The past and present of pandemic management: health diplomacy, international epidemiological surveillance, and COVID-19.

The establishment of international sanitary institutions, which took place in the context of rivalry among the great European powers and their colonial expansion in Asia, allowed for the development of administrative systems of international epidemiological surveillance as a response to the cholera epidemics at the end of the nineteenth century. In this note, I reflect on how a historical analysis of the inception of international epidemiological surveillance and pandemic management helps us to understand what is happening in the COVID-19 pandemic today.

Regional cooperation and health diplomacy in Africa: from intra-colonial exchanges to multilateral health institutions.

Tracing the pathways of cooperation in health in sub-Saharan Africa from hesitant exchanges to institutionalized dimensions from the 1920s to the early 1960s, this article addresses regional dynamics in health diplomacy which have so far been under-researched. The evolution thereof from early beginnings with the League of Nations Health Organization to the Commission for Technical Assistance South of the Sahara and the World Health Organization's Regional Office for Africa, shows how bilateral dimensions were superseded by WHO's multilateral model of regional cooperation in health. Alignments, divergences, and outcomes are explored with respect to the strategies and policies pursued by colonial powers and independent African states regarding inter-regional relations, and their implications for public health and epidemiological interventions.

Regional cooperation and health diplomacy in Africa: from intra-colonial exchanges to multilateral health institutions / Cooperação regional e diplomacia sanitária na África: dos intercâmbios intracoloniais às instituições multilaterais de saúde

Abstract Tracing the pathways of cooperation in health in sub-Saharan Africa from hesitant exchanges to institutionalized dimensions from the 1920s to the early 1960s, this article addresses regional dynamics in health diplomacy which have so far been under-researched. The evolution thereof from early beginnings with the League of Nations Health Organization to the Commission for Technical Assistance South of the Sahara and the World Health Organization's Regional Office for Africa, shows how bilateral dimensions were superseded by WHO's multilateral model of regional cooperation in health. Alignments, divergences, and outcomes are explored with respect to the strategies and policies pursued by colonial powers and independent African states regarding inter-regional relations, and their implications for public health and epidemiological interventions.

Resumo Trilhando os caminhos da cooperação sanitária na África subsaariana, de intercâmbios incertos a dimensões institucionalizadas dos anos 1920 até início dos anos 1960, este artigo aborda a dinâmica regional na diplomacia sanitária que, até o momento, carece de pesquisas. A evolução, desde os primórdios da Organização da Saúde da Liga das Nações até a Cooperação Técnica na África Subsaariana e o Escritório Regional da África da OMS, demonstra como dimensões bilaterais foram substituídas pelo modelo multilateral da OMS de cooperação sanitária regional. São analisados alinhamentos, divergências e resultados de estratégias e políticas empregados por potências coloniais e Estados africanos independentes em relações inter-regionais, bem como suas implicações em intervenções epidemiológicas e de saúde pública.

Imigraçao, ciência e saúde: controle de riscos e expansao de direito na bacia do Rio da Prata (1873-1911) / Immigration, science and health: risks control and expanding rights in th e Rio de la Plata Basin (1873-1911)

Este artigo analisa como o processo imigratório nos países da Bacia do Rio da Prata, em especial Brasil e Argentina, promoveu inflexões na assinatura de acordos sanitários no final do século XIX. O porto é compreendido como um dispositivo onde se definem saberes e normas e se estabelecem intervenções sobre as populações em trânsito, em especial imigrantes. Os entraves na assinatura de convenções sanitárias entre estes países estavam não só relacionados às controvérsias no interior das comunidades médico-científicas como também às tensões políticas e econômicas vinculadas à disputa por mão de obra imigrante. Nas primeiras décadas do século XX, assistimos a um deslocamento de interesses e problemas relacionados à saúde pública. Não bastava mais só conter epidemias, os estados nacionais deveriam garantir certos benefícios às populações, em especial associados à assistência à saúde. Esta nova perspectiva é analisada a partir das compreensões e usos da ideologia liberal no que diz respeito à auto-regulação dos riscos, à coletivização de bemestar e à expansão de direitos civis e sociais, alavancados, em parte, pela inclusão da população imigrante nestas sociedades (AU)

This paper analyzes how immigration process in the Rio de Plata Basin countries, specifically Brazil and Argentina, promoted inflexions in the sanitations agreements in the end of 19th century. The port is a device within in which are defined knowledge and standards and are established interventions on people in transit, particularly immigrants. The barriers in the agreements between these countries were not only related to controversies within medical and scientific communities but also to political and economics tensions linked to the labor immigrants disputes. In the beginning of 20th century, we can see a shift of interest and issues related to public health: epidemic control was not enough. The states must guarantee some benefits to the populations, especially heath care. This new view is analyzed according to the understanding and uses of the liberal ideology concerning risk self-regulations, collectivization of welfare and expanding of civil and social rights. This process is leveraged in parts by the inclusion of the immigrants in theses societies (AU)

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Global Health Diplomacy, "San Francisco Values," and HIV/AIDS: From the Local to the Global.

BACKGROUND: San Francisco has a distinguished history as a cosmopolitan, progressive, and international city, including extensive associations with global health. These circumstances have contributed to new, interdisciplinary scholarship in the field of global health diplomacy (GHD). In the present review, we describe the evolution and history of GHD at the practical and theoretical levels within the San Francisco medical community, trace related associations between the local and the global, and propose a range of potential opportunities for further development of this dynamic field. METHODS: We provide a historical overview of the development of the "San Francisco Model" of collaborative, community-owned HIV/AIDS treatment and care programs as pioneered under the "Ward 86" paradigm of the 1980s. We traced the expansion and evolution of this model to the national level under the Ryan White Care Act, and internationally via the President's Emergency Plan for AIDS Relief. In parallel, we describe the evolution of global health diplomacy practices, from the local to the global, including the integration of GHD principles into intervention design to ensure social, political, and cultural acceptability and sensitivity. RESULTS: Global health programs, as informed by lessons learned from the San Francisco Model, are increasingly aligned with diplomatic principles and practices. This awareness has aided implementation, allowed policymakers to pursue related and progressive social and humanitarian issues in conjunction with medical responses, and elevated global health to the realm of "high politics." CONCLUSIONS: In the 21st century, the integration between diplomatic, medical, and global health practices will continue under "smart global health" and GHD paradigms. These approaches will enhance intervention cost-effectiveness by addressing and optimizing, in tandem with each other, a wide range of (health and non-health) foreign policy, diplomatic, security, and economic priorities in a synergistic manner--without sacrificing health outcomes.