International Public Health and Health for All Movement

1. International Public Health:
Health for all Movement
Mohammad Aslam Shaiekh
MPH 3rd Batch
School of Health & Allied Science (SHAS)
Pokhara University (P.U)

2. Foundation and Development of
International Public Health
In mid 1800s USA and European nations
intensified protective legislative measures to
prevent the importation of infectious disease from
trading ships and cargo.
Precursor of today’s International Health
Regulation – International Sanitary Conference
1851, group of European nation drafted
international quarantine regulations.

3. The eleventh international sanitary conference
1903 in France was the adoption of 1st international
sanitary convention for prevention and control of
tropical diseases.
L’Office International d’Hygiene Publique
(OIHP), the 1st international health office was
established in 1907 whose objective was to protect
Europe from 3 tropical diseases.
The International Sanitary Bureau of America
was established in 1902 to facilitate the exchange
of information of infectious disease among nations
of America.

4. After establishment of OIHP, the International
Sanitary Bureau of America named as Pan
American Sanitary Bureau which later become
PASO.
PASO acted as the regional organization of
WHO, renamed Pan American Health Organization
(PAHO) in 1957 with Hq. at Washington DC.

5. Before 1st world war in 1911, OIHP was expand
to become first truly international health agency
with main responsibilities of;
• Monitoring & reporting outbreaks of three
tropical diseases occurring around the world.
• Providing information through a monthly
bulletin to public on general measures undertaken
over these diseases.

6. The epidemics of plague, typhus, cholera and
influenza pandemic during 1910-1920 were widely
distributed in many countries. OIHP with small
staffs and funding couldn’t cope the international
public health issue.
After intense negotiation between nations in the
league & other independent nations, League of
Nation Health Org(LNHO) was established in
1923.

7. LNHO was assigned to;
•Handle international health matters, technical
assistance to countries
•Weekly epidemiological research publishment
•Series of basic, clinical and field research on
medicine and public health
•series of international conference and meeting of
several experts
The conference of far eastern countries on rural
hygiene organized by LNHO in 1937, Indonesia
was a cornerstone in public health development of
Asia.

8. UNGA in June 1946 approved to include health
in its charter and called for international
conference, foster consensus in establishment of
new international organization in place of OIHP
and LNHO.
At Newyork conference in 22 July 1946, a total
of 61 nations approved the constitution of WHO,
- came into force in 7th April 1948. Main tasks
assigned to WHO were;
- to direct & collaborate international health work
and to cooperate with member states and partners
in international health development.

9. IHR-2005 were adopted by 58th WHA on 23
May 2005, came into force on 15th June 2007 to
prevent, protect against, control and provide a
public health response to international spread of
disease.

10. Health for all movement
Before Health for all during 1950s, LMI
countries made efforts to reduce burden of
communicable disease with establishment of
nationwide medical care and public health system.
After 20-25 years, many countries realized that
health care system based on hospitals and health
centers were burden on public.
By mid 1970s, there were glaring contrasts
between high income and LMI countries.

11. The avg. life expectancy at birth in LMI
countries was below 55 with IMR & CMR above
100/1000.
Despite these drawbacks, few LMI countries like
Cuba, China, Srilanka, Tanzania, Kerala state of
India had showed significant improvement.
The adoption of historical resolution at WHA in
1977 set the main social targets of member states
and WHO, of the attainment by all the citizens of
the world by the year 2000 of a level of health that
would permit them to lead a socially and
economically productive life. The universal social
target was termed as HFA2000.

12. Conceived as a process leading to progressive
improvement in the health of people, people would
use better approach than they had before. EHC
would be accessible to individuals and community
in acceptable and affordable ways with their full
involvement.
These principles were further clarified at
international conference on PHC jointly organized
by WHO and UNICEF at Alma-Ata in 1978
declaring that existing gross inequality in health
between developed and developing countries and
within countries is unacceptable, acceptance of
WHO goal Health for All by 2000 .

13. Called for urgent action by all governments,
health and development workers & world
community to protect and promote the health of all
people using PHC as approach.
LMI countries saw PHC as practical,
scientifically sound and socially acceptable public
health measure. They formulated new health
policies, strategies and plan of actions to launch
and sustain their health care services within
common framework of global HFA strategies.

14. The adoption of universal goal helped many
countries to recognize new ways of reaching a
higher level of health status and to emphasis
adherence to health goals.
Some countries concentrated on vertical health
care interventions while others tried on
comprehensive. UNICEF and other development
partners focus on GOBIF. (Comprehensive Vs
Selective PHC)
 Ottawa Charter for Health Promotion 1986,
source of guidance and inspiration for Health
promotion

15. The accessibility of essential health care in fact
improved in most countries with over 80%
coverage however remained very slow in
particularly the least developed ones.
The widely accepted idea of integrated health
system in 1950s had practical operational
constraints in transforming semi-autonomous
vertical or selective program into general health
services.

16. The lack of full understanding of fundamental
policies and principals of PHC & HFA that were
applicable to health system development,
inadequate coordination and collaboration,
difficulties in involving communities, weak
planning and management at operation level
slowed implementation of HFA strategies using
PHC as key approach. This led to achieving an
insufficient level of universal access to EHC.

17. The intense democratization process by late
1990s in many LMI countries led to certain
devolution/decentralization of power to locals
thereby increasing involvement in planning and
management of development programs.
World bank, IMF and other bi/multilateral
organizations used these changes in devolution as a
condition for external assistance.
Promoted community awareness and creation of
active and effective mechanisms for community
involvement.

18.  To minimize the cost of expansion of Basic
Health Care services, large no. of trained
volunteers were mobilized for certain period
basically for disease prevention & control,
epidemic control, immunization, MCH care
including nutrition promotion, surveillance,
treatment of minor injuries etc.
 Proved to be a success for expanding EHC in
many countries.

19.  Series of health reforms had fostered in
achievement of universal HFA goal.
- improved essential package of health
- models of health financing at national and local
level
- social health insurance
- increased role of private sector for profit and
non profit

20. Thank you for your patience !!!
207/6/2018 Aslam Aman_MPH