This paper examines how international organisations such as the WHO, UNICEF, and the World Bank navigated China’s economic transformation and adapted the Expanded Programme on Immunisation (EPI) to its needs and context, which in turn influenced their global strategies. Launched by the WHO in 1974, the EPI aimed to provide universal access to vaccines for six preventable diseases—tuberculosis, poliomyelitis, diphtheria, tetanus, whooping cough, and measles—to improve child health worldwide. Following China’s entry into the WHO in 1972, the EPI became a focal point of collaboration between Beijing and international health organisations. However, unlike many low- and middle-income countries, China had a relatively robust production line and vaccination infrastructure, producing most vaccines domestically. This self-sufficiency enabled China to resist certain external programmes and funding offers that did not align with its priorities. This unique position forced organisations like the WHO, UNICEF, and the World Bank to adapt their strategies, emphasising technical assistance and knowledge exchange over direct programme delivery. These adjustments were further shaped by China’s shift toward economic liberalisation in the late 1970s, which introduced market-oriented reforms and decentralised health governance. By examining how these dynamics influenced the negotiation and decision-making processes of the EPI in China, this paper highlights the broader implications for global health policy-making. It underscores how China’s experience fostered more flexible, context-sensitive approaches, challenging Western-centric models and fostering diverse collaborative frameworks in global health.

About the speaker

Lu Chen is a postdoctoral research fellow at the Wellcome Centre for Cultures and Environments of Health at the University of Exeter. She is member of the Wellcome Trust funded project Connection Three Worlds: Socialism, Medicine and Global Health After WWII. As a historian of medicine, her research focuses on social-political aspects of disease, vaccination programmes, infectious disease control, geopolitics of global health, equitable access to health care, and social medicine.