From Medical Development Aid to Global HealthGerman Approaches to International Health Work, 1950-2010

关于目前在德国相当激烈的关于全球卫生的学术和政治辩论，必须根据档案和出版的资料以及对“口述历史”的采访，汇编和分析德国行为者对国际卫生工作的不同方法的背景和重叠继承及其发展、变化和消失、复兴和重新制定。这一领域的不同历史表明，在西德的国家、教会和私人“发展援助”以及东德的“团结”的建立和后期阶段，医药和卫生发挥了哪些作用--以及与国际环境的纠缠如何改变了它们的讨论和实施。卫生部门在发展合作中的命运，就像国际、国家和地方各级、国家和非政府参与者、卫生服务部门和其他发展合作部门之间的相互作用一样，在促进经济发展与采取基本需求办法之间、监管与放松管制之间以及短期、中期和长期目标之间的紧张关系中也同样明显。这项研究的目的不是重复各自的卫生-经济或流行病学辩论，而是第一次调查医疗和卫生-政治问题及其在更广泛的发展政治路线中的重要性，以及其地方性(将通过选定的例子加以证明)和国际条件性。这项研究主要不是比较的，而是关于国际纠缠的，但是--通过不可避免地考虑联邦共和国和民主德国、教会和社会运动--不可避免地包含比较的时刻，这将以系统的方式进行，只要它与整个问题相关。研究的重点仍然是治疗医学与预防、不同的健康问题、为他人服务与自我服务、慈善与正义、技术与政治方法、领导层与相关人群的合作伙伴、行政与参与性方法、国家与民间社会、对专业的广泛影响与集中、个人与社会利益、宏观经济与社会政治模式等各自偶尔发生变化的方向。在发展合作中，考虑到艾滋病毒、衰败的国家和新的战争、人才流失和气候变化等挫折对健康的影响。

With regard to the academic and political debate on Global Health that is quite intense in Germany presently the contextualised and overlapping succession of the diverse approaches of German actors to international health work with their development and varying success, change and disappearance, revival and reformulation has to be compiled and analyzed on the basis of archival and published sources as well as by interviews of 'oral history'. The diverse history of this field exhibits which roles were played by medicine and health during the establishment and in later phases of national, church and private 'development aid' in West Germany and 'solidarity' in East Germany - and how the entanglement with international contexts changed their discussion and implementation. The fate of the health sector in the syn- and diachrone tensions of development co-operation between promotion of economic development and basic needs approaches, between regulation and deregulation as well as between short-, medium- and long-term objectives becomes just as visible as reciprocal effects between international, national and local levels, national and non-governmental participants, the health service and other sectors of development co-operation. The research does not aim at a repetition of the respective health-economic or epidemiological debates, but at a first survey of the medical and health-political issues and their importance in the more general lines of development politics as well as at its local (to be demonstrated by selected examples) and international conditionality. The study is not primarily comparative, but on international entanglement, contains however - by the inevitable consideration of Federal Republic and GDR, churches and social movements - inevitably moments of comparison which will be done in systematic ways as far as it is relevant for the overall question. The focus of the research remains the respective, occasionally changing orientation between curative medicine and prevention, different health problems, utility for others and self-utility, charity and justice, technical and political approaches, partners on leadership levels and populations concerned, administrative and participatory approaches, state and civil society, broad effects and concentration on majors, individual and social interests, macro-economic and socio-political models. Setbacks such as HIV, failing states and new wars, brain drain and climate change are considered in their effects on health in development cooperation.