摘要：The evolution of international health has typically been assessed from the standpoint of central institutions (international health organizations, foundations, and development agencies) or of one-way diffusion and influence from developed to developing countries. To deepen understanding of how the international health agenda is shaped, I examined the little-known case of Uruguay and its pioneering role in advancing and institutionalizing child health as an international priority between 1890 and 1950. The emergence of Uruguay as a node of international health may be explained through the country’s early gauging of its public health progress, its borrowing and adaptation of methods developed overseas, and its broadcasting of its own innovations and shortcomings. THE HISTORY OF INTERNATIONAL health has typically been examined from the perspective of metropolitan institutions such as the World Health Organization, the International Red Cross, and the Rockefeller Foundation. 1 – 5 While some works trace the interactions of these agencies with far-flung actors, the motives, ideas, and operations of international health are invariably portrayed as centrally determined, then diffused around the world. To broaden this account of the development of the international health agenda, I examine the little-known case of Uruguay and its pioneering role in advancing child health as an international priority between 1890 and 1940. Uruguay became involved in international health at least in part to search for solutions to its intractable infant mortality problem, and it ended up offering local approaches—including a children’s code of rights—that had global appeal. As the home of the International American Institute for the Protection of Childhood (Instituto Internacional Americano de Protección a la Infancia, or IIPI), the first permanent organization of its kind, founded in 1927, Montevideo became a node of international health which—though lacking the political cachet of Washington, DC, or Geneva, Switzerland—helped shape a worldwide children’s health agenda. The transformation of Uruguay’s domestic debates into an influential institute can be observed through the international networks of Uruguayan doctors and child health advocates, the opportunities and interests that gave rise to the IIPI, and its repercussions, including Uruguay’s Children’s Code. My analysis, unlike a conventional history, highlights the emergence of a significant initiative from a peripheral location through the interplay of local political and social conditions with widely shared health priorities.
