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AJPH First Look, published online ahead of print Dec 1, 2005
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AJPH.2004.050831v1
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January 2006, Vol 96, No. 1 | American Journal of Public Health 62-72
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2004.050831

PUBLIC HEALTH THEN AND NOW

The World Health Organization and the Transition From "International" to "Global" Public Health

Theodore M. Brown, PhD, Marcos Cueto, PhD and Elizabeth Fee, PhD

Theodore M. Brown is with the Department of History and the Department of Community and Preventive Medicine, University of Rochester, Rochester, NY. Marcos Cueto is with the Facultad de Salud Pública, Universidad Peruana Cayetano Heredia, Lima, Peru. Elizabeth Fee is with the History of Medicine Division, National Library of Medicine, National Institutes of Health, Bethesda, Md.

Correspondence: Requests for reprints should be sent to Elizabeth Fee, PhD, History of Medicine Division, National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20974 (e-mail: elizabeth_fee{at}nlm.nih.gov).

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.




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