The global institutionalization of health as a social concern: Organizational and discursive trends

Drawing from sociological neoinstitutionalism, this article considers the emergence and evolution of the global health system. Tracing the dates of the founding of health-related international organizations shows a clear pattern of institutionalization over time. First, the article shows a clear trend of organizational structuration and expansion: with the oldest health-related international organizations tracing their origins to the 17th century, the global organizational field today includes some 2600 health-related organizations. Second, the field has clearly changed over time in the framing of health as a social concern: delineating the goals and aims of these health-related international organizations, the article reveals four general approaches to international health (as an act of charity, as a professional activity, as a means for development and as a basic human right) and a historic thematic shift from charity to human rights-based notions of health between 1650 and 1997. Such shifts are theorized within the framework of the neoinstitutional perspective.