Contribution short abstract:

This paper interrogates the training of workers at a public health school in the Lao People’s Democratic Republic where the idea of health as a common good and collective endeavour rests on values and practices of self-improvement and learning to improve others.

Contribution long abstract:

What can research on health care systems in socialist states contribute to discussions of health as a common good and collective endeavour? The public health care strategy (2021-2030) of the Lao People’s Democratic Republic builds on principles of universality, quality, fairness and equality. It aims for universal health coverage in the year 2025, to lift Laos out of the UN’s “least developed country” status in 2026, and achieve the SDGs by 2030.

In Lao PDR, global health goals, international aid and foreign capital are mobilized for a socialist project conceived in terms of “developing” and “civilizing” the (largely rural) population. In this political economy, public health and socio-economic development of Laos – mainly made possible through foreign investments – are entangled: corporations build hospitals and roads in exchange for land concessions or permissions for resource extraction. Yet some such developments have exacerbated health disparities: broken hydropower dams flood villages, pesticides spread on banana plantations pollute watercourses, deforestation reduces people’s access to nutritious foods.

In this context, the Lao state aims to train people as “good citizens” with revolutionary morals who take on the work of public health: to assess communities’ development status, plan interventions, and educate about matters of public health in homes and hospitals. Drawing on ethnographic fieldwork conducted at a Lao public health school between 2024-2025, this paper argues that health is conceived of as the citizens’ duty of self-improvement and improving others in order to achieve health as a universal, common good – but at what cost?