During the nineteenth century, the connection between politics and public health was clear.¹ In the heroic era of sanitary reform, reformers broke ground for new and, from a liberal point of view, drastic interventions. Private property rights were limited in the name of sanitary infrastructure. Individual behavior was curbed and controlled in the interest of public salubrity. The controversy over smallpox vaccination—a classic contest between individual and public goods—was one of the major political battles of the nineteenth century, though curiously forgotten now. The disputes over the Contagious Disease Acts during the 1880s laid the foundations for the...

When the French National Assembly declared health, along with work, a right of man in 1792, it laid the political foundations that would form the basis of a social contract of responsibility for population health between the democratic state and its citizens.¹ By the middle of the nineteenth century, the British state translated the idea of health citizenship into a universal equal right under the law to protect the population from epidemic disease.² In 1848, a French and a German revolutionary—Jules Guérin in the Gazzette médicale de Paris and Rudolf Virchow in his reports on typhus in Upper Silesia—...

American foundations have been powerhouses of international health reform. They supported a broad spectrum of policies, encompassing laboratory research, public health training, and sanitary fieldwork. Infectious and parasitic diseases, mental health, and drug therapy have at various times appeared on foundation agendas. These programs have involved strategic evaluation of some fundamental problems: how to measure health and disease and their economic costs, how most efficiently to turn discoveries in the laboratory into preventive policies, and how to calculate the prospects for wholesale eradication of infectious diseases. Foundations have had greater freedom than state agencies to support experimental projects and to...

The “space” within which an organization acts is shaped by its mandate, its financial and material resources, and its prestige, as well as the qualification, imagination and dedication of its staff. An organization’s “space” may become contentious because of conflicting interpretations of the organization’s function or because of alterations in the landscape in which that organization is embedded. For the League of Nations Health Organization (LNHO), which had been instrumental in establishing international public health during the interwar period, all of the above factors operated simultaneously during World War II. This chapter explores how the LNHO coped with and navigated...

The international sphere was radically reshaped in the aftermath of World War II. Having emerged as the dominant power, the United States used its new influence to construct a new world order—at least in the West—based on a global network of institutions covering most areas of economic activity, trade, and security. With the growth of a new and lasting space for international economic and political cooperation, relations among the industrial democracies were profoundly reshaped. As John Ikenberry has argued, this postwar settlement spawned a “managed order organized around a set of multilateral institutions and a ‘social bargain’ that...

“Public health, like government, must be ‘of all the people’ and ‘by all the people,’ as well as ‘for all the people.’” This statement by C. E. A. Winslow, professor emeritus of public health at Yale University, to the Fifth World Health Assembly in 1952, outlines a grassroots, developmentalist program of public health that he hoped would not be “sold as a finished product of expert thinking” but would instead be “planned to meet the needs of a particular locale.”¹

A legacy of the League of Nations Health Organization (LNHO), Winslow’s call included three essential components: (1) the equation of...

The year 1945 and the end of World War II in Germany is often called the Stunde null, or “Zero Hour.” According to this myth, following the liberation of the German population from fascism, Germany returned to democracy with the assistance of the Allies in the heart of Europe. Only the “Eastern Zone” under Soviet control maintained structures dating from the Nazi dictatorship. This account, however, is not supported by the historical sources. A study of the models of public health in occupied Germany shows that the governing authorities in both the Eastern and Western zones drew on traditions that...

“Demography,” as a recent critique of the discipline has observed, “offers its wares to a range of agencies.”¹ The purpose of this chapter is to focus on demography as a realm of expert knowledge that has applications in the practice of one of these agencies, public health. By demography, we mean the study and analysis of population structure (age, sex, ethnicity, spatial distribution, and so on) and the dynamic components of fertility, marriage and divorce, migration, and mortality. We might assume that public health would be more concerned with the last of these components—mortality—than perhaps with the others,...

The finding and measurement of social facts are critical components of statecraft. These activities, James Scott tells us, help policy makers to make their society “legible,” to read it, and then to shape it.¹ Fact-finding “away from home” has a different raison d’être: it allows those who craft policies at home to situate their nation in a larger world that they have designated as relevant, and it provides them with baselines against which they may judge that world—and themselves.

The decade after World War I saw exponential growth in travel by public health experts to European countries to find...

On the threshold of the 1930s, malariology was already “a house divided.”¹ In Europe, some researchers saw malaria as a “social disease” determined by socioeconomic factors (housing, food, poverty, working conditions). Others, particularly in America, believed it to be a “local disease” contingent on insect and human geography in the affected area.² Debates over etiology were reflected in the solutions championed. For partisans of basic health care, the treatment of patients and their dwellings was the priority; for partisans of public health campaigns, the key lay in the struggle against that most important feature of the malarial locale, the mosquitoes.³...