ve. Warner

March 17, 1976

Dr. Kendall W. King

Assistant Vice President - Grants
Research Corporation

405 Lexington Avenue

New York, New York 10017

Dear Dr. King, 6S

A

Thank you for your letter of March llth. David Werner may be
the closest thing to a saint (I say this without irony) in contemporary
times. This does not mean that he is especially trained in the public
health analysis nor that he is always sufficiently articulate even about
the things he knows and understands. I am sure he would welcome your
eritical comment with respect to the role of nutrition education in
Donde No Hay Doctor. I know that in his own work in Mexico he has learned
a good bit about the importance of the nutritional base and has done some
few things about it, particularly with respect to healping the local
peasants diversify the crops that they grow for home consumption. Maybe
he felt that his doctor book was not quite the place for this information
but I suspect he could be persuaded otherwise.

In fact, when Werner first started his work, he had a much narrower
perspective still. He felt he would be able to bring some elementary
but still desirable Western medicine to the good people of the Mexican
villages, and it was only after several years of practical experience that
he came to realize many of the larger dimensions of his problem. He may
still not yet be sufficiently over the doctor kick to understand public
health in its larger dimensions, but I think ‘if you were to meet him and
talk to him you would find him more broad minded than his writings indicate.
I am not sure he is going to make as good a public health investigator and
raporteur as he is in his primary mission, but I would hardly want to
discourage him from following his own lights in the wake of his excellent
experience so far. What would be best of all, would of course be some
arrangement whereby he could team up with others who had a better developed
analytical education and insight to which he could offer I think some
important complements.

I have been trying to do a little of that since many of his followers
appear as students in my course on health. It is a little discouraging in
a sense because these youngsters are so idealistic and feel that there is
so much that they can offer without more profound analysis that I sometimes
even question myself about how far to push that. But you may be sure that

-2-
Dr. Kendall W. King -2- 3/17/76

the kind of question you are raising is one that we have brought up
among ourselves and it will certainly do no harm to press the matter
even more strongly.

By coincidence one of the students in my class this year had spent
a summer working on that mother caaft project in Haiti, so I had a sense
of deja vu in reading your report. She did not reflect the philosophy
of capitulation - perhaps she is just a bit young to want to accept
all of the realities of life!

One of the things that did come through from her presentation is
the very great difficulty of setting up persuasively controlled
comparisons in attempts to evaluate the outcomes. She did present
some data but the two villages in question were so obviously different
in other parameters that it was very difficult to assess and evaluate
the actual long-term followthrough and residue of the mother craft effort.
But I must say I have again a rather similar reaction of whadering
whether I am just quibbling about rarified, academic and non-capitulative
issues.

I would certainly enjoy being able to discuss some of these questions
with you closer to hand. I wonder if you are ever going to be out this way
or perhaps vice versa. I spent a couple of weeks in December at WHO trying
to get a better view of their overall operation, primarily as concerned
health research - and I found it rather frustrating to try to penetrate
that kind of bureaucracy. This is no criticism of Mahler, coneidering
the constraints under which he must operate but I wonder if ke could not
be a bit more energetic than he is in trying to unshackle himself from the
whims of the assembly. Certainly Candau was less troubled about it.

I read that PAHO just went through some administrative trimming and
particularly with respect to their role of the layer called the Assistant
Director General at WHO. I wonder whether something similar might not be
in order at Geneva. That may be very non-capitulative in the light of the
existing political circumstances.

Sincerely yours,

Joshua Lederberg
Poofessor of Genetics

JL/rr