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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2004.050831v1 96/1/62    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (17) Citing Articles via Google Scholar Google Scholar Articles by Brown, T. M. Articles by Fee, E. Search for Related Content PubMed PubMed Citation Articles by Brown, T. M. Articles by Fee, E. Related Collections Global Health Health Policy Health Promotion Immunization/Vaccines History Public Health Practice

Theodore M. Brown, PhD, Marcos Cueto, PhD and Elizabeth Fee, PhD

Theodore M. Brown is with the Department of History and the Department of Community and Preventive Medicine, University of Rochester, Rochester, NY. Marcos Cueto is with the Facultad de Salud Pública, Universidad Peruana Cayetano Heredia, Lima, Peru. Elizabeth Fee is with the History of Medicine Division, National Library of Medicine, National Institutes of Health, Bethesda, Md.

Correspondence: Requests for reprints should be sent to Elizabeth Fee, PhD, History of Medicine Division, National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20974 (e-mail: elizabeth_fee{at}nlm.nih.gov).

The term "global health" is rapidly replacing the older terminology of "international health." We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term "global health" emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances.

Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context.

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