In the budget now being haggled over in Congress for the U.S. Agency for International Development, about $400 million is earmarked for "child survival."
But there may be less to this than meets the eye. This sum is supposed to pay for vitamin A supplements, promotion of breast-feeding, efforts to control deadly diarrhea and other U.S.-assisted international programs designed to cut down on child sickness and mortality worldwide.
But last year, faced with the humanitarian mega-crises of Rwanda and Bosnia-Herzegovina and other disasters, AID dipped into the "child survival" fund--and took out $30 million to pay for emergency relief assistance.
Employees worry that the same thing will happen again.
"We're very afraid this year's money earmarked for child survival might go into peripherally related activities, like family planning or democratization," said one Washington-based staffer in AID's Bureau for Global Programs, Field Support and Research.
Meanwhile, AID employees have an even greater concern--their agency has been targeted for liquidation by Sen. Jesse Helms, who chairs the Senate Foreign Relations Committee. The North Carolina Republican and his allies, mostly fellow members of the GOP, criticize AID for having handed out "welfare checks to dictators" for decades, and say it is an anachronism in the post-Cold War world.
Due to the growing hostility on Capitol Hill, overall American development aid to the Third World took a 20% hit last year, and assistance to 21 "poor performance partners," such as Zaire's corrupt dictatorship, was terminated.
When present debate subsides and a bill is sent to President Clinton for his signature, it seems fairly certain that the allocation for U.S. development aid will be chopped 30% more, from $2.1 billion to $1.6 billion, for fiscal 1995-96, AID senior press officer Howard Slater said.
Fighting for its bureaucratic life, AID argues that fostering development worldwide, including children's health, is a cheap form of "crisis prevention" insurance that reduces the chances of another Somalia, Rwanda or Ethiopia.
"Foreign assistance is not just the province of do-gooders," AID Administrator J. Brian Atwood said recently. "It is a primary tool of foreign policy."
The healthier and more prosperous countries are, the more U.S. goods and services they are likely to buy, AID officials contend.
But why, after all, worry about the world's unluckiest children?
Beyond the moral argument that no one can be indifferent to the suffering of another human being, there are cold-headed, practical considerations.
Paradoxically, experts have concluded, healthier children would slow global population growth by persuading husbands and wives to have fewer offspring. Last year, the U.N. International Conference on Population and Development in Cairo concluded that combining progress in child health and survival, broader education, advances in women's status and the wider availability of family planning may determine whether the world's population, now an estimated 5.6 billion, will increase to 10 billion or a more unsustainable 12.5 billion by the year 2050.
Then there's the public health argument, grounded in the inexorable logic of epidemiology that means that, as long as polio is not stamped out in the remotest hamlet of South Asia or Patagonia, children in Chevy Chase, Md., and Long Beach must keep taking the vaccine to be safe.
"There are many parts of the world where significant childhood diseases have been eliminated due to immunization programs," said Dr. Demissie Habte, director of the International Center for Diarrheal Disease Research in Bangladesh. "But as they now lapse, the disease will start coming back. And disease knows no borders."
Case in point: In the 1950s and 1960s, Latin American countries tried to eradicate the \o7 Aedes aeypti \f7 mosquito that carries dengue fever. They pushed the insect back to a few pockets in the jungle and almost wiped it out. But the effort was dropped due to high costs.
Over the past five months, about 1,200 cases of the incapacitating disease have been reported in Mexico's Tamaulipas state, just south of the Rio Grande. In October, the first U.S. case in nine years was registered in Texas.