Issues in Contemporary International Health

349 Pages·1990·9.81 MB·English

by  Stacey B. Day

Issues in Contemporary
International Health
Issues in Contemporary
International Health
Edited by
Thomas A. Lambo
Deputy Director General (Retired)
World Health Organization
Geneva, Switzerland
and
Stacey B. Day
Founding Professor and Director
World Health Organization Collaborating Center for
Community-Based Education for Health
Nashville, Tennessee
Springer Science+Business Media, LLC
Library of Congress Cataloging-In-Publication Data
Issues 1n contemporary International health I edited by Thomas A.
Laabo and Stacey B. Day.
p. CJI.
Includes bibliographical references.
1. Pub11c health--Internat1onal cooperat1on. I. Lambo, Thomas A.
<Thoaas Adeoye) II. Day, Stacey B.
[DNLM: 1. Pub11c Health. 2. World Health. WA 540.1 I86]
RA441. I88 1990
362. 1--dc20
DNLM/DLC
for L1brary of Congress 89-72169
CIP
ISBN 978-1-4899-3715-5 ISBN 978-1-4899-3713-1 (eBook)
DOI 10.1007/978-1-4899-3713-1
© 1990 Springer Science+B usiness Media New York
Originally published by Plenum Press, New York in 1990.
Softcover reprint of the hardcover 1st edition 1990
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Contributors
B. ABEL-SMITH, M.SC., PH.D.
Professor of Social Administration
London School of Economics and Political Science
London, England
s.
PRINCE AI<PABIO, LDS(RCS)E, FICO
Consultant, Oral Health
World Health Organization
Geneva, Switzerland;
Clinical Lecturer
University College Hospital Dental School
University of London
London, England
N. P. BocHKOv, M.D.
Director, Institute of Medical Genetics
USSR Academy of Medical Sciences
Moscow, USSR
v.
E. BULYZHENKOV, M.D.
Hereditary Diseases Programme
Division of Noncommunicable Diseases
World Health Organization
Geneva, Switzerland
J. I. COHEN, M.D., M.P.H.
Former Advisor on Health Policy
Director-General's Office
World Health Organization
Geneva, Switzerland
v
vi CONTRIBUTORS
STACEY B. DAY, M.D., PH.D., D.SC.
Professor of International Health
Founding Director
World Health Organization Collaborating Center for Community
Based Education for Health
Nashville, Tennessee 37208
S. S. FLUSS, B.SC., M.SC.
Chief, Health Legislation
World Health Organization
Geneva, Switzerland
FRANK GUTTERIDGE, M.A., LLB, BL
Former Director
Legal Division
World Health Organization
Geneva, Switzerland
DAVID A. HAMBURG, M.D.
President, Carnegie Corporation of New York
New York, New York 10022
THOMAS A. LAMBO, M.D., FRCP, D.SC.
Deputy Director General (Retired)
World Health Organization
Geneva, Switzerland
ERNESTO MEDINA, M.D., M.P.H.
Professor of Preventive and Social Medicine and Director
School of Public Health
University of Chile
Santiago, Chile
ALLYN M. MoRTIMER
Program Associate
Carnegie Corporation of New York
Washington, D. C. 20036
ELENA 0. NIGHTINGALE, PH.D.
Special Advisor to the President
Carnegie Corporation of New York
Washington, D. C. 20036
CONTRIBUTORS vii
D. M. PARKIN, M.D.
International Agency for Research on Cancer
69372 Lyon, Cedex 8, France
NORMAN SARTORIUS, M.D., FRCP
Director, Division of Mental Health
World Health Organization
Geneva, Switzerland
L. TOMATIS, M.D.
Director, International Agency for Research on Cancer
69372 Lyon, Cedex 8, France
H. VAINIO, M.D.
International Agency for Research on Cancer
69372 Lyon, Cedex 8, France
LADE WosoRNu, M.D., FRCS, FRCS(E)
Professor, Department of Surgery
Director, Residency Programs
King Faisal University
College of Medicine
Dammam, Saudi Arabia
ANNETTE M. YONKE, PH.D.
Associate Professor, Department of Medical Education
College of Medicine
University of Illinois at Chicago
Chicago, Illinois 60612
Preface
Dr. Oliver Wendell Holmes was once asked, "When should the training
of a child commence?"
"A hundred years before birth" was the reply.
Indeed it is this perspective on life through posterity that underlies
the maturing field of international health, embracing as it does a respon
sibility for and an awareness of the needs of all peoples.
The concepts of international health are increasingly revitalizing
modern medicine as it attempts to relieve mankind of the burden of
disease. Curative medicine, once the paradigm, took a relatively benefi
cient approach to treatment. But epidemiological recognition of the fre
quency of disease on a global basis-and an appreciation of the vast
number of those afflicted-evoked a humiliating backlash of awareness
that curative medicine alone neither constrains disease nor permanently
advances human health, happiness, or longevity. The growing reliance
on truly international health strategies by national and international
agencies, including the more definite and extended practice of preven
tive medicine, has provided the means to achieve significant gains in the
quality of health in years to come.
A redeeming feature of contemporary failures in science and medi
cine is that-once intelligently studied, analyzed, and evaluated-even
these failed efforts may provide real insights that can mold our capacity
and determination. So it is that, more than in any bygone age, the past
ten years have seen the implementation of a sound and systematic in
frastructure for international health undertakings, thus paving the way
for improved health for all.
Although this short monograph cannot hope to cover every current
international program in medicine, public health, dentistry, or phar
macy, we hope that it will dearly demonstrate our belief that inter
disciplinary integration of biopsychosocial and biobehavioral specialties
within the broad disciplines of classical medicine can spearhead im-
ix
X PREFACE
provements in global health through more effective prevention of ill
ness, through improved education and social and cultural understand
ing of disease, and through research and scientific investigation on
behalf of the public good.
If we, and our colleagues who have herein contributed to the dis
cussion, have succeeded in raising the threshold of interest and deter
mination that every passing year in this field should be worth ten of
those that went before, and if we can share the view that, though death
may come, disease need not, then we shall have achieved our goal of
furthering the influence of preventive medicine and international
health-a goal to which we hope the reader can also subscribe.
THOMAS A. LAMBO
STACEY B. DAY
Contents
1 • Introduction: International Health and Health for All
STACEY B. DAY AND THOMAS A. LAMBO
Background ......................................... . 1
Perception of Needs .................................. . 3
Science and Technology for Development .............. . 4
Education and Health ................................ . 6
Contributions of This Volume ......................... . 8
References............................................ 10
I • MANAGEMENT OF INTERNATIONAL HEALTH
2 • Health Policy, Management, and Economics
J. I. CoHEN
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
The Nature of Health Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
The Scope of Health Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
The Content of Health Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Resource Allocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Health Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
The Process of Defining Health Policies and Strategies . . . . 21
International Health Policy and Strategy . . . . . . . . . . . . . . . . . 26
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
xi