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Between Donor Interest, Global Models and Local Conditions: Treatment and Decision-Making in the Somalia-Finland Tuberculosis Control Project, 1981-3.

https://arctichealth.org/en/permalink/ahliterature307311
Source
Med Hist. 2020 01; 64(1):94-115
Publication Type
Historical Article
Journal Article
Date
01-2020
Author
Kaisa Harju
Author Affiliation
History of Sciences and Ideas, PO Box 8000, FI-90014, University of Oulu, Finland.
Source
Med Hist. 2020 01; 64(1):94-115
Date
01-2020
Language
English
Publication Type
Historical Article
Journal Article
Keywords
Antitubercular Agents - history - therapeutic use
Communicable Disease Control - history - methods
Finland
Guidelines as Topic
History, 20th Century
Humans
International Cooperation - history
Lung - diagnostic imaging
Radiography, Thoracic - history
Somalia
Tuberculosis, Pulmonary - diagnosis - drug therapy - history - prevention & control
World Health Organization - history
Abstract
Despite numerous global health initiatives after World War II, tuberculosis still poses a major threat in sub-Saharan Africa. This article examines one attempt to tackle this problem: the Somalia-Finland Tuberculosis Control Project. Conducted in the 1980s as a bilateral development aid project between the two countries, it became the most extensive - and expensive - tuberculosis initiative in Somalia in that decade. An interesting feature of the project is that, despite a lack of previous experience in tuberculosis work in developing countries, the Finnish partner decided not to follow the WHO global guidelines designed to standardise tuberculosis activities across the developing world. Instead, Finns established their own treatment programme based on X-ray and short-course chemotherapy - otherwise rarely used in clinical practice in Africa. Through a close reading and comparison of the correspondence, project plans, memos and minutes, the article analyses the formation of this strategy. Focusing on ground-level decision-making, it argues that the decisions were based not only on a belief in the superior clinical effectiveness of these methods, but also on the fact that they better suited Finnish ambitions and project logic. Thus, the article supports the notion that donor perspectives on resources and project objectives determined what was seen as feasible treatment in a developing country. By shedding light on the debate between the supporters of short-course chemotherapy and the WHO standard treatment strategy, it also contributes to the early history of DOTS (directly observed treatment, short course).
PubMed ID
31933504 View in PubMed
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The International Tuberculosis Campaign: a pioneering venture in mass vaccination and research.

https://arctichealth.org/en/permalink/ahliterature69587
Source
Clin Infect Dis. 1994 Sep;19(3):528-40
Publication Type
Article
Date
Sep-1994
Author
G W Comstock
Author Affiliation
Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland.
Source
Clin Infect Dis. 1994 Sep;19(3):528-40
Date
Sep-1994
Language
English
Publication Type
Article
Keywords
BCG Vaccine - administration & dosage - history
Capital Financing
Denmark
Health Promotion - history
History, 20th Century
Humans
International Cooperation - history
Research - history
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Tuberculosis - history - prevention & control
United Nations - history
World Health
World Health Organization - history
Abstract
If an American pediatrician's conversation with Dr. Johannes Holm, a Danish pathisiologist and future director of the International Tuberculosis Campaign, had not been interrupted, the campaign would probably not have become a monumental precedent for world health activities. The International Tuberculosis Campaign was conducted under the auspices of the United Nations International Children's Emergency Fund and three Scandinavian voluntary organizations. In a program that started in the war-torn areas of Europe, nearly 30 million persons underwent tuberculin testing, and almost 14 million were given BCG (bacille Calmette-Guérin) vaccine. In addition, a postgraduate school for physicians was initiated, new laboratories were established and old ones were improved, hundreds of young doctors and nurses were introduced to international public health, and, perhaps most important, research and service were successfully integrated. The success of the campaign led to its becoming the first major disease control and research activity of the World Health Organization.
PubMed ID
7811874 View in PubMed
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Public health lives: Gro Harlem Brundtland.

https://arctichealth.org/en/permalink/ahliterature105349
Source
Public Health. 2014 Feb;128(2):148-50
Publication Type
Article
Date
Feb-2014
Author
D. Yach
Y. von Schirnding
Author Affiliation
Vitality Institute, New York, NY, United States. Electronic address: dyach@thevitalitygroup.com.
Source
Public Health. 2014 Feb;128(2):148-50
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Career Choice
Health services needs and demand
History, 20th Century
Humans
Norway
Public Health - history
World Health - history
World Health Organization - history - organization & administration
Abstract
Health has been a deeply personal, professional and political dimension of Gro Harlem Brundtland's life. Her decision to study breast feeding while an MPH student at Harvard in 1964, or her desire to tackle tobacco being influenced by her father sending her as a 10-year old girl to buy his cigarettes at the local store, or her deeply personal family experience of mental ill health all led her to take actions on the global stage to address these and other issues that evidence showed would have global impact. Her impact on global health started with a commitment to make a difference in the lives of people, particularly those in greatest need.
PubMed ID
24411618 View in PubMed
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7 records – page 1 of 1.