A SALUTE TO THE PAN AMERICAN HEALTH ORGANIZATION’ Myron E. Wegman’ On 2 December 1977 the Pan American Health Organization, the oldest of the intergovernmental health agencies, celebrated its 75th Anniversary. Limited at the outset in scope and activi- ties, and corres#ondingly restricted in growth during the first part of this century, the Organization has had an impressive expansion in importance and influence over the past three decades. Historical Notes This lack of significant progress must have been among the factors which moti- In 1851 the first of a number of efforts vated the Second Meeting of the Interna- was made, at a meeting in Paris, to organize tional Conference of American States multi-country cooperation in public health (October 1901-January 1902) to direct the on some sort of formal basis. The story of convening of an International Sanitary this meeting and the series of international Conference in order to “organize an Inter- sanitary conferences which followed has national Sanitary Bureau for the Amer- been put together recently in a fascinating icas. “4 There was major concern with monograph by Norman Howard-Jones.3 expediting movement of perishable cargoes Unfortunately, although the recorded be- and combating the crazy quilt of quaran- ginnings of foreign quarantine go back to tine, inspection, and exclusion regulations the 14th century, the achievements of the which were seriously impeding the trans- conferences were disappointingly meager port of goods. Another timely point was the and United States participation was limited. then very recent proof of the theory of Carlos Finlay, the great Cuban physician, ‘Condensed version of the article published in the about the transmission of yellow fever by AmericanJournal of Public Health, Vol. 67, No. 12, Aedes aegyfiti. The demonstration of this 1977 (pp. 1198-1204). These excerpted portions are re- printed by permission. theory in Havana by Reed, Lazear, and A Spanish translation of the complete article will Agramonte highlighted the possibilities of also appear in the Boleltn de la Oficina Sanitaria international cooperation. Panamericana 83(6), 1977. The complete article has a section on program which was omitted here for lack of The conference was held in Washington space. 2John G. Searle Professor of Public Health and 4A. A. Molt, The Pan American Sanitary Bureau: Dean Emeritus, School of Public Health, University of Its Origins, Develofiment, and Achievements (1902- Michigan. 1944), PASB Publication 240, Pan American Sanitary ‘N. Howard-Jones, The Scientific Background oi Bureau. Washington, D.C., 1948. the International Sanitary Conferences, 1851-1938, ‘President, American Public Health Association World Health Organization, Geneva, 1975. (U.S.), 1903-1904. 297 298 PAHO BULLETIN l vol. XI, no. 4, I977 FIRST DIRECTORS OF PASB DR. WALTER WYMAN DR. RUPERT BLUE DR. HUGH S. GUMMING from 2 to 5 December 1902, with representa- (b) And to furnish said bureau every opportu- tives of eleven countries in attendance. A nity and aid for a thorough, careful, and scien- series of resolutions resulted, including one tific study and investigation of any outbreaks of pestilential diseases which may occur within the to organize the Bureau. The new unit was territory of any of the said Republics. to concentrate on immediate concerns, but (c) It is further resolved, That it shall be the with commendable prescience the charge duty of the International Sanitary Bureau to went beyond that: lend its best aid and experience toward the widest possible protection of the public health of each of the said Republics in order that disease may be VII. eliminated and ‘that commerce between said Republics may be facilitated. International Sanitary Bureau- To aid and (d) It is further resolved by this convention, to be aided by the several Republics. That it shall be the duty of the International Sanitary Bureau to encourage and aid or enforce Whereas the Second American International in all proper ways the sanitation of seaports, Conference of the Pan American States, held in including the sanitary improvements of harbors, the City of Mexico, October, 1901, to January, sewage, drainage of the soil, paving, elimination 1902, provided that a sanitary convention con- of infection from buildings, and the destruction vene in Washington within one year from the of mosquitoes and other vermin. signing of t’he resolutions on sanitation and (e) It is also recommended by this convention, quarantine, and shall elect an International That in order to carry out the above measures a Sanitary Bureau, with permanent headquarters fund of $5,000 shall be collected by the Bureau at Washington, for the. purpose of rendering of American Republics in accordance with para- effective service to the different Republics repre- graph 7 of the resolutions of the Second Inter- sented in this convention: It is hereby national American Conference above referred Resolved: to. (a) That it shall be the duty of the Inter- In this manner the foundations of inter- national Sanitary Bureau to urge each Republic country cooperation for health purposes to promptly and regularly transmit to said bureau all data of every character relative to the were laid, five years before the first sanitary conditions of their respective ports and organized worldwide effort-signature of territories. the agreement to establish, in Paris, the Wegman l A SALUTE TO PAHO 299 Office International d’Hygi8ne Publique. Conference, the Directing Council, the At the 1902 International Sanitary Con- Executive Committee, and the Pan Amer- ference the pattern was established of con- ican Sanitary Bureau (the secretariat). The vening a similar conference periodically to geographic scope of operations was defined act as a governing body for the Bureau, to as all of the Americas. A budget of US$1.3 establish its budget, and to elect a Com- million was adopted-a far cry from the mittee and Chairman to supervise the $5,000 of 1902. program. The first Chairman was the then A new phase in global international Surgeon-General of the United States health came with the signing of the Consti- Public Health and Marine Hospital Service, tution of the World Health Organization Dr. Walter Wyman. (WHO) in 1946. Special provision (in By 1924 all twenty-one American Repub- Article 54) was made for integrating PASB lics had joined in the work of the Bureau, and other regional health organizations and that year’s Pan American Sanitary with WHO. On the basis of this article and Conference, attended by eighteen countries, a series of negotiations, Dr. Soper (on behalf took the significant step of adopting the Pan of PASO) and Dr. Brock Chisholm, first American Sanitary Code-which was for- Director-General of the World Health mally ratified as an international treaty by Organization (on behalf of WHO) signed a all twenty-one Republics. The Code, a cul- formal agreement in 1949 by which PASB mination of 12 years of effort and still in would serve simultaneously as Regional force, endowed what it called the Pan Office of the Americas for WHO. The American Sanitary Bureau (PASB) with far Directing Council was to serve simulta- broader powers and goals than previously neously as the WHO Regional Committee and established a much firmer juridical for the Americas, and since the WHO Con- basis for the growing organization. stitution provided for the Regional Director Surgeon-General Rupert Blue had suc- for the Americas to be appointed by the ceeded Walter Wyman as Chairman and Executive Board in agreement with the was in turn succeeded in 1920 by Surgeon- Regional Committee, the Council, sitting as General Hugh S. Cumming. When Dr. Regional Committee, could assure appoint- Cumming retired as Surgeon-General in ment of the Director of PASB as Regional 1936 he became the first full-time Director Director. of PASB, serving a total of 26 years until he The wording of the agreement meant that was named Director Emeritus by the XII the international health organization of the Pan American Sanitary Conference in Western Hemisphere would maintain the January 1947. Dr. Cumming had main- independent status established for it in tained PASB’s programs successfully 1902, but because it assumed the additional through. a depression and a war, holding functions of a WHO Region, intergovern- fast to the basic goals but with slow growth. mental health work in the Americas would The 1947 Conference elected as Director be carried out under a single program. In Fred L. Soper, who had enjoyed a distin- practice this has worked out remarkably guished career with the Rockefeller Foun- well over the years, and most PASB staff dation in South America, Italy, and North members are unaware of which organiza- Africa. Dr. Soper soon moved to greatly tion is their actual employer. The program expand the scope of operations and the and budget, of course, identifies the various influence of PASB. The 1947 Conference sources of funds, but to all intents and adopted a Constitution establishing the Pan purposes the same operating procedures, American Sanitary Organization (PASO)- employment policies, staff rules and bene- composed of the Pan American Sanitary fits, and fiscal arrangements apply. Main- 300 - PAHOBULLETIN l vol. XI, no. 4, 19 77 PASB DIRECTORS IN THE LAST 30 YEARS I DR. FRED 1. SOPER DR. ABRAHAM HORWITZ DR. HECTOR R. ACUfiA tenance of the two identities has benefited Center (PANAFTOSA), dealing with an the peoples of the Americas because, since animal disease that threatens the world their governments contribute to interna- protein supply; and the Pan American tional health through both PAHO and Zoonoses Center (CEPANZO). WHO, the program in the Americas is cor- In 1958 Dr. Abraham Horwitz of Chile respondingly larger than in other WHO was elected Director, the first Latin Regions. American to serve. in that post, bringing to Fred Soper was reelected twice as Direc- it a new measure’of imaginative innovation, tor, and during the twelve years of his as well as the’ insights of a health worker tenure the work of the Bureau was system- who had grown up in a developing country.