Smallpox eradication in China and emerging narratives of global health, 1949-79

In the Cold War, East Asian nations became involved in a variety of transnational health initiatives. Although Taiwan, South Korea, and Japan all provided support to the World Health Organization and its American-oriented interventions and strategies, the non-aligned People’s Republic of China followed a different path. The public success of mass immunization in China, as determined by the eradication of smallpox and the “control” of other infectious diseases like measles and cholera in the 1950s and 1960s, contributed crucial evidence for the success of Chinese public health more broadly. By the 1970s, immunization was comfortably entrenched in the rural health system that the People’s Republic of China promoted on a global scale via the export of medical materials, personnel, and funds. State agents also cultivated the goodwill of Western observers who traveled to China after 1971. These international activities contributed to the prominence of the PRC in discussions of global health policy, culminating in the World Health Organization’s Alma-Ata Declaration of 1978 and its major policy shift towards promoting primary health care: interventions meant to provide basic clinical services for many people, including those in rural areas. Although the PRC became famous for its “barefoot doctors” as the human faces of the rural health system it promoted, its eradication and control of infectious diseases—a consequence of mass immunization—provided key evidence that helped consolidate its position as a leading national model of public health.