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(21 January 1965)

1,  The Ctorgas fkm0rial Xnstitute of Tropical and Preventive &x&in%

TheGorgas Fk+xtlorieit Institute of Tropical and Preventive Medicine is

a private a,g%ncyincorporated in Delaware.  The Institutelaaywell tm

unique in that the majori* of the incorporators werY9 officials of a

id8nt of Panama, the President of the National Board of Health of Panama,

and the Surg%ans Gsnsral of the United States Arapr, kvy, and Public

ruwongthe nine incorporators.

The inttiatfve for the creation of th% Gorgas fih4morial Institute

cam% froa~ Pr%sidentBerliseurio Pc~rras of Panama in1920, only a fewmonths

after the death of Go~gas.  The Pr%sid%nt of Panama ernvisaged the ~QlT@t3

Memorial as a medical research center associated with the FAnto Tom&s

Hospitalinwkkh the nations of the Americas would commemorate the

pion8%r sanitary work of General Gcrrgas in Cuba and Panama by cooperati3q

in llrtudies leading to the s0lution of their common dieease problems.

In reply to a psrsunal letter frost President Forras asking the

Surgeon Ckneral of the United States Navy to cooperate in the organisa-

~SOA Of an InStitUt% Of %~pfC&l &xiki~ in Par&a&a to be named for th8

late Surgeon Gen43rald. C. Corgas of the Utited Statsrs Army, Admiral

Braisted had writtar

II . ..the studyoftmpicalm%dlci.neis ofvitaliqortance t0 the
people of Ammica and should be 12rxiertaken by the scientiata of
the various republics of this c0ntWt not only with a view to
aaviqhumanllfe . ..but also as an indlr8ct m%ans of incrt~asing
the harmony and mutual %steem which should prevail a~ng us."


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  The Surgeon General had proposed also that the Chargd d'llffaires of

Panama sound out the Department of State, the Fan American Union, and

the Foreign Relations Committee of the Senate regarding government aid

to the Gorgas Memorial.

  Nothing is known of any approach to the United States Government at

that time looking towards U.S. support of the Gorgas Hemorial Institute.

Instead, plans were made to raise an endowment fund of ~,OOO,OOO.OO dol-

lars by public subscription to finance the work of the Institute.

2.  The Gorgas Memorial Laboratoq

The Gorgaa Memotial Laboratory is a research laboratory operated by

the Gorgas Memorial Institute of Tropical and Preventive Medicine with

resources made available by the governments of the Republic of Panama

and of the United States, and by other agencies.

  Following the incorporation of the Gorgas Memorial Institute in 1921

in the United States, under the laws of the State of Delaware, its charter

was registered and legalized in the Republic of Panama.  In 1923, the

Republic of Panama purchased land for the Gorgas Memorial Laboratory adja-
cent to that of the Santo Ton& Hospital3 this site was officially dedicated

in February 1923 by the President of Panama for the Gorgas Memorial Labo-

ratory, and a marker placed commemorating the act.

  The attempt to raise an adequate endowment by public subscription
failed; in 1928, Representative Maurice H. Thatcher of Kentucky, a member

of the Isthmian Canal Commission during the construction period and later

Governor of the Canal Zone, introduced a bill (HR 8128) to authorize a

permanent annual appropriation for support of the projected Gorgas Memorial

Laboratory on the Isthmus of Panama.  After due action by the House and the


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Senate, HR 8128 became Public Law No. 350 (70th Congress) by signature

of President Calvin Coolidge on May 7, 1928.

Purposes

The Committee on Foreign Affairs, in reporting to the Committee of

the whole House (House Report No. 706, 70th Congress, 1st Session), gave

the twofold purposes of the measure as:

"First, to authorize as the contribution of the United States
Government thereto a permanent annual appropriation of 50,000
dollars for the maintenance and operation of the Gorgas Memorial
Laboratory, on the Isthmus of Panama; and, second, to memorialize
in a vital and effective way the name of General kLLlliam Crawford
Gorgas, who wrought such miracles of sanitation in Cuba and on
the I~thmus.~~

3.  The International Nature of the Gorgas Memorial Laboratory

From the beginning in 1921, the Gorgas Memorial Laboratory was

planned as an international venture.  At the first meeting of the Provi-

sional Committee, the President of Panama was declared President and

Founder of the Provisional Board of Directors of the Gorgas Memorial

Institute; at the second meeting, the Ambassador of Peru and the Ministers

of Cuba and Ecuador were made Honorary Members of the Memorial; and at the

fourth meeting the Ambassador of Peru, the Ministers of Cuba and Venezuela,

and the Charg6 d$Affaires of Argentina were present.

After incorporation of the Gorgas Memorial Institute, an approach was

made to the Latin American governments through diplomatic channels and

through personal visits to the Presidents of several countries. Promising

relations were established which could not be developed at the time because

of the failure to secure funds in the United States.

The commitment of Panama to furnish a site and a building for the

Gorgas Memorial Laboratory and the favorable reactions of other nations

were reported to the Congress in the hearings on RR 8128.


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  The authorization for a permanent annual contribution to the Gorgas

Memorial Institute for the maintenance and operation of the Gorgas Memorial

Laboratory was conditional to the construction of the Laboratory building

within the next five years, on the site offered by the Republic of Panama,

or on a site in the Canal Zone to be provided by the United States. This

stipulation was promptly met by the Republic of Panama which deeded to the

Gorgas Memorial Institute, in perpetuity, so long as it be used as a

research laboratory, the site and building in which the Gorgas Memorial

Laboratory has operated since 1929. In 1963 an additional building,

financed by the United States Government, was constructed on the same site.

  The Gorgas Memorial Laboratory was further recogniaed as an inter-

national effort by Congress in providing that each of the Latin American

governments be invited and permitted to contribute to its maintenance and

operation; each contributing Latin American nation was to be represented

on the Directing Council of the Gorgas Memorial Laboratory in proportion

to its contribution.  Inadvertently, this proviso limited the total Latin

American representation to 43 per cent, since the Latin American financial

contribution was limited by the same act to 75 per cent of the United

States contribution.

  In emphasizing the quasi-official nature of the Gorgas Memorial Labo-

ratory, the Congress established permanent United States representation on

the Directing Council "in such manner as tie President may determine."

(President Hoover declared on December 1, 1930 his satisfaction with the

representation of the United States by the Surgeons General of the Army,

the Navy, and the Public Health Servicei today's By-Laws provide also for

representation by the Surgeon General of the Air Force.)


  The Congress also requires a full annual report to it by the Gorgas

I4emorial Institute on the operation and the work of the Gorgas Memorial

Laboratory3 the Comptroller General of the United States audits the

accounts of the Gorgas Memorial Laboratory.

   Thus, the United States Congress, while providing for the participa-

tion of other nations, made such participation unattractive by keeping

control in the Directing Council and requiring the Gorgaa Memorial Insti-

tute to report to the United States Congreats and to have its books audited

by the United States Government.  Usual usage would have the report made

to the Directing Council and the audit made by a nominee of the Council.
  It may well be that the difficult financial situation in the years
following 1929 may have been the determining factor in preventing a greater
participation of Latin American nations in the financing of the work of the

Gorgas Memorial Laboratory.  Thirty-five years later few will remember the
impact of the economic crisis on the political life of Latin America; all
of the governments of South America suffered upheavals, with the exception

of Paraguay and Venezuela.  Even in the United States this was a period of

severe retrenchment.

  Fortunately, the Act authorizing a permanent annual appropriation for
the maintenance and operation of the Gorgas Memorial Laboratory of Hay 7,
1928 was amended by PL 339 (83rd Congress, 2nd Session) of April 19, lp!j&,
making it much more acceptable as the basis for true international

collaboration.

  The stipulations regarding the limitations on and the pro rata nature

of contributions and of representation of Latin American nations were
rescinded; also rescinded was the stipulation regarding U.S. representation

on t,hc iXrect.ini: Council,


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In their plaue, the following was enacted:

n . ..and (2) that the Baid Gorgae Memorial Institute be, and it
is hereby, authorized within its discretion, henceforth to
acaept from any of the Latin Amerioan Governments, or from any
other sourcea, aqy funds which may be offered or given for the
use of the Gorgasr Memorial Institute for the maintenance and
operation of the Gorgas Memorial Laboratory, and for carrying
on the work of said Laboratory wherever deemed by the said
Institute to be necessary or desirable."

In 1953 (October p), six months before the liberalization of the U.S.

legislation relating to Latin American participation, the Bureau of the

Budget, considering the Qorgas Memorial Laboratory as a national rather

than an international operation, took from the Department of State ard

assigned to the Department of Health, Education, and Welfare budgetary

responsibility for contributions made by the United States to the Gorgas

Hemorial Institute for its support. This move, in effect, denied the

continued participation of the Republic of Panama in the Gorgas Memorial

Laboratory.

This action overlooked entirely the international origin of the Gorgaa

Memorial Institute itself and the conditions under which the Gorgas Memo-

rial Laboratory was created; viz., the Gorgaar Memorial Institute acted as

an intermediary in a non-treaty agreement through which the Governments of

Panama and of the United States collaborate through the Gorgaer Memorial

Laboratory in researoh on tropical diseases to memorialize for future

generations the life and work of General Gorgas. This action also left

out of consideration the termsp of the agreement between the Gorgaa Memo-

rial Institute ani the Government of Panama under which the Gorgas Memo-

rial Laboratory operatee in that Republic.

At the time of this action, the State Department made clear its


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interest in continued support of the Gorgas Memorial Laboratory by the

United States; in a letter to the Secretary of Health, Education, and

Welfare from the Secretary of State (December 2, 1953) are to be found

the following statements:

If . ..my purpose in writing is to express the interest of the Depart-
ment of State in the oontinued appropriation of funds for the main-
tenance of this organization... the Department of State desires to
point out that there are involved in this matter important consider-
ationra affecting the international relations of this government.

"The Laboratory was established as a memorial to a great American,
who, because of his major contribution to the realization of the
trans.Isthmian Canal, is held in high esteem in Panama. The Canal
Zone and the Panamanian Government have drawn freely upon and
benefitted greatly from the work of the Laboratory, and the Pana-
manian Government always has followed the work and the development
of the Laboratory with great interest.

"It has manifested this interest in donating to the Laboratory an
appropriate building and valuable real estate in its capital city,
together with various services.  Its Ambassador to the United States,
who is an ex-officio Director of the Gorgas Memorial Institute, has
indicated to the Department of State on numerous occasions the desire
of his Government for the continued maintenance of the Laboratory.
The P anamanian view the Laboratory as a signal example of cooperation
which benefits both nations and its discontinuance through lack of
support would be widely interpreted in Panama as disinterest on the
p&t of this`Government in such cooperation.

"For these reasons the 'Department of State expects that (a) the
independent identity of the Gorgaa Memorial Institute and Laboratory
will be maintained, including policy making functions; and (b)
because the Department of State has the responsibility for deter-
mining the foreign relations aspects of the Laboratory and fnsti-
tute, the Public Health Service will consult with the Department
concerning requests for annual appropriations and any other legis-
lation in connection with the Gorgas Memorial Laboratory."

In spite of this letter, the Department of Health, Education, and

Welfare unilaterally appointed an ad hoc technical committee to determine

whether the United States should continue to support the Gorgas Memorial

Institute in its operation of the Gorgas Memorial Laboratory. Fortunately,

a possible crisis was averted by the committee's recognition of the value


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of the scientific work of the Gorgas Memorial Laborat5ry and the future

potential of it6 +trategic position.

  During the past decade the Gorgas Nmorial Laboratory has been mod-

ernized in keeping with today's altered research needs; additional quar-

ters have been provided in part by the United States and in part from

private sourcesj salaries have been increased in line with scientific

salaries elsewhere; and new fields of research have been added. The

increased operating costs have been paid during the past two years in

part from non-recurring private funds.

4. The Eiddle Ammica Research Unit (PIARU)

Some years ago, the United States, in spite of its interest in the

Gorges Hemrial Laboratory, moved to create its own tropical disease

research unit in.Panama.  Gn October 16, 1957, the Secretary of the Axmy,

the Governor of the Canal Zone, and the Surgeon General of the Public

Health Service signed an agreement authorizing the Rational Institutes

of Health of the United States Public Health Service (MIH) to establish

in the Canal Zone a field party for the study of tr5plcal diseases.

  This aotion was taken because the Rational Institutes of Health, in

collaboration with the Walter Reed Army Institute of Research, the Naval

Medical Research Institute, the Research Mvision of the Bureau of Nedi-

tine and Surgery of the Department of the Navy, the Research and Develop-

ment Division of the Office of the Surgeon General of the Department of

the Army, the Canal Zone Government, and possibly other agencies of the

Government of the United States, wa8 desirou8 of establishing in the

Canal Zone a field research party for the study of tropical diseases.


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  The initial agreement was for a three-year period, with provision

for evaluation at the end of the second year to determine whether the

project abuld become permanent or not.

  The action was taken at a time when the Cforgas Memorial Laboratory

was struggling to improve its physical Pnstallation8 and its technical

staff to meet the demands of modern research, particularly in the tirus

field; it was taken three years after the National Institutes of Health
became responsible for the defense of the Gorgas Memorial Laboratory

budget before the Congress.

  The pre-empting of collaboration with all of the agencies mentioned
by the National lnstftutes of Health came in the face of previous collabo-
ration of the United States Army and the United States Navy in tropical
disease research with the Gorgas Memorial Laboratory.

  The field research party was established without due consultation

with the State Department since, although located in the Canal Zone under

the .American flag, its designation, Middle America Research Unit, declares

its international objectives,

  In accord with the initial agreement, an ad hoc Committee for the
Ovaluation of MARU was appointed in 1959. This Committee recommended the

continuation of MARU for an indefinite period.  Additional recommendations

included2

   i.  That, in tiew of the increarsing anti-united States sentiment in

the Republic of Panama, steps be taken to secure the provision of suitable
quarters in the Canal Zone for all IQRU personnel;

  ii.  That a joint scientific advisory board for the MARU and the

GOIV~S Memorial Labornt,5rv frrML) bn est.nhli shed tm deli neatw RPCIZIR of


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research interest and maintain productive relation8 between these

organizationa; and

  iii.  That the wIH/Pan American Sanitary Bureau (PASB) agreement on

MARU be revised.

  In accord with the recommendation for continuation of MARU, the

Secretary of Health, Education, and Welfare requested, in 1960, the con-
currence of the Director of the Bureau of the Budget of the designation
of the Middle America Research Unit of the National Institutes of Health

as a permanent research facility of the Public Health Service. The
Bureau of the Budget concurred but assumed that the Secretary of Health,
Education, and Welfare would seek the advice of the Department of State
with respect to any relevant foreign policy implications of this action.
No record of consultation with the Department of State has been found.

  The recommendation that the personnel of MARU should all be housed

in the Canal Zone servers but to emphasize the difficulties encountered
by official agencies of one government attempting to operate from a

domestic base in other countries.  (The succe8s of the Naval Medical

Research Units in Egypt and in Taiwan has been possible because these
units were established in the countries concerned under agreements with

those countries,  There is no c5rresponding agreement with Panama and
the other countries of Middle America covering MARU.)

  In contrast to the MARU staff, the staff of the Gorgas I4em5rial.
Laboratory live in the Republic of Panama; they and the Laboratory itself
were not molested during the anti-United States riots a year ago.
  The proposal for a joint advisory board for MARU and GML brings
into the open the difficulties of coexistence of the two agencies.


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Although it has been repeatedly declared that there is no conflict in
the programs of MARU and the Gorgas Memorial Laboratory, it is obvious

that the HARU program is in conflict with what that of the Gorgas I4emorial

Laboratory should be.

The creation of a situation which led the Government of Panama to

reserve the field of medical research in the Darien region for the Gorgas

Memorial Laboratory is certainly not a healthy one. Cbviously, the exist-

ence of PIllRU has complicated the relations between the Republic of Panama

and the United States.  Panama views the Gorgas Memorial Laboratory as

part of the national scenery, an agency staffed in part by Panamanian

scientists, and views MARU as unwarranted intrusion.

The masons for the proposed revision of the NIH/PASB agreement are

not apparent in the Committee's report; but it is obvious that MARU could

operate more easily outside of the Canal Zone under the banner of the Pan

American Sanitary Bureau than under the flag of the United States.

5. The Present Situation in Panama

The present situation merits an objective analysis. Such an analysis

will show:

   i.  That MARU exists as a 100 per cent United States operation, based
in the Canal Zone over which the Republic of Panama cl&m3 sovereignty;

  ii.  That MARU is limited to the Canal Zone except in so far as it

operates through diplomatic channels, through the GML, or through the PASB;

  iii.  That the Gorgas Memorial Laboratory now has the potential for

becoming a powerful center of medical research and training in the Ameri-

can tropics;

iv.  That this potential is based on:


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a) The charter of the Gorgas Memorial Institute of Tropical and

Preventive Medicine, issued by the State of Delaware, duly registered and

legalized in the Republio of Panama, establishes the functions of the

Sorgas Memorial Institute as followsl

nTo conduct, assist and encourage investigations in the sciences
and arts of hygiene, medicine and surgery and allied subjects,
in the nature and causes of disease and the methods of its
prevention and treatment, and to make knowledge relating to
these various subjects available for the protection of the
health of the public and the improved treatment of disease
and injury, particularly as applied to Tropical and Preventive
Medicine.  It shall be within the purposes of this corporation
to use any means to those ends which from time to time shall
seem to it expedient, including research, publication, educa-
tion, the establishment and maintenance of charitable or benev-
olent activities, agencies or institutions appropriate thereto,
and the aid of any other such activities, agencies or institu-
tions already established or which may hereafter be established.

"The corporation shall have the power to acquire by grant, gift,
purchase, devise or bequest, either absolutely or in trust, and
to hold, mortgage, convey and dispose of such property, real or
personal, situated or being within or without the State of
Delaware, as the purposes of the corporation shall require,
withovt limitation as to amount, location or Value; to accept
and administer any trust of property, real or personal, wherever
situated, for any purpose within the objects of the corporation;
and to prescribe by by-laws or otherwise the term and conditions
upon which property, real or personal, shall be acquired or
received by the said corporation.

'The corporation shall also have power to build, purchase,
improve, enlarge, equip and maintain laboratories and other
buildings within the Republic of Panama and elsewhere necessary
or appropriate for its work; to own and operate land and build-
ings for the breeding, raising and keeping of plants and ani-
mals to be used for its purposes; to furnish treatment for
diseases of man and of animals, and to provide and maintain
all necessary equipment therefor; to conduct and assist such
scientific experiments or investigations upon plants or animal8
as may be necessary or proper for carrying on its work of
research; to appoint committees of experts to direct special
lines of research; to aid, cooperate with, or endow other asso-
ciations or corporations engaged in similar work within the
Republic of Panama or elsewhere; to aid and cooperate with
investigators in its own laboratories or elsewhere; to collect
statistics and information, and to publish and distribute


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doouments, reports and periodicals; to carry on such educa-
tional work along the lines of its corporate purposes as it
may deem wise; to provide for and furnish public instruction
in hygiene, sanitation, and laws of health; to conduct
lectures and hold meetings; to acquire and maintain a library;
to erect and maintain museums; and in general to do and per-
form all things necessary or convenient for the promotion and
the objects of corporation or aw of them.

"To have offices, plants and places for carrying on and conduct-
ing its affairs and for fulfilling the objects of its organiza-
tion, outside of the State of Delaware, and to carry on its
business and affairs and to promote its objects without restric-
tions as to place or amount.

"To do any or all of the things herein set forth to the same
extent as natural persons might or oould do and in any part
of the world, as principals, agents, contractors, trustees or
otherwise, alone or in company with others."

b) The specific authorization in PL 339 of the 831-d Congress,

amending PL 350 of the 70th Congress, which reads as follows:

N . ..and (2) that the said Gorgas Memorial Institute be, or it
hereby is, authorized within its discretion, henceforth to
accept from any of the Latin American Governments, or from
airy other sources, any funds which may be offered or given
for the use of the Gorgas 24emorial Institute for the mainte-
nance and operation of the Gorgas Namorial Laboratory, and
for carrying on the work of said Laboratory wherever deemed
by the said Institute to be necessary or desirable."

c) Thirty-five years of peaceful cooperation with the authori-

ties and people of Panama with the development of an international staff.

d) Recently constructed modern laboratory facilities a&

insectary.

e) Access to the wards of the Santa Tom& Hospital and to a

number of beds specifically reserved for patients studied at the Gorgas

Memorial Laboratory.

f) A fully qualified Director and the nucleus of a well quali-

fied scientific staff experienced in tropical disease study and adapted


    g) Its strategi c 1 ocation on the Isthmus at a time when the

southward extension of the Pan American Highway and plans for a new

trans-Isthmian Canal emphasize the importance of continuing study of

tropical diseases.

    h) The cooperation of the six countries of the Isthmus during

the past 15 years in the Institute of Nutrition of Central America and

Panama (INCAP), which should make it relatively easy to develop similar

multi-nation participation in research in tropical diseases through the

Gorgas Memorial Laboratory already located in the region.

    i) The facility of the Gorgas Memorial Institute, as a private

corporation, to work with governments of many countries in the manner

developed by the Rockefeller Foundation during its studies on and control

of yellow fever.

  It 18 obvious that there is need for research beyond the capacity

of both MARU and the GML; it seems likely that a better situation might

exist today had the United States found a way to channel the resources

poured into MARU since 195'7 into the earlier development of the GML.

Today there is every reason for the Gorgas Memorial Institute to take

the leadership in developing greater participation of the Republic of

Panama and of the United States in the development of the Gorgas Memorial

Laboratory, in such a way as to facilitate the participation of the

National Institutes of Health and other United States agencies in tropical

disease research while at the same time opening up neighboring countries

for necessary expansion of the field of operations.