691 



Early Efforts Toward International Collaboration 



It is to the credit of diplomacy in international action under these 

 circumstances that the nations sought a constructive plan to control 

 the spread of disease. It was a long step forward, for example, when 

 in 1851 the French government convened the first international quar- 

 antine congress. The 12 nations which sent delegations to the congress 

 in Paris were fully aware of the "* * * pressures of the non-mai-itime 

 powers to bar the entrance of disease, at any cost [and of] the great 

 shipper, the United Kingdom * * * at any cost, to keep commerce 

 and traffic moving." ^^ Knowledge of the origin and transmission of 

 infectious disease was not well enough advanced to impose a purely 

 technological decision. Nevertheless, the participants from time to time 

 seemed willing to do just that and to do it as a basis for international 

 action. The scientific community, such as it was at the time, was di- 

 vided between the sanitarians and the quarantinists. It is interesting 

 to point out that their views were both wrong as single solutions to 

 the problem, but both correct as combined approaches to it. Today, 

 sanitary control and quarantine are significant components of the man- 

 agement of international epidemics. 



When the delegates to Paris in 1851 got down to work it was with 

 considerably more skill in negotiation than knowledge of epidemi- 

 ology. In an atmosphere of ignorance concerning the origin and trans- 

 mission of diseases like cholera and plague, diplomacy was faced with 

 a unique challenge. Since the medical men were unable or unwilling to 

 agree on whether or not certain diseases were contagious, the diplomats 

 were forced to use a political strategy regarding the retention or abo- 

 lition of international ship quarantine practices. Meanwhile, delegates 

 from the same nation were free to exercise difi'erent motives and even 

 to vote against each other. Thus — 



Each nation was represented by a doctor and a diplomatist, and it 

 was decided at the outset that they should vote individually. This set 

 up tensions between medical men and the administrators, making the 

 voting at times useless, since they tended to cancel each other out.^' 



Accordingly, it was possible for the diplomat from France to express 

 the concern of the central government with the effect of prevailing reg- 

 ulations on trade, while the French expert familiar with epidemics in- 

 troduced by travellers at the port of Marseilles advocated strict ap- 

 plication of the regulations. This pattern of one diplomat and one 

 doctor from each country continued during ten international sanitary 

 conferences which followed between 1851 and the end of that century. 



Although this first conference ended on a predictably inconclusive 

 scientific note, the diplomats and doctors finally were able to put to- 

 gether 137 articles on international sanitary regulations. There is evi- 

 dence of a considerable amount of patience behind this achievement; 

 it required six months of work involving 48 plenary sessions. 



In perspective it seems to have matterea little that the Convention 

 was not ratified by all the governments, or indeed that it lapsed com- 

 pletely in 1865. TTie fact remains that a number of important inter- 

 national rules were established to promote uniformity m quarantine 



1= H. van Zile Hyde. "The International Health Program," an address before the Army 

 Medical Service Graduate School, Walter Reed Army Medical Center (Washington, B.C. 

 March 9, 1954), pace 4. 



"John Taylor, 'Tlrst Steps." World Health (World Health Organization, March 1968), 

 pa?:e 5. 



