Eradicating Malaria in Taiwan: Lien Ri-ching and a Public Health Engineering Project that Integrated Mosquitoes into Governance

In November 1946, the Malaria Research Center in Chaozhou, Pingtung, was established. Lien Ri-ching, who entered the Tropical Medicine Research Institute’s Entomology Laboratory at the Imperial University of Taipei at age 15, would later become a central figure in Taiwan’s malaria prevention efforts. On December 4, 1965, Taiwan received the Malaria Eradication Certificate from the World Health Organization (WHO). ^{1 2 3}

These three dates are easily arranged into a heroic biography: a young person meets a good teacher, studies mosquitoes, and leads a team to eradicate a disease. But Taiwan’s malaria eradication was more like an institutional machine. It connected microscopes, antimalarial drugs, DDT sprayers, local health centers, the military, household registration, and citizens’ homes, ultimately transforming a disease from an endemic epidemic into a public health risk requiring the prevention of imported cases. ^{1 4 5}

30-Second Overview: During the Japanese colonial period, Taiwan was a malaria-endemic area, and post-war Taiwan faced medical system restructuring and resource shortages. The 1946 Chaozhou Research Center connected the Rockefeller Foundation, local Taiwanese researchers, and local disease prevention networks, and was reorganized into the Taiwan Provincial Institute of Malaria in 1948. Indoor DDT spraying, antimalarial drugs, vector mosquito research, and case surveillance continued for about twenty years, leading to Taiwan’s WHO eradication certification in 1965. The contrast in this story is that eradication did not make mosquitoes disappear; instead, it left behind a state capacity that must be continuously monitored. ^{1 6 4}

Taiwan Was Not Always Malaria-Free

Malaria is not a disease unrelated to Taiwan on a tropical map. The historical exhibition of the Taiwan Centers for Disease Control (CDC) records that during the Japanese colonial era, the number of deaths from malaria in Taiwan reached tens of thousands annually. The National Human Rights Memorial Database notes that the Taiwan Governor-General’s Office established Malaria Suppression Offices, which used the Baojia (mutual responsibility) system to promote examination, treatment, and environmental cleanliness, temporarily suppressing the epidemic. ^{1 4}

This Japanese colonial experience cannot be simplified as “Japan did it first, and Taiwan followed post-war.” The Baojia system provided a path for administration to enter villages, but it also placed disease prevention within the control structure of colonial governance. After the outbreak of war, quinine produced in Taiwan was prioritized for the South Pacific battlefield, medical facilities were damaged by bombing, the sanitary environment deteriorated, and malaria spread again. ⁴

The post-war problem was therefore not just the lack of a specific drug. Researcher Tsai Tzu-yi, who compiled the history of malaria prevention from 1945 to 1965, pointed out that at that time, it was necessary to simultaneously handle research institutions, drug supply, health personnel, case statistics, and public cooperation. Prevention and control work gradually formed an operable plan by combining the administrative foundation left by the Japanese colonial period, Western public health technology, and Taiwan’s local environmental conditions. ⁵

📝 Curator’s Note
Taiwan’s malaria history is not a story of foreign medicine pressing a stop button on local diseases. What truly changed the situation was a set of technologies translated into actions that local health workers, researchers, and residents could perform daily.

Chaozhou: Why the Research Center Was Chosen There

In 1946, experts from the Central Institute of Public Health were sent to Taiwan for inspection and found local malaria prevention technology to be lagging. Watson, the Rockefeller Foundation’s representative in China, and Hsu Shih-chü, a researcher at the Central Institute of Public Health, came to Taiwan in November of the same year to find a base for coordinating malaria prevention affairs. Finally, the research center was established in Chaozhou, where the epidemic was most severe. ⁴

Chaozhou was located in the area with the highest disease density and the greatest need for research, so the research center could not only conduct experiments far from the local context. The center initially used the space of the former Chaozhou Malaria Suppression Office from the Japanese colonial period, and later moved into the former Chaozhou Shrine building provided by the Kaohsiung County Government. In 1947, the research center also established field research stations in Shuili-keng, Taichung, and Keelung, extending research from a single building to different geographical environments. ⁴

The work of the research center was not just identifying malaria parasites on paper. It studied the ecology of malaria mosquitoes, trained prevention personnel, tested drugs like atabrine and chloroquine, and introduced methods such as residual indoor spraying, field larval treatment, and automatic flushing. Chaozhou thus became a public health base that placed entomology, drug testing, sanitary engineering, and administrative training in the same space. ⁴

On April 1, 1948, the Malaria Research Center was merged into the Health Division of the Taiwan Provincial Government and reorganized into the Taiwan Provincial Institute of Malaria. The Rockefeller Foundation later withdrew personnel and equipment due to the political situation in China, causing a break in existing international aid. The institute did not disappear; the Joint Commission on Rural Reconstruction provided subsidies starting in 1949, allowing malaria prevention work to continue. ⁴

This turning point changed the ownership of the results. Taiwan’s public health achievements cannot be written solely as “US aid brought success,” nor conversely as “local completion.” External funding brought instruments, drugs, training, and international standards, while local institutions transformed these resources into work that could pass through villages, homes, and seasonal changes. Without either, the research center might have remained only a brief history of aid. ^{4 5}

Source: Taiwan Centers for Disease Control, National Human Rights Museum, WHO, NTU Alumni Bi-Monthly

Lien Ri-ching First Learned to Type, Not to Eradicate Malaria

Lien Ri-ching was born in 1927 in Dadaocheng. At age 15, due to family economic needs, he was recommended to work in the Entomology Laboratory of the Tropical Medicine Research Institute at the Imperial University of Taipei, primarily responsible for English typing and document processing. The Science Museum records that his supervisor, Professor Omori Minami-san, required him to pause typing when visitors were present to focus on listening to research discussions. ^{2 3}

This scene explains his starting point better than the “genius youth” narrative. He did not first receive complete academic training; instead, he listened to discussions on mosquito classification, tropical diseases, and prevention next to the office, and then practiced microscope observation on his own. Acting Director Morioka Tadao tasked him with identifying malaria mosquito larva specimens. The first time ten slides, the second time ten slides, the results were all correct. Later, when identifying Anopheles lindesayi during pond sampling, he gradually determined that he wanted to devote his life to mosquito research. ^{3 7}

There is an easily overlooked aspect to Lien Ri-ching’s story. He was later called the “Mosquito Doctor” not because he stood at the center of the research system from the beginning, but because a boy originally responsible only for English typing gradually gained research qualifications through listening, practicing, sampling, and repeated comparison. This is a story of personal ability, and also a story of how the system occasionally allowed people in marginal positions to approach the core of knowledge. ^{2 3}

After entering the Taiwan Provincial Institute of Malaria, his fieldwork covered all of Taiwan, participating in malaria eradication and studying Japanese encephalitis, dengue fever, and scrub typhus. In 1958, he received WHO funding to study at the London School of Hygiene & Tropical Medicine in the UK, learning techniques for insecticide susceptibility analysis of mosquitoes. This expertise was later used not only to identify mosquitoes but also to determine whether prevention methods remained effective. ^{1 3 7}

📝 Curator’s Note
What is most memorable about Lien Ri-ching is not just how many kinds of mosquitoes he found for Taiwan, but his ability to turn “seeing a mosquito” into “knowing how a community should prevent disease.”

The Power of DDT Comes from Its Ability to Enter Every House

How Prevention Became the Rhythm of Local Work

The most difficult part of malaria prevention often lies not in one-time drug distribution, but in making work repeat according to seasons and geographical conditions. Researchers must know when the rainy season begins, health workers must record the villages where cases appear, spraying teams must return to the same households to confirm coverage, and local residents must accept examinations, take medicine, and receive health education in their daily lives. This work has no single image that represents all results; it relies on many people doing small things for a long enough time.

The value provided by the Chaozhou Research Center was precisely to transform these scattered actions into teachable, comparable, and trackable processes. Mosquito specimens could be sent to the laboratory, cases could enter statistical tables, drug tests could feedback to the field, and household spraying could be executed by trained personnel. When cases in a village decreased, researchers still could not immediately declare success, because the decrease might be related to seasons, population movement, or insufficient diagnosis. The eradication plan had to separate “not seeing cases” from “actually having no local transmission.”

This also explains why malaria prevention cultivated a group of technicians familiar with local conditions. They knew which roads were difficult to walk after rain, which house wall surfaces did not easily retain chemicals, and which village residents needed different languages or methods of explanation. Official plans provided standards, and local workers filled in environmental differences, allowing eradation to have the opportunity to transform from a goal on paper into a daily executable rhythm.

Figure: Historical photo of the National Malaria Eradication Program using DDT to spray mosquitoes in 1958. Image from the US Centers for Disease Control and Prevention, released as a work of the US federal government, public domain. This photo is not an image from the Taiwan site, but is used to illustrate the working form of international malaria prevention technology at the time. Image file page: ⁸

One of the key tools for Taiwan’s post-war malaria prevention was DDT. The CDC records that the prevention plan, through health units in various counties and cities, the National Army, and public cooperation, conducted large-scale indoor chemical control. This was not spraying an invisible field from afar, but allowing prevention workers to enter homes and leave chemicals on walls that could continue to function. ¹

This method was effective precisely because it connected the habits of vector mosquitoes with housing structures. The Chaozhou research base confirmed that Anopheles minimus was the main vector and preferred to rest indoors. Thus, indoor walls became the point of intervention for prevention, and residents’ houses became spaces where national health policy could be measured, handled, and reviewed. ^{1 4}

Figure: Close-up of Anopheles albimanus malaria mosquito. Image from the US Centers for Disease Control and Prevention Public Health Image Library, released as a work of the US federal government, public domain. Image file page: ⁹

But effective does not mean without cost. DDT represented the public health trust in chemical control at the time and incorporated residents into a collective action requiring cooperation. Research indicates that post-war malaria prevention was not solely dependent on legal coercion, but simultaneously used propaganda, education, and soft communication to increase participation. The flip side of this sentence is that the government had to know who lived where, which houses had been sprayed, and where cases remained, so that prevention could form coverage. ⁵

Therefore, malaria eradication was a medical engineering project and also a governance engineering project. It transformed vector mosquitoes from an insect in the natural environment into a public object that needed to be classified, monitored, estimated, and handled. For people at the time, this might have been one spray. For the institution, it was an exercise in connecting family space to national statistics and health networks. ^{1 5}

1965: Two Ways to Record the Date of Eradication

The WHO’s malaria-free certification list places Taiwan in the region certified in November 1965. The Taiwan CDC’s historical exhibition records that Taiwan received the Malaria Eradication Certificate from the WHO on December 4, 1965. These two dates are not an error where an article can arbitrarily choose one; they are two institutional times: “the certification month of the international list” and “the date of certificate issuance.” ^{1 10}

This achievement is usually written as “Taiwan became the first malaria-free region in the world.” Articles from the Ministry of Foreign Affairs and National Taiwan Normal University use this statement, placing it in the context of national health, social development, and economic development. For post-war Taiwan, eradicating malaria indeed meant that a long-term, cross-departmental public health capacity had taken shape. ^{2 11 10}

But “eradication” does not mean Taiwan no longer has mosquitoes, nor that all work related to malaria has ended. Data from the Ministry of Health and Welfare in 2015 indicated that Anopheles minimus could still be found in Taiwan, with an average of 10 to 30 imported cases per year. The CDC therefore continues to conduct vector surveys, test imported cases, track patient treatment, and stockpile antimalarial drugs. ^{1 6}

📝 Curator’s Note
“Eradication” is most easily misunderstood as a full stop. For public health, it is more like a threshold: only after crossing it does society have the leisure to shift energy from total eradation to maintaining non-recurrence.

The Chaozhou Institute Also Operated in the Shadow of White Terror

The history of the Malaria Institute cannot be isolated as a purely bright scientific history. The National Human Rights Memorial Database records that in 1948, the Chaozhou branch used the post-war renovated Chaozhou Budokan as office space, and after the institute headquarters and branch merged in 1952, it became the headquarters of Taiwan’s malaria eradication plan. In 1969, the headquarters moved to Nangang, Taipei, and the original building was later allocated for use by Chaozhou High School. ⁴

The same human rights memorial data also records that Ye Sheng-chi was arrested by military police at the Chaozhou branch on May 29, 1950, sentenced, and executed by firing squad in November of the same year. Ye Sheng-chi was originally a physician graduated from the National Taiwan University College of Medicine, had visited the Chaozhou branch to observe DDT spraying and malaria mosquito collection, and had left a positive impression of the research equipment there. ⁴

This overlap does not mean malaria prevention is equivalent to White Terror, nor that it uses one political case to negate public health work. It reminds us that research institutions have never existed in a political vacuum. The Chaozhou branch could simultaneously be a place where young researchers saw American instruments and learned vector science, and a place where the state security machine arrested people. Placing both memories on the same map prevents writing “modernization” as an indoor photo without shadows. ⁴

📝 Curator’s Note
An institute might allow people to see mosquitoes under a microscope, or it might allow people to see military police outside the door. Taiwan’s public health history is important not because it can be placed into a purely progressive story, but because it must be read together with the state power of the same era.

After Eradication, Taiwan Brought Experience Overseas

Taiwan’s malaria history did not stop in 1965. Lien Ri-ching later entered the US Navy’s Second Medical Research Institute, continuing medical entomology research, and also participated in anti-malaria work in Bolivia and São Tomé and Príncipe. Data from NTNU and the Ministry of Foreign Affairs record that he participated in São Tomé’s malaria prevention plan at an advanced age after 2003, with Taiwan transforming local eradation experience into part of public health diplomacy. ^{2 11}

Official data uses different year figures for incidence in São Tomé. An article from the Ministry of Foreign Affairs records that incidence dropped from 50% in 2003 to 4% in 2012, and 1.01% in 2015. The Science Museum describes the infection rate dropping from 40% to below 1% using a different plan statistical methodology. These numbers cannot be mixed into a single precise downward curve; the article can only mark the source’s statements separately. ^{3 11}

This difference is actually significant. Malaria prevention is not a machine that can be copied intact once it leaves the local context. Vector mosquitoes, houses, rainfall, medical accessibility, drug supply, and administrative capacity are all different. What Taiwan exported was not just a spraying method, but also research, training, monitoring, and the method of translating technology into local work. ^{1 3 11}

The Responsibility Left by a Mosquito: Monitoring Must Continue After Eradication

The most worthwhile aspect of Taiwan’s malaria eradication for re-reading is that it contains three scales simultaneously. The first is the personal scale of Lien Ri-ching identifying larvae under a microscope. The second is the institutional scale of the Chaozhou Institute, local health units, and prevention personnel passing through homes. The third is the transnational scale formed by WHO certification, international aid, and public health diplomacy. Any single scale taken out is insufficient to explain the results of 1965. ^{1 2 4 5}

It also leaves three times simultaneously. The pre-history of administration and health provided by the Japanese colonial suppression offices, the introduction of knowledge, drugs, and equipment by post-war US aid and research centers, and the CDC system post-eradication treating “no local cases” as a state that must be continuously maintained. This is not a straight line from backward to advanced, but a period of continuous reorganization, succession, and repair. ^{6 4 5}

Talking about malaria today, it is easiest to remain with just one sentence: “Taiwan has already eradicated it.” But if that sentence is not connected to the 1946 Chaozhou research base, Lien Ri-ching’s field sampling, DDT on residents’ walls, the two dates of 1965, and the Anopheles minimus that still exists after eradation, it will flatten an institutional engineering project into a single medal. ^{1 3 6 10}

Taiwan once established a capacity sufficient to press a disease to invisibility and recognize it before it returns; this capacity is closer to the true meaning of eradation than “mosquitoes disappearing.” This capacity bears traces of foreign aid, the hands of local researchers, the power of state governance, and the intervention of the authoritarian era on bodies and space. The key point to preserve is not the word “miracle,” but how this capacity was formed and why it must continue to be checked. ^{11 6 4}

📝 Curator’s Note
The last object left by malaria eradication is less a certificate and more a mosquito sampling tube that has not yet been put away. It reminds us that the most reliable victory of public health is never announcing that things have ended forever, but knowing where to go to re-check tomorrow.

References

Further Reading

If you wish to continue reading this history, you can enter along three routes. The first is the Chaozhou base and Taiwan medical entomology, tracking how the research center transformed from a foreign aid institution into a Taiwan Provincial Government prevention agency. The second is state governance, comparing DDT household spraying, case surveillance, and body management during the White Terror. The third is international health, reading from WHO certification to São Tomé and Príncipe’s malaria prevention plan, observing how an island transformed local experience into transnational cooperation.