Guest Post by visiting fellow Heidi Tworek, University of British Columbia
I had the good fortune and great privilege of spending a month as a visiting fellow at the Reluctant Internationalists project earlier this year. As someone who has only recently started to work on the history of health, I found our discussions tremendously helpful for understanding how to think about health as an international phenomenon. One of the main recurring questions throughout our discussions revolved around the place of health in international interactions. What, if anything, made health different from other international concerns like labour, communications, war or trade?
Health stood for me as an area that bureaucrats often designated as “technical” to enable broader participation in health-related organisations. The designation of “technical” allowed experts to claim that health concerns existed beyond politics and could thus include non-members of international organisations.
In the interwar period, countries like Germany or the Soviet Union were critical players in the League of Nations Health Organisation. Germany continued to send out epidemiological bulletins over wireless after Hitler rescinded the country’s membership of the League in October 1933. The Rockefeller Foundation provided the majority of funding for the Health Organisation, even though the United States never joined the League. Similarly, David Brydan’s recent PhD thesis has shown how Spanish health officials remained deeply involved in the World Health Organisation although Spain was not allowed to join the United Nations until 1955. Disease crossed borders and did not discriminate between members and non-members of an international body. Despite political differences, nation-states often recognised that and cooperated accordingly.
Our discussions about how labels like “technical” enabled broader participation in health matters reminded me of my earlier work on the history of communications, where the label had performed a similar function. Calling communications standards “technical” enabled officials from the nineteenth centuries onwards to reach agreements about cross-border connections. A special issue that I co-edited for Journal of Policy History found that communications standards have succeeded historically when they regulated technical issues like frequencies, but not when they tried to regulate content.
If I apply that distinction back to the history of health, it implies that standardisation in health was likelier to occur when officials could designate something as “technical” (like causes of death) than when it required agreement on broader social issues. Social issues took health out of the purportedly technical into the very definitely political.
What made health different than communications was the very obvious stakes of life or death. In this sense, health was more like war. Health and war have long been linked metaphorically. We talk about “battling” disease or the “war on AIDS.” Conversely, health metaphors are tremendously virulent. We talk about the “health” of the economy or memes going “viral” online. These metaphors had real consequences. Robert Peckham’s work has shown, for example, how the metaphor of contagion in financial crises affected assessments of risk and responses to stock market crashes. Within the world of the military, some countries stopped supplying health data to the League of Nations around 1940 because they feared that the information could be misused by enemy nations for war planning.
Health, then, could be both as “technical” as communications standards and as “political” as war. By comparing health with other areas of internationalism, we gain a far more nuanced picture of how, when, and why cross-border interactions made reluctant experts into enthusiastic participants or vice versa.