IDSB04 Chapter 3 Notes – International Health Agencies – October 21, 2009
•Know Sidebar 3-1 Definitions Page 62
The Evolution of international Health after WWII
•Large imperial powers (North America, Europe, Australasia) colonized regions
(Africa, the Carribean, South Pacific, and much of Asia)
•Each imperial power had its own health office, charged with control of epidemic,
medical care, and infrastructure.
•The intense collaboration undertaken to defeat the Axis Powers during WWI helped
US and western European planners envision a future of international economic and
political stability through new institutions and policies.
•The new postwar institutions emphasized recovery of Europe, the formulation of
trade, and currency stabilization; but they soon turned to issues of international
cooperation, health and social development
The Role of UN
•Focus on macroeconomic policy and eventually provide loan conditional on adoption
of anti-inflationary and international payment policies (particularly for
•Origin of UN: When representatives of 26 nations pledged to continue fighting
against the Axis powers.
•In 1945, UN recommended the establishment of a specialized health agency with
•WHO was responsible to coordinate the remnants of the prewar international health
•Many supporters of UN viewed international cooperation idealistically – as a means
of preventing war and freeing humanity from widespread misery
oHowever, even from the start, the UN was designed to maintain the
international balance of power, under the control of a handful of large
From the Colonial Legacy in health to the Cold War
•Relations among the imperial blocks changed fundamentally after WW2,, as explicit
colonialism was replaced with a less politically volatile and less costly division of
•As imperial system gave way to a new political and economic order, the
international health field and its key institutes were shaped by two factors:
oThe context of the Cold war- the political and ideological contest between
Western capitalism and Soviet communism.
oThe paradigm of economic development which was perceived as the sole path
of progress for countries in Asia, Africa, and Latin America.
Current Snapshot of international health actors, agencies, and programs
Multilateral Agencies with a health focus
•Largely UN aligned agencies, with membership of most countries, are aimed at aid,
cooperation, the provision of technical assistance, and the setting of international
norms and standards.
•Multilateral agencies focus on public health while others may have different
mandates on health
•Specialized agencies help set standard, formulate policies, and provide technical
assistance in their areas of expertise. (Example: the world bank)
The World Health Organization
•Flagship of international health organization
•Mission: “the attainment by all people of the highest possible level of health”
•Work of WHO in two major categories
oCentral Technical services include epidemiologic intelligence, development of
international agreements concerned with health, standardization of vaccines
and pharmaceuticals, and the dissemination of knowledge through meeting of
experts and technical reports.
oServices to governments
•The 34 member WHO executive board (EB) may authorize the Director General
(DG) to take action toward combating epidemics, provide health relief to victims of a
calamity, and undertake studies and research on urgent matters
oMembers of EB are representatives from their own countries
•WHO can only intervene when requested and that all resolutions are urged and
never oblige member of states to act.
•Fixed budget comprised of required member state contributions.
oWHO also relies on extrabudgetary contributions that are not subject to
regulation and priority setting by the World Health Agency
•Earliest efforts of WHO involved control of postwar epidemics in the Mediterranean