In 1946, the World Health Organization’s constitution declared that “the enjoyment of health is one of the fundamental rights of every human being.” This declaration significantly broadened the notion of natural and human rights and shaped the global discussion of social justice for the rest of the century.
The World Health Organization (WHO) was born between the end of World War II and the beginning of the Korean conflict. World War II set the stage for decolonization, as the war weakened the major European colonial powers and Japan demonstrated to colonized countries that European powers could be defeated. The formal advent of the nuclear age, with the dropping of atomic bombs on Hiroshima and Nagasaki in August, 1945, and the Korean conflict in 1950 further destabilized the old international power system. The system that emerged was one with two superpowers, the United States and the Soviet Union.
Europe and Japan were being rebuilt, largely with American aid, and the new technologies of the era began to have a global impact. The world’s attention, given such turbulence, was not on health issues. Nevertheless, WHO proclaimed that its prime objective was to raise the standard of health care for all persons. This idea’s institutional ancestry can be traced back to 1851, when the first International Sanitary Conference
The next major international efforts concerning health and health care came with the founding of the Health Organization of the League of Nations in 1923 and the International Office of Public Health in 1909. These organizations helped in healing the wounds left by World War I and in creating a better world through potent new health care weapons such as penicillin. The International Office of Public Health continued to operate after the League of Nations’ collapse during World War II. These preliminary global health systems evolved into the World Health Organization in 1946.
In 1945, fifty nations attending the San Francisco Conference created and adopted the United Nations Charter. It was also decided, on June 26, to establish a world health body. The International Health Conference
WHO was to be the medical body of the United Nations. It was to direct and coordinate everything related to international health issues, assisting governments in strengthening their national health services and providing emergency and technical assistance as needed. Some of the other goals and functions stipulated in its constitution were to educate all peoples (the general public as well as health care providers) about health issues; to foster and promote work (applied and research) to eradicate diseases, especially those of epidemic, endemic, or social natures; to advocate and advance maternal and child health; and to promote mental health.
WHO was designed to be a decentralized umbrella organization with six regional offices, operating independently within the larger framework of the United Nations. WHO was to establish regional centers that would conduct research and collect health data. The cancer research center in Lyon, France, is one such center designed to operate independently. The Center for Disease Control in Atlanta, Georgia, was established as a joint effort with WHO to collect data on influenza and other communicable diseases. WHO also works with other U.N. agencies, such as the Food and Agriculture Organization, on topics of mutual concern.
Article 1 of the WHO constitution states that attainment of the best possible health care by all peoples is a basic human right. The constitution also states that “the enjoyment of health is one of the fundamental rights of every human being.” WHO intended to promote these rights through education, through restructuring and training government agencies and service providers at the national level, and by providing comprehensive services (for example, technical assistance, standardized diagnostic procedures, environmental hygiene and sanitation research and assistance, and conferences on various topics).
The major innovation of the WHO constitution, reinforced by specific articles in the Universal Declaration of Human Rights (adopted on December 10, 1948), was to define health as a universal human right for the first time. Furthermore, by expanding the definition of health to cover all aspects of health-related well-being (including food, housing, and clothing), responsibility for well-being was placed squarely on the shoulders of individual governments. Maternal and child welfare, as well as social security for the unemployed, the elderly, the sick, and the widowed, were also included. The constitution also stated that health is connected to international politics, in that health is necessary for the attainment of peace and security.
Initially, this statement in the WHO constitution was ignored while WHO established its fundamental activities and organized the necessary frameworks and networks to achieve its prime directive. Short-term needs of the developed and less developed countries, especially concentrated disease eradication programs for smallpox and malaria, were the initial action areas. Over time, as WHO gained more resources and influence, its constitution’s declaration of a right to health became more important on the international stage.
Not all has run smoothly for WHO. For example, the definition and categorization of human rights in the U.N. Charter do not include health as a human right. This right is listed in Article 25 of the Universal Declaration of Human Rights, but it has never been given high priority. The basic question of what constitute human or natural rights forms the context of many debates within the United Nations, especially when these rights clash with traditional values and ways of life. Such debates also occur within WHO and its various agencies, on topics such as population control and family planning.
This lack of consensus over the meanings of “human rights” and “health as a human right” has created problems in the implementation and coordination of WHO’s goals and activities. One example of such difficulties concerns the World Health Assembly (the WHO’s major body) and how it forms policy regarding health standards. If a policy becomes a “regulation,” it is difficult to monitor. Another difficulty is that regulations are binding on each member state, unless a state expresses some reservations or rejects the regulation. WHO has no authority to enforce its regulations. Another type of policy, less binding and stringent than a “regulation,” is a “recommendation.” Recommendations are more common than regulations because reservations and rejections are avoided. Recommendations are more likely to promote consensus among WHO’s members.
In spite of such problems, WHO has made considerable progress. Smallpox has been wholly eradicated. Global birthrates began to decrease in the 1990’s, in part because of WHO-sponsored family planning programs that are one leg of its larger program in family health. WHO, in conjunction with other agencies and groups, has been trying actively to improve the quality of the environment. To this end, international reference systems have been established that study, monitor, and gather data on community water supplies, waste disposal, air and water pollution, and radiation protection.
The medical research programs overseen by WHO are engaged in ongoing efforts to control communicable diseases, including the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS). WHO is also engaged in efforts to prevent nutritional disorders, which can cause permanent brain damage in infants and children and contribute to high infant and maternal death rates; to study cancer and cardiovascular diseases, which are on the rise in South America as well as in other parts of the world; and to study the incidence, treatment, and causation of mental disorders. By September, 1970, WHO’s malaria eradication program had improved living conditions for about 80 percent of almost two billion people in 145 targeted countries and territories. Even as older health scourges are gradually brought under control, new health threats emerge, but WHO continues to monitor these threats and to work to defeat them. With WHO funds, fellowships are provided to train and educate people; specifically targeted are medical officers in key positions in governments.
In spite of its wobbly beginnings, WHO has become the global symbol of international health care. Increasingly, as countries recognize that primary health care, at a minimum, is essential to a country’s economic well-being as well as its future, more countries will come to define health care as a basic human right. This definitional shift must occur within each country, however, before WHO can begin to achieve this ultimate goal. The general economic development of countries is increasingly being seen as closely tied to the health of human populations, and thus WHO will continue to serve as a vital specialized agency within the U.N. system.
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Beaglehole, Robert, Alec Irwin, and Thomson Prentice. Changing History. Geneva, Switzerland: World Health Organization, 2004. Statement of the accomplishments, priorities, and ongoing programs of the WHO. Bibliographic references and index. -
Berting, Jan, et al., eds. Human Rights in a Pluralist World. Westport, Conn.: Meckler, 1990. A collection of papers delivered at two international conferences on human rights in concert with the United Nations’ fortieth anniversary of the Universal Declaration of Human Rights. Papers discuss the achievements, problems, and difficulties in defining and implementing “human rights.” -
Burci, Gian Luca, and Claude-Henri Vignes. World Health Organization. Frederick, Md.: Aspen, 2004. Profile and analysis of the WHO and its contributions to world health. Bibliographic references and index. -
Chandler, William U. “Investing in Children.” In State of the World, 1986, edited by Lester R. Brown. New York: W. W. Norton, 1986. Discussion of the efforts of WHO, UNICEF, and other United Nations agencies in concert with local governments to improve child health through improved basic health care, nutrition, and sanitation. -
Henderson, Donald A. “Smallpox: Never Again.” World Health (August/September, 1987): 8-11. WHO launched a concerted and collaborative effort in 1967 to eliminate smallpox globally. This is a good discussion of this time-limited, focused approach. -
Lambo, Thomas A., and Stacey B. Day, eds. Issues in Contemporary International Health. New York: Plenum Press, 1990. Good selection of readings on international health issues. Authors of the various articles are experts but write for general readers. -
Senderowitz, Judith, and John M. Paxman. Adolescent Fertility: Worldwide Concerns. Population Bulletin 2. Washington, D.C.: Population Reference Bureau, April, 1985. Good demographic analysis of global teenage fertility patterns. Issued in concert with the International Youth Year. Covers laws, access to information, behavioral patterns, and programs.
Oxford Committee for Famine Relief Is Founded
United Nations Holds Its First Conference on Food and Agriculture
Duggar Develops the First Tetracycline Antibiotic
UNICEF Is Established
Salk Develops a Polio Vaccine
Eisenhower Begins the Food for Peace Program
United Nations World Food Programme Is Established
Head Start Is Established to Aid Poor Children
World Health Organization Intensifies Its Campaign to Eradicate Smallpox
United States Joins the International Biological Program