The Lancet, Volume 375, Issue 9722, Page 1248, 10 April 2010

Carl E Taylor

Original Text

Alison Snyder

Pioneer in international public health. Born July 1, 1916, in Mussoorie, Uttarakhand, India, he died of prostate cancer on Feb 4, 2010, in Baltimore, MD, USA, aged 93 years.

At the age of 88 years, Carl Taylor, who founded and chaired the Department of International Health at the Johns Hopkins University Bloomberg School of Public Health for almost 25 years, moved to Afghanistan. For 2 years he worked there, helping people provide basic health care for their communities. Afghanistan presented an opportunity for Taylor “to put almost nine decades of community-based primary health care research done throughout the world into practice one last time”, according to Henry Perry, senior associate in the Department of International Health at Johns Hopkins University who travelled with Taylor in Afghanistan. Taylor was particularly interested in the role of women in providing health care to the community and led a programme there to teach women literacy and health-care skills.

“His real passion was working for the poor and marginalised no matter where they were”, says Raj Arole, who studied with Taylor at Johns Hopkins University in the late 1960s and has since led the Comprehensive Rural Health Project in Jamkhed, India, which was inspired by Taylor. Arole adds that Taylor was “a wonderful combination of scientist, humanitarian, and spiritual leader”.

Taylor worked in more than 70 countries researching community-based health care, mentoring health professionals and community workers, and leading programmes and research projects. He wrote extensively about his field research and issues of health equity. His 2002 book, Just and Lasting Change: When Communities Own Their Futures, written with his son Daniel Taylor-Ide, urged public health programmes to integrate community-level initiatives, support from national government agencies, and expertise from researchers.

Born in the foothills of the Indian Himalayas, as a child Taylor travelled by oxcart with his parents, both medical missionaries, to isolated villages where they ran health clinics. After graduating from Harvard, in 1941, and completing an internship and residency in Panama during World War II, Taylor returned to India, in 1947, to direct the Fatehgarh Presbyterian Hospital where he led a medical team during the India and Pakistan partition riots. 2 years later, he joined an ornithological expedition in Nepal as an expedition doctor and undertook the first public health survey of the country. He returned to Harvard, where he received his doctorate in public health in 1953. His thesis research focused on the relation between nutrition and infection, which was verified in subsequent work by Taylor and others and has since become a fundamental principle in public health. “He was very influential of public health workers and health economists being aware of the linkage between nutrition and health”, says Agnes Soucat, regional adviser for health, nutrition, and population for Africa at the World Bank.

In the early 1950s, Taylor established the department of preventive medicine at Ludhiana Christian Medical College in the Punjab and, in 1960, became director of the affiliated Narangwal Rural Health Research Project in northern India. A year later he founded the Department of International Health at Johns Hopkins University, but he continued to lead research efforts at Narangwal that underscored the importance of working with communities in establishing health-care programmes. Taylor and his colleagues showed that childhood pneumonia can be diagnosed without radiography and treated with antibiotics given by community health workers; they described how prenatal nutritional care to pregnant women can affect child growth, disease, and mortality; and they further elucidated the synergism between malnutrition and infection as it relates to childhood diarrhoea. Taylor's research on infant and child mortality shaped his ideas about how improving child survival could reduce fertility. “He was incredibly intellectually honest and had a capacity for questioning common wisdom and articulating alternative visions”, says Soucat.

Taylor advised WHO between 1957 and 1983 and helped write the landmark 1978 Declaration of Alma Ata that set the global agenda for primary health care. After becoming professor emeritus at Johns Hopkins University in 1983, he served as UNICEF's representative in China for 3 years.

Taylor's wife, Mary Daniels Taylor, predeceased him. He is survived by his three children, Daniel, Betsy, and Henry.