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East Asian Science, Technology and Society. 2016 Dec; 10(4):445-467.This paper studies the formation of Japanese ventures in family planning deployed in various villages in Asia from the 1960s onward in the name of development aid. By critically examining how Asia became the priority area for Japan's international cooperation in family planning and by analyzing how the adjective "humanistic" was used to underscore the originality of Japan's family planning program overseas, the paper shows that visions of Japanese actors were directly informed by Japan's delicate position in Cold War geopolitics, between the imagined West represented by the United States and "underdeveloped" Asia, at a time when Japan was striving to (re-)establish its position in world politics and economics. Additionally, by highlighting subjectivities and intra-Asian networks centered on Japanese actors, the paper also aims to destabilize the current historiography on population control which has hitherto focused either on Western actors in the transnational population control movement or on non-Western "acceptors" subjected to the population control programs.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr.  p. (FS-15-136; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This executive summary introduces the full report (See POPLINE record 337627) examining the 50-year period starting in the mid-1960s that witnessed a dramatic decline in fertility and steady increase in contraceptive use in the Latin America and Caribbean (LAC) region.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr.  p. (SR-15-118C; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. El Salvador has made enormous progress in terms of family planning over the past five decades. It has reduced fertility rates; it has developed a robust legal and regulatory framework for FP; it has allocated resources for procuring contraceptives for its population; it now offers information and contraceptive services to the entire population of the country with the active participation of civil society organizations, especially women’s organizations.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr.  p. (SR-15-118F; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. Nicaragua has made significant progress in improving its macro-level primary health care indicators, reducing maternal mortality and increasing contraceptive prevalence. There has also been increased participation by the Instituto Nicaragense de Seguridad Social (INSS) in providing family planning services and commodities, thus reducing the burden on health ministry facilities. The government has shown its strong commitment to comprehensive services to improve the health of the population.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr.  p. (SR-15-118H; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. The family planning movement in Haiti began in the 1960s, only a short time after family planning activities had been initiated in many other countries in the Latin American and Caribbean region. Initially, doctors and demographers worked together to encourage government policies around the issue and to begin private sector service provision programs in much the same way early family planning activities occurred elsewhere. Yet, in comparison with other countries within the region, Haiti’s progress on reproductive health has been slow.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr.  p. (SR-15-118A; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. Family planning has become so deeply entrenched as a social norm in Colombia that it no longer constitutes the special area of interest that it did in the 1960s and 1970s. Nonetheless, challenges remain.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr.  p. (TR-15-101; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This report examines the 50-year period starting in the mid-1960s that witnessed a dramatic decline in fertility and steady increase in contraceptive use in the Latin America and Caribbean (LAC) region. The current contraceptive prevalence rate (all methods) of 74 percent is among the highest of any region in the developing world. Many factors have contributed to the dramatic decline in fertility in the LAC region over the past 50 years: increased educational levels, improved economic conditions, decreased infant and child mortality, rapid urbanization, political stability, and changing cultural norms, among others. While recognizing the influence of these factors on fertility, what role did use of family planning play in fertility decline in the region? What lessons can be drawn for other developing countries committed to a development path that strengthens family planning services and improves health and living standards for their people? This report examines the specific role of family planning in accelerating fertility decline in the LAC region.
Washington, D.C., Population Action International, 2008.  p.This report was developed through review of the early literature on HIV/AIDS policies and programs in non-industrialized countries and of media material promoting prevention of heterosexual transmission of HIV in those countries. Material from the early days of the epidemic was difficult to obtain. Most materials were long ago archived or are in personal files in "basements". While the report focuses on the experiences of three countries, it also examines the early responses of international organizations to HIV in many other developing countries. Additional data were obtained using a snowball sampling technique through which the authors contacted people who had worked in HIV/AIDS prevention strategies. The pool of respondents is not intended to be exhaustive, but the respondents provide important voices of those working in the developing world at the beginning of the epidemic.
In: The global family planning revolution: three decades of population policies and programs, edited by Warren C. Robinson and John A. Ross. Washington, D.C., World Bank, 2007. 155-174.In Jamaica, as in many countries, the pioneers of family planning were men and women who sought to improve the well-being of their impoverished women compatriots, and who perhaps were also conscious of the social threats of rapid population growth. When, eventually, population control became national policy, the relationship between the initial private programs and the national effort did not always evolve smoothly, as the Jamaican experience shows (see box 10.1 for a timeline of the main events in relation to family planning in Jamaica). A related question was whether the family planning program should be a vertical one, that is, with a staff directed toward a sole objective, or whether it should be integrated within the public health service. These issues were not unique to Jamaica, but in one respect Jamaica was distinctive: it was the setting for the World Bank's first loan for family planning activities. Family planning programs entailed public expenditures that were quite different from the infrastructure investments for which almost all Bank loans had been made, and the design and appraisal of a loan for family planning that did not violate the principles that governed Bank lending at the time required a series of decisions at the highest levels of the Bank. These decisions shaped World Bank population lending for several years and subjected the Bank to a good deal of external criticism. For that reason, this chapter focuses on the process of making this loan. (excerpt)
Jornal de Pediatria. 2006; 82 Suppl(3):S1-S3.In the last few decades, immunization -- one of the greatest breakthroughs in health sciences -- has increasingly gained significant ground all over the world. Advances in general sciences, microbiology, pharmacology and immunology have, together with results of epidemiology and sociology studies, demonstrated the remarkable impact of vaccines on society and the importance of vaccination in health promotion and disease prevention. In the beginning of the 17th century, smallpox was one of the most devastating communicable diseases in the world; it affected most individuals before they reached adulthood, and had high mortality rates. Lady Mary Montagu, wife of the British ambassador in Istanbul at the time, observed that the disease could be avoided by using a technique adopted by Muslims, who inoculated dried pus from smallpox pustules obtained from an infected patient into the skin of healthy individuals. This procedure, known as "variolation," probably originated in China; later, it was taken to Western Europe. Although it led to several cases of death due to smallpox, it was used in England and in the United States until the beginning of investigations by British physician Edward Jenner, whose research results were published in the study Variolae Vaccinae in 1798. Dr. Jenner studied peasants who developed a benign condition known as "vaccinia" due to their contact with cowpox, and his investigation resulted in the development of the first immunization techniques. (excerpt)
American Journal of Public Health. 2006 Jan; 96(1):62-72.The term "global health" is rapidly replacing the older terminology of "international health." We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term "global health" emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances. Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context. (author's)
Population Index. 1948 Apr; 14(2):97-104.Research in migration has been peculiarly susceptible to the changing problems of the areas and the periods in which demographers work. American studies of international movements diminished after the passage of Exclusion Acts, and virtually ceased as immigration dwindled during the depression years. On the other hand, surveys of internal migration proliferated as the facts of mass unemployment and the social approaches of the New Deal focused governmental attention on the relation of people to resources and to economic opportunity. Geographers and historians took over the field the demographers had vacated. The studies of pioneer settlement directed by Isaiah Bowman and those of Marcus Hansen dealing with the Atlantic crossing are outstanding illustrations of this non-demographic research on essentially demographic problems. Even when demographers investigated international movements they served principally as quantitative analysts of historical exchanges. This is not to disparage such studies as that of Truesdell on the Canadian in the United States, or of Coates on the United States immigrant in Canada, but merely to emphasize the point that Americans regarded international migration as an issue of the past. (excerpt)
[Unpublished] 2001. Presented at the International Union for the Scientific Study of Population, IUSSP, 24th General Conference, Salvador, Brazil, August 18-24, 2001. 17 p.The purpose of this paper is to sketch the common lines of development of both the scientific elaboration of world population projections and the international political debate that prepared the ground for such projections and encouraged their development. A partial history of the elaboration of world population projections has already been written. International population debates from the XIX° and XX° centuries are also under scrutiny. But the link between these two developments has not been fully established. The link between projections and politics work both ways. In one direction, projections can contribute to a rationalization of government in the area of economic development, urban planning and so on. They provide societies with a partial view of their future. In the other direction, population projections cannot be undertaken without the help and support of governments and major international organizations. They rely on accurate and detailed censuses. They are costly and time consuming. At both end of the spectrum, there is a need for a global consensus not only within the scientific community and political arenas for population projections to be computed, received and considered as legitimate. More than many other instruments of demographic analysis, the history of world population projections demonstrate these linkages. (excerpt)
Women's organizations in El Salvador: history, accomplishments, and international support. [Organizaciones femeninas en El Salvador: historia, logros y apoyo internacional]
In: Women and civil war. Impact, organizations, and action, edited by Krishna Kumar. Boulder, Colorado, Lynne Rienner Publishers, 2001. 183-203.Women's organizations in El Salvador have undergone a unique evolution, first in relation to the conditions of war that permeated El Salvador from 1980 to 1992 and then in response to economic restructuring and the challenges of democratization following the war. The conditions of El Salvador's civil war, along with the fact that many women's organizations became stronger during the war, have resulted in a unique set of organizations that are marked by their autonomy at the beginning of the twenty-first century. Early-conflict women's organizations (1980 to 1985) were characterized by their attachment to a wide range of popular grass-roots organizations and attempts to incorporate women into these groups. Many of these organizations mobilized women around economic issues, survival in the war, and human rights. A few formed in this period began to work with battered women and to question women's legal, political, and domestic subordination. Few, however, were willing to embrace the concept of feminism. Late-conflict and post-conflict women's organizations (1986 to 2001) are characterized by women challenging gender hierarchies within mixed grass-roots organizations and putting forth a gendered discourse on specific women's rights, ranging from violence against women to inequities in the labor force. Feminism also became more prevalent during this time. In this chapter we look at the particular changes found in women's organizations and link them to specific historical, social, and economic circumstances. We then evaluate what the impact of women's organizations has been in terms of empowering Salvadoran women and make recommendations for international donor organizations so that they can better serve Salvadoran women's organizations. (excerpt)
[Technical cooperation of PAHO / WHO in the traditional midwives program] Cooperación técnica de OPS / OMS al programa de parteras tradicionales.
In: La partera tradicional en la atención materno infantil en México, [compiled by] Mexico. Secretaría de Salud. Programa Nacional de Parteras Tradicionales. Mexico City, Mexico, Secretaría de Salud, Programa Nacional de Parteras Traditionales, 1994. 137-145.Mexico is one of the pioneering countries with the most experience in the work of traditional midwives, not only in the Latin American region, but throughout the world. Formal activities were initiated in 1937 and were mainly focused on training. To date, the institutions authorized to train traditional midwives in the country (the Secretariat of Health, the National Indigenous Institute, and the Mexican Social Security Institute) have registered approximately 24,000 midwives, of which 75% are trained. During this period, many strategies developed in Mexico have been disseminated and adopted by other countries in the region. (excerpt)
[A review of breastfeeding in Brazil and how the country has reached ten months' breastfeeding duration] Reflexôes sobre a amamentação no Brasil: de como passamos a 10 meses de duração.
Cadernos de Saude Publica. 2003; 19 Suppl 1:S37-S45.In 1975, one out of two Brazilian women only breastfed until the second or third month; in a survey from 1999, one out of two breastfed for 10 months. This increase over the course of 25 years can be viewed as a success, but it also shows that many activities could be better organized, coordinated, and corrected when errors occur. Various relevant decisions have been made by international health agencies during this period, in addition to studies on breastfeeding that have reoriented practice. We propose to review the history of the Brazilian national program to promote breastfeeding, focusing on an analysis of the influence of international policies and analyzing them in four periods: 1975-1981 (when little was done), 1981-1986 (media campaigns), 1986-1996 (breastfeeding-friendly policies), and 1996-2002 (planning and human resources training activities backed by policies to protect breastfeeding). The challenge for the future is to continue to promote exclusive breastfeeding until the sixth month, taking specific population groups into account. (author's)
[International system of protection of the human rights of women] Sistema internacional de proteccion de los derechos humanos de las mujeres.
In: Derechos humanos de las mujeres. Aportes y reflexiones, [compiled by] Movimiento Manuela Ramos. Lima, Peru, Movimiento Manuela Ramos, 1998 Nov. 161-97. (Serie Mujer y Derechos Humanos 6)The evolution over the past few decades of international law protecting the human rights of women is described, and the international instruments designed to protect these rights are assessed from the perspective of jurisprudence. The first sections examine factors that have allowed implantation of a culture of human rights throughout the entire planet to emerge as a goal of international law, and describe some assumptions underlying the theme of human rights of women. Documents that were crucial in the evolution are then analyzed, including the UN Charter, the first instrument expressly signaling the equality of rights of men and women, and the Universal Declaration of Human Rights. The UN Commission on the Juridical and Social Condition of Women and the Fourth International Conference on Women in Beijing in 1995 are also discussed. Mechanisms for international protection of the rights of women are examined, including the Declaration on Elimination of Discrimination Against Women and the Convention on Elimination of All Forms of Discrimination Against Women. Other organs for protection that are discussed include the Human Rights Committee and the Committee for Elimination of Discrimination Against Women, and regional mechanisms such as the Interamerican Human Rights Commission and Court and the Interamerican Conventions on Political Rights of Women, Civil Rights of Women, and Against Gender Violence. The final section contrasts the normative development of protections for women’s human rights with actual practices, and identifies the next steps that should be taken.
REVISTA DE NUTRICAO DA PUCCAMP. 1997 Jan-Jun; 10(1):5-19.The study analyzed the critical contribution of the WHO, PAHO, and FAO to the literature on nutritional education, which provides the material for teachers of nutritional education courses. The differences between education and orientation were summarized. Various challenges were also listed for nutritionists pertaining to the teaching, research, and implementation of programs. The first publication of the WHO that dealt specifically with nutrition education was published in 1951. It addressed eating habits and their social significance as well as the organization of nutrition programs. The major contributors to nutrition education included the following authors: Jean Ritchie (1951; dealing with good nutritional habits); Jean Ritchie (1968; addressing agronomists, economists, physicians, health personnel, and biochemists); Burgess and Dean (1963; techniques for the implementation of programs); Jelliffe (1970; human suffering caused by living conditions and malnutrition); Bosley (1976; nutrition education and preventive medicine); Mushkin (1982; investment in nutrition and economic development); Jelliffe (1983; the planning process in nutrition education); and Williams (1991; food, environment, and health). Some other authors (Reboul, 1974; Freire, 1983; Alves, 1984; Morais, 1986; Freire, 1985; Amatuzzi, 1989; Garcia, 1992) dealt with the problem of how to change human thinking to ensure the successful implementation of programs. The challenges in the area of nutrition education are the construction of theories supporting research that reflect reality, the implementation of nutrition education activities in public health services, and investment in the training of specialists.
[From family planning to reproductive health and beyond. Draft] De la planificacion familiar a la salud reproductiva y mas alla. Borrador para libro.
[Unpublished] 1997 Mar. 155,  p.This work traces the evolving orientation of institutional family planning at the international level, from the beginning of the birth control movement in the US around 1915 to the recent consensus that family planning should be considered in the broader framework of reproductive health. The opening chapter discusses the origins of the antinatalist movement in the birth control, eugenics, and population control movements and the beginning of US government involvement in family planning. Family planning and its objectives are defined, and the growing view of family planning as a right is discussed in chapter 2. The pressures and achievements of the 1974 World Population Conference in Bucharest, which led to a broadening of the focus to encompass issues of development, are assessed. The impact of the environmental movement and the international decade of women, and the economic crisis of the 1980s in Latin America and its consequences for family planning are discussed. The attitudes expressed at the 1984 World Population Conference in Mexico City and the decline of US support for international family planning activities are then examined. Beginning around the mid-1980s, a series of shortcomings in family planning programs were noted at the same time that worldwide survey programs demonstrated impressive gains in family planning in developing countries. The gathering movement for reproductive health was embraced by foundations, and reflected in changes of emphasis in the most important international organizations. The focus on reproductive health prevailed at the 1994 International Conference on Population and Development in Cairo, but doubts have arisen since then over the future of support for family planning and other reproductive health services.
American Journal of Public Health. 1999 Mar; 89(3):399-407.Despite conceptual advances that incorporate broad structural approaches, international agencies embrace a persistent reliance on "reductionist reproductive terms" to define women's health. This article locates the origins of this phenomenon in the policies and activities of the Rockefeller Foundation's (RF) public health program in Mexico in the 1920s and 1930s. After an introduction, the article describes the Mexican work of the RF and how it "stumbled upon" gender health differentials during a hookworm eradication campaign and then furthered gender stereotypes in its health education materials. The article continues with a consideration of the RF's eventual dual targeting of women as patients and as public health workers (nurses) during the effort to create permanent health units and institute a system of nurses who visited homes as proponents of the supremacy of modern medicine. Next, the article describes how the RF further entered women's domain by identifying, monitoring, and training traditional midwives. This targeting of midwives coupled with a total disregard for every aspect of traditional midwifery reflected the RF's policy of blaming midwives for infant mortality while ignoring socioeconomic determinants. The policy also exacerbated the differentials of social class by elevated working- and middle-class nurses and denigrating peasant midwives. The article concludes that the RF's faulty and often ineffectual policies in Mexico created the women's health paradigm based on reproduction that was later intensified by population control efforts and that fails to advance health for all as a matter of equity.
INTERNATIONAL JOURNAL OF HEALTH SERVICES. 1997; 27(3):523-40.This article draws largely on the work of Linda Gordon's "Woman's Body, Woman's Right" and of Bonnie Mass's "Population Target" to analyze the history of the birth control movement and trace the elements present in current debate to their origins in the conflicts and contradictions of the movement's history. After noting that humans have attempted to control births since ancient times, the article begins with the efforts of English radical neo-Malthusians to promote birth control and continues by sketching the change in emphasis from poverty reduction to women's rights. By the 20th century in the US, changing views of sexuality and working-class militancy ignited the US birth control movement and inspired the work of Margaret Sanger. After Sanger split with social radicals, professionals and eugenicists began to play a major role in population control efforts. Eugenicists and racists attempted to use birth control for social engineering; it was to be used again as a tool in a new era of social planning after World War II when it metamorphosized into "family planning." The US need for the resources of developing countries led to concerns about population growth fueling nationalistic fires. Thus, private agencies began a postwar population control effort in developing countries. This received official US approval with the 1958 report of the Draper Committee that targeted world population growth as a US security issue. In 1966, Dr. Ravenhold led the US Agency for International Development into the population field. Population control efforts garnered international opposition at the World Population Conference in Bucharest in 1974, however, but this had little impact on the strong US commitment to population control.
Intimidation, coercion and resistance in the final stages of the South Asian smallpox eradication campaign, 1973-1975.
Social Science and Medicine. 1995 Sep; 41(5):633-45.Occasions during 1973-75 are reviewed when physician-epidemiologists working under the auspices of the World Health Organization (WHO) in south Asia intimidated local health officials and resorted to coercive vaccination in the final stages of the Smallpox Eradication Program (SEP). The SEP was established inside this structure in 1962 with the goal of immunizing 80% of the population. By 1964, however, when 80% coverage had indeed been achieved in some states, outbreaks continued to occur because vaccination had been concentrated on the most accessible groups. From 1964 to 1967 a goal of 100% vaccination was set to include slum dwellers, migrant workers, and fishermen in less accessible regions. However, still numerous outbreaks occurred with more than 130,000 cases reported between 1970 and 1973. In mid-1973 an intensified campaign was launched in both India and Bangladesh under WHO guidance that appointed expatriate epidemiologists to work in cooperation with national SEP authorities. Surveillance teams were equipped with jeeps and motorcycles so they could search markets, schools, pilgrimage sites, tea-shops, and slums for cases. Repeated village-to-village and house-to-house searches were launched in both countries; cash awards were offered for hidden cases; rigorous containment measures were taken; and motorized teams rushed to the scene of outbreaks to backstop local vaccination personnel. Nonetheless, the SEP came close to a collapse in the first six months of 1974 with an explosion of outbreaks in Bihar and Madhya Pradesh. After June of 1974 the number of foreign epidemiologists doubled to about 100. Coercion was justified by containment, and in the last phase of the campaign, containment was defined to mean the vaccination of everyone living within a 1-1.5 km radius of an outbreak. Sustained resistance was infrequent, but there were a range of coercive encounters involving American WHO advisers during this period of time that were all documented by the advisors involved.
BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION. 1992; 26(4):391-7.From 1961 onwards, the Pan American Health Organization (PAHO) has been instrumental in the setting of regional health plans, each of which has served as a blueprint for hemispheric and national action. In 1961, when the Charter of Punta del Este proclaimed the 10-year public health program of the Alliance for Progress, health became a concern of chiefs of state. The 10-year public health program set forth the goals to increase life expectancy by a minimum of 5 years and to improve individual and public health. In 1963 the Task Force on Health at the ministerial level met. PAHO convened over a 15-year period a series of 4 special meetings of Ministers of Health. PAHO and the Center for Development and Social Studies (CENDES) in Venezuela worked together to devise the CENDES/PAHO method of normative planning. The presidents of most of the American states, meeting in Punta del Este in 1967, committed themselves to the expansion of programs for the improvement of health. At the 1972 meeting the ministers devised a new 10-Year Health Plan for the Americas declaring health a universal right. At the 1977 meeting the ministers endorsed the goal of health for all; they adopted a regional policy that defined primary health care. In 1980 the regional strategies spelled out the targets essential to achieving the goal of health for all by the year 2000: immunization services will be provided by 1990 to 100% of children under 1 year of age; and access to safe drinking water and sewage disposal will be extended to 100% of the population. During 1987-1990 PAHO was to channel its efforts toward development of health services infrastructures with emphasis on primary health care. The XXIII Pan American Sanitary Conference, meeting in 1990, established guidelines for 1991-1994 in the area of health programs, the environment, food and nutrition, eradication of preventable diseases, maternal and child health, workers' health, drug addiction, and AIDS.
BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION. 1992; 26(4):469-74.The decisions of the first Pan American Sanitary Conferences, which focused on improving sanitary conditions and decreasing pestilent diseases in ports and territories, undoubtedly were aimed at facilitating international trade. The creation of the International Sanitary Bureau and the adoption of the Pan American Sanitary Code were pivotal steps in establishing a firm basis for hemisphere-wide cooperation. The VIII Pan American Sanitary Conference, held in 1927, recommended that member countries establish special agencies within their health administrations in order to ensure the best possible living and working conditions for workers. The creation of the World Health Organization in 1948 represented an enormous humanitarian step, in that it legitimized the desire of the majority of the countries in the world to consider health as a fundamental human right. An agreement signed in 1950 with the Organization of American States set forth PAHO's functions as a specialized inter-American agency, defining the way in which the 2 organizations would coordinate their efforts and reinforcing the concept of health as a basic component of development. Particular emphasis was placed on programs aimed at controlling various diseases as, for example, the malaria campaign; projects to supply water; and general sanitation, as a means of preventing basic health problems. The 10-Year Health Plan for the Americas covered the 1970s. The target of health for all by the year 2000 was adopted in 1977 by the 30th World Health Assembly. By 1980, all the countries had formulated national health strategies and many had developed health sector plans. The campaign launched in 1985 to eradicate poliomyelitis was successful. Some countries had succeeded in boosting life expectancy, reducing infant mortality, and increasing immunization against the common childhood diseases. Yet after 2 decades of economic growth, the number of poor people had increased by 50%, inequalities had been exacerbated, and numerous health needs were not being met.
BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION. 1992; 26(4):370-8.In 1902 the First General International Sanitary Convention specified that countries should dispose of garbage to prevent the spread of diseases and to disinfect the discharges of all typhoid and cholera patients. The Pan American Sanitary Bureau was to elicit information regarding the sanitary conditions in their ports and territories and to encourage seaport sanitation, sewage disposal, soil drainage, street paving, and elimination of the sources of infection from buildings. The 2nd and 3rd Pan American Conferences of National Directors of Health, in 1931 and 1936, focused on topics of urban and rural sanitation, safe water and milk supplies, and industrial hygiene. In 1948 the Inter American Association of Sanitary Engineering (AIDIS) was created for the exchange of new ideas, experiences, and technologies. From 1942 to 1948, these special public health services benefited an estimated 23 million people by extending potable water supply and sanitation in the region and training hundreds of Latin American sanitary engineers. The 1961 American Governments' Charter of Punta del Este envisioned extending, over a 10-year period, water supply and excreta disposal services to 70% of the urban and 50% of the rural populations. In 1968, the Pan American Health Organization (PAHO) established the Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS), with headquarters in Lima. Over the years, CEPIS projects have encompassed air pollution, wastewater treatment and stabilization ponds, water treatment systems, solid waste collection and treatment, development of water and sewerage systems, and industrial hygiene. The 10-Year Health Plan for the Americas (1971-1980) stipulated that cities with more than 500,000 inhabitants establish programs to control pollution. 10 years later, actual coverage was: urban water supply, 82%; urban sewerage, 78%; rural water supply, 47%; and rural excreta disposal, 22%. PAHO's recent policy, Strategic Orientations and Program Priorities for 1991-1994, formulates workers' health programs with the aim of increasing service coverage to curtail risks to occupational health.