ABSTRACT
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.
Subject(s)
Politics , World Health Organization/history , World Health Organization/organization & administration , Developed Countries/history , Developing Countries/history , Europe, Eastern , Global Health , History, 20th Century , Humans , USSR , United States , World Health Organization/economicsSubject(s)
Medicare/history , Politics , Aged , History, 20th Century , Humans , Medicare/legislation & jurisprudence , United StatesSubject(s)
Education, Medical/history , Schools, Medical/history , History, 18th Century , Paintings , PennsylvaniaSubject(s)
Epidemiology/history , Social Justice/history , History, 20th Century , History, 21st Century , Humans , South Africa , United StatesSubject(s)
Global Health , Health Care Reform/history , Health Policy/history , Health Priorities/history , Human Rights/history , Social Justice/history , Social Responsibility , Developed Countries , Developing Countries , Healthy People Programs/history , History, 20th Century , History, 21st Century , Humans , Primary Health Care/history , Public Health/historySubject(s)
Public Health/history , History, 20th Century , History, 21st Century , Humans , United StatesSubject(s)
Anemia/history , Ancylostoma , Ancylostomiasis/complications , Ancylostomiasis/epidemiology , Ancylostomiasis/history , Anemia/epidemiology , Anemia/etiology , Anemia/prevention & control , Animals , History, 19th Century , History, 20th Century , Humans , Public Health/history , Puerto Rico/epidemiologySubject(s)
Information Dissemination , Information Services , Information Storage and Retrieval , National Library of Medicine (U.S.) , District of Columbia , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Information Dissemination/history , Information Dissemination/methods , Information Services/history , Information Services/organization & administration , Information Storage and Retrieval/history , Information Storage and Retrieval/methods , Information Storage and Retrieval/statistics & numerical data , Information Storage and Retrieval/trends , MEDLARS , MEDLINE , Medical Subject Headings/history , National Library of Medicine (U.S.)/economics , National Library of Medicine (U.S.)/history , National Library of Medicine (U.S.)/organization & administration , National Library of Medicine (U.S.)/trends , PubMed , United StatesABSTRACT
This article examines the cures recorded in Lourdes, France, between 1858, the year of the Visions, and 1976, the date of the last certified cure of the twentieth century. Initially, the records of cures were crude or nonexistent, and allegations of cures were accepted without question. A Medical Bureau was established in 1883 to examine and certify the cures, and the medical methodology improved steadily in the subsequent years. We discuss the clinical criteria of the cures and the reliability of medical records. Some 1,200 cures were said to have been observed between 1858 and 1889, and about one hundred more each year during the "Golden Age" of Lourdes, 1890-1914. We studied 411 patients cured in 1909-14 and thoroughly reviewed the twenty-five cures acknowledged between 1947 and 1976. No cure has been certified from 1976 through 2006. The Lourdes phenomenon, extraordinary in many respects, still awaits scientific explanation. Lourdes concerns science as well as religion.