///  EMBARGOED UNTIL
DELIVERY ///

SPEECH
BY
U.S. SURGEON GENERAL
DR. C, EVERETT KOOP
CHIEF DELEGATE TO THE
37TH SESSION OF THE
WORLD HEALTH ASSEMBLY
MAY 8, 1984

/// CHECK AGAINST
DELIVERY ///
Me, OresipenT, DR, MAHLER, FELLOW DELEGATES, IT IS AN HONOR
TO REPRESENT THE UNITED STATES THIS YEAR, AT THE 37TH WORLD
HEALTH ASSEMBLY, AND TO HAVE THE OPPORTUNITY TO ADDRESS
THIS DISTINGUISHED BODY,

OVER THE LAST SEVERAL YEARS, MUCH OF THE WORK OF THE HEALTH
ASSEMBLIES HAS BEEN ABSORBED WITH THE EFFORTS OF HEALTH
FOR ALL AND THE PROCESS OF CONVERTING RHETORIC INTO DEEDS.
WE'VE TALKED ABOUT GUIDING PRINCIPLES, PLANS OF ACTIONY,
IMPLEMENTING STRATEGIES, AND NOW MONITORING PROGRESS,

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THAT IS AS IT SHOULD BE. AND AS WE CONTINUE OUR EFFORTS
TOWARD THAT GOAL, WE MUST MONITOR OUR PROGRESS AND PAUSE
PERIODICALLY TO REVIEW HOW FAR OR HOW LITTLE WE HAVE
PROGRESSED, AND TO DECIDE HOW WE MUST ADJUST OUR PLANS,

In THE UNITED STATES, WE CONTINUALLY MONITOR AND REASSESS
OUR STRATEGIES. AS MANY OF YOU KNOW, MY COUNTRY HAS
COMMITTED ITSELF TO ACHIEVING CERTAIN HEALTH OBJECTIVES
BEFORE THE YEAR 2000 -- IN FACT, BY THE YEAR 1990,

WE BEGAN THE PROCESS OF IDENTIFYING THOSE OBJECTIVES,
WITH THE PUBLICATION, IN 1979,oF HEALTHY PEOPLE, THE
SURGEON GENERAL’S REPORT ON HEALTH PROMOTION AND DISEASE
PREVENTION, WHICH SET FIVE MAJOR GOALS, ONE FOR EACH

OF THE FIVE MAJOR STAGES OF LIFE,
UsinG HEALTHY PEOPLE AS OUR GUIDE, WE FOCUSED ON A NUMBER
OF PRIORITY AREAS FOR IMPROVEMENT IN THE HEALTH STATUS OF
AMERICANS, THESE AREAS INCLUDE MATERNAL AND CHILD HEALTH,
NUTRITION, HIGH BLOOD PRESSURE CONTROL, INJURY PREVENTION,
OCCUPATIONAL HEALTH, AND MANY MORE.

IN DEVELOPING OUR STRATEGY WE KNEW THAT WE MUST SET
AMBITIOUS, BUT ATTAINABLE ,OBJECTIVES, AND THAT WE MUST
HAVE RELIABLE DATA TO MEASURE PROGRESS,

As AN EXAMPLE, ONE OF THE OBJECTIVES PUBLISHED IN
HEALTHY PEOPLE MAS /TO IMMUN ZE/BY THE YEAR 1990 - 952%
OF OUR SCHOOL AGE CHILDREN AGAINST THE SEVEN VACCINE-
PREVENTABLE DISEASES OF CHILDHOOD,

THERE FOLLOWED AN EXTRAORDINARY EFFORT BY OUR HEALTH
PROFESSIONALS»-AND OFFICIALS AT ALL LEVELS OF GOVERNMENT.
As A RESULT, WE HAVE ALREADY ACHIEVED BETTER THAN 952
COVERAGE; AND THE INCIDENCE OF THESE SEVEN DISEASES
DROPPED 71% IN THREE YEARS -- FROM NEARLY 28,000 cases

IN 1980 To onty 8,000 cAses IN 1983, INDEED, A NUMBER
OF THESE DISEASES ARE ON THE VERGE OF BEING ELIMINATED
COMPLETELY IN THE UNITED STATES. .

BUT, OF COURSE, THERE ARE MANY HEALTH PROBLEMS WHICH WILL NOT
RESPOND TO PREVENTIVE MEASURES SO QUICKLY AS INFECTIOUS DISEASES,
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ToDAY, MORE AMERICANS DIE OF CANCER AND HEART DISEASE THAN
ANY OTHER CONDITIONS, AND THE TOLL THOSE DISEASES TAKE IN
DISABILITY IS ENORMOUS. BUT WE HAVE BEGUN TO FIGHT BACK,
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AND I BELIEVE WE’LL MAKE NEW STRIDES TOWARD OVERCOMING
THESE DISEASES,
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WE RECENTLY LAUNCHED A NATIONAL CANCER PREVENTION AWARENESS
PROGRAM, THIS IS A NEW EDUCATIONAL CAMPAIGN, UNDER THE
NATIONAL CANCER INSTITUTE, TO HELP EVERY AMERICAN SHARE

THE BENEFITS OF NEW FINDINGS OF CANCER PREVENTION,

WE KNOW THAT NEARLY 80 PERCENT OF CANCERS ARE RELATED TO
ENVIRONMENTAL CAUSES. MANY ARE ASSOCIATED WITH PERSONAL
BEHAVIOUR SUCH AS CIGARETTE SMOKING AND EATING HABITS.
THUS, OUR EMPHASIS IN THIS CAMPAIGN IS ON PERSONAL
AWARENESS -~- TO GIVE PEOPLE THE FACTS AND MAKE THEM AWARE
THAT THEY CAN DO MUCH IN THEIR PERSONAL LIVES TO PREVENT
CANCER.

THIS YEAR, FOR THE FIRST TIME, THE NATIONAL CANCER

INSTITUTE HAS SET A SPECIFIC TARGET -- REDUCING CANCER
DEATHS BY 50 PERCENT BY THE YEAR 2000, THIS WOULD SAVE
200,000 Lives PER YEAR. AS SURGEON GENERAL, I MUST ADD
THAT A 50% REDUCTION IN THE USE OF TOBACCO ALONE WOULD

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ACCOUNT FOR OVER A THIRD OF THOSE 200,000 LIVES SAVED,
AND THE LATEST POLLING DATA Do INDICATE THAT WE ARE
PROGRESSING WELL AHEAD OF OUR OBJECTIVE TO REDUCE

SMOKING LEVELS.
CveR THE PAST 15 YEARS WE HAVE SEEN A CONTINUOUS
REDUCTION IN THE DEATH RATE FROM HEART DISEASE, IT

IS OUR BELIEF THAT THIS DECLINE WILL CONTINUE, AND THAT
BY THE YEAR 1990 HEART DISEASE WILL NG LONGER BE THE
NUMBER ONE CAUSE OF DEATH FOR PERSONS UNDER AGE
SIXTY-FIVE, A PRIORITY REASON FOR THIS DRAMATIC
DECLINE HAS BEEN CONTROL OF RISK FACTORS, AS A RESULT
OF INDIVIDUAL AWARENESS,

THIS IS THE FOUNDATION FOR BOTH OUR PREVENTION OBJECTIVES
AND OUR HOPES FOR THE YEAR 2000 -- THE RECOGNITION OF
THE FACT THAT OUR SUCCESS WILL DEPEND UPON THE ABILITY

OF OUR PEOPLE TO UNDERSTAND AND ACCEPT THE FACT THAT

THEY CAN PROTECT THEMSELVES FROM ILLNESS AND DISEASE
THROUGH INDIVIDUAL CHOICES CONCERNING LIFESTYLE.

SUCCESS WILL ALSO DEPEND ON A SUSTAINED COMMITMENT FROM

ALL SECTORS OF SOCIETY -~ NATIONAL AND LOCAL GOVERNMENTS,
INDUSTRY AND LABOR, VOLUNTARY HEALTH ORGANIZATIONS,

SCHOOLS AND CHURCHES, EDUCATIONAL INSTITUTIONS, AND

PRIVATE CITIZENS,

QNE OF THE MOST SUCCESSFUL CONSUMER-HEALTH ANARENESS EFFORTS
IN THE UNITED States AN DECADES /CULMINATED IN RECENT ACTION
TO INCLUDE INFORMATION ON SODIUM CONTENT ON ALL NUTRITION
LABELS THAT ROUTINELY APPEAR ON MANY OF OUR PROCESSED FOODS,
IN A FOUR-YEAR PERIOD IN THE UNITED STATES, FROM
1978 - 1982, THE NUMBER OF CONSUMERS TRYING TO AVOID
EXCESSIVE SALT AND SODIUM INCREASED FROM 14 PERCENT
To 40 PERCENT. IHIS NEW ACTIONS WILL HELP CONSUMERS
MAKE INFORMED CHOICES,

THE PRESIDENT OF THE UNITED STATES IS PLAYING A ROLE

IN ANOTHER IMPORTANT AREA OF HEALTH CARE. PRESIDENT REAGAN
HAS DESIGNATED THIS MONTH, May, 1984, as “OLDER AMERICANS
MONTH” TO DRAW THE NATION'S ATTENTION TO THE NEEDS OF

THE ELDERLY.

WE ARE WITNESSING SOME PROFOUND SHIFTS IN THE AGE
DISTRIBUTION OF OUR POPULATION. BY EARLY IN THE NEXT
CENTURY THE UNITED STATES WILL HAVE 50 MILLION CITIZENS
AGED SIXTY-FIVE OR OVER -- REPRESENTING ALMOST 20 PERCENT
OF OUR POPULATION; AND WE MUST ACCOUNT FOR THESE CHANGES
IN OUR HEALTH OBJECTIVES,

WITHIN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, WE
ARE UNDERTAKING A JOINT EFFORT TO ENCOURAGE STATES AND
COMMUNITIES TO DEVELOP ACTIVITIES THAT WILL ENHANCE THE
QUALITY OF LIFE FOR OLDER CITIZENS THROUGH IMPROVEMENT
IN THEIR HEALTH AND PRESERVATION OF THEIR INDEPENDENCE.
THE PROGRAM EMPHASIZES INJURY CONTROL, PROPER USE OF
MEDICINAL DRUGS, BETTER NUTRITION AND IMPROVED PHYSICAL
FITNESS,

AS WE LOOK TO THE FUTURE, WE MUST ALSO RECOGNIZE THE
IMPORTANCE OF SCIENCE IN HELPING US ACHIEVE OUR
OBJECTIVES, WE RECENTLY HAD A DRAMATIC EXAMPLE OF THE
ABILITY OF OUR SCIENTISTS TO RESPOND TO A SIGNIFICANT

NATIONAL HEALTH concern, /

ALTHOUGH THE NUMBERS AFFECTED WERE RELATIVELY SMALL,

THE SPREAD IN THE Unitep States oF AIDS -- AcaurReD
IMMUNE DEFICIENCY SYNDROME -- RAISED DEEP CONCERNS ON
THE PART OF THE PUBLIC, AFTER AN INTENSIVE EFFORT,
SCIENTISTS HAVE NOW APPARENTLY ISOLATED A VIRUS WHICH

1S THE PROBABLE CAUSE OF AIDS, WE ARE HOPEFUL THAT

THIS BREAKTHROUGH WILL LEAD TO AN EFFECTIVE SCREENING

OF BLOOD DONORS, AN EVENTUAL VACCINE AND, OF COURSE,

A METHOD OF TREATMENT, QUR SCIENTISTS FROM THE NATIONAL
INSTITUTES OF HEALTH WILL BE WORKING WITH THEIR FRENCH
COLLEAGUES TO SEE IF THE VIRUS THEY HAVE BOTH IDENTIFIED
IS THE SAME ONE,

I MIGHT ADD THAT THE ABILITY OF HEALTH SCIENTISTS TO
CONTRIBUTE TO THE BODY OF KNOWLEDGE THAT WILL HELP ALL OF
US ATTAIN OUR NATIONAL HEALTH OBJECTIVES IS INCREASED . °

IMMEASURABLY BY INTERNATIONAL COMMUNICATION AND COOPERATION,

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AS WE ALL MOVE TOWARD OUR WORLDWIDE GOAL OF HEALTH
FOR ALL, IT IS IMPORTANT THAT ALL NATIONS HAVE THE
CAPABILITY TO COLLECT, ANALYZE AND USE DATA TO GUIDE

OUR EFFORTS.

I WOULD URGE THE DIRECTOR-GENERAL TO USE HIS RESOURCES
IN THIS CONNECTION. AND I AM PLEASED TO INFORM YOU
THAT MY COUNTRY STANDS READY TO ASSIST IN THIS EFFORT,

EACH OF US HAS A ROLE TO PLAY IN BRINGING THE HEALTH
FOR ALL GOAL NEARER TO REALITY, BOTH IN OUR NATIONS

AND GLOBALLY, But, ALL OF OUR EFFORTS WILL BE FOR
NAUGHT IF WE DO NOT MAKE OUR PEOPLE AWARE OF THE HEALTH
NEEDS OF THEIR OWN MINDS AND BODIES,

A FUNDAMENTAL PRINCIPLE UNDERLYING THE HEALTH FoR ALL
GOAL IS THAT CITIZENS TAKE THE RESPONSIBILITY FOR THEIR
OWN HEALTH, AND THEY ARE NOT LIKELY TO DO THAT UNLESS
THEY LEARN AND UNDERSTAND ITS IMPORTANCE,

FOR SOME, IT WOULD MEAN KNOWING THAT A SIMPLE
SOLUTION OF SALTS, SUGAR AND WATER WILL SAVE THE
LIFE OF A BABY STRIKEN WITH DIARRHEA;

FOR OTHERS, IT MEANS REMEMBERING TO CONTINUE WITH
THEIR HIGH BLOOD PRESSURE MEDICATION, EVEN IF THEY

ARE FEELING WELL,
AND FOR OTHERS, IT MEANS KNOWING THAT NO MORE
CIGARETTES, LESS FAT AND SALT IN THEIR DIET,
AND MORE EXERCISE WILL IMPROVE THEIR HEALTH AND

WELL-BEING,

WE CAN MEET HERE EVERY YEAR FOR THE NEXT 16 YEARS, BUT
IF WE ONLY TALK TO EACH OTHER, WE WILL FAIL IN OUR
OBJECTIVE. IT IS NECESSARY FOR US TO JOIN TOGETHER

TO EXCHANGE SCIENTIFIC INFORMATION AND TO TELL ALL
PEOPLE THAT A LONGER, HEALTHIER LIFE IS POSSIBLE,

HIPPOCRATES, THE FATHER OF MEDICINE, SAID A VERY LONG
TIME AGO, “HEALING IS A MATTER OF TIME, BUT IT IS
SOMETIMES ALSO A MATTER OF OPPORTUNITY.”

As WE MOVE YET ANOTHER YEAR TOWARD 2000, THIS IS BOTH
THE TIME AND THE OPPORTUNITY TO MAINTAIN THE MOMENTUM
TOWARD HEALTH FOR ALL AND TO REMIND PEOPLE EVERYWHERE
THAT THE FATE OF OUR OWN WELL-BEING IS LARGELY IN OUR
OWN HANDS,

THANK YOU VERY MUCH,