Global public health notes

Last major update: 2016-02-26
Status: notes; belief: possible

Contents

• When and how did global health become a movement?
• What does the success of global health tell us about other movements?

These are some notes on global public health as part of a larger project. The final results will likely not be published here (but I will try to link to them from here when they’re done), but this is the most convenient place for notes.

When and how did global health become a movement?

Some relevant Quora questions I’ve asked that might spring up useful information:

• When did global health charities start to emerge?
• How did global health become “commodified” (through a movement advocating donations)?
• How did global public health become so popular?

Initial hypotheses (after reading the Wikipedia section):

• The push toward global health was crisis-driven, in the sense that outbreaks somewhat unrelated to the rest of global health were responsible for kick-starting interest in the rest of the area. The analogy here is that things like natural disasters influence people to donate more money.
• Somehow organizations like the WHO formed and convinced people to donate more money.

It’s important to distinguish between government interest and public interest in global health. It seems that government interest came first, followed by public interest. There is also “philanthropic interest” from individuals with a lot of money.

This page provides an outline of how government bodies formed, but not a lot of underlying motivation.

‘The World Health Organization and the Transition From “International” to “Global” Public Health’:

“International health” was already a term of considerable currency in the late 19th and early 20th century, when it referred primarily to a focus on the control of epidemics across the boundaries between nations (i.e., “international”). […] “Global health,” in general, implies consideration of the health needs of the people of the whole planet above the concerns of particular nations. The term “global” is also associated with the growing importance of actors beyond governmental or intergovernmental organizations and agencies—for example, the media, internationally influential foundations, nongovernmental organizations, and transnational corporations.

On potential motivations for countries like the US:

In 1955, Candau was charged with overseeing WHO’s campaign of malaria eradication, approved that year by the World Health Assembly. The ambitious goal of malaria eradication had been conceived and promoted in the context of great enthusiasm and optimism about the ability of widespread DDT spraying to kill mosquitoes. As Randall Packard has argued, the United States and its allies believed that global malaria eradication would usher in economic growth and create overseas markets for US technology and manufactured goods. It would build support for local governments and their US supporters and help win “hearts and minds” in the battle against Communism. Mirroring then-current development theories, the campaign promoted technologies brought in from outside and made no attempt to enlist the participation of local populations in planning or implementation. This model of development assistance fit neatly into US Cold War efforts to promote modernization with limited social reform.

Interesting note on WHO’s funding:

Another symptom of WHO’s problems in the late 1980s was the growth of “extrabudgetary” funding. As Gill Walt of the London School of Hygiene and Tropical Medicine noted, there was a crucial shift from predominant reliance on WHO’s “regular budget”—drawn from member states’ contributions on the basis of population size and gross national product—to greatly increased dependence on extrabudgetary funding coming from donations by multilateral agencies or “donor” nations. By the period 1986–1987, extrabudgetary funds of $437 million had almost caught up with the regular budget of $543 million. By the beginning of the 1990s, extra-budgetary funding had overtaken the regular budget by $21 million, contributing 54% of WHO’s overall budget.

1990s:

Best-selling books and news magazines were full of stories about Ebola and West Nile virus, resurgent tuberculosis, and the threat of bioterrorism. The message was clear: there was a palpable global disease threat.

This Harvard course spends quite a bit of time on the role of missionaries. I’m not sure if it’s worth looking into.

From this chapter:

• 501(c)(3) and 501(c)(4) came along in 1954.

• On the role of legislation:

  It is no accident that the impressive proliferation of registered tax-exempt nonprofits in the United States from fewer than 13,000 in 1940 to more than 1.5 million at the end of the century coincided with legislative and regulatory policies that defined and systematically favored nonprofits and those who contributed to their support. Nor is it a coincidence that ownership of hospitals shifted from predominantly public and proprietary in 1930 to nonprofit by the 1960s to proprietary by the century’s end with changes in tax and health policy.

• Soon after the US was founded, US federal and state governments tried to stop charities and corporations for fear of losing power to them. Also:

  At the end of the eighteenth century, indigenous philanthropy and voluntarism were still embryonic. Most philanthropy was devoted to public institutions—municipal governments, schools and colleges, and religious congregations (most of which were tax-supported). Voluntary participation in organizations was restricted to fraternal associations, local social clubs, a handful of medical societies, and the secretive political societies that would eventually form the basis for political parties. The absence of a legal infrastructure to enforce charitable trusts, as well as broad hostility to ward corporations, discouraged private initiatives professing to benefit the public.

What does the success of global health tell us about other movements?

Specifically, I’m interested in anti-aging.

Some parts of early history of philanthropy are less relevant. For instance, the way in which nonprofits became codified in US law was important the first time around (i.e. for currently-existing philanthropy), but is less relevant for newer developments like anti-aging, since these laws are already in place.

Tags: global health.

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