The Modern Era
International conferences aimed at drafting sanitary conventions and quarantine regulations led first
to the establishment (1909) of an international health organization based in Paris and ultimately to the 1942 founding of the World Health Organization (WHO), an agency of the United Nations. Its broad scope of activities includes worldwide campaigns to control such widespread diseases as malaria, tuberculosis, and the venereal diseases; to help establish pure-water supplies, sanitation systems, and health education; to provide health planning assistance; and to help train health workers.
The health services of individual countries are organized in many different ways. In Russia public health is the responsibility of the national government, and its administration is strongly centralized. The United Kingdom allows substantial autonomy to local governments. The United States, with its pluralistic approach to health services, gives local and state governments and the private sector large areas of responsibility.
The Public Health Service, the principal health agency of the U.S. federal government, however, is among the largest and most varied of federal organizations. PHS had its beginnings as the Marine Hospital Service (1798Ð1902), which provided medical relief to merchant seamen. Its functions gradually expanded to include the supervision of quarantine laws, the medical inspection of immigrants, and general investigations in public health. It became the Public Health Service in 1912. Today the Public Health Service is made up of eight operating divisions of the Department of Health and Human Services plus the Office of Public Health and Science.
Of the eight divisions making up the PHS, five are responsible for carrying out its major functions: the National Institutes of Health (NIH); the Food and Drug Administration (FDA); the Centers for Disease Control and Prevention (CDC); the Substance Abuse and Mental Health Services Administration; and the Health Resources and Services Administration. Important functions of the PHS include medical research and dissemination of research results; the supply of health professionals and facilities to the public; the provision of medical services to such special groups as American Indians; the investigation of the causes of such epidemics as Legionnaires disease; the testing of foods and drugs to ensure their safety; the development of treatment programs for alcohol and drug abuse and mental health problems; and the collection and analysis of statistical health data.
One of the major public health responsibilities of the CDC is to conduct and coordinate research into infectious diseasesÑsuch as the Ebola virus and AIDSÑand bacteriaÑincluding E. coli and SalmonellaÑthat can cause food poisoning. AIDS research and prevention programs account for about one-third of the work of the CDC, with the rest of infectious disease research accounting for about 20%. Other public health interests of the CDC include chronic diseases and environmental health issues.