Lecture Notes for chapter 3
DepartmentInternational Development Studies
ProfessorAnne- Emanuelle Birn
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IDSB04 - Introduction to International Health
September 28th, 2010
Chapter 3: International Health Agencies, Activities and Other Actors
→What shapes the organization of international health?
→How have various agencies and actors in international health and their activities
evolved over the past half century?
→Who are the major players in international health?
→What political, economic, and ideological, rationales guide their policies and
→Agency: an organization with a defined purpose often administratively related or
subsumed under a larger governmental or intergovernmental structure.
→Program: an umbrella structure involving several related projects, generally with
a particular purpose.
→NGO: nongovernmental organization---not for profit civic entity or network that
not directly related to government structures and focuses on a particular issue or
**INGO (international NGO)
→PPP: public private partnership, collaborative entity involving both public and
private sector organizations.
What is International Health?
•Three sects of organizations were established in the wake of WWII which have
profoundly shaped international health ideas, activities, and developments:
→The World Health Organization (WHO) and other United Nations (UN)agencies
→The World Bank and related multilateral financial institutions
→Bilateral aid and development organizations based in industrialized countries
(mostly in former colonial powers)
•The term “international health is a misnomer, the vast majority of international health
work is not shared among nations as equivalents, but rather reflects the prevailing
international political and economic order, whereby international assistance is “provided”
by wealthy/industrialized countries, and received by poor/underdeveloped countries.
•It is essential to understand that international assistance reflects geopolitical relations
and reproduces dominant imbalances of power and resources.
•Large multilateral, bilateral, private, and non governmental entities are not the only
health actors. Many other health organizations with smaller budgets but sizeable
memberships have emerged in recent decades. These groups agree on the importance
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of local priority-setting and advocate an integrated social, political, and technical
approach to health and healthcare in context to economic redistribution and meeting
•There is a panorama of organizations and actors involved in international health: those
with a direct mandate for health, those that provide public health and healthcare services
through public and private channels, and those that influence the determinants of health,
including international financial and trade agencies as well as social justice and health
The Evolution of International Health after WWII:
•Only until 50 years ago, the world and international health, was characterized by large
imperial blocks, rival powers in Europe, North America, and Australasia; colonized
regions; and regions that were economically dominated by imperial powers.
•Each imperial power had its own health office, charged with control of epidemics,
medical care organization, and infrastructure, often bolstered by “tropical health”
research institutes and the activities of religious missionaries. Bothe the world of political
order and the organization of international health would undergo profound changes in
the aftermath of WWII.
•The Role of the UN:
→In 1944, the U.S govt organized the UN Monetary and Financial Conference, and
invited 43 countries to attend.
→The main outcomes of the conference were the establishment of the International
Monetary Fund (IMF), to focus on macroeconomic policy and, eventually provide
loans and conditional on adoption of anti-inflationary and international payment
policies, and the International Bank for Reconstruction and Development (IBRD)
more commonly known as the World Bank, to provide loans for particular
→An international health conference in 1946 produced the Constitution of the WHO
which was ratified by 26 nations on April 7th, 1948, which is now known as World
The World Health Organization:
→the mission of the WHO is as follows “ the attainment by all peoples of the
highest possible level of health”
→The work of the WHO is divided in to 2 major categories: central technical
services (which include epidemiologic intelligence, development, of international
agreements concerned with health, standardizations of vaccines and
pharmaceuticals, and dissemination of knowledge through meetings of experts
and technical reports) and services to governments.
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