Shifting Paradigms of International Health

Abstract

The evolution of international health is showing increasing symptoms of decline. The paradigms of world health crystallized into a clear system of international health relations in the post-war period (1945-1960), based upon the tenet to preserve and promote peace, culminating in the establishment and effectiveness of the World Health Organization (WHO). The last decades have witnessed the emergence of Primary Health Care (PHC) and the subsequent objective of “Health for All” (HFA) as the guiding principles of the field. By the 1990s, however, the strategic weakness of these paradigms has become apparent, yet no realistic substitute is in sight. Unless a serious and urgent attempt is undertaken at reformulating its basic conceptual tenets, the field of international health, and with it WHO, is risking a major decline and could ultimately pass into obscurity and oblivion.

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References

1. MacKenzie MD : Potentialities of international colla-boration in the field of public health. American Journal of Public Health 1945; (3):100.

2. WHO. Address to the 30th WHA. Annual Report. Geneva: World Health Organization 1976; 7.

3. WHO. Constitution, Article 21 juncto 22. Geneva: World Health Organization.

4. WHO. Proceedings of the Special Committee and of the 4th WHA on WHO Regulations No. 2. Geneva: World Health Organization (WHO Off. Rec., No. 37: 335-353).

5. WHO. International Health Regulations Annex I.. Geneva: World Health Organization 1974. 59–61.

6. WHO. Constitution, Article 19, juncto 1, 20 and 21. Geneva: World Health Organization.

7. Declaration of Alma Ata, International Conference on Primary Health Care. Alma Ata, USSR, 6-12 September 1978.

8. Tocqueville A : De la Democratie en Amerique, Volume II.. Paris: Genin, 1951; 344.

9. Pannenborg CO : A New International Health Order, An Inquiry into the International Relations of World Health and Medical Care, Part II. Germantown, Maryland, 177–201.

10.

10. WHO . Conference on Primary Health Care in Industrialized Countries.

Bordeaux: World Health Organization

1984.

11.

11. Wennberg JE : Improving the medical decision making process. Health Affairs 1988; Spring: 99–106.

12.

12. Wennberg JE : What is Outcomes Research? In: Gelijns AC , ed. Medical Innovation at the Crossroads, Vol. I, Modern Methods of Clinical Investigation. Washington, DC: National Academy of Sciences 1990, 33–46.