At the Roots of The World Health Organization's Challenges: Politics and Regionalization.

The World Health Organization's (WHO's) leadership challenges can be traced to its first decades of existence. Central to its governance and practice is regionalization: the division of its member countries into regions, each representing 1 geographical or cultural area. The particular composition of each region has varied over time-reflecting political divisions and especially decolonization. Currently, the 194 member countries belong to 6 regions: the Americas (35 countries), Europe (53 countries), the Eastern Mediterranean (21 countries), South-East Asia (11 countries), the Western Pacific (27 countries), and Africa (47 countries). The regions have considerable autonomy with their own leadership, budget, and priorities. This regional organization has been controversial since its beginnings in the first days of WHO, when representatives of the European countries believed that each country should have a direct relationship with the headquarters in Geneva, Switzerland, whereas others (especially the United States) argued in favor of the regionalization plan. Over time, regional directors have inevitably challenged the WHO directors-general over their degree of autonomy, responsibilities and duties, budgets, and national composition; similar tensions have occurred within regions. This article traces the historical roots of these challenges.

An Asymmetrical Network: National and International Dimensions of the Development of Mexican Physiology.

This article examines the history of Mexican physiology during the period 1910-60 when two noted investigators, José J. Izquierdo, first, and Arturo Rosenblueth, second, inscribed their work into an international network of medical research. The network had at its center the laboratory of Walter B. Cannon at Harvard University. The Rockefeller Foundation was its main supporter. Rosenblueth was quite familiar with the network because he worked with Cannon at Harvard for over ten years before returning to Mexico in the early 1940s. Izquierdo and Rosenblueth developed different strategies to face adverse conditions such as insufficient laboratory equipment, inadequate library resources, a small scientific community, and ephemeral political support. Both acquired local influence and international prestige, but the sources of financial and academic power remained in the United States. This case study provides insight into the circulation of scientific ideas and practices in an important Latin American country and suggests that the world's circulation of science among industrial and developing nations during the mid-twentieth century was intrinsically asymmetric but opened temporary opportunities for talented individuals and groups of researchers.

Overcoming social segregation in health care in Latin America.

Latin America continues to segregate different social groups into separate health-system segments, including two separate public sector blocks: a well resourced social security for salaried workers and their families and a Ministry of Health serving poor and vulnerable people with low standards of quality and needing a frequently impoverishing payment at point of service. This segregation shows Latin America's longstanding economic and social inequality, cemented by an economic framework that predicted that economic growth would lead to rapid formalisation of the economy. Today, the institutional setup that organises the social segregation in health care is perceived, despite improved life expectancy and other advances, as a barrier to fulfilling the right to health, embodied in the legislation of many Latin American countries. This Series paper outlines four phases in the history of Latin American countries that explain the roots of segmentation in health care and describe three paths taken by countries seeking to overcome it: unification of the funds used to finance both social security and Ministry of Health services (one public payer); free choice of provider or insurer; and expansion of services to poor people and the non-salaried population by making explicit the health-care benefits to which all citizens are entitled.

Saúde Global: uma breve história / Global health: a brief history

Neste livro, são analisados conceitos sobre a saúde global sempre levando-se em conta que o olhar histórico é fundamental para compreender os desafios das políticas de saúde. O termo saúde global costuma ser usado em resposta a eventos novos, como epidemias internacionais que atingem países ricos e pobres. Mas, afinal, saúde global e saúde internacional são ou não diferentes? O professor e pesquisador Marcos Cueto não se dedica a encerrar o debate, mas sim a estudar os termos saúde internacional e saúde global, investigando a trajetória de mudanças e continuidades das agências e programas internacionais envolvidos com a saúde da população durante o período de 1850 a 2010. Para ele, este livro expressa a esperança de que o estudo da história da saúde global seja de utilidade para os encarregados da elaboração de políticas públicas e para os estudiosos dos sistemas de saúde em todos os países, auxiliando-os no controle das doenças alimentadas pela pobreza...

[Considerations on the Sistema Único de Saúde in the twenty-first century: an interview with Lígia Bahia]. / Pensar o Sistema Único de Saúde do século XXI: entrevista com Lígia Bahia.

This interview with Lígia Bahia explores evaluations of the first 25 years of Brazil's Sistema Único de Saúde (SUS) and analyzes the project's progress, impasses, and missteps. Bahia is critical of both tendencies currently found within SUS: the one that sees the system as aimed at equity and the other posing equality as its goal. She criticizes the ambivalence that various spheres of government have displayed in their decisions regarding large corporate groups and private health insurance plans, which conflict with the ideas of SUS. She evaluates the participation of doctors and other healthcare professionals in the system. Lastly, she analyzes the emergence of identity politics, which are missing from the public health reform project, whose emphasis was on equality.