From China's "Barefoot Doctor" to Alma Ata: The Primary Health Care Movement in the Long 1970s

This chapter argues that during the Long 1970s, health and medicine played an important role in the politics of the PRC and its relationship with both the First and Third Worlds. It examines the widely acclaimed Barefoot Doctor Campaign in Mao’s China. The Barefoot Doctor Campaign was applied domestically in the PRC in the aftermath of the Great Leap Famine, and then during and immediately after the Cultural Revolution period (1968–1978), partly to redress rural health disparity and health crisis but more importantly as a political tool for the CCP to re-establish its power in the Chinese countryside. In the Long 1970s, the Barefoot Doctor Campaign, referred to in the West as the “Chinese approach to health,” came to hold out the promise of a true alternative to the crumbling single-disease-centered “vertical” health program advocated by the United States and the centralized healthcare structure of the Soviet Union. The World Health Organization (WHO) embraced it as a model of Primary Health Care, adopted to achieve a goal of “Health for All” by the World Health Assembly in 1977, and formally included in the Declaration of Alma Ata the following year. Concurrently, the PRC’s purported success in healthcare delivery also became a useful weapon to those in the West who were prepared to see some good in Maoist China in their criticism of America’s military agression in Vietnam.