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Coming to Terms with World Health

The League of Nations Health Organisation 1921-1946

Iris Borowy

The League of Nations Health Organisation was the first international health organisation with a broad mandate and global responsibilities. It acted as a technical agency of the League of Nations, an institution designed to safeguard a new world order during the tense interwar period. The work of the Health Organisation had distinct political implications, although ostensibly it was concerned «merely» with health. Until 1946, it addressed a broad spectrum of issues, including public health data, various diseases, biological standardization and the reform of national health systems. The economic depression spurred its focus on social medicine, where it sought to identify minimum standards for living conditions, notably nutrition and housing, defined as essential for healthy lives. Attracting a group of innovative thinkers, the organization laid the groundwork for all following international health work, effective until today.

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II. The Basis

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At the end of its provisional stage, the organization could boast substantial achievements. In the course of a mere two and a half years, it had become active in a list of fields ranging from epidemiology to sleeping sickness in Africa, biological standardization and the organization of international interchanges of medical or sanitary officers. The choice of topics resulted mostly from suggestions of just a few people in the HC.1 A few topics had been put forth by other institutions, most notably opium (by the Opium Commission) but also anthrax (by the ILO) or pub­ lic health in mandated areas (by the League Mandates Commission). In the process, the LNHO had established more or less friendly contact with other organizations such as the OIHP, ISI, ILO and other League bodies and a close and financially most beneficial working relationship with the Rockefeller Foundation. Building up the work program had entailed decisions of principle that deter­ mined what direction the LNHO would take. Regarding its concept of health, the early LNHO combined elements of medical and political approaches. Notably those initiatives that addressed specific diseases indicated an understanding of health issues as medical problems. Efforts on some diseases, such as tuberculosis, sleeping sickness and plague, did not go beyond the early stages of establishing or collecting epidemiological data. Malaria was most clearly perceived as a medical is­ sue, with an early focus on quinine requirements. Serological and biological stan­ dardization served a medical paradigm in as much as it was helpful...

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