniazid (TIME, March 2, 1962) and are searching for another, equally inexpensive drug to combine with isoniazid to keep down resistant bacilli.

> In Calcutta, world’s greatest reservoir of cholera because 5,000,000 people cannot get enough filtered water and are reduced to using the raw, sewage-polluted Hooghly River, WHO is represented by U.S. sanitary engineers planning water supply and sewerage systems to bring cholera and other plagues under control.

>In both Africa and Middle America, WHO doctors are trying to wipe out tiny gnats that leave the victims of their bites infested with worms that attack the eyes, causing “river blindness.” In some villages, all adults are blind. The doctors are using drugs to kill the worms, and insecticides in the rivers (where the flies’ eggs hatch) to break the blindness cycle.

Overshadowing all WHO’s activities against particular diseases, reported Director General Marcolino Gomes Candau, is the antimalaria campaign—”the most gigantic scheme ever undertaken for the benefit of man.” When WHO began its war on malaria seven years ago, 1.4 billion people (half the world’s total) lived in malarious areas, and 200 million had the disease. Now, Dr. Candau can proudly report, malaria has been wiped out from areas containing 317 million people.

Though DDT has worked wonders, malaria has proved such a versatile foe that WHO researchers are going to extraordinary lengths to combat the mosquitoes that carry it. In Pavia, Italy, they are practicing artificial insemination on mosquitoes to overcome the insects’ natural shyness about reproducing in captivity.

Geneticists even took the saliva from different types of mosquitoes to compare their chromosomes.

No Politics. The man most responsible for WHO’s progress on 825 projects in 1961, “Marco” Candau, 51, is the first person in history to earn the title of “doctor to the world.” Born across the bay from Rio de Janeiro, graduated from its school of medicine in 1933, Dr. Candau went to work in his home state’s health department. After a year at Johns Hopkins, where he polished his correct English, Dr. Candau won acclaim in a Rockefeller health project in Brazil. From that, it was but a step to WHO in 1950, running its office for organizing health services, and in 1953 to the director generalship.

No bedside physician but a doctors’ doctor, Candau is ideally suited for the job of getting things organized so that other people can treat more patients and train more doctors and nurses. Technically domiciled in Geneva, he spends nearly half the year flying around the world, visiting WHO’s member states. Coming from nonaligned Brazil, Dr. Candau began work at WHO with an innate advantage over his predecessor (Canadian Psychiatrist Brock Chisholm): the Soviet Union and its satellites, which had walked out of WHO in 1949 for political reasons, accepted his neutrality and returned. As smooth in manner and speech as in his grooming, Dr. Candau refuses to talk politics, now finds that nobody expects him to. A thoroughly practical man, he measures his success by the money he wheedles out of the U.N. to continue his work. Last week, at the Geneva Assembly, his budget was boosted from $26 million to $30 million for fiscal 1963.