The Preamble of the Constitution of the World Health Organization.

Abstract

This section looks back to some ground-breaking written contributions to public health, reproducing them in their original form and adding a commentary on their significance from a modern-day perspective. To complement the theme of this month's Bulletin, Frank Grad comments on the Preamble to the Constitution of the World Health Organization (1). The Constitution was presented at the International Health Conference in New York on 22 July 1946 and signed by the "duly authorized" representatives of the governments participating. The original version of the document, including the ornate and sometimes hesitant signatures, can be seen at http://www.who.int/library/historical/access/who/index.en.shtml ********** In February 1946 the Economic and Social Council of the United Nations established a Technical Preparatory Committee of Experts to prepare an agenda for the International Health Conference in New York, to be held from 19 to 22 July 1946. The agenda included the preparation of a constitution for a World Health Organization (WHO) (2). The Conference eventually approved the WHO Constitution on 22 July, and designated an Interim Commission to carry out essential public health activities until the new organization was established. The Interim Commission was to discharge the functions and duties of the Office Internationale d'Hygiene Publique, as well as those of the Health Organization that had been part of the Economic and Social Council of the defunct League of Nations. Though much of the work of the League's Health Organization was continued, and its major contributions recognized, the Constitution of WHO owes little to the League of Nations Covenant. Article XXIII of this Covenant contains a list of beneficial provisions, and only in its last subdivision, as an afterthought, one on how members of the League "(f) would endeavor to take steps in matters of international concern for the prevention and control of disease." (3). The Constitution approved by the International Health Conference has shown itself to be robust during the 54 years since it came into effect. Nowhere is its strength more clearly seen than in its Preamble. This part of a legal constitutional document has an important function: it states the principles on which the document is based, and implicitly asserts a claim to jurisdiction which may then be spelt out in the document itself. Unlike the mixture of subjects enumerated in the Conventions of the League of Nations, the Preamble of the WHO Constitution is a masterfully coherent statement, claiming as its own the full area of contemporary international public health. In the same spirit as the Charter of the United Nations, the Preamble asserts that the principles it states are basic to the happiness, harmonious relations and security of all peoples, thus expressing a modern set of universal aspirations. Health, it says, is an essential condition for their attainment, and the highest possible attainment of health is a fundamental right of every human being without distinction of any kind. The preamble defines health positively, as complete physical, mental and social well-being, not merely negatively as the absence of disease or infirmity. The concept of public health is contemporary, but in its phrasing the Preamble echoes the rhetorical cadences of the Age of Reason in the last part of the 18th century. In this view certain rights--such as those to health, or to life, liberty and the pursuit of happiness--cannot be granted or denied by any government because they are fundamental, inalienable human rights, which all of us, being human, already have. 1948, the year that WHO came into existence after 26 Member States had ratified its Constitution, is also the year that the United Nations General Assembly adopted and proclaimed the Universal Declaration of Human Rights (4). The Preamble goes on to analyse the obligation of nations to contribute to the health of their people. …