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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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