Efforts to improve public health and sanitation began in China well before the founding of the People’s Republic in 1949. Between 1911 and 1931, the Chinese-run North Manchurian Plague Prevention Service carried out a range of public health activities in northeast China, successfully fighting not only plague but a variety of other epidemic infectious diseases, such as, for example, cholera. At the same time, there were local efforts to improve health, mainly in urban areas, by establishing medical colleges and hospitals, improving infrastructure, promulgating hygiene regulations, making vaccinations available, and carrying out educational campaigns. In Beijing, the subject of this study, the sewage system was renovated, the water supply was improved, and a variety of initiatives were undertaken to improve sanitation and public health. During the 1930s, the Nationalist government established a Ministry of Health and formulated a comprehensive national health policy focusing on rural areas. In the late 1930s and early 1940s, the Communists instituted a wide range of public health measures in the rural areas they controlled.