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I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations' political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care. These debates led to the development of an alternative, more restricted approach, known as selective primary health care. My study examined library and archival sources; I cite examples from Latin America.

The term "global health" is rapidly replacing the older terminology of "international health." We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term "global health" emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances. Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context.

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No contexto da saúde pública internacional, 'saúde global' parece estar emergindo como um termo de reconhecida preferência. Este artigo apresenta uma análise crítica do significado e importância de 'saúde global', e situa sua crescente popularidade no contexto histórico. Um foco específico deste estudo é o papel da Organização Mundial da Saúde - OMS, tanto na saúde 'internacional' quanto na 'global', e como um agente na transição de uma para outra. Entre 1948 e 1998 a OMS enfrentou dificuldades, ao deparar com uma crise organizacional, cortes orçamentários e status diminuído, especialmente em face da crescente influência de novos e poderosos atores, como o Banco Mundial. Sugerimos que a OMS começou a remodelar-se e a reposicionar-se nos papéis de coordenação, planejamento estratégico e liderança de iniciativas de 'saúde global', em resposta a esse contexto internacional em transformação.

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This book is a narrative history of the world's principal multilateral health agency during its 70 years of existence (1948 to early 2018). According to its Constitution, the mission of the World Health Organization (WHO) was nothing less than the "attainment by all peoples of the highest possible level of health," without distinction of race, religion, political belief, economic status, or social condition. The book will offer a synthetic overview and assessment of how consistently and how well the WHO has pursued this mission and will identify the two perspectives that have marked its history and its changing place in global health.During its first decades of existence, the United Nations' specialized health agency was the acknowledged international leader on matters of health and disease and was at the center of a global network of scientists, physicians, and health policy makers. The agency played a preeminent role in the political validation of international health as a field during the second half of the twentieth century and helped shape the notion of technical health assistance for developing countries. But toward the end of the 1980s, the agency was accused of inefficiency, lack of transparency, and irrelevance. The role of the agency as the coordinating authority for international health was seriously questioned, and it increasingly had to surrender to or compete with private and public organizations that staked claims in global health.The WHO was officially created in 1948 after a protracted period of discussion and negotiation that began in 1945. Its creation marked a change in the history of international health because the WHO merged into a single organization four functions of previous international health organizations: centralized epidemiological surveillance, campaigns against epidemics, disease control, and the reform of health systems. The book will describe what the agency did in surveillance and epidemic intervention but will concentrate on the last two functions during the Cold War and post-Cold War periods. Among its disease-control programs were the unsuccessful attempt to eradicate malaria, launched in the mid-1950s, and the successful elimination of smallpox during the 1970s. An example of a major effort to reform health