International health

GLOBAL HEALTH
Dr. Subraham Pany
Department of Community Medicine.

‘Nothing is more
international than
a disease.’
- Paul Russel.

REFERENCE:
HTTP://WWW.WHO.INT/EN/

WHAT IS GLOBAL HEALTH?
SYN:
- Geographic medicine
- International health
Health problems, issues, & concerns that go
above national boundaries, which may be
influenced by circumstances or experiences in
other countries, & which are best addressed
by cooperative actions and solutions.

HISTORY
14th Century - EUROPE
Quarantine (In outlook to importation of PLAGUE)
Failure of quarantine (Due to opposition)
International conference was set for discussion, agreement and
co-operation on matters of international health.
This led to the origin of International Health work

FIRST INTERNATIONAL SANITARY CONFERENCE
(1851, PARIS)
Attended: Austria, France, Great Britain, Italy, Greece, Portugal, Russia,
Spain
Objective: Introduce some order and uniformity into quarantine measures
which varied from country to country.
Prepared sanitary code  137 articles dealing with
cholera, plague, yellow fever (never came into force).
Ended in failure

PAN AMERICAN SANITARY BUREAU (1902, AMERICAS)
First international health agency
Intended to coordinate quarantine procedure in American
States
1958 Pan American Health organization-grown as major
health agency –headquarters in Washigton,D.C.

Office International D’Hygiene Publique (OIHP)- 1907
* To establish Permanent International Health Bureau(1903)
* Office International D’Hygiene Publique, Paris Office (1907)
 To disseminate information on communicable diseases and
to supervise international quarantine measure
 OIHP AND PASB joined together
 British India joined OIHP
 Continued to exist until 1950 and then taken over by WHO

The Health Organization of the League of Nations (1923)
After first world war (1914-1918)  league of nations was
established for a better world.
‘Health Organization’ was not concerned only on quarantine
rather it branched into nutrition, housing, rural hygiene & training
of health workers.
Till second world war they were co-existing (OIHP, PASB and HO)

THE UNITED NATIONS RELIEF AND REHABILITATION
ADMINISTRATION (1943)
• Purpose  organize recovery from the effect of 2nd
world war.
• Did outstanding work of preventing the spread of typhus
and other diseases.
• Assistance to malaria control in Italy and Greece.
• 1946 - taken over by interim Commission on the WHO.

BIRTH OF WHO – APRIL 1945
The United Nations Conference in San Francisco, USA, unanimously approves
the establishment of a new, autonomous international health organization.

1946
THE INTERNATIONAL HEALTH CONFERENCE IN NEW YORK APPROVES
THE CONSTITUTION OF THE WORLD HEALTH ORGANIZATION IN JULY.

* The epidemiological
information service is
established.
* An automatic telex reply
service, it tracks
information on diseases
subject to the international
sanitary regulations (later
renamed International
health regulations) and
other communicable
diseases of international
importance.
1947

1948
THE WORLD HEALTH ORGANIZATION CONSTITUTION COMES INTO FORCE ON
7 APRIL.

BIRTH OF THE WHO
* 7th April 1948
* World Health Day -
7th April
* Specific theme
each year  focus
attention on specific
aspect of public

1948-1953
DR. BROCK CHISHOLM FROM CANADA IS ELECTED AS THE FIRST DIRECTOR-GENERAL OF
THE WORLD HEALTH ORGANIZATION.

1950
THE WORLD HEALTH ASSEMBLY ESTABLISHES WORLD HEALTH DAY TO TAKE
PLACE ANNUALLY ON 7 APRIL.

WHO
The world health organisation is a specialised, non –
political health agency of the United Nations, with head
quarters at Geneva.
Objective:
The attainment by all peoples of the highest level of
health
(Its major task is to combat disease, especially key
infectious diseases, and to promote the general health of

Membership:
Open to all countries.
Each member state contributes yearly to the budget
Each member is entitled to the services and aid the
organization can provide.
Have right to vote.
 Africa; HQ Brazzaville, Congo
 Americas; HQ: Washington D.C.,
USA
 Eastern Med.; HQ: Cairo, Egypt
 Europe; HQ: Copenhagen, Denmark
 South East Asia; HQ: New Delhi, India
 Western Pacific; HQ: Manila,
Philippines
REGIONAL OFFICES AND REGIONS OF THE WHO:

WORK OF WHO
Constitutional Function: Act as the directing and
coordinating authority on all International health
work:
1. Prevention and Control of specific Diseases
2. Development of Comprehensive Health Services
3. Family Health
4. Environmental Health
5. Health Statistics
6. Bio-Medical Research
7. Health Literature and Information

1. PREVENTION AND CONTROL OF SPECIFIC DISEASES
Communicable diseases :
* Almost all communicable disease are at some point of time the subject of
WHO activities
* e.g.. Global eradication of Small pox  International health cooperation.
* Important work  Epidemiological surveillance of CD
Non-Communicable Diseases:
Paid attention to NCD’s like Cancer, DM, CVD, Genetic disorders, mental
disorders, drug addiction etc.
Vector biology and control, immunology,
Immunization against common diseases of childhood

2. DEVELOPMENT OF COMPREHENSIVE HEALTH SERVICES
* Function is to promote & support Nat. health policy
development
* NHP 2002  Eradicate Polio by 2005, Eliminate
Leprosy 2005
* Development of comprehensive  Nat. health
Programme

3. FAMILY HEALTH
Major Programme activities of WHO since 1970
Subdivided  Maternal and child health care, human
reproduction, nutrition, and health education
Chief concern  improvement of the quality of life of
the family as a unit.

4. ENVIRONMENTAL HEALTH
*Advisory to Govt.’s – Sanitary services.
*Protection of quality of air, water and food.
*Health conditions at work.
*Radiation protection.
*Detection of new hazards from new technological
developments.
*PROGRAMMES: WHO Environmental Health Criteria
Programme.

5. HEALTH STATISTICS
Since 1947, morbidity and mortality statistics are published in
a. Weekly Epidemiological Records.
b. World Health Statistics Quarterly.
c. World Health Statistics Annual.
2. Statistics from different countries should be comparable hence, WHO publishes-
International Classification of Diseases. (Updated in every 10 years. 12h revision- 2013 )
3. Assistance is provided to countries to improve their medical records and help in planning
and operation of National Health Information Systems.

6. BIO-MEDICAL RESEARCH
WHO  Stimulates and coordinates research work.
Worldwide network of  WHO collaborating centers.
For promoting research  WHO awards grants to
researchers and research institutions

7. HEALTH LITERATURE AND INFORMATION
* WHO LIBRARY Satellite center of
* Medical Literature Analysis and Retrieval System (MEDLARS).
* Only fully computerized indexing system covering the whole
of medicine on an international basis.
* Public information services are found both at
headquarters and six regional offices.

8. COOPERATION WITH OTHER ORGANIZATIONS.
Collaborates with UN and other specialized agencies.
WHO maintains working relationships  with a number of International
Government Organizations.

THREE PRINCIPAL ORGANS
1. The World Health Assembly.
2. The Executive board.
3. The Secretariat.

“Health Parliament” of Nations and the supreme governing body of the
organization.
Meets annually at headquarters in Geneva, Switzerland.
Health Assembly appoints “Director general” on the nomination of
Executive board.
Functions:
1. To determine international health policy and programs.
2. To review the work of the past.
3. To approve the budget for following year.
4. To elect Member States to serve for 3 years on the Executive Board.
WORLD HEALTH ASSEMBLY

THE EXECUTIVE BOARD
Board now has 34 members  each designated by a
“Member State”.
Should have at least 3 persons from each WHO region.
Meets twice a year.
To give effect to the decisions and policies of the Assembly.
Has power to take decisions  Emergencies. E.g. Earthquakes, epidemics,
floods etc.

THE SECRETARIAT
Headed by Director General - chief technical and administrative officer
of the organization.
Assisted by 5 Assistant Director Generals at the headquarters.
Function:
To provide technical and managerial support for their national health
programs.
WHO staff –
In 1948 – 250 --- in 2010 - 8000

THE SOUTH EAST ASIA REGION
Head quarter in New Delhi – k/as
World Health House, Indraprastha Estate.
Region has 11 members – India, Bangladesh, Bhutan, Indonesia, Korea,
Maldives, Myanmaar, Nepal,Srilanka, Thailand, Timor-leste.
Major activities –
Malaria eradication, TB control, control of other communicable disease,
health statistics, public health administrations, environment health and water
supply, nutrition, mental health, quality control and medical education.

1950
MASS TB IMMUNIZATION GETS UNDER WAY AS THE BACILLE CALMETTE -
GUERIN (BCG) VACCINE WAS USED TO PROTECT CHILDREN FROM
TUBERCULOSIS.

1953-1973
DR MARCOLINO GOMES CANDAU OF BRAZIL IS ELECTED AS THE SECOND
DIRECTOR-GENERAL OF THE WORLD HEALTH ORGANIZATION.

1955
THE MALARIA ERADICATION PROGRAMME IS LAUNCHED. ITS OBJECTIVE WAS MODIFIED
IN 1969. SUBSEQUENTLY, MOST OF THE MALARIA ERADICATION PROGRAMMES WERE
TURNED INTO NATIONAL MALARIA CONTROL PROGRAMMES.

1965
THE FIRST REPORT ON DIABETES MELLITUS IS ISSUED. BY 2000, 171 MILLION PEOPLE WORLDWIDE
CARRIED THE DISEASE. THE NUMBER IS LIKELY TO INCREASE TO AT LEAST 366 MILLION BY 2030.

1965
THE INTERNATIONAL AGENCY FOR RESEARCH ON CANCER IS ESTABLISHED TO
COORDINATE & CONDUCT EPIDEMIOLOGICAL AND LABORATORY RESEARCH INTO THE
CAUSES OF HUMAN CANCER.

1966
THE NEW HEADQUARTERS BUILDING OF THE WORLD HEALTH
ORGANIZATION IN GENEVA IS INAUGURATED.

1973-1988
DR HALFDAN T. MAHLER OF DENMARK IS ELECTED AS THE THIRD DIRECTOR-
GENERAL OF THE WHO.

1974
THE ONCHOCERCIASIS CONTROL PROGRAMME IS LAUNCHED IN
COLLABORATION WITH THE WORLD BANK, THE UNITED NATIONS
DEVELOPMENT PROGRAMME AND THE FOOD AND AGRICULTURE
ORGANIZATION.

1974
THE EXPANDED PROGRAMME ON IMMUNIZATION IS LAUNCHED.
IMMUNIZATION CURRENTLY AVERTS BETWEEN 2-3 MILLION DEATHS EVERY
YEAR.

1975
THE SPECIAL PROGRAMME FOR RESEARCH AND TRAINING IN TROPICAL DISEASES IS
ESTABLISHED TO HELP COORDINATE, SUPPORT AND INFLUENCE GLOBAL EFFORTS TO
COMBAT NEGLECTED INFECTIOUS DISEASES THAT DISPROPORTIONATELY AFFECT POOR
AND MARGINALIZED POPULATIONS.

1976
THE WORLD HEALTH ASSEMBLY ADOPTS A RESOLUTION ON DISABILITY PREVENTION AND
REHABILITATION, CALLING FOR AN INTEGRATION OF REHABILITATION INTO PRIMARY
HEALTH CARE PROGRAMMES AND COMMUNITY LIFE.

1977
THE FIRST ESSENTIAL MEDICINES LIST IS PUBLISHED. TODAY, THE LIST CONTAINS 340
MEDICINES THAT ADDRESS MOST GLOBAL PRIORITY CONDITIONS, INCLUDING MALARIA,
HIV/AIDS, TUBERCULOSIS, REPRODUCTIVE HEALTH AND, INCREASINGLY, CHRONIC
DISEASES SUCH AS CANCER AND DIABETES.

1978
THE INTERNATIONAL CONFERENCE ON PRIMARY HEALTH CARE IN ALMA-ATA (IN THE
FORMER SOVIET UNION) SETS THE HISTORIC GOAL OF "HEALTH FOR ALL".

1979
A GLOBAL COMMISSION CERTIFIES THE WORLDWIDE ERADICATION OF
SMALLPOX.

1986
THE GLOBAL PROGRAMME ON AIDS IS CREATED TO DEVELOP AND COORDINATE A
GLOBAL STRATEGY TO FIGHT THE DISEASE.

1988-1998
DR HIROSHI NAKAJIMA OF JAPAN IS ELECTED AS THE FOURTH DIRECTOR-
GENERAL OF THE WHO.

1988
THE WORLD HEALTH ASSEMBLY ENDORSES A RESOLUTION ON NON-DISCRIMINATION
AGAINST PEOPLE LIVING WITH AIDS.

1988
THE GLOBAL POLIO ERADICATION INITIATIVE IS ESTABLISHED IN COLLABORATION WITH
ROTARY INTERNATIONAL, THE US CENTRES FOR DISEASE CONTROL AND PREVENTION
AND UNICEF.

1995
THE INTERNATIONAL COMMISSION FOR THE CERTIFICATION OF DRACUNCULIASIS
ERADICATION IS ESTABLISHED. DRACUNCULIASIS IS ALSO KNOWN AS GUINEA-WORM
DISEASE.

1996
UNAIDS IS CREATED WITH SIX FOUNDING PARTNER AGENCIES.

1998-2003
DR GRO HARLEM BRUNDTLAND OF NORWAY IS ELECTED AS THE FIFTH
DIRECTOR-GENERAL OF THE WHO.

2001
THE MEASLES INITIATIVE IS LAUNCHED IN PARTNERSHIP WITH THE AMERICAN RED
CROSS, UNICEF, THE U.N. FOUNDATION AND THE US CENTERS FOR DISEASE CONTROL &
PREVENTION. AS OF OCTOBER 2007, OVERALL GLOBAL MEASLES DEATHS HAVE FALLEN
BY 68%.

2002
THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA IS CREATED TO
SUBSTANTIALLY INCREASE RESOURCES TO FIGHT THREE OF THE WORLD'S MOST
DEVASTATING DISEASES.

2002
THE FIRST WORLD REPORT ON VIOLENCE AND
HEALTH IS LAUNCHED.
THE REPORT'S FINDINGS AND RECOMMENDATIONS
SET A NEW AGENDA.
IT WAS FOR THE PREVENTION OF VIOLENCE, AND
LEAD THE WAY FOR COMMUNITIES, GOVERNMENTS
AND INTERNATIONAL AGENCIES TO ADDRESS
INTERPERSONAL, SELF-DIRECTED AND COLLECTIVE
VIOLENCE.

2003-2006
DR LEE JONGWOOK OF THE REPUBLIC OF KOREA IS ELECTED AS THE SIXTH DIRECTOR-GENERAL OF THE
WORLD HEALTH ORGANIZATION.

2003
THE WORLD HEALTH ASSEMBLY ADOPTS THE FRAMEWORK CONVENTION ON TOBACCO
CONTROL, NOW ONE OF THE MOST WIDELY SUPPORTED TREATIES IN THE HISTORY OF THE
UNITED NATIONS.

UNICEF
United Nations International Children’s Emergency
Fund
Specialized agency of United Nations
Established  1946
To deal with rehabilitation of children in war ravaged
countries
Head Quarters United Nations, New York.
Regional Office  New Delhi
Works in collaboration with WHO, UNDP, FAO
E.g.. Worked with WHO  urgent problems Malaria, TB

SERVICES PROVIDED BY UNICEF
1. Child Health
2. Child Nutrition
3. Family And Child Welfare
4. Formal And Non – Formal Education
UNICEF’s GOBI — FFF Programs
Growth
monitoring
Oral
rehydration
Breast feeding
Immunization
Female
Education
Family planning
Food
supplements

UNDP- (UNITED NATIONS DEVELOPMENT
PROGRAMME)
To help poor nations develop their
human and natural resources.
They cover economic and social
sector
e.g.. Industry, education,
agriculture etc.

FAO (1945)
Chief aims are to raise the living standards; improve
nutrition; increase efficiency of farming, forestry, fisheries;
and to better the living conditions of rural people, thus
widening the opportunity for all to indulge in productive
work.
1960  FFHC (Freedom from Hunger Campaign) – To
combat malnutrition and to spread awareness.

As an affiliate to the League of Nations to
improve the living and working conditions of
the working class.
Its purpose was to establish peace, improve
international action, labour conditions, and the
living standards; to promote economic and

WORLD BANK
Governed by ‘Board of Directors’.
Funds projects concerned with electric
power, roads, railways, health, agriculture,
family planning etc.

INTERNATIONAL RED CROSS:
An international humanitarian movement
started to protect human life and health
to ensure respect for the human being;
and to prevent and alleviate human
suffering, without any discrimination
based on race, religion etc.

National Red Cross and Red Crescent
Societies “National Societies”
 International Federation of Red Cross and
Red Crescent Societies
“International Federation”
 International Committee of the Red Cross
"ICRC"
International Red Cross Red Crescent Movement

•Indian Red Cross Society ( IRCS ) was established in 1920
under the Indian Red Cross Society Act.
•The IRCS has 35 State / Union Territories Branches with
their more than 700 districts and sub district branches.
•His Excellency The President of India is the President and
Hon'ble Union Health Minister is the Chairman of the
Society.
Indian Red Cross

ACTIVITIES OF USAID
The US government is assisting in a number of
projects designed to improve the health of Indian
people.
1)Malaria eradication
2)Medical education
3)Nursing education
4)Health education
5)Water supply and sanitation
6)Control of communicable diseases
7)Nutrition

“Co-operative for assistance and relief everywhere”
founded in North America in the wake of the second world
war in the year 1945.
Activities:
CARE-India focused it’s food support in the ICDS
programme and in developments of programmes in areas
of health and income supplementation.
Integrated nutrition and health projects,
anaemia control project,
improving women’s health projects,
improved health care for adolescent's girls projects,
child survival projects,
Improving women’s reproductive health and

The United Nations Population Fund, is the lead UN
agency.
UNFPA supports healthy families by:
• Training health workers to deliver quality family
planning services
• Supplying contraceptives
• Ensuring youth-friendly reproductive health care
• Providing counselling and choices to women who
want to avoid or delay pregnancy
• Educating men on the benefits of birth spacing

Danish International Development
Agency (DANIDA), provides humanitarian aid and
development assistance to other countries, with
focus on developing countries.
Four main priority areas:
*Human rights and democracy
*Green growth
*Social progress
*Stability and protection

The United Nations Educational, Scientific and Cultural
Organization is a specialized agency of the United
Nations (UN).
UNESCO pursues its objectives through five major
programs: education,
natural sciences,
social and human sciences,
culture, and

SIDA
* Swedish International Development Cooperation (SIDA) Agency
is providing assistance since 1979 in form of X- ray Units,
microscope and anti- TB drugs. It also supported the pilot study of
Short Term Chemotherapy during 1983-1984.
* Being terminated in 2013.

Concern with medical education, public health, social science and agricultural
sciences.
Help in Establishment of AIIPH Calcutta, AIIMS Delhi, KGMC Lucknow.
CMC Vellore,National Institute of Virology Pune.
Sponsor educational visits for advance training of health professional, sponsor
visit of specialist from USA.
Grant in Aid for research activities
Also giving support for improvement of agriculture, family planning and rural
development.

Bill and Millinda Gates foundation :

It delivers proven tools—including vaccines,
drugs, and
diagnostics—as well as discover pathbreaking new
solutions that are affordable and reliable.
They invest heavily in vaccines to prevent infectious
diseases—including HIV, polio, and malaria—and
support the development of integrated health solutions
for family planning, nutrition, and maternal and child

OTHer Non Governmental Organisations
American Association for the Advancement of Science (AAAS)
American Society of Tropical Medicine and Hygiene (ASTMH)
Consortium of Universities for Global Health (CUGH)
Center for Strategic and International Studies (CSIS) Global
Health Policy Center
Global Alliance for Chronic Diseases (GACD)
Accordia Global Health Foundation
Foundation for NIH (FNIH)
Wellcome Trust
Institute for Health Metrics and Evaluation (IHME)

International health

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