Public health or public menace? The Rockefeller Foundation and public health in Mexico, 1920-1950

Abstract This article explores how the Rockefeller Foundation's hookworm campaigns, sponsorship of local sanitary units and involvement in public health education in Mexico shaped the conceptualisation and practice of public health during the decades following the Mexican Revolution. A 1923 hookworm agreement set the terms of the relationship, minimising the Foundation's financial commitment while maximising its administrative control. In establishing rural health units, the Foundation adapted to local conditions without compromising scientific public health by ingeniously incorporating midwives while shunning other traditional healers. When President Lázaro Cárdenas's socialist politics threatened the Rockefeller model of public health in the 1930s, delicate tactics enabled the Foundation to overcome these challenges. For the Mexican government, the overriding goals of modernisation and progress required an acceptance of Rockefeller pressure and scientific expertise. The special status granted the Rockefeller Foundation, its political, administrative, educational and financial strategies, and its institutional flexibility enabled it to influence profoundly the development of the Mexican public health system.