Infant mortality was a prominent object of global intervention in the second half of the twentieth century. Envisioned by liberal health experts at mid-century as a blueprint for a comprehensive and cooperative approach to social health, by the late decades of the twentieth century the problem had been reduced to a target, to be tracked and eliminated through technical solutions. While this trend can be documented in sites geographically contained within the United States, the phenomenon was produced globally. In settings around the world, these health experts interacted with the wide variety of meanings, determinants, and responses animating the shared experience of infant mortality. Historical work on infant mortality has compared social responses to infant death and highlighted cases of international influence on the deployment of the metric, yielding insights into the production of policies and inequalities. Critical scholarship on the metric itself, however, has been limited. Using archival materials collected in personal, medical, state, and national archives in Ecuador, India, and the United States, this paper traces the shifting utility of the infant mortality rate and discusses the consequences of the particular diplomatic approach it espoused. The shifting meanings and approaches to the IMR critically elucidate historical changes in medical authority, expertise, and responsibility, as well as notions of community and the very ways of counting the “global” in human health.
