Taiwan achieved a rapid decline of infant mortality, from 54 per 1000 in 1960 to less than 6 per 1000 in 2005, in part through what the World Bank has termed “shared growth,” a process that involves a rapid rise of GDP per capita in a context of low income inequality. Less widely appreciated is the role of the public provision of basic social services in reducing infant mortality on the island, before as well as after 1960. Infant mortality fell rapidly from 1947 to 1960 not only because of economic recovery from World War II, as the wealthier is healthier conjecture would lead one to expect, but also because of the activities of the Sino-American Joint Commission on Rural Reconstruction (JCRR), which built and staffed health clinics across the island and developed programs to control malaria and other infectious diseases.

Before 1995, the year in which national health insurance was introduced, Taiwan had a small welfare state in terms of social spending, health insurance coverage, and pension eligibility. The ruling Kuomintang (Nationalist Party) nevertheless did well at providing basic social services, notably primary and secondary education, but also basic health care as of the late 1940s and early 1950s, disease control as of the 1950s, and family planning as of 1964. Such inexpensive programs were fully compatible with a small welfare state, and Taiwan could implement them despite a low GDP per capita.