Worldly approaches to global health: 1851 to the present.

The tension between managing episodic, acute, and deadly pandemics and the arduous path to ameliorating the chronic maladies and social conditions that kill many more people, but in far less dramatic ways, has always shaped the agenda and work of the World Health Organization. Yet the historical record amply demonstrates how international efforts to control infectious disease, beginning in the mid-nineteenth century and extending to the present, have dominated global health policies, regulations, agendas and budgets: often at the expense of addressing more chronic health and environmental concerns. How these challenges have affected present circumstances and created demands for an entirely new conception and execution of 21st century global health efforts is the focus of this paper.

Journals of the plague years: documenting the history of the AIDS epidemic in the United States.

This commentary discusses several journalistic, literary, and historical accounts of the AIDS epidemic as it has unfolded in the United States over the past 2 decades. By examining the different ways that different types of storytellers chronicle the political, social, public health, medical, and economic aspects of epidemic disease, this essay will demonstrate why the AIDS epidemic has been of such intense interest not only to physicians and public health experts but also to journalists, novelists, playwrights, memoirists, and historians. AIDS is a particularly fascinating example of society's broad concern with epidemics because it both is a global pandemic and, in recent years, has become a chronic disease.

For the welfare of children: the origins of the relationship between US public health workers and pediatricians.

The majority of children living in the United States today enjoy excellent health and access to health care. This was not always so; before the late 19th century, the field of pediatric medicine scarcely existed, and the combination of harsh and unsanitary living conditions in the urban areas where most immigrants settled, infectious diseases, and improper handling of milk was particularly deadly for infants and children. This article discusses the relationship between pediatric medicine and the broader children's health and public health movements in the United States in the early decades of the 20th century. That relationship resulted in 3 developments that had a profound impact on children's health: the establishment of dispensaries and milk stations that served impoverished children, campaigns to educate parents about illness prevention and child rearing, and the medical inspection of public schools and schoolchildren. Today, American children face both new threats to health and the reemergence of infectious diseases that were once thought conquered. Pediatricians and public health professionals must work together in the same spirit of social activism and community responsibility to meet these challenges.

Making history: Thomas Francis, Jr, MD, and the 1954 Salk Poliomyelitis Vaccine Field Trial.

This article focuses on the poliomyelitis vaccine field trial directed by Thomas Francis,Jr, MD, of the University of Michigan Vaccine Evaluation Center and sponsored by the National Foundation for Infantile Paralysis (NFIP) or, as it was better known to the public, the March of Dimes. It was a landmark in the widescale testing of a vaccine and the ethical use of human subjects. Millions of American parents readily volunteered their healthy children to participate. A total of 150,000 volunteers, including schoolteachers, physicians, nurses, and health officers all endorsed the study and donated their time and effort to make it successful. Avoiding the use of marginalized groups, the field trial purposefully did not involve institutionalized children; instead, it was based in 15,000 public schools in 44 of the 48 states as clinic sites. A group of 650,000 children received some type of injection, either the vaccine or a placebo, and another 1.18 million served as controls. The field trial depended, most essentially, on both public support and the participation of millions of children who remained enrolled in a study that required a series of 3 injections and a 6-month evaluation period. Enlisting the huge number of participants presented practical examples of the difficulties in experimenting on human subjects. On April 26, 1954, Randy Kerr, a participant or "Polio Pioneer" as the children involved were called, received the first inoculation of the Salk poliomyelitis vaccine. The nationwide study "designed to test the safety and efficacy" of the Salk vaccine had officially begun.

The University of Michigan Medical School, 1850-2000: "an example worthy of imitation".

The 150th anniversary of the University of Michigan Medical School affords occasion for both celebration and reflection, not just in Ann Arbor but throughout the world, as we consider its contributions to medical education, research, and health care over the past century and a half. This article explores the medical school's origins as a frontier medical outpost and describes the vital reforms in medical education implemented in Ann Arbor long before the landmark Flexner Report on Medical Education of 1910. It also depicts how and why the medical school developed as it did and what features are distinctive or typical about the school during this period.

Academic pediatrics: the view of New York City a century ago.

Pediatrics arose as an academic and medical specialty in the United States during the late nineteenth century. This paper documents the first three stages of academic pediatrics in the United States between 1850 and 1950: (1) 1850-1880, a period focused on sanitary reform as a means of reducing infant mortality; (2) 1880-1900, the era where discoveries being made in bacteriology, physiology, and nutrition began to be applied to improving the health of children; and (3) 1900-1930, when the field was characterized by an active health reform movement directed at parents and health care professionals. Three prominent pioneer pediatricians, Drs. Abraham Jacobi, Henry Koplik, and L. Emmett Holt, are profiled as representative practitioners of these eras.