History of Global Health

(working syllabus; changes to readings and assignment dates likely. Assignment and assessment structures unlikely to change).

Summer Session II

M-T-Th 12:30-2:35


Course Description: This course traces the development of the “global health” paradigm over a sweeping five centuries of historical precedent. How did ensuring the health of marginalized people become a governmental concern, let alone an international goal? How have the questions about and solutions to disparities in population health changed over time as medicine itself has changed? We will follow these developments and shifts beginning with the unification of the modern world system in 1492, when the “Columbian exchange” brought the western and eastern hemispheres together with enormous consequences for human health. The course continues to explore how the acceleration of international trade and, later, industrialization transformed how practitioners, laypeople, and governments thought about individual and public health. As we turn to the late-nineteenth and twentieth centuries, we will explore how national governments and then international bodies came to see the health of marginalized people as their problem. We will explore how their methods for controlling and improving population health evolved from paradigms such as colonial medicine, tropical medicine, international health, and modern “global health.” Throughout, we will discuss the continuities and changes between these different systems, recognizing that medicine has always been a matter of global concern and action.

Learning Objectives:
– demonstrate knowledge of significant events and chronologies in the history of global health. This knowledge will serve as the base on which students will evaluate the meanings ascribed to historical events and processes both in historical sources and modern historical scholarship.
– interpret historical sources (what historians call “primary sources”). These sources are always subjective, incomplete, and can be contradictory. You will gain experience in reading these sources critically and consider how the complexity of primary sources shapes the narratives we construct about the past.
– evaluate the arguments of modern historians and incorporate them into your own engagement with the past. Critical engagement with primary sources leads to the next step in historical inquiry, in which these sources are brought together as evidence for an argument. With every piece of modern scholarship (secondary source) we read, we will ask a series of questions: what is the historian’s argument? What sources did they use to construct it? What are the merits and limits of the argument? Discussions like these will help to illustrate how the research process progresses and will aid you as you make your own historical arguments.
– evaluate the impacts of historical events and processes on the lives of living people. Historical knowledge helps us to understand the world we live in today. In learning the historian’s toolkit of content knowledge, interpretation, and argumentation, you will also become more literate in modern politics, geography, and socioeconomic inequity.
– understand and evaluate the historical and social construction of health, medicine, and disease. The sweeping nature of this course will demonstrate that concepts of “health” “disease” and “medicine” are not objective, but rather are embedded in time and place. We will continually ask how the social construction of health and medicine informs our reading of primary and secondary sources, and our understanding of global health as a developing paradigm.

Course Policies and Requirements

You will access our weekly class meeting via the Zoom link on the course Sakai. I have set all meetings to begin ten minutes prior to class and participants can join before the host. If you are having trouble accessing the meeting, email me immediately – in the first few minutes of class, I will send you an individual link.

Etiquette for Online Courses

  • If you arrive early and see colleagues, feel free to chat amongst yourselves.
  • If you know that your environment may include unavoidable distractions (such as other people in your space, noise, or possible interruptions) use the chat to let me know at the start of our weekly session. If this is an ongoing concern for you throughout the semester, please make an appointment to discuss solutions with me privately.
  • Act as if you are in a classroom. Have your class materials nearby in your workspace. As much as possible, stay in one location.
  • Please mute your audio when you are not speaking.
  • Please keep chats to a minimum while people are speaking. Reading new chat posts distracts attention from the speaker and what they are saying.

Diversity and Inclusion: This course takes place on land which has long served as a site of meeting and exchange amongst Indigenous peoples, including the Catawba, Shakori, and Tuscarora Nations. Want to help with decolonizing this land? Decolonizing means returning the land to Indigenous groups. If you have the means, you can help decolonizing efforts by donating to legal efforts to return land back to Indigenous groups and/or protecting Indigenous lands, whether across North America, in the Triangle, or wherever you are now.

This class is an inclusive learning environment and I am committed to ensuring that all students are respected and valued. Student diversity in identity and background is a crucial source of strength. I expect that for all class activities and discussions, we will contribute together to the enrichment of our collective learning environment by respecting the diversity of thoughts, perspectives, and experiences present amongst ourselves by listening to one another’s views. This means that personal attacks or insults will not be tolerated. Additionally, please advise me as to your correct name and pronouns at the start of the semester.

Attendance and Participation: This course is structured around collaborative engagement with primary and secondary readings that should be read before the class period for which they are listed. Therefore, your participation is crucial to both you and your classmates. Attendance and participation account for a major portion of the available points for course completion, but you are encouraged to take engagement in the course into your own hands (more in the “Assignments” section of this syllabus below). If you miss multiple classes in a row, I will email to check in and assess your need for further support.

If you are sick, injured, or have an emergency (death or serious illness in the family, automobile accidents/breakdowns), please inform me as soon as possible by sending me a short, explanatory e-mail and by filling out a STINF form. If you or a family member contracts COVID-19 or another serious illness, I am committed to ensuring it does not negatively impact your grade. This requires open communication between us: please email me as soon as possible if something like this happens.

Importantly, federal and state law requires me to protect your health privacy in all email communications. I encourage you to protect your own privacy online. Therefore, when emailing me about health-related matters, please include “Personal and Confidential” in the email subject line.

Accessibility: You have an inalienable right to whatever services you need for academic success. If you have any specific personal or academic accessibility requirements (due to learning disability, physical disability, language comprehension, chronic illness, or mental illness), I welcome you to speak with me or email me to let me know how to best accommodate your needs. You are not obligated to disclose any of these needs with me, but I encourage you to let me know at least whether there are any accommodations required. I am happy to adapt course materials to your needs. You are also encouraged to register with Duke’s Student Disability Access Office, but again this is not a requirement.

Accessibility is not simply a requirement in my course, but an institutional commitment that goes beyond this classroom. Duke University is committed to providing equal access to students with documented disabilities. Students with disabilities may contact the Student Disability Access Office (SDAO) to ensure your access to this course and to the program. There you can engage in a confidential conversation about the process for requesting reasonable accommodations both in the classroom and in clinical settings. Students are encouraged to register with the SDAO as soon as they begin the program. Please note that accommodations are not provided retroactively. More information can be found online at access.duke.edu or by contacting SDAO at 919-668-1267, SDAO@duke.edu.

Integrity: Academic writing is seldom self-contained with respect to its ideas and proof. Quoting and citing sources strengthens your writing by explicitly situating your argument within an ongoing conversation and body of evidence. There are several systems for documenting sources. In this course, we will learn and employ Chicago Style citation. We will discuss quotation, paraphrase, and citation in pre-writing workshops to reduce the chances of accidental plagiarism.

On occasion, a student may attempt to disguise sources, sometimes due to being unprepared to complete an assignment, or because of time constraints. Copying without attribution from the work of a classmate, from a printed text, or an electronic text weakens your integrity as a student and writer and prevents you from engaging properly with other scholars through writing. Getting caught carries very serious consequences. If I suspect anyone of plagiarism, I am obligated to report it to the Duke University Office of Student Conduct. Plagiarism on any aspect of our course work will result in failure of the course.

Recall the Duke Community Standard: 1. I will not lie, cheat, or steal in my academic endeavors, nor will I accept the actions of those who do; 2. I will conduct myself responsibly and honorably in all my activities as a Duke student. Please ask me if you have any questions about what constitutes plagiarism. You may also consult: http://library.duke.edu/research/plagiarism.

Formatting and Document Design: It is your responsibility as a scholar to present your work in a clear, transparent, and careful manner. Aspects of professional-quality academic documents include:

12 pt. Times New Roman font (or equivalent)
Double line spacing
One-inch margins all around
In accordance with Chicago/Turabian citation style formatting guidelines

Submission of Assignments: The two written assignments will be submitted electronically by email. Please refer to forthcoming assignment prompts for detailed instructions.

Late Work: I will accept late submissions for the primary source worksheet, primary source analysis paper, and annotated bibliography for up to five days after the original due date. For each day after the original due date that the assignment is not submitted, five points will be deducted from the total earned. I will not accept late reading responses or a late final research proposal.

Note: these policies are for unexcused late submissions. If you miss class and submit a STINF or otherwise talk with me about an absence or other problem that has arisen, we can negotiate a sensible way to allow you to complete work without it seriously compromising your grade.

Grades and Assignments: This class is scored on a points system. Rather than deducting points for failure to complete work, you will gain points for different forms of participation. You will notice that there are multiple ways to achieve an A in the course, and you are welcome to choose the path that works best for you. Letter grades map approximately onto the following scale, which I will use in calculating your final grade for the course (grades in between these ranges will be rounded up to the nearest number):

A+ (220+) A (200-220), A- (192-199)
B+ (184-191) B (177-183) B- (169-176)
C+ (161-168) C (153-160) C- (145-152)
D+ (137-144) D (128-136) D- (120-127)
F (0-119)

Point ValueAssignmentDescription
45 total (3/class)Attendance and ParticipationStudents earn 3 points for each class session attended beyond the first and second classes (required) and the final class.
80 total (5/entry)Reading ResponsesSubmit a response on Sakai forums before the beginning of class on that day’s assigned readings.
25 Primary Source WorksheetIn Week 2 (6 July – 10 July) submit a completed primary source worksheet (provided in advance) on a digitized source of your choice from Duke’s History of Medicine Collections.
50 Primary Source Analysis PaperIn 1200-words, analyze a primary source reading from the selection provided in The Great Hanoi Rat Hunt. The primary source analysis should analyze the source’s origins: its author, audience, purpose, form, etc. and should discuss what it teaches about the historical context from which it arose.
50Annotated BibliographyA list of ten secondary sources you could use to support claims in an historical research paper. For each source, you should write a paragraph (200-400 words) describing the source’s key question, argument, scholarly intervention, and how you would use it.
50Final Research ProposalFive pages proposing an historical research project on a topic in global health history. The proposal should make an original historical argument based on research in primary sources and should clarify the project’s key question(s) and scholarly intervention. It will also summarize the primary and secondary sources used to support its argument. I highly encourage drawing from prior assignments (the primary source analysis paper and annotated bibliography) to complete this paper.
 Total Points300

Required Texts

Michael G. Vann and Liz Clarke, The Great Hanoi Rat Hunt: Empire, Disease, and Modernity in French Colonial Vietnam (New York: Oxford University Press, 2018).

I recommend thriftbooks.com for cheap versions of this book. All other readings are available online through Duke Libraries or will be posted under “Resources” on Sakai.

Course Schedule and Readings

28 June: Introductions, or, What is Global Health?

Essential Question: What do historians do? Why is it important to study global health historically?


  • Course and colleague introductions
  • Large group discussion on readings
  • Small group analysis
    • Video: the Black Death in popular culture
    • Primary sources on 14th century plague


Total Pages: ~26

29 June: Smallpox and the Columbian Exchange

Essential Question: how did infectious disease influence the expansion of European empires in the early modern world?


  • Large group discussion on readings
  • Small group analysis
    • Nahuatl accounts of 16th century smallpox
  • Primary source analysis workshop


  • David S. Jones, “Virgin Soils Revisited,” The William and Mary Quarterly 60, no. 4 (2003): 703-742.

Total Pages: 39

1 July: Science, Medicine, and Imperialism in the Early Modern World

Essential Question: how did medical and scientific knowledge circulate in the early modern Atlantic World?

No Meeting: responses to readings due by midnight


  • Antonio Barrera, “Local Herbs, Global Medicines: Commerce, Knowledge, and Commodities in Spanish America,” in Merchants and Marvels: Commerce, Science, and Art in Early Modern Europe, Pamela H. and Paula Findlen Smith, eds. (New York: Routledge, 2002).
  • Roberta Bivins, Alternative Medicine? A History (New York: Oxford University Press, 2010), pp. 41-78.

Total Pages: 46

5 July: Independence Day

No class

6 July: Disease, Medicine, and Slavery

Essential Question: how did disease and medicine influence the expansion, contraction, and reformation of the transatlantic slave trade?


  • Large group discussion on readings
  • Small group analysis: Collins 1803 on plantation medicine
  • Lecture/discussion on efficient reading


  • Dauril Alden and Joseph C. Miller, “Unwanted Cargoes: The Origins and Dissemination of Smallpox via the Slave Trade from Africa to Brazil, c. 1560-1830,” in Kenneth F. Kiple, ed., The African Exchange: Toward a Biological History of Black People (Durham: Duke University Press, 1988), pp. 35-75.
  • Sasha Turner, “Home-grown Slaves: Women, Reproduction, and the Abolition of the Slave Trade, Jamaica 1788-1807,” Journal of Women’s History 23, no. 3 (2011): 39-62.

Total Pages: 63

8 July: Racial and Medical Knowledge in the Western Hemisphere


  • Large group discussion on readings
  • Small group analysis: primary sources from Benjamin Rush and Allen/Jones
  • Workshop on digital primary source acquisition with Rachel Ingold


  • Rana Asali Hogarth, “The Myth of Innate Racial Differences Between White and Black People’s Bodies: Lessons from the 1793 Yellow Fever Epidemic in Philadelphia, Pennsylvania,” American Journal of Public Health 109, no. 10 (2019): 1339-1341.
  • Karol Kovalovich Weaver, “The Enslaved Healers of Eighteenth-Century Saint Domingue,” Bulletin of the History of Medicine 76, no. 3 (2002): 429-460.

Total Pages: 33

12 July: Cholera and the Nation-State

Essential Question: how did 19th century cholera epidemics alter processes of global and local state formation?



  • Victoria Szabo and Deborah Jenson, “Cholera in Haiti and Other Caribbean Regions, 19th Century,” Emerging Infectious Diseases 17, no. 11 (2011): 2130-2135.
  • Mark Harrison, Public Health in British India: Anglo-Indian Preventive Medicine, 1859-1914 (New York: Cambridge University Press, 1994, pp. 100-116.
  • Completed primary source worksheet on a digital document due Saturday, July 10th at midnight

Total Pages: 21

13 July: Disease and Colonial Medicine

Essential Question: how did imperial governance structure social conditions in French colonial Vietnam? Why is this relevant for our global health course?


  • Large group discussion on readings
  • Q&A on primary source analysis assignment


  • Michael G. Vann and Liz Clarke, The Great Hanoi Rat Hunt: Empire, Disease, and Modernity in French Colonial Vietnam (New York: Oxford University Press, 2019), pp. 1-68.

Total Pages: 68

15 July: Infectious Disease and International Health

Essential Question: how did the sociopolitical structure of French colonial Vietnam affect its experience with the Third Plague Pandemic? How did French and Vietnamese people react differently?


  • Large group discussion on readings


  • Michael G. Vann and Liz Clarke, The Great Hanoi Rat Hunt: Empire, Disease, and Modernity in French Colonial Vietnam (New York: Oxford University Press, 2019), pp. 69-123.
  • Select a primary source from pp. 155-179 for your analysis.
  • Primary Source Analysis on a document from the “Primary Sources” section of The Great Hanoi Rat Hunt due Saturday, 17 July at midnight

Total Pages: 54

19 July: Cholera and the Rise of International Medicine

Essential Question: how did cholera epidemics and early-nineteenth century international politics influence one another?


  • Large group discussion on readings
  • Small group analysis
    • 19th century epidemiological cartography


  • Valeska Huber, “The Unification of the Globe by Disease? The International Sanitary Conferences on Cholera, 1851-1894,” The Historical Journal 49, no. 2 (2006): 453-476.
  • Tom Koch, Disease Maps: Epidemics on the Ground (Chicago: University of Chicago Press, 2011), pp. 95-117.

Total Pages: 55

20 July: From Tropical Medicine to International Health

Essential Question: what are the similarities and differences between tropical medicine and international health as paradigms of global health policy?


  • Large group discussion on readings
  • Small group analysis
    • The Rockefeller Foundation Annual Report, 1915, pp. 11-16, 26-28.
  • Workshop on crafting effective questions and arguments in historical research


  • Randall Packard, A History of Global Health: Interventions into the Lives of Other Peoples (Baltimore: Johns Hopkins University Press, 2016), Part I.

Total Pages: 34

22 July: Eugenics, Population Control, and International Health

Essential Question: how has eugenics influenced the construction of modern international health policy?  


  • Large group discussion on readings
  • Documentary short subject
  • Research talk: Martha Espinosa
  • Small group analysis on primary sources


  • Alison Bashford, “Internationalism, Cosmopolitanism, and Eugenics,” in Alison Bashford and Philippa Levine, eds., The Oxford Handbook of the History of Eugenics (New York: Oxford University Press, 2010).

Total Pages: 21

26 July: Women and Nursing in Cross-Cultural Medical Exchanges

Essential Question:


  • Large group discussion on readings
  • Small group analysis
  • Q&A on annotated bibliography assignment


  • Kristin Burnett, Taking Medicine: Women’s Healing Work and Colonial Contact in Southern Alberta, 1880-1930 (Vancouver: UBC Press, 2010), pp. 67-120.

Total Pages: 53

27 July: Making the Modern Global Food System


  • Large group discussion on readings
  • Small group analysis on primary sources


  • Anne Hardy, “Beriberi, Vitamin B1 and World Food Policy, 1925-1970,” Medical History 39 (1995): 61-77.
  • Mary-Ellen Kelm, Colonizing Bodies: Aboriginal Health and Healing in British Columbia, 1900-50 (Vancouver: UBC Press, 1998), pp. 19-37.

Total Pages: 34

29 July: Anti-Capitalist Visions of International Health

Essential Question: how did social movements change the structure of international health policy in the twentieth century?


  • Large group discussion on readings
  • Small group analysis
    • Primary documents on barefoot doctors from Janet Chen, Pei-kai Cheng and Michael Lestz, eds., The Search for Modern China: A Documentary Collection, 3rd ed. (New York: W.W. Norton and Company, 2014), 476-88.


  • Alondra Nelson, Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination (Minneapolis: University of Minnesota Press, 2011), pp. 49-75.
  • Miriam Gross, “Between Party, People, and Profession: The Many Faces of the ‘Doctor’ during the Cultural Revolution,” Medical History 62, no. 3 (2018): 333-359.

Total Pages: 55

2 August: Remembering the Eradication Era

Essential Question: how do eradication movements differ from earlier forms of international health policy?



  • Randall Packard, A History of Global Health: Interventions into the Lives of Other Peoples (Baltimore: Johns Hopkins University Press, 2016), pp. 133-179.

Total Pages: 46

3 August: HIV and the Birth of Global Health

Essential Question: Why and how did the HIV epidemic transform international health policy and practice?


  • Large group discussion on readings


  • Randall Packard, A History of Global Health: Interventions into the Lives of Other Peoples (Baltimore: Johns Hopkins University Press, 2016), pp. 273-327.

5 August: Contemporary Issues in Global Health: Covid-19 and Climate Change

Essential Question: now living in a global health crisis yourself, what do you think modern scientists, politicians, and laypeople can learn about the history of global health?

In-Class: Discussion on Readings

9 August: Reading Period; no class

10 August: Final Exams Period