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League of Nations Health Organization
l'Organisation d'Hygiène de la Société des Nations (French)
1920–1946
Flag of Eddie891/sandbox/LN HO
Semi-official flag of the League (1939)
Anachronous World map showing member states of the League during its 26-year history.
Anachronous World map showing member states of the League during its 26-year history.
StatusIntergovernmental organisation
HeadquartersGeneva
Common languagesFrench and English
Director‑General 
• 1921–1939
Ludwik Rajchman
Historical eraInterwar period
10 January 1920
• First meeting
16 January 1920
• Dissolved
20 April 1946
 Succeeded by
World Health Organization
  1. ^ The headquarters were based from 1 November 1920 in the Palais Wilson in Geneva, Switzerland, and from 17 February 1936 in the purpose built Palace of Nations also in Geneva.

The League of Nations Health Organization (LNHO) was a organization in the League of Nations concerned with international public health. Founded in Geneva, in 1921, Patricia Clavin described the LNHO as "the first global intergovernmental organization."[1] Originally a small organization of little import, under Ludwik Rajchman, the office saw much growth. Until the Organization was restructured into the World Health Organization, it was considered to be one of the most successful of the League of Nations organizations. Under its stated goal to prevent and control disease, the LNHO led the standardization of therapeutic sera and serological tests. It helped prevent typhus epidemics, and worked to end multiple other diseases. The three main achievements of the organization were the "collation of health and disease statistics; managing exchange trips; and to a limited extent sponsoring health research."[2]

The League's health organisation had three bodies: the Health Bureau, containing permanent officials of the League; the General Advisory Council or Conference, an executive section consisting of medical experts; and the Health Committee. The Committee's purpose was to conduct inquiries, oversee the operation of the League's health work, and prepare work to be presented to the Council.[3] This body focused on ending leprosy, malaria, and yellow fever, the latter two by starting an international campaign to exterminate mosquitoes. The Health Organisation also worked successfully with the government of the Soviet Union to prevent typhus epidemics, including organising a large education campaign.[4] The LNHO published the Bulletin Mensuel de Renseignements Épidémiologiques and Rapport Épidémiologique Annuel.

Origins

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Predecessors

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The International Sanitary Conferences, originally held on 23 June 1851, were the first predecessors of the WHO. A series of 14 conferences that lasted from 1851 to 1938, the International Sanitary Conferences worked to combat many diseases, chief among them cholera, yellow fever, and the bubonic plague. The conferences were largely ineffective until the seventh, in 1892; when an International Sanitary Convention that dealt with cholera was passed. Five years later, a convention for the plague was signed.[5] In part as a result of the successes of the Conferences, the Pan American Sanitary Bureau, and the Office international d'Hygiene publique (OIHP) were soon founded in 1902 and 1907, respectively.[6]

Creation

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As the League of Nations was being formed in 1920, Gastao da Cunha wrote a report titled "Report on the Creation of an International Health Bureau within the League of Nations."[7] In it, he strongly recommended creation of such an organization, writing:

If there is a field of action in which the League of Nations can bring immediate relief to nations, and one which will affect individuals in their personal and family life, it is the field of social hygiene in the most liberal sense of the word. Health measures are essentially international measures, whether it be a question of adopting preventative or defensive means to combat contagious or epidemic diseases, or of popularising methods of cures and treatments.

— Gastao da Cunha, [8]
Article 23 of the Covenant of the League of Nations

The organization was to be created in 1920 as specified in Article 23f of the Covenant of the League of Nations. In the Covenant it was authorized to “take steps in matters of international concern for the prevention and control of disease.”[9][10] A conference in London attended by France, Great Britain, Italy, Canada, Japan, Poland, and the United States, the OIHP and the League of Red Cross Societies (LRCS) was held in April 1920 by the League. One of the main goals of the conference was to make a plan for combating the typhus epidemic in Poland. It recommended the creation of a temporary committee, that was established in May 1920. The conference further proposed the establishment of a permanent organization. In the plan, both the OIHP and LRCS were to be absorbed into the LNHO.[11][10][12]

In June 1920 the League of Nations met and established an Epidemic Committee to formally monitor typhus in Poland.[13] By August 1920, the epidemic had worsened, reaching the Soviet Union. The plan that had been made in London was presented to the League of Nations from 18-27 October 1920. A fund was established to raise money to fight typhus. It raised only a small portion of the requested 2 million pounds. In November and December 1920 a plan in more detail was drafted, still based on the incorporation of the OIHP into the LNHO. As typhus continued to spread, there were numerous efforts by competing health organizations, particularly the International Red Cross and LRCS. The Secretary General of the League of Nations responded by urging cooperation between groups.[14]

On March 2 1921, a proposal by Léon Bourgeois was adopted that had the LNHO existing as an 'offshoot' of the OIHP. During 1921, an Advisory Board of the Epidemic Commission was created, meeting in Warsaw on 15 April. From April to May the United States (a member of the OIHP but not the League of Nations) vetoed a proposal to absorb the OIHP into the LNHO, resulting in the Office remaining separate. A Provisional Technical Committee met on 5 May as the League of Nations Temporary Health Committee to facilitate the establishment of a permanent health organization, originally to facilitate the assumption of the OIHP into the League. As the OIHP was already resisting such efforts, the Committee was largely ineffective and only met for a total of 3 hours and 25 minutes over two days.[15]

Due to resistance, it eventually morphed into the Provisional Health Committee, a 14 person group. From 25 to 29 August 1921, the Committee held its first meeting in Geneva. It was announced that Ludwik Rajchman would serve as medical secretary and Thorvald Madsen was elected president of the committee. 'Provisional' was dropped from the name in the published record beginning in late 1922. Around the same time, the Epidemic commission was granted permission to expand into the Soviet Union. It continued to work, primarily coordinating all volunteer efforts.[16]

In September 1922, the International Health Organization saw its budget increased 56%. The following year, the organization began efforts to foster biological standardization, spearheaded by Henry Hallett Dale. On 19 July the Technical Conference for Consideration of Certain Methods of Biological Standardisation was convened in Edinburgh.[17] In January 1923, the League of Nations again proposed combining the OIHP and Provisional Health Committee, a proposal that was rejected by the OIHP. A mixed committee met from 27 May to 2 June and proposed a health organization with "(1) a General Advisory Health Council; (2) a Standing Health Committee; and (3) a Health Section of the Secretariat of the League of Nations".[18] The proposal was adopted on 5 June at the last session of the Provisional Health Committee, approved by the Assembly on 15 September, endorsed by the OIHP in late October—which also elected nine members of the Permanent Health Committee, and on 13 December the remaining six members of the Permanent Health Committee were elected by the LN.[19]

Thorvald Madsen
Carlos Chagas

The first members of the permanent health committee were:[19]

First members of the permanent health committee
Name Nationality
Thorvald Madsen  Denmark
Leon Bernard  France
George Buchanan  United Kingdom
H. Carriere   Switzerland
Carlos Chagas  Poland
G. Pittaluga  Spain
H. S. Cumming  United States
L. Raynaud  France
Alberto Lutrario  Italy
Alexander Granville  Egypt
Ricardo Jorge  Portugal
P. Mimbela  Peru
J. Jitta  Netherlands
Donato Ottolenghi  Italy

At the first session of the committee from 11 to 21 February 1924, three of four 'assessors'—with the same power as committee members—were appointed: Dr. Chodzko, Professor Nocht, and Alice Hamilton; and Madsen was elected president. The LNHO approved a budget and began work.[20] A health bureau of five—later expanded to six—members met more frequently then the committee.[21]

Work and eventual decline

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In 1926 the International Sanitary Conference passed the International Sanitary Convention of 1926, endorsing limited cooperation between the OIHP and LNHO, and the two organizations began sharing documents. In the decade after the convention, the LNHO began to expand and build up its scope under Ludwik Rajchman. By 1923, the Epidemic Commission was dissolved because the typhus epidemic in the Soviet Union and Poland was essentially ended. The Health Organization continued to work to fight other epidemics.[22]

In Europe, Rajchman worked to establish links with Germany and the Soviet Union, which were at the time considered 'pariah states'. On February 18, 1922, he filed a report in which Rajchman concluded that there was a dire state in Eastern Europe, one that could soon result in a typhoid epidemic. As a result of the report, the Warsaw European Health Conference was held, with twenty-four nations represented (all European countries except Albania and Portugal). At the convention, they finalized plans to create a 'sanitary belt' with Russia and the Ukraine on the one side, and Poland and Romania on the other. The Poland anti-typhus program is often considered to be the first successful international public health work in Europe.[23]

During Rajchman's era of directorship, the Health Organization transitioned from promoting defensive quarantines to global work combating diseases. The League began some of the first work combating malaria by establishing a Malaria Commission and promoted nutrition, hygiene and other sanitary principals across the world. It also began working on 'biological standardization' and other programs to unify the global medical community.[24]

After a study by the League of Nations in 1934, the Health Organization was reorganized into a twelve member Health Committee and General Advisory Council made up of the OIHP's permanent health committee. A new Committee was appointed in 1936.[25] In the following years, the Committee often failed to or barely had a quorum of seven members, and accomplished little. Rajchman resigned from his role on a meeting over 20-21 January 1939. According to historian Norman Howard-Jones, "Rajchman's departure really signified the end of the Health Organization."[26]

Raymond Gautier was made the next director of the organization, and the Health Organization continued operating as it had until the outbreak of World War II. The last session of the Health Committee was held from 20 to 24 November 1939. Various sub-committees met and the possibility of epidemics as a result of mass population displacement was discussed in depth. However, by June 1940, only two health officers in the organization remained in Geneva. By then, the organization was effectively defunct.[27] Function of the Eastern Bureau was suspended in November 1942. Issues of the Chronicle of the Health Organization were intermittently published until 1945. An International Conference on the Standardization of Penicillin was held in 1944.[28]

Organization

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The LNHO had four segments: the Health Bureau, containing permanent officials of the League; the General Advisory Council, an executive section consisting of medical experts (which had the same membership as the OIHP); and the Health Committee. The health committee was originally largely European countries, consisting of France, Great Britain, Italy, Belgium, Portugal, Spain, Denmark, Germany, The Netherlands, Poland and Switzerland. Several non-European countries represented included Brazil, India, Japan, Peru and the United States. Non-governmental organizations included the International Labour Organization, International Federation of Red Cross and Red Crescent Societies, and the Committee maintained connections with the OIHP and the Rockefeller Foundation.[29]

Key people

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Epidemiological Intelligence Service

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After the Warsaw conference the Epidemiological Intelligence Service was founded, to standardize and institutionalize medical records. Edgar Sydenstricker was appointed as the first director of the service. The service published the International Health Yearbook beginning in 1925, and ending in 1930. At its peak, 37 countries participated in the Yearbook. As a result of the service, Japan requested that a study be undertaken about the possibility of an epidemic there, and work led by the Service led to a sub-branch of the LNHO being established.[31]

The Service also filed to have a branch formed on March 12, 1924 in the Far East. Based in Singapore, the Epidemiological Intelligence Bureau was created later that year. Sydenstricker led the organization to be fairly well developed, but it was defunded upon the beginning of the Great Depression. In March 1928, a Center for Public Health Documentation was created to house all medical records.[32]

Commission on Education in Hygiene and Preventive Medicine

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The LNHO founded a Commission on Education in Hygiene and Preventive Medicine in 1930. The eight member committee, led by Léon Bernhard, was designed to report on the "1)Training of experts, medical officers, engineers, architects, nurses and public health staff 2) Public health teaching to medical students and general practitioners. 3). Public health instruction to teachers, priests, civil servants and any possible agent in health education and diffusion." The commission worked to "implement public health teaching in medical faculties, programs for experts in schools of public health, evaluation systems, materials for professionals, propaganda, popularization programs and school teaching of hygiene."[33] In 1926, the LNHO led the first International Conference of Public Health Experts and National Schools of Public Health in Warsaw. The following year, another conference was held. Two later conferences would be held in Paris and Dresden in 1930. The conferences focused on building relationships between national schools of health, universities and health authorities.[34]

The Paris conference revolved around standardizing the certification of medical professionals, teachers and the quality of national schools of health. Similarly, in Dresden the same year, the conference attendees dealt with standardizing education for health officers, and establishing a program of both preventive and social medicine to be taught to medical students.[34]

Cancer

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In 1923, the Health Committee established an independent commission to deal with cancer[35][36]

Work with Rockefeller Foundation

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The first contact between the Rockefeller Foundation (RF) and the Health Organization was in 1920, when Wickliffe Rose sent a letter to George E. Vincent, proposing a collaboration. Rajchman soon contacted the Rockefeller Foundation formally on November 18, 1921, and the Foundation soon began working closely with the Health Organization. During the 1920s and 30s, the RF helped to fund the LNHO, in order to allow it to have an amount of financial autonomy.[Lunt, 168] Throughout the 1920s, between 1/3 and 1/2 of the LNHO's budget would come from the RF. After the onset of the Great Depression, funds from the RF would drop dramatically.[37]

Conferences

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Social medicine

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Another facet of the LNHO's work was concerned with social medicine, as it is considered one of the originators of the field.[38]

tsetse fly research and campaigns in Africa or leprosy centers in Rio de Janeiro

Reputation

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https://bloomsbury.com/cw/the-united-nations-in-international-history/the-league-of-nations/league-organizations/health-organisation-lnho/

References

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  1. ^ Clavin, Patricia (3 December 2015). Securing the World Economy: The Reinvention of the League of Nations, 1920-1946. Oxford University Press. ISBN 9780191086649.
  2. ^ "League of Nations Information Section" (PDF). League of Nations Health Organization. 1931.
  3. ^ Northedge 1986, p. 182.
  4. ^ Baumslag 2005, p. 8.
  5. ^ Howard-Jones, Norman (1974). The scientific background of the International Sanitary Conferences, 1851-1938 (PDF). World Health Organization.
  6. ^ McCarthy, Michael (October 2002). "A brief history of the World Health Organization" (PDF). The Lancet. 360 (9340): 1111–1112. doi:10.1016/S0140-6736(02)11244-X. PMID 12387972. S2CID 2076539.
  7. ^ Borowy, Iris (2009). Coming to Terms with World Health: The League of Nations Health Organisation 1921-1946. Peter Lang. p. 48. ISBN 978-3-631-58687-7.
  8. ^ Sweetser, Arthur (3 January 2018). "The League of Nations at Work". Macmillan. p. 167 – via Google Books.
  9. ^ "WHO: Archives of the League of Nations, Health Section Files". World Health Organization. Retrieved 3 January 2018.{{cite web}}: CS1 maint: url-status (link)
  10. ^ a b Cueto, Marcos; Brown, Theodore M.; Fee, Elizabeth (2019). "The Making of an International Health Establishment". The World Health Organization: A History. Retrieved 26 January 2020.{{cite web}}: CS1 maint: url-status (link)
  11. ^ Howard-Jones 1978, p. 8.
  12. ^ Howard-Jones 1978, pp. 18–19.
  13. ^ Howard-Jones 1978, p. 20.
  14. ^ Howard-Jones 1978, pp. 21–24.
  15. ^ Howard-Jones 1978, pp. 8, 24–27.
  16. ^ Howard-Jones 1978, pp. 39–41.
  17. ^ Howard-Jones 1978, pp. 44, 46.
  18. ^ Howard-Jones 1978, pp. 48–52.
  19. ^ a b Howard-Jones 1978, pp. 55–59.
  20. ^ Howard-Jones 1978, pp. 59–60.
  21. ^ Howard-Jones 1978, pp. 59–60, 61.
  22. ^ Howard-Jones 1978, pp. 61–62.
  23. ^ Barona 2013, pp.10-11
  24. ^ Howard-Jones 1978, pp. 62–63.
  25. ^ Howard-Jones 1978, pp. 66–68.
  26. ^ Howard-Jones 1978, pp. 69–70.
  27. ^ Howard-Jones 1978, pp. 69–74.
  28. ^ Howard-Jones 1978, pp. 75–76.
  29. ^ Lunt 2016 p. 167
  30. ^ Gradmann, C.; Simon, J. (8 April 2010). Evaluating and Standardizing Therapeutic Agents, 1890-1950. Springer. p. 144. ISBN 978-0-230-28559-0.
  31. ^ Barona 2013.
  32. ^ Barona 2013, p. 16.
  33. ^ Barona 2013, p. 7.
  34. ^ a b Barona 2013, p. 8.
  35. ^ "The Work of the League of Nations Cancer Commission 1923-1927". The British Medical Journal. 2 (3493): 1157. December 1927. doi:10.1136/bmj.2.3493.1157. PMC 2525278. PMID 20773575.
  36. ^ Pecorelli, Sergio (1 February 2001). 24th Annual FIGO Report on the Results of Treatment in Gynaecological Cancer. CRC Press. ISBN 9781901865394.
  37. ^ Barona 2013, pp. 7–8.
  38. ^ Lunt 2016, p. 168.

Bibliography

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https://www.cambridge.org/core/books/international-health-organisations-and-movements-19181939/league-of-nations-health-organisation/0A25D328AD38CFF408610704C3E594F6

https://www.who.int/global_health_histories/background/en/

https://www.tandfonline.com/doi/abs/10.1080/07075332.2015.1018302?journalCode=rinh20

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2525278/

http://www.who.int/library/collections/health_org_1931.pdf?ua=1

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