In the six year period from 1968–1973, a cascade of international social, intellectual, and political changes upended the postwar arrangement of multilateral lending. Sureties regarding the logic, process, and end results of development-oriented aid were questioned, abandoned, and replaced. The new ideas and institutional orientations that emerged, and were advanced over the remainder of the Cold War, posited the improvement of health in the developing world as an important policy goal. This new health programming was advanced in several institutions and shaped by varying perspectives on Cold War politics. This dissertation is a history of how these late Cold War intellectual and institutional transformations redefined the practice and goals of international health.
Each of the five chapters is a case study of different organizations in the field and approaches to addressing health. Chapter 1 examines how critiques of postwar foreign and development economics led to new policies to correct the social determinants of illness and poverty. Chapter 2 explores the intellectual underpinnings of the community health care that World Health Organization advanced in developing countries. Chapter 3 uses the story of institutional changes at the U.S. National Institutes of health to recount how biomedical research became an important means of countering changes in disease prevalence. Chapter 4 discusses how the Rockefeller Foundation promoted instruction in clinical epidemiology as a means of managing scarce resources for health care. Chapter 5 analyzes how and why the World Bank began lending in health and erected its own Population, Health, and Nutrition Division.
In exploring these cases, this dissertation makes several claims. Previous scholars have depicted development and international health policies as a homogenous, monolithic force emerging from the West. However, I show that despite close interaction and exchange among elite leaders in the field, there were many different notions of health and development that were advanced at the same time. Second, concerns for equity became important at this time for both policy makers in international health and leaders of developing countries. However, in light of larger political concerns, international health conflated its moral and scientific norms, equating equity with efficiency.
|Advisor:||Brandt, Allan M.|
|School Location:||United States -- Massachusetts|
|Source:||DAI-A 72/09, Dissertation Abstracts International|
|Subjects:||Public health, Science history, Public policy|
|Keywords:||Biomedical research, Global health, History of medicine, International health, Rockefeller Foundation, World Bank, World Health Organization|
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