UNIT 3. INTERNATIONAL HEALTH AGENCIES Structure 30 Objectives 31 Introduction 32 World Health Organisation (WHO) 32.1 Fonetons of WHO 3.2.2 Structure of WHO 33° United Nations Agencies 3.3.1 Unites Nations International Children's Emergency Fund (UNICEP) 33.2 United” Nations Development Programme (UNDP) 3.3.3 Food and Agricultural Orgasisation (FA) 3.3.4 International Labour Organisation (LO) 338 World Bank 34 Other Organisations 34.1 United Stes Agency for International Development (USAID) 3.4.2 Colombo Plan 3.4.3 Rockfeller Foundation 34.4 Ford Foundation 34S Cooperation for American Bellet Everywhere (CARE) 35 Intemational Red Cross Society 36 Let Us Sam Up 37 Glossary 38 Model Answers 39 Further Readings 3.0 OBJECTIVES After completing this unit, you should be able to: © explain the role of World Health Organisation; discuss the role of UNICEF; ‘identify the functions of UNDP; discuss the contribution of FAQ; explain the role of 1.0 in worker's health, discuss the contribution of World Bank in the delivery of health services; recapitulate functions of USAID; identify the importatice of Colombo plan; explain te conttibution of Rockefeller foundation; and discuss the functions of Red Cross. eee wee 3.1 INTRODUCTION ‘in unit-2 of this block, we have discussed national health agencies. In: focus on international health agencies. Health and disease have no political or geographical boundaries. Disease in any part ofthe world is a danger to all parts ofthe world, I'the ddigease breaks in the form of epidemic in one part of the world, it isa threat to other parts of ‘the world. During 14th Century, the Ships, crews, travellers and cargoes, suspected of harboring infection were detained for 40 days prior o entering in to Europe to prevent spread of plague This was a method of quarantine. Same practice was gradually adopted in other countries and international health work through international health agencies was established. These 29Systems of Medicine and Health Agencies Health agencies are involved in taking steps in matters of international concern for prevention and control of disease. Ttis essential to learn about some of the international health agencies, which are of great importance to India in promoting health programme, paniculasly inthe contest of geuing aid for our health care delivery system. We will focus on the roles, health functions and structural organisations of these agencies, Let us begin with World Health Organisation. 3.2. WORLD HEALTH ORGANISATION ‘The World Health Organisation (WHO) is a specialised, non-pol United Nations. fis headquarters. in Geneva. Its constitution came into force on 7th April, 1948 which is celebrated every year as “World Health Day” a) Objectivesot WHO ‘© Attainment ofthe highest level of health by al people. ‘© Enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic and social condition, ‘© The healthy developmentof the child, the ability to live harmonously in a changing environment. ‘The main social target of WHO is the attainment of health by all citizens of the world, by the year 2000, a level of health, that will permit them to lead a socially and economically productive life. Thus WHO provides assistance to all the countries for providing primary health care services to reach the goal of Health For All by 2000 A.D. ‘The definition of health given by WHO is used all over the world: “Health is a state of ‘complete physical, mental and social well-being and not merely the absence of disease or infirmity”, 1b) Membership of WHO Membership of WHO is open to att countries, Each member state contributes yearly to the WHO budget and is entitled to services and aid the WHO provides. In 1948, the WHO had 56 members, by 2600 ithas 190 member state. 3.2.1 Functions of WHO ‘The main functions are: Direct and coordinate health programmes through out the world, i) Help countries to strengthen and impeove their own health services by providing experts and demonstration teams for disease control programme. ii) Provides central technical services such as: © Epidemic warnings and disease surveillance. ¢ Administration of International Health Regulation Realth Statistics on global scale. b ¢ Internationat standardisation of drugs and vaccines. + Tecknicat pubticacions, publication of Expert Committee Reports, 2 Monthly journals, periodicals and magazines. # Supporting research on health problems. 3.2.2 Structure of WHO WHO consists of three principal organs. The World Health Assembly, the Executive Board and the Secretariat.‘The World Health Assembly International Health Agencies This is the supreme governing body of the organisation. It meets every year in May. The ‘main functions of the assembly are: ¢ Todetermine international health policy. ‘© Toreview the work of the past year. © To approve the budget. © Todo technical discussion on some subject of world interest. ‘The Executive Board ‘The Executive Board consists of 31 members, all technically qualified in the field of health. ‘The executive board meets twice a year, The main work of the board isto give effect to the decisions and policy approval by the World Health Assembly. The board has also power to take action in emergencies lke epidemics, earthquakes, floods where immediate action is required, ‘The Secretariat ‘The WHO Secretariat is in Geneva. It is headed by the Director General, WHO, The secretariat has |4 divisions, according to the function e.g., Education and training, control of communicable diseases, environmental health and so on. The primary function of WHO secretariat is to provide member states with technical and managerial suppor for theic national health development programmes. Regional organisations For easy operation of the Programme, there are 6 regions of WHO, as given below: Regions Headquarters South East Asia New Dethi (India) Arica Brazzaville (Congo) America ‘Washington, DC (USA) Europe ‘Copenhagen (Denmark) East Mediterranean ‘Alexandria Egyp) Western Pacific Manila Philippines) ‘We belong to South East Asia Region (SEAR), its headquarter is located at New Delhi. The member countries of SEAR are: © Bangladesh Bhutan ¢ Bum -@ India © Indonesia ,* Korea © Maldives Islands © Mongolia © Nepal © SriLanka © Thailand ‘The WHO Activities in SEAR are: © Malaria eradication © Tuberculosis controlSystems of Medicine and Health Agencies © Control of other communicable diseases © Health Laboratory services and production of vaccines © Health statistics, © Publichealth administration © Rural health services © Maternal and child health © Nursing © Environmental health and water supply © Health education © Nutrition © Menta health © Dental health © Medical rehabilitation © Radiation © Quality control of drugs ‘© Medical education 3.3 UNITED NATIONS AGENCIES, ‘We shall discuss about various United Nations agencies in following sub-sections: 3.3.1 United Nations International Children’s Emergency Fund (UNICEF) All of us are familiar with the word UNICEF. Let as discuss, what it means? UNICEF isone of the specialised agencies of United Nations. It was established in 1946 to deal with children who were affected by the world war. Formerty known as UNICEF (United Nations International Children’s Emergency Fund), itis now called “UN Children's Fund”, but che title UNICEF isretained. The headquarters of UNICEF is in New York, it has tegional office in NewDelhi. UNICEF works in close collaboration with WHO, in dealing with programmes for mothers and. 22 children. The main concern of UNICEF is maternal and child health, nutrition, environmentalsanitation, health education and programmes which would directly or indirectly benefit child International Health Agencies health. (Content of Services of UNICEF Main areas of UNICEF are child health, child nutrition, family and child welfare and both formal and non-formal education and primary health care. ‘Currently UNICEF is promoting a campaign known as GOBI to encourage four areas fora child health revolution. These are: G — Growth chart to monitor development © — Oralrehydration to treat dehydration B — Breastfeeding 1 — Immunisation against tuberculosis, diphtheria, pertussis, tetanus, polio, and measles. UNICEF in India UNICEF assists India in the following areas: ') Education — Provides laboratory equipment, workshops, tools, library books and audio- visual aids to educational institutions. i) Health Helps in the field of medical education and training of health personnel, The. primary health centres have been provided with equipment, drugs and vehicles for the development of rural health services. It has supported India’s BCG vaccination programme from the inception. ii) Nutrition - UNICEF is supplying milk powder to feed infants. Ithas supplied equipment for modern dairy plants in various parts of India. UNICEF along with The Food and Agricultural Organisation had started the Applied Nutrition Programmes in India, Special also given for intervention against nutritional deficiency diseases. iv) Water supply - UNICEF has provided equipment to dig wells to improve water supply. ¥) Social Welfare -It has provided funds to strengthen family planning services in rural areas, UNICEF has also helped with training of health personel (ANMS) to improve the health of mothers and children. 3.3.2 United Nations Development Programme (UNDP) ‘The United Nations Development Programme (UNDP) was established in 1966. It provides funds to the member countries for technical assistance. The main UNDP projects are agriculture, industry, education, science, health and social welfare etc. 3.3.3 Food-and Agriculture Organisation (FAO) “The Food and Agriculture Organisation (FAO) was formed in 1945 with headquarters in Rome. The chiefaims of FAO are: — Tohelp nations raise living standards. — To improve nutrition of the people ofall countries. — To increase the efficiency of farming, forestry and fisheries. — Toimprove the condition of the rural people. ‘The most important aspect of FAO work is to ensuie thatthe food is consumed by the people who need it in sufficient quantities and to maintain better state of nutrition throughout the world. The FAO has organised a World Freedom from Hunget Campaign (FFHC) in 1960. ‘The main object of the campaign is to combat malnutrition and spread information and education. + FAO along with WHO has perf programmes and research acti ed many cooperative activities: Nutrition service, training ies. 33Systems of Medicine and Health Agencies 34 Cheek Your Progress 2 ) UNICEF wasestablishadin wi) Four areas for child health revolution are a). » 9. 4). ii) UNDP stands for iv) Chief aims of FAO are: ». b). 3 4) 3.3.4 International Labour Organisation (ILO) Jn 1919, the Interhational Labour Organisation (ILO) was established to improve the working and living conditions of working population all over the world. ‘The ILO in 1977 adopted a Convention 149, and Recommendations 157 n the life and ‘working conditions of nursing personnel, which is a milestone in the history of nursing. ‘The purposes of ILO are: ‘© Tocontribute to the establishment of social justice. © Toimprove labour conditions and living standards, ‘¢ Topromote economic and social stability. 3.3.5 World Bank World Bank is a specialised agency of the United Nations. It was established with the objective of raising the living standards of less developed countries with the assistance of developed countries, The bank gives loans for projects that help in economic growth and improving health of the nations (e.g, India’s Population Projects). The projects are mainly concerned with electric power, roads, railways, agriculture, water supply, education family ‘welfare etc. Health and environmental components are added to many projects. 3.4 OTHER ORGANISATIONS We shall describe the various other international organisations as follows: 3.4.1 United States Agency for International Development (USAID) The United States Agency for International Development (USAID) was created in 1961. Previously it was knows as US Technical Cooperation Mission (TCM). Under USAID, India has received assistance in the following projects: © Malaria eradication © Medical education © Nursing education© Health education Internatios Health Agencies © Water supply and sanitation © Control of communicable diseases © Nutrition and ; © Family planning 3.4.2 Colombo Plan ‘Colombo Plan was formed in 1950 by India and six other Common Wealth Countries. Its ‘membership now is 21. Main philosophy of the plan is freedom and progress of ‘countries of Asia through economic, social and cultural coopération with the industrial nations. Most of the Colombo Plan assistance goes into industrial and agricultural development. The All India Institute of Medical Sciences at New Delhi was established with financial assistance from NewZealand. The contribution of Canada in supplying Cobalt ‘Therapy units to Medical Institutions of India is an important item of aid under the Colombo Plan. This plan seeks to improve the standard of the people and coordinate developmental assistance. Check Your Progress 3 i) HOstands for... ity ‘The main objective of World Bank is. ii) Projects of the World Bank are concerned with: a). b). ©. ’ e). iv) USAID stands for V) Most ofthe Colombo Plan assistance goes into ca 3.4.3 Rockefeller Foundation ‘The Rockefeller Foundation began its activities in 1913. Its purpose is to promote the well being of mankind throughout the world. In the beginning, the foundation was active chiefly in public health and medical education. The All India Institute of Hygiene and Public Health at Calcutta and the National Institute of Virology at Pune were established with the aid from Rockefeller Foundation. Rockefeller Foundation has trained several teachers and research workers in India. The foundation provides financial assistance for the improvement of agriculture, family planning, rurai training centres and medical education. 3.44 Ford Foundation Ford Foundation has been active in the development of rural health services and family planning, The Ford foundation has helped India in the following activities: }) Orientation Training Courses — The orientation training centres at Singur, Najafgarh and Poonamalle were set up with the aid of this foundation. ‘These centres provide short training courses in public health to medical and paramedical personnel from all over India. ii) Research-cum-Action Projects — These projects aimed at solving basic environmental sanitation problems e.g. RCA latrine (Research-cum-Action Project). fi) Pilot Project in Rural Health Services (experimental), Garvthigrar (Tamil Nadu). An attempt was made among a rural population of one lakh people, to develop and operate aSystems of Medicine and Health Agencles 36 a coordinated type of health services, which will provide a useful model for health administrators in the country. tv) _ Establishment of NIHAE ~The National Institute of Health Administration and Education at Delhi was established with the help of ford foundation. ¥) Calcutta Water Supply and Drainage - The foundation has helped in preparation of master plan for water supply, sewage and drainage for the city of Calcutta. vi) Family planning - The foundation is supporting research in the family welfare programme of India. 3.4.5 Cooperation for American Relief Everywhere (CARE) Cooperation for American Relief Everywhere (CARE) is a non-profit organisation. Itwas created in 1945 for the purpose of sending food from American donors to needy people in other counties. CARE began its services in India in 1950. From 1961, CARE is helping India in midday meat scheme for primary schools, provides assistance in medicine, literacy, ‘vocational training and agriculture, CARE supports in the activities like construction of orphanages and cooperatives etc. It also distributes dried milk, wheat, rice, corn and other foodstuffs donated by the US Government. Check Your Progress 4 4) Inthebeginning, Rockefeller Foundation was active in and i) Ford Foundation has helped India in the following activities: An » 9. @, 8). f. iit) CARE distributes: ‘The Red Cross isa non-political, non-official international humanitarian organisation devoted to the service of mankind in peace and war. It was founded by Swiss businessman, Henry Dunant in 1864. International Red Cross is an independent and neutral institution providing sources irrespective of region, religion, race, political, economic and social considerations. In the beginning, the role of Red Cross was confined to humanitarian services, during wartime. Later on the work was extended during the peacetime also to serve human suffering from natural disasters such as famines, floods, earthquakes and fire accidents. Now many other areas, which would prevent human suffering, are included in the Red Cross activities. ‘You should remember that functions of Red Cross comprise services to Armed Forces, services to war victims, disaster services during flood, carthquake, famine, fire, drought etc, First Aid and nursing, health c ucation and maternal and child welfare services, The Red Cross symbolises Hope, Mercy and Service.Check Your Progress S Dm -mational Red Cross was founded by... ii) Functions of Red Cross are: a. »» a. 3. 3.6 LET US SUM UP In this unit we have discussed International Health Agencies. We have come to kstow about ‘World Health Organisation, which is a non-political health agency of United Nations. ‘The objective of WHO is attainment of the highest level of health by all citizens of the world, You have learned about UNICER, which works i close collaboration with WHO. The main concem of UNICEF is MCH, nutrition, environmental sanitation, health education and all programmes related to child health. We discussed about UNDP, which provides assistance toagriculture, education, science, health and social welfare ctc. We have learned about FAO Which aims at raising living standards, improving nutrition, increasing efficiency of farming, forestry and fisheries and improve the condition of rural people throughout the world. We learned about 11.0 which provides assistance in the establishment of social justice, improve labour working conditions and living standards, promote economic and social stability in all the nations of the world. We have learned about World Bank whichis a specialised agency of the United Nations. Its objective is raising the living standards of less developed couiitres. We have discussed about USAID, which assisted India in malaria eradication, ‘water supply and sanitation, contro\ of communicable diseases, nutrition, family planning, and professional development. We have also learned about Colombo plan, whichbelieves that, freedom and progress of countries of Asia can be achieved through economic, social ‘and cultural cooperation with industrial nations. Rockefeller foundation provides assistance forthe improvement of agriculture, family planning, rural saining centres and medical education. Ford foundation has been active in the development of rural health services and family planning. CARE (Cooperation for American Relief Everywhere) aims at sending food from American donors ta needy people in other countries. We have also discussed about contribution of International Red Cross during war and peace. Red Cross provides assistance to armed forces. It provides disaster services, first aid and nursing services, health education and MCH services to the needy people of all the nations. These international health agencies help all the citizens of the world tolead a healthy life. 37 GLOSSARY Combat Tofight Constitution The fundamental laws and practices that normally govern , the operation, Coordinating 5 ‘Tobring into harmonious relation or action. Directing To control, to order orto instruct with authority. Epidemic Affecting many in a large area or community at large. Health Statisties Collection of quantitative data or facts related to health e.g. death rate, birth rate, infant mortality rate et. Orientation The determination or adjustment of one’s position with reference to circumstances, ideals etc, Quarantine A period of tite fixed for ti sisolAtion and observation of persons, animals os plants suspected of harbouring an infectious discaseSystems of Medicine and Health Agencies 38 3.8 MODEL ANSWERS (Check Your Progress I i) ii) ‘7th April, 1948 i) Direct and coordinate health programmes throughout the world i) Strengthen and improve health services of member countries iii) Provide central technical services iii) a) World Health Assembly iv) b) Executive Board ©) Secretariat SEAR Check Your Progress 2 ) ii) iii) 1946 ® G-Growth monitoring b) O-0RS © B-Breastfeeding ¢) Emmunisation United Nations Development Programme a) Raise living standards b) Improve nutrition ©) Increase efficiency of farming, forestry and fisheries 5) Improve conditions of rural people Check Your Progress 3 d it) iv) vy International Labour Organisation Raising the living standards of less developed countries a) Electric power b) Roads and railways ©) Agriculture and water supply 4) Health and family planning ©) Education United States Agency for Intemational Development Industrial and Agricultural Development Cheek Your Progress 4 i) ii) iii) Public Health and Medical Education a) Orientation Training Courses: b) Research-cum-Action Projects ©) Pilot Project in Rural Health Services d) Calcutta Water Supply and Drainage ©) Family planning . 1) Establishment of NIHAE, Dried milk, wheat, rice, cosn and other foodstuffs donated by US Government.Check Your Progress 5 i) Henry Dunant Wa) Servicesto armed forces b) Disasterservice ©) Firstaid and nursing 4) Health education ©) MCH services 3.9 FURTHER READING Annual Repost 1999-2000, Government of India, Ministry of Health and Family Welfare, New Delhi. Park, J.E. and K. Park, Essentials of Community Health Nursing, 2nd ed. Park, K., Textbook of Preventive and Social Medicine, 15th ed., 1997, Jabalpur (India). 39