World Health Organization (WHO)

by

Kelley Lee, Jennifer Fang

• LAST MODIFIED: 22 February 2018
• DOI: 10.1093/obo/9780199756797-0174

Introduction

The World Health Organization (WHO) was established in 1948 as the United Nations (UN) specialized agency for health. While the history of health cooperation dates to ancient times, focused on disease outbreak prevention and control, institutionalized arrangements have a more recent history. In 1851, the first International Sanitary Conference was held to standardize international quarantine regulations against the spread of cholera, plague, and yellow fever. Fourteen conferences were held from 1851 to 1938, highlighted by the adoption of the International Sanitary Regulations (1892), establishment of the Paris-based Office International d’Hygiene Publique (1907), and creation of the League of Nations Health Organization (1920). Several regional health bodies were also formed during this period, notably the Pan American Sanitary Bureau (1902). WHO’s creation after World War II integrated and extended existing international and regional arrangements. The resultant structure—a headquarters, six regional offices (African, Americas, Eastern Mediterranean, Europe, Southeast Asia, and Western Pacific), and around 150 country offices—made WHO “the directing and coordinating authority” (quoted from WHO Constitution) for health in the UN System, with regions and member states prominent in fulfilling this role. WHO was also tasked with an expanded mandate and list of functions toward “the attainment by all peoples of the highest possible level of health” (quoted from WHO Constitution). While its predecessors focused on collecting and reporting epidemiological data, WHO was expected to support all member states through, for instance, disease-focused campaigns, guidelines and protocols, and technical cooperation. Over the ensuing decades, WHO’s work extended to international cooperation across the entire spectrum of health matters amid ideological differences concerning development theory and the appropriate roles of the state and market in health. Notable achievements were the eradication of smallpox, primary health-care movement, and Framework Convention on Tobacco Control. By the 1990s, resource constraints and structural problems raised concerns about WHO’s effectiveness. Globalization brought new challenges that prompted a paradigm shift from international to global health. The organization embarked on a series of reforms during an ensuing period of rapid growth in health cooperation. However, many donor agencies were unconvinced that WHO changed sufficiently and instead formed new initiatives. In the early 21st century, WHO operates within a complex and crowded landscape of institutional arrangements known collectively as global health governance. While some believe a revitalized WHO can restore its role, as the directing and coordinating authority, others support forms of global health cooperation that embrace new decision-making processes and collective action involving state and non-state actors more fully.

General Overviews

Several volumes provide general overviews of the main activities of WHO alongside more detailed works focused on specific periods in the organization’s history. The most comprehensive is a historical dictionary, Lee and Fang 2013, a reference text that includes an extended essay setting out the founding of WHO, its organizational structures, governance, main activities, and past achievements. The volume also includes an extensive bibliography of WHO publications and secondary materials organized by topic areas. Gostin 2014 provides a succinct account of the origins of WHO, constitutional mandate and key functions, successes and its particular role in the early 21st century’s crowded global health governance landscape. The bibliography provided is a valuable source of further readings and resources. Lee 2009 is a short book analyzing the history of international health cooperation, and it focuses on the diverse interests, ideas, and institutions that have shaped WHO’s mandate, membership, and major programs over time. The differing, and sometimes contested, views concerning what WHO should do are given particular attention, along with the shift from international to global health cooperation. Among the personal accounts of WHO, Sze 1982 is a fascinating memoir of a Chinese diplomat who, together with delegates from Brazil and Norway, proposed the establishment of an international health organization at the International Health Conference held after the Second World War. Similarly, Farley 2008 focuses on WHO’s early years, notably the political challenges and tensions faced during the Cold War, under the first director-general, Brock Chisholm. An official account of WHO’s first four decades is provided in World Health Organization 1958, World Health Organization 1968, World Health Organization 2008, and World Health Organization 2011. These volumes document the main operational activities, along with key people, meetings and events, and budgets. While largely descriptive, they are a useful one-stop source of archival information and primary documents such as official records. Samarasekera 2008 provides an overview of the organization’s key historical milestones since the mid-20th century.

• Farley, J. 2008. Brock Chisholm, the World Health Organization, and the Cold War. Vancouver: Univ. of British Columbia Press.

  This work focuses on WHO’s tumultuous early years, under its first director-general, renowned Canadian psychiatrist Brock Chisholm, detailing the organization’s challenges to establish itself amid early Cold War politics and Vatican pronouncements on sensitive health issues. The book focuses on Chisholm and his allies as champions of world government and the United Nations, building up WHO and preventing it from remaining weak like the League of Nations Health Organization.

• Gostin, L. O. 2014. Fulfilling the promise of the World Health Organization. In Global Health Law. By L. O. Gostin, 87–128. Cambridge, MA: Harvard Univ. Press.

  DOI: 10.4159/9780674369870

  This book chapter provides a brief and concise overview of WHO’s origins, key functions, and milestones. It provides a useful account of WHO’s role in an increasingly globalized world, which has changed the institutional landscape for collective health action. Gostin concludes with proposed reforms for WHO to retain an effective leadership role in global health governance.

• Lee, K. 2009. The World Health Organization (WHO). London: Routledge.

  This short book, one of a series on global institutions, provides a succinct overview of WHO’s history, changing institutional structures, and key programs and individuals. It gives particular focus to the challenges that WHO has faced in recent decades, given the emergence of other global health initiatives, and how the organization has sought to remain effective as the “world’s health conscience.” The book includes a useful bibliography section including electronic sources.

• Lee, K., and J. Fang. 2013. Historical dictionary of the World Health Organization. 2d ed. Lanham, MD: Scarecrow.

  This is a useful reference source of alphabetically organized entries detailing the history and activities of WHO. The updated and expanded second edition serves as a valuable source on the origins of international health cooperation, WHO structures, key people, events, and major health campaigns and programs over six decades. The extensive bibliography lists official publications by and about WHO, as well as scholarly works, organized by key topic areas.

• Samarasekera, U. 2008. WHO: 60 years on. The Lancet 371.9619: 5–11.

  DOI: 10.1016/S0140-6736(08)60506-1

  This analysis reflects on WHO’s key achievements, failures, and future role upon the sixtieth anniversary of its founding. The author presents perspectives on WHO by a broad range of global health figures including then-WHO Director-General Margaret Chan, high-level policymakers, civil society representatives, and scholars.

• Sze, S. 1982. The origins of the World Health Organization: A personal memoir, 1945–1948. Boca Raton, FL: LISZ.

  This is a personal account of the establishment of WHO as told by one of its founding fathers. Dr. Sze’s memoire is a rich source of historical detail of the behind-the-scenes diplomacy undertaken to table a proposal to establish a single international organization responsible for health during the United Nations Conference on International Organizations in 1945, the proceedings of the ensuing International Health Conference in 1946, and WHO’s establishment in 1948.

• World Health Organization. 1958. The first ten years of the World Health Organization: 1948–1957. Geneva, Switzerland: World Health Organization.

  This is the first of four commissioned accounts of WHO’s work, with this first volume covering the organization’s first ten years (1948–1957). The volume is largely descriptive, providing useful information on key areas of work; disease programs; and operational details, such as membership, key figures, major meetings, and budgetary data. This is an official source for those interested in documenting the evolution of international health cooperation during WHO’s early years.

• World Health Organization. 1968. The second ten years of the World Health Organization: 1958–1967. Geneva, Switzerland: World Health Organization.

  This is the second of four commissioned accounts of WHO’s work, with this volume covering the organization’s second ten years (1958–1967). The volume is largely descriptive, providing useful information on key areas of work; disease programs; and operational details, such as membership, key figures, major meetings, and budgetary data. This volume includes key health trends and issues at the time, broken down by region, and overviews of resulting programs of work.

• World Health Organization. 2008. The third ten years of the World Health Organization: 1968–1977. Geneva, Switzerland: World Health Organization.

  This is the third commissioned account of WHO’s work, with this volume covering 1968–1977. The volume is largely descriptive, providing useful information on key areas of work; disease programs; and operational details, such as membership, key figures, major meetings, and budgetary data. This is a impressive source of information for those interested in the social, political, and economic landscape during this period as contributing factors to determine WHO’s program of work.

• World Health Organization. 2011. The fourth ten years of the World Health Organization: 1978–1988. Geneva, Switzerland: World Health Organization.

  This is the fourth commissioned account of WHO’s work, with this volume covering 1978–1987. The volume is largely descriptive, providing useful information on key areas of work; disease programs; and operational details, such as membership, key figures, major meetings, and budgetary data. This is the last volume available in this official history, and it pays extensive attention to primary health care and health promotion as key concepts advanced during this period.