International Constructions of Social Security and Public Health: Policy Intersections 1920–1970

Abstract

The problems of national health insurance played a prominent, but shifting role in the formation of global health policy. This paper uses the work of Geneva based organizations from the end of the First World War to the 1970s to explore the crossing points between health policy and social security. From its formation the League of Nations Health Organisation had an uneasy dialogue with the social insurance and security approaches adopted by the International Labour Organization and the International Social Security Association. When the social insurance concerns of the interwar year broadened into ‘social security’, largely led by the ILO, this debate spilled over into conflicts over the leadership of global social policy and carried over into the early years of WHO. Conflicts centred on the difficult relationship between national health insurance and the other elements of what became the welfare state. The paper identifies the difficulties of constructing a global policy space for action on health security.