Betting with lives
Clarence Gamble and the Pathfinder International
James A. Miller
Population Research Institute Review, July/August 1996, p. 5.
One of the most militant, well-funded, and pervasive organizations promoting population control
throughout the world _ especially in underdeveloped nations _ has been Pathfinder International,
formerly known as the Pathfinder Fund prior to a 1991 name change.
Founded in 1957 by the wealthy eugenicist and population control advocate Clarence Gamble,
heir to part of the Gamble fortune from the Proctor and Gamble soap company billions, Pathfinder
was one of the very first organizations to fund overseas population control programs. (Clarence
Gamble himself was "the first American" individual to fund such activities.)1 During its first 10
years of existence, Pathfinder's work was principally financed by Gamble, and other members of
his family. After Gamble's death in 1966, Pathfinder prospered greatly due to substantial funding
from a new entity which entered the population control field with very deep pockets indeed: the
United States Agency for International Development (USAID).
In 1965 Pathfinder's budget was only $250,000,2 but it would soon soar into the millions with the
monies USAID sent its way. With the massive backing of its new sugar daddy, Pathfinder not
only became a major factor in international population control but it no longer had to dip into the
Gamble fortunes to support its work.
Gamble _ first "pathfinder"
Born in 1894 in Cincinnati, Gamble graduated from Princeton in 1914 and received a medical
degree from Harvard in 1920.3 In the mid-1920s, Gamble began friendships with
pro-contraceptionist Dr. Robert Dickinson and Mrs. Margaret Sanger, the founder of the
American Birth Control League, the parent of today's Planned Parenthood Federation of
America.4 Gamble's son Richard, who was president of Pathfinder in the 1970s, traced his
father's interest in population control back to 1924 when Gamble first met Dickinson who urged
the young millionaire to "take up the work."5 As a result of the associations with Sanger and
Dickinson, Gamble naturally gravitated into what would become his life's work over a 40-year
period: population control, eugenics, and contraceptive research.
Throughout his career, Gamble was a prominent champion of eugenic sterilization and fought for
laws mandating the sterilization of mental ward patients and the performance of vasectomies on
"unfit" males. In this way he sought to eliminate hereditary forms of illness and retardation.
He wrote more than 100 articles for medical and scientific journals. Almost all the articles
concerned various contraceptive methods and devices _ spermicides, pessaries, foams, jellies,
powders, diaphragms, pills, IUDs, etc. _ as Gamble continually sought new and better
contraceptives in his on-going quest for the "perfect" one.6
From 1923 to 1938, Gamble taught pharmacology and did research at the University of
Pennsylvania Medical School. While there he helped invent an electrical stethoscope that
broadcast by loudspeaker the sound of the heart and lungs, perhaps the only instance of
non-contraceptive research undertaken by Gamble.7 In 1933, Gamble was elected president of
the Pennsylvania Birth Control Federation, a state affiliate of Margaret Sanger's American Birth
Control League. From that position, Gamble advanced to become a member of the League's
board of directors.
In December 1937, Gamble was appointed "Medical Field Director" of Sanger's Birth Control
Clinical Research Bureau and at the same time became a member of the editorial advisory board
of the Bureau's Journal of Contraception,8 a propaganda vehicle for Sanger's birth control and
Gamble in North Carolina
In 1937 Gamble was financing a program which supplied "birth control information to the natives
of the densely populated little island of Bocagrande, off the Florida Everglades."9 The nurse in
charge of the program, Miss Frances Pratt, homesick for her native North Carolina, interested
Gamble in that state as a good location for testing and proving his contraceptive methods.
Gamble approached the North Carolina State Board of Health with an offer it found too good to
refuse: he would personally fund for one year a project to provide contraception, under state
auspices, to indigent citizens, paying for both the contraceptives and the salary of a "consultant
nurse," Miss Pratt. Miss Pratt thus made her way back to North Carolina and Gamble had the
entire state as a laboratory in which to test his ideas when North Carolina, on 15 March 1937,
became the first of the forty-eight states to sponsor a health department birth control program.
When the North Carolina plan was launched, there were just three (private) birth control clinics in
the state; by the end of 1938, with Gamble's backing, the state had created 56. At that time, with
less than 3 per cent of the country's population, North Carolina had 13 per cent of the nation's
birth control clinics. By mid-1939 the number of birth control clinics in North Carolina had risen
to 62, second only to New York.10
Modestly (or was it fear of repercussions?) Gamble wrote an editorial for The Journal of
Contraception praising North Carolina's "progressive and intelligent" contraceptive program while
completely hiding his own involvement with the project. Gamble offered his "congratulations to
the State...for this marked pioneering advance in public health work," in effect patting himself on
the back. 11
The contraceptive which Gamble provided to the North Carolina clinics was "foam powder and
sponge," chosen for its ease of use since individual fitting was not required, and especially for
Gamble's interest in the method. At the time Gamble was experimenting with various foam
powders, including his own personal concoctions, and now he could ascertain the method's
effectiveness and safety.
Prospective patients were allegedly selected "on the basis of a definite medical indication," which
might be no more than the fact of "having borne as many as four children,"12 or "women in very
poor economic circumstances...[having] two or three children in rapid succession." In the latter
case, two North Carolina physicians involved in the project stated that a "careful [medical] history
and examination will usually reveal sufficient evidence of poor health to make childbearing a
definite risk."13 One of the leaders of the contraceptive project, Dr. Roy Norton, in a frank
admission, noted that the "strictly medical indications" supposedly required for a patient's
enrollment in the program "are sufficiently elastic" so as not to deny service to "those deserving
it,"14 namely North Carolina's indigent population, especially its Negroes.
Racism and eugenics
The overtly racist and eugenic nature of the project was well revealed in an oft-told anecdote
about a local "health officer [who] didn't think his county needed contraception. He was asked to
check his vital statistics. When he discovered that the Negroes were accounting for 85 per cent of
the births he quickly changed his mind."15
Even more damning were the remarks of Dr. George M. Cooper of the North Carolina State
Board of Health and director of the new contraceptive project, who in introducing speaker
Clarence Gamble to a meeting of the North Carolina Public Health Association, said that the
project was designed to promote a "positive breeding of better family children...and the curbing of
the breeding of the undesirables."16
In his speech, Gamble told the assembled public health officers that "among the services which
[they] can give, that of [providing] birth control is of the greatest importance." Gamble explained
his statement: if they "save a carcinomatous life [they] have probably rescued two decades or less
of existence" and in the case of syphilis "a cure may improve three or even four decades of life,"
while with diphtheria "five decades may hang in the balance. But with contraception, it is
possible...to enable an unwanted child to avoid an entire lifetime of unhappy, unhealthy
surroundings." Gamble summed it up: "Can any medical problem be more important?"17
Gamble weighed in with his own eugenics remarks in noting that "unfortunately" the increase in
North Carolina's population was allegedly not coming "from the more intelligent levels" but rather
from the "underprivileged" class. Gamble told his audience that they were "in a strategic
position...to improve North Carolina's next generation by correcting the present undesirable
differential birth rate...."18
The "negro project"
In 1939, Margaret Sanger's new Birth Control Federation of America, a merger of her American
Birth Control League and her research arm, the Birth Control Clinical Research Bureau, designed
a "Negro Project" which sought to bring about a major birth-rate reduction among American
Negroes. Such a result, according to the goals of the project, would help solve the problem of
Southern Negro poverty. According to the project proposal, widely believed to have been written
by Gamble, "The mass of Negroes, particularly in the South, still breed carelessly and disastrously,
with the result that the [population] increase among Negroes...is from that portion...least
intelligent and fit, and least able to rear children properly."
The project was to hire three or four "colored Ministers, preferably with social-service
backgrounds, and with engaging personalities" to travel through the South and propagandize for
birth control. As the project proposal stated, "The most successful educational approach to the
Negro is through a religious appeal."19
In a remarkably frank letter to Gamble, Sanger wrote that "We do not want word to go out that
we want to exterminate the Negro population and the minister is the man who can straighten out
that idea if it ever occurs to any of their more rebellious members."20
Gamble in turn proposed that the ministers enlist the aid of black physicians and attempt to
organize a "Negro Birth Control Committee" in each community. In a private memo concerning
the "Colored Steering Committee," Gamble wrote that "There is great danger that [the project]
will fail because the Negroes think it a plan for extermination. Hence let's appear to let the
colored run it...."21
Despite Gamble's professed concern for the health and well-being of the indigent Negroes he was
targeting, he clashed with South Carolina's Public Health Director who wanted to provide general
health services along with the contraceptive agenda being pushed by Sanger and Gamble. Gamble
wrote Sanger that he did not want his funds to be "diluted with a lot of general health work."22
Out of North Carolina, on to Puerto Rico
Despite all the excitement about Gamble's North Carolina project, it never became self-supporting
and the results of its contraceptive experiments were poor.23 Inasmuch as an indigent population
had been specifically targeted for the venture there was no hope of ever generating sufficient
revenues to relieve Gamble from the burden of paying for the project indefinitely _ unless the state
itself took up the cost or other wealthy contributors could be found, neither of which was in the
offing. The idea of federal funding for such a project was absolutely unthinkable at that time.
At the end of four years of operation the numbers of contraceptive acceptors amounted to only
6,220, a figure which was nonetheless ballyhooed by the program's directors and supporters.24
With such limited results, Gamble terminated his funding of the project and turned his attention to
a far more attractive location for his enterprises Puerto Rico.
Before departing North Carolina, however, Gamble's "field workers [had] helped set up similar
governmental [contraceptive] services in Alabama, Mississippi, Georgia and South Carolina."25
These states had closely watched North Carolina's contraceptive program and were eager to
follow their sister state's lead. As in North Carolina, welfare costs, racism and eugenics
considerations were the primary reasons behind the state-supplied contraceptive services. The
spread of such services, along with the new "respectability" that Gamble had won for population
control schemes and eugenics, were probably the most important legacies of his North Carolina
An ideal birth control lab
Gamble had first commenced working in Puerto Rico in late 1936 when a controversy broke out
over the discovery that the Puerto Rico Reconstruction Administration (PRRA), a New Deal
program, was using government funds to purchase contraceptive devices and supplies for
"maternal health" clinics on the island. With contraception still illegal in Puerto Rico at the time,
it was feared that a Catholic backlash in the States could cost President Roosevelt votes in that
Fall's presidential election. Accordingly, the PRRA was ordered to stop funding birth control, at
least until the election was over and the Catholic vote secured. Into the breech stepped Clarence
Gamble, who personally supplied much of the needed money.26
In 1937 the Puerto Rican legislature, under heavy pressure from the United States, passed a
population control law legalizing both contraception and sterilization. Puerto Rico, with its
homogeneous, stable population of poor and illiterate women, provided Gamble and American
drug companies with an "ideal" environment for mass clinical testing of contraceptives.27
In early 1938, Gamble, in his role as Medical Field Director of Sanger's Birth Control Clinical
Research Bureau, visited two birth control centers on the island which were affiliated with the
Bureau.28 Gamble brought his contraceptive foams and powders to Puerto Rico, but soon
moved on to more sophisticated methods such as the Pill and IUD.
During the 1950s, Gamble financed in part the work of Drs. Gregory Pincus and John Rock, "The
Fathers of the Pill." The first tests of the Pill were conducted in Puerto Rico, with Gamble's
donation covering the field and clinical tests.29
Into the world at large
Gamble also funded large scale IUD projects in Puerto Rico, Korea, and Chile. When Gamble ran
into trouble with the Population Council over patent rights to certain types of IUDs, his supply
was cut off for several years in the early 1960s. Gamble responded by having his own IUDs
manufactured in Hong Kong for just three and a half cents each! Eventually, the dispute was
patched up and Gamble and the Council resumed their working relationship.30
At the same time, through long-established family connections in Asia, Gamble developed a large
market for his foam tablets and homemade salt-rice contraceptive jelly in Ceylon, Hong Kong,
India, Japan, Malaysia, Burma, and Singapore.31 When the International Planned Parenthood
Federation (IPPF) opened for business in 1948 in the offices of the Eugenics Society of London,
Gamble was an early financial contributor. However, when the head of IPPF's India branch
accused Gamble of using Indian women as laboratory guinea pigs for his contraceptive
experiments, Gamble broke off his relationship with IPPF.32 With the end of World War II,
Gamble moved large sums of money into Japan, financing much of the Japanese government's
birth control program.33 Gamble had become a one-man population control powerhouse
throughout the world.
In 1955 in Italy, Gamble funds helped establish a birth control center in Rome which Gamble
supplied with contraceptive diaphragms and jellies. Gamble also devised, and contributed sponge
rubber for an ill-fated salt-solution contraceptive experiment carried out in the slums of Rome.
Gamble found it "quite thrilling to have the [birth control] Center opened in the shadow of the
With his new world-wide commitments, and because of the increasing conflicts with groups such
as IPPF and the Population Council, Gamble decided to establish his own organization to oversee
his many population control projects. Thus, in 1957 the Pathfinder Fund was created as a
non-profit, tax-exempt family foundation chartered in the District of Columbia.35
Pathfinder research funds were quickly employed in the development of the Pill and the IUD,
continuing Gamble's earlier support for those projects. At the time of his death in 1966, Gamble
was involved in a 75-country field study regarding the safety and effectiveness of the IUD.
Interestingly, the man obsessed with controlling everyone else's reproduction, produced five
children of his own. Having been born into the lap of luxury with the proverbial silver spoon in
his mouth, Gamble was certainly not a member of that undesireable, underpriveleged class he so
scorned and desired to eliminate. Elites such as Gamble could have all the children they desired.
In a coming issue: Pathfinder and USAID take on the world
1 Pathfinder International Annual Report 1992, p. 5.
2 Randy Engel, "The International Population Control Machine and the Pathfinder Fund,"
International Review of Natural Family Planning, Vol. V, No. 1, Spring 1981, reprinted in booklet
form by the Human Life Center (Collegeville, Minnesota), p. 16. The author is indebted to Mrs.
Engel and her original research on Gamble and the Pathfinder Fund for much of the information
contained in this article.
3 Obituary, Clarence Gamble, The New York Times, 18 July 1966, p. 27.
5 Engel, op cit, p. 12.
6 One of the more ridiculous papers authored by Gamble, published in the American Journal of
the Medical Sciences (194: 79-84, July 1937), was his report on "The Clinical Effectiveness of
Lactic Acid Jelly as a Contraceptive." Of the original 103 patients given the jelly, only 83 could
be located for follow-up (a loss of 19.4 per cent), of whom 42 (51 per cent) had been "irregular
use[rs] or [had] discontinued" use, while another 22 (26 per cent) had "never used" the
concoction. Imagine, an allegedly "scientific" study in which 81.5 per cent of population were
lost to follow-up or had seldom or never used the product being investigated!
7 Obituary, op cit.
8 Journal of Contraception, December 1937, p. 240.
9 Don Wharton, "Birth Control: The Case For The State," The Atlantic Monthly, Vol. 164,
October 1939 164 (10): 463-67.
10 Wharton, ibid.
ll "A Pioneer Public Health Program in Contraception," The Journal of Contraception, January
1938, pp. 14-15. Specifically, Gamble hid his own role in initiating and funding the project and in
providing the nurse and contraceptives used.
12 Donald Klaiss, "Prevenception, the Health Department and the practicing physician," North
Carolina Medical Journal, September 1940, pp. 468-71.
13 Ibid, p. 468.
14 Roy Norton, "A Health Department Birth Control Program," American Journal of Public
Health, Vol. 29, March 1939, p. 253-56.
15 Wharton, op cit, p. 465; Linda Gordon, Women's Body, Women's Right: Birth Control in
America, (Penguin Books: New York), revised edition, 1990, p. 326.
16 Dr. G.M. Cooper, remarks delivered 2 May 1938 at the 28th annual session of the North
Carolina Public Health Association, reprinted in the Transactions of the Medical Society of the
State of North Carolina, 1938, p. 729.
17 Ibid, Clarence Gamble speech, p. 735
18 Ibid, pp. 735-6.
19 "Birth Control and the Negro," Margaret Sanger Collection, Smith College, cited in Gordon,
op cit, p. 328.
20 Letter, Sanger to Clarence Gamble, 19 October 1939, Sanger Collection, Smith College, cited
in Gordon, ibid.
21 Gamble memo, undated but probably November or December 1939, Sanger Collection, Smith
College, cited in Gordon, op cit, p. 329.
22 Letter, Gamble to Sanger, 25 January 1940, Sanger Collection, Smith College, cited in
23 Engel, op cit, p. 13.
24 Cooper, et al, "Four Years of Contraception as a Public (Health Service in North Carolina,"
American Journal of Public Health, Vol. 31, December 1941, pp. 1248-52.
25 Obituary, op cit.
26 Engel, op cit, p. 14.
27 Ibid, p. 15.
28 The Journal of Contraception, May 1938, p. 116.
29 Engel, op cit, p. 15.
32 Ibid, p. 16.
34 Donne and Greer Williams, Every Child A Wanted Child (Boston: Harvard University Press,
1978), p. 381.
35 Engel, op cit, p. 16.