The Italian War of 1859 helped to create the Red Cross; the First World War precipitated efforts to reorganise it. These may be divided into two quite different categories: those which sought to consolidate and extend the traditional role of the International Committee of the Red Cross (ICRC) and the national societies, and those which asserted the need to create a new kind of Red Cross for the anticipated new era of peace and international co-operation. Support for the idea of a limited reorganisation came primarily from the ICRC (entirely Swiss in membership since its inception in 1863), and from the national Red Cross societies of the smaller European states; proposals for a much more ambitious reform came principally from America and Japan. What rapidly took shape was a power struggle between the Red Cross societies of the victorious Allies, led by the Americans, and the ICRC, which understandably feared for its own survival if the reformers were to triumph. In one form or another, this struggle lasted until 1928, when a settlement of the main issues was finally reached.

More was at stake in this conflict than was apparent on the surface: at its heart lay a fundamental disagreement over what role the Red Cross ought to play in modern society.