The aim of the study is to analyze the history of sanitary reforms in East Asia on the territory of two European enclaves (Hong Kong and Shanghai), which became important centers of transit of Western public health theories and practices to China in the second half of XIX first half of XX centuries. The relevance of the research is conditioned by the necessity of understanding the historical experience of social processes management in complex epidemiological situations and development of Russian society response to new big challenges, connected with epidemic spreading. The novelty of the study consists in clarifying the existing scientific picture of the formation of modern public health management institutions in East Asia during the period from the beginning of European expansion into China to the Japanese invasion. The study was conducted in 2022 using primary sources from digital libraries in London (Wellcome Collection), Hong Kong (Digital Repository of Hong Kong University), and Shanghai (Virtual Shanghai), as well as works by Western and Chinese historians on public health and sanitation in Asia. During the study methods of historical knowledge were used: problem-chronological, comparative-historical, historical-typological. Methodology of social history of public health became the theoretical base of research. The conclusions of the study are as follows. Sanitary reforms began in those parts of East Asia where European influence was strong. At the forefront of the reforms were the British colony of Hong Kong and the international settlements in Shanghai, where Europeans had to adapt to the difficult conditions of climate, the burden of infectious diseases, and constant overcrowding. Rationalizing the management of urban space, they did not try to offer their way of life to the Chinese population, seeing them as culturally backward and unable to assimilate such civilizational achievements as sewage and running water, but under the pressure of economic and epidemiological
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