Story behind world’s first international health organisation

It was 1870. A mysterious disease had struck Argentina, Chile, Uruguay and Paraguay. Men and women would develop fever, muscle pains, yellow eyes, and would die as their liver would fail. This was yellow fever. In a few years, it was seen all over south and Central America. About a decade later, in 1881, a Cuban epidemiologist- Carlos Finlay, proclaimed it to be due to an unknown agent, spread by Ades mosquito. Yellow fever virus was yet to be discovered. Carlos was right, but no one took much of heed then.

Economics, war and disease

Meanwhile, two events were unfolding in Central America. First one was Panama Canal. After successful opening of the Suez Canal in Egypt, a French company wanted to construct a similar one in Panama. Suez Canal was already generating profits. Hence, Ferdinand de Lesseps, a French diplomat could raise funds for anew canal in Panama. Such a canal was to change maritime, and open a direct connection between Atlantic and the Pacific. They started construction in 1881, but abandoned the project in 1896. About 200 construction workers died of yellow fever every month, costs were high and finances were running low.
Second was desire of then US president Theodore Roosevelt for an expansion. While, US defeated Spain in wars fought between 1896-1899, it lost more than 3000 soldiers. About 90% soldiers died of Yellow fever, rather than in a battle. As a result of these Spanish-American wars, US got Guam, Puerto-Rico, and Philippines. Cuba became independent, and a Walter Reed commission was set up, to find the cause of mysterious illness that had a potential of eliminating entire armies. In 1900, the commission reaffirmed that Carlos Finlay was indeed right. Ades mosquito was the culprit of this illness. This was incredible, as the yellow fever virus that Ades mosquitoes carried, could be isolated only in 1927.

1902: First international health organisation is born

Unfinished Panama Canal was also to be built, and this project was now of a greater interest to the US. Since, Panama was part of Columbia, and later was wary of US expansion, dirty games were to follow. US instigated rebels in Panama to secede, and secured Panama Canal treaty in its favour, in 1903. It is believed that this secession was funded through beleaguered remnants of French canal construction works. Next task was to conquer yellow fever, so that canal could be constructed.
In 1902, Carlos Finlay was entrusted with the task to establish a multinational sanitation bureau. Thus, on 2nd December 1902, we had a first international health body. Seven countries (Brazil, Nicaragua, Peru, the United States, and Venezuela) were its founding members. This “International Sanitation Bureau”, became “Pan American Health Bureau” (PAHB) in 1923, and “Pan American Health Organisation” or PAHO in 1958.

International Sanitation Bureau (ISB) set up a coordinated system of disease control, quarantines, and port-sanitation. As these efforts could control spread of Ades mosquito, US completed construction of Panama Canal between 1904-14. Under the collective leadership of its member nations, in 1909 ISB set its goal to eliminate Typhus, Malaria, Small-pox, Plague and Cholera from the Americas. However, Great Depression of 1929, and subsequent Second World War, limited its funding.

WHO: a new kid on the block finds a partner

Second World War was over in 1945, and Word Health Organisation (WHO) was inaugurated in 1948. WHO was bigger, strong, had more members and funds. The very next year, PASB and WHO agreed to partner. PASB agreed to be a regional office for the Americas for WHO. In return independence of PASB was assured, with an inflow of funds.

In 1958, PASB changed its name to PAHO – probably to sync with its younger but more powerful sibling WHO. Together, they have achieved eradication of small-pox and polio from the Americas, and elimination of measles and rubella. Americas have highest anti-HIV medicine coverage amongst people living with HIV. In last 120 years, PAHO credits itself with an addition of 35 years of life expectancy in Americas. Indeed it is a story of triumph of human efforts over war and disease.

Epilogue

For years,US controlled Panama Canal, and its 5km periphery on the either side.This was a consequence of 1903 Panama Canal agreement. Perpetual control as envisaged in this agreement was never popular. In 1999 US gave away its control of canal, back to Panama. Today, both PAHO and Panama Canal, continue to thrive.