November 4, 2018History of Medicine
In response to cholera epidemics in 1830 and 1847, which killed tens of thousands in Europe, the first International Sanitary Conference was convened in Paris in 1851. At the time, the cause of cholera was unknown and due to political differences little was accomplished at this or the next several meetings. Nonetheless, the conferences were the first attempt at establishing a mechanism for international cooperation for disease prevention and control.
The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with international public health. It was established on 7 April 1948, and is headquartered in Geneva, Switzerland. The WHO is a member of the United Nations Development Group. Its predecessor, the Health Organization, was an agency of the League of Nations. The constitution of the WHO was signed by 61 countries on 22 July 1946, with the first meeting of the World Health Assembly. It incorporated the Office International d'Hygiene Publique and the League of Nations Health Organization.
The WHO played a leading role in the eradication of smallpox. Its current priorities include communicable diseases, in particular HIV/AIDS, Ebola, malaria and tuberculosis; as well as the mitigation of the effects of non-communicable diseases such as sexual and reproductive health, development, and aging; nutrition, food security and healthy eating; occupational health; substance abuse; and driving the development of reporting, publications, and networking.
The WHO is responsible for the World Health Report, the worldwide World Health Survey, and World Health Day. The current Director-General of the WHO is Tedros Adhanom, who started his five-year term on 1 July 2017. Tedros Adhanom Ghebreyesus (born March 3, 1965) is an Ethiopian politician, academic, and public-health authority who since 2017 has been Director-General of the WHO. He served in the Government of Ethiopia as Minister of Health from 2005 to 2012 and as Minister of Foreign Affairs from 2012 to 2016. Tedros joined the Ministry of Health in 1986, after graduating from the University of Asmara. An internationally recognized malaria researcher, as Minister of Health, Tedros received praise for a number of innovative and system-wide health reforms that substantially improved access to health services and key outcomes. Among them were hiring and training roughly 40,000 female health extension workers, cutting infant mortality from 123 deaths per 1,000 live births in 2006 to 88 in 2011, and increasing the hiring of health cadres including medical doctors and midwives. In July 2009, he was elected Board Chair of The Global Fund to Fight AIDS, Tuberculosis and Malaria for a two-year term. Tedros was elected as Director-General of the WHO by the World Health Assembly on 23 May 2017. He took office for a five-year term on 1 July 2017.
The International Sanitary Conferences, originally held on 23 June 1851, were the first predecessors of the WHO. A series of 14 conferences that lasted from 1851 to 1938, the International Sanitary Conferences worked to combat many diseases, chief among them cholera, yellow fever, and the bubonic plague. The conferences were largely ineffective until the seventh, in 1892, when an International Sanitary Convention that dealt with cholera was passed. Five years later, a convention for the plague was signed. In part as a result of the successes of the Conferences, the Pan-American Sanitary Bureau, and the Office International d'Hygiene Publique were soon founded in 1902 and 1907, respectively. When the League of Nations was formed in 1920, they established the Health Organization of the League of Nations. After World War II, the United Nations absorbed all the other health organizations, to form the WHO.
During the 1945 United Nations Conference on International Organization, Szeming Sze, a delegate from China, conferred with Norwegian and Brazilian delegates on creating an international health organization under the auspices of the new United Nations. After failing to get a resolution passed on the subject, Alger Hiss, the Secretary General of the conference, recommended using a declaration to establish such an organization. Sze and other delegates lobbied and a declaration passed calling for an international conference on health. The use of the word world rather than international emphasized the truly global nature of what the organization was seeking to achieve. The constitution of the WHO was signed by all 51 countries of the United Nations, and by 10 other countries, on 22 July 1946. It thus became the first specialized agency of the United Nations to which every member subscribed. Its constitution formally came into force on the first World Health Day on 7 April 1948, when it was ratified by the 26th member state. The first meeting of the World Health Assembly finished on 24 July 1948, having secured a budget of US$5 million for the 1949 year. Andrija Stampar was the Assembly's first president, and G. Brock Chisholm was appointed Director-General of WHO, having served as Executive Secretary during the planning stages. Its first priorities were to control the spread of malaria, tuberculosis and sexually transmitted infections, and to improve maternal and child health, nutrition and environmental hygiene. Its first legislative act was concerning the compilation of accurate statistics on the spread and morbidity of disease. The logo of the WHO features the Rod of Asclepius as a symbol for healing.
In 1958, Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health Assembly to undertake a global initiative to eradicate smallpox, resulting in Resolution WHA11.54. At this point, 2 million people were dying from smallpox every year. In 1967, the WHO intensified the global smallpox eradication by contributing $2.4 million annually to the effort and adopted a new disease surveillance method. The initial problem the WHO team faced was inadequate reporting of smallpox cases. WHO established a network of consultants who assisted countries in setting up surveillance and containment activities. The WHO also helped contain the last European outbreak in Yugoslavia in 1972. After over two decades of fighting smallpox, the WHO declared in 1979 that the disease had been eradicated - the first disease in history to be eliminated by human effort.
The following is a chronology of the WHO beginning in 1967:
In 1967, the WHO launched the Special Program for Research and Training in Tropical Diseases and the World Health Assembly voted to enact a resolution on Disability Prevention and Rehabilitation, with a focus on community-driven care.
In 1974, the Expanded Program on Immunization and the control program of onchocerciasis was started, an important partnership between the Food and Agriculture Organization (FAO), the United Nations Development Program (UNDP), and the World Bank.
In 1977, the first list of essential medicines was drawn up, and a year later the ambitious goal of health for all was declared.
In 1986, the WHO began its global program on HIV/AIDS. Two years later preventing discrimination against sufferers was attended to and in 1996 UNAIDS was formed.
In 1988, the Global Polio Eradication Initiative was established.
In 1998, WHO's Director-General highlighted gains in child survival, reduced infant mortality, increased life expectancy and reduced rates of scourges such as smallpox and polio on the fiftieth anniversary of WHO's founding. He, did, however, accept that more had to be done to assist maternal health and that progress in this area had been slow.
In 2000, the Stop TB Partnership was created along with the UN's formulation of the Millennium Development Goals. In 2001 the measles initiative was formed, and credited with reducing global deaths from the disease by 68% by 2007. In 2002, The Global Fund to Fight AIDS, Tuberculosis and Malaria was drawn up to improve the resources available. In 2006, the organization endorsed the world's first official HIV/AIDS Toolkit for Zimbabwe, which formed the basis for a global prevention, treatment and support plan to fight the AIDS pandemic.
The WHO fulfills this objective through its functions as defined in its Constitution: (a) To act as the directing and coordinating authority on international health work; (b) To establish and maintain effective collaboration with the United Nations, specialized agencies, governmental health administrations, professional groups and such other organizations as may be deemed appropriate; (c) To assist Governments, upon request, in strengthening health services; (d) To furnish appropriate technical assistance and, in emergencies, necessary aid upon the request or acceptance of Governments; (e) To provide or assist in providing, upon the request of the United Nations, health services and facilities to special groups, such as the peoples of trust territories; (f) To establish and maintain such administrative and technical services as may be required, including epidemiological and statistical services; (g) to stimulate and advance work to eradicate epidemic, endemic and other diseases; (h) To promote, in co-operation with other specialized agencies where necessary, the prevention of accidental injuries; (i) To promote, in co-operation with other specialized agencies where necessary, the improvement of nutrition, housing, sanitation, recreation, economic or working conditions and other aspects of environmental hygiene; (j) To promote co-operation among scientific and professional groups which contribute to the advancement of health; (k) To propose conventions, agreements and regulations, and make recommendations with respect to international health matters and to perform.
As of 2012, the WHO has defined its role in public health as follows: providing leadership on matters critical to health and engaging in partnerships where joint action is needed; shaping the research agenda and stimulating the generation, translation, and dissemination of valuable knowledge; setting norms and standards and promoting and monitoring their implementation; articulating ethical and evidence-based policy options; providing technical support, catalyzing change, and building sustainable institutional capacity; and monitoring the health situation and assessing health trends.