Tuberculosis Control in Postcolonial South India and Beyond: Fractured Sovereignties in International Health, 1948-1960
Vivek Neelakantan
(Indian Institute of Technology Madras (IITM), Chennai)
Between 1948 and 1960, South India and Southeast Asia emerged as global laboratories for tuberculosis control. This article attempts to situate tuberculosis control of these two regions within the broader context of international health. It investigates the unique ways in which tuberculosis control in Madras state reflected the inner tensions between the notional magic bullet approachāthat focuses on specific cures to root out the cause of the diseaseāand a more holistic approach that relates disease prevention to overall well-being of the population.
The implementation of tuberculosis control across South India and Southeast Asia shed light on the nature of the post-colonial state sovereignty in public health. Across India, as in Southeast Asia, the state sovereignty appertaining to the implementation of health policy was fractured, as evident in the opposition to the Bacillus CalmetteāGuĆ©rin (BCG) vaccination in Madras state. Whereas the then Madras Chief Minister C. Rajagopalachari (1952-57) opposed BCG vaccinationāa symbol of large-scale state intervention in the private domain of individualāA.B. Shetty, the then Health Minister of Madras state had to achieve an equilibrium between compliance with the Indian Ministry of Healthās directives on mass vaccination and the Chief Ministerās opposition to vaccination.
Based on a wide range of primary materials including WHO reports, and Tamil Nadu State Archives, this article examines tuberculosis control in South India and Southeast Asia between 1948 and 1960. It situates tuberculosis control within the context of nationalist discourse and preventive medicine. In doing so, it adds not only to the historiography of tuberculosis in non-Western contextsāthat has hitherto focused on China, India, Africa, or the Caribbeanābut also to the relatively new field of Southeast Asian medical history.