INTERNATIONAL

HEALTH

Presenter:
Dr. NAVPREET
Assistant Prof., Deptt. of Community Medicine
GMCH Chandigarh
 Introduction
• Health and disease can not be limited by the
boundaries of the nations, was recognized long ago.
• Way back in 1377, the first recorded quarantine legislation
was promulgated for prevention of transshipment of rodents.
• International Sanitary Conference, convened in Paris
in 1851,
– the first step towards seeking international cooperation in
prevention of communicable diseases with epidemic
potentials.
• Led to the establishment of Office International d’
Hygiene Publique (OIHP) in 1907
– a precursor of League of Nations and World Health
Organization (WHO).
 International Health
• “A field of research and intervention embracing the
international dimensions of health, disease process
and care systems.”
• Research:
– the analysis of health determinants and the health states
of the individuals and populations,
• Intervention:
– the actions taken at economic, political and administrative
levels.
 Contents of International Health
• Principles of epidemiology.
• Psychosocial aspects
• Demographic aspects
• Economic aspects
• Health system and governance
• Miscellaneous aspects
– ethical issues, utilization of alternative medicine by various population
segments, humanitarian response to disasters and emergencies and
the participation of various governmental, non‐governmental and
private agencies.
 Organizations Involved in
International Health
• Multilateral organizations
– funding comes from multiple governments (as well as from
non‐governmental sources) and is distributed to many
different countries e.g. UN and WHO.
• Bilateral organizations
– governmental agencies in a single country which provide
aid to developing countries e.g. USAID.
• Non‐governmental organizations
– private voluntary organizations, provide approximately
20% of all external health aid to developing countries.
World Health Organization (WHO)
• Following World War II and creation of
intergovernmental organizations like United Nations
(UN)
• International health conference was held in June‐July
1946
• All the 61 members approved the constitution of
World Health organization (WHO) on 22 Jul 1946.
• This constitution, after many deliberations and
ratifications, came into force on 7 April 1948.
• Its objective, as set out in its Constitution, is the
attainment by all peoples of the highest possible
level of health.
 Role in Public Health
1. Leadership : Providing leadership on matters critical to health and
engaging in partnerships where joint action is needed.
2. Setting standards : Setting norms and standards and promoting and
monitoring their implementation.
3. Policy formulation : Articulating ethical and evidence based policy
options.
4. Capacity building : Providing technical support, catalysing change
and building sustainable institutional capacity;
5. Monitoring : Monitoring the health situation and assessing health
trends. Shaping the research agenda and stimulating
6. Research : the generation, translation and dissemination of valuable
knowledge.
 Organisation
• The WHO has its Headquarters comprising of the
World Health Assembly and the executive board, at
Geneva.
• Its regional offices for six regions covering all the
member states, at six different places.
 World Health Assembly
• The supreme decision‐making body for WHO.
• It deals with the administration, finances and
international policies ad programmes.
• It also elects the Director General of the WHO who is
the chief technical and administrative officer of
WHO.
• It meets each year in May in Geneva and is attended
by delegations from all 193 Member States.
 Regions of WHO
Regions Headquarters
America Washington D.C. (U.S.A.)
Europe Copenhagen (Denmark)
Eastern Mediterranean Alexandria (Egypt)
Western Pacific Manila (Philippines)
South East Asia New Delhi (India)
Africa Harare (Zimbabwe)
 Activity Areas in India
• Provides technical assistance and collaborates with
the Government of India and major stakeholders in
health development efforts.
• Assists notably in Policy Development; Capacity
Building and Advocacy.
 Core Programme Clusters

• Health system and community health

• Communicable diseases
• Non‐ communicable diseases
• Sustainable development and healthy environments
• Evidence and information for policy
• Health technology and pharmaceuticals
• Social change and mental health
 United Nations Children’s Fund
(UNICEF)
• United Nations International Children’s Emergency
Fund (UNICEF) was originally created to deal with the
issue of child poverty in Europe after World War II.
• Official permanent status in the UN only in 1953
• In 1961, UNICEF also included the rights of children
to education and proper health care under the
umbrella of its activity.
• The administrative and organizational headquarter
of UNICEF is at New York City.
 Priorities of UNICEF include
 Promotion of breast feeding,
 Immunization,
 Growth monitoring,
 Oral rehydration,
 Education of girl child,
 Child spacing and
 Nutritional supplementation.
 UNICEF in India
• 1949 : UNICEF begins working in India.
• 1967 : UNICEF’s association with GOI’s rural water programme
provides emergency relief to tackle severe drought.
• 1975 : UNICEF supports piloting and launch of ICDS.
• 1985‐86 : UNICEF supports launch of GOI’s UIP.
• 1986 : UNICEF works with GOI to launch ORT Programme.
• 1996 : UNICEF supports launch of GOI’s RCH programme.
• 2000 : UNICEF partners with GOI to ensure eradication of guinea
worm.
• 2004 : UNICEF joins Government of India’s (GOI) efforts to
eradicate polio.
United Nations Educational, Scientific and
Cultural Organization (UNESCO)
• Founded on 16 November 1945.
• Headquarter is at Paris.
• Aims at promotion of international co‐operation
among its Member States in the fields of education,
science, culture and communication.
 UNESCO in India
• Six broad areas for providing assistance and directing
its activities:
 Universal Primary Education
 Promoting gender equity and equality
 Implementation of the new commitment to science
 Protecting world’s cultural diversity
 Equitable access to information and knowledge to all
 Sustainable Development
 Food and Agriculture Organization (FAO)
• Founded in 1945.
• Headquarter is at Rome.
• FAO aims at achieving food security for all.
• Activities comprise 4 main areas:
1. Putting information (relating to nutrition, food,
agriculture, forestry and fisheries) within reach.
2. Sharing policy expertise.
3. Providing a meeting place for nations.
4. Bringing knowledge to the field.
 FAO in India
• It’s current focus is mainly on plant production activities,
forestry, fisheries, nutrition and food quality & safety.
• The various projects in India are as follows :
 Transfer of technology for vegetative propagation of walnuts
in Jammu & Kashmir
 Development of integrated plant nutrition systems
methodology
 Training in sea safety development programmes
 Greenhouse technology for floriculture
 Food quality control
 International Labour Organization (ILO)
• The ILO was founded in 1919 to improve the living
and working conditions of the working population all
over the world.
• In 1946, it became the first specialized agency of the
UN.
• Headquarter is at Geneva, Switzerland.
• It coordinates and provides technical assistance to
India in the field of rural labour, women workers,
employment generation, occupational safety and
health etc.
United Nations Development Programme
(UNDP)
• UNDP provides expert advice, training and grant
support to developing and least developing countries
a) to meet developmental challenges
b) to develop local capacity and
c) to accomplish MDGs.
 The United Nations Population Fund
(UNFPA)
• UNFPA supports countries in using population data
for policies and programmes
a) To reduce poverty
b) To ensure that every pregnancy is wanted
c) To ensure that every birth is safe
d) To ensure that every young person is free of
HIV/AIDS, and
e) To ensure that every girl and woman is treated with
dignity and respect.
 Bilateral Agencies
• United States Agency for International Development
(USAID)
• Colombo Plan
• Danish International Development Assistance
(DANIDA)
• Swedish International Development Agency (SIDA)
 NGOs
• Ford Foundation
• Rockefeller Foundation
• International Red Cross
• Co‐operative for Assistance and Relief Everywhere
(CARE)
• Oxford Committee for Famine Relief (OXFAM)
• Programme for Appropriate Technology in Health
(PATH)
 International Health Regulations
• An international law
• Helps countries work together to save lives and
livelihoods caused by the international spread of
diseases and other health risks.
• 15th June 2007
• 194 countries across the globe
 Aim
• to prevent, protect against, control and respond to
the international spread of disease while avoiding
unnecessary interference with international traffic
and trade.
 Why does the world community need IHR?

• To strengthen the collective defences against the

multiple and varied public health risks.
• Establish a set of rules to support the global
outbreak alert and response system and
• To require countries to improve international
surveillance and reporting mechanisms for public
health events and
• To strengthen their national surveillance and
response capacities.
 History of IHR
18 0- • Cholera epidemic (Europe)
1847 ) - - - - - - - - - - - - - - - - - - - - - -

• 1st International Sanitary Conference

1851

• WHO Members adopted the International Sanitary

1951 Regulations

• Renamed International Health

1969
 IHR (1969)
• Primarily intended to monitor and control six serious
infectious diseases:
• Cholera*
• Plague*
• Yellow fever*
• Smallpox
• Relapsing fever and
• Typhus.

*Notifiable
 • Resurgence of Cholera, Plague
Ea ly • Emergence of Ebola Hemorrhagic fever
1990s- - - - - - - - - - - - - - - - - - - - -

• Call for revision of the IHR at 48t h World Health Assembly

1995

• Adopted Global Health Security: epidemic alert and

2001 response

• Established Intergovernmental Working Group (IGWG) to

2003 review and recommend a draft revision of the IHR.

• World Health Assembly adopted IHR (2005)

2005
 Why were the IHR revised?
• The limitations of the IHR (1969):
 Narrow scope (three diseases),
 Dependence on official country notification, and
 Lack of a formal internationally coordinated
mechanism to contain international disease spread.
 What are the main functions of the
IHR (2005)?
• Notification
• The IHR (2005) require States
 to notify WHO of all events that may constitute a public
health emergency of international concern; and
 to respond to requests for verification of information
regarding such events.

• To ensure appropriate technical collaboration for effective

prevention of such emergencies or containment of
outbreaks
 "Public Health Emergency of
International Concern (PHEIC)"
• An extraordinary public health event which is
determined, under specific procedures:
a) to constitute a public health risk to other States
through the international spread of disease; and
b) to potentially require a coordinated international
response.
THANKS !