Application

Marcos Cueto

Prinicipal Professor
Universidad Peruana Cayetano Heredia
Facultad de Salud Publica y Administracion
International Health and Local Actors: Latin American Public Health During the Second Half of the 20th
Peru

Marcos Cueto (Peru) is an historian and a professor in the School of Public Health at the Universidad Peruana Cayetano Heredia in Lima, Perú. He is also the director of the Institute of Health and Development, the research center of the School of Public Health. His previous research includes both the history of epidemic disease in Perú and the history of public health in Latin America. Presently, his main research interests are: the legacy of the malaria eradication campaigns in Latin America, the origins of Primary Health Care and the history of AIDS in developing countries.

Dr. Cueto received his Ph.D. from Columbia University in 1988. He spent a year as a postdoctoral fellow in the Program of Science, Technology and Society of the Massachusetts Institute of Technology. Institutions that have supported his research include: the John Simon Guggenheim Memorial Foundation, the Social Science Research Council, the Wellcome Trust and the Pan-American Health Organization. In 1998, he was co-winner of the Premio Iberoamericano awarded by the U.S. Latin American Studies Association for the best book in the social sciences and the humanities on Latin America published in Spanish or Portuguese. He has also been a visiting professor at the Center of Latin American and Caribbean Studies of New York University.

Selected Publications:

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· Cueto, Marcos (2001) The Return of Epidemics: Health and Society in Perú during the Twentieth Century. Aldershot: UK: Ashgate.
· Cueto, Marcos (2001) Culpa y Coraje: Historia de las políticas sobre el VIH/Sida en el Perú Lima: Consorcio de Investigación Económica y Social.
· Cueto, Marcos. (1994). Missionaries of Science: The Rockefeller Foundation and Latin America. Bloomington: Indiana University Press

International Health and Local Actors: Latin American Public Health During the Second Half of the 20th Century

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The purpose of my participation in the Fulbright New Century Scholars Program is to write and discuss an historical essay on the development of international health programs in Latin America during the second half of the 20th century. I will concentrate in two experiences that have had a lasting influence: first, the malaria eradication campaigns begun in the late 1950s and second, the Primary Health Care Movement that can be traced to the late 1970s. I will asses the similarities and differences of these two types of health work in a less-developed region of the world. I believe that an integrated analysis of these experiences is instrumental for understanding the influence of reductionistic and holistic approaches in international health and their role in fragmented public health systems.

Although this essay will concentrate in four countries of Latin America, it is part of a larger study on the history of public health in the region that will become a manuscript for a book. The essay will identify both the assumptions behind international health programs and the main features of the negotiation process between international agencies and local institutions. I will argue that the transference of international programs to developing countries has not been a one-way street. Technical authority has been frequently accommodated by recipients who redefined the content and scope of these programs.

Malaria campaigns were influenced by the notions of cultural diffusion and modernization that can be traced to the work of the Rockefeller Foundation during the early 20th century. One of the assumptions of these campaigns was that change came from outside backward societies. Traditional cultures, lay healing practices and health institutions of a developing country were considered inconsistent with modernization. Primary Health Care appeared as a radical departure of technically self-contained vertical campaigns. The Alma Ata meeting, organized by the World Health Organization and UNICEF in 1978, defined Primary Health Care as essential care based on socially acceptable technology. However, the goals of self-reliance and self-determination became more restricted in the 1980s when "Selective Primary Health Care" appeared. The latter limited health interventions to: growth monitoring of infants; oral rehydratation techniques; breast feeding, and immunization.

I believe that I can contribute to the NCS Program by providing an historical perspective to the present-day problems and challenges of international health. In addition, I hope to offer insight into the relationship between international agencies and local institutions interested in promoting health and development. I will benefit from my participation in the NCS Program by learning more about contemporary and future discussions on international health.

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