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INTERNATIONAL HEALTH
“Nothing on the earth is more international than disease” said Paul Russel. Health
and disease have no political or geographical boundaries. Disease in nay part of the world
is a constant threat to other parts. In order to protect against the spread of disease from
one country to another many attempts were made in the past by individual rulers and
placed barriers against infection and detection and isolation. “QUARANTINE” was
introduced in Europe to protect against the importation of plaque. Quarantine soon
becomes an established practice in many countries. This was a origin of international
health work. It become necessary for international agreement and cooperation on
quarantine matters to control communicable diseases. A brief account of these endeavors
and of the early health organization which preceded the WORLD HEALTH
ORGANIZATION.
FIRST INTERNATIONAL SANITARY CONFERENCE (1851):
It was convened by in Paris. Attended mainly by European countries- Australia,
France, Great Britain, Greece, Portugal, Russia, and Spain. Objectives of the conference
were limited, to introduce some order and uniformity into quarantine measures which
varied from country to country. Conference lasted for six months, no result, it is regarded
as failure.
THE HEALTH ORGANIZATION OF THE LEAGUE OF NATIONS (1923):
After the first war (1914-18) the League of Nations was
established to build a better world. It included a “health organization” to take steps in
matters of international concern for the prevention and control of disease. in 1939 the
league of nation was dissolved but its health organization in Geneva continued to deal as
best.
BIRTH OF THE WHO:
The WHO has its origin in April 1945, during the
conference held at San Francisco to set up the United Nations. Brazil and China proposed
that an international health organization should be established, the constitution drawn up
in New York in 1946. The same conference set up an “interim commission” to prepare
the ground for the new organization and to carry out urgent tasks until the WHO
constitution had the ratification were secured by 7april 1948, formal existence of the
WHO as a specialized agency began on that date.
WORLD HEALTH ORGANIZATION (WHO):
WHO is a specialized non-political,
health agency of the United Nations, headquarters situated at Geneva. The constitution
came into force on 7th of April 1948, which is celebrated every year as “world health day”
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OBJECTIVES:
The current objectives of the WHO is the attainment by all people
of the world by the year 2000AD of a level of health that will permit them to lead a
socially and economically productive life.- also known by HEALTH FOR ALL-2000AD.
Some of the highlights of WHO constitutions:
1. Health is a state of complete physical mental and social well being and not
merely the absence of disease or infirmity.
2. Enjoyment of standard of health is one of the rights of every human being
without differences of race, religion, political belief etc.
3. The achievement of any state in the promotion and protection of health is of
value to all.
4. communicable disease is a common danger
5. Govt have responsibility for the health of their peoples which can be fulfilled
only by the provision of adequate health and social measures.
In recent years the global strategy for health for all by 2000 both WHO and UNICEF
(United Nation International Children’s Emergency Fund) are striving towards the global
of HFA ( Health For All) by the year 2000 through health system based on primary
health care.
MEMBERSHIP:
Membership in WHO is open to all countries. While most of the
countries are members of both the UN and WHO, some countries which have
membership in WHO not in UN. In 1948 there were only 56 members in WHO in 1996 it
was increased to 190 members.
WORK OF WHO:
The WHO has specific responsibilities for establishing and
promoting international standards in the field of health, which comprise the following
broad areas.
1. PREVENTION AND CONTROL OF SPECIFIC DISEASES:
Almost all communicable diseases are subjected to the responsibility of the
WHO activities.
Smallpox is the out standing example as it is eradicated from the world by
the international health cooperation. With the same energy and commitment it is now
directing towards global battle against AIDS.
The WHO collects all epidemiological information through an Automatic
telex reply service (ATRS) and the “weekly epidemiological records” (WER)
WHO also paid attention in its programme of work to non-communicable
diseases problems such as cancer, cardiovascular diseases, genetic disorder, mental
disorder drug addiction and dental diseases
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WHO have also branched out into the field of vector biology and control,
immunology, quality control of drug and biological products, as these activities are
relevant to communicable and non-communicable diseases.
2. DEVELOPMENT OF COMPREHENSIVE HEALTH SERVICES:
This broad field of endeavor encompasses a wide variety of activities such
as organizing health system based on primary health care, and health
service research. Appropriate technology for health (ATH) is another new
programme launched by WHO to encourage self-sufficiency in solving
health problems.
3. FAMILY HEALTH:
It is a major programme of WHO since 1970, broadly
divided into maternal and child health care. Human reproduction, nutrition and health
education.
4. ENVIRONMENTAL HEALTH:
Environmental health has been an important activity of WHO, it advises govt on national
programme on basic sanitation. Recent activities are directed to protect the air, water, and
food, and the protection from radiation. For this a number of programme has been
developed such as ENVIRONMENTAL HEALTH CRITERIA PROGRAMME,
ENVIRONMENTAL HEALTH MONITORING PROGRAMME,
5. HEALTH STATISTICS:
It has been a concern to the WHO since 1947 wide variety of Mortality and morbidity
statistics relating to health problems. These data are published in the 1. Weekly
epidemiological record 2. World health statistics quarterly 3. World health statistics
annual. The tenth revision came into effect from 1st January 1993; assistance is also given
to countries in the improvement of their medical records collection and organizing it.
6. BIO MEDICAL RESEARCH:
The WHO does not do itself research but stimulate and
Coordinates research work. Six tropical diseases (malaria, schistosomiasis,
trypanosomiasis, filariasis, leishmaniasis and leprosy) are the target of the WHO special
programme for research and training.
7. HEALTH LITERATURE AND INFORMATION:
WHO act as clearing house for Information on health problems. Its publications
contain hundreds of titles on wide variety of health subjects. The WHO library is one of
the satellite centres of the medical literature analysis and retrieval system (MEDLARS).
MEDLARS are a fully computerized indexing system covering the whole of medicine on
an international basis.
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8. COOPERATION WITH OTHER ORGANIZATION:
WHO collaborates with UN and other international governmental organizations.
STRUCTURE:
WHO consists of tree principles
1. the world health assembly
2. the executive board
3. the secretariat
THE WORLD HEALTH ASSEMBLY:
This “health parliament”. It meets annually,
usually in May and generally in the head quarters in Geneva. Some time in other
countries also (14th WHA in New Delhi 1961). The main functions of the assembly are
1. To determine international health policy programme
2. To review the work of the past year
3. To approve the budget needed for following year.
4. To elect the member states to designate a person to serve for three years and replace
the retiring members.
THE EXECUTIVE BOARD:
Board has 18 members each designated by member of
state. The health assembly increased it to 30 in 1976. The members of the board are to be
“technically qualified in the field of health”. The executive board meets at least twice a
year generally in January.
THE SECRETARIAT:
It is headed by Director General who is the chief technical and
administrative officer of the organization. 1948 staff counted 250 persons in 1985
counted 4475 international public servants. On 31 December 1985 the WHO secretariat
comprised of the following division.
1. Division of epidemiological surveillance and health situation and trend
assessment.
2. division of communicable diseases
3. division of vector biology and control
4. division of environmental health
5. division of public information and education for health
6. division of mental health
7. division of diagnostic, therapeutic and rehabilitative technology
8. division of strengthening of health services
9. division of family health
10. division of non-communicable disease
11. division of health manpower development
12. division of information system support
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13. division of personnel and general service
14. division of budget and finance
REGIONS:
It has six regional organizations
REGION HEAD QUARTER
1. South Asia New Delhi (India)
2. Africa Harare (Zimbabwe)
3. Europe Copenhagen (Denmark)
4. The Americas Washington D.C (U.S.A)
5. Eastern Mediterranean Alexandria (Egypt)
6. Western Pacific Manila (Philippines).
The South Asia Regional Office (SEARO) is in New Delhi, it has 11 members.
OTHER UNITED NATION AGENCIES.
UNICEF:
UNICEF (united nation international children’s emergency fund) is one of
the specialized agencies of the United Nations. Established in 1946 by the United Nations
general assembly to deal with rehabilitation of children in war ravaged countries. In 1953
general assembly gave it a new name “U.N Children’s Fund) so it’s called UNICEF.
Regional office in New Delhi the region is known as South Central Asia Region which
covers Afghanistan, Sri lanka, Maldives, Mongolia, Nepal, head quarters is in New York.
UNICEF works in close collaboration with WHO and the other specialized
agencies of the United Nation like UNDP (united nation development programme) FAO
(food and agriculture organization) and UNESCO. In early years UNICEF and WHO
worked together in the problem such as Malaria and Tuberculosis and Venereal diseases.
Later it covered such field as maternal and child health, nutrition, environmental
sanitation health education programme which would directly benefit the child.
More recently UNICEF to turn away from campaigns for the eradication
of specific diseases unless they are directly benefited to the mothers and children. Greater
attention is being given to the concept of the “whole child”.
CONTENT OF SERVICES:
CHILD HEALTH: UNICEF has aided for the
production of vaccines and sera in many countries. Like supported India’s BCG
vaccination programme from inception. It has also assisted to establish penicillin plant,
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near Pune, donated DDT plant, two plants for manufacture of triple vaccines and iodized
salt. Currently UNICEF is focusing attention on providing primary health care to mothers
and children, emphasis is placed on immunization, infant and child care, safe water, and
adequate sanitation.
CHILD NUTRITION: UNICEF gives high priority to
improving child nutrition with the development of low cost protein-rich food mixtures.
The UNICEF has supplied equipment for modern dairy plants in various parts of India
(Maharashtra, Gujarat, Karnataka, Uttar Pradesh, West Bengal, and Andhra Pradesh).
FAMILY AND CHILD WELFARE: day-care
centers, child welfare and youth agencies and women’s club are established to improve
the care of children both within and outside of their homes.
EDUCATION: in collaboration with UNESCO,
UNICEF is assisting India in the expansion and improvement of teaching science in
India. Science laboratories equipment, workshop tools, library book audiovisual aids are
being available to educational institution.
In short UNICEF activities cover programmes assisting in child survival, protection
and development, intervention like immunization, improved feeding practices, drinking
water, environmental sanitation, birth spacing etc.
UNDP (UNITED NATION DEVELOPMENT PROGRAMME):
Established in 1966. It is main source of
fund for technical assistance. The member countries-rich and poor- of the United Nation
meet annually and pledge contributions to the UNDP.
OBJECTIVES:
Help poorer nations to develop their human and natural resources more
fully. The UNDP projects covers agriculture, industries, education, science, health, and
social welfare etc.
UNFPA (UN FUND FOR POPULATION ACTIVITIES):
UNFPA has been providing
assistance to India since 1974.UNFPA projects on health development and family
welfare, improvement in infrastructure especially in rural areas have been under
implementation in 11 district of Bihar and 4 district of Rajasthan. It also help to boost the
national capability to produce contraceptives and develop population education
programme.
FAO (FOOD AND AGRICULTURE ORGANIZATION):
Was formed in 1945 with head quarters in Rome.
OBJECTIVES:
1. To help nations raise living standards
2. to improve nutrition of the people of all countries
3. To increase the efficiency of farming, forestry, fisheries.
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4. To better the condition of rural people.
Prime concern of the FAO is the increased production of food to keep pace with the ever-
growing population. Important work of FAO is towards ensuring that the food is
consumed by the people who need it. The joint WHO/FAO expert committees have
provided the basis for many cooperative activities- nutritional surveys training courses,
seminars.
ILO (INTERNATIONAL LABOUR ORGANIZATION):
Established in 1919. Head quarters in Geneva, Switzerland.
OBJECTIVES:
1. To contribute to the establishment of lasting peace by
promoting social justice.
2. To improve labour conditions, and living standards
3. To promote economic and social stability.
There is a close collaboration between ILO and WHO in the field of health and labour.
HEALTH WORK OF BILATERAL AGENCIES
USAID (UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT)
Established in 1961, its mission functions in New Delhi. It grants loans which are
extended by agency.
The US has been assisting in a number of projects designed to improve the health of
India’s people. These are 1. Malaria eradication,
2. Medical education,
3. Nursing education,
4. Health education,
5. Water supply and sanitation,
6. Control of communicable disease,
7. Nutrition,
8. Family planning.
SIDA (SWEDISH INTERNATIONAL DEVELOPMENT AGENCY):
The SIDA agency is assisting the national
tuberculosis control programme since 1979.SIDA usually spent on procurement of
supplies like X-ray unit, microscopes and anti-tuberculosis drugs. It supports for short
course on chemotherapy drug regimens under pilot study.
NON-GOVERNMENTAL AND OTHER AGENCIES
ROCKEFELLER FOUNDATION:
It’s a philanthropic organization chartered in 1913
By John D.Rockefeller. Its purpose is to promote the well-being of mankind throughout
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the world. In its early years the foundation was active chiefly in public health and
medical education.
The works of Rockefeller foundation begin in1920 in India. The scheme for the
control of hookworm disease was intension, since then the foundation has been
associated with several medical and public health programmes in India. The foundation
programme included the training of competent teachers and research workers, the
sponsoring of visit of a large number of medical specialists from USA, development of
medical libraries. At present the foundation is directing its support to the improvement of
agriculture, family planning and rural training centers as well as to medical education.
FORD FOUNDATION:
It has been active in the development of rural health
services and family planning. The ford foundation helped in the following projects.
1. Orientation training centers, at singur, poonamalli, and najafgarh. It provides training
courses in public health for medical and paramedical personnel from all over India.
2. research-cum-action projects were aimed at solving some of the basic problem in
environmental sanitation.
3. Pilot project in rural health services,
4. Calcutta water supply and drainage scheme,
5. Family planning programme.
CARE (CO-OPERATIVE FOR ASSISTANCE AND RELIEF EVERYWHERE):
Founded in North America in the year 1945. It is
one of the world largest independent, non-profit, non-sectarian international relief and
development organization. It provides emergency aid and long term development
assistance.
CARE began its operation in India in 1950, till the end of 1980s,
the primary objectives of CARE- India was to provide food for children in the age group
of 6-11 years. It is helping in following projects, integrated nutrition and health project,
better health and nutrition project, anaemia control project, improving women’s health
project, child survival project,
CARE- India works in partnership with govt of India, State Govt, NGO’s
etc.
INTERNATIONAL RED CROSS:
The Red Cross is a non-political non-official international humanitarian
organization to the service of mankind in peace and war. It was founded by Henry
Dunant. It happened while traveling through North Italy; he saw the neglect of thousands
of the wounded and dying soldiers. He recruited volunteers from near by villages to help
the wounded soldiers. Then he urged that voluntary national societies be founded. He met
with success in his aim, thus came into being the international committee of the Red
Cross (ICRC).
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Role of Red Cross:
In early years it was mainly dealing with humanitarian service,
thereafter natural disasters too bring in their wake great human suffering.
INDIAN RED CROSS:
The Red Cross society of India was established by an act of
the Indian legislature in 1920 with 3 objectives. 1. Improvement of health 2. Prevention
of disease and 3. Reduction of suffering. The Red Cross home at Bangalore for disabled
ex-servicemen is one of the pioneer institutions of its kind in Asia. Disaster services
comprise distribution of milk, medicines, vitamin tablets, cod-liver oil, and hundred other
items to the famine stricken people and to those people who have been hit by the floods.
There are numerous other non-govt organizations some of these are: Oxfam, save the
children fund, international Planned Parenthood federation, the population Council,
voluntary health association, international leprosy association, international union against
cancer.
