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be of the same high quality no matter which region of the world one is in In this new high stakes global playing eld, brands like Harvard don t want to be left behind 44
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In addition to reforming our national health system, we must also safeguard against the Macro Quantum cross-border health risks that come with increased international exchange Like other multilateral efforts, coordinating and managing such risks will require institutional reform In 1942, the Of ce of Malaria Control in War Areas, a division of the US Public Health Service, realized that it needed to try to combat not only malaria but also other diseases, such as typhus, that were being found in the southeastern United States and in tropical regions outside of the country where US troops were ghting45 It only took a few years for the nascent organization to realize that more people and resources were needed to protect the American population from such diseases International health became part of the national agenda for the rst time in US history, and in 1946, the Center for Disease Control (CDC now the Centers for Disease Control and Prevention) was born Americans were not the only ones who realized that a new kind of effort was needed to control illnesses and promote health During the same time period, the foundation for the birth of the World Health Organization was being laid On April 7, 1948, the World Health Organization (WHO) constitution came into force46 While a tally sheet of successes and failures might cloud the reputation of the WHO, today we are realizing the same problem as the diplomats of the postwar era: The current infrastructure in place to address matters of global health is insuf cient Although the WHO has been with us for more than 60 years, it did not truly begin to wield in uence until 20 years after its establishment Health entered onto the international stage as a global issue in the mid-1970s It was around this time when the WHO, at the height of its in uence, began the ambitious program, Health for All by the Year 2000 The program originally focused on the principles of equity, community participation, and intersectoral collaboration It was decided at the World Health Assembly in 1977 that the main goal of the WHO
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and of governments the world over should be the attainment by all the citizens of the world by the year 2000 of a level of health that will enable them to lead a socially and economically productive life 47 Despite the establishment of a global vision for health, the WHO s effectiveness has been steadily declining since the 1970s A combination of a awed funding structure, political divides, and competition with private foundations has crippled the organization, leaving many to wonder if it is worth preserving48 On one hand, we should be thankful that the WHO cemented health as a global issue On the other, it may be time to turn to new international networks focusing on addressing the issue in different ways Several nongovernmental (NGOs) have proven more effective in part due to better funding and more focused agendas For example, compare the resources and scope of the Bill and Melinda Gates Foundation with those of the WHO; the Gates Foundation has nearly double the WHO s annual budget ($305 billion as opposed to $166 billion) for a much more limited agenda The Gates Foundation is not alone The international community has enacted a series of piecemeal solutions addressing the traditional problems of health, including UN legislation; the Gleneagles G8 commitments in 2005; the establishment of the global fund to ght AIDS, TB, and Malaria in 2006/2007; the rst Advance Market Commitment for new vaccines in 2007; and the World Economic Forum s global plan to stop tuberculosis in 2006 On a limited budget, the WHO has a broad mission Its efforts range from tobacco education to immunization nance The WHO would have more success if it refocused attention to monitoring efforts; this would make it a powerful force in handling cross-border pandemics Pandemics are low-probability, high-risk events Consider something as simple as the u: You can nd the advertisements on the subways of New York City in Spanish and in EnglishYou can hear it as a mantra in hospitals and doctors of ces throughout the United States, especially if you are a senior citizen or parent of a small child Did you get your u shot this year Some of us simply shrug our shoulders and decide to rely on Thera u and other over-the-counter remedies should we fall ill After all, why all the fuss over such a simple virus that annually comes and goes like clockwork We need to be convinced that waiting in the queues at the local medical center is worth our time
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