Water and the death of ambition in global health, c. 1970-1990 / A água e o fim da ambição na saúde global, c. 1970-1990

Abstract Economic development and good health depended on access to clean water and sanitation. Therefore, because economic development and good health depended on access to clean water and sanitation, beginning in the early 1970s the World Bank, the World Health Organization (WHO), and others began a period of sustained interest in developing both for the billions without either. During the 1980s, two massive and wildly ambitious projects showed what was possible. The International Drinking Water Supply and Sanitation Decade and the Blue Nile Health Project aimed for nothing less than the total overhaul of the way water was developed. This was, according to the WHO, "development in the spirit of social justice."

Resumo Crescimento econômico e boa saúde dependem de acesso a saneamento e água limpa. Assim, o Banco Mundial, a Organização Mundial da Saúde (OMS) e outros órgãos, a partir do início da década de 1970, inauguraram um período de contínuo interesse no desenvolvimento de ambos para bilhões de pessoas desprovidas de tais necessidades. Durante a década de 1980, dois projetos monumentais e extremamente ambiciosos demonstraram o que era viável fazer. A International Drinking Water Supply and Sanitation Decade e o Blue Nile Health Project visavam à total reestruturação do modelo de desenvolvimento da água. Tratava-se, segundo a OMS, do "desenvolvimento do espírito de justiça social".

Global health in the making: health demonstration areas in Europe, 1950s and 1960s / Construcción de la salud global: zonas de demostración sanitaria en Europa, décadas de 1950 y 1960

Abstract Global health is a multifaceted concept that entails the standardization of procedures in healthcare domains in accordance with a doctrine agreed upon by experts. This essay focus on the creation of health demonstration areas by the World Health Organisation (WHO) to establish core nodes for integrated state-of-the-art health services. It explores the origins, theoretical basis and aims of this technique and reviews several European experiences during the first 20 years of the WHO. Particular attention is paid to the historical importance of technical cooperative activities carried out by the WHO in regard to the implementation of health services, a long-term strategic move that contributed to the thematic upsurge of primary health care in the late 1970s.

Resumen Salud global es un concepto complejo que implica la normalización de los procedimientos de actuación sanitaria siguiendo una doctrina acordada por expertos. Este trabajo se ocupa del establecimiento de zonas de demostración sanitaria por la Organización Mundial de la Salud (OMS) a modo de núcleos de modernos servicios sanitarios integrados. Revisa el origen, las bases téoricas y los objetivos de esta técnica y examina diversas experiencias europeas durante los primeros veinte años de la OMS. Pone de manifiesto la importancia histórica de las actividades de cooperación técnica de la OMS en la puesta en marcha de servicios sanitarios, una estrategia de largo plazo que ayuda a entender la aparición de la atención primaria de salud a finales de la década de 1970.

The World Health Organizations changing goals and expectations concerning malaria, 1948-2019 / As mudanças nos objetivos e expectativas da Organização Mundial da Saúde com relação à malária, 1948-2019

Abstract From its inception, in 1948, the World Health Organization made control of malaria a high priority. Early successes led many to believe that eradication was possible, although there were serious doubts concerning the continent of Africa. As evidence mounted that eradicating malaria was not a simple matter, the malaria eradication programme was downgraded to a unit in 1980. Revived interest in malaria followed the Roll Back Malaria Initiative adopted in 1998. This article presents an historical account of the globally changing ideas on control and elimination of the disease and argues that insufficient attention was paid to strengthening health services and specialized human resources.

Resumo Desde sua origem, em 1948, a Organização Mundial da Saúde priorizou o controle da malária. Os primeiros êxitos induziram à crença na viabilidade da erradicação, apesar de sérias dúvidas quanto ao continente africano. À medida que se somavam comprovações de que a erradicação da malária não seria simples, o projeto com essa finalidade foi rebaixado a uma unidade em 1980. O reavivamento do interesse na malária ocorreu após a iniciativa Roll Back Malaria, criada em 1998. Este artigo apresenta um panorama histórico das mudanças nas ideias, em âmbito global, ligadas ao controle e à eliminação da doença e defende a tese de que a atenção dada ao fortalecimento dos serviços de saúde e a recursos humanos especializados foi insuficiente.

Regional cooperation and health diplomacy in Africa: from intra-colonial exchanges to multilateral health institutions / Cooperação regional e diplomacia sanitária na África: dos intercâmbios intracoloniais às instituições multilaterais de saúde

Abstract Tracing the pathways of cooperation in health in sub-Saharan Africa from hesitant exchanges to institutionalized dimensions from the 1920s to the early 1960s, this article addresses regional dynamics in health diplomacy which have so far been under-researched. The evolution thereof from early beginnings with the League of Nations Health Organization to the Commission for Technical Assistance South of the Sahara and the World Health Organization's Regional Office for Africa, shows how bilateral dimensions were superseded by WHO's multilateral model of regional cooperation in health. Alignments, divergences, and outcomes are explored with respect to the strategies and policies pursued by colonial powers and independent African states regarding inter-regional relations, and their implications for public health and epidemiological interventions.

Resumo Trilhando os caminhos da cooperação sanitária na África subsaariana, de intercâmbios incertos a dimensões institucionalizadas dos anos 1920 até início dos anos 1960, este artigo aborda a dinâmica regional na diplomacia sanitária que, até o momento, carece de pesquisas. A evolução, desde os primórdios da Organização da Saúde da Liga das Nações até a Cooperação Técnica na África Subsaariana e o Escritório Regional da África da OMS, demonstra como dimensões bilaterais foram substituídas pelo modelo multilateral da OMS de cooperação sanitária regional. São analisados alinhamentos, divergências e resultados de estratégias e políticas empregados por potências coloniais e Estados africanos independentes em relações inter-regionais, bem como suas implicações em intervenções epidemiológicas e de saúde pública.

The role of the World Health Organization country programs in the development of virology in Spain, 1951-1975 / El papel desempeñado por los programas país de la Organización Mundial de la Salud en el desarrollo de la virología en España, 1951-1975

Abstract Within the framework of recent historiography about the role of the World Health Organization (WHO) in modernizing public health and the multifaceted concept of global health, this study addresses the impact of the WHO's "country programs" in Spain from the time it was admitted to this organization in 1951 to 1975. This research adopts a transnational historical perspective and emphasizes attention to the circulation of health knowledge, practices, and people, and focuses on the Spain-0001 and Spain-0025programs, their role in the development of virology in Spain, and the transformation of public health. Sources include historical archives (WHO, the Spanish National Health School), various WHO publications, the contemporary medical press, and a selection of the Spanish general press.

Resumen En el marco de la reciente historiografía sobre el papel de la Organización Mundial de la Salud (OMS) en la modernización de la salud pública y el concepto multifacético de salud global, se estudia el papel de los llamados "programas país" de la OMS en España desde su admisión en 1951 hasta 1975. Adoptando perspectiva histórica transnacional y enfatizando el estudio de la circulación de personas, conocimientos y prácticas científico-sanitarias, nuestro análisis se centra en los programas España-0001 y España-0025, en evaluar su papel en el desarrollo de la virología en España y en la transformación de la salud pública. Nuestras fuentes vienen de archivos históricos (OMS, Escuela Nacional de Sanidad), publicaciones de la OMS, revistas médicas contemporáneas, y una selección de prensa general española.

Debordering public health: the changing patterns of health border in modern Europe / Tirando as fronteiras da saúde pública: mudanças nos padrões de fronteira sanitária na Europa moderna

Abstract According to David Fidler, the governance of infectious diseases evolved from the mid-nineteenth to the twenty-first century as a series of institutional arrangements: the International Sanitary Regulations (non-interference and disease control at borders), the World Health Organization vertical programs (malaria and smallpox eradication campaigns), and a post-Westphalian regime standing beyond state-centrism and national interest. But can international public health be reduced to such a Westphalian image? We scrutinize three strategies that brought health borders into prominence: pre-empting weak states (eastern Mediterranean in the nineteenth century); preventing the spread of disease through nation-building (Macedonian public health system in the 1920s); and debordering the fight against epidemics (1920-1921 Russian-Polish war and the Warsaw 1922 Sanitary Conference).

Resumo Segundo David Fidler, a gestão de doenças infecciosas entre meados do século XIX e e o XXI guiou-se por uma série de acordos institucionais: Regulamento Sanitário Internacional (não interferência e controle de doenças em fronteiras), programas verticais da OMS (campanhas de erradicação da malária e varíola), e posicionamento pós-vestefaliano além do estado-centrismo e interesse nacional. Mas pode a saúde pública internacional ser reduzida à tal imagem vestefaliana? Examinamos três estratégias que destacaram as fronteiras sanitárias: prevenção em estados vulneráveis (Mediterrâneo oriental, século XIX); prevenção à disseminação de doenças via construção nacional (sistema público de saúde macedônico, anos 1920); remoção de fronteiras no combate às epidemias (guerra polaco-soviética, 1920-1921 e Conferência Sanitária de Varsóvia, 1922).

Historical epidemiology and global health history / Epidemiologia histórica e história global da saúde

Abstract The subdiscipline of historical epidemiology holds the promise of creating a more robust and more nuanced foundation for global public health decision-making by deepening the empirical record from which we draw lessons about past interventions. This essay draws upon historical epidemiological research on three global public health campaigns to illustrate this promise: the Rockefeller Foundation's efforts to control hookworm disease (1909-c.1930), the World Health Organization's pilot projects for malaria eradication in tropical Africa (1950s-1960s), and the international efforts to shut down the transmission of Ebola virus disease during outbreaks in tropical Africa (1974-2019).

Resumo A subdisciplina epidemiologia histórica se propõe a criar um alicerce robusto e refinado para o processo de tomada de decisões em saúde pública global, aprofundando registros empíricos que nos ensinam sobre intervenções passadas. Este artigo se baseia na pesquisa epidemiológica histórica de três campanhas globais de saúde pública para ilustrar essa proposta: os esforços da Fundação Rockefeller para controle da ancilostomose (1909-c.1930), os projetos-piloto da Organização Mundial da Saúde para erradicação da malária na África tropical (décadas de 1950-1960), e os esforços internacionais de interrupção da transmissão do vírus Ebola durante surtos na África tropical (1974-2019).

La hipertensión arterial: un problema de salud internacional / Arterial hypertension: an international health problem

En el mundo actual la hipertensión arterial una de las enfermedades más comunes que afectan la salud humana, siendo patología y factor de riesgo importante para otras enfermedades, por lo que las estrategias de intervención de salud deben estar dirigidas, a la prevención primaria o de ocurrencia y a la secundaria o de progresión. La Organización Mundial de la Salud, en 1974 realizó un proyecto comunitario, en el cual se incluyó a Cuba por sus resultados sanitarios, surge entonces en el Ministerio de Salud Pública, el Primer Programa Nacional para Prevención y Control de la Hipertensión Arterial; en la actualidad coordinado por dicha organización y el Ministerio de Salud se realiza un Programa de Intervención de Salud de esta entidad en la provincia de Matanzas, en un policlínico del municipio cabecera. El objetivo de este trabajo es valorar los contenidos teóricos del tema y con la experiencia acumulada de los autores durante estos años por los roles asistenciales y educativos desempeñados en las Ciencias Médicas, en Cuba y en las misiones internacionalistas (AU).

In the current world, arterial hypertension is one of the most common diseases affecting human health, being pathology and important risk factor for other diseases; therefore the strategies of health intervention should be aimed to the primary or occurrence prevention and to the secondary or progression prevention. In 1974, the World Health Organization developed a community project in which Cuba was included because of its health results. The First National Program for Arterial Hypertension Prevention and Control started then in the Ministry of Public Health. Currently, coordinated by the aforementioned organization and the Ministry of Health, a Program of Health Intervention of this entity is carried out in the province of Matanzas, in one of the policlinics of the capital municipality. The aim of this work is assessing the theoretical contents of the theme on the bases of the experience accumulated by the authors in Medical Sciences, in Cuba and in the international missions (AU).

Políticas sanitarias locales puestas a prueba: consultores, expertos, misiones internacionales y poliomielitis en España, 1950-1975 / Local health policies under the microscope: consultants, experts, international missions and poliomyelitis in Spain, 1950-1975

Este trabajo analisa las misiones de expertos de organismos sanitarios internacionales en España destinadas a informar sobre la situación, las actividades realizadas y las intervenciones necesarias en la lucha contra la discapacidad física de los niños. El Plan España-23 fue el instrumento utilizado por la OMS y otras agencias para poner en marcha el proceso de cambio en un país en transformación durante la larga etapa de vigencia de la dictadura franquista. El trabajo utiliza como fuentes informes inéditos de expertos de la OMS, que fueron resultado de visitas realizadas al país entre 1950 y 1975. El abordaje metodológico consistió en un análisis del discurso que se encuentra en las fuentes y su contextualización en los marcos historiográficos pertinentes.

One of the main focuses of analysis of this paper concerns the missions of international health agency experts to Spain to report on the situation, the activities in the fight against physical disabilities in children and on the actions taken to cope with the problem. The Spain-23 Plan was the instrument used by WHO and other agencies to start the process of change in a country undergoing a period of transformation under the enduring Franco dictatorship. As key sources, the paper uses unpublished reports of WHO experts on the subject, which resulted from visits to the country between 1950 and 1975. The methodological approach consists of an analysis of discourses from primary sources within the historiographical framework.

Doenças crônicas não transmissíveis e associação com fatores de risco / Chronic non-communicable diseases and association with risk factors

Fundamentos: O envelhecimento populacional tem aumentado a prevalência das doenças crônicas não transmissíveis (DCNT). Objetivo: Analisar a associação entre relato de DCNT com fatores de risco. Métodos: Estudo transversal de base populacional com 453 adultos entrevistados, >18 anos de idade, na cidade de Maringá, PR, Brasil, no período de 2011 a 2012. Realizou-se entrevista por meio de questionário proposto pelo Ministério da Saúde. Resultados: Avaliados 453 adultos, idade entre 18-87 anos, média de 52,0±16,2 anos. A presença de DCNT foi observada em 44,8 % (n=203) pacientes. Dos entrevistados 77,5 % eram mulheres; maioria tinha idade ≥60 anos; 54,3 % declararam de 0-8 anos de estudo; 65,3 % eram casados/unidos; e a maioria de cor branca (66,4 %). Após análise por regressão logística, a presença de DNCT foi associada aos adultos mais velhos (p<0,01), aos que declararam cor da pele negra (p=0,01), IMC ≥25 kg/m2 (p<0,01) e entre aqueles que avaliaram sua saúde de modo geral como regular (p<0,01), ruim e muito/ruim (p<0,01). Conclusões: O presente estudo evidenciou que as DCNT foram mais prevalentes nos idosos, nos indivíduos de baixa escolaridade e sem companheiro. Os componentes de risco associados às DCNT foram tabagismo, sobrepeso/obesidade e condição de saúde autorrelatada como ruim/regular.

Background: An ageing population has increased the prevalence of chronic non-communicable diseases. Objective: To analyze the association between chronic non-communicable diseases and risk factors. Methods: This cross-sectional population-based study interviewed 453 adults >18 years old in the town of Maringa, Paraná State during 2011 and 2012. These interviews were conducted through a questionnaire proposed by the Ministry of Health. Results: 453 adults were assessed, between 18 and 87 years old, with a mean age of 52.0±16.2 years and chronic non-communicable diseases noted in 44.8% (n=203). Among these respondents, 77.5% were women, most ≥60 years old, with 54.3% reporting 0-8 years of schooling; 65.3% were married / cohabiting and most (66.4%) were white. After the logistic regression analysis, the presence of chronic non-communicable diseases was associated with older adults (p<0.01), self-declared as black (p=0.01), BMI ≥25 kg/m2 (p<0.01) and rating their health in general as fair (p<0.01), poor and very poor (p<0.01). Conclusions: The present study showed that chronic non-communicable diseases were more prevalent among older people with little schooling and no partners. The risk components associated with chronic non-communicable diseases were smoking, overweight/obesity and self-reported health status as poor/fair.

Joining WHO of Republic of Korea and the Projects in the 1950s / 의사학

The Republic of Korea(ROK) and the World Health Organization(WHO) have done many projects successfully from 1949, in which the government of First Republic joined the WHO. However the relation between the ROK and the WHO have not been studied very much so far. The main purpose of this research, which could be done by the support of WHO, is connected with three questions. First research point would be "how could the ROK joined WHO in 1949 and what's the meaning of it? And the what's the difference in the process for the WHO between the ROK of 1949 and the DPRK(Democratic People's Republic of Korea) of 1973?" The first president of the ROK, Rhee Syngman, who had received his Ph. D.(about international politics) from Princeton University in 1910, was strongly interested in joining international institutes like UN, WHO. The ROK that could join WHO on 17 August 1949, with the approval of Assembly on 25 May 1949, was one of the founder members of the Western Pacific Region. By joining WHO, the ROK could get chance to increase the level of public health and its administration in 1950's. But the DPRK manage to became a member of WHO on 19 May 1973 and joined the South-East Asia Region. The joining of DPRK was influenced by the easing of the cold war after the Nixon Doctrine and the joining of the China(People's Republic of China). Second research point would be "What kind of roll did the WHO take in the First Republic?" Yet the public health administration of the First Republic that had been made in the period of US army military government was been strongly influenced by USA, the roll of WHO was also important in the 1950's. Last research point would be "What kind of the projects did the ROK and the WHO take part in during the period of he First Republic? How could evaluate the results?" The ROK and the WHO handled the projects including health services, communicable disease prevention and control, control of noncommunicable diseases, and protection of health. Specially for the efforts to prevent communicable disease, the WHO focused on leprosy, malaria, measles, smallpox, tuberculosis in 1950's. The First Republic could overcome the bad health condition after the Korea War successfully, supported by WHO.

El proceso de creación de la Organización Mundial de la Salud y la Guerra Fría / The process of creation of the World Health Organization and the Cold War

Este artículo estudia el proceso médico y político de surgimiento de la Organización Mundial de la Salud (OMS), la principal agencia multilateral de salud, formalmente fundada en 1948 y ligada a la recientemente creada Organización de las Naciones Unidas. Este proceso se inició hacia el final de la Segunda Guerra Mundial, en 1945, cuando Estados Unidos y la Unión Soviética colaboraron para vencer a los nazis, y culminó poco después del inicio de la Guerra Fría en 1947, es decir, de la rivalidad entre las superpotencias soviética y norteamericana. La OMS pudo legitimarse en este cambiante contexto y dejar un legado que hasta ahora es importante en la salud pública.

Global and local contexts: the northern Ogoja leprosy scheme, Nigeria, 1945-1960

A missäo católica Ogoja Leprosy Scheme aplicou, em nível local, os conhecimentos internacionais de ponta em lepra, com sucesso e resultados abrangentes, graças ao apoio finaceiro de instituiçöes missionárias da Irlanda, da Grä-Bretanha e dos Estados Unidos, assim como de organizaçöes internacionais como o British Empire Leprosy Relief Association (BELRA). Tirou proveito também de avanços ocorridos no domínio da saúde pública internacional sob os auspícios da OMS e Unicef, na década 1950. O presente artigo combina a apresentaçäo de um bem sucedido programa de controle da lepra, por obra de missionários, com a análise sobre como as políticas médicas internacionais modelaram os parâmetros de sucesso e desenvolvimento de conhecimentos terapêuticos na Nigéria, no final do período colonial.

Visão panorâmica da saúde no mundo e a inserção do home care / Worldwide overview of health and home care

Visão panorâmica da saúde no mundo e a inserção do home care. Descreve a Organização Mundial da Saúde (OMS) em seu aspecto histórico, enfatizando a participação brasileira em sua fundação e alguns dos fatos e eventos mais relevantes que antecederam essa criação. Também descreve a história da Organização Pan-Americana de Saúde (OPS), fundada em dezembro de 1902 e a celebração do seu primeiro centenário em 2002. Uma visão geral da saúde no mundo é oferecida, incluindo-se os aspectos da globalização, como fato irreversível, mudanças demográficas e epidemiológicas, dependência e o trabalho de prestação de cuidados de home care, serviços de home care e políticas de home care.

La Organización Panamericana de la Salud/Organización Mundial de la Salud y la importancia de su labor en el Perú / The Panamerican Health Organization/World Health Organization and the importance of their labor in Peru

Afirma que la OPS ha venido velando por la salud de los pueblos americanos desde su creación; puntualizael cambio de concepto que tiene la salud hoy en dia debido a la evolución a través del tiempo, como también las políticas y los enfoques de la Organización. La colección cuenta con el documento del mismo autor "Historia de la Organización Panamericana de la Salud en el Perú", 1994, con el código PE7.1, 7094

¿Conoce usted la labor de la Organización Mundial de la Salud? / Do you know the labor of Health World Organization?

La Organización Mundial de la Salud, ha realizado una permanente y significativa labor en la promoción del bienestar físico, mental y social de la población mundial, en especial de los sectores de mayor riesgo biológico. Con motivo de su 50º aniversario, la institución está evaluando los resultados obtenidos, para en base a ellos, establecer la conveniencia de introducir eventuales reformas en su estructura y en el desarrollo de sus planes, en estricta concordancia con las necesidades y el requerimiento de sus países miembros. En este contexto, estimamos de interés analizar lo acaecido en medio siglo en torno a la ejecución de los programas, en particular en el ámbito de la salud maternoinfantil y familiar, de gran relevancia en todos los medios

La Organización Mundial de la Salud cumple 50 años / The World Health Organization reaches its 50th. year

In celebration of the World Health Organization's 50th. anniversary, this article features WHO's contribution to the world by examining its current activities in the areas of health, human rights, and development. It briefly summarizes events leading to its establishment over the period from 1851 to 1948, which marks the year when WHO assumed its role as a specialized body of the United Nations. Quoting from various articles in WHO's Constitution, it illustrates the principles that prompt its actions and that have led nations to become aware of their potential goals, thus steering them toward a brighter future. A brief overview of the last 20 years ends with the introduction of WHO's new Director General, Dr. Gro Harlem Brundtland