B-153075, MARCH 4, 1964, 43 COMP. GEN. 573

B-153075: Mar 4, 1964

Additional Materials:

Contact:

Edda Emmanuelli Perez
(202) 512-2853
EmmanuelliPerezE@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

1964: REFERENCE IS MADE TO YOUR LETTER OF DECEMBER 10. IN WHICH HE STATES THAT MORE EFFECTIVE UTILIZATION OF THE RESULTS OF HEALTH RESEARCH WILL REQUIRE GREATER FEDERAL SUPPORT OF A VARIETY OF EFFORTS BY NONGOVERNMENTAL ORGANIZATIONS. IS REQUIRED NOT ONLY TO IMPROVE THE SCOPE AND ADEQUACY OF THE TRADITIONAL METHOD OF COMMUNICATION. HE STATES FURTHER THAT BETTER METHODS FOR COMMUNICATING THE RESULTS OF RESEARCH TO PRACTITIONERS AND MEMBERS OF THE PUBLIC WILL NEED TO BE EXPLORED. AS FOLLOWS: "* * * THE ACCUMULATION OF KNOWLEDGE THROUGH RESEARCH IS OF LITTLE USE UNLESS COMMUNICATED IN USEFUL FORM TO THOSE WHO NEED TO USE IT. THERE IS NOW WIDE RECOGNITION THAT IMPROVED SCIENTIFIC COMMUNICATION IS AN URGENT GOAL.

B-153075, MARCH 4, 1964, 43 COMP. GEN. 573

PUBLIC HEALTH SERVICE - HEALTH RESEARCH, ETC. - COMMUNICATION ACTIVITIES FUNDS APPROPRIATED TO CARRY OUT RESEARCH, TRAINING, AND OTHER ACTIVITIES IN THE MEDICAL AND RELATED SCIENCES PURSUANT TO SECTION 301 OF THE PUBLIC HEALTH SERVICE ACT, 42 U.S.C. 241 (SUPP. IV) FOR THE PROTECTION AND IMPROVEMENT OF THE NATION'S HEALTH MAY BE USED TO MAKE GRANTS-IN-AID FOR ACTIVITIES DESIGNED TO CONTRIBUTE TO MORE EFFECTIVE COMMUNICATION IN THE HEALTH FIELD, SECTION 301 (H) OF THE ACT AUTHORIZING, UPON RECOMMENDATION OF THE NATIONAL COUNCIL, THE ADOPTION OF ADDITIONAL MEANS TO CARRY OUT THE ACTIVITIES AUTHORIZED BY SECTION 301, AND, THEREFORE, THE COMMUNICATION RESEARCH ACTIVITIES, RELATING TO THE GENERAL PURPOSES OF SECTION 301, MAY BE SUPPORTED FROM APPROPRIATED FUNDS, HOWEVER, WHERE DOUBT EXISTS AS TO A PARTICULAR TYPE OF COMMUNICATION THE MATTER OF SUPPORTING THE ACTIVITY BY GRANTS-IN-AID SHOULD BE SUBMITTED TO THE CONGRESS.

TO THE SECRETARY OF HEALTH, EDUCATION AND WELFARE, MARCH 4, 1964:

REFERENCE IS MADE TO YOUR LETTER OF DECEMBER 10, 1963, WITH ENCLOSURE, REQUESTING OUR DECISION AS TO WHETHER FUNDS APPROPRIATED TO THE PUBLIC HEALTH SERVICE TO CARRY OUT THE PURPOSES OF SECTION 301 AND RELATED PROVISIONS OF THE PUBLIC HEALTH SERVICE ACT MAY BE USED TO SUPPORT BY GRANT CERTAIN HEALTH COMMUNICATION ACTIVITIES DESCRIBED HEREINAFTER.

THERE ACCOMPANIED YOUR LETTER A MEMORANDUM TO YOU DATED DECEMBER 2, 1963, FROM THE SURGEON GENERAL OF THE PUBLIC HEALTH SERVICE, IN WHICH HE STATES THAT MORE EFFECTIVE UTILIZATION OF THE RESULTS OF HEALTH RESEARCH WILL REQUIRE GREATER FEDERAL SUPPORT OF A VARIETY OF EFFORTS BY NONGOVERNMENTAL ORGANIZATIONS. SUCH SUPPORT, HE SAYS, IS REQUIRED NOT ONLY TO IMPROVE THE SCOPE AND ADEQUACY OF THE TRADITIONAL METHOD OF COMMUNICATION, VIZ., THE SCIENTIFIC JOURNAL, BUT ALSO TO EXPLORE THE USE BY SCIENTISTS, HEALTH PRACTITIONERS, AND OTHERS OF ELECTRONIC STORAGE AND RETRIEVAL SYSTEMS IN SECURING READY ACCESS TO A LARGE VOLUME OF COMPREHENSIVE AND RELIABLE INFORMATION SUCH AS THAT RELATED TO DRUGS. HE STATES FURTHER THAT BETTER METHODS FOR COMMUNICATING THE RESULTS OF RESEARCH TO PRACTITIONERS AND MEMBERS OF THE PUBLIC WILL NEED TO BE EXPLORED.

IN SUPPORT OF THESE VIEWS, THE SURGEON GENERAL REFERS TO A MESSAGE OF FEBRUARY 7, 1963, FROM PRESIDENT JOHN F. KENNEDY TO THE CONGRESS, RELATIVE TO A HEALTH PROGRAM, AND QUOTES THEREFROM, AS FOLLOWS:

"* * * THE ACCUMULATION OF KNOWLEDGE THROUGH RESEARCH IS OF LITTLE USE UNLESS COMMUNICATED IN USEFUL FORM TO THOSE WHO NEED TO USE IT--- TO OTHER SCIENTISTS, EDUCATORS, PRACTITIONERS, ADMINISTRATORS, AND THE PUBLIC. THERE IS NOW WIDE RECOGNITION THAT IMPROVED SCIENTIFIC COMMUNICATION IS AN URGENT GOAL, AND ACTION IS BEING TAKEN * * *. I HAVE ASKED THE DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE TO TAKE THE LEAD IN DEVELOPING NEW METHODS AND SYSTEMS OF UTILIZING AND MAKING EFFECTIVELY AVAILABLE MORE HEALTH RESEARCH RESULTS AND INFORMATION * * *.' H.DOC.NO. 60, 88TH CONG., 1ST SESS. 9 (1963).

AND TO STATEMENTS BY THE HOUSE AND SENATE COMMITTEES ON APPROPRIATIONS, DURING CONSIDERATION OF APPROPRIATIONS TO THE PUBLIC HEALTH SERVICE, RELATIVE TO THE COMMUNICATION OF HEALTH RESEARCH FINDINGS, AS FOLLOWS:

"THE (HOUSE APPROPRIATIONS) COMMITTEE HAS ON SEVERAL OCCASIONS EXPRESSED GRAVE CONCERN OVER THE LACK OF ADEQUATE COMMUNICATION OF THE RESULTS OF MEDICAL RESEARCH. CONVENTIONAL SYSTEMS FOR THE ORGANIZATION, STORAGE, RETRIEVAL, AND DISSEMINATION OF MEDICAL INFORMATION ARE BECOMING INCREASINGLY STRAINED AND OVER-LOADED. THE CONSTANTLY ACCELERATING PACE OF MEDICAL RESEARCH AND THE RESULTING PROLIFERATION OF PUBLICATIONS, REPORTING, THE RESULT OF THIS RESEARCH, MAKE IT DIFFICULT TO COPE WITH THE PROBLEMS OF FINDING, CORRELATING, AND MAKING ACCESSIBLE FOR USE THE NEW MASSES OF DATA. * * * THE COMMITTEE WILL EXPECT THE PUBLIC HEALTH SERVICES (SIC) TO DEVELOP SPECIFIC PROPOSALS IN THE OVERALL FIELD OF COMMUNICATION OF BIO MEDICAL INFORMATION.' H.REPORT. NO. 1488, 87TH CONG., 2D SESS. 44-45 (1962).

"THE (SENATE APPROPRIATIONS) COMMITTEE WILL EXPECT THAT THE FUNDS WHICH ARE PROVIDED IN THE SEVERAL APPROPRIATIONS FOR THE PUBLIC HEALTH SERVICE UNDER THIS BILL (DEPARTMENT OF LABOR, AND HEALTH, EDUCATION, AND WELFARE AND RELATED AGENCIES APPROPRIATION BILL, 1964, H.R. 5888) WILL BE USED TO THE MAXIMUM EXTENT POSSIBLE TO FURTHER MEANINGFUL EFFORT IN IMPROVING THE MANAGEMENT OF SCIENTIFIC AND TECHNICAL INFORMATION AND IN SOLVING THE PROBLEMS OF HEALTH COMMUNICATIONS.' S.REPORT. NO. 383, 88TH CONG., 1ST SESS. 34 (1963).

TO ILLUSTRATE THE SITUATIONS IN WHICH THE PUBLIC HEALTH SERVICE PROPOSES TO MAKE GRANTS FOR ACTIVITIES DESIGNED TO CONTRIBUTE TO MORE EFFECTIVE COMMUNICATION IN THE HEALTH FIELD, THE SURGEON GENERAL SETS FORTH THREE EXAMPLES WITH EXPLANATORY COMMENTS WHICH MAY BE BRIEFLY SUMMARIZED AS FOLLOWS:

1. GRANTS FOR THE FINANCIAL SUPPORT OF NONGOVERNMENT, NONCOMMERCIAL, SCIENTIFIC AND TECHNICAL PUBLICATIONS AS EVIDENCED BY THE DECLARATION OF POLICY OF AUGUST 1, 1963, BY THE FEDERAL COUNCIL FOR SCIENCE AND TECHNOLOGY. THESE PUBLICATIONS ARE SAID TO PROVIDE A FORUM FOR COORDINATING OTHERWISE DIVERGENT RESEARCH FINDINGS, AND THUS NOT ONLY GUARD AGAINST UNNECESSARY DUPLICATION OF RESEARCH, BUT ENABLE THOSE ENGAGED IN THE FIELD TO KEEP ABREAST OF CURRENT DEVELOPMENTS.

2. GRANTS TO INSTITUTIONS FOR RESEARCH IN THE UTILIZATION OF ELECTRONIC AND OTHER DEVICES FOR HANDLING BIOMEDICAL AND RELATED INFORMATION SO THAT THE LARGE MASSES OF INFORMATION INVOLVED IN MEDICAL RESEARCH OR SERVICE CAN BE SUPERINTENDED. ONE OF THE PROBLEMS, IT IS SAID, IS WHETHER SCIENTISTS CAN DEVELOP A COMPUTER-BASED SYSTEM FOR RECORDING CHEMICAL AND BIOLOGICAL DATA IN A MANNER SUITABLE TO STUDYING THE INTERRELATIONSHIPS BETWEEN THE DATA. SUCH RESEARCH, IT IS SAID, IS NECESSARY TO BEGIN THE MECHANIZATION OF A TOTAL SYSTEM WHICH OTHERWISE WOULD BE TOO EXPENSIVE AND CUMBERSOME TO ESTABLISH OR CONTINUE. THE PURPOSE OF THE CODING SYSTEM WOULD BE TO RENDER CHEMICAL AND BIOLOGICAL INFORMATION INTO A FORM IN WHICH THE STRUCTURE IS UNIFORM AND THE VOCABULARY CONTROLLED.

3. GRANTS TO INSTITUTIONS FOR RESEARCH IN DEVELOPING NEW COMMUNICATION TECHNIQUES OF TRANSMITTING RECENTLY ACQUIRED SCIENTIFIC KNOWLEDGE TO THE PRACTICING MEDICAL COMMUNITY. IT WAS STATED THAT THE GALAXY OF MODERN ELECTRONIC TECHNIQUES FOR COMMUNICATION PRESENTS PROMISING POSSIBILITIES FOR REACHING PRACTICING PHYSICIANS. PREPARATORY TO THE USE OF SUCH TECHNIQUES, HOWEVER, IT IS STATED TO BE NECESSARY TO LEARN MORE ABOUT THE EFFECT UPON PRACTICING PHYSICIANS OF VARIOUS MEDIA AND METHODS. BY THESE MEANS, IT IS PLANNED TO DEVELOP AND SUPPORT BY GRANT, NEW COMMUNICATION TECHNIQUES TO ACHIEVE THAT PRACTITIONER AWARENESS OF RESEARCH FINDINGS WHICH ASSURES MORE EFFECTIVE PREVENTION, TREATMENT AND CONTROL OF THE DISEASES OF MAN.

SECTION 301 OF THE PUBLIC HEALTH SERVICE ACT, 58 STAT. 691, AS AMENDED, 42 U.S.C. 241 (SUPP. IV), READS, AS FOLLOWS:

THE SURGEON GENERAL SHALL CONDUCT IN THE SERVICE, AND ENCOURAGE, COOPERATE WITH, AND RENDER ASSISTANCE TO OTHER APPROPRIATE PUBLIC AUTHORITIES, SCIENTIFIC INSTITUTIONS, AND SCIENTISTS IN THE CONDUCT OF, AND PROMOTE THE COORDINATION OF, RESEARCH, INVESTIGATIONS, EXPERIMENTS, DEMONSTRATIONS, AND STUDIES RELATING TO THE CAUSES, DIAGNOSIS,TREATMENT, CONTROL, AND PREVENTION OF PHYSICAL AND MENTAL DISEASES AND IMPAIRMENTS OF MAN * * *.

TO CARRY OUT THE FOREGOING, THE SURGEON GENERAL IS AUTHORIZED TO---

(A) COLLECT AND MAKE AVAILABLE THROUGH PUBLICATIONS AND OTHER APPROPRIATE MEANS, INFORMATION AS TO, AND THE PRACTICAL APPLICATION OF, SUCH RESEARCH AND OTHER ACTIVITIES;

(D) MAKE GRANTS-IN-AID TO UNIVERSITIES, HOSPITALS, LABORATORIES, AND OTHER PUBLIC OR PRIVATE INSTITUTIONS, AND TO INDIVIDUALS FOR SUCH RESEARCH OR RESEARCH TRAINING PROJECTS AS ARE RECOMMENDED BY THE NATIONAL ADVISORY HEALTH COUNCIL. * * *

(H) ADOPT, UPON RECOMMENDATION OF THE NATIONAL ADVISORY HEALTH COUNCIL * * * SUCH ADDITIONAL MEANS AS HE DEEMS NECESSARY OR APPROPRIATE TO CARRY OUT THE PURPOSES OF THIS SECTION.

THE SURGEON GENERAL CONTENDS THAT THE EFFECTIVE DISSEMINATION OF THE RESULTS OF HEALTH RESEARCH IS AS MUCH A PURPOSE OF SECTION 301 WITHIN THE REACH OF SUBSECTION 301 (H), 42 U.S.C. 241 (H), AS ANY OTHER ASPECT OF THAT SECTION. HE EXPRESSES THE VIEW, THEREFORE, THAT THE AUTHORITY CONFERRED BY SUBSECTION 301 (H) IS BROAD ENOUGH TO ENCOMPASS THE TYPES OF GRANTS OUTLINED ABOVE AS ADDITIONAL MEANS TO CARRY OUT THE PURPOSES OF SECTION 301, AND CITES IN SUPPORT OF THAT VIEW OUR DECISIONS TO THE ADMINISTRATOR, FEDERAL SECURITY AGENCY, OF JUNE 23, 1947, B-66327 AND FEBRUARY 10, 1949, B-83261.

SECTION 301, QUOTED ABOVE, MAKES IT THE RESPONSIBILITY OF THE PUBLIC HEALTH SERVICE, UNDER THE DIRECTION OF THE SURGEON GENERAL, TO CONDUCT AND SUPPORT RESEARCH, TRAINING, AND OTHER ACTIVITIES RELATING TO THE MEDICAL AND RELATED SCIENCES TO PROTECT AND IMPROVE THE HEALTH OF THE PEOPLE OF THE NATION. TO CARRY OUT THIS RESPONSIBILITY, THE SURGEON GENERAL IS AUTHORIZED, AMONG OTHER THINGS, TO COLLECT AND DISSEMINATE THROUGH PUBLICATIONS AND OTHER APPROPRIATE MEANS, INFORMATION AS TO, AND THE PRACTICAL APPLICATION OF, SUCH RESEARCH AND OTHER ACTIVITIES; AND TO MAKE GRANTS-IN-AID TO UNIVERSITIES, HOSPITALS, LABORATORIES, AND OTHER PUBLIC OR PRIVATE INSTITUTIONS, AND TO INDIVIDUALS FOR SUCH RESEARCH, OR RESEARCH TRAINING PROJECTS AS ARE RECOMMENDED BY THE APPROPRIATE NATIONAL ADVISORY COUNCIL ESTABLISHED UNDER THE PUBLIC HEALTH SERVICE ACT. UPON RECOMMENDATION OF THE APPROPRIATE NATIONAL ADVISORY COUNCIL THE SURGEON GENERAL MAY ADOPT SUCH ADDITIONAL MEANS AS HE DEEMS NECESSARY OR APPROPRIATE TO CARRY OUT THE PURPOSES OF THIS SECTION.

THE APPROPRIATIONS MADE TO THE VARIOUS NATIONAL INSTITUTES OF HEALTH FOR, AMONG OTHER THINGS, GRANTS FOR RESEARCH PROJECTS AND RESEARCH TRAINING GRANTS PURSUANT TO SECTION 301 OF THE PUBLIC HEALTH SERVICE ACT, ALSO INCLUDE FUNDS FOR THE DISSEMINATION OF SCIENTIFIC AND TECHNICAL KNOWLEDGE PERTAINING TO SUCH RESEARCH ACTIVITIES. SEE PAGES 14 AND 15OF THE DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE APPROPRIATION ACT, 1964, PUBLIC LAW 88-136, APPROVED OCTOBER 11, 1963, 77 STAT. 237, 238.

IN THE REFERRED-TO DECISIONS OF OUR OFFICE IT WAS HELD TO THE EFFECT THAT GRANTS-IN-AID UNDER SECTION 301 ARE NOT LIMITED TO GRANTS FOR RESEARCH PROJECTS SUCH AS ARE SPECIFICALLY AUTHORIZED BY SUBSECTION 301 (D), 42 U.S.C. 241 (D), BUT THAT, IN VIEW OF THE AUTHORITY VESTED IN THE SURGEON GENERAL UNDER SUBSECTION 301 (H), TO ADOPT SUCH "ADDITIONAL MEANS AS HE DEEMS NECESSARY OR APPROPRIATE" GRANTS MAY BE MADE AS WELL FOR OTHER PURPOSES DETERMINED BY THE SURGEON GENERAL TO BE NECESSARY TO CARRY OUT THE PURPOSES OF SECTION 301. WHILE THESE DECISIONS CONCLUDE THAT THE SPECIFIC PROVISION OF SUBSECTION 301 (D) FOR RESEARCH PROJECT GRANTS IS NOT EXCLUSIVE AS TO THE PURPOSES FOR WHICH GRANTS MAY BE MADE, THE TERMS OF SECTION 301 MAKE IT CLEAR THAT THE AUTHORITY THEREUNDER TO CONDUCT AND SUPPORT RESEARCH, INVESTIGATIONS, ETC., WHETHER ACCOMPLISHED BY GRANT-IN- AID OR OTHER FORMS OF CONTRACTUAL ARRANGEMENT, IS LIMITED TO SUCH RESEARCH, INVESTIGATIONS, ETC., RELATING TO THE CAUSES, DIAGNOSIS, TREATMENT, CONTROL, AND PREVENTION OF PHYSICAL AND MENTAL DISEASES OR IMPAIRMENTS OF MAN. THUS, THE QUESTION TO BE RESOLVED HERE IS WHETHER THE TYPES OF COMMUNICATION ACTIVITIES OUTLINED ABOVE INVOLVE RESEARCH, INVESTIGATIONS, C., RELATING TO THE CAUSE OR PREVENTION OF DISEASES WITHIN THE SCOPE OF SECTION 301 SO AS TO AUTHORIZE THE MAKING OF GRANTS-IN-AID UNDER SUBSECTION 301 (H).

THE TRANSMISSION AND UTILIZATION OF MEDICAL RESEARCH INFORMATION DERIVE NOT ONLY FROM THE SPECIFIC AUTHORITY THEREFOR CONTAINED IN SUBSECTION 301 (A), 42 U.S.C. 241 (A), BUT, IN ADDITION, FROM THE PRIMARY RESPONSIBILITY OF THE SERVICE TO CONDUCT AND SUPPORT RESEARCH, INVESTIGATIONS, ETC., RELATING TO THE CAUSE OR PREVENTION OF DISEASE. THE COMMUNICATION OF RESEARCH FINDINGS IS AN INTEGRAL AND ESSENTIAL PART OF THE RESEARCH PROCESS AND THUS ELIGIBLE FOR FINANCIAL SUPPORT FROM THE SOURCE PROVIDED FOR RESEARCH PROJECT FUNDS AND UNDER SIMILAR CONDITIONS. THE TYPES OF COMMUNICATION ACTIVITIES SELECTED AS A POSSIBLE REFINEMENT OF THE COMMUNICATION MACHINERY TO MAKE THE MEDICAL RESEARCH FINDINGS KNOWN AND AVAILABLE TO THOSE WHO CAN APPLY THEM ARE, OF COURSE, A MATTER PRIMARILY FOR ADMINISTRATIVE DETERMINATION. WITH REFERENCE TO THE TYPES OF COMMUNICATION RESEARCH ACTIVITIES OUTLINED ABOVE, IT APPEARS THAT WHILE SUCH ACTIVITIES MAY NOT BE DIRECTLY IN THE CAUSE OR PREVENTION OF DISEASE AS POINTED OUT BY THE SURGEON GENERAL, THEY REASONABLY MAY BE CONSTRUED TO RELATE TO RESEARCH, INVESTIGATION, ETC., IN THE CAUSE OR PREVENTION OF DISEASE WITHIN THE GENERAL PURPOSES OF SECTION 301, AND THUS WITHIN THE DISCRETION PROVIDED IN SUBSECTION 301 (H).

ACCORDINGLY, YOU ARE ADVISED THAT IF THE SURGEON GENERAL DETERMINES UNDER THE AUTHORITY OF SUBSECTION 301 (H) OF THE PUBLIC HEALTH SERVICE ACT, UPON RECOMMENDATION OF THE APPROPRIATE NATIONAL ADVISORY COUNCIL, THAT SUPPORT BY WAY OF GRANTS-IN-AID IS AN APPROPRIATE OR NECESSARY MEANS FOR THE COMMUNICATIONS ACTIVITIES OUTLINED ABOVE TO MORE EFFECTIVELY COMMUNICATE MEDICAL RESEARCH INFORMATION AND OTHERWISE CARRY OUT THE PURPOSES OF SECTION 301, NO LEGAL OBJECTION WILL BE RAISED HERE AS TO THE USE OF FUNDS MADE AVAILABLE THEREFOR IF OTHERWISE PROPER. HOWEVER, WE WISH TO POINT OUT THAT WHERE ANY DOUBT EXISTS AS TO WHETHER A PARTICULAR TYPE OF COMMUNICATION ACTIVITY RELATES TO THE CAUSES, DIAGNOSIS, TREATMENT, CONTROL, AND PREVENTION OF PHYSICAL AND MENTAL DISEASES AND IMPAIRMENTS OF MAN, WITHIN THE MEANING OF THOSE TERMS IN SECTION 301, THE MATTER OF SUPPORTING SUCH ACTIVITY BY GRANTS-IN-AID SHOULD BE SUBMITTED TO THE CONGRESS FOR FURTHER CONSIDERATION AND CLARIFICATION.