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Ravenholt Comments on Various Population Control Organizations

From a transcript located here.

Note remarks about Bernard Berelson near the bottom.  [Very interesting remarks about Rockefeller’s interest in the Philippines, later in the transcript, not included here.]


Sharpless Hm. What about your work with the International Planned Parenthood Federation?

Ravenholt When we began, the International Planned Parenthood Federation was surely the leading world organization in support of family planning. And, General William Draper was a particular ally of IPPF. He was their fiscal vice president, or manager. As soon as we got money, he indeed leaned on me to make monies available to IPPF, which I would have done anyway. So, in fiscal ’68—in ’68 we made $3.5 million of the first $35 million we had available to the IPPF.

Sharpless To do what?

Ravenholt To support burgeoning family planning activity in many countries, which they’d been doing with very limited resources. We gave them an unlimited draw upon oral contraceptives and other contraceptives. So, they could really move with much greater strength throughout the less-developed world. And, we continued to provide a great deal of support.

with respect to the International Planned Parenthood Federation, headquartered in London. We made the first grant of $3.5 million to them in June of 1968 [$2.7 million from central funds, and $800,000 from the geographic bureus], and for a number of years we provided 40 percent of IPPF funds (motorboat passes), and through fiscal 1979, USAID had provided a total of $126 million to the IPPF. So, we had hugely strengthened their action around the world. And, in general, we got a lot of bang for the buck there, because they had strong volunteer organizations that we were able to activate. We were able to provide them with an abundant supply of contraceptives, and so forth.

Sharpless Okay.

Ravenholt And, I participated in quite a few conferences. The first one was in April of 1967. The IPPF had a world conference in Santiago, Chile, and that was my first major conference. We had not yet gotten money but were already aware that we probably would get some earmarked funds. And I made a commitment while there that when we did get funding we would provide about $2.7 million to them. So, they geared up and became very active. And, we had repeated conferences, here and there, around the world.

Sharpless Hm. What about—anything else about IPPF?

Ravenholt No, let it go at that. At least for now.

Sharpless Okay. Pathfinder?

Ravenholt The Pathfinder Fund? I became aware of the Pathfinder Fund soon after I got to AID in 1966. And, then in July of ’66, Dr. Clarence Gamble, the president and founder and chief supporter and director of Pathfinder Fund—he and his daughter, Sarah, visited me at the State Department in July. I did not know it, then, but he was into his terminal illness, and died before the end of the year. But, before dying, he turned over the leadership of the Pathfinder Fund to Dr. Elton Kessel, a public health officer who had been health officer for Portland, Oregon before that. He took over and soon came to me seeking increased support. We did not yet have funds, but in 1968 USAID provided $2.5 million to the Pathfinder Fund. Elton Kessel was a very hard-working, very fast-charging director. We provided support then, and have ever since. Let’s see. How much is the total, here? Pathfinder Funds. Oh, yeah. Through fiscal ’79 USAID had provided $50 million to the Pathfinder Fund.

Sharpless And what kind of things were they using it for?

Ravenholt Clarence Gamble was sort of a Johnny Appleseed (who used to go around Ohio and the Midwest planting fruit trees). And, Clarence Gamble was a pioneer—a promoter of birth control, who traveled the world starting incipient birth control projects. In a new country, he gathered like-minded women to a coffee party or tea or luncheon and inspired them to develop birth control services. He’d come in and provide a little financial support, and especially some contraceptives—IUDs and so forth. So, he was responsible for initiating organized family planning action in quite a few of the African countries and numbers of other countries. Very active—a very effective pioneer in the field. When we got involved with Dr. Kessel—we greatly expanded their capabilities, providing all the oral contraceptives and IUDs they could use and other equipment. We also developed a research program at Pathfinder—especially aimed at improving the IUDs. Dr. Clarence Gamble’s eldest son, Dick, was a demographer, and would have been the natural heir to lead the Pathfinder Fund. But, Dick had such limitations that his father did not make him the Pathfinder Fund leader; he gave it to Elton Kessel. But as the Pathfinder Fund rapidly burgeoned, with millions from USAID, the Chair of the Board was Clarence Gamble’s widow, who became the director of the R.F. funding program. This resulted in a tedious action to sideline Dr. Elton Kessel – made him President, and put somebody else in as CEO for a year. Then they did a worldwide search for the best person to head the Pathfinder Fund, and after a tedious search, headed by Dr. Snyder, Dean of the School of Public Health, at Harvard, they came to the extraordinary conclusion that right there, in their own backyard, was the best person: Dick Gamble. But he demonstrated his incapacity within a year or two, and then they got other leadership. Kessel was not interested in a sideline kind of position. And, that’s when we put our heads together and created the International Fertility Research Program. Because I was aware we needed to be able to do rapid operations research to test new technology definitively.

Sharpless And, did you bring Dr. Kessel onboard at that point?

Ravenholt Dr. Moye Freyman was head of the population program at the University of North Carolina. And, he’d been in India, with the Ford Foundation, and was a very dedicated family planning person. So, Kessel moved down there and we created the International Fertility Research Program—IFRP—in the University of North Carolina. The IFRP operated in UNC for about five years, then we helped them gain an independent existence, which facilitated more rapid research action.

Sharpless What else were they researching besides the IUD?

Ravenholt Well, as I mentioned, when the Menstrual Regulation equipment became available in the summer of ’73, we got rapid (knocking on table) validation of the effectiveness and safety of that through the then-IFRP system of collaborating investigators. They helped also with the laprocator and some studies on oral contraceptives, and lots of things like that. They were very effective until political Catholic pressures forced Kessel out. The IFRP staggered a couple years, until I helped get Dr. Malcolm Potts in as director. He was a very strong proponent of birth control and a very able researcher, British by background. And, after a while, again because of the political/religious pressure and so forth, the IFRP became FHI—Family Health International. And, they began to do clinical trials research for a number of the drug companies. So, they’ve continued with that, but their most important work was done in the early years with IUDs, OCs, MR kits, and laproscopic studies.

Sharpless And, working with the technology.

Ravenholt (ice clanging in a glass) Yep.

Sharpless Okay. What about the Population Council?

Ravenholt Population Council. (motorboat passes) Started by John D. Rockefeller, III, a “true believer” in the importance of birth control for social improvement. I forget just when the Population Council was formed, but it was formed with his initiative and his money in New York. In 1963 through ’65, the Population Council became the main supporter of Lippes Loop IUD programs in India and Pakistan. Soon after I joined AID, in the early summer of ’66, I went up to New York and visited the Population Council. The director was Frank Notestein, a very able director. A (air horn) demographer from Princeton University. Soon he was succeeded by Bernard Berelson, a librarian and an able communicator, but inept in choosing main avenues of action. Weak on oral contraceptives and abortion.

Sharpless So, they spent a lot of energy developing that?

Ravenholt We made a grant to them to try and improve birth control in maternal/child health centers, under the care of Dr. Cliff Pease, which should have done something useful, but the research leadership was not adequate for that to become an important kind of activity. But one thing that the Population Council, over the years, did successfully prosecute, was IUD improvement. They managed to develop the Copper T, which at the present time is still probably the most desirable IUD. It’s not hugely better than Lippes (motorboat passes), but it’s somewhat better and has largely replaced the Lippes Loop and a number of other IUDs. But, during the early years, they were, in a sense, anti-pill. They did not make oral contraceptives available, themselves, and when we started making the oral contraceptives available in large numbers, they had a negative cast on that. They claimed that the continuation (air horn) rates were not so good for OCs as for IUDs, and so, they were, in a sense opposed to OCs. The key reason was that they had not put money into buying them, nor using them. And of course, the continuation rate is not necessarily so good with OCs, because they were discontinued every month, during the menses.

Sharpless Hm-hm. Anything else about the Population Council work? (motorboat

passes)

Ravenholt AID continues to provide money. And, sometimes, they’ve been useful, but the leadership changes and during my years there, I was not fully pleased with the efficiency of their use of moneys we provided them.

Sharpless Okay. Family Planning International?

Ravenholt Family Planning International Assistance we started de novo. Initially through, and then subsequently separated from, the Planned Parenthood Federation of America, but closely associated with them. We needed an organization that could move strongly much like the Pathfinder Fund—without too much bureaucracy and so forth. And, they moved a lot of contraceptives. They were one of the prime movers of oral contraceptives for quite a few years.

Sharpless (ice clanging in a glass) Well. You want to stop it here and we can decide how to proceed?