Global smallpox eradication was achieved only after decades of unsuccessful experiments in smallpox-endemic countries. A case in point occurred in 1958 when a severe epidemic imposed heavy mortality on East Pakistan. In response a Bengali regional-nationalist ‘Citizens Provincial Epidemic Control Committee’ pushed aside the provincial health department and launched an eradication campaign based on student volunteers using foreign-donated vaccine. In a period of ten weeks thousands of volunteers vaccinated thirty million Bengalis, albeit relying on shortcuts in sterile technique and neglect of patient record-keeping. The US government, in support of its Cold War ally, Pakistan, provided half of the vaccine supplies. The US also sent a team of Communicable Disease Center epidemiologists to assist public health officials. The team, led by Alexander D. Langmuir, proposed ‘active surveillance’ methods but was constrained by T. Aidan Cockburn, the Chief Public Health Adviser, who favored the Bengalis’ volunteer approach. A struggle developed between politicised volunteerism and epidemiological professionalism, and the CDC experts failed to prevail. The two sides' published reports thus made contradictory recommendations to the global campaign, but subsequent experience has shown that both mass participation and active surveillance are critical ingredients for successful disease control and eradication programmes
Through the case of Czechoslovakia and Hungary, this chapter explores the role of Eastern European states in polio prevention and vaccine development in the Cold War. Based on published sources and archival research, the chapter demonstrates that polio facilitated cooperation between the antagonistic sides to prevent a disease that equally affected East and West. Moreover, it argues that Eastern Europe was seen – both by Eastern European states and the West - as different when it came to polio prevention, since the communist states were considered to be particularly well suited to test and successfully implement vaccines.
This chapter deals with the development and production of vaccines in Mexico from the last third of the nineteenth century to 1989, when the erosion of this sector began. Along with discussing Mexican’s physicians’ reception of discoveries in microbiology and immunology, it points out the existence of a network of relationships between Mexican institutions and others around the world. The chapter shows that vaccine development and production did not follow a constant ascendant path, but that it also suffered declines and regressions. It describes the field’s achievements and limitations, and reveals its relationships with the political, economic, and social conditions of the country in different historical moments. Finally, it evaluates the importance of attaining national self-sufficiency in vaccine development and production for the building of the state in pre- and post-revolutionary Mexico, and seeks to provide some answers to the questions of how and why the erosion of this strategic field occurred.
Fighting a tropical scourge, modernising the nation
This chapter shows how successive yellow fever vaccines, conceived as complex sociotechnical constructs, have been involved in the construction of the Brazilian nation state. Three distinct periods in the country’s political history are distinguished: the patriarchal oligarchic state (1822-1930), the national developmentalist state (1930-80), and the state which has since then oscillated between liberal dependency and national interventionism. The successful campaigns against yellow fever run by Oswaldo Cruz formed the backbone for the founding myth of scientific public health and medicine in Brazil. The trajectory of the yellow fever vaccine manufactured at the Oswaldo Cruz Institute, which eventually became the biggest producer worldwide, coincides with economic, welfare, and labour policies that principally benefited urban groups. Rural populations would be the main recipients of the yellow fever vaccine, and it became an important component when national agencies tackled endemic diseases in the interior. Immunisation programmes have helped strengthen the country’s health system, disseminating a culture of prevention. The social mobilisation achieved by the yellow fever and other vaccination campaigns led to new relationships between communities and health services.
This conclusion presents some closing thoughts on concepts discussed in this book. The book describes the origins and foundations of autism as a concept and the role of British researchers in appropriating the concept, making it their own via epidemiological exploration, and then promoting it to the rest of the world. This was an important project that enabled a complete transformation of models for thinking about child development. The book argues that new models of autism and social engagement are not just an extension of previous models of governance as characterised by the growth of 'human relations' psychology. The new autism was a critical concept for rethinking psychology and social development in the 1960s and it became increasingly important. The foundational work for the autism concept was conducted in a unique historical climate in Britain where a population of children were hidden from the gaze of important child psychology researchers.
This chapter explores how British epidemiological research on autism in the 1960s and 1970s came to define global attempts to analyse and understand what, exactly, autism is. Studies of autism have now almost become status symbols, and demonstrations of an advanced neoliberal approach to child rights, within the developing world. The growing focus on autism as a global health crisis has encouraged international organisations to shift their attention to child mental health too, an initiative supported by the WHO. One could argue that there have been so many controversies about the autism 'epidemic' precisely because it was a category that built itself on the idea that child psychology could be completely known through epidemiological research. One thing that Victor Lotter's study did reveal was that the level of provision for the treatment of childhood psychiatric and psychological problems was very limited.
The first autism can only be understood in the context of the legal and institutional networks that enabled the spread of psychological theory as applied to infants and children in Britain in the early twentieth century. This chapter examines the integration of the concept of autism into psychological theory in Britain and the significance of the concept of autism in altering theories of social development in children. Theories of the 'social instinct' in infants and children developed alongside theories of intellectual development. The concept of 'mental deficiency' served as a convenient throwaway label for all infants and children who both psychologists and policy-makers thought were beyond help and not worthy of investigation. The chapter explores how the establishment of the unprecedented legal and political climate for children in Britain encouraged the first applications of the concept of autism.
Most people are aware of many controversies surrounding autism today, as well as those that abounded in the 1960s asserting the fault of mothers in causing the condition. At the British Psychoanalytic Society, other controversial discussions ensued over how to describe the development of subjectivity in infants and children. Although the precise concept of 'autism' was rarely mentioned, the descriptive concepts of 'autoerotism' and 'primary narcissism', a term that had been developed by Sigmund Freud as a response to Bleuler's concept of autism, were discussed frequently. When considering the impact of child psychologists on British childcare policy, it is hard to underestimate the significance of John Bowlby. His work was so influential that historians have since referred to the phenomenon of 'Bowlbyism' as a wide-ranging social tendency to support the place of mothers in the home environment.
This chapter explores how new techniques were developed to measure 'social impairment' in children in light of the Seebohm reforms of 1968 and other legal changes of the early 1970s. These led to major changes in the organisation of educational and social services. The closure of mental deficiency institutions in the wake of the 1959 Mental Health Act, the Seebohm reforms and the slow integration of all children into the education system were transforming ideas about social work. The new theory of autism and the autistic spectrum provided new models for thinking about human social development that were just as detailed and complex as those presented by the psychoanalysts. Lorna Wing's work was important because she developed a new theory of social development that held both political and scientific sway.