Introduction

This chapter traces ideas about health, illness, and universalism during a period marked with world wars, major economic crises, breakups of empires and the emergence of new nation states, and the division of geopolitical spaces into opposing camps: ‘First– Second– Third Worlds’, the ‘West vs the Soviet Union’, and ‘North vs South’. International organizations, especially UN agencies, emerged as key spaces and actors in shaping the developments in the health field amid these political, social, and economic transformations. One aspect of this is where health fits in relation to other social policy issues and broader debates on development. While ideas on universalism cut across all fields of social policy and shape conceptions of rights and responsibilities – both individual and collective – as well as expectations for governments and markets, they have unique dynamics in specific fields. I explore these dynamics historically, starting with World War I. The choice of this starting point for the analysis in this book has to do with the major shifts in economic, political, and social spheres and the emergence of new actors, such as nation states, international organizations, and new relationships.

As I trace the shifts in the conceptions of health and the interest in universalism over time, patterns of continuity and change begin to emerge, which are then analysed by exploring the dynamics between strategic action and strategic context, paying particular attention to the intended and unintended consequences. Such an analysis necessitates attention to the order in which things happen and how they happen, thus providing us with information about trajectories and dynamics among choices, actions, and contexts.