Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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Establishment and Functions of World Health Organization: With a Functionalism Perspective

기능주의 관점에서 본 세계보건기구의 설립과 역할

  • Ko, Han-Soo (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Kim, Chang-Yup (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University)
  • 고한수 (서울대학교 보건대학원 예방의학교실) ;
  • 김창엽 (서울대학교 보건대학원 예방의학교실)
  • Received : 2011.11.21
  • Accepted : 2012.03.19
  • Published : 2012.03.31
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Abstract

Since its establishment in 1948, World Health Organization (WHO) has tried and facilitated international cooperation of public health under the goal of "the highest attainable health," and gained outcomes like the eradication of smallpox and polio, turning itself into the representative of international public health. However, there was discord between member nations during the cold war era, and the status of WHO experienced rise and fall after its establishment. WHO, the representative international health organization, also has not been freed from influences from international regime changes, which means that the discussion on the internal causes of WHO functionings should be expanded more. In this study, functionalism was tested as one of international relations theory that tries to explain the establishment and role of WHO. Especially, this study analyzed the problems and problem-solving process that WHO had to face by using Imber's five steps theory that arranged chronologically the theory of Mitrany. We mainly investigated the secondary source that described historic facts on the rise and fall of WHO in terms of roles and functionings during establishment of WHO, the cold war era, and international cooperation of public health. The roles of WHO were analyzed by selecting the gains of WHO in the post cold war era. The functionalism arrangement of Imber was appropriate to some extent in explaining the establishment and role of WHO. The first step was International Sanitary Conference in 1851 that made nations to recognize international cooperation of public health, and the second step was the establishment of WHO that handles public health as an international organization. Recent cases of the Framework Convention on Tobacco Control and International Health Regulations showed that each nation agreed with an international norm that they had to cooperate each other to tackle infectious diseases and smoking, and this implies that these were emergence of global governance. This process was the third step of Imber's theory (nations had a gain from international cooperation would agree with the expansion of authority of international organization). However, the last two steps of the theory are still not realized. The partial success of WHO was based on the functional elements that WHO deals with non-political elements, human resources centering on professionals, and democratic decision making process. This essential and non-political characteristics mean that necessity of international cooperation catalyzed by WHO would continue despite of the global governance era when global health governance get faced more challenges.

Keywords

References

  1. 강성학. 국제기구 연구경향과 유엔체제. 국제정치논총 1991; 30(2): 49-76.
  2. 김관옥. 국제기구 역할에 관한 이론적 재고찰: 미국의 패권적 국제질서를 중심으로. 대한정치학회보 2004; 12(1): 245-267.
  3. 김용우. 기능주의와 신기능주의: 국제연합체 성장에의 응용성에 관한 비교 연구. 한국행정학보 1984; 18(2): 535-547.
  4. 김용우. 통합이론으로서 기능주의와 신기능주의 국제적 적용상황에 대한 비교연구: 대북통합정책에 주는 정책적 함의. 한국정책과학학회보 2004; 8(3): 5-25.
  5. 김태운.'신현실주의'와'신자유주의'의 국제정치관. 정치.정보연구 2005; 8(2): 190-211.
  6. 김태운. 국제기구 형성과 역할에 관한 이론적 고찰: IAEA의 경험적 사례를 중심으로. 한국콘텐츠학회논문지 2006; 6(7): 79-89.
  7. 김학노. 마스트리히트 사회정책협정 형성과정: 구성주의적 신기능주의 설명. 한국정치학회보 2001; 35(3): 437-453.
  8. 문돈. 거래비용이론, 신제도주의, 그리고 제도의 변화: GATT에서 WTO로의 분쟁해결제도의 변화. 한국사회과학 2002; 24(2): 95-124.
  9. 박재영. 의사결정 방식을 중심으로 본 주권국가와 국제기구와의 관계. 국제정치논총 1998; 38(2): 43-62.
  10. 박종철. 상생공영 정책과 대북포용정책의 비교: 기능주의의 한계와 제도주의의 실험. 국제정치논총 2009; 49(1): 419-426.
  11. 박찬봉. 7.7선언체제의 평가와 대안체제의 모색: 기능주의에서 제도주의로. 한국정치학회보 2008; 42(4): 339-365.
  12. 박흥순. 국제기구와 국제제도. 국제정치논총 2009; 49(1): 401-417.
  13. 이덕형, 박기동. 국제보건규칙의 개정과 전염병 관리 및 검역체계 개선의 과제. 대한의사협회지 2005; 48(8): 784-794.
  14. 장신. 신 국제보건규칙(IHR 2005) 제정에 따른 국제보건법의 발전: 적용범위 확대를 중심으로. 국제법학회논총 2007; 52(2): 399-426.
  15. 정효민. 국제기구 역할에 관한 이론적 고찰: 국제노동기구(ILO)의 문제제기 구조와 관련된 경험적 사례를 중심으로[석사학위 논문]. 서울: 고려대학교 정책대학원; 2010.
  16. 조동준. 국제연합총회에서 미국의 영향력 분석: 영향력 자원과 선호의 상호작용. 한국정치학회보 2004; 38(2): 327-353.
  17. 조동준. 생각의 힘과 돈의 힘: 노예제 폐지론과 자유무역의 상호작용. 한국국제정치학회 하계학술회의 발표논문집; 2006.
  18. 조동준. '인류공동의 유산'의 국제제도화 과정: 심해저 관리를 중심으로. 국제정치논총 2010; 50(4): 127-158.
  19. 카, E.H.. 20년의 위기. 서울: 녹문당; 2005
  20. 한승헌. 국제커피기구(ICO)의 창설 및 붕괴 과정 연구[석사학위 논문]. 서울: 이화여자대학교; 2009
  21. Allen C. World health and world politics. International Organization 1950; 4(1): 27-43. https://doi.org/10.1017/S0020818300028630
  22. Andresen S. Leadership change in the World Health Organization: Potential for increased effectiveness?. FNI Report. The Fridtjof Nansen Institute; 2002.
  23. Bettcher D, DeLand K, Schlundt J, Gonzalez-Martin F, Bishop J, Hamide S, et al. International public health instruments. In : Detels R, Beralehole R, Lansang MA, Gulliford M, editors. Oxford Textbook of Public Health. 5th ed. Oxford: Oxford University Press; 2009.
  24. Buse K, Gwin C. The World Bank and global cooperation in health: the case of Bangladesh. Lancet 1998; 351(9103): 665-669. https://doi.org/10.1016/S0140-6736(97)11453-2
  25. Brown TM, Cueto M, Fee E. The World Health Organization and the transition from"International"to"Global"public health. American Journal of Public Health 2006; 96(1): 62-72. https://doi.org/10.2105/AJPH.2004.050831
  26. Cox RW, Jacobson HK. The anatomy of influence: decision making in international organization. London: Yale University Press, Ltd.; 1974.
  27. Economist. Repositioning the WHO: The World Health Organisation is about to given a much-needed kick in the backside. 1998년 5월 7일.
  28. Ferguson N. You were expecting statehood?. Newsweek 2011년 9월 25일.
  29. Gaddis JL. The long peace: Elements of stability in the postwar international system. International Security 1986; 10(4): 99-142. https://doi.org/10.2307/2538951
  30. Godlee F. WHO in retreat: Is it losing its influence?. British Medical Journal 1994; 309: 1491-1495. https://doi.org/10.1136/bmj.309.6967.1491
  31. Gostin LO. Global regulatory strategies for tobacco control. Journal of American Medical Association 2007; 298(17): 2057-2059. https://doi.org/10.1001/jama.298.17.2057
  32. Imber MF. Re-reading Mitrany: a pragmatic assessment of sovereignty. Review of International Studies 1984; 10(2): 103-123. https://doi.org/10.1017/S0260210500116110
  33. Jolly JE. The evolution and development of international health collaboration [Master of Arts]. University of British Columbia; 1987.
  34. Karns MP, Mingst KA. International organizations. London : Lynne Rienner Publishers; 2004. 김계동 등(옮김). 국제기구의 이해. 서울 : 명인문화사; 2007.
  35. Kickbusch I. The development of international health policies: accountability intact?. Social Science & Medicine 2000; 51(6): 979-989. https://doi.org/10.1016/S0277-9536(00)00076-9
  36. Mclaren RI. Mitranian functionalism: possible or impossible? Review of International Studies 1985; 11(2): 139-152. https://doi.org/10.1017/S0260210500114275
  37. Meier B. The highest attainable standard: The World Health Organization, global health governance, and the contentions politics of human rights[Doctor of Philosophy]. New York: Columbia University; 2009.
  38. Mitrany D. A Working peace system. Chicago: Quadrangle Books; 1966.
  39. Mitrany D. The functional approach to world organization. International Affairs 1948; 24(3): 350-363. https://doi.org/10.2307/3018652
  40. Mitrany D. The functional approach in historical perspective. International Affairs 1971; 47(3): 532-543. https://doi.org/10.2307/2614439
  41. Peabody JW. An organizational analysis of the world health organization: Narrowing the gap between promise and performance. Social Science and Medicine 1995; 40(6): 731-742. https://doi.org/10.1016/0277-9536(94)00300-I
  42. Riggs RE. The Bank, the IMF, and the WHO: More data on functionalist learning. The Journal of Conflict Resolution 1980a; 24(2): 329-357. https://doi.org/10.1177/002200278002400210
  43. Riggs RE. The FAO and the USDA: Implications for functionalist learning. The Western Political Quarterly 1980b; 33(3): 314-329. https://doi.org/10.2307/447258
  44. Roemer R, Taylor A, Lariviere J. Origins of the WHO framework convention on tobacco control. American Journal of Public Health 2005;95(6): 936-938. https://doi.org/10.2105/AJPH.2003.025908
  45. Rothwell C. International organization and world politics. International Organization 1949; 3(4): 605-619. https://doi.org/10.1017/S0020818300014892
  46. Ruger JP, Yach D. Global functions at the World Health Organization. British Medical Journal 2005; 330: 1099-1100. https://doi.org/10.1136/bmj.330.7500.1099
  47. Tarantola D. Global health and national governance. American Journal of Public Health 2005; 95(1): 8.
  48. Wilson K, Brownstein JS, Fidler DP. Strengthening the International Health Regulations: lessons from the H1N1 pandemic. Health Policy and Planning 2010; 25(6): 505-509. https://doi.org/10.1093/heapol/czq026
  49. WHO. The first ten years of the World Health Organization. 1958.
  50. WHO. International code of marketing of breast-milk substitutes. 1981.
  51. WHO. 58th World Health Assembly 58.3 - Revision of international health regulations. 2005.
  52. WHO. Working for health: an introduction to the World Health Organization. 2007.
  53. WHO. 63rd World Health Assembly document A63/40. 2010.
  54. World Bank. The Wrold Bank annual Report 2010. Washington DC: World Bank; 2010.
  55. Yamey G. WHO in 2002: Why does the world still need WHO?. British Medical Journal 2002; 325: 1294-1298. https://doi.org/10.1136/bmj.325.7375.1294