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Your search found 14 Results

  1. 1

    Action on the social determinants of health: learning from previous experiences.

    Irwin A; Scali E

    Geneva, Switzerland, World Health Organization [WHO], 2010. [52] p. (Discussion Paper Series on Social Determinants of Health No. 1)

    Today an unprecedented opportunity exists to improve health in some of the world's poorest and most vulnerable communities by tackling the root causes of disease and health inequalities. The most powerful of these causes are the social conditions in which people live and work, referred to as the social determinants of health (SDH). The Millennium Development Goals (MDGs) shape the current global development agenda. The MDGs recognize the interdependence of health and social conditions and present an opportunity to promote health policies that tackle the social roots of unfair and avoidable human suffering. The Commission on Social Determinants of Health (CSDH) is poised for leadership in this process. To reach its objectives, however, the CSDH must learn from the history of previous attempts to spur action on SDH. This paper pursues three questions: (1) Why didn't previous efforts to promote health policies on social determinants succeed? (2) Why do we think the CSDH can do better? (3) What can the Commission learn from previous experiences -- negative and positive -- that can increase its chances for success? (Excerpt)
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  2. 2

    Reproductive and sexual rights: do words matter? [editorial]

    Gruskin S

    American Journal of Public Health. 2008 Oct; 98(10):1737.

    The 1994 Cairo International Conference on Population and Development helped governments, the organs and agencies of the United Nations system, and nongovernmental organizations move beyond the confines of traditional family planning approaches. This watershed event fostered and defined subsequent international and national reproductive and sexual health policies and programs as well as global efforts to realize reproductive and sexual rights. However, moving beyond history, or the "archeology of Cairo" (as a participant at a meeting I recently attended called it), are we now simply using the language of the Cairo conference with little attention to the conceptual and operational implications of its words? Has the politically charged notion of rights with its attendant government responsibility and accountability succumbed to the less controversial notion of health? As the public health community recognized even before the Cairo consensus, barriers to reproductive and sexual health operate on a number of levels-including legal, social, cultural, political, financial, attitudinal, and practical -- and interact in complex ways. What rights add to this mix is a framework for programming and for action and a legal rationale for government responsibility-not only to provide relevant services but also to alter the conditions that create, exacerbate, and perpetuate poverty, deprivation, marginalization, and discrimination as these affect reproductive and sexual health. By fixing attention on the responsibility and accountability of governments to translate their international-level commitments into national and subnational laws, policies, programs, and practices that promote and do not hinder reproductive and sexual health, the actions of governments are open to scrutiny to determine their influences-both positive and negative-on reproductive and sexual health, including barriers that affect the availability, accessibility, acceptability, and quality of reproductive and sexual health services, structures, and goods. Despite the framework that the Cairo conference helped put into place, work falling under the rubric of reproductive and sexual rights now includes everything from the provision of abortion services to the reduction of maternal mortality -- as though simply working on these issues is equal to working on rights. Consequently, one has to ask this: Are reproductive, and even sexual, rights becoming synonymous with reproductive, and sexual, health? Those who understand their work to be in the area of reproductive and sexual rights sorely need to discuss whether their efforts are aligned with the politics that underlie the words of the Cairo conference or whether, bluntly speaking, the politics are a historical artifact and it is simply time to move on. Bringing the political back into reproductive and sexual rights would require going beyond the technical dimensions of addressing reproductive and sexual health issues to the application of the norms and standards that are engaged by a human rights discourse. This includes attention to the basics of reproductive and sexual rights: the efforts that exist to ensure the sustained participation of affected communities; how discrimination that affects both vulnerability to ill health and access and use of services is being tackled; the extent to which any legal, political, and financial constraints are being addressed; how rights considerations are brought into policy and program design, implementation, and evaluation; and the existence of mechanisms that require government as well as intergovernmental and nongovernmental institution accountability. And so yes, in a word, words do matter. And they matter for the actions they inspire. (full-text)
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  3. 3
    Peer Reviewed

    The World Health Organization and its work. 1993.

    Bynum WF; Porter R

    American Journal of Public Health. 2008 Sep; 98(9):1594-7.

    In 1948, after its first World Health Assembly, the WHO took action to form a Secretariat in Geneva. It was given space for its initial years in the Palais des Nations, which had been the last home of the League of Nations. As stated in Chapter I of its Constitution, WHO was "to act as the directing and coordinating authority on international health work." This was a much broader scope than any other international agency in the orbit of the UN. (excerpt)
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  4. 4

    Vikings against tuberculosis: The International Tuberculosis Campaign in India, 1948 -- 1951.

    Brimnes N

    Bulletin of the History of Medicine. 2007 Summer; 81(2):407-430.

    Between 1947 and 1951 the Scandinavian-led International Tuberculosis Campaign tested more than 37 million children and adolescents for tuberculosis, and vaccinated more than 16 million with BCG vaccine. The campaign was an early example of an international health program, and it was generally seen as the largest medical campaign to date. It was born, however, as a Danish effort to create goodwill in war-ravaged Europe, and was extended outside Europe only because UNICEF in 1948 unexpectedly donated US $2 million specifically for BCG vaccination in areas outside Europe. As the campaign transformed from postwar relief to an international health program it was forced to make adaptations to different demographic, social, and cultural contexts. This created a tension between a scientific ideal of uniformity, on the one hand, and pragmatic flexibility on the other. Looking at the campaign in India, which was the most important non-European country in the campaign, this article analyzes three issues in more detail: the development of a simplified vaccination technique; the employment of lay-vaccinators; and whether the campaign in India was conceived as a short-term demonstration or a more extensive mass-vaccination effort. (author's)
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  5. 5
    Peer Reviewed

    The World Health Organization and the transition from "international" to "global" public health.

    Brown TM; Cueto M; Fee E

    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)
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  6. 6
    Peer Reviewed

    Promoting sexual health and responsible sexual behavior: an introduction.

    Coleman E

    Journal of Sex Research. 2002 Feb; 39(1):[11] p..

    We are at a unique juncture in history and have a rare opportunity to develop global, national, and community strategies to promote sexual health for the new century. This opportunity has been created by the fact that the world is experiencing a new sexual revolution and a public health imperative. Much like the sexual revolution of the 1960s and 1970s, it is a revolution fueled by incredible scientific advances, as well as dramatic social and economic change. We also face a myriad of sexual health problems, which is creating an enormous burden on societies. These two factors are putting pressure on health ministries to develop comprehensive approaches to sexual health promotion. The last major attempt at developing global strategies for promoting sexual health was fueled by the previous sexual revolution of the 1960s and 1970s. In 1975, the World Health Organization (WHO) produced a document Education and Treatment in Human Sexuality: The Training of Health Professionals. This historic document called upon societies around the world to develop the necessary sexuality education, counseling, and therapy to promote sexual health and to provide the necessary training for health professionals. This document also served as a stimulus for the development of the field of sexology and sexual resources centers throughout the world. (excerpt)
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  7. 7
    Peer Reviewed

    Kochi's tuberculosis strategy article is a "classic" by any definition.

    Sbarbaro JA

    Bulletin of the World Health Organization. 2001; 79(1):69-70.

    This article reviews the 1991 paper by Arata Kochi on the strategy of WHO to control tuberculosis. It notes that Kochi's paper did not report a new scientific discovery, rather it depicted the devastating impact of tuberculosis around the world in a clear and forceful manner. Consequently, it changed the public health focus of WHO, national governments and leading voluntary organizations. Kochi's paper pinpointed three major programmatic deficiencies that had to be overcome: inadequate treatment services; high rates of failure to complete therapy; and the worldwide absence of adequate governmental surveillance and monitoring systems. Furthermore, the paper gave attention to the role of public health in addressing the tuberculosis issue. To address the problem, Kochi emphasized that it would take strong, directive leadership by national government to implement systems for an effective prevention and control program for tuberculosis.
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  8. 8
    Peer Reviewed

    Skirting the issue: women and international health in historical perspective.

    Birn AE

    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.
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  9. 9

    Improving people's health through planning.

    Pan American Health Organization [PAHO]


    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.
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  10. 10

    Health: a condition for development.

    Pan American Health Organization [PAHO]


    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.
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  11. 11

    Health and the environment.

    Pan American Health Organization [PAHO]


    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.
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  12. 12

    The right to health -- 1958-1975.

    Pan American Health Organization [PAHO]


    In signing the Act of Bogota in 1960, the member countries of the Organization of American States agreed to cooperate in promoting accelerated economic and social development. The Charter of Punta del Este, Uruguay, in 1961, had the objectives of increasing life expectancy by a minimum of 5 years and improving health. Death rates for infectious diseases were 41% lower in 1963 compared to 1956; those for diseases of the digestive system decreased 35%; and those resulting from ill-defined causes dropped 35%. Malaria deaths dropped from an annual average of 43,368 during 1950-1952 to 2285 in 1964. The Ten-Year Health Plan for the Americas, 1971-1980, gave first priority to the rights of the 120 million people without access to even minimal care. The Pan American Health Organization (PAHO) continued its efforts to eradicate Aedes aegypti, vector of both yellow fever and dengue. To combat poliomyelitis, PAHO collaborated on trials of live attenuated poliovirus vaccine. It also prepared a continental plan to combat tuberculosis and intensify leprosy case detection. Other targets were measles, whooping cough, tetanus, diphtheria, typhoid fever, plague, and such parasitic afflictions as Chagas' disease and schistosomiasis. Both the Charter of Punta del Este and the Ten-Year Health Program singled out sanitation, water supplies, and sewerage services, and during the 1960s and 1970s PAHO gave priority to environmental health. During this period its rural health strategy targeted some 40% of the population; and between 1970 and 1973, 35-40% of the total PAHO budget was dedicated to educational activities. Immunization programs were stepped up, breast-feeding stressed, education of mothers promoted, and prenatal and perinatal health services emphasized. Throughout the 1960s and early 1970s, PAHO developed research projects in acute infections, nutritional states, the role of Simuliidae as vectors of onchocerciasis, live attenuated virus vaccine against foot-and-mouth disease, and zoonoses and their prevention.
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  13. 13

    The burgeoning Bureau -- 1920-1946.

    Pan American Health Organization [PAHO]


    The 6th International Sanitary Conference of the American Republics met in Montevideo, Uruguay, December 12-20, 1920, and elected the US Surgeon General, Dr. Hugh S. Cumming, to head the Pan American Sanitary Bureau. When the 7th Pan American Sanitary Conference met in Havana, Cuba, in 1924, it drafted a Pan American Sanitary Code, which was eventually ratified as an international treaty by all 21 republics. The Bureau assumed in 1926 responsibility for the Pan American Conferences of National Directors of Health of the American Republics. Taking place between Pan American Sanitary Conferences, 6 Conferences of National Directors were held between 1926 and 1948. In the annual report of the Director for 1922, the Bureau's areas of activity had been limited to sanitary engineering, medical instruction conferences, smallpox vaccination, health education materials, ship fumigation, and solid waste incineration. The Director's report for 1927 noted widening continental concerns: drug addiction, venereal disease, sanitary administration, tuberculosis, intestinal parasites, leprosy, trachoma, malaria, puericulture, climate and disease, and immigration. Health conditions according to the report of the director for 1930-1931 included plague in Ecuador, Peru, Argentina, and Chile; yellow fever, mostly in Brazil; typhus in Bolivia, Brazil, Chile, Mexico, and the United States; undulant fever in the United States; onchocerciasis in Guatemala and Mexico; malaria in many of the countries; tuberculosis and small pox in practically all of them; measles and whooping cough in all the countries; and an increasing cancer death rate throughout the region. In April 1936 the directors approved a 7-point program on yellow fever control; discussed bubonic plague, brucellosis, malaria, trachoma, and onchocerciasis; industrial hygiene, maternal and child health, control of venereal disease and malaria, smallpox, typhoid and diphtheria vaccines, and continuation of experimental work in the use of bacillus Calmette-Guerin vaccine.
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  14. 14

    A regional call to arms -- 1946-1958.

    Pan American Health Organization [PAHO]


    In February 1946, a United Nations Technical Preparatory Committee for the International Health Conference met to create an international health organization, the World Health Organization. The International Health Conference convened on June 19, 1946. On July 22, 1946, 61 states signed the Constitution of the World Health Organization. The XII Pan American Sanitary Conference, held in Caracas, Venezuela, in January 1947 decided to consolidate the Pan American Sanitary Bureau's separate identity, reorganizing it as the Pan American Sanitary Organization (PASO). PASO was to cooperate with WHO without becoming absorbed by it. The Bureau of PASO focused on addressing such epidemic diseases as typhoid, smallpox, plague, malaria, and dysentery; excessive child mortality; inadequate nutrition; lack of modern hospitals; and low average life expectancy. The Bureau had special programs for the eradication of Aedes aegypti and malaria. It organized seminars, special training courses, and workshops, awarded fellowships, and helped schools expand their courses. Special projects on health administration, mental health, and alcoholism were developed. The Bureau set up immunization campaigns against diphtheria and whooping cough in unison with UNICEF. In 1949, the eradication of yaws was proposed, and the Bureau and UNICEF launched a successful program based on universal application of a single penicillin shot. In 1950, the eradication of smallpox was initiated, and subsequently PAHO promoted studies to perfect the dried smallpox vaccine for tropical climates. In 1950 the XIV Pan American Sanitary Conference declared the eradication of malaria a priority goal. The Bureau and the countries no longer focused on preventing the passing of diseases from one country to another but on eradicating diseases at their very source.
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