Presentation

Abstract

PresentationIn recent years, global health has become a ubiquitous concept in public health and has practically replaced the nigh on fifty-year-old international health agenda. However, its origins, characteristics, differences and impacts have not yet been adequately analyzed. The scope of this dossier is to bring together historians and specialists to attempt to understand the global health concept, highlighting the history of international health, the changing role of state public health services and medical care, and the local/national/global interaction in the context of Latin America and the Caribbean. Our region has a long and dynamic relationship with international health and its organizations, people of renown, initiatives and programs. Production in the field of the history of health in Latin America and the Caribbean has increased in quantity and matured in terms of quality. These studies require reflection and discussion by historians and specialists on the historical background of the global/international character of health and the possible specificities of our regional context. This task demands a collective effort of reflection, since there is no single definition of global health, nor a consensus about its origins. For some specialists, the process of globalization began in the sixteenth century with the Spanish and Portuguese conquest and colonization of the Americas, which generated colonial medicine. For others, global health dates back to the close ties between imperialism and tropical medicine of the late nineteenth century. They also stress the role played by philanthropic agencies in the early twentieth century, such as the Rockefeller Foundation, which sought to civilize the rest of the world through Western medicine. Some believe that the immediate antecedent of global health is international health that emerged during the Cold War period, which started around 1948, marked by multilateral agencies like the World Health Organization (WHO) and the ideological confrontation between the Soviet Union and the United States to promote health models (state health versus private practice; nationalization of health care services versus vertical campaigns). Others believe that global health is linked to the emergence of neo-liberalism that followed the end of the Cold War (late 1980s) and is associated with the omnipresent theme of "globalization" where economics and technology appear to compress and create a global society. With globalization a new epidemiological scenario arises in which there are new or reemerging infections that affect rich and poor countries alike. It is a scenario of frequent international travel and mass migration, with new actors appearing such as nongovernmental organizations, the new international philanthropy, public-private partnerships and institutions not hitherto traditionally involved with health, such as the World Bank. It is a period marked by a set of new challenges to national and international health services, questioning the premise that the State is the main ...