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Keeping Sight of Albay: Vitamin A Blindness, Randomized Controlled Trials, and Cold War Foreign Aid Policy
1Rajiv M. Sastry is with the Department of the History of Science, Harvard University, Cambridge, MA; the Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA; and the Department of Ophthalmology, Massachusetts Eye and Ear and Harvard Medical School, Boston.
Abstract:
Physicians have long known that vitamin A deficiency causes pediatric blindness. However, in 1986, Johns Hopkins researchers examining the impact of vitamin A supplementation on overall child mortality in Albay, Philippines, encountered strong local opposition, forcing the study's termination. Drawing on internal documents, interviews, and archival correspondence, this article uses the Albay study's collapse as a case study to examine how Cold War‒era cultural, geopolitical, and social forces shaped the public health knowledge production process. This history offers insights into how policymakers might develop effective modern foreign aid projects, especially as funding priorities continue to evolve. (Am J Public Health. 2026;116(7):1044-1052. https://doi.org/10.2105/AJPH.2026.308447).
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