Frustrations with FIDELIS: promising idea, problematic approach.
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Biomedical subjects
Publications and source records attributed to Anne-Emanuelle Birn.
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The evolution of international health has typically been assessed from the standpoint of central institutions (international health organizations, foundations, and development agencies) or of one-way diffusion and influence from developed to developing countries. To deepen understanding of how the international health agenda is shaped, I examined the little-known case of Uruguay and its pioneering role in advancing and institutionalizing child health as an international priority between 1890 and 1950. The emergence of Uruguay as a node of international health may be explained through the country's early gauging of its public health progress, its borrowing and adaptation of methods developed overseas, and its broadcasting of its own innovations and shortcomings.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The priorities and activities of international health organizations have historically been determined at the metropolitan level or through a confluence of central and local interests. The case of maternal and child health and the Pan American Sanitary Bureau during the first half of the 20th century demonstrates a different phenomenon. Rather than sparking interest and actions in maternal and child health in Latin America, the PASB ignored this area even though the agency was repeatedly urged by numerous countries in the region over several decades to provide support. This article begins with an examination of the emergence of maternal and child health circa 1900 in Europe, North America, and Latin America, identifying political, demographic, ideological, economic, and cultural commonalities and differences in these regions. We then turn to the PASB's early history and modus operandi, the pressure exerted by Latin American countries upon the PASB to pay attention to maternal and child health, and the Bureau's unwillingness to work in this area. Next we explore concomitant developments in maternal and child health and eugenics within Latin America in the 1920s and 1930s and the PASB's first steps in this area. Finally we discuss the conflict over the PASB's role in maternal and child health on several dimensions: as a manifestation of differing cultural priorities in the U.S. and Latin America; as a question of struggle for organizational power within the PASB; and as part of a richer understanding of the diffusion of early 20th-century public health and medical practices.
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This paper examines the emergence of child health policy as a global concern from the perspective of Uruguay's interaction with the international public health community in the early 20th century and its role in the circulation of child health ideas and practices. It considers two facets of national-international interplay: a) Uruguay's exploration of an interrelationship with the international panorama of policies, research and lessons on the improvement of child health; and b) the translation of Uruguay's domestic debates into the influential Instituto Internacional Americano de Protección a la Infancia - IIPI and the purveying of Uruguay's policies, research, and lessons on child health improvement to other countries and to international health and welfare agencies.
BACKGROUND: Since the development of the Commonwealth's 1950 Colombo Plan (Canada's first official aid program), health-related development assistance has been an important instrument of Canadian foreign policy, allowing it to gain a presence in a range of countries and help to shape international affairs. This pattern is evident in the history of Canadian multilateral and bilateral health aid to Latin America. METHODS: This analysis draws on historical material from the Departments of External Affairs and National Health and Welfare held at the Library and National Archives of Canada regarding Canadian involvement with the Pan American Health Organization (PAHO), and program information from the Canadian International Development Agency's (CIDA) Corporate Reporting Services Group. FINDINGS: Canada was initially a tentative player in the region. However, as Canadian foreign policy interests shifted towards the region in the 1970s, Canada used both multilateral and bilateral health aid to establish a presence in Latin America that was independent from, yet unthreatening to, United States hegemony in the region. CONCLUSION: The impact of Canada's provision of health aid to Latin America via PAHO and CIDA has been largely symbolic, allowing Canada to pursue an independent foreign policy in the region and to foster a positive international image for itself with minimal spending.