This collection of essays explores the development of public health policies and institutions in the Caribbean. It places this history in the context of patterns in the larger 'tropical' colonial world. In the Caribbean, responses to disease and the public health crises of the late 19th and early 20th centuries coincided with the transition from slavery to freedom. The essays in this collection explore the influence of this, alongside considering the influence of imperial ideas, local actions, race, gender and imperial strategic concerns.