But Yach and Bettcher were convinced that WHO could turn these risks into opportunities. ![]() In another, there were such risks as diminished social safety nets the facilitated marketing of tobacco, alcohol, and psychoactive drugs the easier worldwide spread of infectious diseases and the rapid degradation of the environment, with dangerous public health consequences. In one respect, there was easier diffusion of useful technologies and of ideas and values such as human rights. The globalization of public health, they argued, had a dual aspect, one both promising and threatening. 8 They defined the “new paradigm” of globalization as “the process of increasing economic, political, and social interdependence and integration as capital, goods, persons, concepts, images, ideas and values cross state boundaries.” The roots of globalization were long, they said, going back at least to the 19th century, but the process was assuming a new magnitude in the late 20th century. In 1998, Derek Yach and Douglas Bettcher came closer to capturing both the essence and the origin of the new global health in a 2-part article on “The Globalization of Public Health” in the American Journal of Public Health. Although these respondents believed that a major shift had occurred within the previous few years, they seemed unable clearly to articulate or define it. The other half thought that there were profound differences between international health and global health and that “global” clearly meant something transnational. About half felt that there was no need for a new terminology and that the label “global health” was meaningless jargon. ![]() Walkup tried to answer these questions and published, under the provocative title “US Public Health Leaders Shift Toward a New Paradigm of Global Health,” their report of conversations conducted in 1999 with 29 “international health leaders.” 7 Their respondents fell into 2 groups. 6 Yet the questions remain: How many have participated in this shift in terminology? Do they consider it trendy, trivial, or trenchant? Now there is an increasing frequency of references to global health. 5 But the term was generally limited and its use in official statements and documents sporadic at best. The term “global” was sometimes used well before the 1990s, as in the “global malaria eradication program” launched by WHO in the mid-1950s a WHO Public Affairs Committee pamphlet of 1958, The World Health Organization: Its Global Battle Against Disease 3 a 1971 report for the US House of Representatives entitled The Politics of Global Health 4 and many studies of the “global population problem” in the 1970s. Given these definitions, it should come as no surprise that global health is not entirely an invention of the past few years. Thus, we could say that WHO is an intergovernmental agency that exercises international functions with the goal of improving global health. Logically, the terms “international,” “intergovernmental,” and “global” need not be mutually exclusive and in fact can be understood as complementary. The term “global” is also associated with the growing importance of actors beyond governmental or intergovernmental organizations and agencies-for example, the media, internationally influential foundations, nongovernmental organizations, and transnational corporations. “Global health,” in general, implies consideration of the health needs of the people of the whole planet above the concerns of particular nations. ![]() “Intergovernmental” refers to the relationships between the governments of sovereign nations-in this case, with regard to the policies and practices of public health. “International health” was already a term of considerable currency in the late 19th and early 20th century, when it referred primarily to a focus on the control of epidemics across the boundaries between nations (i.e., “international”). Let us first define and differentiate some essential terms. In particular, we focus on the role of the World Health Organization (WHO) in both international and global health and as an agent in the transition from one concept to the other. Our task here is to provide a critical analysis of the meaning, emergence, and significance of the term “global health” and to place its growing popularity in a broader historical context. We believe that an examination of this linguistic shift will yield important fruit, and not just information about fashions and fads in language use. ![]() We provide historical insight into the emergence of the terminology of global health. “international” also picks up “internationalize” and “internationalization” “global” also picks up “globalize” and “globalization”).
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