Introduction

This introductory chapter provides a background of how mass immunization programs made vaccination a cornerstone of Chinese public health and China a site of consummate biopower, or power over life. Over the twentieth century, through processes of increasing force, vaccines became medical technologies of governance that bound together the individual and the collective, authorities and citizens, and experts and the uneducated. These programs did not just transform public health in China—they helped shape the history of global health. The material and administrative systems of mass immunization on which these health campaigns relied had a longer history than the People's Republic of China itself. The Chinese Communist Party championed as its own invention and dramatically expanded immunization systems that largely predated 1949 and had originated with public health programs developed in southwestern China during the Second Sino-Japanese War from 1937 to 1945. The nationwide implementation of these systems in the 1950s relied on transformations in research, pharmaceutical manufacturing, and concepts of disease that had begun in the first decades of the twentieth century. These processes spanned multiple regime changes, decades of war, and diverse forms of foreign intervention. Most important, they brought with them new ideas about what it meant to be a citizen of China.

Mass Immunization in East Asia and Global Health, 1960–80

This chapter investigates the role of mass immunization in Chinese medical diplomacy programs during the 1960s and 1970s. While most scholarship has stressed the influence of barefoot doctor and other paraprofessional training programs in the emergence of the People's Republic of China (PRC) as a global model for rural health services, mass immunization programs in China had measurable results—in terms of lowered incidence of disease—that helped legitimize these training efforts and the nation's program of rural health care more broadly. Ultimately, the global popularization of Chinese public health was a consequence of regional competition within East Asia. During the Cold War era, the PRC used medical aid to foreign countries to compete for power and influence with the Republic of China on Taiwan, where institutions and personnel that the Nationalist Party brought to the island after 1948 built upon practices established during the period of Japanese colonial rule (1895–1945). The involvement of Taiwan in medical diplomacy reflected the expansionist agendas of its Western allies in the Cold War as well as competition with the PRC for recognition as the legitimate government of mainland China.