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The World Health Organization between North and South

by Nitsan Chorev

Publication Year: 2012

Since 1948, the World Health Organization (WHO) has launched numerous programs aimed at improving health conditions around the globe, ranging from efforts to eradicate smallpox to education programs about the health risks of smoking. In setting global health priorities and carrying out initiatives, the WHO bureaucracy has faced the challenge of reconciling the preferences of a small minority of wealthy nations, who fund the organization, with the demands of poorer member countries, who hold the majority of votes. In The World Health Organization between North and South, Nitsan Chorev shows how the WHO bureaucracy has succeeded not only in avoiding having its agenda co-opted by either coalition of member states but also in reaching a consensus that fit the bureaucracy's own principles and interests.

Chorev assesses the response of the WHO bureaucracy to member-state pressure in two particularly contentious moments: when during the 1970s and early 1980s developing countries forcefully called for a more equal international economic order, and when in the 1990s the United States and other wealthy countries demanded international organizations adopt neoliberal economic reforms. In analyzing these two periods, Chorev demonstrates how strategic maneuvering made it possible for a vulnerable bureaucracy to preserve a relatively autonomous agenda, promote a consistent set of values, and protect its interests in the face of challenges from developing and developed countries alike.

Published by: Cornell University Press

Title Page, Copyright Page

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pp. 2-5


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pp. v-vi

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pp. vii-x

International organizations have been a prominent feature of the post–World War II order and have become even more central in the current global era. In the last half-century, the number of international organizations has proliferated, and their roles have expanded substantially as they have acquired broader powers and responsibilities. ...

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1. The World Health Organization

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pp. 1-16

In his address before state delegates at the World Health Assembly, on May 15, 1975, the director-general of the World Health Organization (WHO), Dr. Halfdan T. Mahler, spoke of the “changes that are rapidly taking place in the political and economic relationships between Member States.” ...

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2. The Strategic Response of International Organizations

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pp. 17-41

How can we explain the selective correspondence between external pressures— the call for a New International Economic Order in the 1970s–1980s and neoliberal thought in the 1990s–2000s—and WHO policies and programs in the respective periods? I address this question by analyzing the strategic response of international bureaucracies to exogenous demands. ...

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3. A New International Order in Health

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pp. 42-85

By the early 1970s, the global political-economic conditions that had informed the policies of the World Health Organization during its first decades had radically transformed. Decolonization led to the establishment of a large number of independent states, and Third World countries, as they were then called, soon became the majority in the United Nations and its specialized agencies, ...

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4. Appropriate Technology, Inappropriate Marketing

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pp. 86-123

The New International Economic Order intended to transform not only the relations between developing and developed countries, but also between developing countries and multinational companies. As examined in chapter 3, a central tenet of the NIEO was that of economic sovereignty, which promoted independence in economic affairs among developing countries, ...

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5. The WHO in Crisis

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pp. 124-159

The missionary zeal that characterized Mahler turned into despair toward the end of his tenure. In an address in December 1987, Mahler mourned the failure of North-South talks. ...

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6. Health in Economic Terms

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pp. 160-188

When Dr. Gro Harlem Brundtland was elected director-general, in 1998, the political environment of the WHO was markedly different from the environment that had confronted Mahler when he was elected back in 1974: in the new balance of influence, rich countries were now able to exploit the WHO’s dependence on their resources ...

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7. How to Win Friends and Influence Enemies

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pp. 189-225

Although describing the WHO as the “lead agency in health,”1 Director-General Brundtland engaged in a strategy of co-opting other agencies and actors rather than competing with them. In her first speech before the World Health Assembly after her election, Brundtland declared that the WHO must “reach out to others” (cited in Yamey 2002c). ...

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Conclusion: Structural Transformations of the Global Health Regime

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pp. 226-242

In the previous chapters I offered an account of the response of the WHO bureaucracy to external pressures. I showed how both in the 1970s–1980s and the 1990s–2000s, the WHO secretariat adapted to changes in the political environment by advocating policies and programs that could be reconciled with the new dominant logic. ...


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pp. 243-264


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pp. 265-274

E-ISBN-13: 9780801463921
E-ISBN-10: 0801463920
Print-ISBN-13: 9780801450655
Print-ISBN-10: 0801450659

Page Count: 273
Publication Year: 2012

Edition: 1