2.1 A Timeline of Antibiotic Culture

2.2 Barefoot Doctors

2.3 Family Archive: From Barefoot Doctor to Army Medic

How did antibiotics become part of everyday life in China?

This timeline traces the development of antibiotics in China not only as a medical history, but also as a lived experience. Alongside key national milestones, there are also additional information regarding my grandmother’s memories of how antibiotics were actually encountered, understood, and used in rural healthcare. The timeline connects large-scale changes in pharmaceutical production, public health, and medical regulation with smaller and more personal memories. It also shows that antibiotics did not become “ordinary medicines” all at once; their meaning changed gradually as access expanded and medical systems transformed. By placing historical events next to oral history, this section asks how antibiotics became both scientific drugs and culturally trusted treatments in China.

During the Second Sino-Japanese War, Chinese bacteriologists at the National Epidemic Prevention Bureau attempted to produce penicillin domestically in wartime Kunming. This was small-scale and experimental, but it marked the beginning of China’s antibiotic history and linked penicillin to war, scarcity, emergency medicine, and scientific self-reliance.

A small, modernised penicillin factory was established in China. Although this was not yet full industrial production, it marked the transition from wartime laboratory experimentation to more organised pharmaceutical manufacture.

A small, modernised penicillin factory was established in China. Although this was not yet full industrial production, it marked the transition from wartime laboratory experimentation to more organised pharmaceutical manufacture.

After reform and opening-up, China’s pharmaceutical market, hospitals, and medicine availability expanded rapidly. Broad-spectrum antibiotics became increasingly common, shifting the problem from lack of access to overuse and AMR risk.

ZhangWeiShen, father of antibiotics in China, imparted new technologies and established many new methods to producing antibiotics. His knowledge then led to the Shanghai No. 3 Pharmaceutical Factory beginning its batch production of penicillin. This institutionalised antibiotic production within China’s pharmaceutical system made penicillin part of planned medical-industrial development.

China’s first national AMR action plan expanded antibiotic governance beyond hospitals to include agriculture, surveillance, public education, and institutional management. This reframed AMR as a national One Health issue.

One historical account states that early experimental production in Gaoyao Village, Kunming produced only five bottles of penicillin, each containing 5,000 units. This shows how rare and valuable penicillin was in its earliest stage in China, before it became widely available.

The North China Pharmaceutical Factory began operation in Shijiazhuang. This expanded antibiotic production on a much larger scale and helped China move from antibiotic scarcity toward mass availability.

Zhang Weishen and colleagues helped China achieve industrialised penicillin production in Shanghai. This transformed penicillin from a scarce experimental medicine into a domestically produced pharmaceutical product.

Through barefoot doctors, commune clinics, and rural health networks, antibiotics became more accessible in rural China. However, limited diagnostic resources also encouraged symptom-based use, helping antibiotics become understood as anti-inflammatory drugs in everyday medical culture.

China launched a national rational-use campaign in 2011 and implemented the Administrative Measures for Clinical Application of Antimicrobial Drugs in 2012. Antibiotics were classified into non-restricted, restricted, and special-use categories, showing that the state had begun treating antibiotic overuse as a governance problem.

China banned colistin as an animal growth promoter in 2017 and ended the use of chemical antibiotic growth promoters in animal feed additives by 2020. This showed that antibiotics were increasingly treated as protected public-health resources rather than productivity tools.

1944

-1945

1947

1950s

-1960s

1980s

-2000s

1953

2016

1944

1958

1960s

-1970s

2011

-2012

1953

2017

-2020

September

June

Early

Late

Late

Experimental penicillin production in wartime China

Establishment of a small,

modernised penicillin factory

Establishment of a small,

modernised penicillin factory

Marketisation and broad-spectrum antibiotic use

Batch production at Shanghai No. 3 Pharmaceutical Factory

First National Action Plan to Contain Antimicrobial Resistance

Extremely limited early penicillin output

Grandma’s Notes

Grandma’s Notes

Grandma’s Notes

Grandma’s Notes

Antibiotics entered rural healthcare

Rational-use campaign and clinical-use regulation

Large-scale antibiotic production at North China Pharmaceutical Factory

Industrialised penicillin production in Shanghai

Livestock antibiotic restrictions

In late 1952, Chinese scientists successfully developed a domestic method for synthesizing chloramphenicol, making one of the first broad-spectrum antibiotics available for local production.

Throughout the 1970s, penicillin skin testing became routine before every injection, reinforcing the importance of antibiotic safety in grassroots healthcare.

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During the 1970s and 1980s, injectable antibiotics became widely used in village clinics, reflecting the common belief that injections were faster and more effective than oral medicines.

In 1969, lower drug prices made Western medicines more affordable, allowing antibiotics such as penicillin, streptomycin, and sulphonamides to become part of everyday practice in village clinics.

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The Barefoot Doctor's Manual was published, becoming an essential guide that taught barefoot doctors how to diagnose common illnesses and use antibiotics in rural practice.

By the 1980s, streptomycin had gradually disappeared from routine medical practice as newer antibiotics became more widely available.

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After the 1990s, growing awareness of antibiotic resistance shifted attention from simply treating infections to promoting more rational antibiotic use.

What was it like to work as a barefoot doctor in rural China during the 1970s?

How can one family archive reflect a wider medical history?

Through my grandmother’s photographs and records, I trace her journey from barefoot doctor to army medic. From 1975 into the 1980s, she travelled with the army to different regions to treat patients. Her later progress through formal nursing-school examinations also reflects China’s shift from grassroots medical practice toward a more professional healthcare system.

Medical Supplies from a Rural Healthcare Archive, including Penicillin Injection

Barefoot Doctor Refresher Training Textbook

Barefoot Doctor Training Completion Certificate

Barefoot Doctor Certificate

Type 76 First-Aid Kit

Handwritten Medical Timeline by My Grandmother

Medical Practice Qualification Certificate