Partnerships for health: Decimating tuberculosis in the Cook Islands, 1920–1975

• Story of successful control of TB despite geographical and colonial challenges.
• Demonstrates relevance of historical research to current health promotion.
• The key to success is the quality of the complex and varied partnerships.
• In partnerships for effective health promotion, one size does not fit all.
• We can learn from success, not just from failure.

How did the Cook Islands manage to achieve a significant reduction in tuberculosis from a high rate in the early 20th century to low rates by 1975? With the mid-century invention of effective drug therapy there was a widespread belief around the Western world that TB could be eradicated. The Cook Islands was one place which almost reached this goal. Based on primary and secondary historical and anthropological research, we argue that the geo-political emplacement of the Cook Islands and development of multi-scale partnerships were crucial to success. Our research indicates the value of understanding and engaging with local community networks and culturally appropriate partnerships in dealing with health issues.