HEALTH CARE SERVICES 115 and less developed countries. In brief, China has chosen to do both, but has husbanded its resources—and almost certainly improved the results—by limiting health care investment in ^high-level" technology (such as speciality hospitals or highly trained doctors) and insisting instead in services carried out by the people themselves through what is now being called "intermediate" or ^appropriate" technology. China's choice of methods and allocation of priority are of interest too because in twenty-five short years, startling progress has been made in improving the health of the people. While comparisons with other societies are hard to make because of differing disease patterns and different social, economic, cultural, and historical circumstances, a case can be made for China having made more rapid progress in health than any other society in a comparable period of time. China has moved from a society which was riddled with affnost every known form of nutritional and infectious disease, with sickness and death visible in the streets., to a society whose people appear to every observer to be healthy, well-nourished and vigorous. It is a society in which there is not only no visible evidence of gross ill-health but even no evidence of the drug abuse, alcoholism or ambulatory psychosis that one sees on the streets of large cities of other countries.1 Current Health Picture Although statistics are still hard to obtain, there is a good evidence that over the past twenty years China has eradicated smallpox, cholera and plague, essentially eliminated venereal disease and drug addiction, and effected a major reduction in the prevalence of parasitic illnesses like schistosomiasis. In Shanghai and Peking, which are certainly atypical but whose health indices are now becoming available, current infant mortality rates are reported to be lower than those of New York City (Talkie I) and indeed lower than those of most of the world's cities. The leading causes of death in Shanghai are now cancer, stroke and heart disease (Table II), an ironic testimonial to the improvement of health in a city in which twenty years ago the leading causes of death were said to be complications of malnutrition and infectious disease. TABLE I INFANT MOR'IALFlY RAIES IN SHANGHAI AND PEKING (Deaths in the first year of life per thousand live births) Shanghai Peking Year City P toper City Proper 1948 150.0 1949 117.6 1959 38.9 1972 8.7 1973 11.6