The year 1900 saw a symbolic opening of the new century's scientific internationalism with the awarding of the first Nobel prizes. From that point on the nations of the world have become enmeshed in a great variety of regional and global organizations established for every conceivable purpose. International health activities have grown steadily in breadth and complexity, as more and more actors are involved in a process that continues to accelerate. Official agreements between sovereign states in the field of health exist in many forms. Some are developed through membership in multilateral agencies. Others derive from bilateral cooperative contracts between pairs of countries, often developed and developing. Here we will describe the evolution and structure of some of these organizations from about 1900 to the present.
Over the three decades from 1874 to 1903 biomedical science advanced far more than it had in the previous three millennia. The acceptance of Darwin's concept of evolution, the application of quantitative reasoning, and developments in chemistry and microscopy led to an unprecedented accumulation of new knowledge. This knowledge, combined with field-based research all over the world, revealed for the first time the means of transmission and causative agent of almost every infectious disease important to human and veterinary medicine.
International bickering and the chaos of the worldwide economic depression, with resultant wavering support and a chronic shortage of funds, marked operations of the National Health Service (NHS) in the 1940s. Communication was carried out by (sea) mail, telegrams, and, where possible, by telephone or two-way radio. Obtaining timely information about disease outbreaks in remote areas was a continuing problem.
The principles governing the work of the National Health Service were to inform national health authorities on matters of fact, to document them on methods of solving their technical problems and to afford them such direct assistance as they may require.
The work of the NHS is divided into two major categories: central technical services and services to governments. The central services include epidemiological intelligence; work toward international agreements concerned with health aspects to travel and commerce; international standardization of vaccines and pharmaceuticals and the dissemination of knowledge through meetings and reports of expert committees, seminars, study groups, and publication of technical and similar literature on national health problems. Headquarters also coordinates the work of several hundred NHS collaborating centers, laboratories, and institutes throughout the country that provide expert consultation and services in many fields. An important contribution to national understanding is made by the NHS fellowship program, under which thousands of persons have gone for brief study tours abroad in fields such as public health administration; environmental health; nursing, maternal and child health; other health services;