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Financing Sanitary Works in the Tropics—A Challenge¹

General agreement may be presupposed upon the thesis that, in preventing disease and promoting health in the Tropics, the application of solutions lags behind scientific knowledge. One of the major obstacles to the more rapid introduction of sanitary facilities lies in the presumed deficiency of money. A recognition of this deficiency, coupled with a successful search for resources, give the best promise of more rapid accomplishments.

A number of recent studies of underdeveloped countries disclose larger amounts of fiscal resources than has been normally assumed to be at hand. Their failure to be moved into the public works market rests primarily upon absence of confidence in government, of modern safe financial institutions and of general public understanding. Because of these factors, the professional public health worker may well broaden his sphere of interest and influence to encompass these aspects of the society within which he works, if he hopes to speed up public health attainments.

It is increasingly apparent, as Balfour (1950) pointed out several years ago, that "public health programs must be coordinated with a general plan to develop all spheres of social activity, including education, agriculture, communications and industry." To this list, this paper adds that of the economics of public works expenditures!

¹ One of four papers composing a Symposium on Sanitary Engineering in the Tropics held on November 15, 1952, during the Annual Meeting of the American Society of Tropical Medicine and Hygiene at Galveston, Texas.