For Bishop's University special topics course History of Pandemics

1. Global health
THE LEAGUE OF NATIONS HEALTH ORGANIZATION (LNHO)
& THE WORLD HEALTH ORGANIZATION (WHO)

2. The idea of international health
 Ideas + institutions  concept of “the international” 19th century
 Int’l Telegraph Union 1865, Universal Postal Union 1874
 International Sanitary Conference held for first time 1851,
institutionalized as Office internationale d’hygiene publique in 1907
 Epidemics cross borders; so must health care
 “International health” field emerges, not apolitical and technical
only, but entangled with imperialism and nationalism (Amrith)
 Role of private foundations (Rockefeller early 20th C; Gates now)

3. Tools of empire
 Disease as a barrier to imperial expansion
 The role of quinine in the penetration of Africa
 Sanitation & spatial design of colonial cities
 Colonies as contamination threat

4. The League of Nations Health
Organization
 Lack of information flow during “Spanish flu” 1918-19
harmed efforts to stop the pandemic
 LNHO 1920 creates information system able to reach 2/3 of
world population – flow of accurate information as tool for
epidemic management
 Focus on “technical assistance” for health in Asia, esp.
China, aids push for reliable, standardized statistics
 LNHO sees information as neutral; govts eg GB see security
threat
 Standardized, accurate information as key – 2016 World
Health Assembly calls for more “rapid information sharing”
post-Ebola
“Chinese staff disinfecting at close
of working hours. 1:3000 mercury
bichloride.” Lantern slide, 1911,
Center for the History of Medicine
collection.

5. Brock Chisholm, first DG of WHO

6. The World Health Organization
 Health defined as “a state of complete physical, mental and social well-
being, and not merely the absence of disease or infirmity”
 First success of interim WHO – cholera in Egypt (vaccination, quarantine)
 WHO able to define and classify diseases
 Chisholm vs. Canada : Are WHO employees international civils servants, or
representatives of their country?
 Chisholm vs USA: A social approach to medicine based on wider causes, or
a bio-medial approach based on treatment?
 “magic bullets” eg DDT spraying for malaria
 World Health Assembly – global “parliament of health”
 Decentralized control to regional offices
 Smallpox (eradicated by 1979) vs. malaria (still active)

7. WHO & malaria – an integrated
approach to health & development
WHO malaria operations, Kpain, Liberia
(courtesy UN Photo)
UN land resettlement project, Kpain,
Liberia (U of Regina archives)

8. UN Mission for
Ebola
Emergency
Response
(UNMEER)
2014-15:
health as int’l
security issue,
multi-sector
response

9. WHO and malaria
 Disease beyond borders
 Information and technologies as political or apolitical
 Integrated or targeted approaches to health
 Time for self-study!
 Workbook on moodle