Communicable disease control in China: From Mao to now

Hipgrave, David

Early efforts in public health included work on vaccination, environmental sanitation and hygiene (including the early introduction of composting of night-soil to reduce the concentration of intestinal parasites) and the development of organized CDC programs. Incredibly, between 1950 and 1952, over 512 million of China' s ~600 million people were vaccinated against smallpox, massively reducing case numbers; the last outbreak of smallpox in China occurred in 1960, 20 years before global eradication (7) . By 1957, more than two-thirds of China' s then ~2050 counties had an epidemic prevention station (EPS) or more specialized centres for the control of specific diseases (such as malaria, plague, schistosomiasis, leishmaniasis and brucellosis) modelled on those established in the Soviet Union earlier in the 20 th century. Their efforts included "patriotic health campaigns" focusing on ensuring as the growth rate of 0.57% per annum has fallen substantially. China' s population, along with that in the rest of the world, began to grow very rapidly from the mid-18 th century, from an estimated 177 million in 1750 to approximately 430 million in 1850 and 580 million by 1950 (1) . The low annual growth rate of only 0.3% during the century to 1950 changed with the relative political stability since 1949; the population sky-rocketed in the 1950s and 1960s. This resulted in public advocacy on family planning ("later, longer, fewer") and finally the one-child policy that has applied to around two-thirds of couples since the late 1970s (2) . The need for population control in China was based not only on the formerly high fecundity of Chinese women, but also the rapid fall in the crude death rate that accompanied the establishment of the People' s Republic of China (PRC). This fall was largely due to communicable disease control (CDC).