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História, Ciências, Saúde-Manguinhos

Print version ISSN 0104-5970

Hist. cienc. saude-Manguinhos vol.22 no.1 Rio de Janeiro Jan./Mar. 2015 

International Health/global Health Dossier - Presentation


Marcos Cueto

Gilberto Hochman

In recent years, global health has become a ubiquitous concept in public health and has practically replaced the nigh on fifty-year-old international health agenda. However, its origins, characteristics, differences and impacts have not yet been adequately analyzed. The scope of this dossier is to bring together historians and specialists to attempt to understand the global health concept, highlighting the history of international health, the changing role of state public health services and medical care, and the local/national/global interaction in the context of Latin America and the Caribbean. Our region has a long and dynamic relationship with international health and its organizations, people of renown, initiatives and programs. Production in the field of the history of health in Latin America and the Caribbean has increased in quantity and matured in terms of quality. These studies require reflection and discussion by historians and specialists on the historical background of the global/international character of health and the possible specificities of our regional context.

This task demands a collective effort of reflection, since there is no single definition of global health, nor a consensus about its origins. For some specialists, the process of globalization began in the sixteenth century with the Spanish and Portuguese conquest and colonization of the Americas, which generated colonial medicine. For others, global health dates back to the close ties between imperialism and tropical medicine of the late nineteenth century. They also stress the role played by philanthropic agencies in the early twentieth century, such as the Rockefeller Foundation, which sought to civilize the rest of the world through Western medicine. Some believe that the immediate antecedent of global health is international health that emerged during the Cold War period, which started around 1948, marked by multilateral agencies like the World Health Organization (WHO) and the ideological confrontation between the Soviet Union and the United States to promote health models (state health versus private practice; nationalization of health care services versus vertical campaigns). Others believe that global health is linked to the emergence of neo-liberalism that followed the end of the Cold War (late 1980s) and is associated with the omnipresent theme of "globalization" where economics and technology appear to compress and create a global society. With globalization a new epidemiological scenario arises in which there are new or reemerging infections that affect rich and poor countries alike. It is a scenario of frequent international travel and mass migration, with new actors appearing such as non-governmental organizations, the new international philanthropy, public-private partnerships and institutions not hitherto traditionally involved with health, such as the World Bank. It is a period marked by a set of new challenges to national and international health services, questioning the premise that the State is the main health authority.

The articles in this dossier are an integral part of this historic effort of reflection. They are based mostly on lectures given at the International Health/Global Health International Seminar - Historical Perspectives of Latin America and the Caribbean, held on June 20, 21 and 22, 2012 at Casa de Oswaldo Cruz (COC)/Fiocruz in Rio de Janeiro, Brazil. The seminar had the decisive support of Faperj and the management of COC/Fiocruz in the person of Nara Azevedo. Academics from (or based in) Brazil, Argentina, Peru, Mexico, United States, Canada, Germany and Spain participated in the seminar, along with historians from various Rio de Janeiro-based institutions who were invited to comment on the presentations. The objective of the seminar was precisely to examine the notion of global health, highlighting continuities and changes in the international health concept and is the result of a broad research network into the history of health in Latin America. It is made up of Latin-American scholars and Latin Americans who have enhanced knowledge about health and disease from a historical perspective in the Americas with publications, seminars and post-graduate courses.

The articles analyze different dimensions and periods of the interface between global/international health and national/local public health with emphasis on the negotiation, resistance, adaptation and also the circulation of knowledge. Adam Warren studies the activities of midwives in Peru in the early days of its Republican period in the first half of the nineteenth century, and the influence of a French midwife in Lima. Karina Rammaciotti studies the legal knowledge and the institutions linked to occupational accidents in Argentina; a growing topic of importance to international agencies and States in the region in the mid-twentieth century. Luiz Antonio Teixeira presents a topic that is coming under increasing scrutiny: the cancer-prevention campaigns in Brazil. According to him, the development of knowledge about cervical cancer was related simultaneously to the transformations in medical knowledge, the broadening of concerns over women's health and the transformations of the Brazilian health system. Mariola Espinosa's article studies the links between the National Health Service in the United States and the origins of health systems in the Caribbean region at the turn of the twentieth century. The article by Marcos Cueto analyzes the campaigns by international agencies and national organizations to eliminate infectious diseases in Latin American rural areas of the mid-twentieth century. The article on the impact of influenza A (H1N1) in Paraná newspapers is the result of research by Sandra Mara Maciel-Lima, José Miguel Rasia, Rodrigo Cechelero Bagatelli, Giseli Gontarski and Máximo José D. Colares. The text analyzes more than 180 articles on influenza A (H1N1) newspapers from the state of Paraná in 2009, by means of which the authors discuss the social impact that the H1N1 pandemic represented for an increasingly globalized society, defying public authorities, institutions and ordinary citizens. The dossier concludes with a Research Note by historian Diego Armus on the influence of Geneva and the WHO on the medicalization of smoking in Argentina.

Marcos Cueto and Gilberto Hochman

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.