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

Published online by Cambridge University Press:  01 January 2026

Anne-Emanuelle Birn
Anne-Emanuelle Birn*
Affiliation:
Assistant Professor of Health Policy and Historical Studies, Robert J. Milano Graduate School of Management and Urban Policy, New School for Social Research, New York
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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.

Résumé

Résumé

L’article étudie l’impact de l’action de la Fondation Rockefeller — ses campagnes contre l’ankylostome, son soutien des unités sanitaires locales et sa participation à l’éducation à la santé publique au Mexique — sur la conception et la mise en oeuvre du système de santé publique pendant les décennies qui ont suivi la Révolution méxicaine. Les conditions de cette action ont été définies par un accord de 1923 sur la lutte anti-anklyostome qui a réduit la participation financière de la Fondation au minimum tout en maximisant son rôle de contrôle administratif. Lors de la création des unités sanitaires rurales, la Fondation a su s’adapter avec beaucoup d’ingéniosité aux conditions locales, sans pour autant compromettre la santé publique d’un point de vue scientifique, en intégrant les sages-femmes tout en écartant d’autres catégories de guérisseurs traditionnels. Lorsque son modèle de santé publique fut menacé par la politique socialiste du Président Lázaro Cardenas, la Fondation a su, grâce à sa tactique habile, surmonter cette remise en question. Le gouvernement mexicain fut contraint à accepter l’influence et les compétences scientifiques de la Fondation pour atteindre ses objectifs prioritaires de modernisation et de développement. Grâce au statut spécial qui lui a été accordé, ainsi qu’à sa stratégie politique, administrative, éducative et financière et à sa souplesse institutionnelle, la Fondation a profondément marqué l’évolution du système de santé publique au Mexique.

Zusammenfassung

Zusammenfassung

Der Aufsatz zeigt den Beitrag der Rockefeller Stiftung auf die Entwicklung des Systems der öffentlichen Gesundheitsfürsorge in Mexico auf. Im Rahmen gesundheitspolitischer Maßnahmen, die mit der Hookworm-Epedimie der 20er Jahre ihren Anfang nahmen, entwickelte sich eine weitgehende und konflikthafte Zusammenarbeit zwischen der Stiftung und der mexikanischen Gesundheitsbehörden. Der Beitrag unterstreicht die besondere Bedeutung privater, US-amerikanischer Stiftungen für die Entwicklung der Sozial- und Gesundheitspolitik in Lateinamerika und zeigt die dabei entstehenden Probleme auf.

Resumen

Resumen

Este artículo examina cómo las campañas realizadas por la Fundación Rockefeller contra el anquilostoma, su patrocinio de unidades sanitarias locales y su participación en programas educativas de sanidad pública en México determinaron la conceptualización y práctica de la sanidad pública durante las décadas siguientes a la Revolución. En 1923, un acuerdo acerca del anquilostoma sentó las bases de la relación. Dicho acuerdo minimizaba el compromiso financiero de la Fundación, mientras que maximizaba su control administrativo. Al establecer unidades sanitarias rurales, la Fundación se adaptó a las condiciones locales sin comprometer la sanidad científica pública, incorporando de forma muy hábil a comadronas y rechazando a la vez a otros curadores tradicionales. Cuando en los años treinta la política socialista del Presidente Lázaro Cárdena puso en peligro el modelo Rockefeller de sanidad pública, unas delicadas tácticas permitieron a la Fundación superar esas dificultades. Para el gobierno mexicano la imperiosa necesidad de modernización y progreso requería una aceptación de la presión y pericia científica de Rockefeller. El rango especial otorgado a la Fundación Rockefeller, sus estrategias políticas, administrativas, educacionales y financieras, y su flexibilidad institucional, le permitieron influir profundamente en el desarrollo del sistema mexicano de sanidad pública.

Information

Type
Research Article
Information
Voluntas: International Journal of Voluntary and Nonprofit Organizations , Volume 7 , Issue 1 , March 1996 , pp. 35 - 56
Copyright
Copyright © International Society for Third-Sector Research 1996

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Footnotes

*

The author gratefully acknowledges the assistance provided by Christine Ridge in the preparation of this manuscript. This article is based on a paper presented at the International Society for Third-Sector Research 1994 Inaugural Conference held at Janus Pannonius University, Pécs, Hungary, July 1994.

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