Fortifying the Nation: International Health Initiatives in North Africa After Independence

Previous scholarship on medicine and public health in Africa has primarily focused on the colonial period but few studies have examined the historical legacies and continuities of these policies into the post-independence period. This paper examines how Morocco, Algeria, and Tunisia, all previously under French rule, constructed their national health policies in the wake of decolonization. Specifically, it analyzes health initiatives of international health organizations, including the World Health Organization, the Food and Agriculture Organization, and the Rockefeller Foundation in the Maghrib between 1956 and 1975. Newly independent Ministries of Health across North Africa faced numerous public health challenges that threatened to derail their efforts at effective governance. International organizations supplied critical funding and technical experts to help officials navigate questions of population control, nutrition, and disease prevention. This paper makes three interventions. First, it argues that international organizations were critical partners in supporting and expanding national health care policies and that they played an important role in disseminating international medical standards in Morocco, Algeria, and Tunisia. Second, it shows more continuity with the colonial health care infrastructure than the independent regimes may care to acknowledge, thus supporting Frederick Cooper’s observation that postcolonial Africa shared many administrative and bureaucratic features with colonial Africa. And third, it demonstrates how North Africa, similar to the rest of the African continent, embarked upon difficult state-building projects in the 1960s and 1970s. Health initiatives were chief among them because they were frequently equated with modern statecraft by Africans and international organization representatives.