A prime mover of this outcome was Clarence Gamble, President of the Pennsylvania Birth Control Federation, founding member of the Human Betterment League and later of Birthright, heir to the Proctor & Gamble/Ivory Soap fortunes, and correspondent and colleague of Margaret Sanger. Through the years he was involved in initiatives in Israel, India, Hawaii, Egypt, Japan, Ceylon (now Sri Lanka), Pakistan, South Africa, and, in the US, Appalachia and the South, where he maintained that a reduction in the birthrate among African Americans was the solution to the region’s poverty.