ABSTRACT

The term ‘globalization of health’ implies a historical process whereby health understandings, institutions, actors, status, etiologies, determinants and priorities have moved from a primarily community domain to a linking of the local to worldwide trends, concerns, and political and social forces. While the globalization of health suggests shared phenomena across space, the notion of global or globalization is totalizing and so fraught with scholarly anxieties (Appadurai 2001) that its utility is questionable. Clearly the underpinnings of the ‘globalization of health’ vary across time and place and must be qualified, making historical contingencies and contextualization vital to illuminating the notion. This chapter takes up the historicization of the ‘globalization of health’ (on the importance of historicizing, see the preceding chapter) by first exploring how health became an international issue in(to) the modern period and then describing how health concerns were institutionalized at an international level before and between the two World Wars. This effort – conceptualized at the time in terms of ‘international health’ – involved the creation of intergovernmental and multi-lateral (though not supra-national) agencies, as well as philanthropic and voluntary organizations with an (often self-declared) international purview. Notwithstanding these new institutional arrangements and the idealism of the many new actors who appeared on the scene, the power politics and policies of international health remained, to a great extent, aligned with and subsidiary to the existing Europe-centred imperial order. As such, institutionalizing health at an international level in this period created intractable dilemmas regarding reach, approaches, and inclusion/ exclusion, many of which resonate to the present day.